Prescribing Sgt + Ws

Question 1

when prescribing an antibiotic for pneumonia, what should be documented on the chart?

Answer 1

CURB-65 score

Question 2

when should you review diagnosis and abx regime?

Answer 2

after 24hrs

Question 3

stepping down antibiotic treatment

Answer 3

according to clinical markers step down to oral treatment

Question 4

when changing dose for insulin, how much do you change by

Answer 4

10-20% of total daily dose
+ must justify

Question 5

symptoms of phenytoin toxicity

Answer 5

confusion, nystagmus, hyperglycaemia, bradycardia HR 55

Question 6

WCC low/ high in neutropenic sepsis

Answer 6

low. infection but would be high

Question 7

how to inject humulin

Answer 7

Belly, upper leg, fleshy area
Easiest to dial up even numbers older T2DM not young T1DM.
Clean site and rotate site
Push pen in, keep needl e in contact with skin for 6 seconds, time it taken for insulin to enter SC fat

Question 8

whats DAFNE in terms of insulin doses

Answer 8

dose adjustment for normal eating

Question 9

ask px about their beliefs about insulin regimen why

Answer 9

adhering? Or not – fear of hyperglycaemic may go hypo?…
SE for T2DM: GI disturbances, weight gain!!! May put them off don’t want to take it

Question 10

why should you avoid cephalosporins in UTIs

Answer 10

antibiotic associated colitis

Question 11

how to assess falls

Answer 11

ask about incontinence, fears, vision, CV exam

Question 12

what are the ways that medications increase the risk of falls

Answer 12

postural hypotension, sedation/drowsy, dizziness, changes in HR

Question 13

Quinolone oral antibiotic all 100% same as IV t/f?

Answer 13

true can switch at any point

Question 14

is 10mg amlodipine a high dose for elderly patients

Answer 14

yes - lipid soluble drug

Question 15

why is temazepam not an appropriate drug in the elderly

Answer 15

half life becomes longer and more sedation and postural hypotension

Question 16

which antihypertensives can cause adverse effects when stopped suddenly

Answer 16

centrally acting (methyldopa, hydralazine, clonidine)

Question 17

why would you prefer to switch from simvastatin 80mg to atorvastatin

Answer 17

simvastatin 80 has increased risk of myopathy

Question 18

why should warfarin be taken in the evening

Answer 18

so that if dose adjustments need to be made following INR clinic, the adjusted dose can be taken

Question 19

why might side effects of amiodarone not occur at the expected time?

Answer 19

due to long half life, SE and interactions can happen even after the drug is stopped

Question 20

why is warfarin cautioned in thyroid problems?

Answer 20

hyperthyroidism increases metabolism of clotting factors so lower warfarin doses needed

Question 21

should warfarin be prescribed in number of tablets?

Answer 21

no - only in mg

Question 22

why does renal function need to be monitored closely in patients receiving digoxin

Answer 22

renally cleared so there is a risk of toxicity

Question 23

lithium does not have to be prescribed by brand name, true or false?

Answer 23

false - different salts have different bioavailabilites

Question 24

what else should be given when prescribing lithium

Answer 24

lithium alert card

Question 25

NSAIDs reduce elimination of methotrexate, true or false?

Answer 25

true

Question 26

when prescribing methotrexate, is it appropriate to write ‘as directed’ on the prescription

Answer 26

no - increases risk of methotrexate overdose

Question 27

what else should be given when prescribing methotrexate

Answer 27

methotrexate treatment card

Question 28

dont give enoxaparin to px with low X

Answer 28

platelets. p bleeds out