Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals pharmacology new > PSA: prescription writing > Flashcards

PSA: prescription writing Flashcards

1
Q

what must all prescriptions include

A
  • legible
  • unambiguous (don’t give a range of doses)
  • approved generic name (unless brand is important)
  • IN CAPITALS
  • no abbreviations
  • signed and with a bleep number
  • if ‘as required’ provide a) indication and b) max freq or total dose in 24hrs
  • if it is an antibiotic, include indication and stop/review date
  • include duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the most common cytochrome p450 inducers. what does this mean?

A

increased enzyme activity –> decreased drug concentration as it is metabolised quickly

PC BRAS

Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic excess)
Sulphonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the most common cytochrome p450 inhibitors. what does this mean?

A

decreased enzyme activity –> increased drug concentrations as not metabolsied quickly

AODEVICES

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (Acute intoxication)
Sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what does o.n mean

A

omni nocte (every night)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does o.m. mean

A

o. m. = omni mane (every morning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does p.c. mean

A

p. c. = post cibum (after food)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does PRN mean

A

p. r. n. = pro re nata (when required)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of delirium

A
  1. treatment of the underlying cause
    + modification of the environment
  2. haloperidol 0.5 mg oral every 2-4 hours until there is a clinical response. or olanzapine.
    USE FOR 1W OR LESS
  3. lorazepam 0.5mg-1mg oral every 2 hours until response. max 2mg/24hr. prescribe at STAT. can do IM or slow IV inj if req
    USE FOR 48 hr OR LESS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

management iron salt poisoning eg Ferrous sulphate tablets

A

desferrioxamine mesilate

intravenous infusion

initial infusion up to a rate of 15 mg/kg/hour, (max. 80 mg/kg in 24 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

dosing sertraline depression

A

50mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

key features for identifying opioid overdose

A

pinpoint pupils

resp depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PReSCRIBER mneumonic

A

Patient details
Reaction (allergy plus reaction)
e
Sign front of chart
Route
IV fluids needed?
Blood clot prophylaxis needed?
antiEmetic needed?
pain Relief needed?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what drug in heart failure reduces morbidity and mortality

A

beta blocker

bisoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what to include in a prescription for controlled drugs

A

Name and address of patient (printed or written, but no sticky labels)
Approved product name, strength (where more than one exists), and formulation (e.g. solution)
Dose (‘when required’ or ‘as directed’ is not acceptable unless accompanied by an actual dose)
Total quantity to supply must be in words and figures.
Prescriber’s handwritten signature, and date (can be word-processed or handwritten)
Prescriber’s address.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Writing adrenaline drug name for anaphylaxis

A

Drug: Adrenaline (1:1000)

500mcg = 0.5ml of 1:1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Writing aciclovir prescription for HSV encephalitis

A

frequency : x hourly (change in renal impairment)

duration : 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when prescribing a topical treatment sucha s a steroid, what is important in the drug name

A

the concentration and formulation eg.

Hydrocortisone 1% cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

major fracture, pain relief?

A

iv morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

if a pt is vomiting, what route should antiemetics be given

A

not oral ie iv im or subcut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

who gets blood clot prophylaxis? who to be careful of?

A

almost everyone - assessment is on the drug card

LMWH eg dalteparin 5000 units daily s/c + compression stocking

dont give anticoagulation if risk of bleeding eg recent stroke

dont give compression stocking if PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

write a prescription for regualr paracetamol

A

paracetamol 1g oral 6 hourly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

write a prescription for regular co-codamol

A

Co-codamol 30/500, 2 tablets, 6hourly, oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

write a PRN prescription for paracetamol

A

paracetamol 1g up to 6 hourly oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

write a PRN prescription for codeine

A

codeine 30mg up to 6 hourly oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

write a PRN prescription for oromorph

A

morphine sulphate (10mg/5ml)
10mg
up to 6 hourly
oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

write a prescription neuropathic pain

A

amitryptilline 10mg oral nightly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

for how long should you not give thromboprophylaxis stroke

A

varies but typically a few months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Prescribe for scabies

A

permethrin 5% cream
Apply to whole body
Topical
Once weekly for two doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Prescribe for GORD

A

omeprazole
20mg
oral
1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Prescribe for bph

A

Tamsulosin hydrochloride oral - 400 micrograms once daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

prescribe for stress incontience

A

duloxetine 40mg PO BD

32
Q

1st step pharmacological copd management

A

SABA or SAMA

33
Q

copd pt is on saba and sama but still uncontrolled, next step?

A

Do they have asthmatic features/features suggesting steroid responsiveness?

Yes: Long-acting beta agonist (LABA) and Inhaled corticosteroid (ICS) (+SABA/SAMA as required)

No: LABA and LAMA. if taking SAMA, switch to SABA

34
Q

management copd

A
  1. SABA (e.g. salbutamol) or SAMA (e.g. ipratropium bromide)
  2. Do they have asthmatic features/features suggesting steroid responsiveness?
    Yes: Long-acting beta agonist (LABA) and Inhaled corticosteroid (ICS) (+SABA/SAMA as required)
    No: LABA and LAMA. if taking SAMA, switch to SABA
  3. Triple therapy: LABA + LAMA + ICS (+ SABA as required)
  4. Specialist guided
35
Q

3rd line treatment copd

A

Triple therapy LABA + LAMA + ICS (+ SABA as required)

36
Q

what criteria determines whether a pt has asthmatic/steroid resposnsive features?

A

history:
any previous, secure diagnosis of asthma or of atopy

investigations:
a higher blood eosinophil count - note that NICE recommend a full blood count for all patients as part of the work-up
substantial variation in FEV1 over time (at least 400 ml)
substantial diurnal variation in peak expiratory flow (at least 20%)

37
Q

name SABA

A

salbutamol

38
Q

name SAMA

A

ipratropium

39
Q

name LABA

A

salmeterol

40
Q

name LAMA

A

tiotropium

41
Q

name a combined LABA + ICS

A

Formoterol with budesonide

42
Q

prescribe oral for fungal nail infection

A

terbinafine 250mg oral once daily 6 weeks

43
Q

management fungal nail infections

A

limited involvement amorolfine 5% nail lacquer; 6 months for fingernails and 9 - 12 months for toenails. extensive involvement oral terbinafine

44
Q

who is at high risk of neural tube defects and therefore requires 5mg folic acid

A

maternal folate deficiency, maternal vitamin B12 deficiency, previous history of having an infant with a neural tube defect, smoking, diabetes, obesity, use of antiepileptic drugs and sickle cell disease.

45
Q

prescribe rampiril

A

nightly

46
Q

prescribe GTN

A

Glyceryl trinitrate spray
dose: 2 sprays
route: sublingual

47
Q

angina treatment algorithim

A

asprin + statin + sublinguial nitrate
1. BB or CCB (non-di) 2. increase to max dose 3. BB + CCB
4. one of: a long-acting nitrate
ivabradine
nicorandil
ranolazine

48
Q

hypertension treatment algorithm

A
  1. A or C 2. A+C or A/C + D 3. A+C+D 4. if K <4.5 spiro, if K>4.5 alpha blocker or beta blocker
49
Q

heart failure with normal EF treatment algorithm

A
  1. furosemide for symptomatic relief
    +SGLT-2 inhibitor eg dapagliflozin
50
Q

heart failure with reduced EF treatment algorithm

A

+furosemide for symptoms
1. ACEi + BB (1 at a time)
2. MRA eg Spironolactone
3. specialist advice

51
Q

when do you not offer ACEi for heart failure

A

clinical suspicion of hemodynamically significant valve disease, until the valve disease has been assessed by a specialist

52
Q

if can’t tolerate aCEi heart fialure, what do you do

A

offer ARB

53
Q

heart failure, which to start first out of ACEi or BB in diabetes

A

ACEi

54
Q

heart fialure, which to start first out of ACEi or BB in fluid overload

A

ACEi

(a beta-blocker may make the symptoms of heart failure worse)

