Prescription Review Flashcards
Which drugs should be increased during surgery?
Patients on long-term corticosteroids - double dose
Which drugs should be stopped before surgery?
I - Insulin L - Lithium A - anticoagulants/antiplatelets C - COCP/HRT K - K sparing diuretics O - oral hypoglycaemic P - Perinodopril and other loop diuretics
When should COCP/HRT be stopped before surgery?
4 weeks before surgery
When should lithium be stopped before surgery?
Day before surgery
When should K sparing diuretics and ACE inhibitors be stopped before surgery?
Day of surgery
When should oral hypoglycaemics be stopped before surgery?
Metformin stop morning of
All others 24 hours before
Start variable rate insulin
When should Clopidogrel be stopped before surgery?
7 days before
When should warfarin be stopped before surgery?
5 days before
Start on treatment dose LMWH
INR<1.5 so reverse using Vit K if req.
When should aspirin be stopped?
Can be continued
What are the essential things to consider when prescribing?
P - patient details R - reactions e S - sign front of chart C - contraindications R - route I - IV fluids B - blood clot prophylaxis E - antiEmetic R - pain Relief
When should patients not be given 0.9% saline?
Hypernatraemic
Hypoglycaemic
Ascites
Shocked from bleeding - give blood
What blood clot prophylaxis is usually prescribed?
LMWH (dalteparin 5000 units)
Compression stockings
When should compression stockings not be prescribed?
Patient with peripheral arterial disease
What anti-emetics are typically prescribed
Cyclizine 50mg 8 hourly IM/IV/Oral
Metoclopramide 10mg 8 hourly IM/IV
How quickly should potassium be prescribed?
Max 10mmol/hr
