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Welcome! Prescription review You will need access to BNF (NHS evidence or app)

Welcome! Prescription review You will need access to BNF (NHS evidence or app) You will also need access to Prescribing Skills iBooks 1 & 2 Refer to case studies from workshop 1 and prescription review in prescribing skills handbook. Aim & Outcomes An introduction to prescription review

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Welcome! Prescription review You will need access to BNF (NHS evidence or app)

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  1. Welcome! • Prescription review • You will need access to BNF (NHS evidence or app) • You will also need access to Prescribing Skills iBooks 1 & 2 • Refer to case studies from workshop 1 and prescription review in prescribing skills handbook

  2. Aim & Outcomes • An introduction to prescription review • Purpose of prescription review • Performing a prescription review (a-h) • Medications not to miss when reviewing a prescription • Review case studies from workshop 1 • Homework

  3. Prescription review A Check for allergies and intolerances B Check the patient demographics C Check the medicine indication D Check medicine dose, frequency, duration and route E Check for drug interactions F Check for relevant co-morbidities G Check the prescription is legible and complete H Check how the patient is taking their medication (iBook 1)

  4. Practice points: Some common medicines that you SHOULD NOT miss when reviewing a prescription Medications that cause bleeding (Anticoagulants) Strong pain killers (Opioids) Medications that make you sleep (Sedatives) Insulin Medications that need strict monitoring (TDM) Medications that should not be omitted (AEDs, PD medications, Antimicrobials) Medications that commonly interact (inducers/inhibitors)

  5. Case study 1 **CONFIDENTIAL** Mr. Matthew Hale 8yrs 14 Tree Drive, Manchester M6 REPEAT PRESCRIPTION ORDER FORM - Tick items required and post in order box Phone orders 0161-256-****. PLEASE ALLOW TWO WORKING DAYS BEFORE COLLECTION Please note we are CLOSED Wednesdays 12:30 – 15:00 --------------------------------------------- There are 3 items on this re-order form 1. SALBUTAMOL METERED 100MCG DOSE INHALER INHALE TWO PUFFS FOUR TIMES A DAY AS REQUIRED FOR ASTHMA You may order 2 more. 2. BECLOMETASONE(CLENIL)50 METERED DOSE INHALER INHALE TWO PUFFS TWICE A DAY FOR ASTHMA You may order 2 more. 3. HYDROCORTISONE1%CREAM APPLY TWICE A DAY TO HANDS FOR ECZEMA You may order 2 more. Patient MH (Matthew Hale) 8yrs old attends the surgical ward with his mum for an elective tonsillectomy. As the clerking doctor you are required to undertake a prescription review and prescribe any required post-op analgesia on a hospital prescription chart. Matthew is 30kg.

  6. Case study 2 • You are about to review Mr RB on your daily ward round. He has been admitted for a fall (mechanical). PMHx: Benign prostatic hyperplasia (BPH), Hypertension (HTN) and Atrial fibrillation (AF) • Review Mr RB’s prescription chart. Can you identify the medications that may pose a falls risk?

  7. Case study 2

  8. PC: admitted for a fall (mechanical) • PMHx: Benign prostatic hyperplasia (BPH), Hypertension (HTN) and Atrial fibrillation (AF) • DHx: amlodipine 5mg one tablet every morning, dabigatran 150mg one tablet 12-hourly, tamsulosin 400mcg one capsule every morning. Paracetamol and codeine when required. • What additional questions, testsor observations would you ask/undertake? • Would you make any changes to Mr RBs prescription?

  9. Case study 3 Miss DH visits you at your GP practice for some more tramadol and a repeat prescription. Perform a prescription review and prescribe accordingly. **CONFIDENTIAL** Miss Dawn Hall 32yrs 3a Longsdale, Manchester M2 REPEAT PRESCRIPTION ORDER FORM Tick items required and post in order box Phone orders 0161-256-****. PLEASE ALLOW TWO WORKING DAYS BEFORE COLLECTION. --------------------------------------------- Please note we are CLOSED Wednesdays 12:30 – 15:00 There are 3 items on this re-order form 1. RANITIDINE150MG TABLETS TAKEONETABLETTWICEADAY You may order 2 more. 2. GAVISCON ADVANCE LIQUID TAKE10MLS WITH MEALS AS REQUIRED You may order 2 more. 3. CO-CODAMOL 30/500 TABLETS TAKE ONE OR TWO TABLETS UP TO FOUR TIMES A DAY WHEN REQUIRED You may order 2 more.

  10. Prescription review Further revision: - iBooks - PSA revision questions - Additional case studies, ask your tutors

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