Pocket prescriber 2014 PDF
Preview Pocket prescriber 2014
Coverflap.qxd 2/4/11 6:39 PM Page 1 Coverflap.qxd 2/4/11 6:39 PM Page 6 Pocket Prescriber 4 Pocket Prescriber 2014 is a concise, up to date prescribing guide. It 1 contains all the ‘must have’ information that junior doctors, nurse 0 Adult ALS (Advanced Life Support) cardiac arrest algorithm prescribers and medical students need at their fingertips. 2 Pocket European Resuscitation Council Guidelines 2010 NICE TIA Algorithm 2008 Key features Unresponsive? Suspected TIA • A–Z list of the 500 most commonly prescribed drugs with each entry Not breathing or only occasional gasps a••n TBdrSP ect oaamrntatms niAdeasnegprtei rtwmihnieet 3h nf0 tos0tll aomtwignisng: Yes Is histworiyth c oTmIAp?atible Yes syNmerepustrooolmlvoesgd if?cuallly No • cFoocnutaseinsi nogn tshaefe kteyy i spsrueessc,r iwbainrgn iinngfso,r dmruagti oenrrors and adverse effects Prescriber CRTeaealslumscitation • Lifestyle management No See stroke algorithm • Practical guidance on drug selection, plus protocols and guidelines CPR 30:2 Attach defibrillator/monitor Asvsaelsids aritsekd o sfc ostrrionkge s yusstienmg a alternaCtoivnesi ddeiargnosis • Advice and reference information for complicated prescriptions • Minimise interruptions such as ABCD2* • Concise management summaries for the common medical emergencies • Includes the European Resuscitation Council algorithms Specialist assewssimtheinn t1 a wndk investigation Specialist assewssimtheinnt 2 a4n hd investigation • Clinically useful reminders of basic pharmacology (e.g. receptor profiles) Assess Rhythm Shockable Non-shockable Best medical treatment (e.g. control of Best medical treatment (e.g. control of From reviews of the previous editions: (VF/Pulseless VT) (PEA/Asystole) BP, antiplatelet drugs and cholesterol ↓ BP, antiplatelet drugs and cholesterol ↓ through diet and drugs and smoking through diet and drugs and smoking ‘A pocket book that is truly pocketable, every medical student and junior cessation) cessation) Return of doctor should carry this book…If you’re unsure about prescribing a drug, a spontaneous circulation Where vascular territory or Yes Where vascular territory or Yes quick glance at the relevant page in this book will tell you everything you pathology uncertain pathology uncertain need to know…I really cannot recommend Pocket Prescriber highly enough.’ IMMEDIATE POST CARDIAC No Bwraiitnh iDmsyWamgIp*in*tog (m wp irotehnfiesner at1)b wlyk M oRfI No Ur2g4eM nhtR obI fwr aoiintnhs e iDmt WoagfI *isn*ygm ( wppritteohfmeinrsa) b ly Oxford Medical School Gazette 1 Shock A• RURseE SATB TCRDEEA aTpMpEroNaTch • Controlled oxygenation and ‘The simple precaution of checking facts in any unfamiliar prescribing ventilation • 12-lead ECG situation is likely to prevent mistakes and exemplifies current emphasis • Treat precipitating cause Carotid imaging if patient is candidate Carotid imaging if patient is candidate • Temperature control/therapeutic No for carotiodf isnytmerpvteonmti oonn sweitthin 1 wk Yes No for carotiodf isnytmerpvteonmti oonn sweitthin 1 wk Yes on safe practice and cPlrionfiecsasol rr Cis.Mk . mBlaacnka (Pgaesmt Perenstid.’e nt of the Royal College of Physicians) MImiCnPmimRe i3dz0eia: 2itne ftloeyr rr r2eu spmutmiinoens hypothermia MImiCnPmimRe i3dz0eia: 2itne ftloeyr rr r2eu spmutmiinoens No surgery Level of symptomatic No surgery Level of symptomatic carotid stenosis carotid stenosis ‘Do not rely on your memory when prescribing drugs – it is fallible. 4 70%–99%† <70%† 70%–99%† <70%† This neat vade mecum puts the information you need at your fingertips.’ DURING CPR R• EHVyEpRoSxIiBaLE CAUSES Carotiwd iethnidna 2rt werkesctomy No surgery Carotiwd iethnidna 2rt werkesctomy No surgery Professor R.M. Kirk (ex-member of the Royal College of Surgeons’ Council) 1 ••• EPGnliavsneu raoecx thyigoigenhns- qbuefaolirtey iCnPtRer: rruapteti,n dge CpPthR, recoil ••• HHHyyypppooov-t/hohelyarpememirakiaalaemia/metabolic • Consider advanced airway and capnography K23350 • Continuous chest compressions when advanced airway in place • Thrombosis – coronary or pulmonary • Vascular access (intravenous, intraosseous) • Tamponade – cardiac *†*acecxocredpitn wg htoe rteh eco Enutrroapinedainca Cteadro, tiind wSuhricghe rcya sTeri aClT ( EshSoCuT)ld c rbitee urisaed ISBN-13: 978-1-48229-0410301-00 0 •• GCoivrere acdt rreenvaelrisnibel e(e cpainuesepshrine) every 3–5 min •• TToenxisniosn pneumothorax Edited by Timothy RJ Nicholson 2 9 781482 241310 www.crcpress.com and Donald RJ Singer K23350_Cover_mech.indd 1,5 3/25/14 11:52 AM Coverflap.qxd 2/4/11 6:39 PM Page 3 Coverflap.qxd 2/4/11 6:39 PM Page 4 Coverflap.qxd 2/4/11 6:39 PM Page 5 Coverflap.qxd 2/4/11 6:39 PM Page 2 Adult BLS (Basic Life Support) algorithm for in-hospital cardiac arrest *12 34 5 6 AA...... tsCCIgrOmCcCcIw(bTwfftisehhuhhihhnr eepiwvoirsneeetrteeeesmsepeeuhoanhscphsccccs ontk t tp ekkkkiOpCa 3bpoAhrhn itnt anaoas02sfbofrax i Asd &in,dooetlagn Reyftr r lcvoplaoagi efrerweg s oheaRrbge rpettslfa erceoeynnlbteuahirto leoitnbam gyeyskrtcssuyhi tswCtccn c u roea e,i:ptoapi otiiu mh Pngcdsttn tllsounonaplviaclho R g Na saeum s(iddneo tLtuima ttatit:it onr3oi n ss reoal1oipoifsEvgaks/o 0e:ogpngnets mc iepniueesbiu:n:sn rri o2 ebriTirneSe&awrogpam t:boccneiou ypst ocnfe rful haaas f ip eekippormnfTniialenymceitoea spereneth gpfeogaee anet lrooaanga l pydrin d dpl asoarrbmrn oif r titsen&jrdaoitS(nocr)u ihraiimt gehveRar wlpgvnaiitcte aq loeneenr n oac cksartcauinussantol areahyhelbssuattert rCt t s)i rorsoiotme e,nsefltoeth etaocdp c s hsli1ailoliotsrlydevyuiatSa0elmf u/n n a.Hsntidctp0b lgctl ,ertad Ee–u(s riia1inpnitnneee1Lobnfi0asutdua Pnnr2rng s t soitt /si(0ueui ss&s n eheo&f/Cd ylismwg&.a cci npog)l naok.,ia : eiui fa.sgtcu Ctnts espcethrrhak aen t? feaaaek te nos*cflsnthmncsioaoui rin keibledr uprs.s ng c neGc c dcaaIrkdo efi tibabtltudr He pyicaictmloeonipO oaasiutd“ovn njitronoxoluAoeeh.dtaerddy rr*C nlrI tie ng yifoo aesias ns o ioteuctfv raulmeeRyh ln ensecm5 AasoaeseRast ur,e–re pm siu/ Icpnemlr 2om6tfsvotji e ols ear 0naaaee1ugoicsoa swfpln1 rst0mRsnsnlaut y p ea0c oeiYcriisA tst)fristop1io shr eth eogeoafBupyau0pmc spro phra Csot .&surariblciptmlnonDlisosyr ?iaorsrtdtptgr nE”eetiorw)ateb re,.*ean ol pt isTolieLa*atictevroehodo etti .oaaena sk oICbn.mt)c f k .Tet cPyOl n yoMee. Ri2n nowas(, escn mbsaeaotrrnaedrwasttihnhigsle AnapAhiyrDwla•••••i••• aa x W gyCHEHI i VAAL,asnshh yii t ngBncofeldfaaouedhlrdsnrlbue-rti/go tsopflieuasidhc los rkht–osoo rh huAri ceCwerllni •••hialotnnaaitnss rialho aoita selcgCLRralyeokmupxmtlw,iaan en en yslhAoCfliiadanki g elsnoynpfi( dtye gir5ef Relernigaicro aoe:nl4pqe uet lcr3cnAniaunl tseh aheiitiapuncarptieslw eritsnsiRmloo nnpcgfaenbeilteeyaatM•••’,l2ns asect aD ttlomtPEBne iiianouCslgodsovatnlG1s/nsioabo?oeid irlr Cl ao i:Bptobxyrrilu,eeme aEns:setxcuhtpirriloyne UsguKr e2008) NICE Stroke Algorithm 2008 Suspected stroke:• Exclude hypoglycaemia• Use the Face Arm Speech Test (FAST) to screen for diagnosis of stroke Negative screenPositive screen Consider alternative diagnosisEstablish diagnosis rapidly(stroke remains a possible diagnosis)using a validated tool e.g. ROSIER Indications for*No immediateimmediateindicationsscanningScan immediatelyScan as soonfor scanningAssessment for(ideally within the next slotas possiblebrain scanningor definitely within 1 