Case 6 medical conditions Flashcards
(20 cards)
what vitamin is given to babies as per protocol directly after birth
vitamin K
where is the injection site for an epidural
epidural space
how does an epidural work
provide pain relief from the point of injection downwards up until around the knees
how would you respond to a patients concern about childhood vaccines giving children autism
- autonomy, beneficence, non-maleficence, and justice
✅ Acknowledge concern: Listen empathetically without judgment.
💬 Explore beliefs: Ask what specifically the mother read or fears.
📚 Provide evidence: Vaccines do not cause autism (fraudulent study retracted).
❤️ Promote benefits: Vaccines protect the child and others (herd immunity).
🧠 Respect autonomy: Support informed decision-making without pressure.
⚖️ Public health duty: Highlight societal impact and justice.
🤝 Offer support: Signpost reliable info (e.g., NHS) and keep communication open.
describe what the stepped approach to prescribing in eczema is
for atopic eczema there are stepped treatment options. firstly assess the symptoms and decide which category it falls into: mild, moderate, severe. Then go down the list in terms of prescribing. Start with emollients always and see if the CORRECT use manages symptoms. If it does not then we move down the list and so on. The stepped approach is to find the correct thing that will MANAGE symptoms. It means that medicines are only added if needed. less medicines the better!
what are the key councelling points for epimax
- apply generously multiple times a day
- can be used as a soap substitute
- shouldnt need to rub it in. smooth onto the skin and let the skin absorb this
what are some general lifestyle points about managing eczema
- prevent babies and small children from scratching by putting cotton gloved on their hands and keeping nails short
- apply emolients generously and smooth onto skin rather than rubbing it in
- ## some emollients can be used as a soap subtitute
describe the counselling involved in the use of a salbutamol pMDI and a easychamber device with a child mask
- Remove the cover of the mouthpiece of the inhaler. Shake the inhaler
- Attach the spacer to the inhaler then attach the mask
- Tidal breathing technique:
- Tilt head up – helps med reach lungs
- Press the canister down to release the med
- Breathe in and out slowly 5 times
- Remove from your mouth.
- If a second puff is needed, take a minute away from the inhaler. Shake it and repeat.
- Replace the caps on both the spacer and inhaler
- Clean using warm sopay water and leave to air dry
- Clean the inhaler once a week by holding it under a tap.
what is MART
Maintenance And Reliever Therapy—a combination of an ICS and a fast-acting LABA such as formoterol in a single inhaler, see beclometasone with formoterol and budesonide with formoterol
how many puffs of an inhaler could you give someone having an asthma attack in 1 go
10
How would you repsond to an ethical scenario regarding a young person being caught with possession of pregablin and cyclizine
. Pregabalin is a CD3 – cannot be sold and is addictive in nature.
- Cyclizine can cause euphoric and hallucinogenic effects
- These are drugs that can be abused, so it is a safeguarding issue.
- is there a pattern of bad behaviour and illicit drug use.
- We need to know how they
have come to find these drugs. Has he stolen them from someone? Is this a county lines issue? It is illegal to possess these medications without a prescription, so we need to contact the police
- We also need to signpost the parents to receive support
what are extrapyrimidal side effects and what kinds of drugs is this associated with
The extrapyramidal side effects are involuntary movements without one’s control. It is most commonly seen due to the intake of antipsychotic drugs. The extrapyramidal side effects are dystonia(involuntary contraction of muscles), tardive dyskinesia(involuntary facial movements), akathisia(restlssness), and parkinsonism(symptoms similar to Parkinson’s disease)
why do steroids need to be weened
they replace endogenous cortisol production so if abruptly stopped the body enters adreal crisis. This can be life threatening
what needs to be monitored in risperidone treatment
- hyperprolactinemia - high prolactin
- Weight gain
- ECG - qt interval may be increased – check annually
- Constipation
- Dislipidemia
- All vitals
What should you do if you are unsure about the dosage of methadone for an aggressive patient
confirm the dose from external sourses - not the patient
- community pharmacy
- gp
we should also reassure them about withdrawal. This reaches its peak in terms of symptoms 2-4 days after the last dose.
what should happen if there is a missed doses of risperidone injection
re-titration
in the mean time use oral supplementation also
how many days can a patinet go without methadone to require re-titration
3
why does prolactin levels and ECG need to be monitored with risperidone use
antipsycotics like risperidone increase prolactin levels: can interfere with the functioning of reproductive, endocrine, and metabolic systems
this is more common with 1st gen antipsycotics but can still be the case with 2nd gen like risperidone
ECG i done to monitor for arythmia - an adverse effect associated with risperidone
What kinds of tests should be done when prescribing gentamicin, and why
Measure renal function using crcl
This is because gentamicin is primarily cleared via the kidneys so that kidney impairment can lead to accumulation leading to nephrotoxicity
BMI is also measured as those who are obese should receive a lower gentamicin dose. This is because it is not well distributed in adipose tissue.
