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Pre Reg Pharmacy > Miscellaneous info > Flashcards

Miscellaneous info Flashcards

1
Q

What is given in Acute coronary syndrome (MI, unstable angina)?

A
  • Aspirin dispersible tablets 300mg PLUS:
  • GTN spray 1-2 puffs repeated as required
  • OR GTN tablets 0.3mg-1mg, repeat as required
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2
Q

what is the adrenaline dose for ages 5 years and below?

A

0.15ml (150mcg), repeated every 5 mins if necessary

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3
Q

what is the adrenaline dose for ages 6-11 years?

A

0.3ml (300mcg), repeated every 5 mins if necessary

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4
Q

what is the adrenaline dose for ages 12-17?

A
  1. 5ml (500mcg), repeated every 5 mins if necessary, .

- 0.3ml if child is small or prepubertal

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5
Q

what is the adrenaline dose for an adult?

A

0.5ml (500mcg), repeated every 5 mins if necessary

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6
Q

other an adrenaline, what else can be given for prophylaxis?

A
  • high flow O2 and IV fluid asap.
  • IM/IV chlorphenamine
  • IV hydrocortisone (for more severe patients).
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7
Q

what abx is given for pneumococcal disease?

dose?

A

Benzylpenicillin IV or IM if venous access is not available.

single dose should be given before urgent transfer to hospital.

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8
Q

what are the doses to treat pneumococcal disease?

A 
neonate: 300mg
child 1-11 months: 300mg
child 1-9 years: 600mg
child 10-17 years: 1.2g
adult: 1.2g
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9
Q

what abx is given for pneumococcal disease for those with a penicillin allergy? dose?

A

Cefotaxime IV (IM if venous affect is not available)

  • neonate: 50mg/kg
  • child 1 month- 11 years: 50mg/kg (Max of 1g)
  • Age 12 - adult: 1g
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10
Q

What does the GFR range of 90ml/min and over indicate?

A

Normal

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11
Q

What does the GFR range of 60-89ml/min indicate?

A

Mild reduction

Relative to Normal range in young adults

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12
Q

What does the GFR range of 45-59ml/min indicate?

A

Mild to Moderate reduction

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13
Q

What does the GFR range of 30-44ml/min indicate?

A

Moderate-severe reduction

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14
Q

What does the GFR range of 15-29ml/min indicate?

A

Severe reduction

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15
Q

What does the GFR range of under 15ml/min indicate?

A

Kidney failure

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16
Q

Who do we administer the quadrivalent flu vaccine to?

A

Under 65 years of age

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17
Q

Who do we administer the trivalent flu vaccine to?

A

Over 65 years of age

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18
Q

What is the live flu vaccine? Who is it usually given to? When is this CI?

A

Nasal flu vaccine given nasally.
Usually given to children (around age 2-9)

Do not give to patients with uncontrolled asthma or immunocompromised: give inactivated injection instead

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19
Q

What is trigeminal neuralgia? What is the 1st line treatment?

A
  • Sudden, severe facial pain.
  • Describedas a sharp shooting pain or like having an electric shock in the jaw, teeth or gums.

Treatment: Carbamazepine

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20
Q

what are the cautions for inhaled antimuscarinics?

A

susceptibility to angle closure glaucoma
paradoxical bronchospasm
bladder outflow
prostatatic hyperplasia

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21
Q

which inhaled antomuscarinic has the warning of the risk of acute angle closure glaucoma?

A

neb ipratropium bromide
especially when given with neb salbutamol and possibly with other beta2 agonist.

protect the patient’s eyes from neb drugs or drug powder.

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22
Q

what is bambuterol the pro drug of?

A

terbutaline

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23
Q

what is antiepiletic hypersensitivity syndrome? which drugs cause this?

A
  • CP3 (carbamzaepine, phenytoin, phenobartial, primidone)
  • lacosamide, lamotrigine
  • oxcarbazepine
  • rufinamide

symptoms start between 1 and 8 weeks of exposure

  • fever, rash and lymphadenopathy most common.
  • STOP DRUG IMMEDIATELY IF THIS HAPPENS
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24
Q

what are the CI of opioids?

A
  • acute respiratory depression
  • comatose patients
  • head injury
  • raised intracranial pressure
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25
Q

What points should be included when reporting biological adverse effects?

A

Brand name
Batch number

Biologics are subject to Black triangle status

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26
Q

What makes an oral liquid preparation sugar free?

A

DOES not contain glucose, fructose or sucrose.

CONTAINS: hydrogenated glucose syrup, mannitol, maltitol, sorbitol or xylitol

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27
Q

What excipients should be avoided in neonates in injections and why?

