Oxford handbook of Clinical Pharmacy

7 0

INDEX 707

colchicine 610 congenital cornea 673
colecalciferol, in malformations 188 coronary arteries,

osteoporosis  607–​8 conjunctiva 673 revascularization
colestyramine 302 conjunctivitis  675–​6 procedures 329
colleagues as patients, constipation corticosteroids
in acute gout  610
confidentiality 83 causes 303 adverse effects  378
colonization, pathogenic definition 303 appetite stimulation  630
in enteral nutrition  588 in asthma  377–​8
organisms 453 in MS 439 in COPD  394
colostomies  see stoma opioid-i​ nduced  306 in eczema  620–​1
in palliative care in glaucoma  675
patients in hyperemesis
coltsfoot 146 patients 631
combined oral contracep- in stoma patients  319 gravidarum 514
treatment  304–​6 inhaled  see inhaled
tives (COCs)  506 continuing (type C)
drug interactions  509–1​ 0 corticosteroids
missed pills  507 reactions 19 in MS relapses  439
perioperative continuous ambulatory perioperative

considerations 225 peritoneal dialysis considerations 226
venous thromboembolism (CAPD)  see renal in psoriasis  625
replacement therapies in spinal cord
risk 509 continuous arteriovenous
COM-B​ model  3–​4 haemofiltration compression 635
comforting patients  68 (CAVH)  see renal corticosteroid withdrawal,
commensal replacement therapies
continuous data  129 adrenal insufficiency  394
micro-​organisms  453 continuous mandatory venti- cortisol levels,
Common Terminology lation (CMV)  652
continuous subcutaneous drug–​laboratory
Criteria for Adverse infusion (CSCI)  637 interference 667
Events (CTCAE)  540 contraception  506–1​ 0 cost evaluation, new
communication counselling points  510 drugs 245
with carers and depot injections  508 C-​reactive protein, paediat-
drug interactions  509–1​ 0 ric values  693
relatives 70 emergency hormonal creatine kinase (CK)
with dying patients  69–7​ 0 normal range  691
writing in medical notes  59 contraception 510 paediatric values  692
see also patient information implants 509 range and
intrauterine system  508
leaflets; report writing oral contraceptive pills  506 interpretation 687
communication skills  86–8​ risk of venous creatinine clearance  181–3​

barriers to good thromboembolism 509 calculation of  182
communication 88 transdermal patches  506 in infants and
vaginal ring  508
checklist of interpersonal controlled clinical trials  109 children 183
skills 89 controlled drugs normal range  691
accountable officer  118
delivering the disposal of  121, 275–6​ paediatric values  692
message  86–7​ inclusion in PGDs  256 in older people  216
losses within hospitals creatinine levels
listening skills  87, 89 normal range  691
planning and notes for investigating
pharmacist 119 paediatric values  692
preparation 86 range and
questioning 88 pharmacy department
community-​acquired losses 119 interpretation 686
critical appraisal
pneumonia 455 ward or clinic level
community pharma- losses 118 of papers  139–4​ 1
of systematic reviews  138
cists, responsible patient’s own critical care  644–6​
pharmacists 264 management on delirium 647
compliance 2 admission 120 mechanical
comprehensive disease return on discharge  120
management  6–​7 use of in hospital  120 ventilation  651–​2
concentrations  231–​2 methodical
calculations 232 records of
concordance 2 destruction 121, 276 approach  645–​6
confidence intervals  135 motility stimulants  650
confidentiality  82–3​ see also opioids networking 646
disclosure of pharmacist’s role  645, 646
putting the patient
information 82
friends, relatives, or first  644–​5

colleagues as
patients 83

078

708 INDEX

critical care (contd.) extravasation  545–​6 data, binary and
recognizing expertise  646 anthracyclines 550 continuous 129
stress ulcer follow-u​ p care  549
prophylaxis  648–9​ management  547–​9, 551 data analysis  295–6​
talking to friends and paediatric death rattle  634
relatives 645 patients  551–2​ decision-​making, ethical
vasoactive agents  653–​4 prevention  545–6​
risk factors for  545 dilemmas  73–​4
crossover studies, critical signs and symp- decoctions, Chinese herbal
assessment of  140 toms  545, 547–​9
vinca alkaloids  549 medicine 150
crystalloids 569 deep vein thrombosis
cultural dietary extravasation classifica-
tion  534, 547–​9 (DVT)  342–​4
considerations 197 treatment  344–5​
culture of frequency of see also venous thrombo-
administration 529
micro-o​ rganisms  448–​9 embolism (VTE)
cyclizine 308 handling during defibrillation 370
pregnancy 522 dehydration
dose and
contraindications 309 incident management  522 clinical features  300
intrathecal fluid and electrolyte
drug compatibilities  637
cystic fibrosis, gene administration 541 therapy  301–​2
contraindicated delayed (type D)
therapy  267–8​
cytarabine, dose drugs 544 reactions 19
frequently asked delirium
calculation 529
cytochrome P450 questions  541–3​ prevention 647
points for nursing screening tools  647
(CYP450) system treatment 647
CYP2D6  269–​70 staff  543 denosumab
drug interactions  24 points for in hypercalcaemia of
information on drug
pharmacists 543 malignancy 633
metabolism 25 safe practice  541 in osteoporosis  609
cytotoxic drugs  518–2​ 3 pre-​administration dentistry, Medicines

accidental spillage  521 assessment  528–3​ 0 Information services  95
administration of   520–1​ prescription, depot
chemotherapy-​
preparation, and antipsychotics 424, 427
induced nausea and reconstitution  518–1​ 9 depot contraception  508
vomiting  531–​9 prescription depression 413
antiemetic endorsement 526
prescription screening in bipolar disorder  431
combinations  536–7​ annotations 527 St John’s wort  419–​21
antiemetic clinical check  526
second and subsequent drug interactions  421
prescribing  535–​6 treatment 413
antiemetics for failure of cycles 526
validation of details see also antidepressants
control 538 treatment resistance  419
antiemetics in refractory 524 dermatitis  619–​22
verification of cycle 1 Dermatology Life Quality
emesis 538
definitions 534 prescriptions 525 Index (DLQI)  624
emetic risk of safety issues  286 desensitization  664–5​
transport of  519–2​ 0 dexamethasone
chemotherapy  532–3​ treatment guidelines  530
non-​pharmacological vinca alkaloids  544 in nausea and
waste management  521 vomiting 308
interventions 539
other causes to be D chemotherapy-​
induced 535
considered 534 dabigatran 353
patient risk factors  536 perioperative dose and
recommended IV considerations 227 contraindications 309

antiemetic doses  538 daclizumab 445 in spinal cord
recommended oral dalteparin, in acute compression 635

antiemetic doses  537 DVT  344–​5 see also corticosteroids
Common Terminology dandelion 146 dexrazoxane, in extravasation
danshen, perioperative
Criteria for Adverse of anthracyclines  550
Events (CTCAE)  540 considerations 153 diabetes mellitus  484–9​
dispensing and
labelling  519–​20 monitoring  490–4​
disposal of excreta and annual review  493–4​
blood  521–2​ blood glucose levels  490
dosing  528–9​ blood glucose
meters 491

7 90

INDEX 709

blood glucose dilutions  235–6​ hierarchy 39
targets 490 dimethyl fumarate  442 working with medical
diphenoxylate +
blood ketone staff   39–​40
levels  492–3​ atropine 302 documentation
directly observed
HbA1c 493, 494 clinical trials  113
recording blood glucose therapy (DOTS), TB records of controlled drugs
treatment 480
results 491 direct thrombin inhibitors destruction 121, 276
urine testing  492 (DTIs), oral  353 screening of chemotherapy
pharmaceutical discharge prescriptions
for opioid-​replacement prescriptions 527
management  485–6​ docusate tablets  305
alpha-​glucosidase therapy 223 domiciliary oxygen
role of pharmacy
inhibitors 487 therapy  167–9​
DPP-4​ inhibitors technicians 280 ambulatory  168–​9
screening 56 long-t​ erm  167–​8
(gliptins) 488 discharge summaries  277 practicalities 169
incretin mimetics  488 discoid eczema  619–​22 short-​burst  169
insulins 489 discontinuation syndrome, domperidone 308
meglitinides 487 for chemotherapy-​
metformin 486 antidepressants 419, 420
NICE clinical disease-m​ odifying anti-​ induced nausea and
vomiting 536
guideline 486 rheumatic drugs dose and
SGLT2 inhibitors (DMARDs) 598, contraindications 309
599–​600 gut motility
(gliflozins) 488 in ankylosing stimulation 650
sulfonylureas 487 dong quai, perioperative
thiazolidinediones spondylitis 605 considerations 153
in psoriatic arthritis  605 dopamine 654
(glitazones)  487–​8 disease-​orientated evidence in acute heart failure  334
risk factors for  484 dopexamine 654
symptoms and (DOE)  244–8​ dose banding, cytotoxic
disease-​specific feeds  587 drugs  528–3​ 0
diagnosis 485 disk diffusion, measure- dose calculations
Diabetes UK Tracker cytotoxic drugs  528–​9
ment of antimicrobial medicines for
app 491 resistance 467 children  208–​9
dialysis  see renal replace- dispensing, safety issues  285 estimation as a
dispensing errors, risk
ment therapies management 64 proportion of adult
diarrhoea disposable IV pumps  558 doses 209
distressed patients  68 dose frequency  3
assessment 300 distribution double-​blind studies  109
causes 300, 301 in children  205 doxorubicin, cumulative
definition 300 drug interactions  23 dose 529
in enteral nutrition  588 in older people  215 DPP-4​ inhibitors
treatment 301 in renal impairment  181 (gliptins) 488
disulfiram 660 dressings  see wound
drug therapy  302 dithranol 625 dressings
fluid and electrolyte ditiazem, angina drug and therapeutics
prevention 324 committees  253–4​
therapy  301–2​ diuretics drug chart review  49–​50
diazepam, in alcohol and acute gout  610 advice for inhalers  50
avoidance in advice for insulins  50
withdrawal 658 drug charts, writing on  52
dietary pregnancy 512 drug clearance
in heart failure  330 high-​ and low-h​ epatic-​
considerations  196–​7 extraction drugs  176
cultural or religious acute management  333 in liver disease  175
in hypertension  337, drug compatibilities, syringe
factors 197 infusion pumps  637
food allergy or 338, 339 drug desensitization  664–5​
perioperative drug history (DHx)  41–2​ ,
intolerance  196–7​ 49, 55, 100
in gout  610 considerations 226 preoperative  224–​8
metabolic disorders  197 dobutamine 654
dietary fibre  304
diffusion 572 pharmaceutical
digoxin calculations 237
drug assays  667
in heart failure  332 docetaxel, frequency of
interactions with herbal administration 529

