Pitfalls in Prescribing and how to Avoid Them

Front Cover
Radcliffe Publishing, 2009 - Medical - 141 pages
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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Contents

Introduction
9
Treatment failure due to antacids
13
Grapefruit juice can cause drug toxicity
19
Warfarin
25
Amiodarone a candidate for the title riskiest drug
31
The nonsteroidal antiinflammatory drugs NSAIDs including the COXIB NSAIDs
43
Drugs that disrupt the fine equilibrium of renal function
49
Sudden cardiac collapse due to oftenprescribed drugs causing QT c prolongation
57
Two serious prescribing pitfalls caused by alcohol use and abuse
81
Monitoring the effects of drug treatment to avoid pitfalls Which drugs? Which tests? How often?
87
Serious lung diseases caused by prescribed drugs
95
Preventable prescriptionrelated illness caused by patient noncompliance
101
The scientific basis of prescribing for the elderly
111
Clinical quizzes practical examples from Chapters 113
121
Answers to clinical quizzes
129
Index
135

Some important interactions between drugs at shared sites of action andor therapeutic effect
63
Major prescribing pitfalls due to drugdrug interactions in the liver
71

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About the author (2009)

Course Organiser for General Practitioner Continuing Clinical Education, Northern Ireland Medical and Dental Training Agency, and Visiting Professor in Prescribing Science, Faculty of Life and Health Sciences, University of Ulster

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