National Prescribing Curriculum

NPC logoThe National Prescribing Curriculum (NPC) is a series of interactive case-based modules that encourage confident and rational prescribing. The modules follow a stepwise approach as outlined in the WHO's Guide to Good Prescribing.

Target audience: Undergraduate and postgraduate medical students

Other audiences: Pharmacy, dental, nurse practitioner and other health professional students with an interest in prescribing.

The NPC modules are computer and mobile device compatible.      Compatible with computer and mobile devices

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CPD

It is recommended that 1 CPD hour be recorded for each module for the purposes of self-directed CPD.


Learning objectives

Click on the module title below to view its learning objectives

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Acute coronary syndrome

In this module, you will treat an episode of acute coronary syndrome in an elderly patient recovering from pneumonia.

Learning objectives

On completion of this module, you should be able to:

  • name three therapeutic goals in the management of acute coronary syndrome
  • name the main drug classes in the management of acute coronary syndrome
  • name 3 major characteristics in the beta-blockers used in the treatment of acute coronary syndrome
  • name 2 major differences between the use of unfractionated and low molecular weight heparin
  • name an absolute contraindication to the use of aspirin in patients with acute coronary syndrome
  • list 3 ways of monitoring a patient with acute coronary syndrome.

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Acute mania in bipolar disorder

In this module, you will assess and manage a patient previously diagnosed with type I bipolar disorder presenting with symptoms of acute mania.

Learning objectives

On completion of this module, you should be able to:

  • identify evidenced-based management of acute mania in bipolar I disorder
  • explain the importance of non-pharmacological management of bipolar disorder
  • recognise the importance of adherence to pharmacological therapy
  • state the adverse effects of medicines used for bipolar I disorder
  • select appropriate parameters to monitor treatment response during acute and maintenance phases of bipolar disorder.

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Acute pulmonary oedema

In this module, you will treat an acute episode of pulmonary oedema in a patient with chronic heart failure.

Learning objectives

On completion of this module, you should be able to:

  • identify therapeutic goals in the management of acute pulmonary oedema and chronic heart failure
  • choose the classes of drugs used in the management of acute pulmonary oedema and chronic heart failure
  • choose your Preferred drugs for treating acute pulmonary oedema and chronic heart failure
  • monitor for common potential adverse effects of and interactions with and between drugs used in chronic heart failure
  • identify co-indications to the use of specific drugs for heart failure
  • identify common contraindications to the use of specific drug classes in heart failure.

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Adolescent depression

In this module, you will support and consider appropriate treatment for a teenager exhibiting symptoms of depression.

Learning objectives

On completion of this module, you should be able to:

  • understand the importance of considering a full history to put  into context a presentation of depression
  • integrate risk assessment, including risk of harm to self or others,  into routine care of young people with depression
  • discuss the range of management options for young people with depression
  • understand the risks and benefits of antidepressants in young people with depression
  • develop a systematic approach for monitoring treatment and referring as appropriate.

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Anaemia

In this module, you will treat a woman with anaemia.

Learning objectives

On completion of this module, you should be able to:

  • demonstrate an understanding of the risks and benefits of blood transfusion for anaemia
  • identify the common causes of anaemia
  • select a preferred (first line) drug for the treatment of anaemia due to common nutritional deficiencies (B12, folate and iron)
  • describe the contraindications & precautions related to prescribing these agents.

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Analgesics in persistent pain

In this module, you will look at the use of analgesics in managing persistent pain.

Learning objectives

On completion of this module, you should be able to:

  • identify the therapeutic goals in the management of persistent pain
  • choose the classes of drugs used in the management of persistent pain
  • choose your preferred drugs for treating persistent pain
  • monitor for common potential adverse effects of drugs used for the management of persistent pain
  • be aware of drug-drug and drug-disease interactions for drugs used for the management of persistent pain
  • identify contraindications when considering choice of medicine for a patient with persistent pain.

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Anticoagulation in atrial fibrillation

In this module, you will consider appropriate anticoagulation for a patient with atrial fibrillation.

Learning objectives

On completion of this module, you should be able to:

  • stratify the risk of stroke for a patient with atrial fibrillation
  • recall some of the non-pharmacological options in the management of a patient with atrial fibrillation
  • describe the stroke risk reduction with the different anticoagulants and antiplatelets in atrial fibrillation
  • understand the bleeding risk of the different anticoagulants and antiplatelets in atrial fibrillation
  • stratify the bleeding risk associated with the different anticoagulants and antiplatelets in atrial fibrillation
  • recognise contraindications to warfarin therapy.

