Prescribing Sgt + Ws Flashcards
when prescribing an antibiotic for pneumonia, what should be documented on the chart?
CURB-65 score
when should you review diagnosis and abx regime?
after 24hrs
stepping down antibiotic treatment
according to clinical markers step down to oral treatment
when changing dose for insulin, how much do you change by
10-20% of total daily dose
+ must justify
symptoms of phenytoin toxicity
confusion, nystagmus, hyperglycaemia, bradycardia HR 55
WCC low/ high in neutropenic sepsis
low. infection but would be high
how to inject humulin
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
whats DAFNE in terms of insulin doses
dose adjustment for normal eating
ask px about their beliefs about insulin regimen why
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
why should you avoid cephalosporins in UTIs
antibiotic associated colitis
how to assess falls
ask about incontinence, fears, vision, CV exam
what are the ways that medications increase the risk of falls
postural hypotension, sedation/drowsy, dizziness, changes in HR
Quinolone oral antibiotic all 100% same as IV t/f?
true can switch at any point
is 10mg amlodipine a high dose for elderly patients
yes - lipid soluble drug
why is temazepam not an appropriate drug in the elderly
half life becomes longer and more sedation and postural hypotension
which antihypertensives can cause adverse effects when stopped suddenly
centrally acting (methyldopa, hydralazine, clonidine)
why would you prefer to switch from simvastatin 80mg to atorvastatin
simvastatin 80 has increased risk of myopathy
why should warfarin be taken in the evening
so that if dose adjustments need to be made following INR clinic, the adjusted dose can be taken
why might side effects of amiodarone not occur at the expected time?
due to long half life, SE and interactions can happen even after the drug is stopped
why is warfarin cautioned in thyroid problems?
hyperthyroidism increases metabolism of clotting factors so lower warfarin doses needed
should warfarin be prescribed in number of tablets?
no - only in mg
why does renal function need to be monitored closely in patients receiving digoxin
renally cleared so there is a risk of toxicity
lithium does not have to be prescribed by brand name, true or false?
false - different salts have different bioavailabilites
what else should be given when prescribing lithium
lithium alert card
NSAIDs reduce elimination of methotrexate, true or false?
true
when prescribing methotrexate, is it appropriate to write ‘as directed’ on the prescription
no - increases risk of methotrexate overdose
what else should be given when prescribing methotrexate
methotrexate treatment card
dont give enoxaparin to px with low X
platelets. p bleeds out
