Other things from Summary Flashcards
What types of medicines are most likely to cause falls
ones that act on the heart
ones that act on the brain or circulation
why do medicines that reduce BP or HR cause falls ?
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
Name the 7 steps of medication review
- AIMS identify the aims and objectives of drug therapy
- ESSENTIAL identify essential drug therapy
- UNNECESSARY does the patient take unnecessary drug therapy
- THERAPEUTIC OBJECTIVES are therapeutic objectives being achieved
- ADR is the patient experiencing any ADR’s or are they at risk of any potential ADR’s
- COST is the drug therapy cost effective?
- TAKE AS INTENDED is the patient willing and able to take their medicines as intended ?
what is a THROMBOTIC STROKE
occurs when a blood clot (thrombus) forms in one of the arteries that supplies blood to the brain
what is an EMBOLIC STROKE
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.
what is an HEMORRHAGIC STROKE
caused by an artery in the brain bursting and causing localised bleeding in the surrounding tissues, bleeding kills the brain cells
what are some of the modifiable risk factors of stroke
¬ 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)
what are some of the non-modifiable risk factors of stroke
¬ Age
¬ Sex (female)
¬ Race
PFO (patient foramen ovale, hole in the heart that hasn’t closed the way it should have at birth)
what are some of the problems associated with using liquid formulations in enteral drug administration
suspension stablilty
effervescent tablets – salt content
sorbital may cause diarrhoea or cramps
liquids with high osmolarity can cause osmotic diarrhoea
what are some fo the problems associated with enteral drug administration
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
what does gas chromatography do
used in drug confirmatory testing
a technique for separating and analysing compounds which can be vaporised without chemicals
what is gas chromatography + mass spectometry
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
what is liquid chromatography
Separates non-volatile compounds
separates and analyses chemical substances in solution based on distribution between liquid phases and mobile phases
what is the test matrix
the biological specimen used for detecting the presence or absence of a drug or its metabolites
why do you gove a loading dose
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.
what will drug clearance be in relation to fu and GFR if drug is cleared by glomerular filtration
Drug CL Renal = fu x GFR
what will drug clearance be in relation to fu and GFR if drug is cleared by active secretion
Drug CL Renal > fu x GFR
what will drug clearance be in relation to fu and GFR if drug is reabsorbed
Drug CL Renal < fu x GFR
what problems are associated with the CrCl eon (what does it assume)
creatinine production is at steady state
creatinine production is normal
what is the problem with using the cockcroft gault eqn in elderley
it can underestimate renal function because of their lower muscle mass which means that their creatinine production is lower than normal
how is creatinine made
it is a product of muscle metabolism
Creatine (liver) –> creatinine phosphate (muscle) –> creatinine
what can occur as a result of alcohol addiction
Korsakof’s psychosis
Wernickes encapalopathy
Vit B malabsorption
what are the aims of injecting equipment provision
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
what can cause SJS or TEN as an ADR
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
what should be screened for when starting carbamazepine treatment
HLA-B* 15:02
what is the definition of a drug interaction
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
what happens when medicines interact with antacids
they chelate with the metal ions (iron/aluminum/calcium) and form insoluble compledes
therefore the drug cannot be absorbed
what are the headings for a fishbone diagram
eqiptment people process materials environment
what are the headings for a fishbone diagram in medicines storage
moisture light air temperature production distribution storage ---> unable drug product
what medicine can be given for excessive respiratory secretions or excessive secretions in general
hyoscine butyl bromide
what medicine can be given for COPD cough
NaCl nebulas
what medicine can be given for excessive mucous-y saliva
carbocystine
pineapple
hydration
what medicine can be given for pain/spaciti
baclofen
tizadine
What is important to consider when thinking about covert drug administration
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
