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Nurses can now prescribe any licensed medicine, including some controlled drugs, if they are qualified to do so. At the same time, pharmacists became eligible to train as pharmacist independent prescribers, being able to prescribe all licensed medicines but, as yet, no controlled drugs.

However, she tells you she is really worried about the operation because she had a bad experience with an operation when she was a child. Ms Clarke cannot quite remember the details, but she says that when she came round from the previous operation she couldnt move and can remember being scared. What do you think might have happened to Ms. Clarke after the previous operation. How can you reassure her that this will not happen again. You should be able to answer these review questions from the material in this chapter.

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In addition ambulance paramedics may administer a range of named injections in emergency situations. Exemptions are also made to allow the supply and use of POM for research, business and other unusual circumstances. All labels for medicines must be indelible, legible and generally in English. POM must also bear specific information. The following information must be written on the POM label: Name of patient Name and address of supplier Containers must be clean, sound and fit for the intended purpose.


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The distribution of a drug into these different compartments depends on many factors. Aqueous solubility affects distribution because water-soluble drugs have difficulty crossing cell membranes and therefore tend to remain in the circulation.

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If warfarin and aspirin are used simultaneously, both drugs appear in the plasma in higher than expected concentrations due to competition for plasma protein binding.

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Aids to help compliance can be suggested, for example packaging of daily doses can be arranged with pharmacists, special containers can be obtained, the help of relatives can be sought, suitable time of day for administration can be chosen and provision of written information can all help.

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