Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MPharm 4 > PH4118 Desired Outcomes > Flashcards

PH4118 Desired Outcomes Flashcards

1
Q

What is the desired outcome for inappropriate dose/treatment of antibiotics

A

Cure disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the desired outcome for incorrect length of antibiotic treatment

A

Cure disease by treating infection + prevent harm through antimicrobial stewardship

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the desired outcome for Breathlessness/pain

A

Manage symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the desired outcome for incorrect VTE prophylaxis

A

Minimise risk of thrombosis whilst inpatient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the desired outcome for Smoking Cessation

A

Improve health and reduce risk of further infections.
Prevent harm (acute nicotine withdrawal)
Prevent harm (lots of possible answers here related to smoking related diseases!)
Halt/slow disease progression
Reduce symptoms of a disease (exacerbations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the desired outcome for blood pressure treatment

A

Normalise physiological parameters
Monitor blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the desired outcome for high doses

A

Prevent harm (side effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the desired outcome for Constipation (particularly on opioids)

A

Prevent symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the desired outcome for counselling a patient on a new medicine?

A

Prevent harm, promote adherence and enable patient to engage with treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would be the reason for Action when counselling a patient on a new medicine

A

Pharmacist to give key information/ask patient what they would like to know about their new medication and provide information as appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the desired outcome for Weight not indicated in the medication chart when weight is required for dosing?

A

Avoid potential overdose with medication. Max dose should be….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What error does a potent steroid usually indicate?

A
  • potent steroid regularly? should use least potent which is effective
    Minimise side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should you always check for with a patient that has eczema?

A

An emollient is prescribed and being used regularly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should always be checked when the patient is on a contraceptive and teratogenic drug

A

Contraceptive dose instructions are clear and the contraception is being used.
- is it due ?
- Patient takes correctly and therefore minimises chance of pregnancy
- isit the most appropriate method of contraception? Cu IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For community cases what should be checked alongside the RX?

A

The repeat slip
- medications that should no longer be on it
- Medications that arent there (emollients)

The PMR
- what other medication have they recently had?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the action for VTE prophylaxis?

A

Ask prescriber to consider prescribing LMWHs.
- if other factors such as surgery, try to work out the length of prophylaxis, e.g 28 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should always be checked when antibiotics are prescribed on a hospital chart?

A

Length of treatment is indicated?
Correct antibiotic?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

As a community pharmacist what role can you take in ensuring patients like Mr. Bowden are kept safe when they move between care providers? (5 marks)

A
  • Help patients construct an up to date list of their current medicines, including dose, frequency, formulation, what it is for and medicines they cannot take.
  • Advise patients to take their medicines with them if they go into hospital.
  • Perform a Discharge Medication Review (Wales) within 4 weeks of discharge to reconcile medication and check patient understanding of their medicines.
  • Update PMRs with relevant info to medicines changes post-discharge.
  • Any other relevant / appropriate suggestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If steroids come up what should be considered?

A

Prednisolone should be taken after a meal to minimise GI side effects
Time of day that they are taken
Length of treatment - treatment longer than 3 months may require calcium and vitamin D due to increased fracture risk.
Dose - if tapering down, have they got the right strength of tablets to comply with the tapering?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is it advisable to take prednisolone as a single dose in the morning?

A

To prevent disruption of circadian rhythm (1mark)
As repeat evening doses can cause pituitary-adrenal suppression (1mark)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ALWAYS COMPARE HOSPITAL CHART AND USUAL MEDICATIONS

A

SPECIFIC BRands ?
Usual dosing?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should be checked if opioids are prescribed in the hospital?

A
  • dose increase does not exceed 50% increase - work out total daily dose and divide by 2 for max dose
  • Is Naloxone Prescribed?
  • Is the breakthrough dose correct?
  • Have they been given laxative and correct one (stimulant)?
  • Paracetamol - should be in regular pain meds as its opioid sparing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is lifestyle advise

A
  • cardioprotective diet à balanced diet, reduce saturated fat and salt
    Foods high in saturated fat include:
    • meat pies
    • sausages and fatty cuts of meat
    • butter
    • ghee – a type of butter often used in Indian cooking
    • lard
    • cream
    • hard cheese
    • cakes and biscuits
    • foods that contain coconut or palm oil
  • Less salt in diet, have to reduce fluid intake 1500-2000ml
    less than 6g
  • 5 a day
  • omega 3 - oily fish atleast twice a week.
  • pregnancy- limit to one portion of oily fish a week - no more than 2 due to containing pollutants.

