High risk medications and never events Flashcards
What to remember in the situation when pt is post-op and we are about to stop their IV insulin therapy?
15 - 30 min prior to stopping IV insulin therapy -> we need to give short-acting insulin
This is because stopping IV insulin would quickly leave a pt with no insulin cover
What is the potential risk and why in midazolam use during conscious sedation
Death or severe harm as a result of overdose of midazolam injection following use of high strength midazolam (5mg/ml or 2mg/ml) for conscious sedation
Can we write ‘mcg’ in the prescription?
No, we need to write the whole word = MICROGRAMS
Do we write ‘u’ when prescribing insulin, e.g. 5000 u?
No, we need to wrote the whole word ‘units’
What does it mean ‘opioid naive’?
What is the danger in that?
Opioid naive = patient who does not receive opioids chronically/on daily basis
*an overdose/wrong dose of opioids may occur easily
What do we need to remember about while prescribing oral methotrexate?
Methotrexate is ONCE weekly medicine
*Alendronic acid is another example of ONCE weekly medicine
What is the ONLY route to administer Vincristine?
Vincristine to be administrated ONLY intravenously
*Vincristine - a chemotherapeutic agent
*it is dangerous as many patients who receive vincristine also receive many other treatments intrathecally. Vincristine is neurotoxic, so if administrated intrathecally it will # CNS -> paralysis and death occur
Examples of medicine classes (3) that will result in harm to the patient if delayed/not given on time?
- insulin
- anticoagulants
- antibiotics -> e.g. in query sepsis (abx delivered iV within an hour)
What section of a drug chart should we use if we want medicine to be administrated now?
STAT section
for treatments like PE, DVT (heparin), antibiotics in sepsis
What’s the trust’s list of ‘critical medicines’?
List of the drugs that patient should never miss or be delayed in terms of administration
Examples of drug classes that belong to ‘critical medicines’
‘Critical medicines’ - administration should never be omitted or delayed
- anti-infectives
- anti-coagulants
- insulin
- meds for Parkinson’s disease
- etc.
What’s the usual insulin regime for type I diabetic?
- short-acting insulin with meals -> 3 x a day
- long-acting insulin at night
What to remember while prescribing insulin to a diabetic patient (when they are admitted to hospital)
They may have a different amount of units prescribed at different times (e.g. different with every mean) - ask the patient
How many times a day is an insulin given type II diabetic patient?
Types II diabetic patient = intermediate insulin *
Given usually TWICE daily
It is the mixture of long and short-acting insulin (different proportions in preparations)
