practice stuff

 

 

 

 

 

Anti diarrheals

  • loperamide (Imodium AD)
  • bismuth
  • difenoxine and atropin (Motofen)
  • diphenoxylate and atropine (Lomotil)
  • Octreotide (Sandostatin)
  • Opium tincture
  • Polycarbophil (FiberCon, FiberTabs)
  • Psyllium (Metamucil

 

 

 

 

 

Sentinel Events

 

 

 

  • Events which cause serious harm to the patient
  • Events which could have potentially caused serious harm to the patient

 

 

 

 

 

 ADRs

 

 

 

  • Manufacturers are required to report them
  • Doctors, pharmacists, nurses, etc. are not required ot report them

 

 

Antibiogram

 

  1. What is it?
  2. What is the purpose of it?

 

 

  1. In vitro assay to determine what antibiotics an isolated bacterial strain is susceptible to
  2. To give a guideline for choosing antimicrobials based on susceptibility

 

 

 

 

 

How does one report Medication errors?

 

 

 

 

 

FDA 3500

 

 

 

USP 797

 

  1. What is it?
  2. Why do we have it?

  • Need vertical hoods for chemo drugs
  1. Regulations for compounding sterile preparation, storage, and dispensing that applies to health care institutions, pharmacies, and physicians practice facilities, and other facilties
  2. Sets practice standards/policies to help ensure that compounded sterile preparations are high quality and free from contamination

 

 

P&T Committee

 

  1. Who is on it?
  2. How often do they meet?
  3. Hwat is their purpose?

 

  1. A pharmacist and a doctor have to be on it.  A pharmacist (director of pharmacy) is the secretary and a doctor heads the committee 
  2. Anywhere from once a month to quarterly
  3. Policydevelopment, communication and education, formulary management/administration

 

 

 

 

Differentiate between the different medicine distribution machines

 

 

 

 

 

Omnirx is linked to a patient profile

 

Formulary

 

  1. What is it?
  2. why do we need one?
  3. Who decides what is on it?

 

 

 

  1. List of drugs that are to be used in a facility
  2. Save $$
  3. P&T committee

 

 

IV to PO swtich

 

  1. Why do we need to do this?
  2. What are teh criteria must meet?

 

1a. reduce length of hospital stay

  b. avoid risks associated with continued intravenous therapy

  c. lower medciation costs

2a. permission from P&T committee

  b. drug must have a good therapeutic index

  c. cardiovascular meds…

 

 

 

Adverse effects of Imodium AD

 

 

 

 

 

dizziness, constipation, abdominal cramping, nausea

 

 

 

 

 

What kind of drug is Dewey’s Carminative and what does it contain?

;

;

;

;

Anacid

;

Magnesium Carbonate

;

;

;

;

;

Ultram Max dose

;

;

;

;

;

400 mg/day

;

;

;

;

Absorbents

;

What drugs are in this type?

What do they treat?

;
;
– Attapulgite
– Kaolin
– Pectin
;
Diarrhea

;

;

;

;

;

How do the different types of antidiarrheals work?

;
– Loperamide:; mu agonist-slows motility of intesting;
– Aborbents:; absorb noxious substances in GI tract
– BSS:; reacts with HCl in stomach forms bismuth oxychloride
-Digestive enzymes:; lactase
-lactobacillus:; probiotic-replenishes NF (not considered effective therapy

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;

;

;

;

Vitamin A deficiency

;

;

;

;

;

Blindness

;

;

;

;

;

Vitamin D deficiency

;

;

;

;

;Rickets

Calcium abormalities

increased risk of breast cancer

;

;

;

;

;

;

Vitamin E deficiency

;

;

;

;

peripheral neuropathy, intermittent claduication, muslce weakness, ; hemolytic anemia

;

;

;

;

Vitamin K

;

;

;

;

;

Unusual bleeding, prolonged PT

;

;

;

;

;

Vitamin C deficiency

;

;

