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We are now going to move on to prescribing and prescriptions. The only people who can prescribe are a doctor, dentist, vets or a nurse prescriber. These are professionals who have undertaken training and understand the medication. A formal document called the prescription has to be signed and dated by the relevant person. The prescription is issued by the GP and passed to the home or directly to the pharmacy. In certain circumstances, the prescription can be faxed from the GP to the pharmacy, and the pharmacy will then deliver the medication to your home. This cannot be done with regard to controlled drugs. A pharmacy will not issue controlled drugs without seeing the original prescription.

The majority of the medication that you administer to your clients or service users will be prescribed by your GP. It's not our role as healthcare professionals to decide what medication is to be given. But we do need to be aware of the medication we're giving. We need to have an understanding of what it is used for and any potential side effects. When issuing a prescription, the doctor will take into account various factors. They look at the client's age, weight and other medications that they're on. Often it takes time to get the exact dose of medication right.

The GP will start at a base level, and this can be tweaked up or down, depending on the symptoms of the condition. In many cases, it can be trial and error. The GP will prescribe a medication not knowing exactly if it will work because there are various different forms of medication in certain groups. With these medications, you will have to monitor the effects, side effects and any changes in your client. Details of the medication will be in the instruction leaflet, but there should also be a copy of the BNF, the British National Formulary within your workplace; this has a list of all your medications, indications, contraindications, side effects, and you can refer to this anytime or, as previously stated, you can always call your pharmacist for advice.

As previously mentioned, doctors take into account various factors when prescribing medication. It's important when an elderly client group. Dosages may be a lot smaller. We have to bear in mind that over the years the elderly client group may have an excess build-up of medication in their body. Also, their liver and kidneys work less efficiently, so their liver won't break down the medication as easily and the kidneys won't excrete it. Also, the side effects may be more obvious with the elderly client group. As previously stated, the doctor will take all these factors into account when prescribing the medication.

We're now going to talk about polypharmacy. This is where two or more medications are prescribed. The doctor prescribing the medications will be fully aware of all the side effects and interactions between the two medications. But you also need to have a basic awareness of the medications. Sometimes medications will be prescribed that have negative side effects. The GP will have already decided that the benefits of the medication far outweigh any side effects that the medication may give. When talking about polypharmacy, you need to be aware of your homely remedies. As we've previously discussed, always make sure you know what's in the homely remedy and that it's not going to interact with any medication that the client is already prescribed. As we've stated throughout this course and will continue to state, if you've got any concerns, always ask. You have your line manager, you have your pharmacist and you have a GP.