Prescribing Flashcards
(24 cards)
what are the main things you need to consider when prescribing?
diagnosis/ indication
recommended drug / regime (bnf/ formulary)
contraindications/ special consideration (?pregnant/ liver function/ renal function)
Product licence
patient expectations
cost effectiveness
follow up
what are the anticholinergic side effects of amitriptyline ?
tachycardia urinary retention constipation dry mouth blurred vision exacerbation of narrow angle glaucoma
what to give for neuropathic pain ?
gabapentin
when do you have to be careful when prescribing gabapentin ?
controlled drug so make sure not addict - don’t prescribe in hx of substance abuse / psychosis/ mixed seizures/ diabetes/ elderly/ low body weight adults
why is atorvastatin better than simvastatin ?
can give at any time of the day when simvastatin can only be given at night
what is the difference between strength and dose
eg strength 10mg
eg dose one tablet
what are the main things to remember about a prescription
block capital s
ink
write quantity in letters not numbers
score the bottom of it so they cannot self prescribe
if you make a mistake on prescriptuion
score it initial it sign it
what do you write on a prescription in order
name strength formulation
then
dose frequency
if you need to prescribe 7mg of a drug but there isn’t a 7mg tablet what do you do ?
look at formulations and make do - so 5mg and 2mg
aspirin is contraindicated in
peptic ulcer disease
need to be cautious of bisoprolol in
hf and diabetes
if you found there was a reaction with clarithromycin and the statin the patient is taking what would you do ?
temporarily withhold statin for 7 days
if patient on metronidazole what do you need to inform them
do not drink alcohol
what are the two main types of drug interactions
drug-disease
drug-drug
why do you need to be careful with steroids in elderly women
post menopausal so at risk of osteoporosis
what do you need to monitor more closely with steroids
blood glucose in diabetics
what side effects do you get from long term steroid use
weight gain moon face mood swings
why not stop steroids suddenly
steroid crisis
what do you need to warn patients about when on steroids
increased risk of infections so avoid people with measles and chickenpox
what is the problem with warfarin and amiodarone?
increases the anticoag effect pf warfarin even after the treatment has stopped due to long half life so need close monitoring of inr
what is the risk with simvastatin
myopathy
need to lower alcohol intake
what do you need to know before you prescribe nitrofurantoin?
need to know GRF (needs to be greater than 45)
what is therisk with trimethoprim
risk of hypokalaemia
need gfr>30
