Medication Error Definitions: Mild: enhanced monitoring, no harm Moderate: active treatment required, enhanced monitoring, but no lasting harm Severe: patient harm that requires enhanced treatment and increased patient stay FDA’s Adverse Event Reporting System (FAERS): FAERS is a database that contains adverse event reports, medication error reports and product quality complaints resulting in adverse events that […]
Laws and Regulations to Know
This section is tricky. I recommend knowing a few laws and what they do. Food, Drug and Cosmetic Act (1938) – Give authority to the U.S. Food and Drug Administration (FDA) to oversee the safety of food, drugs, medical devices, and cosmetics. Covers orphan drugs. The introduction of this act was influenced by the death of more […]
Depression
Diagnosis: MDD – Major Depressive Disorder/Unipolar DisorderAt least five symptoms every day for at least 2 weeks.Depressed mood = SIG E CAPS Sleep disturbances Interest in activities lost Guilt or worthlessness feelings Energy decreased Concentration decreased Appetite and weight changes Psychomotor retardation Suicidal ideation Rating Scales: HAM-D: Hamilton rating scale for depression – 18 moderate, 7 […]
Dementia
Cognitive Screening Mini – Mental Status Exam – MMSE Montreal Cognitive Assessment – MOCA St Louis University Mental Scale – SLUMS Mood screening: Geriatric Depression.ScaleIADL: Instrumental Activities Of Daily Living Diagnosing Dementia: Rule out delirium and drug-related causes. Other causes: vitamin B12 deficiency, hypothyroidism, depression, NPH, opioids, sedative-hypnotics, antidepressants, anticholinergics, antiparkinson’s drugs Treatment: Initiate a cholinesterase inhibitor in […]
Chemo Induced Nausea and Vomiting
Prophylactic therapy should be given prior to moderately to highly emetogenic agents or radiation They should be scheduled for after chemo to prevent delated N/V Lorazepam is useful for anticipatory nausea/vomiting, but can also just change routine Chemo agents with high emetic risks: Day 1 = 3 agents neurokinin-1 antagonist (fosaprepitant) serotonin 3 antagonist (ondansetron) […]
Bipolar Disorder
Manic Episode: 1 week of abnormal and persistently elevated mood. inflated self-esteem, irritability, decreased need for sleep, flights of ideas, poor attention span, high-risk behaviors. Bipolar 1: one or more manic or mixed episodes and major depressive episodes Bipolar 2: one or more major depressive episodes accompanied by at least one hypomanic episode Cyclothymic disorder: Periods […]
Best Tips and Random Info
Random things they ask: Names of tests for disease states (ie: Montreal Cognitive Assessment, for example) All names are generic Know drugs with REMS programs, NTIs and Black box warnings well.
Anxiety, OCD and PTSD
Generalized Anxiety Disorder (GAD): 6 months or more of excessive worry or anxiety. OCD – intrusive thoughts that can not be controlled PTSD: trauma related to avoidance of stimuli. Benzos are the first line therapy in anxiety. Can cause tolerance or dependence. Abrupt discontinuation can lead to withdrawal. Treat for 3-4 weeks until trial for […]
Respiratory Syncytial Virus
Treatment: Mostly supportive care Ribavirin – only in select patients (complicated congenital heart disease, chronic lung disease, bronchopulmonary dysplasia, immunocompromised patients) Beta-agonists or race epinephrine – not usually used Corticosteroids, hypertonic saline or antibiotics are also not usually used. Prophylaxis: Palivizumab: 15 mg/kg/dose; prophylaxis is not recommended if > 29 weeks gestation (risk factors not considered) Neonates […]
Meningitis
Signs and Symptoms: Tsai J, Nagel MA, Gilden D. Skin rash in meningitis and meningoencephalitis. Neurology. 2013 May 7;80(19):1808-11. doi: 10.1212/WNL.0b013e3182918cda. PMID: 23650233; PMCID: PMC3719428. Treatment: Age Antimicrobial Therapy < 1 month Ampicillin plus cefotaxime; OR ampicillin plus an aminoglycosideStreptococcus agalactiae, Escherichia coli, Listeria monocytogenes 1-23 months Vancomycin + Ceftriaxone 100 mg/kg/day IV divided every 12 to […]