Pharmacology Flashcards
What is clinical reasoning?
The process by which clinicians collect, analyse and interpret information to make an accurate diagnosis/develop a plan of action
How often is diagnosis incorrect?
10-15% of the time
Where can clincial reasoning go wrong?
Knowledge Fail to think laterally – generate enough diagnoses Fail to appreciate the patient’s agenda Close down differential too soon Generate inappropriate working diagnosis Cognitive bias
Give an example of a surgical sieve?
I VINDICATE AID
Inflammatory Vascular Infectious Neoplastic Degenerative Idiopathic Congenital Autoimmune Traumatic Endocrine and metabolic Allergic Iatrogenic Drugs
What is occams razor?
The answer that requires the fewest assumptions is usually the correct one
What is sutton’s law?
The most obvious answer should be considered first
What is anchoring?
Tendency to fail to adjust initial impression in light of later information
What is availability in relation to diagnosis?
Judge diagnosis as being more likely if readily comes to mind. Common things are common.
What is confirmation bias in diagnosis?
Tendency to give preferential attention to confirming evidence for a diagnosis rather than disconfirming evidence
What is diagnosis momentum?
Once diagnostic label becomes attached to patient it tends to stick
What is the framing effect in diagnosis?
How diagnosticians see things be strongly influenced by how they have been framed by other individuals
What is overconfidence bias in diagnosis?
Tendency to believe we know more than we do acting on incomplete information, intuitions or hunches
What is premature closure in diagnosis?
Accepting a diagnosis before it has been fully verified
What is search satisfying in diagnosis?
Call off search once something is found, missing for example 2nd fracture, co-morbidities and co-ingestants in poisoning etc
What is triage cueing in diagnosis?
Patient triaged in a particular direction cues their subsequent management
What defines complementary and alternative medicine?
A broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system
List some examples of complementary/alternative medicine?
Herbal medicine Homeopathy Acupuncture Anthroposophic medicine Aromatherapy Ayuveda Chiropractic Hypnosis Meditation Naturopathy Osteopathy Reflexology Reiki Shiatsu Yoga
What are some potential concerns of complementary therapies?
Implausibility of most therapies Lack of evidence for benefit Lack of safety data Evidence of harm Adverse Effects / Herb-Drug Interactions Unqualified practitioners / Missed diagnoses Stopping conventional medicine Cost-effectiveness?
What are the functions of the MHRA?
- Ensures that human medicines meet acceptable standards on safety quality and efficacy
- Ensures that the sometimes difficult balance between safety and effectiveness is achieved.
What is pharmacovigilance?
The process involving detection, assessment, understanding and prevention of adverse drug reactions (ADRs).
What is the main method for post-marketing drug surveillance in the UK?
Yellow Card scheme
What information is collected by the MHRA Yellow Card Scheme?
- Side effects (ADRs)
- Medical device adverse incidents
- Defective medicines
- Counterfeit/fake medicines or medical devices
- Safety concerns
What should be reported by healthcare professionals on the yellow card system?
All suspected ADRs to
- New drug on market and black triangle drug
- Children (Mostly off license)
- Serious ADRs for established drugs and vaccines, e.g. anaphylaxis, events that have led to significant harm, those which are fatal.
What pieces of information need to be included in a yellow card report?
- The side effects
- Information about person experiencing side effect
- Name of medicine
- Your name and full address
