Pass the PSA, 1e

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For each question in this section, there will be a clinical scenario with results of investigations and you have to make a change to the drug prescriptions. The investigations may include plasma drug concentration. Single-best answer– planning management, providing information, adverse drug reactions, drug monitoring, data interpretation Jarzyna D, Jungquist CR, Pasero C, Willens JS, Nisbet A, Oakes L, et al. American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain management nursing : official journal of the American Society of Pain Management Nurses 2011;12(3):118-45 e10.

Sometimes it is inappropriate to treat/change management and it important to bear in mind non-drug therapies (e.g. physiotherapy, TENS machines for pain relief) have a role.

How many questions are on the prescribing safety assessment?

Know which drugs are prescribed in MICROgrams (e.g. levothyroxine, digoxin) – these are often prescribed in MILLIgrams to catch you out. You are advised to spend no more than 4 minutes for each question in the Prescribing section, no more than 3 minutes for each question in the Prescription Review section and no more than 85 seconds for each question in all other sections. Generally, information that is directly related to the safety and effectiveness of the drug should be given priority. Know your metrics! milligrams and millilitres, micrograms and nanograms. Know the difference and how to convert between them. assessbloodresultsgivenandmedsthatcouldaffectthemforexampleSertalineandhyponatremia.(LookinthePASSTHEPSAbookforthis)

questions-long practice papers are available to candidates who are registered to take the assessment. The beginning of Appendix 1 in the paper BNF contains several tables of ‘drugs that cause…’. This saves you from looking up each drug individually when being asked which drug is most likely to cause ‘x’. After you prescribe a drug, you have to state the dose and route of administration. For regular medicines and general practice prescriptions, you also have to state the frequency. You need not state the duration. Refer to the BNF for the correct dose, route and frequency under the right indication. For the 2023 PSA, all medical schools may decide to offer re-sits, especially if the PSA is taken as a summative test. Medical schools where the test is formative should also offer re-sits. Medical schools are responsible for providing further training and support in prescribing for those re-sitting, and they will inform their students of the local re-sit dates. The PSA is a very time-sensitive assessment and therefore time management is important. A guide of how long you should spend on each section (based on weightage) is as detailed below:The BNF can be used at any point during the PSA examination. Therefore, it is absolutely vital that candidates are confident with using the BNF prior to the exam. This section alone carries 40% of the total marks and is therefore the most important section in the PSA. You should attempt this section first and try your best to score well in it.

Prepare for the PSA was written by Finn Catling , an academic foundation doctor at North Middlesex Hospital, London. The PSA is a prescribing exam for final-year medical students, which was introduced in some UK medical schools from the 2013/14 academic year onward.The post-assessment review can take a number of days depending on the assessments sat and number of candidates involved and the results will be made available up to three weeks after the PSA date. When titrating drugs, for example, thyroxine to get TSH in range, you should usually make the smallest increment change possible. PSA Question Item Styles: Planning Management, Providing Information, Adverse Drug, Reactions, Drug Monitoring and Data Interpretation - Dr Lynne Bollington

Be ready to answer questions on drugs that require monitoring of their plasma levels (e.g. phenytoin, digoxin, lithium).Sedrakyan A, Hebert P, Vaccarino V, Paltiel AD, Elefteriades JA, Mattera J, et al. Quality of life after aortic valve replacement with tissue and mechanical implants. The Journal of thoracic and cardiovascular surgery 2004;128(2):266-72. For F1s, the PSA certificate does not have an expiry date as such. A PSA pass within two years prior to starting the F1 year is valid, but the pass does not expire during the F1 year (e.g. if a trainee joins the foundation programme in August 2022 and passed the PSA in February 2021, the PSA certificate would not expire in February 2023 before their F1 year is complete). If trainees are required to record an expiry date in their e-portfolio it is suggested that the last date of the F1 year is entered. When identifying drugs that are causing an adverse effect, you may sometimes find that the number of drugs that could be causing the effect is greater than the number of drugs that the question is asking for. In this case, you should take into consideration how commonly each drug causes the adverse effect and when the drug was started relative to when the adverse effect developed. If everything seems equal, then you should exclude from your answer the drug that is less likely to cause the adverse effect based on your own understanding of its pharmacology. Koul PB. Diabetic ketoacidosis: a current appraisal of pathophysiology and management. Clin Pediatr (Phila) 2009;48(2):135-44.