On 1st April 2019, pregabalin was classified as a controlled…

On 1st April 2019, pregabalin was classified as a controlled drug. This reclassification presented a number of different challenges for prescribers and patients. a) Explain how the reclassification affected patients using the NHS Repeat Dispensing Scheme and suggest a solution. (2 marks)   b) Explain how the change in classification affected prescribers who prescribe the drug privately. (1 mark)   A 38-year-old epileptic patient who takes carbamazepine and pregabalin for epilepsy.  She has been taking both medicines for a number of years and is stable on them, her last seizure being four years ago.  The GP practice where she is registered issues her with a 56-day supply of each medicine on a prescription. c) How will the change in classification of pregabalin practically affect the patient?  (2 marks)

A 23-year-old woman is admitted to hospital with abdominal c…

A 23-year-old woman is admitted to hospital with abdominal cramps, epigastric pain, perfuse diarrhoea, fever, tiredness and weight loss. She is newly diagnosed with Crohn’s Disease. PMH Nil of note Medication History Paracetamol 1g QDS PRN (OTC) Ibuprofen 400mg TDS PRN (OTC) Allergies NKDA Social History Occupation: IT Technician in a busy secondary school Smoking History: 7 cigarettes per day Diet: varies depending on work and how much money she has. Doesn’t like cooking so often gets takeaways or ready meals. Drinking: 18 units per week (mainly at weekends) Weight: 66kg   a) What are the possible triggers of this patient’s symptoms?   (3 marks)   Test Results Haemoglobin 9.0                         (11.5 – 16.5g/dL) Red cell count 3.4                         (4.0 – 5.8×1012/L) Packed cell volume 0.31                        (0.37 – 0.47%) Mean cell volume 72                          (76 – 100fL)   b) What do the blood results show and how should they be managed? (2 marks)                

A 76-year-old woman presents to her GP with low mood, lack o…

A 76-year-old woman presents to her GP with low mood, lack of interest in daily activities and insomnia following the loss of her husband.  She is diagnosed with mild depression.  The GP decides to prescribe a tricyclic antidepressant, dosulepin 75mg ON.   Past Medical History Hypertension NSTEMI (2011) Hypercholestrolemia Medication History Aspirin 75mg OD Atorvastatin 80mg OD Ramipril 5mg OD Bisoprolol 2.5mg OD GTN Spray 400microg PRN NKDA Discuss the appropriateness of the GPs choice of first line agent for the patient with reference to NICE guidelines.  (5 marks)