 everyone, welcome back to another vlog. Thank you as always for joining me. Thanks for coming back if you are returning and a huge massive welcome if you are new to the channel. So thank you so much. So today's vlog is all about common medications you will see as a general practice nurse or if you're a student going on a placement in general practice. The first most common medication you will see is a B12 injection. I'm gonna put the full name here because I can't fully say the word, I know. This is a very common medication that we do at the minute. It comes in tablet form or injection. We give it as an IEM injection into the arm. We rotate arms each time they come because they have it so often. And it goes into the deltoid muscle right at the top. So this chunky bit here. Someone said it's like four fingers down. I don't know where that's come from but that's what someone told me. But yeah, somewhere there, you know, where your BCG is, roundabout there, that'll do. And these are just prescribed for people that have low bitumen B12. So they will come in and they will initially have a load in dose. So they will have one injection three times a week for two weeks. That's the total of six injections over two weeks, if that makes sense. It'll be an injection on Monday, Wednesday, Friday. And then the following week, Monday, Wednesday, Friday, it's got to have a gap in between each one. And then after their initial load in dose, they will go to 12 weekly injections. However, you can give this one at 10 weekly. So between 10 and 12 weeks they can have it but the doctor has to obviously prescribe that for that time. And people have it at 10 weeks rather than 12 if they really suffer with the side effects. So if they're getting to like week nine and 10 and they're really struggling with fatigue and all them sort of symptoms that you get with a deficiency, then they'll have it at 10 weeks instead of 12. But normally it's just a 12 weekly injection and less prescribed otherwise. I'm not gonna go into all of the cautions, contraindications, side effects and all that jazz with all of these medications because we will be here all day long. So please just look up the BNF. I always promote this. Come on, BNF for all of your medications. It'll tell you everything, literally everything you need to know. Even the method of action in the body. If you go online, BNF is all there for you. The next most common medication we see as a general practice nurse is what they call ProStap or Zolodex injection. So these are hormone injections. They are given to people with prostate cancer, breast cancer. If someone's got endometriosis, if they've got anemia because they've got fibroids, loads of different things they can be given it for. If it's for a prostate, then they have to do regular prostate checks on the blood tests, just to make sure that it's a stain where it should be basically in target range. But these again are injections. ProStap is just into the arm again. You can give it subcut or IM. I don't think there's any right or wrong. You can give it both ways. You can give it into the arm or into the abdomen area as well. A bit like if you were gonna give a Clexane or an Oxyparin, something like that into the stomach. And it's all, the ones that you get are pre-filled syringes as well. Some of them are a bit of a nightmare because you have to mix them up because they're coming two different parts and you have to mix it up. Or there'll be ones where it's all in together. So you'll have a powder and then a liquid under it in a syringe and you push it up so that the water goes into the powder and then you have to mix it frantically without getting bubbles in it. It's ridiculous the way you have to mix some of these up. But yeah, they can be tricky. And then the Zolodex one is the exact same pretty much as the Hormone ProStap one. Same way it works and everything. But it's more of an implant. It's not the nicest to give. It's the one that I actually hate with a passion to give because it just looks evil. And luckily my patients have all been okay and it's not too painful for them. And they never complained that it's too painful. It's gonna be sore because it is quite a big needle and it's quite a wide needle as well. It's quite, yeah, it's not nice. And it's got like a little implant in that you just push under the skin, release it and then pull it out. And they don't have local anesthetic or anything. It's literally just in, out, that sort of thing. My last one went really well actually and that person said, actually I didn't feel that. I was actually quite happy with that. So yeah, that was okay. But it's not a nice one to give guys. It's, yeah, actually I'll put it here. I'll put the picture here so you can see what I'm talking about. Otherwise you're just not gonna know. But you need separate training to do this. So I couldn't initially give it as a newly qualified nurse. I had to do the separate training as part of it. And then I had to watch someone do it. And then I was watched doing it as well. And then I was signed off to do it. So it's not one that you can just give for fun. You do need to actually have training for it. So I'm coming at work just giving him a hormone injection. So I just wanted to show you the types that we have. So this is one that we use for a patient with prostate cancer. He's on this one for life. It will come in a glass bottle. Obviously I've already given it. So this is after, and I've just got a little break. So