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Training to be independent prescribers andor supplementary prescribers is provided by Higher Education Institutions in the United Kingdom according to a curriculum developed and agreed with the HPC. Supplementary prescribing is likely to be most suitable with patients who have chronic conditions and can be managed by a supplementary prescriber between reviews by the doctor.

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There is some evidence for the involvement of serotonin and possibly other transmitters interacting with dopamine pathways. Most anti-psychotic drugs seem to work by blocking dopamine receptors in the brain, although some of the new atypical anti-psychotics also block serotonin receptors. mesocortical mesolimbic nigrostriatal hypothalamicpituitary chemotrigger zone to vomiting centre Figure There are two main types of dopamine receptor: the D and is excitatory; and the D significance of different types of dopamine receptors is still unclear, but drugs that are effective in schizophrenia appear to have an affinity for D Anti-psychotic drugs are used in the treatment of schizophrenia and there are many in use. The choice of drug depends on the severity of the condition and the diagnosis of positive or negative symptoms. Other factors to take into consideration are whether sedation is required and how susceptible the individual is to Parkinsonian side effects. Most drugs are more effective at relieving the positive symptoms and all provide better results in acute schizophrenia.

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In light of the recent extension to the exemptions list with regards to local anaesthetics, it has also been highlighted that podiatrists and podiatric surgeons also require keeping up to date with their resuscitation skills, with immediate life support being the minimum level. For further details of how supplementary prescribing will work and information about which health care professionals can undertake supplementary prescribing, which medicines can be prescribed under supplementary prescribing arrangements and training, see Chapter Acknowledgements I would like to take this opportunity to thank Mr Thomas Galloway, Consultant Podiatric Surgeon, Hereford PCT for his input in helping me produce this section.

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