Clinical Pharmacology. Prescribing October 2005 Dr Joseph Cheriyan Dr Fraz Mir. Why use drugs?. To improve quality or quantity of life To cure , suppress or prevent disease. Before starting treatment !. Decide whether a drug is necessary. If it is:
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Dr Joseph Cheriyan
Dr Fraz Mir
Decide whether a drug is necessary. If it is:
1. What are you hoping to achieve?
2. Will the drug chosen will bring this about?
3. What other effects the drug might have – could these be harmful?
4. Does benefit outweigh risk?
“I can’t take antibiotics, they make me ill, doctor”
However, many patients do not receive treatment from which they would clearly benefit (e.g. in hyperlipidaemia and heart failure)
William Withering 1789
Date: 21/10/5 Line: IV Type of fluid: 5% dextrose or 0.9% Saline
Additives: Aminophylline 300mg Volume: 100 ml Rate: over 20 mins.
Date: 21/10/5 Line: IV Type of fluid: 5% dextrose or 0.9% saline
Additives: Aminophylline 500mg Volume: 500ml Rate: 30ml/hour
or 500mg in 250 ml dextrose/saline at a rate of 15ml/hour.
= 2000mg in 100ml
= 20 mg in 1 ml
Date: 21/10/2005 Drug: Lidocaine 2% Dose: 200mg
Route: S/C Time: as and when given
Date: 21/10/05 Line: IV Type of fluid: Saline 0.9% Additives: Phenytoin 1200mg Volume: 200ml Rate: 8ml/min SIGN!!
200mg in 20 ml saline “ “ at 5ml/min.
= total 1200mg
Drug: Phenytoin Dose: 100mg Route: IV Start Date: 21/10/2005 Circle frequencies eg 8,14,22
Additional Instructions: in 100 ml saline SIGN!!!
2500mg in 500ml over 4 hours then
5000mg in 1000ml over 16 hours
Write out on yellow infusion card as:
Date: 7/11/3 Line: IV
Type of fluidAdditives Vol Rate
5% dextrose N-Acetlycysteine 7500mg 200ml over 15 minutes
5% dextrose N-Acetylcysteine 2500mg 500ml over 4 hours
5% dextrose N-Acetylcysteine 5000mg 1 litre over 16 hours
On regular drug card:
Start Date: 21/10/05
Additional instr: in 200 ml saline 0.9%
Freq: Circle 8,14,22
ER-WEB – further information on prescribing
Clinical Pharmacology Unit – Lecture Slides & further drug calculations