Table 1.

Extract from a pharmaceutical care plan completed in the feasibility study

Drug	Dose, frequency, quantity	Indication	Potential drug related problems	Suggested action	For use by GP
Amiodarone tabs	100 mg, od, 28	?arrhythmia	Deposits in eye, SOB, peripheral neuropathy	No change
Aspirin tabs	75 mg, 2 od, 56	2° prevention CHD	GI effects	No change (could reduce to 75 mg od)
Diclofenac tabs	50 mg, bd, 56	Pain	GI effects, dizziness, vertigo	Stop – no benefit
Tylex® caps	2, qds,100	Pain	Constipation	Stop – no benefit
Isphagula husk	3.5 g, bd, 30	Constipation	Patient not taking sufficient fluid for effective use	Stop – exacerbates dehydration, unpalatable, prefers senna
Lactulose liq	mdu, 300 ml	Constipation	Patient not taking sufficient fluid for effective use	Stop – finds senna more effective
Ranitidine tabs	150 mg, bd, 60	?dyspepsia	GI effects, dizziness, confusion, tiredness	Leave existing stocks for use prn
Tamsulosin MR tabs	400 mg, od, 30	Enlarged prostate	Dizziness, hypotension, drowsiness	No change