A

Benzyl alcohol: fatal toxic syndrome in preteen neonates

Polyoxyl caster oils: associated with severe anaphylactoid reaction.

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28
Q

when travelling abroad, which medicines do not subject to import/export licensing? what do they need to carry instead?

A

sch 4 part 2 (CD anab) for self admin
sch 5 CD.

advised to carry a cover letter signed by the prescriber or drug worker.

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29
Q

when travelling abroad, which medicines are subject to having a personal export/import license?

A

sch 2, 3 or 4 part 1 CD

sch 4 part 2 CD if they are carrying more than a 3 months supply or intending to travel for more than 3 calendar months.

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30
Q

what is the application process for obtaining a export/import license for travelling?

A

supported with a covering letter signed by their prescriber or drug worker which confirms:

  • patient’s name and address
  • travel itinerary
  • the names of the prescribed CD, doses and total amounts to be carried.

processing time: at least 10 days

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31
Q

what does the black triangle symbol indicate?
how long products have this symbol for?
what should be reported?

A

identifies newly licensed medicines that require additional monitoring by the EMA.

  • product usually has the black triangle for 5 years, can be extended if needed.
  • all suspected reactions, including those considered not to be serious should be reported via the yellow cars scheme.
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32
Q

what does NRLS mean?

A

national reporting and learning system.

-adverse reactions where harm occurs can be reported here.

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33
Q

list the drugs capable of causing oral ulceration

A 
ACEi
gold
nicorandil
NSAIDS
pancreatin
penicillamine
proguanil
34
Q

list the drugs associated with lichenoid eurptions

A 
ACEi
NSAIDS
methyldopa
chloroquine
oral antidiabetics
thiazide diuretics
gold
35
Q

what is the equivalent subcut dose of diamorphine compared to oral morphine?

A

1/3

36
Q

in pallative care, what is taken for anorexia?

A

prednisolone or dexamethasone

37
Q

in pallative care, what is taken for bowel coli and excessive respiratory secretions?

A

subcut injection of hyoscine HBr
hysocine butylBr or
glycopyrronium

given every 4 hours prn

38
Q

in pallative care, what is taken for capillary bleeding

A

tranexamic acid orally.

usually discontinued 1 week after the bleeding has stopped.

alternatives:
guaze soaked n tranexamic acid or adrenaline appied to the area.

39
Q

in pallative care, what is taken for constipation?

A

lactulose and senna
co-danthramer

methylnalrexone Br: for when the above have been tried and not helping.

40
Q

in pallative care, what is taken for convulsions?

A

prophylactic phenytoin or carbamezepine

  • or diazepam rectally or phenobarbital infusion
  • midazolam by subcut infusion
41
Q

in pallative care, what is taken for dry month?

A

good oral hygiene
chew SF gum
suck on ice cubes or pineapple pieces
artificial saliva

dry month associated with oral thrush: treat with nystatin or miconazole

42
Q

in pallative care, what is taken for dysphagia?

A

dexamethasone

43
Q

in pallative care, what is taken for dyspnoea?

A

breathlessness at rest may be relieved by oral morphine in carefully titrated dose.

diazepam can be given for dyspnoea with anxiety

dexamethasone can be given if there is bronchospasm or partial obstruction.

44
Q

in pallative care, what is taken for GI pain?

A

the pain of bowel coli may be reduced by loperamide.

hyoscine HBr s/l tablets (Kwells)

stomach disention pain due to pressure: antacid + antiflatulance + prokinetic (domperidone) before meals.

45
Q

in pallative care, what is taken for hiccups?

A
  • antacids + antiflatulance preps
  • if this fails add metoclopramide PO or S/C or I/M
  • if this also fails: baclofen, nifedipine or chlopromazine can be tried.
46
Q

in pallative care, what is taken for insomnia?

A

temazepam

47
Q

in pallative care, what is taken for intractable cough?

A

moist inhalations or regular admin of oral morphine.

AVOID methadone because it has a long duration of action and can accumulate.

48
Q

in pallative care, what is taken for muscle spasm?

A

diazepam or baclofen

49
Q

in pallative care, what is taken for pruritius?

A

colestryamine

50
Q

in pallative care, what is taken for raised intracranial pressure?

A

high dose of corticosteriods e.g. dexamethasone.

dose given before 6pm to reduce the risk of insomnia.

51
Q

what drugs are compatible with diamorphine?

A

-cyclizine- can precipitate at concs above 10mg/ml or when NaCl 0.9% is present.

  • dexamethasone
  • haloperidol- likely to precipitate after 24 hrs at concs above 2mg/ml
  • hyoscine
  • levomepromazine
  • midazolam
  • metclopramide
52
Q

What is the NRT chewing gum dose for those that smoke less than 20 cigarettes per day?