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Chronic angina

In this module, you will review and manage a patient with poorly controlled chronic angina in a patient with a recent history of myocardial infarction.

Learning objectives

On completion of this module, you should be able to:

  • identify therapeutic goals in the management of patients with chronic stable angina
  • name the drug classes available for achieving these various therapeutic goals, their major contraindications, and how to monitor them
  • name three non-pharmacological approaches in the management of chronic angina
  • name some strategies to improve compliance.

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Chronic heart failure

In this module, you will review and optimise the management of a patient's chronic heart failure.

Learning objectives

On completion of this module, you should be able to:

  • identify therapeutic goals in the management of chronic heart failure
  • choose the classes of drugs used in the management of chronic heart failure
  • choose your Preferred drugs for treating chronic heart failure
  • identify adverse drug reactions as a cause of clinical deterioration
  • identify potentially significant interactions that may occur between different drugs that may be prescribed in the management of heart failure.

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Chronic obstructive pulmonary disease exacerbation

In this module, you will treat a patient admitted to ED with an acute exacerbation of COPD.

Learning objectives

On completion of this module, you should be able to:

  • identify at least 2 therapeutic goals in treating patients with acute exacerbations of COPD
  • choose the classes of drugs used in the management of acute exacerbations of COPD
  • choose your Preferred drugs for treating an acute exacerbation of COPD
  • properly complete all the details on a patient's medication chart so that the drugs which you have written up can be given in the way that you intend
  • select suitable measurements with which to monitor response to the treatment during the acute exacerbation and the longer term course of COPD.

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Confusion associated with alcohol withdrawal

In this module, you will treat a confused elderly hospital patient with a history of heavy drinking.

Learning objectives

On completion of this module, you should be able to:

  • identify presentation of alcohol withdrawal in the elderly
  • formulate a suitable management plan for a confused elderly patient with alcohol withdrawal
  • describe the course and management of an episode of alcohol withdrawal
  • choose an appropriate short term drug strategy for managing alcohol withdrawal
  • list factors that may complicate the management of alcohol withdrawal
  • describe how changes in measured response to treatment may require modification in treatment.

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Confusion in a geriatric patient

In this module, you will manage confusion arising during an exacerbation of an elderly patient's chronic heart failure.

Learning objectives

On completion of this module, you should be able to:

  • identify common causes of confusion in the elderly, including alcohol and other drug withdrawal
  • formulate an acute management plan for a confused elderly patient
  • choose an appropriate short term drug strategy for managing confusion
  • write a prescription for immediate management
  • describe how changes in measured response to treatment may require modification of treatment
  • identify key information for the patient and her carers on discharge.

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Dental - Bone complication (following dental extraction)

In this module you will treat a patient with symptoms that could arise from one or more different diagnoses.

Learning objectives

On completion of this module, you should be able to:

  • identify at least two therapeutic goals in treating patients with complications arising from bone infections,
  • make the correct diagnosis and identify therapeutic objectives for treating the patient,
  • identify non-drug treatments that will assist the patient,
  • identify the classes of drugs used to manage both the abscess, and the acute pain,
  • choose your Preferred drugs for treating infection and pain,
  • write a PBS prescription and a pharmacy note for over-the-counter (OTC) items.

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Dental - Facial pain

In this module you will be managing a dental patient with symptoms that could arise from either trigeminal neuralgia or a periodontal abscess.

Learning objectives

On completion of this module, you should be able to:

  • identify at least two therapeutic goals in treating patients with acute exacerbations of facial pain.
  • make the correct diagnosis and identify therapeutic objectives for treating the patient
  • identify non-drug treatments that will assist the patient
  • identify the classes of drugs used to manage both the abscess, and the acute pain
  • choose your Preferred drugs for treating infection and pain
  • write a PBS prescription and a pharmacy note for over-the-counter (OTC) items.

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Dental - Sore mouth

n this module you will treat a dental patient with a complex range of oral symptoms.

Learning objectives

On completion of this module, you should be able to:

  • make the correct diagnosis and identify therapeutic objectives for treating the patient
  • recognise that more than one pathological state may co-exist
  • identify non-drug treatments that may assist the patient
  • identify the classes of drugs used to manage the acute pain and ulcers
  • choose your Preferred drugs for treating inflammation and pain
  • write a PBS prescription and a pharmacy note for over-the-counter (OTC) items.

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Glycaemic control in long-established diabetes

In this module, you will consider further treatment options for an elderly patient diagnosed with type 2 diabetes more than a decade ago.