medicines 152 doctors
pharmaceutical

calculations 237
therapeutic drug

monitoring 670

170

710 INDEX

drug interactions  23–​5, 36 treatment enflurane, drug
antidepressants 420 options  314–​15, 316 interactions 225
with antiretrovirals
477–8​ dystonias, antipsychotic-​ enoxaparin, in acute
in enteral feeding  590 induced 425 DVT  344–5​
with herbal
medicines 145, 151 E enteral feeding  586–​8
St John’s wort  421 administration of
with hormonal Easi-Breathe® inhaler  386–7​ feeds 587
contraception  509–​10 Echinacea 146, 147 complications 588
lamotrigine 433 discharge plans  587
lithium 432 drug interactions  151 drug
management 26 eczema administration  589–​91
mechanisms 23 absorption
pharmacodynamic 25 classification  619–​22 problems 590
pharmacokinetic  23–4​ treatment administration through
perioperative 225 the tube  590
prediction of  25 bandaging 622 adsorption onto feeding
with TB treatment  480 emollients 620 tubes 590
with UVB and PUVA potassium bioequivalence
treatment 627 issues 591
valproate 433 permanganate 622 drug–f​ eed
topical calcineurin interactions 591
drug–​laboratory drug interactions  590
interference 666, 667 inhibitors 622 drug-​specific issues  590
topical formulation
drug misusers  219–​22 difficulties 589
concurrent illness corticosteroids  620–1​ feed categories  586–7​
management 221 edoxaban 353 tube-​related issues  586
discharge prescriptions for effectiveness evaluation, types of  586
opioid-​replacement
therapy 223 new drugs  245 Entonox®
management of drug mis- efficacy of medication  36 clinical uses  158
use on the ward  219 egg allergy  196–​7 cylinder data  162
managing behaviour  219 eicosapentaenoic acid, in
opioid dependence Environment Agency  273–6​
management  220–​1 cachexia 630 enzyme induction and
pain control  221–​2 elderly people  see
pharmacist handling of inhibition 24
illegal drugs  220 older people ephedra (ma huang)  146
electrolyte
drug protocols  249–5​ 0 drug interactions  151
limitations 250 requirements 576 perioperative
stages of children 584, 694
development  249–5​ 0 electronic prescribing  281–2​ considerations 153
benefits 281 epiglottitis 455
dry mouth, palliative care potential problems  282 epinephrine  see adrenaline
patients 634 security 282 EpiPen® 29
training 282 epithelializing (granulating)
duodenal ulcers (DU)  312 elemental feeds  587
see also peptic ulcer emergency drug box wounds  614–​15
disease dressings 617
contents 371, 372 eplerenone
dying patients  69–7​ 1 emergency hormonal con- in heart failure  331
discovering a dead secondary prevention of
patient 72 traception (EHC)  510
emotional reactions emollients CVD 362
to  70–​1 epoprostenol, in renal
euthanasia 71 in eczema  620
grief process  69–​70 in psoriasis  624 replacement therapy  657
talking to carers and emotional lability, manage- eptifibatide
relatives 70
talking to the ment in MS  439 in NSTE-A​ CS  365
patient  69–​70 emphysema  see chronic in PCI  359
errors 284
dyspepsia 312 obstructive pulmonary management of  64–​5
indications for disease reporting of   65, 260, 287
endoscopy  313–​14 endocarditis 456 risk management  64–​5
end-​of-​life care  638
end-o​ f-​needle reactions  28 administration of
end-​of-​use (type E) medication  64–5​
reactions 19
endophthalmitis 678 dispensing 64
endoscopic therapy, upper prescribing 64
GI bleeding  317
endoscopy  317–​18
indications for  313–​14

1 7

INDEX 711

erythromycin, gut motility extravasation kits  550 flow rate calculations  238
stimulation 650 exuding wounds  615 floxuridine, dose

escitalopram, QT interval dressings 617 calculation 529
prolongation 420 eye structure  673 fluid balance  571–​2, 573
fluid compartment
esomeprazole  314–​15 F
estimated GFR barriers 572
facemasks, oxygen fluid distribution  573
(eGFR) 182, 183 therapy 168 fluid restriction, in heart
stages of chronic kidney
facilitated diffusion  572 failure 329
disease 184 factor Xa inhibitors  353 fluid therapy  see
etanercept 601 failure, mode, and effects
intravenous fluids
in psoriasis  628 analysis (FMEA)  287 fluoroquinolones, admin-
E-t​est, measurement of anti- family history
istration with enteral
microbial resistance  467 (FH)  41–2​ , 100 nutrition 590
ethical committees  114–​15 fasting 197 5-​fluorouracil, frequency of
see also ‘nil by mouth’ administration 529
pharmacist advisors  115 ‘fast metabolizers’  269–7​ 0 fluoxetine, drug
timelines 114 fatigue interactions 420
ethical issues  73–​4 fluticasone propionate, BDP
disclosure of in multiple sclerosis  439 equivalence ratio  375
in palliative care foam wound dressings  617
information 82 folate deficiency  641–2​
genotyping  269–​70 patients 631 folic acid supplements  642
etonogestrel implants  509 fat-​soluble vitamin require- in methotrexate
EudraCT numbers  107
European Clinical Trials ments, children  585 therapy 599
febuxostat 611 during pregnancy  191, 513
Directive  106, 110–1​ 1 felodipine, angina fondaparinux
euthanasia 71 in acute DVT  345
evening primrose prevention 324 in NSTE-​ACS  364–​5
fentanyl, transdermal  406–7​ thromboprophy-
oil 146, 147 feverfew 146, 147
drug interactions  151 laxis 342, 344
perioperative drug interactions  151 food allergy or intolerance,
perioperative
considerations 153 196–​7
evidence, hierarchy considerations 153 formularies  245–​6
fibrin degradation products
of   124–5​ interface issues  277–​8
evidence-​based clinical normal range  691 formulary
range and
pharmacy 124 applications  246–8​
evidence-​based medicine interpretation 689 fosaprepitant, for
fibrinogen levels
(EBM) 242 chemotherapy-i​ nduced
definition 124 normal range  691 nausea and vomiting  535
disease-o​ rientated range and four E’s triangle  9
friends as patients,
evidence  244–​8 interpretation 688 confidentiality 83
statistical versus clinical fibrinolysis 340
G
significance 126 absolute
excretion contraindications 359 gabapentin, in chronic
drug interactions  24 pain 411
antithrombin therapy  360
in older people  216 relative contraindica- galactosaemia 197
in renal impairment  181 gamma-​glutaryl transferase
exfoliants  534, 547–9​ tions  359–6​ 0
expert patient schemes  6–7​ in STEMI  359–​60 (GGT) 173
extracorporeal albumin film type wound blood levels, range and

dialysis 180 dressings 617 interpretation 689
extrapyramidal side effects, financial reports  75 normal range  691

antipsychotics 425 hospital budget paediatric values  693
extravasation  545–6​ statements 76 garlic 146, 148

of chemotherapy finasteride, interactions with drug interactions  152
adult patients  547–​9 herbal medicines  152 perioperative
paediatric
patients  551–2​ fingertip units  621 considerations 153
in children  621 gastric juice,
classification of cytotoxic
drugs 534 fingolimod  442–3​ composition of  570
fish oil supplements
prevention  545–6​
risk factors for  545 drug interactions  152
signs and symptoms  545 perioperative

considerations 153

172

712 INDEX

gastric ulcers (GU)  312 theoretical values in gravity infusion
see also peptic ulcer renal replacement controllers 557
disease therapy 186
Green Bag Scheme  279
gastrointestinal absorption glucose, plasma levels grief process  69–​70
in children  205 normal range  691 GROW coaching model  15
in older people  215 paediatric values  693 guarana, perioperative
range and
gastrointestinal fluids, interpretation 685 considerations 153
composition 570 guidelines
glucose-​6-​phosphate dehy-
gastrointestinal drogenase deficiency development of  142
infections 456 (G6PD)  198–​9 for antimicrobial

gastrointestinal stomas  see drugs to be used with prescribing  463–​5
stoma patients caution 199
H
gastrointestinal toxicity, drug treatment  198–9​
herbal medicines  146 treatment of a haemolytic Hs2tarnetsasguolcneisrts  315
prophylaxis 649
gastro-o​ esophageal reflux attack 199
disease (GORD)  312 glucose oxidation rate haem arginate  200–1​
haematemesis  317–​18
treatment (GOR)  575–​6 haematocrit 639
options  314–1​ 5, 316 glycated haemoglobin
normal range  691
gene therapy  267–8​ (HbA1c) 493 range and
genetically modified units equivalence
interpretation 687
organisms 268 table 494 haemodiafiltration
genetic testing  269–​70 glycerol/​glycerin
gene transfer vectors  267–​8 (HDF) 655
gentamicin, therapeutic drug suppositories 305 see also renal replacement
glyceryl trinitrate
monitoring 672 therapies
germander 146 (GTN) 323 haemodialysis
gifts  271–2​ in acute MI  356
ginger 146, 148 in NSTE-​ACS  363–​4 (HD) 655, 656
tolerance to nitrate see also renal replacement
drug interactions  152
in hyperemesis therapy 327 therapies
glycoprotein IIb/I​ IIa haemofiltration
gravidarum 515
perioperative inhibitors 365 (HF) 655, 656
goitre 502 see also renal replacement
considerations 153 gold, in rheumatoid
ginkgo biloba  146, 148 therapies
arthritis 600 haemoglobin levels
drug interactions  152 golden rod  146
perioperative golimumab 602 normal range  691
good clinical practice paediatric values  693
considerations 153
ginseng 148 (GCP) 106 range and
gout  610–1​ 1 interpretation 687
drug interactions  152
perioperative acute management  610 haloperidol
lifestyle interventions  610 in delirium  647
considerations 153 prophylaxis 611 drug compatibilities  637
glatiramer 441 Gram-s​ taining  449 in nausea and
glaucoma 673 granisetron, dosage vomiting 308
dose and
angle-​closure  674–5​ IV 538 contraindications 309
open-​angle  673–4​ oral 537
glibenclamide, perioperative granulating wounds  614–1​ 5 HandiHaler® inhaler  388
dressings 617 Harris–​Benedict
considerations 228 Grave’s disease  498–​501
glicazide, perioperative clinical features  498 equation 575
pharmaceutical Harvard style
considerations 228
gliflozins (SGLT2 management references 297
adverse effects  500 Hashimoto’s thyroiditis
inhibitors) 488 antithyroid
glipizide, perioperative 502
drugs  499–5​ 01 hawthorn 146, 148
considerations 228 beta-​blockers  500 Hazardous Waste
gliptins (DPP-4​ radioactive iodine
Regulations  273–​6
inhibitors) 488 therapy 500 HbA1c (glycated
glitazones (thiazolidinedi- surgery 500
see also hyperthyroidism haemoglobin) 493
ones)  487–8​ gravitational eczema  619–2​ 2 units equivalence
glomerular filtration rate
table 494
(GFR)  181–​3 health coaching  14
calculation of  182
estimation in liver

