Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacotherapeutics 1 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What are the pharmacotherapy review steps?

A
  1. Gather relevant patient information
  2. Interpret information to identify actual or potential problems
  3. Develop a prioritised problem list
  4. Consider possible treatments and their appropriateness for the individual patient and individual patient goals
  5. Make a plan for treatment
  6. Describe the required follow up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the types of patient information?

A
  • demographic
  • ability to communicate
  • presenting complaint & diagnosis
  • past medical history
  • social/lifestyle history
  • allergies
  • lab and diagnostic tests
  • physical exam
  • medication history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medication related problems - DOCUMENT

A

D - drug selection
O - over or underdose prescribed
C - compliance
U - undertreated
M - monitoring
E - education or information
N - not classifiable
T - toxicity or adverse reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some key reasons for testing?

A
  • assess the appropriateness of drug therapy
  • assess drug adverse effects/toxicity
  • monitor therapeutic effect
  • compliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is it not appropriate to give pure water in IV?

A

As the cells contain lower levels of ions, the water will move into the cell more and cause it burst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to treat water imbalance - Depletion

A
  • oral water if possible
  • if oral is not possible then IV with glucose 5% or with sodium 0.9%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How to treat water imbalance due to Excess

A
  • remove the cause
  • consider fluid restriction
  • some diuretic drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some symptoms of hyponatraemia (135-145mmol/L)

A
  • usually asymptomatic until <125mmol/L
  • Nausea
  • headache
  • hypervolaemia = oedema
  • lethargy
  • confusion
  • muscle cramps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is hyponatraemia classified?

A

according to Extra-Cellular Fluid status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 ECF status?

A
  1. Hypovolaemic
  2. Euvolaemic
  3. Hypervolaemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of Reduced ECF = Hypovolaemic

A
  • GIT loss = diarrhoea, vomiting
  • Poor water intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of normal ECF = Euvolemic

A
  • SIADH
  • adrenal insuff.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of increased ECF = hypervolemic

A
  • congestive cardiac failure
  • cirrhosis
  • drugs = NSAIDs or corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some medications can cause SIADH?

A

SSRIs, SNRIs and carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an important consideration when treating Chronic Hyponatraemia?

A

can produce permanent CNS injury due to osmotic demeythlination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the features of Hypernatraemia

A
  • mild to moderate 145-159mmol/L
  • rare occurance of sodium gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some symptoms of Hypernatraemia?

A
  • thirst
  • restlessness
  • confusion
  • muscle twitching
  • seizures
  • coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some treatment options for Hypernatraemia?

A
  • correct cause
  • oral fluid replacement with water
  • IV fluid without sodium = may require 5% glucose
  • If SEVERE = medical emergency + ICU
  • If CHRONIC = replace water GRADUALLY as this can be a risk for cerebral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the features of Hyperkalaemia

A

MILD = 5.1 - 5.9mmol/L
MODERATE = 6.0-6.4mmol/L

  • most serious electrolyte emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is true excess of Hyperkalaemia caused?

A

drug induced, increased input or decreased output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is apparent excess of Hyperkalaemia caused?

A
  • metabolic acidosis
  • insulin deficiency
  • digoxin toxicity
  • cell lysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some signs and symptoms of Hyperkalaemia?

A
  • muscles weakness
  • paraesthesia
  • palpitations
  • dyspneoa
  • bradycardia
  • ECG changes
  • cardiac arrest is possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for Hyperkalaemia?

A
  • If Asymptomatic consider = pseudohyperkalaemia
  • remove or withhold drugs that contain potassium or causing this hyperkalaemia
  • low potassium diet
  • increase in renal potassium elimination = diuretic
24
Q

How to treat severe or life-threatening Hyperkalaemia?

A
  1. protect heart
  2. reduce serum potassium level
    - IV insulin and glucose infusion
  3. remove potassium from the body
    - oral sodium = removes potassium from the bowel lumen
    - haemodialysis
25
Q

Describe the features of Hypomagnesaemia

A

Mild = <0.9mmol/L
Moderate = 0.41 - <0.7mmol/L
- Magnesium is a key electrolyte in cellular metabolic reactions
- is common

26
Q

How to treat mild hypomagnesaemia?