A

2mg

53
Q

What is the NRT chewing gum dose for those that smoke more than 20 cigarettes per day?

A

4mg

54
Q

what vaccine is given to to those what work with primates?

A

hep A vaccine

55
Q

what lab test is associated with Crigler-Najjar syndrome?

A

Bilirubin build up

56
Q

what is given to control bleeding due to incomplete miscarriage or abortion via IM admin?

A

Oxytocin

57
Q

what is a common side effect of Montelukast newly started?

A

hyperkinesia

58
Q

what antimalarial is not recommended for the treatment of falciparum malaria?

A

chloroquine

59
Q

what is duration of admin of malarone?

A

start 1-2 days before travel, during travel and then 7 days after travel.

60
Q

what antiepiletic drug causes kidney stones?

A

topirimate

61
Q

what are the CIs of nitrates?

A
  • hypotensive conditions
  • raised intracranial pressure due to cerebral haemorrage and head trauma.
  • toxic pulmonary oedema
62
Q

what are the further info points on tolerance and nitrates?

A
  • reduction of blood-nitrate concs to low levels for 4-12 hours OD maintains effectiveness.
  • transdermal patches should be left off for 8-12 hrs (overnight) in each 24 hours.
  • for the case of M/R ISBDN (and conventional formulations of ISBMN): the 2nd dose of BD doses should be given 8 hrs rather than after 12 hrs.
  • conventional forms of ISBMN should not be usually given BD unless small doses are given.
63
Q

when is tibolone given for osteoporosis?

A

restricted to younger post menopausal women with menopausal symptoms who are at high risk of fractures.

taken continuously

64
Q

what is the therapy of hyperthyroidism in pregnancy?

A

1st trimester: PU (carbimazole has a risk of congential malformations)

2nd trimester: Carbimazole (PU is hepatotoxic to the mother and foetus in the 2nd trimester)

65
Q

when patients start feeling better for their 1st episode of depression while taking their antidepressants, can they stop treatment

A

continue taking for a further 6 months (12 months in elderly), then gradually taper off medicines.

66
Q

when patients start feeling better for their 2nd episode of depression or high risk of relapse while taking their antidepressants, can they stop treatment

A

take meds for at least 2 years, then taper off gradually.

67
Q

when is a patient likely to notice the effects of antidepressants?

A

until 2 weeks

68
Q

when is an antidepressant deemed as not effective?

A

taken for 4 weeks with no difference, (6 weeks in elderly)

can be switched to another drug

69
Q

what opioids should be avoided in renal impairment?

A

dihydrocodeine
pethidine

codeine- use with caution in mild to moderate renal impairment.

70
Q

what opiods are safest in renal impairment?

A

fentanyl and alfentanyl- metabolised into non toxic metabolites

  • buprenorphine- excreted in the bile
  • oxycodone= max inital dose pf 2.5mg every 6 hours (avoid if eGFR is less than 10ml/min)
71
Q

what is given for N+V caused by chemicals (drugs, toxins etc)?

A

halperidol

72
Q

what is given for N+V caused by chemo?

A

ondansteron

73
Q

what is given for N+V caused by gastro issues?

A

metoclopramide

74
Q

what is given for N+V caused by raised intracranial pressure, motion sickness, bowel construction?

A

cyclizine

75
Q

what is given for N+V in parkinson’s disease?

A

domperidone

76
Q

What are the common SEs of valproate?

A 
Abdo pain
Agitation 
Alopecia 
Anaemia 
Hepatic disorders 
Abnormal behaviour 
Confusion 
Low Na+
Irregular Menstrual cycle
Thrombocytopenia 
Weight gain
Nystagmus
77
Q

When would stop valproate treatment immediately?

A

Hepatic dysfunction signs and symptoms (stop if prothrombin time is high)

Pancreatitis

78
Q

What are the monitoring requirements of valproate?

A

Liver function before therapy and during the 1st 6 months

FBC

79
Q

What is the MHRA product recall class 1?

A

Requires immediate recall because the product poses a serious or life threatening risk to health.

80
Q

What is the MHRA product recall class 2?

A

Specifies a recall within 48 hours because. The defect could harm the patient but its not life threatening.

81
Q

What is the MHRA product recall class 3?

A

Requires action to be taken within 5 days because the defect is likely to harm the patient and is being carried out for reasons other than patient safety.

82
Q

What is the MHRA product recall class 4?

A

Advises caution to be exercised when using the product but indicates the product poses no threat to patient safety.

Pre Reg Pharmacy (36 decks)

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