Prescribing VIVA New

What should be avoided with patients with renal impairment?

Avoid NSAIDs

Adjust dose for Amox and Metro

Use Paracetamol with caution

What should be avoided with patients with Hepatic impairment?

Caution with Metronidazole, erythromycin and paracetamol

Reduce dose or increase dose intervals

What can you prescribe for pregnant patients?

Avoid tetracyclines in 1st

Avoid metronidazole in 1st trimester

Avoid NSAIDs in the 3rd trimester

Amox and Paracetamol can be used safely

What should be avoided with anticoagulants?

Avoid NSAIDS

How can you treat patients who are immunosuppressed?

Use ABx for infections early

Be aware of opportunistic infections

How can you treat patients who are on Polypharmacy?

Risk of interactions

Check BNF interaction checker

How can you treat epilepsy patients?

Avoid tramadol

Metronidazole may interact with phenytoin

What should be avoided with Mental Health Meds?

Avoid NSAIDs as risk bleeding

When is Amox contraindicated?

Penciillin allergy

Hepatic Impairment

When is metronidazole contraindicated?

1st trimester of pregnancy

Warfatin interaction (increases INR)

Alcohol don't have until 48h post cessation

When are tetracyclines contraindicated?

Children <12 years

Pregnancy

Breastfeeding

When are NSAIDs contraindicated?

Asthma

Gastric ulcers

Renal impairment

Elderly

Anticoagulants (bleeding risk)

Pregnancy (especially in 3rd trimester)

When is paracetamol contraindicated?

Hepatic impairment

Alcohol abuse

When is codeine contraindicated?

Avoid in children <12 years old

Breastfeeding

Respiratory depression risk

When should you prescribe antibiotics generally speaking?

Only prescribe antibiotics when there is evidence of a spreading infection, systemic involvement, or patient is immunocompromised.

What are the first line Abx that are given?

Amoxicillin 500mg TDS for 5 days

Metronidazole 400mg TDS for 5 days

Clarithromycin 500mg 2x daily for 5 days (Only for Penicillin Allergy)