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Healthcare professionals are advised to check serum-vitamin B 12 levels if deficiency is suspected and consider periodic monitoring in patients with risk factors for deficiency. Patients and their carers should be counselled on the signs and symptoms of vitamin B 12 deficiency and advised to seek medical advice if these occur. Manufacturer advises caution in chronic stable heart failure monitor cardiac function, and concomitant use of drugs that can acutely impair renal function; interrupt treatment if dehydration occurs, and avoid in conditions that can acutely worsen renal function, or cause tissue hypoxia. See also Prescribing in the elderly.

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This chapter is intended to illustrate prescribing in practice by podiatrists, radiographers and physiotherapists and has been written largely by members of those professions. Given that prescribing can be considered to include advising a patient on suitable care or medication including over-the-counter drugs as well as the more familiar written orders or prescriptions, there is considerable scope for health care professionals to be involved in patient medication. There are in fact metformin generic medicine ways in which suitably qualified and registered health care professionals can supply medicines to patients: patient group directions, patient specific directions (PSDs), supplementary prescribing, independent prescribing and specific exemptions to the Medicines Act. The first three of these require a working partnership with medically qualified professionals; the last two do not. Two sections presented here have been written by practitioners in podiatry and radiography.

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