CPT Revision Flashcards
Medicines Reconciliation
Ensures all medication patient is taking is correctly documented on admission and each transfer of care.
1) Admission
2) Post admission verification by pharmacy
3) Discharge
SCRs
Summary Care Records
Minimum = allergies, adverse reactions, medications
BNF
- guidance on prescribing
- individual therapeutic areas
- appendices (interactions/additives)
- drug monographs = indications for that drug
Gabapentin
- licensed for epilepsy and neuropathic pain
Amitriptyline
Licensed for depression and nocturnal enuresis.
Unlicensed indications = neuropathic pain and migraine prophylaxis.
Formulations
Drugs have different doses depending on formulation used as bioavailability differs
Modified Release
To allow less frequent dosing
Pharmacodynamic
Drugs have additive or Antagonistic pharmacological effects
- often predictable
Pharmacokinetic
Drug increases or decreases amount of another drug available in body by affecting absorption, distribution, metabolism or excretion of the other.
Valid Prescription
- signed in ink with your name
- indelible ink permanent
- address of practitioner
- date
2 error types
- slips and lapses (actions do not go according to plain)
- mistakes (plan itself is wrong)
Aspirin
Reyes syndrome
Corticosteroids in infants
Growth Suppresion
Paracetamol in infants
Reduced susceptibility to hepatotoxicity
Valproate in infants
Increased frequency of hepatotoxicity
Systemic chloramphenicol
gray baby syndrome
SSRIs
Increased suicidal ideation in teens
High dose pancreatic enzyme replacement
Bowel stenosis
Aspirin augmented
1 = bleeding 2ry = gastric irritation
Bisoprolol
1 = bradycardia 2dry = bronchospasm
Salbutamol
1 = bronchodilation 2ry = lactic acidosis
Phenytoin
Ataxia, nsytagmus
Digoxin
Visual aura, nauseua, arrhythmias
Warfarin
Bleeding
Subdural haematoma
Unfractionated heparin
Bleeding
Diclofenac
Heart Failure
Type C
Bisphos = jaw osteonecrosis Corticosteroids = osteoporosis
Type D
Carbimazole = agranulocytosis
Typical antipyschotics = tardive dyskinesia
Chemo = infertility
Many drugs = teratogenicity
Stilbestrol
Clear Cell adenocarcinoma of genital tract in young women
Type E
Benzodiazepine = agitation/insomnia Cortciosteroids = adrenal insufficiency Opiates = flu like withdrawal
Pharmacokinetics
Gentamycin = trough plasma levels
Pharmacodynamics
Warfarin = INR
Objective side effects
ACEi = renal function
Subjective SE
Aspirin = gastritis
IM
CI in haemophillia
Intrathecal
- single dose analgesia
- limited chemo agents
- baclofen
- respiratory depression potential
Intranasal
DDAVP
Midazolam
PV
Hormonal
IUD
Pessaries
Max potassium rate fludis
Not faster than 10mmol/hr
Max 40mmol/L in peripheral line
20 or 40
Resus Fluids
Crystalloids
sodium 130-154
bolus 500ml over less than 15 mins
severe sepsis = human albumin solution 4-5%
Maintenance Fluids
- 20-30ml/kg/day of water
- 1mmol/kg/day of K+, Na+, Cl-
- obese adjust IV to ideal body weight
- do not exceed 30ml/kg/day
- less if old/frail/renal failure/cardiac failure
- 25-30ml/kg/day sodium chloride 0.18% in 4% glucose
- 27mmo/l potassium on day 1
- > 2.5:L increases hyponatremia risk
- 1L over 8-12 hs
- 2L-2.5L over 24 hrs