;

;

;

Scurvy

;

;

;

;

;

B1(thiamine) deficiency

;

;

;

;

;

Beriberi

;

;

;

;

;

B2 (riboflavin) deficiency

;

;

;

;

;

blurred vision

;

;

;

;

;

B3 (niacin) deficiency

;

;

;

;

;pellagra ; 3D’s

dementia, diarrhea, dermatitis

 

 

 

 

 

B5 (panthenoic acid) deficiency

 

 

 

 

 

burning sensation in hands/feet

 

 

 

 

 

B6 (pyridoxine) deficiency

 

 

 

 

 

pellagra

irritability & convusions

 

 

 

 

 

B7 (biotin) deficiency

 

 

 

 

N/V

depression

 

 

 

 

B9 (folic acid) deficiency 

&

daily recommended dose

 
 
 
neural tube defects
sore mouth, diarrhea, forgetfullness, irritation
 
400 mcg 
(600 mcg if pregnant)

 

 

 

 

 

B12 (Cyanocobalmin) deficiency

 

 

 

 

 

macrolytic anemia, pernicious anemia, neruologic symptoms, GI symptoms

 

 

 

 

 

Vitamin B1

 

 

 

 

 

thiamine

 

 

 

 

 

Vitamin B2

 

 

 

 

 

Riboflavin

 

 

 

 

 

Vitamin B3

 

 

 

 

 

 

Niacin

 

 

 

 

 

Vitamin B5

 

 

 

 

 

 Panthenoic acid

 

 

 

 

 

 

 

 

Vitamin B6

 

 

 

 

 

Pyridoxine

 

 

 

 

 

Vitamin B7

 

 

 

 

 

Biotin

 

 

 

 

 

Vitamin B9

 

 

 

 

 

Folic Acid

 

 

 

 

 

Vitamin B12

 

 

 

 

 

Cyanocobalmin

 

 

 

 

 

Different types of diaper rash treatments

(all skin protectants)

Zinc Oxide

talc and cornstarch

Calamine

Allantoin

Mineral oil

lanolin

petrolatum

white petrolatum

kaolin

cod liver oil

 

 

 

 

 

Rule of 3 for colic

 

 

 

Crying that begins sometime after the third week, lasts for at least three hours each day, occurs on more than three days per week, and continues for at least three weeks

 

 

 

 

 

treatment for colic

 

 

 

 

 

gas reducers

 

 

 

 

 

types of insulins

 
-rapid acting – start in 5 to 15 min; work for 3-4 hours
 (humalog & novolog)
-short-acting – start in 30 minutes; work for 5-8 hours
 (regular, Humulin R)
-intermediate-acting – start in 1-3 hours; work for 16-24 hours (NPH)
-long-acting – start in 4-6 hours; work for 32 hours (lantus)

 

 

Extreme thirst

Frequent urination

Dry skin

Hunger

Blurred vision

Drowsiness

Nausea

 

 

 

 

 

Hyperglycemia

 

Shaking

Fast Heartbeat

Sweating

Anxiousness

Dizziness

Hunger

impaired Vision

Weakness and/or fatigue

Headache

Irritability

 

 

 

 

 

Hypoglycemia

 

 

 

 

Normal value for INR

normal patients

 

warfarin patients

 

 

 

 

1

 

2-3

 

 

 

Normal lab value for HbA1c

 

non-diabetics

 

diabetics

 

 

 

 

 

 

4-6%

 

less than 7%

 

 

 

Normal lab values for Thyroid

(Tsh)

 

 

 

 

 

 

 

0.35-6 u/ml

 

 

 

 

 

Normal lab values for triglycerides

 

 

 

 

 

less than 200

 

 

 

 

 

Normal lab values for LDL

 

 

 

 

 

less than 100 is optimal

 

 

 

 

 

Normal lab values for HDL

 

 

 

 

more than 50 is good/great

 

less than 40 is bad

 

 

 

 

 

