CDW 05 Flashcards
What is a Care Plan?
The pharmacist tool its purpose is a clear logical process for the clinical decisions making for patient care.
There are 4 components: IRJD.
I-Information gathering, R-reasoning, J-judgement, D-decision.
Information gathering: Review a patient’s clinical history, medication history, laboratory results and observations.
Reasoning: Consider the treatment goals from both a clinician and a patient perspective taking into account patient comorbidities and factors.
Judgement: critically examine each treatment option you considered, taking into account your goals and your patient comorbidity and factors, in order to determine which option/s is/are the best for your patient.
Decision: How you implement your judgement choice in practice. Follow-up monitoring and patient counselling points
Laboratory results/investigations abbreviation?
CRP: C reactive protein (inflammation)
FBC: Full blood count (RBC, WBC, platelets)
WBC: White blood cell count (infection)
Neutrophils : Neutrophils count (infection)
Cellulitis is?
(Acute infection of the skin) involving the deep dermis and subcutaneous fat
Where should adults and children with uncomplicated cellulitis be best managed?
Most uncomplicated cellulitis cases can be managed in the community after the involvement of a GP
Treatment Options Considered for cellulitis?
Flucloxacillin 500 mg, orally, four times daily, for five days
Erythromycin 800 mg, orally, twice daily, or 400 mg, orally, four times daily, for five days
What are the Patient Counselling Points for cellulitis?
Take flucloxacillin regularly as directed. Keep taking it until the course is finished, even if you start to feel better. Take the capsules with a glass of water.
For Liquid: Measure the liquid carefully with an oral syringe or measuring spoon. Shake the bottle well before measuring each dose
For missed dose: Take the missed dose as soon as possible and continue as directed
Tell your doctor immediately if you experience any severe allergy reaction
Tell your doctor if you have kidney, liver, or gut problems, glandular fever, or have ever had an allergic reaction to penicillins or any other medicine. Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Store flucloxacillin liquid as directed. Once the course is finished, take any leftover liquid back to your pharmacy.
What are the Treatment/ Therapy Goals for cellulitis?
Patients Goals:
· Regain mobility in his arm as soon as possible, so that he doesn’t have to take much time off work.
· Prevent any future infections.
Pharmacist Goal:
· Recommend a suitable empiric antibiotic therapy to treat the current infection.
· Recommend appropriate pain relief if Robert feels he needs it.
· Educate Robert on common causes of cellulitis and first aid of cuts and wounds.
· Minimise the risk of side effects from therapy.
What are the co-morbidities associated with a higher risk of getting a cellulitis infection?
Diabetes Eczema Obesity Pregnancy Previous episodes of cellulitis Venous insufficiency Tinea pedis Ulcers
Empiric therapy for cellulitis will likely involve antibiotic/s that are effective against?
Streptococci (because these bacteria are the major pathogens that cause cellulitis infection).
What is the main purpose of white blood cells?
To fight infection
Of the five different types of white blood cells, what type is the majority?
Neutrophils
In which of these scenarios could your neutrophils be raised?
Excessive exercise High stress level Infection Injury/surgery Non-infectious inflammation Smoking cigarettes Steroid use
What factors relating to the suspected OR cultured “BUG” need to be considered before starting Empiric antibiotic therapy?
Likely organism
The severity of infection systemic or localised
What factors relating to the first line DRUG need to be considered before starting therapy?
Spectrum of activity PK& PD distribution half life Toxicity and ADR Formulation available Funding considerations
What PATIENT factors need to be considered before starting empiric therapy?
allergy status age renal function hepatic function comorbidity pregnancy breastfeeding previous antimicrobial exposure drug interaction site of infection