disease 178

37 1

INDEX 713

how it works  14–1​ 5 herbal drugs  144–​5 honey wound dressings  618
indications for 16 Chinese herbal hops
value of  15 medicine 150
heart failure  328–​9 clinical trials  154 drug interactions  152
acute management  333–4​ drug interactions  151–2​ perioperative
classification of  328 efficacy 145
drug treatments  329–​32 evidence sources  155 considerations 153
general information  147–​9 hormonal contraception
aldosterone receptor legislation  144–​5
antagonists 331 patient and public see contraception
perceptions 154 hormone replacement ther-
angiotensin-​ perioperative
converting enzyme considerations 153 apy (HRT), perioperative
inhibitors 331 pitfalls for pharmacists and considerations 225
technicians 154 horse chestnut  148
angiotensin II receptor quality  154–​5 drug interactions  152
antagonists 332 safety and adverse perioperative
effects 145, 146
beta-​blockers  330, 333 considerations 153
digoxin 332 herb–​disease hospital-a​ cquired
diuretics 330, 333 interactions 151
hydralazine 332 pneumonia 456
nitrates  332, 333–4​ HerbMed database  155 hospital formularies  245–6​
inotropes and hierarchy of
formulary
vasopressors 334 evidence  124–​5, 125 applications  246–8​
ivabradine 332 high-​risk infusion pumps
opiates 333 hospitality, acceptability
oxygen therapy  333 556 of  261, 271–​2
intravenous fluids  568 high-r​ isk medications  284–​7
non-d​ rug high-​risk patients  287 human insulins  489
history of presenting com- hyaluronidase, in
interventions 329
nutritional plaint (HPC)  41–​2, 100 extravasation of vinca
HIV (human immunodefi- alkaloids 549
requirements 576 hydralazine
heart transplantation  329 ciency virus)  472–8​ in heart failure  332
heavy-m​ etal contamination, diagnosis 472 in pre-e​ clampsia  512
promotion of hydrocolloid wound
Chinese herbs  150 dressings 617
Helicobacter pylor i 313 prevention 473 hydrofibre wound
stages following dressings 617
eradication therapy  316 hydrogel wound
Heliox 162 transmission 473 dressings 617
helium transmission 472 hydroxychloroquine, in rheu-
treatment  472–4​ matoid arthritis  599
clinical uses  158 hyoscine 308
cylinder data  162 adherence  476–​7 dose and
helium/o​ xygen/​nitrogen antiretroviral classes  475
drug interactions  477–​8 contraindications 309
mixture, cylinder effects 476 hypercalcaemia of
data 164 monitoring  475–6​
heparin patient counselling  478 malignancy  632–​3
in renal replacement as prevention  474 management  632–​3
resistance to 477 signs and symptoms  632
therapy 657 home IV therapy  592–6​ hyperemesis
reversal 360 assessment and discharge
safety issues  286 gravidarum  513–1​ 5
see also low-​molecular-​ planning  593–​4 antiemetic therapy  513
central line handling  593 corticosteroids 514
weight heparin; unfrac- community support  595 ginger 515
tionated heparin drug selection and intravenous fluids  514
hepatic blood flow, effect on lifestyle advice  513
drug clearance  175 administration  594–​5 non-p​ harmacological
hepatic encephalopathy  174 follow-u​ p care  595
hepatitis, definition  172 homecare companies  596 treatment 515
hepatocellular injury, home IV therapy pyridoxine 514
definition 172 thiamine
hepatorenal syndrome team 592
(HRS)  174, 179–8​ 0 IV access  592–3​ supplementation 514
management  179–8​ 0 outcome measures  596 hyperglycaemia, in enteral
treatment regimen  179 pharmacist’s role  596
hepatotoxicity  172–4​ hom(He OOO2 oFr)d e1r69form nutrition 588
agomelatine 420 hyperkalaemia, treatment
herbal medicines  146
concentrated
products 564

K+-​containing IV
fluids 565

174

714 INDEX

hyperkalaemia, treatment calcium solutions  566 incretin mimetics  488
(contd.) dilution of calcium independent prescribing  257
risk minimization  564 infants  see children
risks of IV solutions 566 infected wounds  614–1​ 5
potassium 564 emergency
safety measures for IV dressings 618
potassium 564 management 567 infection control  469–7​ 1
training non-p​ harmacological  566
development 564 hypochromic anaemia  639 hand hygiene  470
hypoglycaemia, definition in isolation procedures  470
hypermagnesaemia children 694 pharmacist’s role  471
causes 560 hypoglycaemic drugs  485–8​ universal
interactions with herbal
complications 560 precautions  469–7​ 1
monitoring 560 medicines 152 inflammatory
treatment 560 hypokalaemia
hyperphosphataemia agents  534, 547–9​
causes 563 infliximab 601
causes 562 complications 563
complications 562 in hyperemesis in psoriasis  628
monitoring 562 information
treatment 562 gravidarum 514
hyperprolactinaemia, treatment 563 provision  8–​10, 10
hypomagnesaemia on ADR risk  21
antipsychotic-​ see also patient information
induced 425 causes 559
hypersensitivity complications 559 leaflets
drug desensitization  664–​5 monitoring 559 information sources
see also allergies treatment 559
hypertension  335–​9 hypomania 430 poisons information
classification 335 treatment 430 centres 662
in pregnancy  511 hyponatraemia
diagnosis 335 drug-​induced  418–1​ 9 useful websites  695
drug treatment  336 in hyperemesis information transfer  277
ACE inhibitors and infusions
gravidarum 514
ARBs  336–​8 hypophosphataemia flow rate calculations  238
beta-​blockers  338 pharmaceutical
calcium-c​ hannel causes 561
complications 561 calculations 237
blockers 338 monitoring 562 inhaled corticosteroids
diuretics 338 treatment 561
guidelines 337 hypothyroidism  501–2​ in asthma  375, 376
non-d​ rug clinical features  502 BDP equivalence
diagnosis 496, 497
interventions 336 myxoedema coma  503 ratios 375
pre-e​ clampsia  511–1​ 2 treatment  502–3​ in COPD  392–3​
resistant 339 hypoxia, oxygen spacer use  383
target blood pressure  339 inhalers  380–9​
hyperthyroidism  498–5​ 01 therapy  165–6​ Accuhaler® 387
clinical features  498 Easibreathe 386
diagnosis 496, 497 I education on
pharmaceutical
ibandronic acid, in use  380–1​ , 383–​4
management hypercalcaemia of effects of incorrect
adverse effects  500 malignancy  632–3​
antithyroid use 381
identity checks, hospital HandiHaler® 388
drugs  499–​501 inpatients 38 pMDIs 385
beta-​blockers  500
radioactive iodine ileostomies  see stoma use with a spacer  386
patients prescription
therapy 500
subclinical 501 illegal drugs, pharmacist endorsement 50
surgery 500 handling of  220 problems with use  381–​2
hypocalcaemia spacers  382–3​ , 386
causes 566 immunosuppressants Turbohaler® 389
complications 566 in asthma  379 use in COPD  393
monitoring 567 drug interactions with injecting drug users  see drug
treatment herbal medicines  151
misusers
in asymptomatic impila root  146 inotropes  653–​4
patients 567 implantable cardiac
in acute heart failure  334
defibrillators 329 INR  see international
implanted IV pumps  558
incident reporting  260 normalized ratio
insomnia, palliative care

patients 635
instalment prescriptions,

opioid-r​ eplacement
therapy 223

57 1

INDEX 715

insulins 489 lower-​risk infusion frequency of
metabolism in renal pumps  556–​7 administration 529
impairment 181
prescription neonatal infusion iris 673
endorsement 50 pumps 556 iron
safety issues  286
syringe pumps  557 dietary intake  640
integrase inhibitors  475 volumetric pumps  557–​8 plasma iron studies  641
interactive wound intravenous drug iron deficiency anaemia  640
administration iron therapy  640
dressings 616 home IV therapy ferrous iron con-
interface medicines
team 592 tent of different
management  277–​9 home therapy  592–​6 preparations 641
acute commissioning  278 irritant contact
antimicrobial assessment and discharge dermatitis  619–2​ 2
planning  593–4​ irritants  534, 547–​9
stewardship 278 isoniazid, drug
formularies  277–​8 central line handling  593 interactions 480
seamless care  277 community support  595 ispaghula granules  305
service redesign  278 drug selection and ivabradine
shared care  278 in angina  325
waste reduction  279 administration  594–5​ in heart failure  332
interferon betas  440–​1 follow-u​ p care  595
intermittent mandatory homecare companies  596 J
IV access  592–​3
ventilation (IMV)  652 outcome measures  596 Jewish religion, dietary
international normalized pharmacist’s role  596 considerations 197
sodium content of
ratio (INR)  173 Jext® 29
normal range  691 drugs 680, 681 journals, critical assessment
monitoring, anticoagulation information sources  681
see also extravasation of papers  139–4​ 1
clinics 352 intravenous fluids  568–​73
targets 347 assessment and K
international private
monitoring 568 kaolin 302
patients 262 crystalloids 569 kaolin cephalin clotting time
interpersonal skills  89 in hepatorenal
intervention (KCCT) 341
syndrome  179–​80 kava rhizome  146
monitoring  62–​3 in hyperemesis
categories of pharmacist perioperative
gravidarum 514 considerations 153
interventions  62–​3 in resuscitation  569
significance defini- routine maintenance  568 keratitis
surgical patients  569–7​ 1 amoebic 677
tions of pharmacist intravenous infusions bacterial 676
interventions 63 burette sets  554 viral 677
intragastric feeding  586 calculating flow rates  554
intramuscular administration, cannula care  555 ketone monitoring, in
in children  205 cannula sizes  555 diabetes 492
intraocular pressure, changing administration
raised  see glaucoma ketones, blood levels,
intrathecal sets 554 monitoring in
chemotherapy 541 end-​of-n​ eedle diabetes  492–​3
contraindicated drugs  544
frequently asked reactions 28 kombucha 146
questions  541–​3 peripheral venous access Korsakoff ’s psychosis  659
points for nursing
staff  543 devices 555 L
points for pharmacists  543 rates 554
safe practice  541 intubation 651 L’Abbé plots  130
intrauterine system invasive ventilation  651 labetalol, in
(IUS) 508 investigational medicinal
intravenous pre-​eclampsia  512
administration pumps products (IMPs)  106 laboratory tests
ambulatory pumps  558 documentation and
disposable IV pumps  558 drug interference  666, 667
gravity controllers  557 records 113 normal ranges  691
high-​risk infusion labelling, packaging, and paediatric reference values

