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Hot flushes, oedema, fluid retention, dry skin, vaginal bleeding, vaginal discharge, pruritus vulvae, GI upsets, nausea, dizziness, rashes, blurred vision, loss of acuity, alopecia, increased liver enzymes, hypertriglyceridaemia, uterine fibroids and endometrial hyperplasia. Potentially Fatal: Blood dyscrasias, cholestasis, hepatitis, hypercalcaemia in patients with bone metastasis, thromboembolic events. Increased risk of endometrial cancer and uterine sarcoma. Aminoglutethimide reduces plasma-tamoxifen concentration. Potentially Fatal: Concurrent use increased anticoagulant effect of warfarin; increased risk of thromboembolic events with other cytotoxic drugs. Tamoxifen, a triphenylethylene derivative, produces a nuclear complex by competitively binding to oestrogen receptors on tumours and other tissue targets thus, decreasing DNA synthesis and inhibiting oestrogen effect.
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The following patient is being investigated for recurrent urinary tract infection. It is planned that the patientвs urinary tract will be imaged using intravenous iodine contrast.
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The stated outcomes of PGDs are: в Understand the concept of patient group directions в Understand the historical and legal background to patient group directions в Understand the meanings of pharmacodynamics and pharmacokinetics in relation to the drugs that the radiographer is able to supply and administer в Understand the pathophysiological processes in the conditions under which the patient group directions can be used в Understand the protocols and guidelines that exist to support the use of patient group directions.
Supplementary prescribing courses are offered by universities and these are open to all professions that are legally permitted to hold these responsibilities. Presently, ring-fenced monies from the Department of Health are managed by Strategic Health Authorities to fund these courses in an attempt to promote non-medical prescribing.
There will come a point, however, when this funding is withdrawn. All Trust and university-based training offered to radiographers in this area is normally on a multi-professional basis. There is very little published evidence to indicate how and when PGDs and supplementary prescribing can be used in radiography (Hogg and Hogg, Hogg and Hogg practices have had on radiography patient care and management.