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Clinical Management exam I > Rx writting and Rashes > Flashcards

Rx writting and Rashes Flashcards

(53 cards)

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1
Q

steps for PA prescribing

A
  1. National Commission on Certification of Physician Assistants (NCCPA) - pass PANCE
  2. apply for state license
  3. apply for DEA license
  4. apply for mass controlled substance license (MCR)

optional DEA-X / MAT waiver optional 24 hours of training to prescribe addiction management meds

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2
Q

superscription

A

Identifying info of

patient and prescriber

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3
Q

inscription

A

name of the medication,
dose, quantity, ingredient, dosage form
(tabs, capsules, syrups)

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4
Q

subscription

A

Directions for use of

medication

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5
Q

signature

A

Provider name, signature,

number of refills

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6
Q

key elements of written rx

A 
 Prescriber
 Supervising physician
 Prescription
 Controlled Substance
 Brand/Interchange
 Patient
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7
Q

define
BID
TID
QID

A

BID -2x a day
TID- 3x a day
QID- 4x a day

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8
Q 
define 
QHS
QAM
QAC
Q4H
Q4-6 H
A

QHS - every bedtime
QAM - every morning
QAC - w/ meals
Q4H - every 4H

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9
Q

if prescribing PRN what must you also include

A

REASON “nausea” “pain” “insomnia”

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10
Q

when dispensing place a ___ before numeric value

A

#

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11
Q

JCAHO “do not use list”

A 
 U or u – unit
 IU – international unit
 QD/ QOD
 Always lead and never follow - we may write 0.5mg but do not write 5.0
 MS – write out Morphine Sulfate
 MgSO4 – write out Magnesium Sulfate
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12
Q

No prescription for a controlled substance listed Schedule ___ or ____ shall be filled
more than _____ after the date of issue and may not be refilled more than ____
times.

A

III or IV
6 months after date of issue
refilled more then 5 times

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13
Q

T/F

Schedule II prescriptions CAN be refilled.

A

CANNOT

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14
Q

T/F

DEA number must be listed on the narcotic/ scheduled II-IV prescriptions.

A

TRUE

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15
Q

name schedule I drugs

A

heroin
marijuana / THC
ecstasy
peyote

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16
Q

name schedule II drugs

A

HIGH potential for abuse

roducts with less than 15 mg of hydrocodone per dosage
unit (Vicodin, Norco)
• Cocaine , methamphetamine
• methadone
• hydromorphone (Dilaudid) / Oxycodone/ OxyContin
• meperidine (Demerol)

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17
Q

name schedule III drugs

A 
products with less than 90 mg of codeine per dosage unit
(Tylenol with codeine)
• ketamine
• anabolic steroids
• testosterone
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18
Q

name schedule IV drugs

A 
xanax
• soma
• Valium
• ativan
• ambien
• tramadol
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19
Q

name schedule V drugs

A 
cough preparations with less than 200 mg of codeine per 100
ml (Robitussin AD)
• Lomotil
• Lyrica
• parepectolin
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20
Q

name schedule VI drugs

A

abx

topical antifungals

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21
Q

verbal scripts are acceptable for schedule ___-____ but the prescription must be filled out w/ in ___ days

A

III-V

7 days

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22
Q

do pts need to present a hard copy of scripts for schedule III-VI

Study These Flashcards
A

NO - just schedule II.

23
Q

schedule II scripts may only be issued for ____days EXCEPT _____ or ______ can be issued a script of up to ____ days when used to tx adha, narcolepsu

Study These Flashcards
A

30 days
methylphen / dextroamphetamine

60 days

24
Q

Schedule III-IV: prescriptions 30-day supply - refilled up to ____ times within ____ months of the date of the prescription.

