Facts Learnt In Practice

Question 1

What is the fast acronym for stroke

Answer 1

Face weakness: Can the person smile? Has their mouth or eye drooped?
Arm weakness: Can the person raise both arms fully and keep them there?
Speech problems: Can the person speak clearly and understand what you say? Is their speech slurred?
Time to call 999: if you see any one of these signs.

Question 2

What were the findings of the CTT meta analysis of statins in 2010?

Answer 2

for every 1mmol/L reduction in LDL cholesterol, there is a 22% reduction in major vascular events.

Question 3

Why are antihistamines often prescribed in liver failure

Answer 3

Causes itchy skin

Question 4

Why do you need to be cautious of drugs that cross the BBB in renal impairment

Answer 4

When patients have Renal dysfunction they also have altered BBB
increased BBB permeability
Cautious of drugs that cause CNS side effects

Question 5

Why would patients with hepatic dysfunction have to be assessed in more depth for VTE prophylaxis

Answer 5

Clotting factors are made in the liver, if liver works less then more likely to bleed

Question 6

Why is Iv iron used in heart failure instead of oral and why is oral iron no longer multiple daily dosing

Answer 6

• Heart failure is often associated with gut edema and reduced gut perfusion, which impair oral iron absorption.
• Additionally, inflammation in chronic disease raises hepcidin levels, which further blocks iron absorption from the gut.

•	Oral iron doses stimulate hepcidin production, especially when taken frequently (e.g. TDS).
•	Hepcidin peaks around 6–24 hours after a dose and can block further iron absorption from subsequent doses.
•	So, with TDS dosing, the body may absorb less iron overall due to consistently elevated hepcidin levels.

Question 7

What key information is there regarding Vanc and Fidaxomycin treatment for C.Diff
- SEs
- Bioavailabbility
- Use

Answer 7

Fidaxomycin is given for C.Diff reoccurence according to NICE guideline. However the hospital sometimes use it 1st line in pts at higher risk of reoccurence such as elderly or immunocompromised.
Fidaxomycin and Vancomycin have minimal systemic side effects when used to treat C. Diff because they are taken orally. They both have poor bioavailabilty and therefore have minimal absorbance systemically. therefore SEs like Nephrotoxicity and Ototoxicity are not prevalent in C.diff treatment with Vanc.
Fodaxomycin reduces likelihood of C.diff reoccurence, however is much more expensive than Vanc.
If Fidaxomycin is not effective at preventing reoccurence when used previously then it is not used routinely again as C.diff infections reoccurence increases with each infection. Only get one Pop with fidoxy basically.