pumps 556 stability 112 biochemistry 692
implanted IV pumps  558 receipt of supplies  112 haematology 693
storage and handling  112 ranges and
irinotecan
drug interactions, with interpretation 684

herbal medicines  152

176

716 INDEX

lactate levels, normal paedi- in hypertension  336 in COPD  392, 393
atric values  693 in osteoporosis  607 long-t​erm oxygen therapy
in psoriasis  624
lactation  see breastfeeding limit setting, aggressive (LTOT)  167–8​
lactose intolerance  196–7​ in COPD  395–6​
lactulose syrup  304–​6, 305 patients 67 loop diuretics, in heart
lamotrigine lipid requirements,
failure 330
adverse effects  434 children  582–3​ loperamide 302
in bipolar disorder  433–4​ liquid medicines, waste
drug interactions  433 in stoma patients  319–2​ 0
lansoprazole  314–1​ 5 management 275 ‘loss leaders’  277–​8
lanthanum carbonate  562 liquid paraffin oil low-​adherent wound
laquinimod 445
larval (maggot) therapy  618 emulsion 305 dressings 617
latanoprost 674 liquorice root  146, 148 lower-​risk infusion
laxatives 305
in acute porphyria  201 perioperative pumps  556–7​
bulk-​forming  304 considerations 153 low-m​ olecular-w​ eight
in malignant bowel
lisinopril, secondary preven- heparin (LMWH)
obstruction 636 tion of CVD  362 in acute DVT  344–5​
osmotic  304–6​ with fibrinolysis  360
in palliative care listening skills  87, 89 thromboprophy-
lithium 431
patients 631 laxis  342, 343–4​
stimulant 306 adverse effects  432 lubricant laxatives  305
in stoma patients  319 drug assays  667
leflunomide, in rheumatoid drug interactions  432 M
perioperative
arthritis 599 macrocytic anaemia  639
legislation considerations 226 macrogols
therapeutic drug
of herbal drugs  144–5​ sachets  304–​6, 305
responsible monitoring 431, 671 macrolides, mode of
toxicity  432–4​
pharmacists 265 liver disease  172–​4 action 451
lens (of the eye)  673 alcohol withdrawal  659 macronutrient
leukotriene receptor analgesia 178
drug absorption  177–​8 requirements 575
antagonist 376 drug distribution  177–​8 maggot (larval) therapy  618
levels of care  644–6​ drug dosing  175–​8 magnesium imbalance
levodopa, bioavailability in factors affecting drug
hypermagnesaemia 560
older people  215 clearance hypomagnesaemia 559
levomepromazine 308 cholestasis  176–7​ magnesium levels
hepatic blood flow  175 normal range  559–6​ 0, 691
dose and hepatic cell mass  175
contraindications 309 portal systemic paediatric values  693
range and
levonorgestrel, emer- shunting 176
gency hormonal GFR estimation  178 interpretation 685
contraception 510 hepatorenal syndrome magnesium

levosimendan 334 (HRS)  179–8​ 0 requirements 576
levothyroxine treatment high-​ and low-h​ epatic-​ children 694
magnesium therapy  559
in hyperthyroidism  499 extraction drugs  176 in acute MI  360
in hypothyroidism  503 prescribing guidelines  177 in torsades de pointes  371
licensing of medicines pro-d​ rug malignant bowel
for children  207
see also unlicensed use metabolism  177–8​ obstruction 636
terminology 172 malnutrition 574
of drugs liver failure  174 malodourous wounds  615
lidocaine, in cardiac definition 172
intravenous fluids  568 dressings 617, 618
arrest 371 nutritional management plans  101–2​
life root  146 managing meetings  81
lifestyle interventions requirements 576 mania 430
liver function tests  178
in chemotherapy-​ treatment 430
induced nausea and interpretation 173 valproate  432–​3
vomiting 539 long(-L​aActBinAgs)β2 agonists
march blazing star  146
in COPD  391–2​ in asthma  376 mean cell volume
in gout  610 in COPD  392, 393
in heart failure  329 long-a​ cting muscarinic (MCV) 639
in hyperemesis paediatric values  693
antagonists (LAMAs) mean corpuscular haemo-
gravidarum 513 in asthma  377
globin concentration
(MCHC) 639

7 1

INDEX 717

mean differences  131, 132 Medicines Act, legislation of in renal impairment  181
mechanical herbal drugs  144–5​ metformin 486

ventilation  651–​2 Medicines and Healthcare perioperative
intubation 651 Products Regulatory considerations 228
invasive 651 Agency (MHRA)  107
non-​invasive  651 methadone, for cancer
ventilation modes  652 medicines pain 407
medical ethics  73–​4 committees  253–​4
medical gases methadone
air 158 Medicines Information prescription  220–1​
carbon dioxide  158, 163–4​ services  95–6​
cylinder data  161–4 discharge
cylinder identification specialist information prescriptions 223
centres 95
coding 160 methotrexate
cylinder types  164 medicines perioperative
Entonox®  158, 162 management  283–4​ considerations 226
helium  158, 162 in psoriasis  627
nitrous oxide  159, 162 drug protocols  249–​50 in rheumatoid arthritis  599
oxygen  159, 161–4 formularies  245–​8
guidelines for use  165–6​ interface issues  277–9​ methyldopa, in
physical properties  160 patient group directions pre-​eclampsia  512
valve types  164
medical gas flowmeters  160 (PGDs)  255–6​ methylnaltrexone, in opioid-​
medical hierarchy  39 pharmacy technician induced constipation  631
medical notes  41–​2
clerking  41–2​ role 280 methylxanthines
commonly used unlicensed use of in asthma  376
in COPD  392
abbreviations  43–​8 drugs  251–​2
writing in 59 in children  207 metoclopramide 308
medical representatives  261 waste management  273–​6 for chemotherapy-​
medication event monitoring medicines induced nausea and
optimization  242–​3 vomiting 536
systems (MEMs)  5 implementation as routine dose and
medication problem contraindications 309
practice 243 drug compatibilities  637
checklist  35–​6 medicines gut motility
PRIME problem types  36 stimulation 650
medication reviews reconciliation  57–8​
definition 60 medroxyprogesterone metoprolol
documentation 61 appetite stimulation  630 angina prevention  323
levels of  61 depot injection  508 secondary prevention of
in older people  217–1​ 8 meetings, CVD  361–​2
potential benefits  61
principles 60 management of  81 metronidazole, mode of
what they involve  60 megestrol, appetite action 452
who to target  61
medication stimulation 630 metronidazole gel, use on
meglitinides 487 wounds 616
safety  242, 283–4​ melaena  317–​18
error reporting  287 membrane type wound microcytic anaemia  639
high-r​ isk medications micromoles  233–4​
dressings 617 micro-​organisms
284–​7 Ménière’s disease, antiemetic
high-r​ isk patients  287 classification  448–9​
human factors  288 treatments 308 colonization 453
medication errors  284 meningitis 455 commensals 453
potential issues and meperidine (pethidine) examples of

risk-​reduction adverse effects  405 pathogens 450
strategies 285 drug interactions  225 Gram-s​ taining  449
see also adverse drug meta-​analyses, mean identification
reactions
Medication Safety Officers differences and culture  448–​9
(MSOs)  283–​9 standardized mean microscopy 448
Medicines (Retail Sale differences 131, 132 in vitro activity of
and Supply of Herbal metabolic disorders
Remedies) Order  144–​5 dietary considerations  197 antibacterials 698
glucose-​6-​phosphate midazolam

dehydrogenase drug compatibilities  637
deficiency  198–9​ drug interactions  225
porphyrias  200–​1 milk thistle  146, 149
metabolism drug interactions  152
in children  205–​6 millimoles  233–4​
CYP2D6 levels  269–​70 mirtazapine, adverse
drug interactions  24
in older people  215 effects 418, 420
miscarriage 188

