Reflective model and consultation model

 If able please make mention of the prescribing pyramid also with this assignment, which needs to include:

a) Assessment, history, examination and consultation

b) Knowledge of the relevant pathophysiology

c) Sources of information/advice, legislation, record keeping, public health and decision support systems used to inform prescribing practice

d) Influences identified that affected this prescribing practice, and how these were managed

e) Identify roles and relationships of others involved in prescribing, supplying and administering medicines

f) Rationale for final prescription including drug actions, numerical calculations, activities needed to monitor response to therapy, and modifications that may be necessary to treatment or the referral to other health professionals as appropriate

The assignment relates to an 88yr old gentleman with alzheimers on galantamine 8mg bd, seen at home who lives with his daughter who has lasting power of attorney (both forms i.e. health and financial) due to him being deemed to lack capacity and granddaughter (both in good health and daughter retired and at home full-time carer), he had been seen 8 days previously by myself and my mentor (doctor) and diagnosed with viral rhinosinusitis due to 4 day history of blocked nose, tenderness over frontal sinus and referred pain to the left temple. Prescribed paracetamol 1g qds oral tablet form as over 50kg in weight (77kg) but not a prescription for antibiotics which had been his daughters expectation. (Public health – overuse of antibiotics and how not appropriate) instead watch and wait used with patient and education on why not given/appropriate, advised on adequate hyfration, warm compresses. Patient and daughter reassured and happy with agreed treatment plan, advised to contact if symptoms worsened or didn’t abate. On this review symptoms of purulent nasal secretions and mucosal erythema diagnosed as bacterial rhinosinusitits and prescribed Clarithromycin PO 500MG every 12 hours for 10 days as per my trusts guidelines written to my regions population need. Not In a Streptococcus pneumonae resistant area. Following NICE guidelines (please incorporate)

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