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Clinical pharmacology and therapeutics > Decision making in therapeutics > Flashcards

Decision making in therapeutics Flashcards

1
Q

What scoring system is used to identify the risk of stroke

A

CHA2DS2VASc

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2
Q

Describe the CHA2DS2VASc score

A 
Congestive heart failure (1)
Hypertension (1)
Age >75 (2)
Diabetic (1)
Previous stroke, TIA or thromboembolism (2) 
Vascular disease (1)
Age 65-74 (1)
Sex - female (1)
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3
Q

What drugs does a patient with a CHA2DS2VASc score of 2 or more require?

A

Warfarin or direct oral anticoagulant

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4
Q

Describe the mechanism of action of warfarin

A

Vitamin K antagonist

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5
Q

Describe the mechanism of action of Aspirin

A

Cyclooxygenase inhibitor

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6
Q

Describe the mechanism of action of apixaban

A

Direct inhibitor of activated factor Xa

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7
Q

Describe the mechanism of action of Dabigatran

A

Direct thrombin (IIa) inhibitor

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8
Q

Describe the mechanism of action of Clopidogrel

A

P2y12 receptor inhibitor

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9
Q

What are the advantages of apixaban

A

Quick onset and offset
No monitoring required
Less drug interactions
Good safety profile

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10
Q

What are the disadvantages of apixaban

A

No antidote

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11
Q

What are the advantages of warfarin?

A

Antidote - vitamin K

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12
Q

What are the disadvantages of warfarin

A

Monitoring of INR required
Interactions
Slow onset and offset

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13
Q

What considerations should you make before prescribing warfarin?

A 
Bleeding risk 
GI bleeding
Peptic ulcer
Haemorrhagic 
Hepatic involvement 
Stroke 
Surgery
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14
Q

What are the sins of opiate toxicity

A 
Agitation
Drowsiness
Miosis - pinpoint pupils
vivid dreams
Hallucinations
Hypotension
Bradycardia
Coma
Death
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15
Q

When is the risk of opiate toxicity increased?

A

Old age
Impaired excretion
Co-existing conditions - dementia
rapid dose increases

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16
Q

Which drug reverses paracetamol overdose?

A

Acetylcysteine

17
Q

Which drug reverses Antidepressant overdose?

A

Activated charcoal

18
Q

Which drug reverses Benzodiazepine overdose?

A

Flumazenil

19
Q

Which drug reverses opiate overdose?

A

Naloxone

20
Q

Which drug reverses warfarin overdose?

A

Phytomenadione

Clinical pharmacology and therapeutics (27 decks)

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