Regular exercise Reduced chances of developing high blood pressure - lower cholesterol level
* physical activity
* 150 mins of aerobic exercise a week - can still carry on a convo
* 75 mins of vigorous exercise a week
* strength exercise 2 days a week
* weight management

  • smoking cessation
  • need to check motivation to quit.
  • alcohol consumption - causes high blood pressure which is a risk factor - reduce - no more than 14 units per week
24
Q

How can type 2 diabetes affect COPD?

A

It can make COPD worse. High blood sugar can affect the blood vessels in the lungs. Over time this can damage the blood vessels, leading to worsening of asthma or COPD .
COPD can make it more difficult to do physical activity.

25
Q

How does quitting smoking benefit COPD and diabetes?

A

Smoking is one of the main causes of COPD. Quitting smoking is the most effective way to slow down the progression of symptoms.
Chemicals from Smoking can cause inflammation and to blood vessels

26
Q

How is circulation affected in diabetes and COPD?

A

Chemicals from Smoking can cause inflammation and to blood vessels
Diabetes - High blood glucose levels cause fatty deposits to form inside blood vessels. Over time, these deposits make your blood vessels narrow and hard, lessening blood flow.
Peripheral Neuropathy

27
Q

what are the common features of scabies?

A

itching (particularly at night)
a raised rash or spots
Tiny mites lay eggs in the skin, leaving lines with a dot at one end.
The rash can appear anywhere, but is common between the fingers.

28
Q

What are the symptoms of measles?

A

Fever, malaise and loss of appetite, conjunctivitis, cough and coryza (blocked or runny nose).
* - Koplik spots appear after 2-3 days (blue-white spots on the inside of the mouth) and 24-48 hours BEFORE the exanthem (rash) stage.
* - Red spots ranging from 0.1-1.0cm in diameter appear on the 4th or 5th day following the start of symptoms
* - NON-itchy rash, NO fluid
* - Begins on face and behind the ears, spreads to the ENTIRE trunk and extremities (palms and soles rarely involved).
* - The spots may all join together, especially in areas of the face
* - Rash usually coincides with the appearance of a high fever
* - When rash fades, it fades to a purplish hue and then to brown/coppery coloured lesions with fine scales

29
Q

What are the symptoms of chickenpox?

A

Most children and adults experience prodromal flu-like symptoms for up to 48 hours before breaking out in rash. These include fever, malaise, headache, loss of appetite and abdominal pain.

    • Begins as an itchy rash of red papules (small bumps) progressing to vesicles (blisters) on the stomach, back and face, and then spreading to other parts of the body. Blisters can also arise inside the mouth.
    • Usually very ITCHY, WITH fluid
    • The spread pattern can vary from person to person – covers ENTIRE body
    • Different stages of lesions are present simultaneously (papules, blisters, crusts)
  • When rash fades, it forms crusts that eventually clear off, leaving scars in some cases
30
Q

What are the symptoms of Shingles?

A

You have to have had CHICKENPOX to suffer from shingles

Usually PAIN (may be severe, in the areas of one or more sensory nerves, often where they emerge from the spine)
* - Sometimes the burning area is ITCHY too
* - Pain just in one spot or may spread out
* - Patient feels unwell, with fever and headache, sensitivity to light
* -Lymph nodes draining the affected area are often enlarged and tender

    • After 1-3 days, a blistering rash appears in the painful area of skin
    • Always asymmetrical
    • Starts as a crop of closely-grouped red bumps in a continuous band on the area of skin supplied by one, occasionally two, and rarely more neighbouring spinal nerves.
    • Blisters in RESTRICTED area
    • New lesions continue to appear for several days, each blistering or becoming pustular then crusting over.
    • Occasionally affects internal organs and causes blisters inside the mouth or ears, lungs, or the genital area.
    • Occasionally shingles “sine eruption” – no rash, difficult to diagnose
31
Q

How would you differentiate irritant and contact dermatitis?

A

Contact - Skin contact with substances that most people DON’T react to (nickel, perfume, rubber, hair dye, preservatives)
- Hours after contact with responsible material and
- NOT from first contact! (delayed T-cell mediated type of allergic reaction)
- Itching, burning sensation

Irritant - - Presence of trigger factor
- Handling water, detergents, solvents, chemicals
- Immediately after exposure to irritant
- More PAINFUL than itchy

32
Q

What are the symptoms of uticaria?

