Drug Application And H&S PDF

Presented by Dr Emma Drug application and H&S Gibson Prep work support  The idea of pre-work is not for you to understand everything you read, but to start opening up your mind to new ideas. The pre-work is to give you an overview of the content because it is all new stuff, if t...

Presented by Dr Emma Drug application and H&S Gibson Prep work support  The idea of pre-work is not for you to understand everything you read, but to start opening up your mind to new ideas. The pre-work is to give you an overview of the content because it is all new stuff, if the first time you hear it is in a lecture with 60 other students it will be very overwhelming. Pharmacology does have a lot of new words, I recommend having a tab open for you to search for terms you don’t know: I have to do this too so don’t feel bad about it. When we go through the key information in the session it should help to clarify the bits you got confused on. By reading before the lecture it allows you to know what you are comfortable with and what you need to focus on. It also gives you the opportunity to write down questions to ask in the lecture or to email to me so I can go through them in the lecture for you.  Reading should not be done in one go. I am reading all the chapters I allocate to you. I am having to break it down into sections too. This is why I have released the whole module rather than 48 hours before. You may want to come back to some of the information again after the session to help you read it with the context of the lecture. This may sound time consuming but it is impossible to teach you everything you need to know in 2 hours a week. Hopefully you’ll understand more of it the second time. You may want to download a copy of the online book (available with the 1989 version) and use a highlighter to highlight the key parts. I do this when reading the chapters and it helps me direct my attention when I look through it again. Writing an MCQ- a great revision tool Encourage you to work as a group Look at what has multiple items o For example drug names o True and false statements https://guidance.college-optometrists.org/ guidance-contents/knowledge-skills-and-pe rformance-domain/use-and-supply-of-drug s-or-medicines-in-optometric-practice/instil ling-eye-drops-checking-risks/ Module content: Understanding your patient history Taking a careful px drug history is essential Alerts practitioner of potential adverse drug reactions Interactions between systemic and topical medications History and symptoms What questions would you ask a patient? H&S general Ocular history o Disease o CLW o Ocular medications o Surgery Medical history o Renal and hepatic disease o Cardiovascular and respiratory disease o Thyroid disease o Diabetes o CNS o Mental health o Pregnancy H&S 1. Have you experienced any adverse reactions to eye drops in the past? 2. Have you had any adverse reactions to medications in the past? 3. Tell me about your eye health 4. Tell me about your general health. 5. Which medications do you take? ̶ Do you take any vitamins or herbal medicines? Question.. Which are the 7 most common diseases in the UK? Most common UK diseases Heart disease Chronic respiratory disease (COPD, asthma) Stroke and CVD Alzheimer’s Disease and dementia Diabetes Cancer Mental health problems Question: What are the chances that these conditions and/or their treatment will cause an unwanted side effect with diagnostic ophthalmic drugs? Example: Propranolol BNF ̶ Uses ̶ Side effects ̶ What if we add timolol Clinical examination Manual dexterity VA Pupils Refractive error Accommodation Cover test Slit lamp (corneal integrity, ACA/AC) IOP Why do we assess each of these? Hygiene in use of topical ophthalmic drugs  Storage, care of drugs in practice Store all medications out of reach of children Minims vs bottles Many practices store ophthalmic drugs in fridge (Fridge should be dedicated to ophthalmic drugs, so no potential for cross contamination from food) Examples: Proxymetacaine, tropicamide, phenylephrine, cyclopentolate Check temperature ranges for safe storage on label Date of expiry – important to ensure someone in practice has this responsibility to check stocks of drugs kept for practice use What should you say to the patient? 1. why you are instilling the drops 2. what effects the drops might have 3. how long the effects might last 4. the side effects they might experience 5. what to do if they experience an adverse reaction. Why would you say each of these? Example I’m instilling this drop because…. This drop will …. These effects will last…. Some people experience…. You should not ….. 2 examples: o Cyclopentolate o Lidocaine with fluorescein Example Cyclopentolate I’m instilling this drop because…. This drop will …. These effects will last…. Some people experience…. You should not ….. Example Lidocaine with fluorescein I’m instilling this drop because…. This drop will …. These effects will last…. Some people experience…. You should not ….. Choosing your drug Use the lowest concentration Minimal dosage Consistent with drug’s purpose Confirm the dosage if unsure Consider the potential adverse effects Ensure patients give informed consent Record keeping Whenever you are to instil a drug into your patient’s eyes, ensure the following is noted clearly on px record: 1. 2. 3. 4. Record keeping Whenever you are to instil a drug into your patient’s eyes, ensure the following is noted clearly on px record: 1. DRUG e.g. Cyclopentolate HCl 1% 2. DOSE e.g. 1 drop in each eye instilled at 2 p.m. 3. DATE OF EXPIRY e.g. 07/06/2022 4. Batch number (on box of minims) Hygiene Wash your hands Provide a tissue Instruct the patient Eyelid control Instruct patient to wipe excess solution from lids & lashes Consider nasolacrimal occlusion Practice instilling We will be doing a dry run today Perform a teach Hygiene Checks Hand positioning Where to look Where to put the drop How many Squeeze versus press bottles CC-CB-BV Menti revision from last week