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That is, providing the supplementary prescriber is competent to manage the patientвs condition and there is a close working relationship between the independent prescriber and the supplementary prescriber who can share the same patient records.
High doses of prilocaine can cause methaemoglobinaemia and cyanosis. For this reason, it is used with caution in patients with anaemia, cardiac failure, congenital or acquired methaemoglobinaemia or impaired respiratory function.
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Sensory nerves that carry the stimulus of pain are the most sensitive to the actions of local anaesthetics. Accidental overdose can cause systemic effects including cardiorespiratory depression and loss of consciousness.
No details of dosages are given in this book, because these are subject to change and often have to be varied to suit individual patients. In practice, the BNF or MIMS should be used as a guide to dosages. Examples of individual drugs have been kept to a minimum in the text, with usually just one or two examples given in each section.
It would be impractical to try to remember the names of all drugs available. In practice, health care professionals quickly become familiar with drugs commonly used in their area. Nevertheless, the examples used in this book amount to over are listed for easy reference in Appendix I.
The respiratory system is made up of air passages through the nose, windpipe and into the lungs, which are situated in the thoracic cavity. The walls of the thoracic cavity are supported by the ribs and its floor is formed by a sheet of muscle called the diaphragm. The inner surface of the thoracic cavity and the outer surface of the lungs are covered by a shiny slippery membrane, the pleural membrane. Pleural fluid is secreted between this double membrane and acts as a lubricant reducing friction as the lungs move against the ribs during breathing.
The pleural membranes also ensure that the chest cavity is airtight.