,OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Clinical Pharmacy
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,Oxford Handbook of
Clinical
Pharmacy
Third Edition
Edited by
Philip Wiffen
Editor in Chief, European Journal of Hospital Pharmacy;
Visiting Professor, Dept of Pharmacy and Pharmacology,
University of Bath, UK
Marc Mitchell
Divisional Lead Pharmacist, Oxford University
Hospitals NHS Foundation Trust, UK
Melanie Snelling
Lead HIV/Infectious Diseases Pharmacist,
Oxford University Hospitals NHS Foundation Trust, UK
Nicola Stoner
Cancer Consultant Pharmacist, Oxford Cancer and
Haematology Centre and Oxford Cancer Research
Centre, Churchill Hospital, Oxford University
Hospitals NHS Foundation Trust, UK;
Visiting Professor, School of Chemistry, Food and
Pharmacy, University of Reading, UK
1
,1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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First Edition published in 2007
Second Edition published in 2012
Third Edition published in 2017
Impression: 1
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ISBN 978–0–19–873582–3
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Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
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, v
Preface to the
third edition
When we embarked on the first edition almost 10 years ago we did not
envisage the enthusiasm that has developed for the Oxford Handbook of
Clinical Pharmacy. We are very happy to launch the third edition. This edi-
tion has some 25 or so new topics and most of the existing topics have
been revised or reworked in some way. We have widened the number of
authors to bring new skills and knowledge into this edition.
Clinical pharmacy has undergone rapid development during the lifetime
of this little book. In the UK, a hospital pharmacy without clinical services
now seems strange but the battle to establish clinical pharmacy is still not
won in parts of Europe, particularly in Eastern Europe. The last 10 years
have also seen rapid development around the appointment and role of
consultant pharmacists, who are making major contributions in improving
patient outcomes and raising the research agenda within pharmacy. We
have sections in this edition on annotating medicine charts and writing in
patients’ notes. We suspect the life of these topics is limited as we progress
rapidly into electronic patient records. Finally, we are encouraged to see
the concept of evidence-based practice permeating the whole of hospital
pharmacy activities.
We would remind you that this handbook was never perceived as a for-
mulary but sits alongside such texts to provide evidence and hopefully wis-
dom for clinical pharmacists.
PW
MM
MS
NS
,vi
Acknowledgements
We are grateful to the following people who provided comments and
help: Jen Weston, Janice Craig, David Hutchings, Rhiannon Thomas, Eunice
Morley, Emma Pullan, Sarah Cripps, Charlotte Harris, Jo Coleman, Vicky
Price, Yovana Sooriakumaran, and Hannah Hunter.
, vii
Contents
Contributors ix
Symbols and abbreviations x
1 Adherence 1
2 Adverse drug reactions and drug interactions 17
3 Anaphylaxis 27
4 Clinical pharmacy skills 33
5 Clinical trials 105
6 Controlled drugs 117
7 Evidence-based medicine 123
8 Herbal medicines 143
9 Medical gases 157
10 Patient management issues 171
11 Patient-specific issues 203
12 Pharmaceutical calculations 229
13 Medicines management 239
14 Research 291
15 Therapy-related issues: gastrointestinal 299
16 Therapy-related issues: cardiovascular system 321
17 Therapy-related issues: respiratory system 373
18 Therapy-related issues: central nervous system 397
19 Therapy-related issues: infections 447
20 Therapy-related issues: endocrine 483
21 Therapy-related issues: obstetrics and gynaecology 505
22 Therapy-related issues: malignant diseases
and immunosuppression 517
,viii CONTENTS
23 Therapy-related issues: nutrition and blood 553
24 Therapy-related issues: musculoskeletal 597
25 Therapy-related issues: skin 613
26 Therapy-related issues: palliative care 629
27 Therapy-related issues: miscellaneous 643
Appendix: Supplementary data 679
Index 701
, ix
Contributors
Judith Bailey Olivia Moswela
Oxford University Hospitals Oxford University Hospitals
NHS Foundation Trust, NHS Foundation Trust,
Oxford, UK Oxford, UK
Nina Barnett Bernard Naughton
Pharmacy, London Northwest Formerly Oxford University
Healthcare NHS Trust & NHS Hospitals, NHS Foundation
Specialist Pharmacy Service, UK Trust, Oxford, UK
Rachel Brown Sarah Poole
Oxford Health Oxford University Hospitals
NHS Foundation Trust, NHS Foundation Trust,
Oxford, UK Oxford, UK
Fearn Davies Jas Sagoo
Oxford University Hospitals Medicines Management
NHS Foundation Trust, Lead, Oxfordshire Clinical
Oxford, UK Commissioning Group, UK
Louise Dunsmure Aarti Shah
Oxford University Hospitals Formerly Oxford University
NHS Foundation Trust, Hospitals, NHS Foundation
Oxford, UK Trust, Oxford, UK
Clare Faulkner Laura Smith
Oxford University Hospitals Oxford University Hospitals
NHS Foundation Trust, NHS Foundation Trust,
Oxford, UK Oxford, UK
Janet Hemingway Amy Tse
Oxford University Hospitals Oxford University Hospitals
NHS Foundation Trust, NHS Foundation Trust,
Oxford, UK Oxford, UK
Gwen Klepping Laura Watson
Oxford University Hospitals Formerly Oxford University
NHS Foundation Trust, Hospitals, NHS Foundation
Oxford, UK Trust, Oxford, UK
Katie McDonald
Oxford University Hospitals
NHS Foundation Trust,
Oxford, UK
