Other things from Summary Flashcards

1
Q

What types of medicines are most likely to cause falls

A

ones that act on the heart

ones that act on the brain or circulation

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2
Q

why do medicines that reduce BP or HR cause falls ?

A

elderly people with heart rate <110mmHg are at an increased risk of falls

maintaining upright posture/ consciousness requires adequate blood flow to the brain, this requires adequate BP and HR

therefore any medicine that reduces HR or BP can cause falls

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3
Q

Name the 7 steps of medication review

A
  1. AIMS identify the aims and objectives of drug therapy
  2. ESSENTIAL identify essential drug therapy
  3. UNNECESSARY does the patient take unnecessary drug therapy
  4. THERAPEUTIC OBJECTIVES are therapeutic objectives being achieved
  5. ADR is the patient experiencing any ADR’s or are they at risk of any potential ADR’s
  6. COST is the drug therapy cost effective?
  7. TAKE AS INTENDED is the patient willing and able to take their medicines as intended ?
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4
Q

what is a THROMBOTIC STROKE

A

occurs when a blood clot (thrombus) forms in one of the arteries that supplies blood to the brain

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5
Q

what is an EMBOLIC STROKE

A

occurs if a blood clot that forms elsewhere in the body breaks loose and travels to the brain via the blood stream. The clot then lodges in an artery and blocks the flow of blood then causes a stroke.

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6
Q

what is an HEMORRHAGIC STROKE

A

caused by an artery in the brain bursting and causing localised bleeding in the surrounding tissues, bleeding kills the brain cells

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7
Q

what are some of the modifiable risk factors of stroke

A
¬	Smoking
¬	Drug use
¬	Hypertension
¬	TIA
¬	Diabetes
¬	High cholesterol
¬	Atrialfibrillation
¬	Alcohol
¬	Poor diet
Lack of exercise

Hypoperfusion (very rare though, can cause stroke because of increases coagulation risk)

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8
Q

what are some of the non-modifiable risk factors of stroke

A

¬ Age
¬ Sex (female)
¬ Race
PFO (patient foramen ovale, hole in the heart that hasn’t closed the way it should have at birth)

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9
Q

what are some of the problems associated with using liquid formulations in enteral drug administration

A

suspension stablilty
effervescent tablets – salt content
sorbital may cause diarrhoea or cramps
liquids with high osmolarity can cause osmotic diarrhoea

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10
Q

what are some fo the problems associated with enteral drug administration

A

binding of drugs to tube

direct interaction of drug and feed causing tube blockage

direct interaction of drug and feed causing reduced drug absorption

administration of drug on empty stomach

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11
Q

what does gas chromatography do

A

used in drug confirmatory testing

a technique for separating and analysing compounds which can be vaporised without chemicals

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12
Q

what is gas chromatography + mass spectometry

A

gas chromatography separates analytes in a specimen
components enter mass spec
mass spec identifies and quantifies separated analytes (creates charged ions and separates them based on mass-to-charge-ratio)
ions form a unique mass spectra that can be used to identify the analytes

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13
Q

what is liquid chromatography

A

Separates non-volatile compounds

separates and analyses chemical substances in solution based on distribution between liquid phases and mobile phases

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14
Q

what is the test matrix

A

the biological specimen used for detecting the presence or absence of a drug or its metabolites

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15
Q

why do you gove a loading dose

A

A loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.[1]

A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life. Such drugs need only a low maintenance dose in order to keep the amount of the drug in the body at the appropriate therapeutic level, but this also means that, without an initial higher dose, it would take a long time for the amount of the drug in the body to reach that level.

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16
Q

what will drug clearance be in relation to fu and GFR if drug is cleared by glomerular filtration

A

Drug CL Renal = fu x GFR

17
Q

what will drug clearance be in relation to fu and GFR if drug is cleared by active secretion

A

Drug CL Renal > fu x GFR

18
Q

what will drug clearance be in relation to fu and GFR if drug is reabsorbed

A

Drug CL Renal < fu x GFR

19
Q

what problems are associated with the CrCl eon (what does it assume)

A

creatinine production is at steady state

creatinine production is normal

20
Q

what is the problem with using the cockcroft gault eqn in elderley

A

it can underestimate renal function because of their lower muscle mass which means that their creatinine production is lower than normal

21
Q

how is creatinine made

A

it is a product of muscle metabolism

Creatine (liver) –> creatinine phosphate (muscle) –> creatinine

22
Q

what can occur as a result of alcohol addiction

A

Korsakof’s psychosis
Wernickes encapalopathy
Vit B malabsorption

23
Q

what are the aims of injecting equipment provision

A
hat are the aims of Injecting Equipment Provision
•	Provide clean injecting equiptment 
•	At least one kit per injection
•	Reduce injecting related harm
•	Reduce BBV transmission
•	Reduce viral pool
•	Dispose of used apparatus
•	Provide harm reduction messages
•	Signposting services
•	Never share messages
24
Q

what can cause SJS or TEN as an ADR

A

Due to genetic variation in HLA complex ,
this complex helps the body to distinguish the bodies own proteins from proteins made by foreign invaders

HLA-B* 15:02 increases the risk og SJS pr TEN
Common in people from south east asia

25
Q

what should be screened for when starting carbamazepine treatment

A

HLA-B* 15:02

26
Q

what is the definition of a drug interaction

A

when the pharmacological or clinical response to the administration of a drug combination differs from the known effects of the two agents when given alone

27
Q

what happens when medicines interact with antacids

A

they chelate with the metal ions (iron/aluminum/calcium) and form insoluble compledes
therefore the drug cannot be absorbed

28
Q

what are the headings for a fishbone diagram

A
eqiptment
people
process
materials
environment
29
Q

what are the headings for a fishbone diagram in medicines storage

A
moisture
light
air
temperature
production
distribution
storage
---> unable drug product
30
Q

what medicine can be given for excessive respiratory secretions or excessive secretions in general

A

hyoscine butyl bromide

31
Q

what medicine can be given for COPD cough

A

NaCl nebulas

32
Q

what medicine can be given for excessive mucous-y saliva

A

carbocystine
pineapple
hydration

33
Q

what medicine can be given for pain/spaciti

A

baclofen

tizadine

34
Q

What is important to consider when thinking about covert drug administration

A

Covert drug administration adults with incapacity (scotalnd) act 2000
♣ Benefit
♣ Least restrictive
♣ Take patients wishes into account
♣ Cpntultation with others
♣ Should be a team decision with HCP and damils
♣ Pharmacist must be involced