Pass The PSA (Prescribing Safety Assessment) - Highlighted Key Content Exam Questions With Correct Answers.

Pass The PSA (Prescribing Safety
Assessment) - Highlighted Key Content
Exam Questions With Correct Answers
What |is |1 |FTU? |- |CORRECT |ANSWER✔✔-1 |FTU |is |the |amount |of |medication |needed |to |
squeeze |a |line |from |the |tip |of |an |adult |finger |to |the |first |crease |of |the |finger,



What |effect |do |Enzyme |inducers |have? |- |CORRECT |ANSWER✔✔-An |enzyme |inducer |will |
increase |P450 |enzyme |activity, |hastening |metabolism |of |other |drugs |with |the |result |that |they |
exert |a |reduced |effect |(and |thus |a |patient |will |require |more |of |some |other |drugs |in |the |
presence |of |an |enzyme |inducer).



What |effect |do |Enzyme |inhibitors |have? |- |CORRECT |ANSWER✔✔-an |enzyme |inhibitor |will |
decrease |P450 |enzyme |activity |and, |subsequently, |there |will |be |increased |levels |of |other |
drugs |(which, |in |the |hands |of |a |diligent |physician, |require |a |reduced |drug |dose).



What |effect |can |the |addition |of |erythromycin |(an |enzyme

inhibitor) |to |warfarin |have? |- |CORRECT |ANSWER✔✔-Can |unpredictably |cause |a |dangerous |rise
|in |international



normalized |ratio |(INR) |if |the |warfarin |dose |is |not |decreased



What |Does |PC |BRAS |stand |for |in |terms |of |Enzyme |inducers? |- |CORRECT |ANSWER✔✔-
Phenytoin

Carbamazepine

Barbiturates

Rifampicin

Alcohol |(chronic |excess)

Sulphonylureas

,What |Does |AODEVICES |stand |for |in |terms |of |Enzyme |inhibitors? |- |CORRECT |ANSWER✔✔-
Allopurinol

Omeprazole

Disulfiram

Erythromycin

Valproate

Isoniazid

Ciprofloxacin

Ethanol |(acute |intoxication)

Sulphonamides



What |Drugs |are |necessary |to |stop |before |surgery? |- |CORRECT |ANSWER✔✔-I |LACK |OP:



Insulin

Lithium

Anticoagulants/antiplatelets

COCP/HRT

K-sparing |diuretics

Oral |hypoglycaemics

Perindopril |and |other |ACE-inhibitors.



When |do |you |stop |the |Combined |oral |contraceptive |pill |(COCP) |and |hormone |replacement |
therapy |(HRT) |before |surgery? |- |CORRECT |ANSWER✔✔-4 |weeks |before |surgery; |restart |2 |
weeks |after



When |do |you |stop |the |Lithium |before |surgery? |- |CORRECT |ANSWER✔✔-Day |before

,When |do |you |stop |Potassium-sparing |diuretics |and |angiotensin-converting |enzyme |(ACE) |-
inhibitors |before |surgery? |- |CORRECT |ANSWER✔✔-Day |of |surgery



When |do |you |stop |warfarin |before |surgery? |- |CORRECT |ANSWER✔✔-5 |days; |therapeutic |
LMWH |can |be |prescribed |in |the |interim |in |most |cases



When |do |you |stop |DOACs |before |surgery? |- |CORRECT |ANSWER✔✔-24 |hours |for |minor |
surgery; |48 |hours |before |major |surgery



When |do |you |stop |Oral |hypoglycaemic |drugs |and |insulin |before |surgery? |- |CORRECT |
ANSWER✔✔-Avoid |on |day |of |operation; |prescribe |variable |rate |(sliding |scale) |insulin |infusion |
with |surgical |fluid |from |midnight |the |night |before |(unless |minor |surgery).



When |do |you |stop |unfractionated |heparin |before |surgery? |- |CORRECT |ANSWER✔✔-4 |hours; |
re-start |post-operatively



When |do |you |stop |LMWH |before |surgery? |- |CORRECT |ANSWER✔✔-24 |hours |before



When |do |you |stop |Antiplatelets |(aspirin/clopidogrel/dipyridamole) |before |surgery? |- |CORRECT |
ANSWER✔✔-7 |days |ideally |(1 |week |before)



When |do |you |stop |insulin |before |surgery? |- |CORRECT |ANSWER✔✔-Avoid |morning |dose; |
prescribe |variable |rate |(sliding |scale) |insulin |infusion |with |surgical |fluid |from |midnight |the |
night |before |(unless |minor |surgery)



For |how |long |should |you |avoid |metformin |Post-Operatively |so |to |avoid |lactic |acidosis? |- |
CORRECT |ANSWER✔✔-2 |days |after |surgery

, When |do |you |stop |Diuretics/ACE |inhibitors |before |surgery? |- |CORRECT |ANSWER✔✔-Avoid |on |
day |of |operation



What |pre-operative |measure |would |you |take |in |a |patient |that |has |a |drug |history |of |Long-term |
corticosteroids |use |? |- |CORRECT |ANSWER✔✔-Change |to |equivalent |dose |hydrocortisone



Why |should |patients |on |long-term |corticosteroids |have |a |change |or |gradual |withdrawal |in |
steroid |use |as |opposed |to |immediate |cessation? |- |CORRECT |ANSWER✔✔-Patients |on |long-
term |corticosteroids |(e.g. |prednisolone) |commonly |have |adrenal |atrophy; |they |are |therefore |
unable |to |mount |an |adequate |physiological |('stress') |response |to |surgery, |resulting |in |
profound |hypotension |if |the |steroids |are |discontinued. |Avoids |Adrenal |crisis |or |Acute |Adrenal |
Insufficiency.



What |is |meant |by |'sick |day |rules' |regarding |steroids? |- |CORRECT |ANSWER✔✔-Where |patients |
on |steroids |double |their |daily |dose |to |counter

the |increased |steroid |requirement |when |unwell |or |sick



In |a |patient |with |recent |hemorrhagic |stroke, |what |medication |could |you |consider |stopping? |
And |what |might |you |consider |regarding |VTE |prophylaxis? |- |CORRECT |ANSWER✔✔-
Anticoagulants |and |Antiplatelets; |this |is |one |of |the |few |cases |wherein |VTE |prophylaxis |in |
LMWH |is |not |indicated



Give |3 |common |contraindications |to |ACE |Inhibitor |use? |- |CORRECT |ANSWER✔✔-1) |Acute |
kidney |injury |(AKI) |

2) |Hyperkalaemia

3) |Concurrent |NSAID |use



Why |do |you |need |to |be |wary |of |concurrent |Paracetamol |and |Co-codamol |use? |- |CORRECT |
ANSWER✔✔-Patient |could |already |be |on |4g/day |within |co-codamol