Safe prescribing Flashcards

1
Q

some medication errors (give some examples)

A
  • professional practice
  • health care products
  • procedures and systems
  • product labeling, packaging, and nomenclature
  • dispensing
  • distribution
  • administration
  • education
  • monitoring
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2
Q

Common mistakes with cancer (temazepam)

A

should have been given tamoxifen

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3
Q

giving a contraceptive steroid instead of an ?

A

antipsychotic injection

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4
Q

INR is a measure of?

what is the normal values?

A

warfarin activation

- should be 2.5-3.5

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5
Q

NR 5.0–8.0, minor bleeding - WHAT DO YOU DO?

A

—stop warfarin sodium; give phytomenadione (vitamin K1) by slow intravenous injection;

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6
Q

restart warfarin sodium when?

A

INR <5.0.

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7
Q

NR 5.0–8.0, no bleeding— what do you do?

A

withhold 1 or 2 doses of warfarin sodium and reduce subsequent maintenance dose.

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8
Q

warfarin replacement?

how is this done?

A

vitamin K or replacement of vitamin K-dependent clotting factors.

IV administration of a prothrombin complex concentrate (PCC),

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9
Q

Cytochrome P450 are very ?

A

potent antifungals,

warfarin wasn’t being metabolised

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10
Q

lowest INR level for preventing stroke?

A

2

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11
Q

Types of medication error (4)

A
  • mostly occurs from surgery
  • complications from drug treatment
  • therapeutic mishaps
  • diagnostic errors were the most common non-operative events.
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12
Q

Which patients are most at risk? (5)

A
  • Those undergoing cardiothoracic surgery, vascular surgery, or neurosurgery
  • Those with complex conditions
  • Those in the emergency room
  • Those looked after by inexperienced doctors
  • Older patients
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13
Q

Some factors that could increase the rate of medication errors? (5)

A
  • More rapid throughput of patients
  • New drug developments, extending medicines into new areas
  • Increasing complexity of medical care
  • Increased specialisation
  • Increased use of medicines generally
    Sicker and older patients, more vulnerable to adverse effects
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14
Q

People related causes of medication incidents?

A
  • Fatigue: Sleep deprivation
  • Hunger: Long lapses between food/drink
  • Concentration: Lapses
  • Stress
  • distraction
  • lack of training
  • lack of access to information
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15
Q

Common Prescribing Errors - give some examples

A
  • Wrong drug (e.g. drugs that sound alike)
  • Wrong dose
  • Inappropriate Units
  • Poor/illegible prescriptions
  • Failure to take account of drug interactions
  • Omission
  • Wrong route/multiple routes (IV/SC?PO)
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16
Q

some of the most common drug GROUPS that cause harm/incidents

A

opiates

anticoagulants

anaesthetics

insulin

antibiotics

chemotherapy

infusion

chemotherapy

17
Q

ARI most common drugs prescribed wrong

A
Paracetamol
Gentamicin
Warfarin
Oxycontin - opiate
Methadone
Insulin
18
Q

Always check the patient information..give examples

A
  • Age
  • Weight
  • Renal and hepatic function
  • Concurrent diseases
  • Laboratory test results
  • Concurrent medications
  • Allergies
  • Medical/Surgical/Family - History
  • Pregnancy
19
Q

Use 500 mg for

A

0.5 g

20
Q

Use 125 microgrammes for

A

0.125 mg

21
Q

oral methotrexate is regularly prescribed how often?

A

Methotrexate prescribed

as 10mg once weekly

22
Q

what does methotrexate do?

A

suppress bone marrow - can lead to patient death

23
Q

Prevention of Medication Errors - the FIVE R’s?

A
Right Patient
Right Drug
Right Dose
Right Route 
Right Time