...and if you're going to do it I have some charts with appropriate tests /
times etc set up for each drug. with the help of local rheumatologist who
keeps a close eye on Brit Rheum Soc guidelines. Let me know if you want a
copy
Didn't stop us giving trimethoprim for UTI to patient taking Methotrexate
for RA and rendering her almost instantly (but thankfully reversibly)
neutropenic .
I recommend you don't ever do this!
Chris
Dr Chris Burton
GP, Sanquhar, Dumfriesshire
Member of WestNet, The West of Scotland Primary Care Research Network
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]On Behalf Of Bradley Cheek
Sent: 28 August 1998 12:40
To: [log in to unmask]
Subject: Re: monitoring in practice: the other view
Rheumatology drug monitoring
A nurse does all ours. A recent non-questionnaire survey suggested that
GP's in Northumberland were only doing this fairly well and so we had an
educational meeting for nurses. As a result, it is all done almost perfectly
(i.e. without involving stroppy doctors) ;-) These are pretty toxic
drugs, after all, but if properly monitored there is no reason why GP's
can't do it, surely. Like clomiphene Rx, suturing, setting fractures,
putting in chest drains, reading ECG's, interpreting exercise tests,
starting warfarin, low forceps deliveries or setting up a practice
intranet...
I actually thought that this was core work anyway. And the GMSC have been
less than helpful, let's face it.....
Bradley Cheek
email: [log in to unmask]
web: www.wcsquare.demon.co.uk
-----Original Message-----
From: Dr I Cox <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 26 August 1998 21:23
Subject: monitoring in practice
>We have just had a letter about patient taking salazopyrine and other 2nd
>line anti-rheumatic drugs, asking us to:
>1. take blood monthly
>2. monitor changes and trends in results
>3. fill in co-operation card
>4. ask patient to remember to bring card to clinic each time.
>
>
>My partners had all initialled the letter (suggesting acceptance) but I was
>feeling particularly stroppy. I found that we have 30 patients on these and
>similar drugs from different departments. If you estimate, as most sensible
>professions would, that it would take 10 minutes to do this for each
patient
>safely, it equates to half a day a month at least. No new money-just a
>request from a consultant ( and a friend,, I believe who is having similar
>troubles in his clinic).
>
>Any comments from people out there?
>Am I being paranoid?
>Do I need another holiday?.....( only back 3 days!)
>
>Ian Cox
>Pangbourne
>
>
>
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