2011/2012 pre-reg thread

[Asterix]

Salbutamol nebs aren't usually first line, 10 units actrapid with 50ml glucose 50% after stabilising the heart with 10ml calcium gluconate 10% is the common starting point. Ion exchange resins are last resort, stopped when plasma K+ reaches 5 as it will still have an effect once stopped.

I thought it was 20 units of actrapid? how do they decide the number of units anyway or is dependent how elevated the potassium is. I have seen a combination of all 3 I listed used though...

[Nik]

Salbutamol nebs & calcium resonium % insulin and dextrose KCL ??

Why would you give more K+ ?

20 units actrapid is a bit high, there might be a guideline on what your trust recommend, but most docs will go by the BNF and use between 5 and 10 units actrapid followed by insulin. Some might add in nebs as well but I've not seen it that often.

[Asterix]

Why would you give more K+ ?

20 units actrapid is a bit high, there might be a guideline on what your trust recommend, but most docs will go by the BNF and use between 5 and 10 units actrapid followed by insulin. Some might add in nebs as well but I've not seen it that often.

sorry I was thinking about diabetic ketoacidosis which if I remember rightly can lower K+ due to iv insulin?

out of interest whilst we are on the topic, how does someone decide the number of units in normal diabetics, I had a flick through my clinical textbook but no mention as to how to specify exact units to a patient

[Nik]

Sliding scale is the norm along with K+ infusion.

[Asterix]

Sliding scale is the norm along with K+ infusion.

sliding scale is also actrapid right

[Ama2007]

I am getting worried now about the exam. I have not done any revision and my knowledge of OTC is not that great. Where do you start first? calculations or learning the BNF and MEP? I am planning to take about 2 weeks as study leave , anyone taken more or less?

[Nik]

Start doing regular calcs if you haven't done so already. Don't worry about the OTC stuff, it's not too difficult and can be left to later on. Familiarise yourself with the important bits which were in the MEP but no longer are, CD's, prescription and register requirements. BNF should go without saying, should be using that everyday during work and after to look up new things you come across.

[Asterix]

how is everyones revision going then

[pre-reg trainee]

Anyone heard about the ultimate GPhC registration assessment exam guide? I ordered one from amazon as isn't very expensive. Apparently it is provided by pharmacy CPA. Is it good, worth the time?

[pre-reg trainee]

how is everyones revision going then

Mine is slow a bit. I am sort of waiting for the mock exam that is in March. I need to see myself how I do then I will start serious revision although I do read BNF when I can.