178

718 INDEX

misoprostol 315 disease-m​ odifying National Patient
mistakes  see errors treatments  440–​5 Safety Association
mitomycin (NPSA)  283–​9
alemtuzumab  444–5​
dose calculation  529 dimethyl fumarate  442 National Poisons Information
frequency of fingolimod  442–​3 Service (NPIS)  662
glatiramer 441
administration 529 interferon betas  440–​1 nausea and vomiting
moclobemide, dietary natalizumab  443–4​ antiemetics 308
pre-​treatment causes 307
considerations 420 chemotherapy-​
Modification of Diet in screening 440 induced  531–​9
teriflunomide  441–​2 antiemetic
Renal Disease (MDRD) treatments under combinations  536–7​
equation 182, 183 antiemetic
modular supplements  587 investigation 445 prescribing  535–6​
molecular adsorbent relapse antiemetics for failure of
recirculating system control 538
(MARS) 180 management  438–9​ antiemetics in refractory
molecular weight  233–​4 symptoms 436 emesis 538
moles  233–​4 symptoms definitions 534
mometasone furoate, BDP emetic risk of
equivalence ratio  375 management 439 chemotherapy  532–​3
monitored dose systems mycobacteria  479–​81 non-p​ harmacological
(MDSs) 7 interventions 539
monoamine oxidase see also tuberculosis other causes to be
inhibitors (MAOIs) mycophenolate, in rheuma- considered 534
414 patient risk factors  536
adverse effects  417–1​ 8 toid arthritis  600 recommended IV
drug interactions, with myocardial infarction antiemetic doses
538
herbal medicines  152 (MI) 354 recommended oral
perioperative enzyme changes  355 antiemetic doses  537
NSTEMI 354, 363 effects of   307–1​ 1
considerations 226 hyperemesis
montelukast 376 antiplatelet drugs  364–5​ gravidarum  513–​14
morphine sulfate  405 antithrombin in malignant bowel
obstruction 636
for cancer pain  406–7​ therapy  364–5​ management  307–​8
spinal administration  407 glycoprotein IIb/I​ IIa postoperative  310–​11
drug compatibilities in risk factors for  307
inhibitors 365
syringe drivers  637 initial supportive necrotic wounds  614–1​ 5
epidural or intrathecal neonatal infusion
therapy  363–4​
use 405 long-t​ erm treatment  366 pumps 556
in NSTE-​ACS  364 revascularization 365 neonates  see children
use in older people  216 treatment of low-r​ isk neostigmine 652
in patient group
disease  365–6​ gut motility
directions 256 STEMI  356–​66 stimulation 650
in renal disease  405
in STEMI  357 immediate and neurokinin receptor
see also opioids early hospital antagonists 535
motility stimulants  650 management  356–​7
motion sickness  308 neuroleptic malignant
mouth care, palliative care IV beta-b​ lockers  360 syndrome (NMS)  426
pre-h​ ospital
patients 634 neuropathic
MRSA (meticillin-​resistant management 356 pain  398–​9, 411–​12
reperfusion
Staphylococcus in MS 439
aureus ) 467 therapy  357–​60 neurotoxicity, herbal
mucolytics 394 secondary
mucositis 634 medicines 146
mugwort 146 prevention  361–​3 neutral agents  534, 547–9​
multi-​drug resistant TB myxoedema  501–2​ neutropenic sepsis  457
479 myxoedema coma  503 ‘never events’  283–​9, 544
multiple sclerosis new drugs
(MS)  436–4​ 5 N
diagnosis 436 ADR reporting  22
Revised McDonald nalmefene 660 evaluation of  244–8​
nanomoles  233–​4
criteria  437–8​ nasal cannulae  168 STEPS acronym  244–​5
disease courses  438 natalizumab  443–4​
National Acute Porphyria

Service (NAPS)  200–​1
National Patient Safety

Alerting System
(NaPSAS)  283–9​

97 1

INDEX 719

WHO selection glycoprotein IIb/I​ IIa ofatumumab 445
criteria 245 inhibitors 365 ‘off label’ use of

NHS eligibility  262 initial supportive drugs  251–2​
nicorandil  324–5​ therapy  363–4​ in children  207
nifedipine olanzapine
long-t​ erm treatment  366 in delirium  647
angina prevention  324 revascularization 365 long-​acting
in pre-e​ clampsia  512 treatment of low-r​ isk
‘nil by mouth’ (NBM) formulation 427
drug administration  224 disease  365–6​ older people  214
medication review  225 noradrenaline
nitrates blood pressure
in acute angina  323 (norepinephrine) 653 targets 339
in acute MI  356 noradrenaline reuptake
in angina constipation 303
inhibitors 414 inhaler use  382
prevention  324–​5 norethisterone, depot medication
in heart failure  332
injection 508 reviews  217–1​ 8
acute normocytic anaemia  639 pharmacodynamics 216
management  333–4​ NO TEARS tool  218 pharmacokinetics  215–​16
nucleoside analogue reverse risk factors for
tolerance to 327
nitrogen requirements  576 transcriptase inhibitors medication-​related
(NRTIs) 475 problems  217–1​ 8
children 583 number needed to harm omalizumab  378–9​
nitrous oxide (NNH) 134 omega-3​ fatty acids, drug
number needed to treat interactions 152
clinical uses  159 (NNT)  127, 133–​4 omeprazole  314–1​ 5
cylinder data  162 calculation  133–4​ Ommaya reservoirs  542
nociceptive pain  398 nut allergy  196–​7 on call  97
noisy breathing, dying nutritional assessment  574 dealing with medical and
nutritional nursing staff  99
patients 634 requirements  575–​6 environmental
non-​adherence, causes  2–​4 in alcohol awareness 97
non-i​ nvasive ventilation prioritizing 97
withdrawal  659–​60 recording calls  98
651 basal metabolic rate skills development  98
non-​medical staff management and
calculation 575 delegation  97–​8
prescribing  257–9​ children supply options  98, 99
benefits 259 useful resources  98
clinical management fat-​soluble vitamins  585 oncology
trace elements  584 hypercalcaemia of
plans 258 water-​soluble malignancy 632
independent malignant bowel
vitamins 584 obstruction 636
prescribing 257 Harris–B​ enedict Medicines Information
supplementary service 95
equation 575 see also cancer pain;
prescribing  257–9​ macronutrients 575 cytotoxic drugs
non-n​ ucleoside analogue nutritional support  574 ondansetron 308
composition of contraindications 310
reverse transcriptase dosage 310
inhibitors (NNRTIs)  475 parenteral nutrition IV 538
drug interactions  477–​8 regimens  575–6​ oral 537
with herbal see also enteral feeding; QT prolongation  535
parenteral nutrition open-a​ ngle glaucoma  673–​4
medicines 152 open-l​ abel studies  109
non-​steroidal anti-​ O ophthalmology
eye structure  673
inflammatory drugs obsessive–​compulsive glaucoma 673
(NSAIDs) disorder (OCD)  435 angle-​closure  674–5​
in acute gout  610 open-​angle  673–​4
in acute pain  404–​5 obstructive sleep apnoea  336 ocular infections
adverse effects  405 ocrelizumab 445 acanthamoeba
peptic ulcer disease  313 octreotide 636
in chronic pain  411 odds ratios  127 keratitis 677
combination with
benefits over relative
opioids 407 risks 128
topical 405
non-​ST segment elevation comparison with relative
risks 127
myocardial infarction
(NSTEMI) 354, 363 formula for  128
antiplatelet drugs  364–​5 odour-a​ bsorbing wound
antithrombin
dressings 617
therapy  364–​5

270

720 INDEX

ophthalmology (contd.) Outpatient Parenteral management 412
bacterial keratitis  676 Antimicrobial Therapy nociceptive 398
conjunctivitis  675–6​ (OPAT)  592–​6 pain control
endophthalmitis 678 methods available  399
viral keratitis  677 assessment and discharge see also analgesia
planning  593–4​ pain intensity scales  400–​1
‘red flag’ symptoms  675–​6 pain relief scales  400–​1
opioid-i​ nduced central line handling  593 paliperidone, long-a​ cting
community support  595
constipation 306, 631 drug selection and formulation 427
opioid-i​nduced nausea and palliative care patients
administration  594–​5
vomiting 310 follow-​up care  595 anorexia and cachexia  630
opioid-r​ eplacement homecare companies  596 constipation 631
home IV therapy drug compatibilities  409
therapy  220–1​ end-o​ f-​life care  638
discharge team 592 fatigue 631
IV access  592–3​ hypercalcaemia of
prescriptions 223 outcome measures  596
opioids pharmacist’s role  596 malignancy  632–​3
overseas visitors  262 insomnia 635
in acute heart failure  333 Oxford chronic pain record malignant bowel
in acute pain  405
in cancer pain  406–7​ chart 402 obstruction 636
combination with oxygen mouth care  634
noisy breathing  634
NSAIDs 407 clinical uses  159, 165 spinal cord
equianalgesic doses  408 acute heart failure  333
safety issues  286 cardiac arrest  371 compression 635
spinal 407 COPD  395–6​ syringe drivers  637
waste management  276 NSTE-​ACS  363–4​ palonosetron, dosage
optic disc  673 respiratory failure
oral contraceptive pills  506 management  165–​6 IV 538
drug interactions  509–1​ 0 oral 537
cylinder data  161–4 pamidronate, in hypercalcae-
with herbal medicines  152 domiciliary therapy  167–​9 mia of malignancy  632–​3
missed pills  507 pancreatic juice,
oral glucose tolerance test ambulatory  168–​9 composition of  570
long-​term  167–​8 pantoprazole  314–1​ 5
(OGTT) 485 practicalities 169 PanOor2mal range  691
oral hypoglycaemics, short-​burst  169 range and
dosing in acute
perioperative interpretation 690
considerations 228 conditions 159 papers, critical assessment
oral presentation skills  90 long-t​ erm use  159
case presentations  100–​2 oxygen/​carbon dioxide of  139–4​ 1
oral rehydration paracetamol
solutions  301–2​ mixtures, cylinder
orbit 673 data 163 in acute pain  404–5​
oscillopsia, management oxygen delivery systems  159 in chronic pain  411
in MS 439 use in liver disease  178
osmolality 572 P overdose management  661
osmosis 572 parenteral nutrition  574
osmotic laxatives  304–​6 Pabrinex®, in alcohol addition of
osteoarthritis 606 withdrawal 660
osteomyelitis 457 medications 580
osteoporosis paclitaxel, frequency of cessation of  577
lifestyle interventions administration 529 in children  581–5​

