Pitfalls in Prescribing and how to Avoid Them
Five percent of all accident and emergency admissions are caused by prescribed medicines. This figure rises to an alarming twelve percent in elderly patients. This may be through inappropriate use or dosage, side effects, drug: drug interactions, failing metabolism in the liver and reduced excretion by the kidneys. Also, erratic compliance with drug taking by a large proportion of patients complicates and sometimes worsens iatrogenic harm. This practical guide details the most common errors made in prescribing and is ideal for day-to-day use. The clear, accessible language used throughout makes for quick and easy reference. It clarifies complex scientific issues and presents them in a practical format, indispensable for professional life. It is highly recommended for all prescribers, clinical pharmacists, medical students and Foundation Year doctors. It is also a vital resource in the medication review now required for the Quality and Outcomes Framework for General Practitioners in England.
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Treatment failure due to antacids
Grapefruit juice can cause drug toxicity
Amiodarone a candidate for the title riskiest drug
The nonsteroidal antiinﬂammatory drugs NSAIDs including the COXIB NSAIDs
Drugs that disrupt the ﬁne equilibrium of renal function
Sudden cardiac collapse due to oftenprescribed drugs causing QT c prolongation
Two serious prescribing pitfalls caused by alcohol use and abuse
Monitoring the effects of drug treatment to avoid pitfalls Which drugs? Which tests? How often?
Serious lung diseases caused by prescribed drugs
Preventable prescriptionrelated illness caused by patient noncompliance
The scientiﬁc basis of prescribing for the elderly
Clinical quizzes practical examples from Chapters 113
Answers to clinical quizzes
Some important interactions between drugs at shared sites of action andor therapeutic effect
Major prescribing pitfalls due to drugdrug interactions in the liver
Other editions - View all
ACEIs acenocoumarol acute ADRs adverse drug reactions alcohol aldosterone amiodarone antacid anti-epileptics antidepressants antipsychotics antivirals Appendix asthma AVOID COMBINATION High beneﬁt beta-blockers British National Formulary calcium-channel blockers carbamazepine cardiac cause chronic renal failure ciclosporin clinical clinicians co-prescribed COMBINATION High Increased Commonly prescribed difﬁcult digoxin diltiazem diuretics dosage dose drug treatment drug–drug interactions effect elderly patients eplerenone erection enhancers erythromycin excretion family doctor ﬁnd grapefruit juice heart failure High concentration rises High Increased risk hypertension hypokalaemia hypotensive increase the plasma inhibit intestinal Joint Formulary Committee K+ retention kidney lithium liver enzymes loss and K+ medication medicines metabolites metronidazole monitoring myocardial Na+ loss non-compliance NSAIDs nurse P450 enzyme pharmacist phenytoin plasma concentration plasma electrolyte prescribing pitfalls prescription problem prostaglandin pulmonary ﬁbrosis reduced regimen renal function risk of ventricular Royal Pharmaceutical Society serious side-effects simvastatin Table theophylline therapeutic therapy torsade de pointes toxicity tricyclic ventricular arrhythmias verapamil warfarin