This article will look at the pharmacological considerations when prescribing for children. It will illustrate the common issues to consider when prescribing in the under 18 year-old group. Focus will be on pharmacokinetics, but legal aspects and consent issues surrounding prescribing in this age group will be discussed.
Nurse PrescribingVol. 16, No. 5 Historical SpotlightLook into my eyesSteve AinsworthSteve AinsworthSearch for more papers by this authorSteve AinsworthPublished Online:8 May 2018https://doi.org/10.12968/npre.2018.16.5.244AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article FiguresReferencesRelatedDetails 2 May 2018Volume 16Issue 5ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 8 May 2018 Published in print 2 May 2018 Information© MA Healthcare LimitedPDF download
Calculate the total amount of apomorphine administered as needed per day. Each dose as needed is 5 mg. Paul has seven doses as needed in 24 hours. 7 x 5 = 35 mg total medication as needed per day Calculate how many days one pack of apomorphine 50 mg/5 ml would last. 1 pack apomorphine 50 mg/5 ml contains five ampoules. 5 x 50 mg = 250 mg apomorphine per pack Paul requires 35 mg of medication as needed per 24 hours 250 mg / 35 mg = 7 mg 1 pack would last 7 days
Nurse PrescribingVol. 16, No. 9 Historical SpotlightFacing the music: Beecham's PillsSteve AinsworthSteve AinsworthSearch for more papers by this authorSteve AinsworthPublished Online:12 Sep 2018https://doi.org/10.12968/npre.2018.16.9.452AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article FiguresReferencesRelatedDetails 2 September 2018Volume 16Issue 9ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 12 September 2018 Published in print 2 September 2018 Information© MA Healthcare LimitedPDF download
Nurse PrescribingVol. 16, No. 3 NewsNICE recommends interferon beta-1b for routine use in MS following cost reductionAysha Mendes, Sarah Jane PalmerAysha MendesSearch for more papers by this author, Sarah Jane PalmerSearch for more papers by this authorAysha Mendes; Sarah Jane PalmerPublished Online:7 Mar 2018https://doi.org/10.12968/npre.2018.16.3.106AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology. 1993 Apr;43(4):655–61 Crossref, Google ScholarMS Trust. Prevalence and incidence of multiple sclerosis. 2017a. https://www.mstrust.org.uk/a-z/prevalence-and-incidence-multiple-sclerosis (accessed 13 February 2018) Google ScholarMS Trust. Extavia (interferon beta 1b). 2017b. https://www.mstrust.org.uk/a-z/extavia-interferon#work (accessed 13 February 2018) Google ScholarNational Institute for Health and Care Excellence. Multiple sclerosis patients to have routine access to beta interferon drug, says NICE in new draft guidance. 2017. https://www.nice.org.uk/news/article/multiple-sclerosis-patients-to-have-routine-access-to-beta-interferon-drug-says-nice-in-new-draft-guidance (accessed 13 February 2018) Google ScholarNovartis Pharmaceuticals summary of product characteristics. Extavia [Prescribing Information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2016 https://www.extaviahcp.com/efficacy (accessed 26 February 2018) Google Scholar FiguresReferencesRelatedDetails 2 March 2018Volume 16Issue 3ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 7 March 2018 Published in print 2 March 2018 Information© MA Healthcare LimitedPDF download
Nurse PrescribingVol. 16, No. 2 EditorialDuty of candourDeborah RobertsonDeborah RobertsonSearch for more papers by this authorDeborah RobertsonPublished Online:6 Feb 2018https://doi.org/10.12968/npre.2018.16.2.53AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Clarke, R. Hadiza Bawa-Garba could have been any member of frontline staff working in today's overstretched NHS. http://blogs.bmj.com/bmj/2017/12/08/rachel-clarke-hadiza-bawa-garba-could-have-been-any-member-of-frontline-staff-working-in-todays-overstretched-nhs/ (accessed 30 January 2018) Google Scholar FiguresReferencesRelatedDetails 2 February 2018Volume 16Issue 2ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 6 February 2018 Published in print 2 February 2018 Information© MA Healthcare LimitedPDF download
Rashes in babies and young children are distressing and a concern for parents and close family members. It can sometimes be difficult to determine the cause when many are similar in appearance and symptoms. This article therefore hopes to help nurse prescribers with recognition and management of some of the more common rashes, which they may see in their clinics.
Female urinary incontinence is a common and costly problem that affects the quality of life for many women. However, it can be managed using the correct strategies. There are several different types of female incontinence and this article discusses these along with the most common treatments, with particular emphasis on pharmacological treatments. The pharmacological treatments are discussed in detail, including dosages, side effects and monitoring.
Postural hypotension is an abnormal fall in blood pressure—of at least 20 mmHg systolic and 10 mmHg diastolic—within 3 minutes of standing upright. It can predispose patients to increased risk of falls, decreased quality of life and mortality. The patient's history is of particular importance and has a high diagnostic value; however, the majority of patients with postural hypotension are asymptomatic. This article re-examines the evidence and questions why there are still no national screening guidelines for higher risk patients in place.