607 PanCoOrm2 al range  691 nutritional
risk factors for  607 range and requirements  581–​3,
treatment interpretation 690 584–​5

bisphosphonates 608 pain composition of
calcium and acute, incidence of  403 regimens  575–6​
assessment of  400–​1
vitamin D  607–​8 Oxford chronic pain effects of specific
denosumab 609 record chart  402 conditions 576
raloxifene 609 chronic 410
strontium ranelate  608 management 411 initiation of  577
teriparatide 609 UK statistics  410–1​ 1 monitoring  577, 578,
otitis externa  455 definition  398–9​
otitis media  455 neuropathic  398–​9, 580, 585
outcome measures, critical 411–1​ 2 prescription of  579–​80
assessment of  140 re-i​ ntroduction of

diet 577

17 2

INDEX 721

storage on the ward  580 percutaneous coronary pharmacists, role of   34–​5
parkinsonism, antipsychotic-​ intervention (PCI)  357–9​ critical care  645, 646
home IV therapy  596
induced 425 perindopril, secondary pre- infection control  471
Parkinson’s disease, vention of CVD  362 patient group
directions  255–​6
perioperative perioperative medicine TB management  479–8​ 0
considerations 227 management  224–​8 therapeutic drug
paroxetine, discontinuation monitoring 669
syndrome 420 anticoagulants 227
parts per million (ppm)  231 dabigatran 227 pharmacodynamic drug
passion flower interactions 25
drug interactions  152 anti-P​ arkinson’s drugs  227
perioperative antiplatelet drugs  226–7​ pharmacodynamics
antipsychotics, anxiolytics, in children  206
considerations 153 in older people  216
past medical history and clozapine  227
beta-​blockers  226 pharmacogenetics  269–​70
(PMH)  41–2​ , 100 combined oral pharmacokinetic drug
patient-c​ entred care,
contraceptives 225 interactions
medicines corticosteroids 226 absorption 23
optimization  242–3​ diuretics 226 distribution 23
patient-​controlled analgesia, drug interactions  225 excretion 24
waste management  276 hormone replacement metabolism 24
patient education, inhaler pharmacokinetics
technique  380–1​ , 383–4​ therapy 225 in children  205–​6
patient etiquette  37–​9 lithium 226 in older people  215–1​ 6
patient group methotrexate 226 pharmacy procedures  266
directions (PGDs) monoamine oxidase pharmacy records  265
antimicrobials 256 pharmacy technicians
authorized health inhibitors 226
‘nil by mouth’ period  224 280
professionals 255 pharyngitis 455
controlled drugs  256 medication review  225 phases of clinical trials  108
definition 255 oral hypoglycaemics  228 phenobarbital, therapeutic
excluded products  256 tamoxifen 225
pharmacist’s role  255–​6 peripherally inserted central drug monitoring  671
patient information phenylketonuria 197
catheters (PICCs)  593 phenytoin
leaflets  11–1​ 3 peripheral venous access
content 12 administration with enteral
design and layout  13 devices 555 nutrition 590
patient preferences  12 cannula sizes  555
review and updating  13 for parenteral therapeutic drug
Patient Safety monitoring 671
nutrition  577–​9
Collaboration  283–9​ pernicious anaemia  641 phosphate, normal
pazopanib personalized asthma action range  561–2​

dosage 529 plans (PAAPs)  374–9​ phosphate binders  562
frequency of pethidine (meperidine) phosphate enemas  305
adverse effects  405 phosphate imbalance
administration 529 drug interactions  225
peanut allergies  32 P-g​ lycoprotein hyperphosphataemia 562
penicillamine 600 hypophosphataemia
penicillin allergy  32, 458 drug interactions  24
penicillins, mode of information on drug 561–2​
phosphate levels
action 451 metabolism 25
pennyroyal 146 pH normal range  691
peppermint 149 paediatric values  693
peptic ulcer disease normal range  691
range and range and
(PUD) 312 interpretation 686
bleeding  317–1​ 8 interpretation 690
pathology of ulcer pharmaceutical care  34–​6 phosphate
requirements 576
formation  312–​13 core elements
treatment pharmacists  34–5​ phosphate
risk factor supplementation 561
options  314–1​ 5, 316 identification 35
H. pylori eradication phosphodiesterase
pharmacist interventions inhibitors 654
therapy 316 categories of  62–​3
peptidoglycan 451 significance definitions  63 drug interactions  323
percentage strength  231 photodermatitis  619–2​ 2
pharmacist photosensitivity,
prescribing  257–9​
antipsychotic-i​ nduced
benefits 259 426
clinical management

plans 258

27

722 INDEX

phytomenadione concentrated prescribing, safety
(vitamin K), warfarin products 564 issues 285
reversal 350, 351
K+-​containing fluids  565 prescribing errors, risk
‘pill school’  212 risk minimization  564 management 64
environment 212 risks 564
equipment 212 safety prescription charges, in clini-
preparation 212 cal trials  113
process 213 measures 286, 564
training development  564 prescription endorsement
pilocarpine 675 potassium requirements  576 cytotoxic drugs  526
pimecrolimus topical  622 children 694 hospital and institutional
plasma iron studies  641 povidone iodine, use on drug charts  51
platelet levels dose endorsement  50–1​
wounds 616 drug chart review  49–5​ 0
normal range  691 prasugrel pharmacy annotation
range and section 51
in NSTE-A​ CS  364–5​
interpretation 688 in PCI  357–9​ prescription reviews  61
platelet response  340 secondary prevention of for antimicrobials  462
pneumonia
CVD 361 prescription screening  53–​6
community-​acquired  455 pre-e​ clampsia  511–1​ 2 care plans  55–​6
hospital-​acquired  456 cytotoxic drugs
poisoning incidents  661–3​ risk factors for  511–​12 annotations 527
first aid  663 treatment  511–1​ 2 clinical check  526
information required  662 pregnancy  188–9​ 1 second and subsequent
information sources and drug cycles 526
validation of details  524
poisons information characteristics 188 verification of cycle 1
centres  95, 662 drugs to be avoided  189 prescriptions 525
drugs with a good safety discharge prescriptions  56
TICTAC 661 drug history checking  55
TOXBASE® 662 record 189 first impressions  53–4​
polymeric feeds  586 folic acid supplements  642 prescribed drugs review  54
porphyrias  200–​1 general considerations  190 talking to patients  55
drug treatments in acute handling cytotoxic
presentations 90
porphyria 201 drugs 522 presenting complaint
Medicines Information in HIV infection  474
hyperemesis (PC) 100
services 95 pressure support ventilation
Port-A​ -C​ ath® device  593 gravidarum  513–​15
portal hypertension  174 antiemetic therapy  513 (PSV) 652
portal systemic shunting corticosteroids 514 pressurized metered-​dose
ginger 515
176 intravenous fluids  514 inhalers (pMDIs)  385
portfolios  103–4​ lifestyle advice  513 common problems with
non-​pharmacological
ideas for evidence  103 use  381–​2
organization of   103–​4 treatment 515 use with a spacer  386
positive end-​expiratory pyridoxine 514 see also inhalers
thiamine primary progressive MS
pressure (PEEP)  652
posterior segment of the supplementation 514 438
hypertension PRIME problem types  35–6​
eye 673 prioritizing  91–​2
postoperative fluid classification 511
maternal on call requests  97
considerations  570–​1 privacy, hospital
postoperative nau- considerations  190–​1
Medicines Information inpatients 38
sea and vomiting private patients  263
(PONV)  310–1​ 1 services 95 probenecid 611
antiemetics 308 occupational exposure prochlorperazine 308
post-​pyloric feeding  586
potassium imbalance  see to teratogens dose and
hyperkalaemia; 191, 522 contraindications 310
hypokalaemia pre-​eclampsia  511–​12
potassium levels treatment  511–​12 progestogen-o​ nly pill
normal range  691 and radioactive iodine (POP) 506
paediatric values  693 therapy 501
range and TB treatment  480–1​ drug interactions  509–1​ 0
and teriflunomide  441–​2 missed pills  507
interpretation 684 timing of drug risk of venous
potassium permanganate, in exposure  189–​90
premature infants thromboembolism 509
eczema 622 see children progressive–​
potassium replacement  563
relapsing MS 438

37 2

INDEX 723

project planning  93–​4 tazarotene 626 ratio 230
prokinetics 314 topical ratio strengths  231
record keeping  see
in upper GI bleeding  318 corticosteroids 625
promethazine 308 ultraviolet A radiation documentation
rectal absorption,
dose and and psoralen (PUVA)
contraindications 310 therapy  626–7​ children 205
ultraviolet B (UVB) re-f​ eeding
proof of concept radiation 626
studies 108 vitamin D and its syndrome 576, 588
analogues 626 refusal of medication,
proportion 230 treatment options  623
propranolol, secondary pre- Psoriasis Area and Severity children  210–​11
Index (PASI)  624 regional anaesthesia  405
vention of CVD  361–​2 psoriatic arthritis  605 relapsing–​remitting MS
propylthiouracil  499–5​ 01 biologic therapies  601–2​
psychiatry, Medicines 438
adverse effects  500 Information services  95 relative risks (risk
prostaglandin analogues, psychosis
causes  422–9​ ratios) 127
in glaucoma  674 see also schizophrenia comparison with odds
protease inhibitors  475 pulmonary embolism
(PE)  342–​4 ratios 127
drug interactions  477–​8 see also venous thrombo- formula for  128
with herbal medicines  152 embolism (VTE) relatives as patients,
pupil 673
protein, plasma levels PUVA treatment  626–7​ confidentiality 83
normal paediatric cautions 627 religious dietary
values 693 pyrethrum 146
range and pyridoxine considerations 197
interpretation 688 in chronic pain  411 renal function
in hyperemesis
protein binding gravidarum 514 assessment  181–​3
and breastfeeding  193 renal impairment  181–​7
as cause of drug Q
interactions 23 distribution of drugs  181
in children  205 QT interval prolongation dose adjustments  183–​5
and liver disease  172, antidepressants 420
174, 177 antiemetics 535 drugs requiring dose
in older people  215 reduction 185
and renal impairment  181 questioning 88
thyroid hormones  496 quinolones, mode of excretion of drugs  181
ideal drug attributes
prothrombin complex con- action 452
centrate (PCC), warfarin 184
reversal 350, 351 R LMWH therapy

prothrombin time rabeprazole  314–1​ 5 monitoring 345
(PT) 173, 341 radioactive iodine Medicines Information

range and therapy 500 services 95
interpretation 688 radioactive waste metabolism of drugs  181
nutritional
proton-​pump management 275
inhibitors  314–1​ 5 raloxifene 609 requirements 576
ramipril, secondary preven- in older people  216
H. pylori eradication opioid use  405, 408
therapy 316 tion of CVD  325–6​ , 362 stages of chronic kidney
randomized clinical
in stoma patients  319–2​ 0 disease 184
stress ulcer trials 109 renal replacement therapies
assessment of  136–​7
prophylaxis 649 codes for  113 (RRTs)  185–​7
in upper GI critical assessment of  140 anticoagulants  656–​7
ranitidine, adverse buffer  655–6​
bleeding  317–1​ 8 clotting cascade
psoralen therapy  626–​7 effects 649
psoriasis  623–​8 ranolazine  324–​5 activation 657
rapid-s​ equence drug dosing  186–​7
lifestyle interventions  624 drug removal  186
severity assessment  624 induction 651 haemodiafiltration 655
treatment haemodialysis 655, 656
haemofiltration 655, 656
acitretin 627 terminology 655
ciclosporin 627 theoretical GFR  186
coal tar  624 renal toxicity
cytokine modulators  628 herbal medicines  146
dithranol 625 in older people  216
emollients 624 repacked medicines  251–​2
methotrexate 627 reperfusion therapy,
salicylic acid  625
STEMI  357–6​ 0

