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Like cardiac disorders and hypertension, disorders of coagulation, anaemia and hyperlipidaemia are all conditions that are more common in older patients.
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The list of medicines available to podiatrists was extended in November extended prescribing and supplementary prescribing are relatively new and because PGD usage is now integral to practice in many organizations, confusion has arisen about the difference between them and which is the most appropriate in which circumstances. While the definition of a PGD is straightforward, local interpretation has allowed them to be used creatively in a wide range of circumstances.
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There are in fact five ways in which suitably qualified and registered health care professionals can supply medicines to patients: patient group directions, patient specific directions (PSDs), supplementary prescribing, independent prescribing and specific exemptions to the Medicines Act. The first three of these require a working partnership with medically qualified professionals; the last two do not.
Drugs of choice are imidazoles, terbinafine and amorolfine. Some of the preparations of these drugs are prescription-only medicines but they can be accessed and supplied by podiatrists. In severe extensive infection, oral terbinafine or griseofulvin may be needed. Even so, infection may take weeks or months to clear, particularly infection of the nails. Bacterial infection of the skin causes a condition known as cellulitis, which requires systemic antibiotics.
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