Nurse PrescribingVol. 16, No. 6 EditorialPrescribing in pregnancy cautionDeborah RobertsonDeborah RobertsonSearch for more papers by this authorDeborah RobertsonPublished Online:23 Jun 2018https://doi.org/10.12968/npre.2018.16.6.253AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Medicines and Healthcare products Regulatory Agency. Valproate banned without the pregnancy prevention programme. 2018. https://www.gov.uk/government/news/valproate-banned-without-the-pregnancy-prevention-programme (accessed 21 May 2018) Google Scholar FiguresReferencesRelatedDetails 2 June 2018Volume 16Issue 6ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 23 June 2018 Published in print 2 June 2018 Information© MA Healthcare LimitedPDF download
This article is a case study of a patient who initially attended a minor illness clinic with restless leg syndrome. During the consultation it became obvious that the patient had pica. Pica is an eating disorder where people ingest a non-nutritive substance for at least 1 month. Angela (pseudonym) had been eating one full sheet of sand paper a day. The case study reviews the assessment and management of the patient. The usual management is a multidisciplinary approach to care.
Rashes are common and often share similarities in presentation and symptoms. This article provides an overview of some of the more common rashes and hopes to give nurses more confidence for diagnosis and treatment when they present in clinic
The last decade has seen a marked increase in the use of gabapentinoid drugs for pain management. This, in part, reflects the shift from some non-steroidal anti-inflammatory drugs (NSAIDs), as well as issues arising from the protracted use of opioids. More extensive use of gabapentin and pregabalin has seen the clinical role widen to incorporate a range of unlicensed pain scenarios, as well as increased medicines costs. The evidence for efficacy in some pain conditions, namely post-herpetic neuralgia and diabetic neuropathic pain, is stronger than for non-neuropathic pain conditions, such as fibromyalgia. Anxiolytic properties, as well as widespread availability, have encouraged recreational misuse, which is associated with doses outside the therapeutic range. Safe use for neuropathic pain (central and peripheral), complex pain, and migraine, and the evidence for some non-neuropathic pain conditions will be discussed, as well as the emerging abuse issues. Anti-convulsant interventions will not be covered in this article, nor will use in children.
The recently updated National Institute of Health and Care Excellence guideline for attention deficit hyperactivity disorder (ADHD) emphasises the need for psychoeducation as part of ongoing assessment, treatment and management. Noreen Ryan and Tim McDougall discuss the implications for supporting children and young people with ADHD and the vital roles that nurses can play during assessment and treatment.
Ustekinumab is an IV induced, SC maintained biological therapy that has been shown to induce and maintain remission in Crohn's disease, as well as promoting deep mucosal healing. Ustekinumab has been licensed for use in patients who have not responded to a traditional medical therapy, such as an aminosalicylate, corticosteroid or immunosupressant, or another biologic, such as infliximab. There is debate as to whether biologics should be commenced at the end of a step-up approach or the beginning of a step-down approach.
Although there is no cure for inflammatory bowel disease (IBD), its symptoms can be treated and remission induced using biological medicines, including the anti-TNF (tumour necrosis factor) drug infliximab. Biosimilars of infliximab have been made available in guidelines from the British Society of Gastroenterology and the National Institute for Health and Care Excellence, and they represent a considerable cost-saving opportunity for the NHS. The potential difficulties of switching infliximab to a biosimilar at a hospital can be overcome with a two-step implementation process. Emerging evidence on the factors influencing the variable effectiveness of these therapies is shaping best clinical practice, including studies on anti-TNF trough levels and anti-drug antibodies to infliximab, as well as the use of immunosuppressants. IBD nurse have the specialist knowledge and are in a unique position to measure progress, educate patients and encourage compliance, all of which helps optimise and prolong the effectiveness of biologic treatment.
Rosemary Adsley provides an overview of Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) and highlights their similarities and differences The use of both Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) is commonplace in primary care. This article will provide a brief overview of the two directions and highlight some similarities and differences between them. It will also provide examples of the situations where each type of direction is currently used and discuss some of the benefits that one type of direction may have over another in certain situations.
Smoking tobacco is the single biggest preventable cause of mortality in England and Wales and is the cause of much ill-health with over 1.5 million people in England suffering from a smoking-related disease. This article provides an overview of smoking cessation training needs for practice nurses, information on carbon monoxide and advice on the different methods of cessation and relevant medication.
Up to a half of all medication prescribed for long-term conditions are taken incorrectly, or not at all. This article will examine the increasing use of compliance aids, specifically multi-compartment compliance aids in primary and secondary care, and discuss their potential advantages and disadvantages. It will also highlight other options that can be used to improve adherence.
Medication reviews are important in primary care and help prevent adverse reactions from medications, improve the medical condition of the patient and reduce the usage of medicines to save money in the NHS. A medication review can be conducted by a suitably qualified nurse, doctor or pharmacist either as part of a meeting or medical consultation with a patient. Where possible, it is suggested that medication reviews be tailored to suit individual patient needs and held in conjunction with medicine reconciliation as both of these factors are important in prevention of hospital admission. The aim of this article is to identify which patient groups may benefit from a medication review and will provide insight into the process using an anonymised example from clinical practice.
