Wednesday, January 16, 2008

Thank you, you kind sir!

Q & A on pp3...

Diconal tablets
mitte : 10 (ten)
sig: 1bd for 10days

Patient information : Jenson had a car crash and broke his both legs.

The dose check from bnf shows that for acute pain, 1tablet gradually increased to 3 tablets every 6hours. (which mean daily dose = 4tablets - 12tablets?)

Is 1bd appropriate for this case?

Or we need to speak to the prescriber as a golden rule, and to enquire if 10mg bd is sufficient to control the patient's pain, if so, then we can give 1bd? (although it is an underdose from the bnf)

You are correct with question 1, if the dose taken is enough to control the pain then there is no need to increase it to comply with the BNF recommendation. Why should a patient take more medication than they require? You could ask the prescriber but you could also ask the patient about their pain relief. If the patient reported insufficient pain relief
you would contact the prescriber to discuss a dosage adjustment. If not ,so long as you recorded your conversation with the patient as an explanation of why you were supplying an apparent underdose you would not need to contact the prescriber

From the BNF for children, we realised that the dose categories range from the age of 1month -5 years, 5years -12years, and 12 years -18years. If the child is at age of 12, which category do we refer to? is it the 5years -12years or is it the 12years - 18years?

Regarding question 2, you would need to make a judgement on an individual case. Consider for example, the actual weight of the child or would it be more dangerous for the patient to have an overdose or a sub therapeutic dose. There will be other factors to consider, but essentially this is one of those circumstances when you have to make a professional decision and explain why you made your decision.

5more days left to pp3 resit........


weithian said...

oi mehhh. with this kind of postttt?!?!?!? T_T

huiyin said...

dead boring post lah for God's sake.
type this kinda post yet no time to really talk to me in skype?
damn problem.