PSA talk Flashcards
Basic things to check when prescribing
Correct patient details
Signed and dated
Check allergy status
Write units and micrograms in FULL
When should furosemide and prednisolone be given in the day?
Morning
What do you need to do for controlled drugs?
Write everything out and specify TOTAL AMOUNT to give in words
Morphine sulpahte
If you miss a warfarin dose what can you do?
Take it later on the same day, DO NOT DOUBLE DOSES
Insulin sick day rules
Never omit fluids
Maintain intake
Unable to keep down, seek medical attention
Steroid sick day rules
Double dose
Volume of medication formula (when not in a nice concentration)
Dose required (mg)/ dose available (mg)
All x volume (ml)
Drugs as percentages, what does 1% mean
1g in 100ml
1g in 100g
How much lidocaine in 5ml of 1% lidocaine
50mg
1:1000 means
1g in 1000ml
How much adrenaline in 10mls of 1:10000 adrenaline?
1mg
What’s in tazocin?
Piperacillin with tazobactam
Name of vitamin K drug
Phytomenadione
Warfarin monitoring =
INR
Levothyroxine monitoring =
TFTs
Every 4w at the start and titrate up in 25mcg steps
ACEi monitoring
U&E
Gentamicin monitoring involves
Monitoring serum levels due to narrow therapeutic window
Phenytoin monitoring
Need to monitor serum levels and adjust dose accordingly
In liver disease prescribing what do you have to look out for?
Beware of medications that can exacerbate failure, e.g. phenytoin and prednisolone
Things not to prescribe to pregnant women
Sodium valproate
Warfarin
ACEi
Tetracyclines
Lithium
Example of paternal teratogen
Methotrexate
Initial treatment of DKA
Fluid, 500ml normal saline over 15 minutes
Difference between a variable and fixed rate insulin infusion
Variable = monitor the BMs (post operative or intraoperative). For normal diabetics, keep monitoring and adapting their glucose levels.
Fixed rate = for people in DKA. Because in DKA the tissues are very starved, need to drive sugar into the tissues.
What’s the cut off of glucose for giving dextrose?
<14
What might you add to the bag in DKA (not the first one)?
Potassium, because is getting driven into tissues by the new insulin introduced
What do you do with patients basal insulin medications in DKA?
Keep them going alongside the actrapid you are probably giving
A->E in DKA, what are you looking out for?
Sepsis, because something probably triggered the DKA
Max rate for IV potassium
10mmol/hr
Bolus for HF
250ml
Scoring system for pneumonia
CURB65
How does clarithromycin tend to be given?
Orally
Why do you have to consider a diff antibiotic to clarithromycin if they are on a statin?
Both CYP450
