Five percent of all accident and emergency admissions are caused by prescribed medicines. This figure rises to an alarming twelve percent in elderly patients. This may be through inappropriate use or dosage, side effects, drug:drug interactions, failing metabolism in the liver and reduced excretion by the kidneys. Also, erratic compliance with drug taking by a large proportion of patients complicates and sometimes worsens iatrogenic harm. This practical guide details the most common errors made in prescribing and is ideal for day-to-day use. The clear, accessible language used throughout makes for quick and easy reference. It clarifies complex scientific issues and presents them in a practical format, indispensable for professional life. It is highly recommended for all prescribers, clinical pharmacists, medical students and Foundation Year doctors. It is also a vital resource in the medication review now required for the Quality and Outcomes Framework for General Practitioners in England.
Contents: Treatment failure due to antacids. Grapefruit juice may cause toxic plasma concentrations of many common drugs. Warfarin. Amiodarone. All NSAIDs (including COX-2 inhibitors). A therapeutic minefield – spironolactone, ACEIs, NSAIDs (old and new) and all diuretics – drugs which disrupt the fine equilibrium of renal function. Sudden cardiac collapse caused by often-prescribed drugs causing QTc interval prolongation. Some important interactions between drugs at shared sites of action and/or therapeutic effect. Serious drug:drug interactions during liver metabolism. Alcohol use (and abuse) causes two serious, little-recognized prescribing pitfalls. Drug monitoring to avoid pitfalls – which drugs? Which tests? How frequently? Drug-induced lung disease, often missed in primary care. Facts the prescriber needs to know about patient non-compliance, and how to improve compliance. Avoiding pitfalls in prescribing for elderly patients. Clinical quizzes. Solutions.