Category: Prescribing

Paediatrics: Prescribing

As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like general surgery. Having a few prescribing skills under your belt will help you feel more confident in managing them in these cases. Ask the paediatric team or paediatric pharmacist to provide brief teaching on prescribing

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Transfusion

In this article, we will go through the three most common scenarios you will encounter. These are: (1) Does this patient need a transfusion? (2) Can you group & save or transfuse this patient? (3) This patient may be having a transfusion reaction, could you please advise? Scenario 1: Does this patient need a transfusion?

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Bowel Obstruction

Bowel obstruction is a common reason for admission or complication of patients under the surgical team, but doctors don’t frequently get that much exposure to it in medical school. It is a condition in which the normal passage of intestinal products is impaired. It can affect both large and small bowel. Bowel obstruction can be

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Opiate Withdrawal

As doctors, you will frequently see patients with opiate dependence. It isn’t uncommon for these patients to be admitted due to withdrawal or due to consequences of their drug use such as a groin abscess or overdose. It is difficult to differentiate symptoms of withdrawal from other conditions & the symptoms can be horrible leading

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Hypokalaemia

As an FY1 you will frequently see hypokalaemia and most trusts have guidelines that should be used in the first instance. The advice below is informal & based on broad day to day practice. It should never replace clinical judgement and escalation for senior support if indicated. The UK Medicines Information group have provided information

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Alcohol Withdrawal

Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged periods is dangerous and can lead to severe withdrawal. Delirium tremens can occur in about 10% of patients with withdrawal and carries a 5-10% mortality risk. Certain patients will require pharmacological (and non-pharmacological) tools as part of an inpatient alcohol detoxification programme,

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Nausea & Vomiting

You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their diagnosis or treatment. You must consider anything concerning that could be causing it and give appropriate treatment for the underlying cause, correct any electrolyte disturbances & dehydration due to it in addition to antiemetics. Certain

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Paracetamol Overdose

As an FY1, you will encounter these either during clerking shifts or you may look after them on the ward. As it is quite common, the information below is to help give you an overview. For management, use Toxbase, the login should be on your trust intranet or from A&E. The app allows you to sign

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Palliative Care

Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on call. Despite this, very little time is dedicated during our training towards managing the dying patient. Instead, all the focus is upon saving and resuscitating the patient. The question is though, what do we do

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Hypophosphataemia

The UK Medicines Information group have provided excellent guidance on how to replace phosphate. Clinical features Generally asymptomatic if mild Can cause many systemic features CNS & MSK: weakness/myalgia, lethargy, confusion, seizures Cardiorespiratory failure Rickets/Osteomalacia if chronic Causes Malabsorption D&V Refeeding syndrome Investigations Check the calcium, U&Es, renal function Treatment Use local guidelines or consider

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