It's not uncommon for folks to be prescribed viagra cialis online pharmacy pharmacy to take when it's needed, rather than regularly at the same time each day.
Such medicine is prescribed with the accepted abbreviation PRN (pro re nata), i.e. when required.
Doesn't this get you thinking?
If I prescribe a drug PRN for one of my in-patients, it's not there to be used regularly (or I'd write it up regularly, at specified times). It's then wholly up to the nurse to decide if or when it's given.
Usually if I want a nurse to decide if the patient has a particular problem, then formulate presentations to conclude that pharmacological treatment is indicated, then determine that a drug I've suggested is the right drug for that patient with that problem at that time, then ensure my patient gets that drug, the nurse is a Supplementary Prescriber. She's done courses on therapeutics, pharacokinetics and dynamics and (critically) has ongoing teaching and ongoing individual supervision with me and mandatory attendance at our ongoing training programme and attendance at our non-medical prescribing forum.
Thus, for an experienced band 7 community to think, yes, this psychotic patient who is believing that "they are out to get me" and is 'phoning police a dozen times a day and daren't leave the house really could use some additional medication (that a Consultant has written in a Clinical Management Plan with the nurse) to de-escalate their distress and help them cope, they have a rigorous training and ongoing development programme.
For a less experienced band 5 ward nurse to think, yes, this psychotic patient is agitated and I'll settle them down with some additional medication (that a Consultant has written on a drug card with a nurse at the MDT), they have no scrutiny or guidance or support or supervision or review of their practice.
This seems odd.
Is it just in my corner that life's like this?
Tuesday 1 November 2011
Saturday 29 October 2011
Oral Pharmacotherapy for Male Sexual Dysfunction: A Guide to Clinical ManagementPublicado porDr. JUAN PABLO JARAMILLO MORENO, 7 de julio de 2008 at 08:34, in Etiquetas:UROLOGIA
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A state-of-the-art review of each aspect of male sexual dysfunction (interest, performance, and orgasm) and their implications for treatment. The authors address a wide variety of clinical issues, ranging from common medical risk factors for ED, to the evaluation and management of men who have atypical presentations that require focused testing; from diabetic ED to the safety assessment of PDE inhibitors for cardiac patients; and from combination drug therapy for refractory patients to neuropharmacological therapies. On the pharmaceutical side, the authors summarize the pharmacology and development of PDE-type 5 inhibitors, review the preclinical data and 5 years of postmarketing data on Viagra®, examine the preclinical data on Levitra®, and discuss the design and conduct of US clinical trials of Cialis®. Oral Pharmacology for Male Sexual Dysfunction: A Guide to Clinical Management clarifies for urologists, family physicians, and internists each of the diagnostic approaches to male sexual dysfunction, as well as the pharmacological strategies available for its safe and effective management.
A state-of-the-art review of each aspect of male sexual dysfunction (interest, performance, and orgasm) and their implications for treatment. The authors address a wide variety of clinical issues, ranging from common medical risk factors for ED, to the evaluation and management of men who have atypical presentations that require focused testing; from diabetic ED to the safety assessment of PDE inhibitors for cardiac patients; and from combination drug therapy for refractory patients to neuropharmacological therapies. On the pharmaceutical side, the authors summarize the pharmacology and development of PDE-type 5 inhibitors, review the preclinical data and 5 years of postmarketing data on Viagra®, examine the preclinical data on Levitra®, and discuss the design and conduct of US clinical trials of Cialis®. Oral Pharmacology for Male Sexual Dysfunction: A Guide to Clinical Management clarifies for urologists, family physicians, and internists each of the diagnostic approaches to male sexual dysfunction, as well as the pharmacological strategies available for its safe and effective management.Tuesday 3 May 2011
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Men’s Health magazine is the largest lifestyle magazine for order cialis in the United States. It was first published annually, but now, it is published ten times in a year. Its success overpowered GQ and Esquire combined. Men’s Health provides information on health and fitness, sex and relationships, guy wisdom and nutrition and style. The magazine not only takes pride in its accomplishments in publication. Every year, members of its website double, making it one of the most searched sites in the United States.
Review the words and phrases used in this material.
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