h)(within 24 h) Admit to an acute strokeunit for specialist monitoringand treatment Screen patients on admission formalnutrition using a validated toolRoutine nutritional supplementation one.g. MUSTadmission is not recommended forScreen for assessment ofadequately nourished patientsswallowing before giving oralfoods, fluid or oral medication NoNoYesDoes screenIs the patient able toSpecialistFeedingindicate problemstake adequate nutritionassessmentstrategywith swallowing?and fluids orally? Initiate iv/NG tube feeding Early mobilisation ASAPfollowing an assessment IschaemicHaemorrhagicType of stroke Give aspirin 300 mgReverse anticoagulationunless contraindicatedif indicated Control:Control:• Maintain O levels only if O• Maintain O levels only if O 2222 drops below 95% drops below 95%• Blood sugar (4–11 mmol)• Blood sugar (4–11 mmol) NoSurgical referral for acuteIs surgical referral forBest medicalintracerebral haemorrhagedecompressive craniectomytreatmentindicated?** Yes• Small deep haemorrhagePreviously fit patient with:• Lobar haemorrhage without• haemorrhage with hydrocephalus or rapid neurological hydrocephalus orRefer within 24 deterioration• who is deterioratinghours of symptom• Large haemorrhage and significant neurologicallyonset prior comorbidities• GCS < 8 Consider surgicalDecompressive craniectomyinterventionwithin 48 hrs of symptomMedical treatmentonsetinitially Medical treatment prior to discharge:• Cholesterol lowering • BP control• Antiplatelet treatment • Dietary advice• Lifestyle advice*see page 206–207 **Indications for decompressive craniectomy:• Aged up to 60 years• Clinical deficits suggestive of infarction in the territory of the MCA with a score on the National Institute of Health Stroke Scale (NIHSS) of above 15• Decrease in the level of consciousness to a score of 1 or greater on item 1a of the NIHSS• Signs on CT of an infarct of at least 50% of the MCA territory with or without additional infarction in the territory of the anterior or posterior vertebral3 artery on the same side, or infarct volume greater than 143cm as shown on MRI with DWI trachea intubated give 10 breaths/min. ** Airway, Breathing, Circulation, Disability & Exposure K23350_Cover_mech.indd 6,10 3/25/14 11:52 AM Pocket Prescriber K17K224343_5C00.i0n0d.bin d 1d 1 033//3015//1143 85::0587 PPMM K23350.indb 2 3/31/14 8:08 PM Pocket 4 Prescriber 1 0 2 Edited by Timothy RJ Nicholson MBBS BSc MSc PhD MRCP MRCPsych Academic Clinical Lecturer, Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK Donald RJ Singer BMedBiol MD FRCP FBPharmacolS Professor of Clinical Pharmacology and Therapeutics, Fellowship of Postgraduate Medicine, London, UK Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business K23350.indb 3 3/31/14 8:08 PM CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2014 by Timothy RJ Nicholson and Donald RJ Singer CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20140305 International Standard Book Number-13: 978-1-4822-4134-1 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently veri- fied. The reader is strongly urge to consult the relevant national drug formulary and the drug companies’ printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and pub- lishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. 