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ΩΩ 4 Bateman - PSA + Pharmacology > 1 The Principles of Prescribing > Flashcards

1 The Principles of Prescribing Flashcards

1
Q

What class of drug is oxybutinin?

A

Antimuscarinic

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2
Q

What are the side effects of antimuscarinics?

A
  1. Dry mouth
  2. Dizziness
  3. Constipation
  4. Blurred vision
  5. Cognitive impairment
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3
Q

What is the definition of adherence?

A

The extent to which the patinet’s behaviour matches agreed recommendations from the prescriber

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4
Q

What is compliance the old term for?

What is it’s definition?

A
  1. Adherance
  2. The extent to which the patient’s behaviour matches the prescriber’s recommendations
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5
Q

What is concordance?

A

A process of prescribing and medicine-taking based of partnership

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6
Q

What are the reasons for non-adherence to medication regiemes?

A
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7
Q

What are the side effects of NSAIDs?

A
  1. GI adverse effects
    Dyspepsia
    Ulceration
    Bleeding
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8
Q

What are the side effects of thiazide diuertics (e.g. Indapamide)?

A
  1. Can cause hyperuricaemia, which may exaccerbate gout
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9
Q

What is the made side effects of ACE inhibitors (e.g. lisinopril)?

A
  1. Cough
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10
Q

What is the main side effect of corticosteroids (e.g. Prednisolone)?

A
  1. Alter mood and behaviour
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11
Q

What side effects can antipsychotics cause (e.g. prochlorperazine)?

A
  1. Extra pyramdial side effects
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12
Q

What is the main side effect of statins?

A
  1. Myalgia
  2. Myositis
  3. Myopathy
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13
Q

What is an example of subjective monitoring of adherance?

A

A patient self reporting what they are taking

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14
Q

What is an example of objective monitoring of adherance?

A

Measuring concentrations of a drug in the blood

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15
Q

What is a monitored dosage system (MDS)?

A

Monitored Dosage System (MDS) is a medication management tool that organises a patient’s solid oral dose medication according to the day of the week and the time of day it should be taken. Also known as a blister pack,

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16
Q

HOW DO YOU ESTIMATE A PAEDIATRICS WEIGHT?

A

(Age+4) x 2(kg)

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17
Q

What do these stand for:

% w/w?

%w/v?

% v/v?

A
  1. % w/w = weight per weight = weight of a medicine (or chemical) added to a weight of a diluent
    1% = 1g of a drug in 100 g of the final product
  2. % w/v = weight of medicine is added to a voume of a diluent
    1% w/v = 1g in 100 ml of final product
  3. % v/v = volume of medicine is added to a volume of diluent
    1% v/v = 1 ml of liquid drug in 100ml of the final product
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18
Q

What does 1 in 1000 represent?

A

1g in 1000 ml

= 1 mg per ml

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19
Q

What ages is:

Neonate?

Infant?

Adolescent?

A
  1. Neonate = up to 1 month
  2. Infant = up to 1 year
  3. Adolescent = 12-16 years
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20
Q

What is the conversion of oral morphine to SC and fentanyl patch?

A
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21
Q

What do corticoid steroids contain?

A

Mineralacorticoid and glucocorticoid

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22
Q

What is acetlcysteine?

A

Used in paracetamol overdose

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23
Q

What is the dosing of acetylcysteine?

A
  1. 1 hour in 200 ml of glucose 5% - For the first you need 150 mg/kg
  2. Second - over 4 hours in 500 ml of glucose 5% 50 mg/kg
  3. Third - over 16 hours, in 1 litre of glucose 5% - 100 mg/kg
  4. Total dose of 300 mg/kg over 21 hours
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24
Q

WHAT CAN BISPHOSPHONATES CAUSE IF THEY ARE CRUSHED?

A
  1. GI adverse effects
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25
Q

Which drug is contraindicated post stroke?

A
  1. NSAIDs
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26
Q

What can you do to Indapamide and Doxazosin for patients with swallowing difficulty?

A
  1. Crush them
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27
Q

Where is most oral medicaiton absorbed?

When might this be a problem?

A
  1. Small bowel
  2. If the patient has an ileus or short bowel conditon
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28
Q

What are excipients?

A

Components added to the active ingrediant to make the substance more tasteful or change the colour

29
Q

What are the 4 stages involved with drug processing in the body?

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
30
Q

Which drugs interact with Chelation?

A
  1. Tetracyclines and calcium
  2. Tetracyclines and antacids
  3. Tetracyclines and iron preparations
  4. Quinolones (e.g. ciprofloxacin) and iron perparations
31
Q

Who might modifield-release prepations not be appropriate for?

A
  1. Patients who have had a bowel resection (e.g. ileostomy)
  2. Switch to immediate release more often
32
Q

Which patients is enteric coating not appropriate for?

A
  1. Patients with an ileosomy
33
Q

Which two drugs undergo extensive first pass metabolism?

A
  1. Atenalol 25-50mg oral with 2.5mg IV
  2. Simvastatin
34
Q

Which medicines shouls be prescribed and administered by brand name?