Normal lab values for Hematocrit

 

 

 

 

 

males:  45-52%

 

Females:  37-48%

 

 

 

 

 

Normal lab values for hemoglobin

 

 

 

 

males:  13-18g/100ml

 

females:  12-16g/100ml

 

 

 

 

 

Normal lab values for PSA

 

 

 

 

 

 

0-0.4ng/ml

 

 

 

 

Normal BG levels

 

 

 

 

>70 mg/dl – hypoglycemic

 >180 mg/dl

 

 

 

 

 

Ginger 

 

 

 

 

 

dyspepsia, colic, diarrhea, nausea, heart disease

 

 

 

 

 

Garlic

 

 

 

 

prevents heart disease, atherosclerosis, high cholesterol, hypertension, cancer, regulates high blood sugar levels

 

 

 

 

 

Ginko

 

 

 

 

 

memory and concentration

 

 

 

 

 

Gensing

 

 

 

 

 

stress

 

 

 

 

 

Warfarin MOA

 

 

 

 

inhibits anticoagulation factors II, VII, IX, X and protein C,S

 

 

 

 

 

Warfarin strengths

 

 

 

 

 

1,2,2.5,3,4,5,6,7,7.5,10

 

  

 

Monofilament test

 

  1. What is the reason for it?
  2. Why this is preferred over other "touch" methods
  3. How do you do it?

 

  1. To test for nerve damage
  2. since it is flexible it will allow for consistency form tester to tester.  There is no real difference in the amount of pressure the patient actually feels
  3. have pt turn their head so they can’t watch.; touch the foot at randome spots varying time intervals

;

;

;

;

Hospital Administration dosing

;

;

;

;

;

;QID:; 9:00, 1:00, 5:00, 9:00

TID:; 9:00, 1:00, 9:00

BID:; 9:00 ; 9:00

;

;

;

;

;

Quinolone Antibiotics

;

;

Ciprofloxacin (Cipro)

Gatifloxacin (Zymar, Tequin)

Gemifloxacin (Factive)

Levofloxacin (Levaquin)

Moxifloxacin (Avelox, Vigamox)

Norfloxacin (Noroxin)

Ofloxacin (Floxin, Ocuflox)

;

;

;

;

;

HMG-CoA inhibitors

;

;

Lovastatin (Altoprev, Mevacor, Altocor)

Pravastatin (Pravachol)

Fluvastatin (Lescol, Lescol XL)

Rosuvastatin (Crestor)

Atorvastatin (Lipitor)

Cerivastatin (Baycol)

;

;

;

;

;

Somogyl effect

;

;

;

;

during night, hypoglycemic event

ody releases epi, you become hyperglycemic in the morning

;

;

;

;

;

Dawn effect

;

;

;

;

wake up in the morning (after hormones have been released during night) and have hyperglycemia

;

;

;

;

;

Ciprofloxacin

;

;

;

;

Cipro

;

;

;

;

;

;

Gatifloxacin

;

;

;

;

;

Zymar, Tequin

;

;

;

;

;

Gemifloxacin

;

;

;

;

;

Factive

;

;

;

;

;

Levofloxacin

;

;

;

;

;

Levaquin

;

;

;

;

;

Moxifloxacin

;

;

;

;

;

Avelox, Vigamox

;

;

;

;

;

Norfloxacin

;

;

;

;

;

Noroxin

;

;

;

;

;

Ofloxacin

;

;

;

;

;

Floxin, Ocuflox

;

;

;

;

;

Lovastatin

;

;

;

;

;

Altoprev, Mevacor, Altocor

;

;

;

;

;

Pravastatin

;

;

;

;

;

Pravachol

;

;

;

;

;

Fluvastatin

;

;

;

;

;

Lescol, Lescol XL

;

;

;

;

;

Rosuvastatin

;

;

;

;

;

Crestor

;

;

;

;

;

Atorvastatin

;

;

;

;

;

Lipitor

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