Consider the figure below that denotes Autonomous Systems an…
Consider the figure below that denotes Autonomous Systems and their relationships. Note that ISP-C is a provider for ISP-B. Assume that ISP-B and ISP-E terminate their peering agreement. Would any ISP benefit from this change, and if yes which one?
Read DetailsMrs. PS is ready for discharge and her discharge medication…
Mrs. PS is ready for discharge and her discharge medication is listed on her discharge summary as: Alendronate tabs 70mg NEW 1 on a Saturday Calcium and vitamin D (Adcal D3) NEW 1 twice a day Codeine tablets 30mg NEW 1-2 to be taken four times daily when required Lercanidipine tabs 10mg NEW 1 daily Paracetamol tabs 500mg 2 to be taken four times daily Prednisolone tabs 1mg 3 daily Ramipril capsules 5mg 1 daily Senna tabs 15mg NEW 1 at night as required The discharge summary arrives at her GP practice and the practice pharmacist updates Mrs. PS’ repeat medication list. Identify TWO medicines which should not be added to her repeat medication list. For each one, give a reason why it should not be added. (3 marks)
Read DetailsQuestions 7 to 9: Care Homes Mrs VH is a resident in a care…
Questions 7 to 9: Care Homes Mrs VH is a resident in a care home. Her current medications and their indications are: Amlodipine 10mg one daily (Hypertension) Amitriptyline 25mg one at night (Neuropathic pain following shingles 18 months ago) Aspirin 75mg one daily (Previous MI) Atorvastatin 80mg one daily (Previous MI) Bisoprolol 5mg one daily (Previous MI) Lisinopril 10mg one daily (Previous MI, hypertension, CKD) Oxybutynin 5mg one twice daily (Urinary incontinence) Metformin 500mg one twice daily (Type 2 diabetes) The local CCG has requested that care home staff are educated by local pharmacists about the ‘sick day rules’ to reduce the risk of acute kidney injury (AKI). Below is an excerpt from the CCG’s guidance: As health professionals one of our key aims is to reduce the risk of avoidable harm to our patients. Some people are at increased risk of Acute Kidney Injury (AKI), for example those with Chronic Kidney Disease (CKD), heart failure, or those taking particular medications. Health care professionals should provide advice to such patients that certain drugs should be temporarily discontinued during acute intercurrent illnesses, particularly where there is disturbed fluid balance. This advice is commonly described as ‘sick day rules’ or to take a ‘drug holiday’. The definition of ‘acute illness’ in this context has to be simple enough to be understood by patients at risk. For example: ‘when you are unwell with any of the following; vomiting or diarrhoea (unless minor) fevers, sweats and shaking’ Is Mrs VH at risk of an AKI? How should the ‘sick day rules’ be applied to her? (4 marks)
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