Essential Drug Classifications and Mechanisms of Action
Drugs Acting on the Central Nervous System
Anaesthetic Drugs
Anaesthetics are drugs that produce a reversible loss of sensation, with or without loss of consciousness, thereby allowing surgical or diagnostic procedures to be performed without pain.
Mode of Action: General anaesthetics produce CNS depression by enhancing inhibitory neurotransmission, mainly through GABA-A and glycine receptors, and/or reducing excitatory neurotransmission through NMDA and other receptors. Local anaesthetics block voltage-
Read MoreClinical Nursing Protocols for Insulin Resistance Research
CLEAR Study Objectives
The study is trying to determine why skeletal muscle becomes insulin resistant in obesity.
Researchers compare three groups:
- Lean insulin-sensitive
- Obese insulin-sensitive
- Obese insulin-resistant
The key study procedures are:
- ✅ OGTT
- ✅ DEXA
- ✅ VO2 Max
- ✅ Hyperinsulinemic-Euglycemic Clamp
- ✅ Muscle Biopsies
- ✅ Blood/urine collection
The clamp and biopsies are the most important nurse-related procedures.
Essential Nursing Knowledge
Screening Eligibility Criteria
Know these key criteria:
Infectious Disease OSCE: Clinical Presentation and Management
1. Malaria: Fever and Travel
Key History Clues
- Recent travel to sub-Saharan Africa or South Asia
- Mosquito exposure
- Fever with chills and rigors
- Cyclical fever patterns
- Headache and myalgia
- Possible confusion (indicative of severe malaria)
Investigations
- Thick and thin blood film (gold standard)
- Malaria rapid antigen test
- FBC (thrombocytopenia is common)
- U&Es, LFTs, and glucose (to assess severity)
- Blood cultures (to rule out sepsis)
Management
- Admit if suspected
- IV artesunate for severe malaria
- Oral ACT (artemisinin-
Gastrointestinal Disease Diagnosis and Management
1. Haematemesis Management and Differentials
Differential Diagnoses:
- Oesophageal variceal bleeding secondary to chronic alcohol use
- Mallory-Weiss tear
- Boerhaave syndrome
- Peptic ulcer disease
Investigations
- Bedside: Full set of basic observations, A-E assessment, and ECG.
- Bloods: FBC, baseline U&Es, LFTs, coagulation screen, and group and save.
- Imaging: Endoscopy.
Management
- A-E assessment: Stabilise the patient.
- Keep nil by mouth (NBM).
- Oxygen and IV fluids.
- Group and save.
- IV terlipressin and antibiotics.
Chest X-Ray Analysis: Effusion, Oedema, and Pneumonia
1. Pleural Effusion
Interpretation
- Quality: RIPE – Good
- 1. Airways: Trachea deviated to the right (pushing effect because of effusion); cannot visualize the carina or bronchus.
- 2. Breathing: Effusion in the left lower and middle zones which ends in the upper zone with a meniscus sign; lung markings present throughout the right lung.
- 3. Cardiac: Cannot assess the size; difficult to visualize left heart borders.
- 4. Diaphragm: Right hemidiaphragm can be seen; left cannot be seen; blunting of the left costophrenic
Essential Cardiovascular Emergencies and Management
1. STEMI and NSTEMI
- Initial Management (MONA): Morphine (if severe pain), Oxygen (if sats < 94%), Nitrates (contraindicated in hypotension), Aspirin 300mg.
- Secondary Prophylaxis: Dual antiplatelet therapy (aspirin + clopidogrel), statins, ACE inhibitors, and beta-blockers.
2. Acute Pericarditis
- Clinical Presentation: Pleuritic chest pain, worse on inspiration and lying down; bending forward improves symptoms. Often follows a viral illness.
- ECG Changes: Widespread ST elevation (saddle-shaped) and PR