55
Q

Prescribe fluid for emergency resus

A

sodium chloride 0.9% 500ml over 15 minutes

56
Q

prescribe fluid for hypoglycaemia

A

glucose 20% 100ml over 15 mins

or

glucose 10% 150mls over 15 mins

both give 15-20g over 15 mins

57
Q

prescribe fluid for emergency hypokalaemia

A

sodium chloride 0.9%/potassium chloride 0.3% 1000ml over 4 hours

58
Q

prescribe fluid for emergency hypercalcaemia

A

sodium chloride 0.9% 1000ml over 4 hours

59
Q

maintenance +defecits fluids calcs

A

correct over 4 hours

if defecits of water use 30ml/kg calc instead of 25

60
Q

in what circumstances should you be cautious about glucose fluids

A

AVOID in first 24 hours after ischaemic stroke or head trauma - risk of cerebral oedema

caution in impaired glucose tolerance,
caution in severe malnutrition (risk of re-feeding),
caution in thiamine deficiency

61
Q

Prescribe a drug for hypoglycaemia

A

glucagon

62
Q

How to decide what indication to give fluid to children eg do they need resus, maintenance, somthing else?

A

Is the pt shocked/haemodynamically compromised? –> yes –> resus fluids

can the pt meet their fluid requirements enterally? –> no –> are there signs of clinical dehydration?
–> yes –> calculate fluid defecit + routine maintenance
–> no –> calculate routine maintenance

63
Q

child resus fluids

A

10ml/kg sodium chloride 0.9% over <10 minutes

64
Q

neonate resus fluids

A

10-20ml/kg sodium chloride 0.9% over <10 mins

65
Q

how to calculate fluid defecit

A

fluid defecit (%) = %dehydration x weight (kg) x 10

dehydration = 5%
shock = 10% (but youd be doing resus in this scenario anyway)

fluid defecit + routine maintenance = total to be given in 24 hours

66
Q

maintenance fluids children

A

isotonic crystalloid - unclear if this includes glucose
0.9% sodium chloride (+ 5% glucose (+/- KCl))

First 10 kg 100 ml/kg
Next 10 kg 50 ml/kg
Every other kg 20 ml/kg

Rate (ml/h): Total (ml) / 24

Sodium: 2-4mmol/kg/day
Potassium: 1-2mmol/kg/day

67
Q

maintenance fluids neonates ie <28 days

A

10% dextrose
Day 1 – 60 mls/kg/day
Day 2 – 90 mls/kg/day
Day 3 – 120 mls/kg/day
Day 4 – 150 mls/kg/day

From day 2
Na 3 mmol/kg/day
K 2 mmol/kg/day
Ca 1 mmol/kg/day (rarely)

68
Q

in terms of maintenance fluids what is your upper limit children

A

over a 24‑hour period, males rarely need more than 2,500 ml and females rarely need more than 2,000 ml of fluids.

69
Q

prescribe an iv fluid for children for hypoglycaemia

A

“500mg/kg to be administered as glucose 10%”

500 x kg = xmg
glucose 10% = 10g=100ml
= 0.1g = 1ml
100mg =1ml
xmg = yml

(x x 1)/100 = yml

70
Q

first step in DKA management

A

fluid resuscitation

71
Q

prescribing antiemetics route?

A

if vomiting, not oral - IM or IV if already has access

if not vomiting - oral

72
Q

what type of insulin infusion is used DKA

A

fixed rate IV insulin infusion
0.1 units/kg/hr

73
Q

pt on warfarin, witheld prior to surgery but INR > 1.5 on the day of surgery - plan?

A

give 1-5mg oral vit k using the IV preparation - on the day of surgery

74
Q

when should warfarin be withheld surgery

A

5 days prior

75
Q

if pt is elderly, what should you check for indications and dosing

A

elderly dosing

76
Q
A

Finals pharmacology new (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions