Reasonable care Receivers

In theory, the practitioner, as a professional person, is able to assess the risks and potential benefits to his patient, and to decide that the balance lies in favour of the use of a particular unauthorised product. A company receiving a request from that practitioner will therefore assume that the doctor will exercise reasonable care and skill in using the product in a way that avoids causing injury to his patients. However, the principle that supply is the doctor s sole responsibility does not provide companies with total protection against liability where a patient is injured by treatment with an unlicensed product. 

Patients receiving cytotoxic chemotherapy very often need concomitant administrating of antiemetic therapy. Such protocols will start well in advance of administering the cytotoxic, and last for a reasonable time with regard to pharmacokinetics of the antineoplastic agent. In addition, side effects of antineoplastic therapy are made better tolerable by supportive care. 

The theory described in Sect. 3.5.1 has received most justification from its agreement with observations. Ultimately this must be the case for any successful theory. However, the consequences of any assumptions made should be well understood as several independent and adjustable parameters can make an unrealistic approach appear reasonable. In recent years, some of the experimental features not well represented by this theory have been attributed to unrealistic approximations which would invalidate the basis of the theory. Hence we give a careful step-by-step critique, and emphasize the consequences of alternative assumptions. In Sect. 3.5.3 when we investigate the experimental evidence, we should be better able to establish whether various types of behaviour can be accommodated within the theory. 

The care of a patient receiving a cholinergic drug depends on the drug used, the reason for administration, and the patient s response to the drug. 

The ongoing assessment depends on the reason the drug was prescribed and the condition of the patient. Men receiving an androgen or anabolic steroid are questioned by tlie primary health care provider or nurse regarding the effectiveness of drug therapy. 

ASSESSMENT OF THE HOSPITALIZED PATIENT The hospitalized patient receiving a female hormone requires careful monitoring. The nurse takes the vital signs daily or more often, depending on the patient s physical condition and the reason for drug use. The nurse observes the patient for adverse drug reactions, especially those related to the liver (the development of jaundice) or the cardiovascular system (thromboembolism). The nurse weighs the patient weekly or as ordered by the primary health care provider. The nurse... 

Twenty to 40 percent of patients presenting with STE ACS receive fibrinolysis compared with 7% receiving primary PCI.26,27 Therefore, many patients do not receive early reperfusion therapy. The primary reason for lack of reperfusion therapy is that most patients present more than 12 hours after the time of symptom onset.27 The percentage of eligible patients who receive reperfusion therapy is a quality indicator of care in... 

All health care personnel should be strongly encouraged to receive the influenza vaccine yearly in order to prevent transmission of influenza within the health care facility and to decrease employee absenteeism for influenza-related reasons. The vaccine should be made available to employees at the workplace, free of charge. Employees should be asked to sign a declination if refusing to receive the influenza vaccine. Additionally, health care facilities should report the number of health care personnel receiving influenza vaccine as a patient safety measure.19... 

In 1746, a Scottish naval surgeon named James Lind carried out a carefully controlled study of the effect of diet on scurvy and demonstrated, beyond reasonable doubt, that oranges and lemons would cure (or prevent) scurvy. However, it was not until 1795, about three hundred years since it was known that citrus fruit would cure scurvy and about 50 years after Lind s definitive work, that the British Royal Navy insisted that sailors receive a daily dose of a citrus fruit. Opinion and prejudice outweighed scientific evidence to the detriment of many for far too long. 

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