I thought I'd just do this. But this is where the powder is. And then there was a pre-filled injection, which obviously I've given. So I've had to get this. There'll be a pre-filled injection with water for injection, which then gets mixed up with the powder. But this one comes with a little nozzle. So this is the nozzle that you have to put onto the bottle like this. Oh, hang on. So yeah, I couldn't do that. But this is the nozzle that you have to just literally put onto the bottle, twist it, pull it off, and that's ready. And then you'll get your water for your injection. You attach it to there like that, put the water in, mix it up, draw it back up into the syringe, attach your needle, give to the patient. Next up, we have a contraception. So you're gonna have all sorts of contraception. So you'll be the person doing your pill checks, the height, weight, blood pressure, going through family history and all that jazz, making sure there's no contraindications with other medications. And then the one that you'll physically give is the depot provera injection. There's also Santa press as well. That's a pretty new-ish injection. And a patient can give that themselves at home. They're trained to do it. But yeah, depot is normally given about 12 weeks. It can be given up to 14 weeks now. It used to just be 12, and that was it. But you can actually give it up to 14 weeks. But if they are late for their depot over 14 weeks, do not give it unless you are 100% certain that person is not pregnant. But yeah, depot provera is something that we give. This one goes into the buttocks just at the very, very top. Left or right, and we alternate as well. Like the B12s, we alternate. Same with the ProStap and the Zolodex because we give it so often. You have to alternate the sites. Again, blood pressure, height, weight, family history, risk of osteoporosis and all of that. But that is a common one we see as a g-penis. Sometimes you'll have a patient come in and they'll give you their injection and you've got no idea where it's come from, what it's for, why they're here with you, with it, and you'll just be like, what? So that's when you have to do a bit of detective work. So obviously ask your patient, where have you got this from, who's prescribed it, what's it for, because they will know everything. And normally it's the hospital that's given it them and then they're coming to us to have it. So then you would do your detective work on the computer, just make sure it's suitable for the patient, check all the details, that's what I do anyway. I get up the BNF on the medication. If it's a vaccine or something like that, I'll use the green book on the nice guidelines because that is your Bible and I will have it there in front of me ready for the patient. But the most important thing you can do is be honest with your patient, look at them and say, I'm really sorry, I've never given this particular injection before, I'm fully qualified, I've given many, many injections, just not this one. So I'm just gonna read how to actually give it because some of them come in really strange devices. You're gonna look at the device and think, what is this, like I was talking about about the ProStat where it comes in two separate bits and you have to mix it. And you'll just be like, I don't know how to give this. But there's always instructions in the box and I literally, I'm just honest with my patient, I just say, I just need to read these instructions because I've never given this type of thing before and they all come and I just explain, they all come in different files and syringes. So I just wanna make sure I'm getting it right before I give it to you and that they're happy with that as long as you're honest with them, they're happy. We don't know all of the medications out there, we don't know all of the devices, we just don't know it all guys, it's fine, it's okay. Again, be open, be honest, and you'll be all right. And the next hormone injection is in Abedo, Abedo, I think that's how you say it, but this is one of our transgender patients that are on this and I'd never seen this before either, I didn't know what sort of medications do what and things like that. So this was a really interesting one for me, I really loved it and I loved looking into it and the side effects and how it works in the body for the patient and it's really, really interesting actually to look at, that's a really good one that really enhanced my knowledge as well and it was really great to see that patient as well and how they're getting on with that medication and how it's affecting them as well, so that's a really good one. And my last injection is called, I need to say it slowly guys or I can't say it, denosumab, denosumab, denosumab, denosumab. Something like that, I can't say it for the life of me, I think I've said it before in a vlog, I've been to a doctor before and said, oh, this patient's on this injection, I've just tried to say it and they're just like, what are you on about Claire? I'm like, I don't know, the denso injection, the really good one, you know. Anyway, common, really, really, really common injection that we give as well. This is a six-monthly injection, so this one is for osteo, however, it can affect the calcium level. So with this one, you have to check the patient's blood tests for two weeks before giving it, so this is for calcium, make sure the calcium levels aren't dropping and also check kidneys, make sure the kidney function's okay for it. I