A
  1. Diltiazem preparations
  2. Some antiepileptics
  3. Lithium salts
  4. Theophylline preparations
  5. Some immunosuppressant therapies (e.g. tarcolimus)
35
Q

When do antimicrobials need to be given to treat infection effectively?

A
  1. Evenly throughout the whole day to make sure the therapeutic concentration is made
36
Q

When should nitrates be given?

A
  1. Standard release nitrates should be prescribed so that there is a ‘nitrate free period’ of at least eight hours (ideally 10 hours). This prevents tolerance to the medicine
37
Q

When should medicines used in Parkinson’s disease be given?

A
  1. Prescribed at their usual dosing regieme otherwise resumption of symptoms can occur until the next dose
38
Q

Why does morphine sulfate only prevent pain for a short period of time?

How can this be avoided?

A
  1. Short half life
  2. Modidied release formulations
39
Q

Which drugs interact with enteric feeds?

How do you administer drugs with an enteric feed?

A
  1. Phenytoin - change to IV adminitration
  2. Quinolones
  3. Stop the feed for drug adminitration to take place
  4. Then flushed before and after
40
Q

WHAT DRUGS AREN’T F1’S ALLOWED TO PRESCRIBE?

A

Controlled drugs

41
Q

How are controlled drugs identified in the BNF?

A

Labels CD2 and CD3

42
Q

What extra stuff do you write on a controlled drug prescription?

A
  1. Total quantity or the number of dose units must be stated in both words and figures
43
Q

What should a normal prescription contain?

A
  1. Name and address of patient
  2. Age or date or birth if under 12
  3. Signed by prscriber
  4. Dated (CD only valid for 28 days)
  5. Written as to be indelible
  6. Contain a prescriber identifier
44
Q

What are the additional legal requirements for prescribing controlled drugs?

A
  1. Dose
  2. Form of the preparation (irrespective if there is only one form)
  3. Strength
  4. Total quantity of the preperation of dosage units in both words and figures
45
Q

What is the maximum number of days a controlled drug should be prescribed for?

A

No more than 28 days

46
Q

Is carbamazapine for mood stabilisation a licensed or or off-label use?

47
Q

Is magnesium glycerophosphate an off-label or licesned use for hypomagnesaemia?

48
Q

Is a GTN patch a licensed or off label use for in Raynaud’s phenomenom?

49
Q

Is Hyoscine hydrobromide a licesned or off-label use for hypersalivation?

50
Q

Is salbutamol a licesned or off-label use for hyperkalaemia?

51
Q

What must be satisfied prior to issuing a prescription for an unlicesnsed use?

A

There are no suitable alternatives to meet the patient’s needs

52
Q

Which drug should be prescribed using the BRAND name?

A

Oral Tarcolimus

53
Q

HOW SHOULD LEVOTHYROXINE BE RESTARTED AFTER A DURATION OF NOT TAKING IT?

54
Q

What condition be prescribed unlicensed for?

55
Q

What drugs have to be-titrated up after it hasn’t been taken for a while?

What are the risks associated with restarting it suddenly?

A
  1. Clozapine
  2. ACE Inhibitors
  3. Increase the risk of orthostatic hypotension, which could be accompanied by cardiac or respiratory arrest
56
Q

What can the combination of ACE inhibtor and ARB do?

A
  1. Cause a drop in blood pressure especially postural hypotension
57
Q

What are important surgical drugs to ask about in the history?

A
  1. Contraception
  2. Anticoagulation
  3. Steroids
  4. Ethanol
  5. Smoking
58
Q

What are the side effects of rifampicin?

A
  1. Colours sweat, tears and urine orange
59
Q

What drugs are not suitable for a MDS?

A
  1. Orodispersible or dispersible tablets
  2. Cytotoxic medicines
  3. AS required medications
  4. Chewable tablets
60
Q

What do the different colours of warfarin tablets tell you?

A

Strength

  1. White = 500 micrograms
  2. Brown = 1 mg
  3. Blue = 3 mg
  4. Pink = 5 mg
61
Q

What book is there to monitor warfarin treatment?

A

Ywllow Oral Anticoagulation Book

62
Q

Which drugs have a long half life and therefore require monitoring?

A
  1. Bisphonphonates
  2. Hydroxocobalamin (vitamin B12)
  3. Injectable antipsychotics
  4. Methotrexate
  5. Injectable drugs for rheumatic disease
  6. Goserelin
  7. Implants
63
Q

What class of drug is finasterine?

What conditions is it used in?

A
  1. 5-alpha reductase inhibitor
  2. BPH
  3. Androgen alopecia in men
64
Q

Which drug should be stopped in their is severe oesophageal reactions?

A

Bisphosphonates (e.g. alendronic acid)

65
Q

HOW IS PRESCRIPTION ONLY MEDICINES ABBREVIATED IN THE BNF?

66
Q

What does a black triangle mean in the BNF?

A

Means the drug is being monitored

67
Q

When can you prescirbe a medicine off-label?

A
  1. There are no suitable licensed alternatives that would meet the patients needs
  2. Sufficient evidende for its use
  3. You must be monitoring their condition
68
Q

What is important to remember prescribing in the PSA?

A

HEPATIC AND RENAL IMPAIRMENT

ΩΩ 4 Bateman - PSA + Pharmacology (8 decks)

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