https://dermnetnz.org/dermdiag
The DermDiag Tool is designed to help you understand your skin condition.
https://www.pcds.org.uk/
The main purpose of this blog is to collate some of my therapeutic notes as a way of managing my Continuing Professional Development (CPD). The topics discussed here are not touched in great details and should not be referred to as the only source of information for any given topic...............................پاورقیهای یک داروساز
https://dermnetnz.org/dermdiag
The DermDiag Tool is designed to help you understand your skin condition.
https://www.pcds.org.uk/
https://cpe.org.uk/quality-and-regulations/pharmacy-quality-scheme/
"Inhalers still account for approximately 3% of the NHS’ carbon footprint, mostly due to the propellants used to deliver the medications.
press and breathe pressurised metered-dose inhalers (pMDIs) currently use hydrofluorocarbon gases (HFCs or ‘F-gases’) as propellants. • When released from the inhaler, HFCs remain in the atmosphere for approximately 270 years and they are potent greenhouse gases between 1,300 and 3,350 times greater than CO2.
Used inhalers typically have 30% of the original propellant remaining in the canister.
While residual propellant gases in inhalers can be extracted, cleaned and reused in industrial equipment, such as air conditioning systems, they are being phased out of use in most applications because of their environmental impacts. • Inhalers returned to pharmacies for safe disposal will be incinerated at high temperature by NHS England and NHS Improvement’s waste contractor. This process destroys the propellant gases, so they don’t escape into the atmosphere. Steel and aluminium from inhaler canisters may be recovered and recycled at some incinerators."
For patients using inhaler:
Checked that all children aged 5 to 15 (inclusive) dispensed an inhaled press and breathe pMDI for asthma have a spacer device where appropriate, in line with NICE TA38.
Referred children aged 5 to 15 (inclusive) with asthma to an appropriate healthcare professional where this is not the case.
Personalised asthma action plan (PAAP) can help identify worsening asthma, support corrective action and advise patients and carers of how and when to seek help.
Referrals for patients using 3 or more bronchodilators in 6 months
patients with asthma, for whom three or more short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a six-month period have, since the last review point, been referred to an appropriate healthcare professional for an asthma review.
+++++++++++++++++++++++++++++++++++++++++++++++++++
+++++++++++++++++++++++++++++++++++++++++++++++++++
Carbapenems are powerful broad-spectrum antibiotics that are often the last line of effective treatment for patients with multidrug-resistant infections, including those caused by ESBL-producing bacteria (extended spectrum beta-lactamases).
Cases of carbapenem resistance in E. coli and Klebsiella in the UK started to increase during 2008 and 2009.
Antimicrobial resistance (AMR) is resistance of a micro-organism to an antimicrobial medicine to which it was previously sensitive. Resistant organisms (they include bacteria and viruses) are able to withstand attack by antimicrobial medicines, such as antibiotics and antivirals, so that standard treatments become ineffective and infections are prolonged, with longer periods of infectivity, and may spread to others. Inappropriate and irrational use of antimicrobial medicines provides favourable conditions for resistant micro-organisms to emerge, spread and persist.
+++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++++++++++++++++++++++
"Before starting antiparkinsonian treatment, the patient's individual circumstances, including symptoms, comorbidities and preferences, should be discussed together with the potential benefits and harms from the different drugs available.
Patients and their carers should be informed about the risk of adverse reactions from antiparkinsonian drugs, including psychotic symptoms, excessive sleepiness and sudden onset of sleep with dopamine-receptor agonists, and impulse control disorders with all dopaminergic therapy (especially dopamine-receptor agonists). For further information see Impulse control disorders."
"To avoid the potential for acute akinesia or neuroleptic malignant syndrome, antiparkinsonian drug concentrations should not be allowed to fall suddenly due to poor absorption or abrupt withdrawal."
https://www.medicinescomplete.com/#/content/bnf/_661075101
++++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++++++++++++++++++++++