Resources

Learning outcomes for each session

Taking a safe and effective drug history

  • Know what information is needed to complete a safe and effective drug history.
  • Know the different information sources available to you when obtaining or confirming a drug history, and their limitations.
  • Be able to overcome difficulties in eliciting a drug history.
  • Be able to identify non-adherence, and the impact this can have on the drug treatments you prescribe.
  • Understand what is meant by Medicines Reconciliation, and know your role and responsibility in this process.
  • Understand the importance of effective communication at the transfer of patient care.

Drug Allergy and Anaphylaxis

  • Take an accurate history of any previous reactions to drugs, medicinal and related products and non-drug allergies.
  • Examine a drug chart, and decide which drugs might pose a risk to the patient in light of known allergies.
  • Recognise the signs and symptoms of allergic reactions to drugs.
  • Distinguish allergic reactions from other adverse drug reactions.
  • Manage acute allergic reactions to drugs.
  • Arrange appropriate follow up in cases of suspected drug reactions.

Anti-coagulation

  • Know the indications, cautions, duration and monitoring requirements for anticoagulation therapy.
  • Provide practical guidance on achieving and maintaining a target INR and managing patients with INRs above the recommended therapeutic range.
  • Understand which parenteral treatment to use until oral anticoagulation cover is achieved. (Trust Policy)
  • Appreciate the need to balance benefit with the risk of harm when prescribing anticoagulant therapy.
  • Understand the need to consider lifestyle changes, drug-drug interactions and drug-food interactions when making dosing decisions.

Toxic Tablets

  • Describe the risks of drugs and how harm from the most dangerous drugs can be minimised.
  • Discuss the general methods used to limit harm from drugs.
  • Describe how the prescribing of dangerous drugs requires a concordant approach to therapy to avoid serious harm and adverse drug reactions.
  • Describe the role of policy and protocol in preventing serious untoward medication errors.
  • Understand the importance of monitoring drug therapy.

Parenteral Poisons

  • Describe the risks of drugs and how harm from the most dangerous drugs can be minimised.
  • Discuss the general methods used to limit harm from drugs.
  • Describe how the prescribing of dangerous drugs requires a concordant approach to therapy to avoid serious harm and adverse drug reactions.
  • Describe the role of policy and protocol in preventing serious untoward medication errors.
  • Understand the importance of monitoring drug therapy.

Prescribing in infection

  • Describe the different classes of antibacterials available and their site of action on a microorganism.
  • Describe how bacteria can be resistant to antibacterials.
  • Explain why certain antimicrobials might be restricted in a Trust, and how access to them could be obtained.
  • Know where to look for guidelines on treating infections and why adherence is important.

Fluids

  • Recall the signs and symptoms of hypovolaemia and hypervolaemia.
  • Understand how to calculate fluid loss, gains and requirements.
  • Understand how to how to calculate electrolyte requirements.
  • Describe the difference between crystalloid and colloid fluid replacement therapy and when each might be appropriate for use.
  • Monitor fluid replacement therapy effectively to avoid adverse effects and achieve optimal response.

Drug Interactions

  • Demonstrate knowledge of potential drug-drug interactions (DDIs) mechanisms (pharmacodynamic and pharmacokinetic).
  • Know patient factors that may intensify drug-drug interactions, related to age, gender, metabolising enzyme profile (sometimes related to ethnicity), disease, diet, smoking and illicit drug use.
  • Describe some of the common drug interactions seen in clinical practice and strategies for minimising their occurrence.
  • Know where to find information on potential drug interactions.
  • Highlight the importance of identifying and reporting ‘suspected’ drug interactions and Adverse Drug Reactions (ADRs) to the Medicines and Healthcare Products Regulatory Agency (MHRA)

Prescribing in Renal Dysfunction

  • Show how impaired renal function alters the pharmacokinetics of drugs.
  • Know how to assess renal function and the limitations of the available methods.
  • Know which drugs and agents can be nephrotoxic and how these can cause AKI.
  • Identify common drugs that need dose adjustment in kidney disease.
  • Demonstrate effective management of (a) intravenous fluid therapy (b) hyperkalaemia (c) antihypertensive therapy and (d) diuretics in kidney disease.
  • Know where to find information to guide prescribing in kidney disease.

Prescribing in Older Adults

  • Understand the processes of absorption, distribution, metabolism and excretion of drugs in the older patient.
  • Understand how age-related physiological and pathological processes affect how the body reacts to drugs.
  • Know how physical, cognitive and social aspects may affect an older patient’s ability to adhere to treatment.
  • Understand the factors that make older adults more at risk of developing adverse drug reactions (ADRs).
  • Develop strategies to reduce problems with medication in the elderly population

Pain Management

  • Describe how the WHO Pain ladder assists in rational prescribing of analgesic therapy for both acute and chronic pain.
  • Understand the risks associated with paracetamol and NSAIDs, and how these may be minimised.
  • Identify weak opioid analgesics and when they are appropriate for use.
  • Identify strong opioid analgesics, and how to minimise the risks when switching between different opioid analgesics and titrating doses to meet individual patient requirements. NPSA alert.
  • Understand the indications and cautions of Patient Controlled Analgesia (PCA).
  • Recall the stepwise management of neuropathic pain, and understand when a referral to the specialist Pain team is necessary.
  • Describe the use of local anaesthetics in secondary care setting, and how to recognise and manage toxicity.
  • Identify patients with complex analgesic requirements where input may be required from specialist teams.

Adverse Drug Reactions

  • Identify susceptibility factors that place patients at increased risk of ADRs
  • Discuss the concepts of pharmacovigilance and its importance for public health
  • Explain the role and function of the Yellow Card scheme
  • Identify sources of information on ADRs

Medication Errors

  • Define medication errors, including subtypes
  • Identify individual and systems factors leading to error
  • Describe how medication errors are reported
  • Describe Datix reporting system