have known patients to be on it, that it's got a low GFR kidney function, but the consultant has said they're okay to have this injection because the benefit outweighs the risk. That's okay, it's like with any medications, they will just keep a very close eye on it and monitor it and any problems, any signs, symptoms, anything like that, then they get on the phone. This injection, again, can be given in the arms or the abdomen, it's a subcut injection and it's quite an easy sort of injection to give. It's not really, it's not too difficult to give and this injection is also kept in the fridge. So with our clinic, we will put in the prescription for the patient, it will get sent to the pharmacist and then when the patient collects it, they'll put it in the fridge and then they'll take it out of the fridge the day of their appointment and they'll bring it to their appointment with them. Some injections that we do, like B12 ProStap is kept in our cupboard, so we will order them directly from the pharmacist to our clinic to give to the patient, but we don't do that with all medications. There's only certain ones that we do that with and again, everywhere's different. Everyone will do it different. It just depends on the GP surgery, how they run things, but that's just the way that we do it. But yes, another fun field injection, inhalers. Oh my God, so there's so many different types of inhalers. I'm not gonna go through them all. Literally, it will be here all year. So yeah, so if you are going to GP, you will see long-term conditions. One of them is asthma, which is controlled by firstly, a short-acting beta-2 agonist or SARBA for short, or salbutamol-ventilin, the blue one, that is that one. So they have to have that and they have to have an inhaled cortosteroid inhaler as well, which used to be the brown one, but now they come in purples, pinks, and all sorts of colors. But as long as they're on those two, that is your initial management treatment for asthma. And as always, follow your nice guidelines for every long-term condition. Nice guidelines are there to follow. They are the gold standard. As long as you're following that, you can't go wrong. And then you've got diabetes. So people are beyond things like metformin for diabetes or insulin. I don't do diabetes where I am. We've got an amazing diabetic nurse who is just so knowledgeable. I'm just like, I do the foot ulcers and that's it. But not just that, alongside medications, you also need the health and lifestyle changes. So stop smoking and exercise more, eat better, get fruit and veg in, less carbs because carbs turn into sugar in your body. You don't want that long-acting sugar flowing around your body all the time. So having smaller carbs as well. Those little things can really, really help diabetes. There's all sorts of information out there for diabetes. Have a look at the diabetes organization website. It's brilliant for everything. And again, nice guidelines, guys. And then we have got cardiovascular medication. So you will see people for their blood pressure and you will have things like statins for cholesterol. You'll have things like Ramapril. So your ACE inhibitors. You'll have your bisoprolol. I can't say it still. Which is a beta blocker. So you have beta blockers, ACE inhibitors. All these type of medications all help blood pressure, irregular heartbeats, antideretics. So things like feruzomide as well, which is a water tablet. There's so many. Again, there's just so many different ones. It's like a minefield. It depends on what your patient's condition is, what the background is. If they can have certain medications, what their kidney functions like. So the doctor deals with all that and prescribes. We just look at it and we check the blood pressure. And if the blood pressure is still high, then we refer it back to the doctor to sort out the medications. Next up, we have HRT. So, and when people are on this, we need to monitor things like their blood pressure as well, just to make sure that that's settled. Sometimes they have like an ECG in blood just to check all the levels, make sure the heart's okay, make sure they've had like a full assessment. They'll do the weight, height, blood pressure, all of that jazz, to make sure that it's safe to give HRT. And also family history in the background as well, because with everything, there's always risks somewhere of things like cancer. So it's really important that we do the rechecks before putting any patients on this medication. Not that I do it personally, but the doctors do it. We just do the background stuff, like the ECG, the bloods, the blood pressures. So it's just another medication, just to be more mindful of that you might see in GP. So I think that's it for now. I can't, my mind has just gone, mush, I've covered so many. And I'm trying to think of some other ones that we might have seen, but I really can't think of anything else. They're just the main key ones that we see in general practice. So I hope that's been some sort of help for you. Like I said, got nice guidelines, official websites like NHS, diabetes, asthma UK, all of that jazz for all of your medications and info. But I hope that's been some sort of useful. So if you're going into a placement, like I said, for GP, it's really good to know what sort of medications and injections and things like that you might be seeing and doing. So yeah, I hope that's helped. And thank you so much as always for watching and I shall see you next time.