Rapid Medicines Management for Healthcare Professionals

Paul Deslandes, Simon Young, Ben Pitcher

• Publisher: Wiley-Blackwell
• Year: 2019
• Print ISBN: 9781119397724
• eBook ISBN: 9781119397885
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Rapid Medicines Management for Healthcare Professionals is an accessible, easy-to-use reference guide to safe and effective use of medicines in clinical practice. Introducing readers to the key principles of pharmacology and medicines management, this book addresses the essential elements encountered in healthcare practice.

Clear, concise chapters explain the principles of clinical pharmacology, examine the formulation, administration, and monitoring of medicines, outline the characteristics of common drugs, and explore practical considerations such as vaccinations and evidence-based medicine. Blank templates allow readers to create customised drug information sheets, whilst a glossary enables easy access to explanations of key pharmacological concepts and terminology.

• Offers quick reference to essential pharmacological knowledge
• Covers both pharmacological theory and real-world applications of managing medicines
• Includes practical information on commonly prescribed drugs
• Complements standard reference sources such as the British National Formulary (BNF)

Helping readers make informed medicines management decisions and render the best possible care, Rapid Medicines Management for Healthcare Professionals is a valuable resource for students and qualified nurses, as well as other healthcare professionals with an interest in medicine management.

SECTION III
Therapeutics

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Therapeutics Chapter Template

Section 3 of this book explores some of the drugs and drug groups commonly used in clinical practice. Each of the chapters follows a similar layout, which is described in this chapter. It was not possible to include all of the available drugs or drug groups in this section, therefore we have also included a blank template for you to fill in yourself for a drug or drug group that is relevant to your practice.

Commonly used examples

Each chapter will include examples of some of the more common drugs from this group. This will not be an exhaustive list.

Are these drugs all the same?

Whilst the drugs in each chapter will follow a certain theme, there will be differences between the different drugs being discussed. This section will therefore discuss if there are any fundamental differences which result in the drugs being grouped or used in different ways.

What are these drugs used to treat?

A simple explanation of what condition(s) the drug in question might be used to treat.

What do these drugs do?

An outline of how the drug in question treats the condition it is indicated for.

What’s the difference between different types?

Different drugs will have different properties (good and bad). This section will explore these differences to help understand why one drug may be chosen over another.

How are these drugs given?

Any particular points to consider regarding the possible routes of administration.

Dosing

Whilst specific doses should be obtained from clinical sources such as the British National Formulary (BNF), this section will discuss any specific issues related to how the drug is dosed, for example if it is dosed by weight or age.

What are the notable adverse effects to look out for?

Almost all drugs have adverse effects and a comprehensive list can be found in the BNF or in the summary of product characteristics (SmPC) for the drug in question. The intention of this section is to raise awareness of particular or problematic side effects.

Hypersensitivity and anaphylaxis are technically possible adverse effects of any drug, but this will only be discussed if it is particularly notable (e.g. penicillin‐based antibiotics).

How can the adverse effects be minimised?

This section will explore any strategies that may be employed to avoid or reduce problematic adverse effects. These might include timing of doses or the use of other medicines to alleviate symptoms of adverse effects.

What needs to be monitored?

This section is a discussion of things that may need to be monitored or assessed before or during the use of a drug. This may include some form of specific assay, such as serum potassium or international normalised ratio, or it could involve monitoring a patient's vital signs, such as blood pressure or respiratory rate.

What drug interactions are important?

Some drugs have particularly notable interactions that are either very common or potentially very harmful. This section does not necessarily include an exhaustive list, but a full list of drug interactions can be found in the interactions appendix of the BNF.

Discontinuing treatment

Some drugs should not be abruptly stopped. If a drug is known to cause withdrawal effects or if there are any specific strategies regarding reducing the dose of a drug before discontinuation, they will be discussed here. However, the return of symptoms or worsening of an ongoing condition that would result from stopping treatment will not be discussed, as this can apply to many drugs.

Other considerations

Some drugs or drug groups have eccentricities that are worthy of note to ensure safe and effective use, but do not fit in the other sections.

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Anti‐emetics

Commonly used examples

• Antihistamines, e.g. cinnarizine and cyclizine.
• Cannabinoids, e.g. nabilone.
• Dopamine receptor antagonists, e.g. domperidone, metoclopramide.
• Neurokinin receptor antagonists, e.g. aprepitant.
• 5HT₃ receptor antagonists, e.g. granisetron and ondansetron.
• Phenothiazines, e.g. levomepromazine, prochlorperazine.

Are these drugs all the same?

The medications/groups listed do not have one common mechanism of action: metoclopramide and domperidone block dopamine receptors (which are involved with central and peripheral triggers of nausea) and nabilone is a synthetic cannabinoid.

What are these drugs used to treat?

The medications classified as being used to treat nausea and vomiting are used for a range of indications. These include nausea and vomiting, nausea and vomiting associated with chemotherapy, in pain management/palliative care to treat nausea (this is typically nausea associated with large doses of opioids), labyrinth disorders, postoperative nausea, motion sickness, and other balance disorders.

What do these drugs do?

The exact mechanism by which antihistamines work is unclear. They have effects centrally and on lower oesophageal sphincter tone. Nabilone is a cannabinoid and the cannabinoids are believed to influence the body's emetic mechanisms. Domperidone and metoclopramide have gastrokinetic peripheral effects and an influence on the chemoreceptor trigger zone (CTZ). In addition, metoclopramide has central effects on the triggers of nausea and vomiting. Aprepitant antagonises the pharmacological effects of substance P. The vomiting centre of the brain (area postrema) contains high concentrations of substance P and antagonising its effects reduces nausea and vomiting. 5HT₃ receptor antagonists such as ondansetron may have an effect on the rele...

Table of contents

• Cover
• Table of Contents
• Introduction
• SECTION I: Underpinning Theory
• SECTION II: Applied Theory
• SECTION III: Therapeutics
• SECTION IV: Practice Considerations
• Glossary
• Index
• End User License Agreement