A

Uticaria is another name for HIVES!
- Usually very ITCHY
* - Wheals red or white, surrounded by a red or white flare
* - Wheals well-defined raised lesions with smooth surface (even if they change shape)
* - Range in size from a few millimetres to many centimetres in diameter
* - Shape also varies: round, polycyclic (overlapping circles), annular (ring-shaped), geographic (like a map)
* - Randomly distributed on the body and may affect any site
* - Possible presence of oedematous skin
- Wheals last no more than 24 hours and do not leave any marks behind

33
Q

What are the symptoms of impetigo?

A

Impetigo starts with red sores or blisters, but the redness may be harder to see in brown and black skin.

The sores or blisters quickly burst and leave crusty, golden-brown patches.

The patches can:

look a bit like cornflakes stuck to your skin
get bigger
spread to other parts of your body
be itchy
sometimes be painful

Sores (non-bullous impetigo) or blisters (bullous impetigo) can start anywhere – but usually on exposed areas like your face and hands.

34
Q

What are key things to consider with a COPD exaccerbation care plan?

A

Smoking cessation - Smoking cessation is single biggest intervention in airways disease
- Are they on steroids ?
- Are antibiotics required? (not always), course usually 5 days in length
if so check dose, length of treatment,
- SABA always prescribed
- Step up therapy required?

35
Q

What are the two main types of HRT?

A

There are 2 main types of HRT:

combined HRT (oestrogen and progestogen) – for women who still have their womb
oestrogen-only HRT – for women who have had their womb removed in a hysterectomy

36
Q

What are the advantages and disadvantages of tablet forms of HRT?

A

Tablets
Tablets are one of the most common forms of HRT. You usually take them once a day. Both oestrogen-only and combined HRT are available as tablets.

Advantages
Taking tablets once a day may be the easiest way of having treatment.

Disadvantages
Some of the risks of HRT, such as blood clots, are higher with tablets than with patches, gel or spray (although the overall risk is still small). Find out more about the benefits and risks of HRT.

37
Q

What are the advantages and disadvantages of patch forms of HRT?

A

Patches
Skin patches are also a common way of taking HRT. They work by sticking onto your skin on the lower part of your body and they gradually release small amounts of hormones into your body.

You’ll usually change your patch every few days, but each brand is different.

Both oestrogen-only and combined HRT are available as skin patches.

Advantages
Patches may be a better option than tablets if you have difficulty swallowing tablets, or are likely to forget to take it.

Using patches can also help to avoid some side effects of HRT, such as indigestion, and unlike tablets, they do not increase your risk of blood clots.

Disadvantages
You might find that skin patches do not always stick well, especially if you moisturise your skin. Patches can also cause redness or irritation, or leave a mark on the skin.

Applying the patch to dry, non-moisturised skin, or peeling it off slowly to avoid marks can help.

38
Q

What are the advantages and disadvantages of oestrogen gels?

A

Oestrogen gel
Oestrogen gel is an increasingly popular form of HRT. You take it by smoothing it onto your skin once a day. Oestrogen is gradually absorbed into your body.

If you have not had a hysterectomy, you must use this gel with a progestogen.

Advantages
Like skin patches, gel can be a good way of taking HRT if you cannot take tablets. Using gel does not increase your risk of blood clots.

Disadvantages
It can take 5 minutes or more for the gel to dry on the skin, so you may have to wait a while before you can do anything else.

39
Q

What are the advantages and disadvantages of vaginal forms of oestrogen?

A

Vaginal oestrogen
Low dose oestrogen is also available as a cream, gel, vaginal tablet, pessary or ring that you put inside your vagina. This can help with menopausal symptoms such as vaginal dryness, a burning sensation, or pain during sex.

Advantages
Vaginal oestrogen does not carry the usual risks of HRT and does not increase your risk of breast cancer. You can use it without taking progestogen, even if you still have a womb.

Disadvantages
This form of HRT will not help with other menopausal symptoms such as hot flushes, mood swings or sleeping problems.

40
Q

What counselling is required for diarrhoea?

A

Often caused by dehydration - Alcohol + Caffiene
stay at home and get plenty of rest

drink lots of fluids, such as water or squash – take small sips if you feel sick

carry on breast or bottle feeding your baby – if they’re being sick, try giving small feeds more often than usual

give babies on formula or solid foods small sips of water between feeds

eat when you feel able to – it may help to avoid foods that are fatty or spicy

take paracetamol if you’re in discomfort – check the leaflet before giving it to your child

Stay off school or work until you’ve not been sick or had diarrhoea for at least 2 days.