Learning objectives

On completion of this module, you should be able to:

  • demonstrate an understanding of the role of metformin in monotherapy and combination therapy
  • understand the actions, side effects and place in therapy of sulfonylureas
  • identify patients at risk of thiazolidinedione-induced adverse effects and employ strategies to minimise this risk
  • understand the role and benefit of early insulin initiation
  • advise patients of the usual progression to insulin, identify any barriers and explain the benefits of early insulin therapy
  • describe how to select and initiate insulin therapy in a simple and safe manner and manage associated adverse effects
  • outline the benefits of lifestyle interventions in prevention and ongoing management of diabetes.

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Hypertension

In this module, you will manage a patient with newly diagnosed hypertension with a comorbidity of asthma.

Learning objectives

On completion of this module, you should be able to:

  • understand diagnostic issues related to hypertension
  • identify cardiovascular risk reduction goals of BP lowering & related treatments
  • identify the scientifically validated non-drug treatments for hypertension
  • select Preferred classes of drugs for treatment
  • compile a limited Personal formulary of individual drugs for the initiation and continuing treatment of hypertension
  • provide information to the patient and /or carers about the nature of the treatment and the need for continuing monitoring.

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Insomnia

In this module, you will be considering the treatment options for a middle-aged patient with sleeping difficulties.

Learning objectives

On completion of this module, you should be able to:

  • identify and address causes and exacerbating factors for insomnia
  • outline the role of non-pharmacological therapies for the management of insomnia
  • counsel patients on good sleep practices
  • discuss the risks and benefits of using hypnotic medicines in treatment of insomnia
  • develop a plan for stopping and withdrawing benzodiazepines.

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Lipid management and CVD risk

In this module, you will be addressing the cardiovascular risk of a 49-year-old man who is concerned that he is at high risk of having a heart attack.

Learning objectives

On completion of this module, you should be able to:

  • assess a patient's cardiovascular risk
  • discuss cardiovascular risk with patients to encourage lifestyle modifications
  • choose an appropriate lipid-modifying therapy
  • monitor the effectiveness of lipid-modifying therapy
  • encourage long-term adherence to lifestyle modifications and, if prescribed, lipid-modifying therapy.

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Opioid analgesics in chronic non-cancer pain

In this module, you will be considering the role of opioid analgesics in managing a 64-year-old man who suffers from chronic non-specific back pain.

Learning objectives

On completion of this module, you should be able to:

  • recognise the role of thorough history and physical examination to determine if investigations are necessary
  • develop a multidisciplinary pain management plan
  • explore non-drug strategies for management of chronic non-cancer pain
  • understand the importance of initiating any opioid therapy on a trial basis only to assess effectiveness and adverse effects
  • understand the risks and benefits of opioid analgesia in chronic non-cancer pain
  • assess the indications for ongoing opioid analgesia on an individual patient basis.

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Opioid dependence

In this module, you will initiate and plan ongoing outpatient treatment for a patient who presents at ED with narcotic analgesic dependence. In addition you will consider legal issues around prescribing for Schedule 8 (S8) drugs.

Learning objectives

On completion of this module, you should be able to:

  • explain the legal and practical differences between prescribing Schedule 8 (S8) and Schedule 4 (S4) drugs
  • list the range of services available for those with opioid dependence and appropriate steps to be taken when dealing with such patients
  • understand the range of opioids available
  • understand the pharmacological principles guiding decisions to prescribe.

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Peptic ulceration with H. pylori

In this module, you will treat a patient with peptic ulcer disease due to Helicobacter pylori.

Learning objectives

On completion of this module, you should be able to:

  • identify therapeutic objectives in treating patients with peptic ulcer
  • choose the classes of drugs used to manage peptic ulcer
  • choose your Preferred drugs for treating peptic ulcer
  • write an appropriate prescription
  • consider drugs for H. pylori eradication.

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Peptic ulceration with NSAID use

In this module, you will treat a patient with peptic ulcer disease following use of two nonsteroidal anti-inflammatory drugs.

Learning objectives

On completion of this module, you should be able to:

  • identify therapeutic objectives in treating patients with peptic ulcer induced by NSAIDs
  • choose the classes of drugs used to manage peptic ulcer induced by NSAIDs
  • choose your Preferred drugs for treating peptic ulcer induced by NSAIDs
  • write an inpatient prescription
  • examine the pathogenesis of NSAID gastroduodenal toxicity to explain therapeutic options

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Polypharmacy

In this module, you will treat an elderly patient on multiple medications and comorbidities who presents with various signs and symptoms indicating multiple system failure.

