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Advanced Pharmacy Practice > Exam > Flashcards

Flashcards in Exam Deck (16)
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1
Q

Intercurrent illness means what with regard to diabetes?

A

Need to more tightly control BG.

2
Q

We should aim for a target plasma glucose level of ___-___mmol/litre for adults with type 1 diabetes during surgery or acute illness.

A

5-8

3
Q

A fasting plasma level of _____mmol/litre on waking and a plasma glucose level of _____mmol/litre before meals at other times of the day is recommended for type 1 diabetic adults.

A

5-7 fasting
4-7 before meals.

5-9 at least 90 minutes after eating.

4
Q

ACR of above what is indicative of nephropathy

A

3.0

5
Q

Target HbA1c

A

48-59mmol/mol

6
Q

NICE remommend regime for T1D

A

Basal/bolus
Twice daily insuline detemir as basal insulin therapy for adults with T1D.

Novorapid TDS before meals = rapid acting analogue for bolus. q

7
Q

Why would we consider adding metformin to T1D management?

A

Fat.
BMI >25 (>23 if asian)
to aid weight loss and improve blood glucose control.

8
Q

What is the target BP in diabetes?

A

<140.90
130.80 if target organ damage (raised ACR)

ACEI first line as nephroprotective

9
Q

What long term complications are there from uncontrolled blood glucose?

A

Macrovascular complications: MI, stroke, peripheral vascular disease.

Microvascular complications: Nephropathy, neuropathy, retinopathy.

10
Q

Do we use QRISK for T1D?

A

No, offer statin anyway.

DO NOT OFFER ASPIRIN FOR PRIMARY PREVENTION IN ADULTS WITH T1D

11
Q

Baseline monitoring for LMWH

A
APPT
INR
Platelets and at 4 days
LFTS
GFR (renal function)

Inhibition of aldosterone secretion by unfractionated or low molecular weight heparin can result in hyperkalaemia. Risk increases with duration of therapy.

Bruising, bleeding, platelets, anti-factor Xa in obese, pregnany etc.

12
Q

Pros of NOACS (3)

A

No monitoring
Reduced bleed risk
Less drug/diet interactions

13
Q

Pros of Warfarin (3)

A

Can monitor and therefore ensure efficacy
Less impact from missing a dose
Reversal agent

14
Q

Do we avoid Ibuprofen in elderly?

A

Definitely

15
Q

Do we avoid ibuprofen in asthmatics?

A

Maybe

16
Q

PPIs can cause

A

hyponatremia: fall risk in elderly. H2RA better