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Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Contributors vii Foreword ix Acknowledgements x How to use this book xi List of abbreviations xiii How to prescribe safely xxiii Common/useful drugs 1 Drug selection 169 Antibiotics 170 Hypertension management 180 Asthma 184 Analgesia 186 Palliative care and subcutaneous pumps 187 Antiemetics 190 Alcohol withdrawal 193 Antidepressants 195 How to prescribe 199 Insulin 200 Anticoagulants 205 Thrombolysis 213 Controlled drugs 218 Miscellaneous 219 Intravenous fluids 220 Steroids 223 Sedation/sleeping tablets 225 Benzodiazepines 227 Combined hormonal contraception 229 Side effect profiles 232 Cytochrome P450 235 K23350.indb 5 3/31/14 8:08 PM vvii Contents Medical emergencies 237 Acute coronary syndromes (ACS) 238 Acute LVF 241 Accelerated hypertension 242 Atrial fibrillation 243 Acute asthma 245 COPD exacerbation 246 Pulmonary embolism 246 Acute upper GI haemorrhage 247 Sepsis (severe or septic shock) 249 Epilepsy 250 DKA 251 HONK 253 ↓Glucose 254 Thyrotoxic crisis 254 Myxoedema coma 255 Addisonian crisis 255 Electrolyte disturbances 256 Overdoses 258 Reference information 265 Coma 266 Cognitive impairment 267 Useful formulae 268 Common laboratory reference values 269 Index 273 K23350.indb 6 3/31/14 8:08 PM Contributors Adam MC Archibald BSc(Hons) MBChB StR Obstetrics and Gynaecology, NHS Greater Glasgow and Clyde Peter J Barnes DM DSc FRCP FMedSci FRS Professor and Consultant in Respiratory Medicine, National Heart & Lung Institute, Imperial College London Alison Bedlow BSc MBBS FRCP DipRCPath Consultant Dermatologist, South Warwickshire NHS Foundation Trust Aodhan Breathnach MD FRCPath Consultant Medical Microbiologist, Department of Medical Microbiology St George’s Hospital, London Emma C Derrett-Smith BSc MBBS MRCP Clinical Research Fellow, Centre for Rheumatology and Connective Tissue Diseases, UCL Medical School, London Timothy WR Doulton BSc MD MRCP Consultant Nephrologist, Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust David Hall BSc(Hons) MBChB(Hons) Royal Air Force Medical Office H Nikki Hall MBChB BSc(Hons) Specialist Trainee in Ophthalmology, Queen Margaret Hospital, Dunfermline Beth D Harrison MA BM BCh DM(Oxon) FRCP FRCPath Consultant Haematologist, University Hospital Coventry and Warwickshire NHS Trust Steven Harsum MBBS BSc PhD FRCOphth Consultant Ophthalmologist, Epsom & St Helier University Hospitals NHS Trust Robin DC Kumar BSc MBBS FRCA Specialist Registrar in Anaesthesia and Intensive Care, King’s College Hospital, London K23350.indb 7 3/31/14 8:08 PM vviiiiii Contributors Pete Maskell MBBS FRCP MSc Consultant Stroke Physician and Elderly Care Lead, Maidstone and Tunbridge Wells NHS Trust Allison C Morton BMedSci MBChB MRCP PhD Consultant Cardiologist, Sheffield Teaching Hospitals NHS Foundation Trust and Clinical Research Manager, NIHR Cardiovascular Biomedical Research Unit, Northern General Hospital, Sheffield Victor Pace FRCP Consultant in Palliative Medicine, St Christopher’s Hospice, Sydenham, London Stephen Derek Quinn MBBS BSc MRCOG Clinical Research Fellow, St Mary’s Hospital, London James JH Rucker MBBS BSc MRCPsych Clinical Research Fellow, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London and Honorary Specialist Registrar in General Adult Psychiatry, The South London and Maudsley NHS Foundation Trust, London Biba Stanton BMedSci MBBS MRCP PhD Specialist Registrar, National Hospital for Neurology and Neurosurgery, Queen Square, London Alex Tulloch PhD MRCP MRCPsych Lecturer, Health Services and Population Research Department, Institute of Psychiatry, King's College London Esther Unitt BMedSci MBBS MRCP DM Consultant Gastroenterologist and Hepatologist at the University Hospital, Coventry and Warwickshire Hospitals NHS Trust W Stephen Waring BMedSci MB PhD FRCP(Edin) Consultant in Acute Medicine, York Teaching Hospital NHS Foundation Trust, and Honorary Senior Lecturer, Hull York Medical School K23350.indb 8 3/31/14 8:08 PM
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