safe prescribing

Question 1

Which drugs in particular are of particular risk

Answer 1

Insulin, warfarin, drugs with variable doses, or no fixed dose (individualised)

Question 2

What must you do if a patient comes in with significant medical condition

Answer 2

Compre to prescription, ensure they are compatable

Question 3

What can aspirin and NSAIDs both increase risk of?

Answer 3

GI bleed

Question 4

How are drug classes selected for treatment

Answer 4

Comparing how they work/efficacy, safety, suitability/convenience, and cost

Question 5

How do NSAIDs work

Answer 5

Blocks cyclo-oxygenase enzymes, reduces prostaglandins. Can prove targeted relief, but also off target. Prostaglandins maintain stomach lining and platelet activity

Question 6

Why do NSAIDs cause GI issues

Answer 6

Prostaglandins maintain stomach lining and platelet activity, unable to make protective mucus barrier against acid

Also, direct erosion of the gastric lining

Question 7

How is risk associated woth steroids minimised

Answer 7

Lowest effective dosage, shortest period
Deliver directly to site, bisphosphonates for bone protection,

High risk when prescribed with NSAIDs

Question 8

What drugs can be prescribed to reduce GI bleed risk

Answer 8

Gastroprotective agents like proton pump inhibitors or H2 agonists, these reduce gastric acid

Misoprostol - a prostaglandin analogue that increases levels of gastric mucus

Question 9

How do people idealistically minimise side effects

Answer 9

avoid polypharmacy, less drugs