Stuck with Pre-reg NON Calculation Questions?

[Nik]

Rifampicin is an auto-inducer - it induces hepatic enzymes and thus its own metabolism, making drug interactions complex. Starting TB treatment in a pt on the drugs detailed above makes predicting the effects extremely tricky. I only reviewed this pt for the last 5 days of their admission, and most of these drug changes had happened before I'd seen them. The valproate dose increase was probably therefore due to initiating rifampicin and meropenem. The point I'm trying to get across is you can't just look in a book, note an interaction and make a change. You have to look at the pt as a whole, particularly when you have so many confounding drugs such as in this case.

[Asterix]

yeah true do you have to know the answer to the emergency supply qu which acted as a catalyst to bring in interactions

[Msocpharm]

why is ibw used in obese pts

[Nik]

Asterix - I'm sure the answer is in the MEP. I don't have one to hand so can't answer you directly.

Msocpharm - I have received your PM, but not had a chance to reply. I would suggest familiarising yourself with pharmacodynamics and stuff like volume of distribution first, perhaps search a clinical pharmacy text. If I find some sites or other info I'll let you know.

[Asterix]

enzyme inhbitiors and warfarin, do we just monitor inr more closely or look for alternative agent?

[sNASA]

From an old paper, but would they still ask this?

17. A patient diagnosed with phenylketonuria presents a prescription for a food supplement. Which one of the following has not been approved for this condition by the Committee on Borderline Substances?

A Juvella low protein bread rolls

B Phlexyvits

C Milupa PKU2

D Maxisorb

E Analog LCP

[sNASA]

why is ibw used in obese pts

I think it's to prevent overdosing!