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The two should be able to communicate easily, share access to the same common patient record and any guidelines used in the CMP, agree common understanding of and access to the written CMP and ideally review the patients progress together at agreed intervals. The responsibilities of the independent prescriber are given below: Initial clinical assessment and diagnosis of the patient Agreement with the supplementary prescriber about the limits of their responsibility Provision of advice and support to the supplementary prescriber Review of patients progress at appropriate intervals with the supplementary prescriber if possible Sharing patients records with supplementary prescriber Reporting of adverse drug reactions.
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Because compensation occurs, there must be takes the form of increased activity in the remaining dopaminergic neurones and increase in numbers of receptors. Dopamine pathways normally balance cholinergic pathways in the basal nuclei and many of the symptoms of Parkinsons disease are thought to be due to over activity of cholinergic pathways.
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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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