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Variation in effect of a drug can occur in different individuals and indeed in the same individuals on different occasions. This can result from either differing concentrations of a drug at its site of action, or differing physiological responses to the same concentration of a drug. Adverse drug reactions present a major clinical problem. It has been estimated that up to up to Many adverse reactions are well known. Information about them can be found in patient information leaflets supplied with medicines, in the Monthly Index of Medical Specialties (MIMS) or in the British National Formulary. However, not all patients will suffer all possible adverse reactions.


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Within the limits of a CMP, the supplementary prescriber may be able to alter the choice of medicine, the dosage, the frequency of administration and other variables. As an alternative to listing medicines individually, the CMP may refer to recognized and accepted local or national clinical guidance in written or electronic form.

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In addition, most diuretics produce an increase in plasma uric acid levels, which may lead to gout.

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Although they do not affect psychological symptoms, such as worry, tension and fear, they are useful for patients with predominantly somatic symptoms such as palpitations and tremor; treatment of these symptoms may prevent the onset of worry and fear. Beta blockers are used to treat arrhythmia, angina and hypertension and are discussed more fully in Chapter Anti-psychotics, in low doses, are also sometimes used in severe anxiety for their sedative action, but long-term use should be avoided in view of a possible risk of tardive dyskinesia Drug therapy is not always necessary or desirable for insomnia.

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In these cases, the radiographer could serially image a patient over several years but it may be as little as once a year and since the CMP should be reviewed at least yearly, it becomes clear that there is limited value in a diagnostic radiographer becoming a supplementary prescriber. There is a potential role for independent prescribers in diagnostic radiography, and this is particularly evident in areas of acute medical practice.

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This is a huge area of therapeutics and there are many drugs available to treat these conditions.

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