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MPharm 2 - PH2113 > PH2110 - Patient Centred Care (PCC) > Flashcards

PH2110 - Patient Centred Care (PCC) Flashcards

1
Q

What needs to be offered before inhalers given for asthma and COPD?

A
  • Support to stop smoking.
  • Vaccines- flu and pneumonia.
  • Self management plan.
  • Optimise treatment for co-morbidities.
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2
Q

When would you start inhaler treatment for COPD?

A
  • All lifestyle changes have been made eg. stop smoking.
  • Needed to relieve breathlessness and exercise.
  • Trained to use inhalers and can use them properly.
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3
Q

What are the first type of inhalers given for COPD?

A

SABA or SAMA.

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4
Q

What can be offered if patients are still getting symptoms and exacerbations of treatment after SABA or SAMA are given?

A

Not asthmatic features or not responsive to steriod treatment: LABA and LAMA.
Asthmatic and/or responsive to steriod treatment: LABA and ICS.

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5
Q

What are the 6 stages of the discharge process?

A
  1. Patient discharged with short term meds.
  2. Discharge information sent to GP and nomiated Pharmacy.
  3. HP produces new repeat Rx.
  4. New repeat Rx presented.
  5. Pharmacist comapred GP Rx and discharge information for issues and chnages.
  6. Pharmacist contacts GP service to amend any issues if there are any.
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6
Q

What are some side effects f long term use of steriods?

A
  • Adrenal insufficiency.
  • Fatigue.
  • Anorexia or weight loss in children.
  • Headache.
  • Abdominal pain and discomfort.
  • Joint Pain.
  • Dizziness.
  • Fever.
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7
Q

What are problems with long term steroids on different parts of the body?

A
  • Endocrine: adrenal insufficiency, weight and diabetes.
  • GI: Peptic ulcers.
  • Psyc: confusion, irritability, mental health problems.
  • Muscoskeletal: osteoporosis
  • Opthalmic: glucoma, cataract adn blurred vision.
  • CV: hypertenson.
  • Skin: thinning, delayed healing and easy bruising.
  • Others: immunosuppression.
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8
Q

What is the DMR service?

A

Discharge medication review: improve communication between settings, reduce costs, reduce re-hospitalisation and wastage

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9
Q

What is ACS?

A

Acute coronary syndrome- sudden reduction of blood flow through coronary arteries. lactic acid can build up causing damage to tissues as there is a lack of oxygen.
Seen as chest pain and discomfort.

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10
Q

Least to most severe for the types of ACS?

A

Stable angina (least) —–> Unstable angina —–> MI.

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11
Q

How does ACS occur?

A
  1. Plaque rupture forming clot.
  2. Clot blocks blood flow.
  3. Oxygen inhibiting causing death to heart cells.
  4. Heart attack (MI) occurs.
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12
Q

How does an atheroma cause a thrombus?

A
  1. Made of cholesterol with a cap.
  2. Unstable cap ruptures causing immune response.
  3. Immune response forms clot to minimise foreign cells going other places forming thrombus.
    Clotting cascade initiated when thrombus ruptures.
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13
Q

What are symptoms of ACS?

A
  • Chest pain.
  • Nausea and vomiting.
  • pain spreading to shoulders, chest and upper abdomen.
  • Indigestion.
  • Shortness of breath.
  • Sudden, heavy sweating.
  • Dizzy.
  • Unusual fatigue.
  • Restless.
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14
Q

What are risk factors fo ACS?

A
  • Age.
  • High BP.
  • High blood cholesterol.
  • Smoking.
  • Unhealthy diet.
  • lack of physical activity.
  • Obesity & diabetes.
  • Family history.
  • History of preeclampsia or diabetes.
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15
Q

What is the acute treatment for ACS?

A

Anticoagulant and antiplatelet:

300mg aspirin and 300mg of clopidogrel.

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16
Q

What are the 6 type of drugs that will be considered for secondary management of ACS?

A
  1. Anti-platlet.
  2. GNT/Nitrates.
  3. ACE inhibitors.
  4. Duel- anti-coagulants.
  5. Statin.
  6. Beta-blockers.
17
Q

What is the drug and dose of choice for anti-platelet treatment in ACS?

A

75mg of clopidogrel.

18
Q

What is the drug of choice for ACE inhibitors treatment in ACS?

A

Ramipril

19
Q

What is the drug of choice for Duel anti-coagulants treatment in ACS?

A

Enoxaparin 1mg/kg 12 hourly 2-8 days.

20
Q

What is the drug of choice for Statins treatment in ACS?

A

Atorvastatin 80mg.

21
Q

What is the drug of choice for beta-blockers treatment in ACS?

A

Bisoprolol- ONCE daily

22
Q

Suggest discharge medication for a patient leaving hospital with confirmed non-ST segment elevation myocardial infarction (NSTEMi)

A
  1. Enoxaparin.
  2. Aspirin.
  3. Clopidogrel.
  4. Atorvastatin.
  5. Bisoprolol.
  6. Ramipril.
  7. GTN spray.
23
Q

What ‘self-help’ advice can be provided to a patient with constipation?

A
  • Healthy balanced diet.
  • Wholegrains, fruit and veg.
  • Increase fibre intake.
  • Increase fluid intake.
  • Activity and exercise.
  • Toilet at regular times, respond to urgency.
24
Q

What are the categories of laxatives in order.

A
  1. Bulk forming.
  2. Osmotic.
  3. Stimulant.
  4. Stool softeners.
25
Q

When should loperamide be used?

A

When symptoms are challenging and affecting life style- after trying oral hydration sachets.

26
Q

What does ABC stand for in IBD?

A

A- abdominal pain or discomfort.
B- Bloating.
C- Change in bowel habit.

27
Q

What are symptoms of ulcerative colitis (UC)?

A
  • Recurring diarrhoea.
  • Stomach pain.
  • Needing to empty bowels frequently.
  • Extreme tiredness.
  • Loss of appetite.
  • Weight loss.
28
Q

What are counselling points when taking statins?

A

Avoid grapefruit juice.

29
Q

What are counselling points when using GTN spray?

A

Sit down when taking.

30
Q

What are counselling points when using ACEi?

A

Cough- return to Pharmacy.

31
Q

What are counselling points when taking beta-blockers?

A

Do NOT stop taking even if fatigued.

32
Q

What is the goals for treatment for ACS?

A

Improving blood flow, treating complications and preventing further problems.

33
Q

Advise on how to take alenndronic acid for osteoporosis

A
  • Take on the same day weekly.
  • Sitting upright.
  • Do not eat, drink or take any other medicines for at least 30 minutes.
  • Take with a full glass of water.
34
Q

What are things to report with osteoporosis?

A
  • Femoral fractures- hip, joint, groin.
  • Osteonecrosis of the jaw- dental check.
  • Osteonecrosis of ear canal- hearing issues.
35
Q

What supplements should be taken for osteoporosis?

A

=> Calcium 700-1200mg.

=> Vitamin D 800 iU.

36
Q

What types of activity can be recommended for a patient with osteoporosis?

A
  • Regular weight bearing excerises.
  • 150 mins of moderate aerobic activity.
  • Strength excerises on 2 or more days a week.
37
Q

What are major differences between hyperthyrodism and hypothryodism?

A

Hypothyrodism- tiredness, muscle pain and weakness, weight gain, sensitive to cold, dry skin and brittle hair, depression and reduce libido.

Hyperthyrodism- tremor, warm sweaty palms, weight loss, heat intolerance, diffuse alopecia or hair thinning, tachycardia, diarrhoea.

MPharm 2 - PH2113 (50 decks)

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