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Loss of drugs in sweat and breast milk occurs, but is of minor importance although the appearance of drugs in breast milk can have serious consequences for the nursing baby. Drugs can be administered to patients by a variety of routes and can be intended to have a local or systemic effect.
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Drugs have been developed against two of them, tumour necrosis factor α (TNF-α) and interleukin and together they are key players in the inflammatory response. Levels of both are raised in rheumatoid arthritis and other autoimmune diseases. Cytokine inhibitors are relatively new and they must only be prescribed under specialist supervision. Their use is still being monitored by the Medicines and Healthcare Products Regulatory Agency. Treatment should be withdrawn if there are severe side effects or no obvious improvement after three months.
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Independent prescribers take responsibility for: the clinical assessment of the patient; establishing a diagnosis; indicating the clinical management required and prescribing where necessary. They prescribe medicines from the British National Formulary (or part thereof) in accordance with their professional competency.
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