By Pharmaceutical Press
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Additional resources for British National Formulary (BNF) 68
Allergy and idiosyncrasy are important causes of adverse drug reactions. Ask if the patient had previous reactions; Adverse reactions to medical devices Sus- . pected adverse reactions to medical devices including dental or surgical materials, intra-uterine devices, and contact lens fluids should be reported. uk. ask if the patient is already taking other drugs including self-medication drugs, health supplements, complementary and alternative therapies; interactions may occur; . age and hepatic or renal disease may alter the metabolism or excretion of drugs, so that much smaller doses may be needed.
Families should be included in the care of the patient if they wish. Many patients wish to remain at home with their families. Although some families may at first be afraid of caring for the patient at home, support can be provided by community nursing services, social services, voluntary agencies and hospices together with the general practitioner. The family may be reassured by the knowledge that the patient will be admitted to a hospital or hospice if the family cannot cope. Drug treatment The number of drugs should be as few as possible, for even the taking of medicine may be an effort.
In the latter case urgent referral to the patient’s medical practitioner may be necessary. Oral mucosa Medicaments left in contact with or applied directly to the oral mucosa can lead to inflammation or ulceration; the possibility of allergy should also be borne in mind. Aspirin tablets allowed to dissolve in the sulcus for the treatment of toothache can lead to a white patch followed by ulceration. Flavouring agents, particularly essential oils, may sensitise the skin, but mucosal swelling is not usually prominent.