PSA talk

Question 1

Basic things to check when prescribing

Answer 1

Correct patient details
Signed and dated
Check allergy status
Write units and micrograms in FULL

Question 2

When should furosemide and prednisolone be given in the day?

Answer 2

Morning

Question 3

What do you need to do for controlled drugs?

Answer 3

Write everything out and specify TOTAL AMOUNT to give in words

Morphine sulpahte

Question 4

If you miss a warfarin dose what can you do?

Answer 4

Take it later on the same day, DO NOT DOUBLE DOSES

Question 5

Insulin sick day rules

Answer 5

Never omit fluids
Maintain intake
Unable to keep down, seek medical attention

Question 6

Steroid sick day rules

Answer 6

Double dose

Question 7

Volume of medication formula (when not in a nice concentration)

Answer 7

Dose required (mg)/ dose available (mg)
All x volume (ml)

Question 8

Drugs as percentages, what does 1% mean

Answer 8

1g in 100ml
1g in 100g

Question 9

How much lidocaine in 5ml of 1% lidocaine

Answer 9

50mg

Question 10

1:1000 means

Answer 10

1g in 1000ml

Question 11

How much adrenaline in 10mls of 1:10000 adrenaline?

Answer 11

1mg

Question 12

What’s in tazocin?

Answer 12

Piperacillin with tazobactam

Question 13

Name of vitamin K drug

Answer 13

Phytomenadione

Question 14

Warfarin monitoring =

Answer 14

INR

Question 15

Levothyroxine monitoring =

Answer 15

TFTs
Every 4w at the start and titrate up in 25mcg steps

Question 16

ACEi monitoring

Answer 16

U&E

Question 17

Gentamicin monitoring involves

Answer 17

Monitoring serum levels due to narrow therapeutic window

Question 18

Phenytoin monitoring

Answer 18

Need to monitor serum levels and adjust dose accordingly

Question 19

In liver disease prescribing what do you have to look out for?

Answer 19

Beware of medications that can exacerbate failure, e.g. phenytoin and prednisolone

Question 20

Things not to prescribe to pregnant women

Answer 20

Sodium valproate
Warfarin
ACEi
Tetracyclines
Lithium

Question 21

Example of paternal teratogen

Answer 21

Methotrexate

Question 22

Initial treatment of DKA

Answer 22

Fluid, 500ml normal saline over 15 minutes

Question 23

Difference between a variable and fixed rate insulin infusion

Answer 23

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.

Question 24

What’s the cut off of glucose for giving dextrose?

Answer 24

<14

Question 25

What might you add to the bag in DKA (not the first one)?

Answer 25

Potassium, because is getting driven into tissues by the new insulin introduced

Question 26

What do you do with patients basal insulin medications in DKA?

Answer 26

Keep them going alongside the actrapid you are probably giving

Question 27

A->E in DKA, what are you looking out for?

Answer 27

Sepsis, because something probably triggered the DKA

Question 28

Max rate for IV potassium

Answer 28

10mmol/hr

Question 29

Bolus for HF

Answer 29

250ml

Question 30

Scoring system for pneumonia

Answer 30

CURB65

Question 31

How does clarithromycin tend to be given?

Answer 31

Orally

Question 32

Why do you have to consider a diff antibiotic to clarithromycin if they are on a statin?

Answer 32

Both CYP450