Prescribing Flashcards

1
Q

what are the main things you need to consider when prescribing?

A

diagnosis/ indication
recommended drug / regime (bnf/ formulary)
contraindications/ special consideration (?pregnant/ liver function/ renal function)
Product licence
patient expectations
cost effectiveness
follow up

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2
Q

what are the anticholinergic side effects of amitriptyline ?

A
tachycardia 
urinary retention 
constipation 
dry mouth 
blurred vision 
exacerbation of narrow angle glaucoma
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3
Q

what to give for neuropathic pain ?

A

gabapentin

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4
Q

when do you have to be careful when prescribing gabapentin ?

A

controlled drug so make sure not addict - don’t prescribe in hx of substance abuse / psychosis/ mixed seizures/ diabetes/ elderly/ low body weight adults

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5
Q

why is atorvastatin better than simvastatin ?

A

can give at any time of the day when simvastatin can only be given at night

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6
Q

what is the difference between strength and dose

A

eg strength 10mg

eg dose one tablet

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7
Q

what are the main things to remember about a prescription

A

block capital s
ink
write quantity in letters not numbers
score the bottom of it so they cannot self prescribe

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8
Q

if you make a mistake on prescriptuion

A

score it initial it sign it

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9
Q

what do you write on a prescription in order

A

name strength formulation
then
dose frequency

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10
Q

if you need to prescribe 7mg of a drug but there isn’t a 7mg tablet what do you do ?

A

look at formulations and make do - so 5mg and 2mg

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11
Q

aspirin is contraindicated in

A

peptic ulcer disease

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12
Q

need to be cautious of bisoprolol in

A

hf and diabetes

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13
Q

if you found there was a reaction with clarithromycin and the statin the patient is taking what would you do ?

A

temporarily withhold statin for 7 days

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14
Q

if patient on metronidazole what do you need to inform them

A

do not drink alcohol

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15
Q

what are the two main types of drug interactions

A

drug-disease

drug-drug

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16
Q

why do you need to be careful with steroids in elderly women

A

post menopausal so at risk of osteoporosis

17
Q

what do you need to monitor more closely with steroids

A

blood glucose in diabetics

18
Q

what side effects do you get from long term steroid use

A

weight gain moon face mood swings

19
Q

why not stop steroids suddenly

A

steroid crisis

20
Q

what do you need to warn patients about when on steroids

A

increased risk of infections so avoid people with measles and chickenpox

21
Q

what is the problem with warfarin and amiodarone?

A

increases the anticoag effect pf warfarin even after the treatment has stopped due to long half life so need close monitoring of inr

22
Q

what is the risk with simvastatin

A

myopathy

need to lower alcohol intake

23
Q

what do you need to know before you prescribe nitrofurantoin?

A

need to know GRF (needs to be greater than 45)

24
Q

what is therisk with trimethoprim

A

risk of hypokalaemia

need gfr>30