Learning objectives

On completion of this module, you should be able to:

  • state the major guiding principles in rational prescribing
  • recognise, and substantiate, over-prescribing or inappropriate use of multiple drugs
  • describe how to perform a full medication review
  • identify the important components of hospital discharge prescribing, including the provision of information to patient, carer and health professionals
  • state the major factors which create differences in the approach to prescribing in special populations, with particular reference to the elderly.

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Post operative pain and vomiting

In this module, you will treat a patient with pain and vomiting following a surgical operation.

Learning objectives

On completion of this module, you should be able to:

  • list the classes of drugs used in the management of post-operative pain and vomiting
  • outline the therapeutic goals of post-operative symptom management
  • adjust the dose of opioids based on pain severity, age, tolerance and comorbidities
  • explain the legal and practical differences between prescribing Schedule 8 (S8) and Schedule 4 (S4) drugs
  • explain the contraindications and side effect profile of the P drugs chosen for post operative pain and vomiting.

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Prophylaxis of venous thromboembolism

In this module, you will consider appropriate prevention of VTE in hospital inpatients. This is a very important topic as pulmonary embolism is responsible for approximately 10% of all deaths in hospital, even though most of these deaths are largely preventable.

Learning objectives

On completion of this module, you should be able to:

  • understand risk factors and their relative importance in the prevention of venous thromboembolism
  • understand the role of non-pharmacological approaches to prevent venous thromboembolism
  • know of the therapeutic options for prevention of venous thromboembolism
  • understand the role of different therapeutic options for patients at different level of risk for venous thromboembolism.

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Respiratory tract infection in a child

In this module, you will treat a young child who presents to ED at night with an upper respiratory tract infection and fever.

Learning objectives

On completion of this module, you should be able to:

  • decide whether an antibiotic is needed for a child with a respiratory infection
  • choose an appropriate antibiotic, if one is indicated
  • develop a comprehensive management plan incorporating any appropriate adjunctive therapies
  • write a prescription specifying the appropriate dose, frequency and duration of treatment
  • adequately communicate the proposed treatment plan and potential medication-related adverse effects to the child's parent/carer
  • develop an appropriate plan for monitoring response to therapy.

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Seizure

In this module, you will treat a young woman presenting to the ED following an episode of generalised seizure.

Learning objectives

On completion of this module, you should be able to:

  • list the principles of the acute management of a patient with an epileptic seizure, including the identification of any precipitating factors
  • state the commonly used anti-epileptic drugs and their side effects
  • choose effective drugs for acute management and ongoing treatment of epilepsy
  • write a prescription for the drug(s) of your choice
  • identify the long-term goals in the management of epilepsy
  • provide verbal and written information about the drug therapy for a patient with epilepsy
  • explain how you would monitor the drug therapy.

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Type 2 diabetes – part 1

In this module, you will be managing a middle-aged patient who has been recently diagnosed with type 2 diabetes.

Learning objectives

On completion of this module, you should be able to:

  • establish appropriate treatment goals for type 2 diabetes
  • describe non-pharmacological and pharmacological treatments of type 2 diabetes
  • describe the classes of hypoglycaemic agents
  • choose drugs for treating type 2 diabetes
  • choose monitoring appropriate to the treatment regime.

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Type 2 diabetes – part 1

In this module, you will be continuing the long-term management of a middle-aged patient with type 2 diabetes at a later stage of the disease.

Learning objectives

On completion of this module, you should be able to:

  • establish appropriate treatment goals for a patient with type 2 diabetes
  • describe the types of insulin
  • describe the process for initiation of insulin in type 2 diabetes
  • choose an insulin regime for treating type 2 diabetes
  • choose monitoring appropriate to the treatment regime.

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Urinary tract infections

In this module, you will treat a young woman presenting with symptoms of a urinary tract infection. She is afebrile, has no rigors, no abdominal or loin pain or tenderness.

Learning objectives

On completion of this module, you should be able to:

  • prescribe an appropriate first-line medication for a woman with uncomplicated urinary tract infection
  • prescribe effective alternatives if your first-line choice is unsuitable in any particular case
  • demonstrate awareness of the implications of penicillin hypersensitivity in the choice, or avoidance, of alternative antibiotics
  • counsel a woman with uncomplicated lower urinary tract infection on non-drug treatment and on the use of drugs, including antibiotics and other drugs used in the treatment of urinary tract infection.

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Last modified: Wednesday, 20 April 2016, 9:59 AM