274

724 INDEX

report writing  77–​80 cautions  598–6​ 04 sclera 673
aim of  77 disease-​modifying anti-​ seamless care  277
bullet points and seborrhoeic eczema  619–​22
numbering 79 rheumatic drugs secondary
charts and tables  79 (DMARDs) 598, progressive MS 438
content 77 599–6​ 00 sedatives
editing checklist  80 symptomatic relief  598 in acute porphyria  201
fonts 79 rifampicin safety issues  286
language 80 drug interac- selective serotonin
layout 78 tions  480, 509–1​ 0 reuptake inhibitors
paragraphs 79 mode of action  452 (SSRIs) 413, 414
revision and editing  80 risedronate 608 adverse effects  416
structure 78 ‘Risk-​adapted approaches to serotonin syndrome  415
Clinical Trials’  107 in bipolar disorder  434
research 293 risk communication, adverse discontinuation
see also clinical trials drug reactions  21 syndrome 419
risk factors  36 in neuropathic pain  412
Research & Development areas of  35 in obsessive–​compulsive
Approval, clinical risk levels, EU disorder 435
trials 107 terminology 21 senna 305
risk ratios (relative sepsis 457
research design  295 risks) 127 septic arthritis  456
research proposals  294–​6 comparison with odds seroconversion, HIV  473
research questions  295 ratios 127 serotonin and noradrenaline
residency 97 formula for  128 reuptake inhibitors
risperidone, long-a​ cting (SNRIs) 414
dealing with medical and formulation 427 adverse effects  416
nursing staff  99 rituximab 602 serotonin syndrome  415
rivaroxaban 353 discontinuation
environmental perioperative syndrome 419
awareness 97 considerations 227 serotonin syndrome  415
secondary prevention of service redesign  278
prioritizing 97 CVD 363 sevelamer 562
recording calls  98 rubefacients 405 sexual dysfunction,
skills development  98 antipsychotic-​
staff management and S induced 426
SGLT2 (sodium-g​ lucose co-​
delegation  97–8​ safety evaluation, new transporter 2) inhibitors
supply options  98, 99 drugs 244 (gliflozins) 488
useful resources  98 shared care  278
resistant hypertension  339 safe use of sharps bins, colour
respiratory failure, oxygen medicines  242, 283–4​ coding  273–4​
short-​acting β2 agonists
therapy  165–​6 error reporting  287 (SABAs)
respiratory rate, high-r​ isk adverse effects  392
in asthma  374–5​
children 694 medications  284–7​ in COPD  391–​2
responsible pharmacists  264 high-​risk patients  287 short-​acting mus-
human factors  288 carinic antagonists
community medication errors  284 (SAMAs) 392, 393
pharmacists 264 potential issues and short-​burst oxygen therapy
(SBOT) 169
condition for absence  265 risk-r​ eduction side effects  see adverse drug
hospital strategies 285 reactions
see also adverse drug sildenafil, drug
pharmacists  264–5​ reactions interactions 323
legal requirements  265 salicylic acid, in psoriasis  625 silver, use on wounds  616
maintenance of pharmacy saliva, composition of  570 simplicity of use, new
sasafras 146 drugs 245
procedures 266 saw palmetto  149 single-​blind studies  109
resuscitation drug interactions  152 sinusitis 455
perioperative siponimod 445
intravenous fluids  569 considerations 153
see also cardiopulmonary schizophrenia  422–​4
symptoms and
resuscitation, diagnosis  422–3​
reteplase  359–​60 see also antipsychotics
reticulocyte count, paediatric

values 693
retina 673
revascularization therapy

in NSTE-A​ CS  365
in STEMI  357–6​ 0
rheumatoid arthritis

(RA)  598–6​ 04
biologic therapies

598–6​ 04

57 2

INDEX 725

skin, functions of   614–1​ 8 standard deviation, and con- sucralfate 315
skin conditions  see eczema; fidence intervals  135 sugar paste wound

psoriasis; wounds standardized mean dressings 618
skin infections  456 differences 131 suicide, risk in bipolar
skullcap 146
sleep disturbance, palliative standards of business disorder 433
conduct  271–​2 sulfasalazine, in rheumatoid
care patients  635
sloughy wounds  614–​15 star fruit  146 arthritis 599
statins sulfinpyrazone 611
chlorinated desloughing sulfonamides, mode of
agents 617 drug interactions  325–​6
secondary prevention of action  451–2​
dressings 617, 618 sulfonylureas 487
‘slow metabolizers’  269–​70 CVD  325–6​ , 362–3​ sunitinib, dosage  529
‘SMART’ principles, research statistical versus clinical supplementary

proposals  294–​6 significance 126 prescribing  257–​9
smoking cessation STEPS acronym, new drug benefits 259
clinical management
and clozapine  429 evaluation  244–5​
in COPD  391–2​ sterculia 305 plans 258
social history stevia 146 surface area
stimulant laxatives  305, 306
(SH)  41–​2, 101 St John’s wort  145, 146, approximation from
sodium bicarbonate, in weight 209
149, 419–2​ 1
cardiac arrest  371 drug interactions  152, calculation of  208–9​ ,
sodium content of 525, 528–​30
421, 509–​10
drugs 680 perioperative surgery
intravenous antimicrobial
considerations 153 prophylaxis 460
medicines 680, 681 stoma patients  319–​20 fluid management  569–​71
information sources  681 see also perioperative
oral medicines  680 bowel preparation  320 management
sodium levels constipation
normal range  691 Synacthen® test  667
paediatric values  693 management 319 synchronous intermittent
range and high output
mandatory ventilation
interpretation 684 management  319–2​ 0 (SIMV) 652
see also hyponatraemia medication choice  320 synergistic drug
sodium requirements  576 stomatitis 634 interactions 25
children 694 stool-s​ oftening syringe infusion pumps  557
sodium valproate  see drug
agents 305, 306
valproate streptokinase 360 compatibilities 409, 637
soft tissue infections  456 stress ulcers  648–​9 systematic reviews, critical
sore mouth, palliative care
pathophysiology 648 appraisal of  138
patients 634 prophylaxis 649 systemic anticancer treat-
soy 146, 149
spacers  382–3​ , 386 therapeutic aims  648 ment (SACT)  see
unwanted effects  649 cytotoxic drugs
care and hygiene  383 risk factors for  648 systems review (S/​R)  41–2​
spasticity, management strontium ranelate  608
ST-​segment elevation MI T
in MS 439 (STEMI)  354, 356–6​ 6
‘specials’  251–2​ immediate and early hospi- tablet identification,
spectrum of antimicrobial TICTAC 661
tal management  356–​7
activity  454–7​ , 698 IV beta-b​ lockers  360 tablet swallowing, ‘pill
spillages, cytotoxic drugs  521 pre-​hospital school’  212–1​ 3
spinal cord compression
management 356 tacrolimus
635 reperfusion therapeutic drug
spinal opioids  407 monitoring 671
spironolactone therapy  357–​60 topical 622
fibrinolysis  359–6​ 0
in heart failure  331 patient selection  357 tadalafil, drug
in resistant percutaneous coronary interactions 323

hypertension 339 intervention  357–9​ tamoxifen, perioperative
secondary prevention of secondary prevention considerations 225

CVD 362 antiplatelet drugs  361 tansy 146
sponsors, clinical beta-b​ lockers  361–​2 tardive dyskinesia
submissive behaviour  84–5​
trials  110–1​ 1 succinylcholine (sux- (TD), antipsychotic-​
SSRIs  see selective serotonin amethonium), drug induced 425
interactions 225
reuptake inhibitors

276

726 INDEX

targeted drugs  270 thyroid disorders  496 topical corticosteroids
tazarotene 626 hyperthyroidism  498–​501 in eczema  620–1​
technicians 280 hypothyroidism  501–​3 in psoriasis  625
teicoplanin, therapeutic drug
thyroidectomy 500 torsades de pointes  371
monitoring 672 thyroid function total body water, changes
tenecteplase 360
teratogens  188–9​ 1 tests 496, 497 with age  205
influences of drugs  497 total protein levels
occupational reference ranges  497
exposure 191 thyroid hormones  495–5​ 03 normal range  691
regulation of  495–​6 paediatric values  693
teriflunomide  441–​2 replacement
teriparatide 609 range and
terlipressin, in hepatorenal therapy  502–3​ interpretation 688
transport of  496
syndrome 179 thyroiditis 501 TOXBASE® 662
tetracyclines, mode of thyroid stimulating hormone toxicology, Medicines