To help avoid spreading an infection:

wash your hands with soap and water frequently
wash any clothing or bedding that has poo or vomit on it separately on a hot wash
clean toilet seats, flush handles, taps, surfaces and door handles every day
do not prepare food for other people, if possible
do not share towels, flannels, cutlery or utensils
do not use a swimming pool until at least 48 hours after your symptoms stop

41
Q

what are key points to consider with Tacrolimus

A
  • Has to be prescribed by brand
  • Macrolides cause a large increase in levels- avoid concomitant use.
    Side Effects of Calcineurin Inhibitors;
    Alopecia, gum hyperplasia (more common with ciclosporin), tremor (dose related), glucose intolerance, increase cholesterol levels, hypertension, neurotoxicity, nephrotoxicity, hepatotoxicity. Monitor kidney
42
Q

What could be the cause of the undetectable Tacrolimus levels?

A
  • Non-adherence
  • African decent - faster metabolism
  • Interacting medication
  • Is medication being absorbed
43
Q

What do you understand by the term “Palliative Care”?

A

Palliative care provides symptom control for patients with terminal illness, this might not necessarily treat the cause of the patient’s symptoms. The focus of the care is improvement in the patient’s quality of life, and that of their families through the prevention and relief of physical, psychosocial and spiritual problems

44
Q

why is subcutaneous route preferred at end of life

A

Less invasive that intravenous administration
Less painful and more predictable than intramuscular administration Allows quicker dose titration than transdermal administration

45
Q

Which medicines should be avoided in syringe drivers and why?

A

Chlorpromazine, prochlorperazine and diazepam are contraindicated as they cause skin reactions at the injection site.
Cyclizine and levomepromazine also sometimes cause local irritation.

46
Q

benefits and risks of enteral nutrition

A

benefits
- cheap
- simple
- fewer complications
- maintain GI mucosal barrier

risks
- independent risk factor for Ventilator Associated Pneumonia
- sinusitis
- PEG associated with high mortality
- metabolic derangements

47
Q

How can the multidisciplinary team work to reduce rates of C. difficile infections?

A

Reducing use of antibiotics
Using narrowest spectrum antibiotic that will treat infection
Ensure appropriate infection control
Treat cases of C diff quickly and effectively

48
Q

What are the 4 cs for C diff infections

A

*Clindamycin
*Cephalosporins
*Quinolones, ciprofloxacin
*Co-amoxiclav

49
Q

Molluscum contagiosum

A

*- fluid-filled vesicles, infectious, not painful, no treatment, self-limiting
redness

try things to help with dryness and itchy skin, such as holding a damp towel against the skin, having cool baths or using an unperfumed moisturiser regularly

keep the affected area covered, including using waterproof bandages if you go swimming

use a condom while having sex if you are infected

50
Q

People most vulnerable to a C. difficile infection are those who:

A

weakened immune system
broad-spectrum antibiotics
*had surgery on the digestive system
65 years old plus

51
Q

Aspiration pneumonia

A

Inflammation and infections of the lungs or large airways
Breath something into lungs instead of swallowing food or liquids - from GI tract
Bacteria can grow as a result in the lungs

52
Q

How would you ensure adherence?

A
  • Advise taking at the same time
  • Explain the importance of the meds
  • Counsel on the side effects
  • Reduce prednisolone to reduce withdrawal
  • Avoid sun and wear SPF
  • Report skin changes
  • Take prednisolone in morning
  • Report bruising and bleeding
53
Q

What things should you look out for when paracetamol is on the drug chart?

A

Paracetamol frequency
incorrect – max frequency
exceeded/no max doses per
day
Recommend to the team that paracetamol is prescribed regularly or when required depending on level of pain
Is weight indicated on the chart? below 50kg may require dose change
Increased risk of hepatotoxicity between methotrexate and paracetamol

54
Q

What are things to look out for with VTE prophylaxis?

A

Are they already on anticoagulants? -VTE assessment should still be done but they should not continue on both

55
Q

What is the treatment for hyperkalaemia?

A

1) Calcium gluconate 10% 10mL over 5-15 mins
2) INSULIN ACTRAPID® 10 units in 50 mL of Glucose 50% IV over 30 minutes
3) Salbutamol nebs 5-10mg QDS
4) Calcium resonium 15 g 3–4 times a day

Treatment of raised K+ prevent harm - protect against myocardial excitability

56
Q

The doctor asks your advice on drug choice, dose and how to switch from warfarin. How do you respond?

A

Any from:
Apixaban, 2.5mg bd, stop warfarin and start apixaban when INR<2
Edoxaban, 30mg od, stop warfarin and start edoxaban when INR </=2.5
Rivaroxaban contraindicated – insufficient dietary intake, 15mg dose with >500cals
Dabigatran contraindicated – CrCl<30ml/min

57
Q
A

MPharm 4 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions