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Supplementary prescribing is currently defined as a voluntary partnership between an independent prescriber and a supplementary prescriber to implement an agreed patient-specific clinical management plan with the patients agreement. Supplementary prescribing is intended to improve patient access to care, make it easier for patients to get the medicines they need, make the best use of clinical skills of health care professionals and enhance professional relationships. Time spent on developing a CMP should save time when the patient returns for review with the supplementary prescriber rather than the doctor. Supplementary prescribers prescribe in partnership with an independent prescriber who must be a doctor or dentist. They are able to prescribe for the full range of medical conditions, providing they do so under the terms of a patient-specific CMP. Discussion between the independent prescriber and the supplementary prescriber will determine which patients would benefit from supplementary prescribing.

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Sublingual administration of a drug allows the drug to go directly into the systemic circulation without first passing through the liver. This route can provide a rapid means of absorption of a drug.

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This usually occurs via the kidneys, although some drugs can be lost in faeces or exhaled air. This chapter discusses the processes of administration, absorption, distribution, metabolism and excretion of drugs together with factors affecting these processes.

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