PSA 1 Flashcards
Every drug prescription must be?
Legible
Unambiguous
Approved name
IN CAPITALS
Without abbreviations
SIgned
‘If used as required’ -
i) indication
ii) max frequency
Duration of treatment
What system most commonly metabolizes drugs in the body?
P450 enzyme system
What is an Inducer? What effect will it have on the drug?
It will increase P450 enzyme activity
Therefore there is reduced effect of the drug
What is an inhibitor? What effect will it have on the drug?
It will decrease P450 enzyme activity
Increased level and effect of drugs
What are examples of inducers?
PC BRAS
Phenytoin Carbamezepine Barbiturates Rifampicin Alcohol Sulphonylureas
What are examples of inhibitors?
AODEVICES
Allopurinol Omeprazole Disulfiram Erythromycin Valproate Isoniazid Cirprofloxacin Ethanol Sulphonamides
What drugs do you stop before surgery?
I LACK OP
Insulin
Lithium
Anticoag/antiplatelets
COCP/HRT (4 weeks before)
K-sparing diuretics
Oral Hypoglycaemics
Perindopril and other ACE-i
What steps for safe prescribing?
PReSCRIBER
Patient details Reaction Sign Contradictions Route IV fluids Blood clot prophylaxis antiEmetic Relief
What do co-amoxiclav and tazocin both contain?
Penicillin
What contra-indications should we be aware of?
If bleeding risk - NO aspirin, heparin and warfarin
If steroids - remember side effects - ulcers, thin skin, oedema, right and left HF, osteoporosis, infection, diabetes
If NSAIDs - Renal issues, Asthma, Indigestion, Clotting abnorm
Antihypertensives - hypotension, brady with b-blocker, ACE and diuretics with electrolyte discturbance
When should 0.9% saline not be given as replacement fluid?
- Hypernatraemic or Hypoglycaemic (give 5% dextrose)
- Ascites - give human-albumin solution
- Shocked - give colloid
- Bleeding - blood transfusion
What amount of fluids should be given as maintenence?
3L IV per 24 hrs
2L for elderly
What’s will provide an adequate amount of electrolytes?
1L 0.9% saline
2L of 5% dextrose
What is standard blood clot prophylaxis?
LMWH - dalteparin 5000 units daily s/c
Compression stockings
What is standard choice of antiemetic?
Cyclizine expect if in cardiac cases
What can be prescribed regularly as pain relief?
Mild pain - rparacetamol 1 g - 6 hourly
Severe pain - co-codamil - 30/500. 2 tablets 6 hourly
What can be prescribed as required for pain relief?
no pain - paracetamol
mild pain - codeine 30mg up to 6 hourly oral
severe pain - morphine sulphate 10 mg up to 6 hourly oral
What can prescribed for neuropathic pain?
Amytriptyline
Pregabalin
Duloxetine
Calcium channel blockers commonly cause what side effect?
Peripheral oedema
What analgesic should not be prescribed in Asthmatics?
NSAIDs
When prescribed co-codamol what must you be wary off?
It contains paracetamol
Caution if there is also normal paracetamol prescription
What drugs can cause low neutrophils?
Clozapine
Carbimazole
What drugs can cause low platelets?
penicillamine
heparin
What can a raised urea indicate?
AKI
Upper GI hemmorhage
Raised urea w/ normal creatinine in patient who isn’t dehydrated should prompt a look at Hb