action 451 (TSH)  495–6​ Information services  95
theophylline reference range  497 trace element requirements,
thyroid storm  498, 501
in asthma  376 thyrotoxicosis  498–​501 children 584
in COPD  392 see also hyperthyroidism trandolapril, secondary pre-
drug interactions, with thyrotrophin-​releasing hor-
vention of CVD  362
herbal medicines  152 mone (TRH)  495–​6 tranexamic acid, in upper GI
therapeutic drug thryerfoexreinnece(Tr4a)n  g4e9 54–95​ 703
bleeding  317–1​ 8
monitoring 671 see also thyroid func- tranquilisers, in acute
therapeutic drug monitoring tion tests; thyroid
hormones porphyria 201
(TDM) 5 transdermal patches,
antimicrobials 672 ticagrelor
carbamazepine 670 in NSTE-​ACS  364–5​ contraceptive 506
ciclosporin 670 in PCI  357–9​ drug interactions  509–1​ 0
digoxin 670 secondary prevention of risk of venous
indications for  669 CVD 361
lithium 431, 671 thromboembolism 509
patient/d​ rug TICTAC 661 transjugular intrahepatic
time management  91–​2
characteristics  668–9​ timolol, secondary preven- portosystemic shunts
pharmacist’s role  669 (TIPS) 180
phenobarbital 671 tion of CVD  361–​2 trastuzumab
phenytoin 671 tinzaparin, in acute dose calculation  529
sample collection  668 response to  269–​70
tacrolimus 671 DVT  344–​5 treatment reviews  61
theophylline/​ tiotropium 377 tricyclic antidepressants
tirofiban (TCAs) 414
aminophylline 671 adverse effects  416–​17
thiamine deficiency, in alco- in NSTE-A​ CS  365 in chronic pain  411
in PCI  358–​9 discontinuation
hol dependence  659 TNF-α inhibitors  601–2​
thiamine supplementation cautions  598–6​ 04 syndrome 419
tobramycin, therapeutic drug in neuropathic pain  412
in alcohol overdose risk  420
withdrawal  660–​59 monitoring 672 tri-​iodothyronine
tocilizumab 603 re(fTer3)e  n4c9e5r–a5​ n0g3e  497
in hyperemesis tolbutamide, perioperative see also thyroid func-
gravidarum 514
considerations 228 tion tests; thyroid
thiazide diuretics tolerability evaluation, new hormones
in heart failure  330 trimethoprim, mode of
in hypertension  337, drugs 245 action  451–2​
338, 339 tonicity 572 Trip database  155
tonsillitis 455 troponin 354, 355
thiazolidinediones topical administration, in Trust Management
(glitazones)  487–​8 Approval, clinical
children 205 trials 107
threatening behaviour topical agents, fingertip tube feeding  see enteral
66–​7 feeding
units 621 tuberculosis (TB)  479–8​ 1
limit setting  67 in children  621 pharmacist’s role  479–​80
thrombin time  341 topical analgesia  405 treatment  479–8​ 1
topical antimicrobials  616 adherence 480
normal range  691 topical calcineurin adverse effects  480
range and
inhibitors 622
interpretation 688
thrombolysis  see fibrinolysis
thrombophilia

screening  344–​5

7 2

INDEX 727

dose adjustments  480 uricosurics 611 vesicants  534, 547–9​
drug interactions  480 uridine 5’-d​ iphospho-​ vinca alkaloids  544
pregnancy and extravasation
glucuronosyltransferase management 549, 552
breastfeeding  480–1​ (UGT), drug violent patients  66–7​
Turbohaler® inhaler  389 interactions 24 limit setting  67
type 1 diabetes  484–9​ urinary output, children  694 viruses, gene transfer
urinary tract infections  456 vectors  267–8​
see also diabetes mellitus urine testing visual analogue scales
type 2 diabetes  484–9​ in diabetes  492 (VASs), pain
drug–​laboratory assessment  400–1​
risk factors for  484 vitamin D
see also diabetes mellitus interference 667 metabolism in renal
type A reactions  19 ustekinumab 628 impairment 181
type B reactions  19 in psoriasis  626
type C (chronic/c​ ontinuing) V vitamin deficiencies
in enteral nutrition  588
reactions 19 vaccines, egg allergy  196–7​ vitamin DB12 641
type D (delayed) vacuum-​assisted wound clo- vitamin
supplements  607–8​
reactions 19 sure (VAC therapy)  618 vitamin K antagonists,
type E (end-o​ f-u​ se) vaginal ring perioperative
considerations 227
reactions 19 contraceptive 508 vitamin requirements,
drug interactions  509–1​ 0 children 584, 585
U risk of venous volumetric infusion
pumps  557–8​
UK Teratology Information thromboembolism 509 vomiting  see nausea and
Service (UKTIS)  188–​91 valerian 146, 149 vomiting

ulipristal, emergency hormo- drug interactions  152 W
nal contraception  510 perioperative
walking problems, manage-
ultraviolet A radiation considerations 153 ment in MS  439
and psoralen (PUVA) valproate
therapy  626–7​ warfarin
adverse effects  433 in acute DVT  345
cautions 627 drug interactions  433 administration with enteral
ultraviolet B (UVB) radiation, in mania  432–3​ nutrition 590, 591
vancomycin, therapeutic alternative oral
psoriasis treatment  626 anticoagulants 353
cautions 627 drug monitoring  672 anticoagulation clinics
unfractionated Vancouver style 352
heparin (UFH) counselling patients  348–​9
in acute DVT  345 references  297–​8 influencing factors  347
with fibrinolysis  360 vasoactive agents  653–​4 INR targets and durations
in NSTE-​ACS  364–​5 of therapy  347
in PCI  358 adrenaline 653 interactions with herbal
thromboprophy- dobutamine 654 medicines 147, 152
dopamine 654 loading dose  346
laxis  342, 343–4​ dopexamine 654 maintenance dose  346
unlicensed use of noradrenaline monitoring
therapy  346–​7, 349
drugs  251–2​ (norepinephrine) 653 perioperative
in children  207 phosphodiesterase considerations 227
unstable angina  354, 363
antiplatelet drugs  364–​5 inhibitors 654 warfarin reversal
antithrombin vasopressors  653–​4 in absence of bleeding
351
therapy  364–​5 in acute heart failure  334 in major bleeding  350
glycoprotein IIb/​IIIa venlafaxine, discontinuation in minor bleeding  350–1​
in over-​anticoagulation
inhibitors 365 syndrome 420 350
initial supportive venous thromboembolism
waste generated  274
therapy  363–4​ (VTE)  342–​4
long-​term treatment  366 mechanical
revascularization 365
treatment of low-r​ isk prophylaxis 343
pharmacological
disease  365–6​
upper GI bleeding  317–1​ 8 prophylaxis  342, 343–4​
urea breath test  313 risk factors for  343
urea levels risk from hormonal

normal range  691 contraception 509
paediatric values  693 ventilatory failure, oxygen

range and therapy 166
interpretation 686 ventricular fibrillation  370
verapamil, angina

prevention 324

278

728 INDEX

waste management  273–​6 WHO analgesic ladder  406 use of topical
carriage of waste  274 WHO criteria for drug antimicrobials 616
controlled
drugs  121, 275–6​ selection 245 writing in medical notes  59
cytotoxic drugs  521 wormwood oil  146
handling within the wound care agents X
pharmacy  274–​5
home IV therapy  595 chlorinated desloughing xanthine oxidase
liquid medicines  275 agents 617 inhibitors 611
policies  273–​4
radioactive waste  275 larval (maggot) Y
transfer to a waste therapy 618
carrier 275 yarrow 146
sugar paste and honey Yellow Card Scheme  22, 288
waste reduction  279 dressings 618
water-​soluble vita- when to report  288–9​
vacuum-a​ ssisted wound
min requirements, closure (VAC Z
children 584 therapy) 618
weight loss  574 zafirlukast 376
Wernicke’s wound care plans  615 zinc levels
encephalopathy 659 wound dressings
wet wraps  622 normal range  691
white cell count ideal properties  616 range and
normal range  691 interactive 616
paediatric values  693 selection of  615–​16 interpretation 685
range and types of  617 zoledronic acid
wound healing, influencing
interpretation 687 in hypercalcaemia of
factors 614 malignancy  632–​3
wounds
in osteoporosis  608
classification of  614–​15
cleaning 614
dressing changes  615

Common haematology values

Haemoglobin men 130–180g/L
115–160g/L
women 76–96fL
150–400 x 109/L
Mean cell volume, MCV 4–11 x 109/L
40–75%
Platelets 20–45%
1–6%
White cells (total)
7.35–7.45
neutrophils >10.6kPa (75–100mmHg)
4.7–6kPa (35–45mmHg)
lymphocytes ± 2mmol/L

eosinophils 135–145mmol/L
3.5–5mmol/L
Blood gases 70–150μmol/L
2.5–6.7mmol/L
pH >90

PaO2 3–17μmol/L
PaCO2 5–35IU/L
Base excess 5–35IU/L
30–150IU/L
U&Es (urea and electrolytes) (non-pregnant adults)
35–50g/L
Sodium 60–80g/L

Potassium <0.1micrograms/L
25–195IU/L
Creatinine 70–250IU/L

Urea <5mmol/L desired
0.5–1.9mmol/L
eGFR 0–180 Somogyi U/dL

LFTs (liver function tests)

Bilirubin

Alanine aminotransferase, ALT

Aspartate transaminase, AST

Alkaline phosphatase, ALP

Albumin
Protein (total)

Cardiac enzymes

Troponin T
Creatine kinase
Lactate dehydrogenase, LDH

Lipids and other biochemical values

Cholesterol
Triglycerides
Amylase

C-reactive protein, CRP <10mg/L
Calcium (total) 2.12–2.65mmol/L
Glucose, fasting 3.5–5.5mmol/L
Prostate-specific antigen, PSA 0–4ng/mL
T4 (total thyroxine) 70–140nanomol/L
Thyroid stimulating hormone, TSH 0.5–5.7mU/L

Biochemistry reference intervals <42mmol/ml (<6%)
42–47mmol/ml (6–6.4%)
HbAc1 ≥48mmol/ml (≥6.5%)
Normal
Pre-diabetes
Diabetes

Reproduced with permission from Longmore M, Wilkinson IB, Baldwin, A, and Wallin, E (2014).
Oxford Handbook of Clinical Medicine (9th edn). Oxford: Oxford University Press.

UKMI specialist centres

Specialist topic Centre Contact number
Drugs in pregnancy Regional Drug & Therapeutics 0191 282 4631
Centre, Newcastle Upon Tyne 0116 258 6491
Drugs in lactation UK Drugs in Lactation Advisory 029 2074 2251
Service (UKDILAS) 0207 351 8901
Complementary Welsh Medicines Information 0151 794 8206
medicine Service 0117 342 2867
Drugs in Royal Brompton and Harefield 029 2074 2251
cardiothoracics NHS Foundation Trust 0203 228 2317
Drugs in dentistry North West Medicines 0208 746 8398
Information Centre
Drugs in renal South West Medicines
impairment Information
Drugs in porphyria Welsh Medicines Information
Service
Drugs in psychiatry The Maudsley Hospital
Drugs in HIV Chelsea and Westminster NHS
Trust

UK National Poisons Information Service (NPIS)
NPIS is comprised of four individual units (Birmingham, Cardiff, Edinburgh,
and Newcastle) with a single national telephone number: 0844 892 0111.