Clinical Checking Exam Flashcards
A patient has been prescribed a dopamine receptor antagonist (metoclopramide 10mg TDS PRN) as an anti-sickness medication. He has a history of parkinsons disease and is on sinemet. Can we dispense metoclopramide ?
a. If not why?
b. Suggest an alternative
No,
1. Metoclopramide is a dopamin receptor antagonist
2. This is known to make symptoms of parkinsons disease worse therefore should be avoided
3. Notify prescriber and discuss an alternative for them to change to
4. Counsel patient for new anti-emetic
5. Explain to the patient the reson for the change
Alternative: Dispense cyclizine 50mg TDS prn
True or false
Clarithromycin has many interactions so it is always good to check its interaction in the BNF first
True
TIPS: Always check clarithromycin first then the others
What is myopathy and what are the symptoms ?
Disease affecting the skeletal muscle. Usually associated with inflammation
Symptoms include:
- Muscle cramps
- Muscle weakness
- Stiffness
- Spasms
Usually affecting the arms, shoulders, thighs
Chlarithromycin should not be used together with simvastatin as it can cause myopathy.
A patient has a been prescribed both, what advice should you give to the patients and who should be contacted ?
- Advice patient to stop taking simvastatin whilst on clarithromycin until full course of antibiotic is complete due to this interaction
- To double check, contact prescriber and ask if this is okay
- Reassure patient that this will not affect cholesterol levels and this can be held without causing any significant effects
- Simvastatin is a long term medication therefore not taking it until the course of antibiotics is complete should not be a problem
What should you do if a prescription has not been signed by the prescriber ?
- legal requirement therefore absence of prescription means it is not legally valid
- Contact the prescriber to sign the prescription otherwise it cannot be dispensed
