CPT Revision

Question 1

Medicines Reconciliation

Answer 1

Ensures all medication patient is taking is correctly documented on admission and each transfer of care.

1) Admission
2) Post admission verification by pharmacy
3) Discharge

Question 2

SCRs

Answer 2

Summary Care Records

Minimum = allergies, adverse reactions, medications

Question 3

BNF

Answer 3

• guidance on prescribing
• individual therapeutic areas
• appendices (interactions/additives)
• drug monographs = indications for that drug

Question 4

Gabapentin

Answer 4

• licensed for epilepsy and neuropathic pain

Question 5

Amitriptyline

Answer 5

Licensed for depression and nocturnal enuresis.

Unlicensed indications = neuropathic pain and migraine prophylaxis.

Question 6

Formulations

Answer 6

Drugs have different doses depending on formulation used as bioavailability differs

Question 7

Modified Release

Answer 7

To allow less frequent dosing

Question 8

Pharmacodynamic

Answer 8

Drugs have additive or Antagonistic pharmacological effects

- often predictable

Question 9

Pharmacokinetic

Answer 9

Drug increases or decreases amount of another drug available in body by affecting absorption, distribution, metabolism or excretion of the other.

Question 10

Valid Prescription

Answer 10

• signed in ink with your name
• indelible ink permanent
• address of practitioner
• date

Question 11

2 error types

Answer 11

• slips and lapses (actions do not go according to plain)

- mistakes (plan itself is wrong)

Question 12

Aspirin

Answer 12

Reyes syndrome

Question 13

Corticosteroids in infants

Answer 13

Growth Suppresion

Question 14

Paracetamol in infants

Answer 14

Reduced susceptibility to hepatotoxicity

Question 15

Valproate in infants

Answer 15

Increased frequency of hepatotoxicity

Question 16

Systemic chloramphenicol

Answer 16

gray baby syndrome

Question 17

SSRIs

Answer 17

Increased suicidal ideation in teens

Question 18

High dose pancreatic enzyme replacement

Answer 18

Bowel stenosis

Question 19

Aspirin augmented

Answer 19

1 = bleeding
2ry = gastric irritation

Question 20

Bisoprolol

Answer 20

1 = bradycardia 
2dry = bronchospasm

Question 21

Salbutamol

Answer 21

1 = bronchodilation
2ry = lactic acidosis

Question 22

Phenytoin

Answer 22

Ataxia, nsytagmus

Question 23

Digoxin

Answer 23

Visual aura, nauseua, arrhythmias

Question 24

Warfarin

Answer 24

Bleeding

Subdural haematoma

Question 25

Unfractionated heparin

Answer 25

Bleeding

Question 26

Diclofenac

Answer 26

Heart Failure

Question 27

Type C

Answer 27

``` Bisphos = jaw osteonecrosis Corticosteroids = osteoporosis ```

Question 28

Type D

Answer 28

Carbimazole = agranulocytosis Typical antipyschotics = tardive dyskinesia Chemo = infertility Many drugs = teratogenicity

Question 29

Stilbestrol

Answer 29

Clear Cell adenocarcinoma of genital tract in young women

Question 30

Type E

Answer 30

``` Benzodiazepine = agitation/insomnia Cortciosteroids = adrenal insufficiency Opiates = flu like withdrawal ```

Question 31

Pharmacokinetics

Answer 31

Gentamycin = trough plasma levels

Question 32

Pharmacodynamics

Answer 32

Warfarin = INR

Question 33

Objective side effects

Answer 33

ACEi = renal function

Question 34

Subjective SE

Answer 34

Aspirin = gastritis

Question 35

IM

Answer 35

CI in haemophillia

Question 36

Intrathecal

Answer 36

- single dose analgesia - limited chemo agents - baclofen - respiratory depression potential

Question 37

Intranasal

Answer 37

DDAVP | Midazolam

Question 38

PV

Answer 38

Hormonal IUD Pessaries

Question 39

Max potassium rate fludis

Answer 39

Not faster than 10mmol/hr Max 40mmol/L in peripheral line 20 or 40

Question 40

Resus Fluids

Answer 40

Crystalloids sodium 130-154 bolus 500ml over less than 15 mins severe sepsis = human albumin solution 4-5%

Question 41

Maintenance Fluids

Answer 41

- 20-30ml/kg/day of water - 1mmol/kg/day of K+, Na+, Cl- - obese adjust IV to ideal body weight - do not exceed 30ml/kg/day - less if old/frail/renal failure/cardiac failure - 25-30ml/kg/day sodium chloride 0.18% in 4% glucose - 27mmo/l potassium on day 1 - >2.5:L increases hyponatremia risk - 1L over 8-12 hs - 2L-2.5L over 24 hrs