week 1 Flashcards
what does beta 2 work on?
lungs, heart, bladder internal sphincter
Subscription
includes dosage form and quantity
pill, liquid, IV) and (mg, ml, grams
Superscription
the symbol Rx. Means “take thou”
A complete prescription contains:
Patients name, DOB, address Date Weight (esp. if a child) Superscription Medication you intend to give Instructions for medication you intend to give (route, frequency, duration) quantity you want dispensed repeat authorization if appropriate Signature and ID number Name, address, phone number
Prescription writing habits to avoid:
- not using pt full name
- using uncommon abreviations
- messy writing
- zero AFTER a whole number (5.0mg mistaken for 50mg)
- writing a rx for someone you haven’t seen
First line and 2nd line eczema therapy?
1= mild to potent glucocorticoids (hydrocortisone, betamethasone esters). Ester = An ester is a chemical compound derived from an acid 2= retinoids (Alitretinoin, acitretin)
Acne treatment: 1st line
1= Antibacterials: erythromycin, clindamycin, antiseptics. Usually topical, sometimes systemic.
Acne treatment: more severe (2)
(1) Retinoids: often combined with anti-infectives.
Topical, sometimes systemic.
i.e. isotretinoin, adapalene, tretinoin
(2) androgen antagonists: co-cyprindol
What does fucidin ointment treat?
primary and secondary skin infections caused by: -S. aureus -Streptococcus spp -C. minutissimum Causing: - impetigo contagiosa -erythrasma (airith thras ma) -secondary infections of wounds/burns -
What bacteria causes most primary skin infections?
1- Staphylococci: furuncles and carbuncles, folliculitis, impetigo or scalded skin syndrome
2- Streptococcal: impetigo, ecthyma, erysipelas, cellulitis
Impetigo and causative bacteria?
Superficial soft skin infection of epidermis.
- Non bullous (any age, yellowish crust)= staphylococcus aureus or with group A strep
- Bullous (2-5 yrs, shiny, wet base, diaper, axillae, neck): S. aureus
Psoriasis is:
Chronic immunological disease with markedly increased epidermal cellular turnover.
What is psoriasis usually present?
knees
elbows
sacral area
Treatment of scalp psoriasis?
- mid to high potency corticosteroids
- (addition of vit D derivatives = minimal improvement)
What is a cohort study?
Looks at an exposure and then follows the people along to see if there is an association between the exposure abc the outcome.
I.e. smokers vs. Non smokers and the development of lung cancer.
Cohort studies determine this.
Relative risk.
Measure of effect or association in a cohort study?
Relative risk.
Causes of pruritis? (4)
Histamine
Leukotrienes
Proteases
Cytokines
What is AA?
absolute risk= the number of events (good or bad) in treated or control groups, divided by the number of people in that group
What is ARC?
ARC = the AR (absolute risk ) of events in the control group
ART
The AR of events in the treatment group
what is ARR?
ARR (absolute risk reduction) = ARC – ART (absolute risk in control group - absolute risk in treatment )
What is relative risk? RR
Risk to those exposed/ have the characteristic versus the risk of those not exposed/ without the characteristic
RR (relative risk) = ART / ARC
RRR?
Proportion of bad events of treatment group compared with the control group.
RRR (relative risk reduction) = (CER – TER) / CER
How to do RRR?
RRR = 1 – RR
What is erythrasma? (Ear a thraz ma)
A common chronic skin condition affecting the skin folds.
The slowly enlarging patches of pink to brown dry skin.
Caused by Corynebacterium minutissimum.
- Null hypothesis: (Ho) means?
Null hypothesis: (Ho)
No difference between groups (treatment A= Treatment B)
Sensitivity of a study
Sensitivity: People with the condition will test positive for the condition
Specificity of results?
Specificity: People without the condition will test negative for the condition
Odds Ratio (OR):
Odds Ratio (OR): (used in case-control studies)
- Ratio of the odds of developing the condition in the exposed group compared to the odds of
developing the condition in a non exposed group
A case–control study is?
a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute.
Odds ratio= 1. This means?
Odds ratio= 1
o Equally likely to occur in both groups
Odds ratio > 1 means?
Odds ratio > 1= more likely to occur in the first group (exposed group)
o Positive association between treatment and outcome
o Risk is greater in the exposed group
Odds ratio < 1 means?
Odds ratio < 1: less likely to occur in the first group (exposed group)
o Negative association between treatment and outcome
o Risk is lower in the exposed group
• Relative Risk (RR) means?
• Relative Risk (RR) : Treatment versus outcome
• Magnitude of an interventions affects but can be misleading*
- Risk of developing a condition related to an exposure
Ratio of risk of an event in people with a specific characteristic, to those without
the characteristic
▪ Used in clinical trials and cohort studies
RR = 1 means?
o 1= no risk (no association between tx and outcome)
ARR is?
Absolute Risk Reduction (ARR)
This is a better number to focus practice on (versus RR)
- Magnitude of the affect of the drug **
- The REAL VALUE
ARR is…
The absolute difference by which a therapy reduces the risk of bad outcomes between the control group and the experimental group
ARR formula:
ARR% = CER% (controlled event rate) – TER% (experimental event rate)
E.g. 25% - 20% = 5%
• There was a 5% lower incidence of a MI in the treatment group compared to the control group.
NNT is?
Number Needed to Treat (NNT) • The number of patients needed to be treated to achieve one additional favourable outcome
CI (confidence interval )
Confidence Interval (CI): A best guess Range where true value is likely to lie.
If the CI includes ZERO (0) then the results are NSS (Not Statistically Significant) • P<0.05 for 95% CIs
- Narrow interval implies high precision. Wide interval = poor precision.
Pharmacokinetics
what the body does to the drug
Pharmacodynamics
what the drug does to the body. (“Look how dynamic that muscle relaxant makes you”)
Find No difference between tx group A and B means?
Failure to reject the null hypothesis (Ho)
Find a difference between treatment group A and B means?
Reject the null hypothesis (Ho). Because the null hypothesis said there is no difference, but there IS A DIFFERENCE!
Smaller p value =?
Stronger evidence to reject the null hypothesis (the treatment had an effect)
P value does this…
Tells you the significance of your results in relation to the null hypothesis (Ho).
P value between 0 and 0.05= ?
Statistically significant
Why is a p value less than 0.05 statistically significant?
Indicates there is less than 5% chance that the null hypothesis is correct and results are random
P value> 0.05 means?
Results are not statistically significant. We reject the alternative hypothesis and retain the null hypothesis
