BASEL SCREENING INSTRUMENT FÜR PSYCHOSEN A. Riecher-Rössler, U. Gschwandtner, R.-D. Stieglitz, J. Aston ANLEITUNG Mit Hilfe dieses Screeninginstrumentes sollen Individuen mit (beginnender) Psychose identifiziert werden. Es fokussiert auf folgende Bereiche: 1. Risikoalter Psychopathologie Prodromalsymptome nach DSM-III , neu aufgetreten in den letzten 5 Jahren
Cumnockhealthcentre.co.ukTanyard Medical Practice
2 Tanyard, Cumnock
Side Effects of Warfarin
Things to Remember
01290 421157 01290 422723
There are a number of possible side effects with Dental Treatment
anticoagulants, with the major side-effect of al being Tel your dentist that you take warfarin, for some dental treatments you may be required to temporarily stop your warfarin. Your GP/INR Nurse Passing blood in your urine or faeces (stools) This may be bright red or darker/black in colour Surgery & Investigations
Heavy bleeding during a period, or other If you have surgery or an invasive test scheduled then you may need to temporarily stop your warfarin. Your GP/INR Nurse wil be able to advise Anticoagulants: Warfarin
A patients education leaflet
Antibiotics are a group of medication which affects the way in which warfarin works. If you are If you cut yourself, or have any other bleeding,
commenced on antibiotic treatment, you wil be INR Clinics
you should seek medical help as soon as possible
advised if your warfarin dose requires to be Tuesday and Thursday mornings
if the bleeding does not stop as quickly as you
changed, and you may be asked to attend for By Appointment Only
would expect it to.
monitoring earlier than planned. This is a precaution to ensure that your INR level Contact your GP practice during working hours.
remains stable throughout the course of treatment. This leaflet will cover;
Contact NHS 24 on 08454 24 24 24 out of hours,
over weekends, and on holidays when the
practice is closed.
By fol owing the advice given to you by your Nurse/GP, by taking your warfarin as directed and by attending to have INR blood tests on time, your warfarin monitoring should be wel managed.
If you have any other questions in relation your warfarin management please discuss at your next What are anticoagulants?
Do I require to have my INR checked out with the
What if I have missed a tablet or think I have
arranged review times?
taken too much?
Anticoagulants are medicines that prevent the blood from clotting as quickly as effectively as normal. Yes, if you suffer from any of the following
If you accidental y miss a dose, NEVER, take a
double dose to “catch up” unless you are specifical y
Some people cal anticoagulants blood thinners. 1. Bleeding
advised to do so by your GP or the INR Clinic Nurse. However, the blood is not actual y made thinner – it 2. Change in medication
just does not clot so easily whilst you take an 3. Unwell, e.g. a fever
If you think that you have taken too much warfarin by mistake or have missed any doses please contact You wil be requested to re-attend to have your INR level your GP practice for advice during working hours. If Blood clotting of the artery or vein can lead to DVT, you require to speak to someone out of hours or over a weekend, please contact NHS 24 on 08454 24 24
Our practice has a dedicated INR clinics that run two Anticoagulants are prescribed if you have already had mornings each week, on a Tuesday and a Thursday.
a blood clot (treatment) – to prevent the clot from
getting bigger, or if you are at risk of having a blood
This clinic is by appointment only and is taken by Drug Interactions
Almost al medications can interact with warfarin, for You wil have your blood taken by one of our Practice Warfarin Monitoring
example antibiotics, pain kil ers and herbal remedies. Nurses using the CoaguChek® machine. The Nurse wil This can change the way in which it works and your inform you of your INR level, what dose of warfarin to dose may need to be altered. It is therefore important When you first start warfarin, your GP or Hospital take, and when you should arrange your next to let your doctor, nurse and pharmacist know that Consultant wil advise you on how to take warfarin, you are taking warfarin before buying over the counter the risks involved, things that can interact with warfarin and where you can attend for monitoring.
If you are a house bound patient, it wil be arranged for a member of the District Nurse team to visit you at home Food Interactions
What is INR?
to perform your INR level check. If you have not heard from the practice by 5pm that day, please cal the INR is a measurement of how long it takes for blood
surgery for your result and dose advice.
A major change in diet may require closer monitoring to clot. This varies depending on the il ness being and a change to your warfarin dose. Some foods treated, but the maximum therapeutic range is 4.
Al warfarin patients should update and carry their yel ow contain Vitamin K, which can decrease the effect of anticoagulant treatment book with them, which wil be warfarin. There are large amounts of vitamin K in certain foods such as liver, broccoli, brussels sprouts How often should I have my INR checked?
given to you when you first start. This is in case of emergencies, should a doctor need to know that you are and green leafy vegetables such as spinach coriander and cabbage and even some cheeses. Two other Once your INR level is stable, we aim towards the commonly eaten foods that are known to interact with longest interval possible between monitoring, unless you are at high risk of bleeding, then a maximum Should I stop Aspirin if I start Warfarin?
This depends on each individual patient and their relevant il nesses. Please discuss this with your GP who wil be able to advise.
What is Papilledema? ♦ A floating black speck, resulting from an Papilledema can narrow the range of your This condition is known as pseudotumor be-enlarged blind spot in the field of vision, usually peripheral vision. Your doctor may check your cause it exhibits the same symptoms caused by a apilledema is a rare condition that involves the in both eyes. Everyone has a “blind