A
  • if mild treat = oral supplementation (500mg tabs)
27
Q

How to treat severe or symptomatic Hypomagnesaemia?

A
  • tremors
  • weakness
  • swallowing difficulties
  • cardiac arrhythmias
  • seizures
    IV mag
28
Q

What is a major side-effect to taking mag supplements?

A

diarrhoea

29
Q

What is an important point to remember about the relationship between hypomagnesaemia and hypokalaemia?

A
  • cause it to be refractory to K+ supplementation
30
Q

Hypokalaemia signs and symptoms

A

True deficit = excessive loss and decreased intake
Apparent Deficit = metabolic alkalosis, cardiac arrhythmias, hyporeflexia, shallow resp, lethargy and confusion

31
Q

Describe the cause for Metabolic ACIDOSIS

A
  • ketoacidosis
  • lactic acidosis
  • diarrhoea
32
Q

Describe the cause for Metabolic ALKALOSIS

A
  • loss of gastric acid
  • potassium deficiency
33
Q

Describe the cause for Respiratory ACIDOSIS

A
  • airway obstruction (COPD)
  • Respiratory centre depression
34
Q

Describe the cause for respiratory ALKALOSIS

A
  • hysterical over-breathing
  • mechanical over-ventilation (ICU)
35
Q

Describe the compensatory mechanisms

A

It may restore pH close to normal. If the pH is significantly out of range, it means the body’s ability to compensate is failing

36
Q

What are the key functions of the Kidney

A
  • excretion of waste products of metabolism
  • regulation of water, electrolyte, acid-base balance
  • Synthesise hormones/vitamins that can regulate BP, make RBCs and maintain healthy bones
37
Q

Define Glomerular Filtrate

A

hydrostatic pressure produced by heart which then pushes water and small solutes through the filtration membrane

38
Q

Define GFR

A

Rate at which both kidneys filtrate the blood

39
Q

What two markers can help us estimate GFR?

A

creatinine and urea

40
Q

Define Serum Creatinine (Cr)

A
  • synthesised in the liver
  • stored in muscle cells as creatine phosphate
41
Q

If there is an increase in Cr what happens to GFR

A

decreases

42
Q

If Cr is normal then what does that mean for GFR?

A

it may not be normal

43
Q

Why is UREA not an indeal marker for GFR?

A
  • diet affects levels
  • influenced by protein break down
  • partial re-absorption in tubules
44
Q

What is estimated GFR (eGFR) used for?

A
  • classifying chronic renal impairment
45
Q

What markers are used in an urinalysis

A
  • albumin - very little passes into the urine normally
46
Q

Is macroabiluminuria (>300mg/day) reversible?

A

no it is irreversible nephropathy

47
Q

Why is microalbuminuria an early marker of nephropathy?

A
  • reversible with good control of hypertension and hyperglycaemia
48
Q

What is the Cockcroft-Gault equation for males?

A
49
Q

What is the Cockcroft-gault equation for Females?

A
50
Q

What are the common clinical uses of Creatinine Clearance CrCl

A
  • assessing kidney function in patients with chronic renal failure
  • monitoring patients on nephrotoxic drugs
  • determining dosage adjustments for renally eliminated drugs
51
Q

what are the three causes for Acute Kidney Injury?

A
  1. Prorenal
  2. Intrarenal
  3. Postrenal
52
Q

How is serum uric acid (URATE) produced?

A

through catabolism of purines

53
Q

If serum uric acid is high what does that signify?

A
  • gout
  • infections
  • renal failure
  • high protein diet
  • alcoholism
54
Q

If serum uric acid is Low what does that signify?

A
  • tubular defects
  • malabsorption
  • por diet
  • liver damage
55
Q

What is the main use for serum uric acid

A

diagnosing/monitoring gout

Pharmacotherapeutics 1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions