Therapeutics in Disorders of the Nervous System

Details

Title

Therapeutics in Disorders of the Nervous System

Type

Stage One

Module code

HPS223

Requirement

Compulsory

Module objective

Clinical Scientists in Neurophysiological Science are not currently permitted to issue prescriptions as either supplementary or independent prescribers. However, there are circumstances known as patient-specific directions whereby medicines can be given by another professional following the directions of an approved prescriber. Provider organisations should have arrangements in place that enable these legal requirements to be implemented. This therapeutics module is included in this HSST curriculum to provide the underpinning knowledge and understanding of a range of therapeutics utilised within Neurophysiological Science to support the Clinical Scientist in HSST to work with other clinicians and healthcare professionals as part of the multidisciplinary team.

By the end of this module the Clinical Scientist in HSST, in respect to Neurophysiological Science, will be able to analyse, synthesise, evaluate and, if appropriate to their scope of practice, apply knowledge of the appropriate therapeutic interventions relevant to clinical practice, including non-medication-based therapeutic and preventative interventions.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST, with respect to their clinical practice/scope of practice, will analyse, synthesise, critically evaluate and apply their knowledge with respect to the:

• mode of action, indications, contraindications, side effects, interactions, adverse reactions and dosages of commonly used drugs relevant to clinical practice, e.g. anticonvulsants, tranquillisers, anti-inflammatory drugs;
• anaesthaesia (systemic, local and spinal or epidural), including the agents, methods of induction, stages, adjunctive drugs such as neuromuscular blockers, analgesics, local nerve blocks and the effects of anaesthaesia on neurophysiological investigations;
• effects of age, body size, organ dysfunction and concurrent illness on drug distribution and metabolism;
• practical challenges and psychological barriers that adversely impact on patient adherence and strategies that support patients and improve adherence;
• tools used to promote patient safety in prescribing, including electronic clinical record systems and other IT systems;
• involvement of patients in shared decision making in their treatment and care;
• drugs requiring therapeutic monitoring and the ability to interpret longitudinal data to support the clinician planning future therapeutic intervention;
• the role of clinical neurophysiology in the monitoring of therapeutic interventions;
• effects and presentation of toxicity associated with therapeutic drugs spanning:
  • AMPA receptor antagonists (e.g. perampanel)
  • barbiturate anticonvulsants (e.g. phenobarbital)
  • benzodiazepine anticonvulsants (e.g. clonazepam)
  • carbamate anticonvulsants (e.g. felbamate)
  • carbonic anhydrase inhibitor anticonvulsants (e.g. topiramate)
  • dibenzazepine anticonvulsants (e.g. carbamazepine)
  • fatty acid derivative anticonvulsants (e.g. valproic acid)
  • gamma aminobutyric acid analogs (e.g. vigabatrin)
  • gamma-aminobutyric acid reuptake inhibitors (e.g. tiagabine)
  • hydantoin anticonvulsants (e.g. phenytoin)
  • neural potassium channel openers (e.g. ezogabine)
  • oxazolidinedione anticonvulsants (e.g. trimethadione)
  • pyrrolidine anticonvulsants (e.g. levetiracetam)
  • succinimide anticonvulsants (e.g. ethosuximide)
  • triazine anticonvulsants (e.g. lamotrigine)
  • miscellaneous anticonvulsants (e.g. lacosamide)
• safety and efficacy of treatment strategies in relation to the design of clinical trials, including ethical/regulatory approval from relevant bodies such as the UK Gene Therapy Advisory Committee, MHRA, on-site research governance committee and local ethics committee, compliance with Good Clinical Practice (GCP), EU Directive 2001 and Declaration of Helsinki;
• roles of regulatory agencies involved in drug use, monitoring and licensing (e.g. International Federation for Clinical Neurophysiology Guidelines, Royal College of Ophthalmologists Clinical Guidelines, Gene Technology Advisory Committee (GTAC), NICE, Committee on Safety of Medicines (CSM), MHRA and hospital formulary committees).

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will apply, within their scope of practice, a range of clinical and communication skills to advise and communicate effectively with relevant clinicians and other healthcare professionals and will, within the multidisciplinary team:

• contribute to the review the continuing need for, the effect of including adverse drug interactions and the adverse effects of long-term medications;
• recognise and anticipate avoidable defined drug interactions, including with complementary medicines;
• provide comprehensible explanations for the use of drugs to the patient and to carers when relevant;
• utilise non-medication-based therapeutic interventions and preventative health interventions;
• recognise the benefit of minimising the number of medications and interventions taken by a patient to a level compatible with best care;
• remain open to advice from other health professionals on medication issues;
• participate in adverse drug event reporting processes;
• remain up to date with therapeutic alerts and respond appropriately;
• critically reflect on their practice and knowledge of medications within their specialism and scope of practice.