Patient specific directions

Assess the effectiveness of (3-blocker therapy by measuring heart rate. Heart rate reduction of 25% from baseline or to 55 to 60 beats/minute is desirable. Ask the patient specific, directed questions regarding adverse effects of p-blockers inquire about symptoms of orthostatic hypotension (e.g., lightheadedness, dizziness, or fainting). 

The Medicines Act divides all medicinal products into three categories general sale list (GSL) items pharmacy medicines (P) and prescription-only medicines (POM). The Act sets out legal requirements associated with each category of medicine and the administration of medicines to patients, including the use of patient specific directions (PSDs) and patient group directions (PGDs). 

A patient specific direction is the traditional prescription written by a doctor, dentist or other qualified prescriber for medicines fo be supplied or administered to a named patient. The majority of medicines are supplied or administered in this way. 

It may be necessary or convenient for a patient to receive a medicine (that is, have it supplied and/or administered) directly from a health care professional other than a doctor. Unless already covered by exemptions to the Medicines Act (see Chapter 14), there are two ways of achieving this by PGD or by patient specific directions. 

Patient specific direction - traditional prescription, or other written direction, for a named... 

Take die drug only as directed on die prescription container. Unless otiierwise indicated, take the drug on a empty stomach with water to enhance absorption. However, die patient should follow specific directions, such as take on an empty stomach or take at die same time each day tiiey are extremely important. 

Based on patient-specific data, local resistance patterns, and other relevant data, design an appropriate empirical antimicrobial regimen directed at the most likely pathogens empirical regimens should consist of high-dose intravenous cidal therapy. 

Apart from patient-specific parameters, external factors - most importantly the concomitant uptake of certain other chemicals present in diet, environment and especially other drugs - influence drug actions. Possible effects are manifold and can affect all stages of pharmacokinetic and pharmacodynamic processes in the body. Also direct interaction and inactivation of concomitantly administered substances are possible. Drug-drug interactions via modulation of metabolism present a very hot topic in pharmaceutical research and drug design. 

The directions for use (element [11]) must be both drug-specific and patient-specific. The simpler the directions, the better and the fewer the number of doses (and drugs) per day, the better. Patient noncompliance (also known as nonadherence, failure to adhere to the drug regimen) is a major cause of treatment failure. To help patients remember to take their medications, prescribers often give an instruction that medications be taken at or around mealtimes and at bedtime. However, it is important to inquire about the patient s eating habits and other lifestyle patterns, because many patients do not eat three regularly spaced meals a day. 

The directions for use (element [11]) must be both drug-specific and patient-specific. The simpler the directions, the better and the fewer the number of doses (and drugs) per day, the better. Patient... 

With the establishment of P T committees in the 1950s, hospital pharmacists acquired more influence over the use of pharmaceuticals within their institutions. Pharmacists now had the opportunity to demonstrate the value of their expertise through advice and guidance in therapeutic decisions. Within hospitals, pharmacists had direct access to patient-specific clinical data, medical literature, and clinicians, which allowed them to provide therapeutic advice to physicians. Hospital pharmacists began to demonstrate their value as medical information resources — a resources that could lead to the delivery of better patient care. 

Besides direct questioning of the patient, valuable information may be obtained by asking the spouse or closest relatives about possible neuropsychiatric symptoms displayed by the patient. Specific questions should be asked regarding changes in personality, working capacity, sleep behaviour, powers of concentration, capacity to register and mental reactivity. (49, 83)... 

Patient Group Directions have been specifically developed to allow first contact services to supply or administer medicines without the patient first needing to see a doctor or a dentist. A first contact service is a service that a patient would make contact with when seeking unscheduled care under the umbrella of the NHS and include ... 

Scotland has introduced a system whereby Patient Group Directions can be used by pharmacists in the urgent supply of medicines or appliances. For specific details on the use of Patient Group Directions in the urgent supply of medicines or appliances to patients in Scotland, see Section 7.3. 

Special warnings, precautions or use limitations cited in the product monograph should be included in the body copy. Examples include abuse potential for narcotics or central nervous system agents, or specific directions for use in special patient groups such as elderly people, children, pregnant women, nursing mothers, women of childbearing age. 

The 24 hour outdatlng period constitutes one of the major problems with frozen red cells today. This is particularly true when cells are deglycerollzed at a blood center and delivered to a hospital at some distance. A unit of cells specifically directed to a particular patient, and then not used, frequently cannot be crossmatched for some other recipient within the 24 hour limit. The 24 hour outdatlng is Imposed because of the hazard of bacterial contamination during processing. 

Thus, echocardiography is recommended as a screening tool, but not as the definitive diagnostic tool in patients suspected of having pulmonary hypertension. For a particular patient, following the initial correlation of the echo estimate of PA pressure with direct catheterization measurement will allow subsequent patient specific correlations. Tricuspid annular plane systolic excursion (TAPSE) has been shown to correlate strongly with RV ejection fraction as assessed by radionuclide angiography (34). It has been used in both two- and three-dimensional evaluations, and as a means of serial follow-up studies of... 

The final part has two chapters. The first of the two (Chapter 14) is about legislation around the use of medicines with discussion of salient points from the Medicines Act 1968 and the Misuse of Drugs Act 1971. Specific exemptions for podiatrists, the use of patient group directions, supplementary prescribing and independent prescribing and a brief history of non-medical prescribing are considered. 

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