Study These Flashcards
A

five times w/in 6 mo

25
schedule II re-evaluate at least once every ___ months.
4 mo
26
Schedule III-VI re-evaluate at least once every ___ months
6 mo
27
May be prescribed for pain management w/ special licensing requirements.
Methadone, Buprenorphine (Subutex), Buprenorphine/Naloxone(Suboxone),
28
primary survey of a pt assessment with SKIN findings
assess ABCs
29
immediate transfer to hospital if:
Signs of airway obstruction – CRITICAL ◦ Anaphylaxis ◦ May initially complain of feeling tightness in throat ◦ Audible airway noises (stridor and wheezing) ◦ May need surgical airway ``` Respiratory rate <10 or >29 Oxygen sat <92% on RA in a otherwise healthy person Pulse <50 or > 120 Systolic BP <90 Glasgow Coma Score <12 ```
30
Normal Primary Survey but… | Admission and Close Monitoring
Suspected rash for meningococcal septicemia Definite exposure to a trigger that previously lead to anaphylaxis Self administration of epinephrine A suspected anaphylactic reaction that has not fully developed Cellulitis in a patient that appears toxic, or affecting periorbital tissues
31
Secondary Survey
These patients are in no immediate danger so take a careful hx and exam to determine how to treat patient ``` Hx - onset of sx rash - diffuse, localized, color assoc sx - how does pt feel, N/V, neck pain, eye pain progression of sx previous hx medication and drug hx family and social hx ```
32
Si/Sx of anaphylaxis
Oral: pruritus of lips, tongue, and palate and edema of lips and tongue; metallic taste in the mouth Cutaneous: flushing, pruritus, urticaria, angioedema, morbilliform rash, and pilor erecti GI: nausea, abdominal pain (colic), vomiting (large amounts of “stringy” mucus), and diarrhea Respiratory (major shock organ): laryngeal: pruritus and “tightness” in the throat, dysphagia, dysphonia and hoarseness, dry “staccato” cough, and sensation of itching in the external auditory canals; lung, shortness of breath, dyspnea, chest tightness, “deep” cough, and wheezing; nose, pruritus, congestion, rhinorrhea, and sneezing Cardiovascular: feeling of faintness, syncope, chest pain, dysrhythmia, hypotension Other: periorbital pruritus, erythema and edema, conjunctival erythema, and tearing; lower back pain and uterine contractions in women; aura of “doom
33
criteria for dx anaphylaxis
Highly likely when 1 of these 3 criteria are fulfilled: (Syx of Shock, Respiratory distress, Skin) two or more occur rapidly involvement of skin-mucosal tissues resp compromise w/ assoc end organ dysfunction reduced bp (infants / children with 30% decrease in systolic BP)
34
what is considered reduced BP in pts w/ suspected anaplyaxis
30% decrease in systolic BP
35
tx of pediatric anaphylaxis
``` assess ABC IM adrenaline O2 / cardiac monitor Normal saline "wide open" nebulized adrenaline hydrocortisone diphenhydramine vasopressors / IV adrenaline ``` observe for at least 4-8 hours
36
how many refills in an epi pen jr
2 pack 11 refills
37
how toes epi work to tx anaphlyaxis
Works to increase peripheral vascular resistance and reverse peripheral vasodilation and decrease angioedema and urticaria
38
tx of contact dermatitis
topical steroids abtihistamines (H1 blockers) topical immunemodulators abx systemic steroids phototherapy
39
when are super-high potency topical steroids used
used for severe dermatoses over non-facial and non intertriginous areas. Scalp, palms, soles, thick plaques on extensor surfaces <4 wks
40
when are medium-high potency topical steroids used
Class II-V mild to moderate non-facial and non intertriginous areas. OK to use on flexor surfaces for short periods <6-8 wks
41
when are low potency topical steroids used
Larger areas and thinner skin such as face, eyelid and genitals. 1-2 wks on face
42
work-up of a rash
* CBC – Leukocytosis, Thrombocyopenia * Mineral Oil mount – Scabies * KOH scrapings – Dermatophytes * Skin Biopsy
43
what are the 3 types of skin biopsys
shave punch - dx rashes excision - cancer
44
how do we tx drug eruption rashes
remove offending agent antihistamines topical steroids BID (hydrocortisone, desonide) oral prednisone
45
Presented with well demarcated erythematous plaques with an overlying silvery scale on extensor surfaces
chronic plaque psoriasis
46
tx of chronic plaque psoriasis
Limited Dz: Topical Steroids (Class I) and Vitamin D Analogs (Calcitriol) Severe Disease: Systemic Rx such as Methotrexate and Biologics (DMARDs)
47
Erythematous annular plaque with peripheral scale and central clearing
dermatophytoses / tinea
48
t/f hair and nail infections respond well to topical antifungals
No usually need ORAL
49
most commonly used topical antifungal
Nystatin, most commonly used topical therapy, is a polyene drug that is not absorbed by the GI tract ``` three formulations: oral suspension ointment powder. ```
50
tx for candida and dermatophytes
imidazoles ketoconazole exonazole clotrimazole micoxonazole
51
Allylamines are (Worse / Better) for treating dermatophytes than Candida
BETTER Naftifine Terbinafine Butenafine
52
best antifungal against candida
polyenes - nystatin
53
tx for tinea pedis
Topical Terbinafine or miconazole cream. | ◦ Apply to affected area BID for 4-6 weeks

Clinical Management exam I (4 decks)

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