Drugs

Question 1

Maintenance fluids under 10kg

Answer 1

100 ml/kg

Question 2

Maintenance fluids 10-20kg

Answer 2

100ml/kg for first 10kg, then 50ml/kg for every kg between 10-20

Question 3

Maintenance fluids 20+kg

Answer 3

First 10kg = 100ml/kg
10-20 kg = 50ml/kg
20+ = 20ml for every kg

UP TO 2 L in females, 2.5 in men

Question 4

Morphine: IV injection dose for 6months - 11 years

Answer 4

100mcg/kg over 5 minutes as initial injection, then continuous infusion of 20-30mcg/kg adjusted by effect.

Question 5

Contraindications of opioids

Answer 5

Respiratory depression, comatose patient, head injury, increased intracranial pressure, risk of paralytic ileus.

Question 6

Morphine specific contraindications

Answer 6

Acute abdomen, delayed gastric emptying, heart failure secondary to chronic lung disease, phaeochromocytoma (adrenal medulla tumor/ extra tissue)

Question 7

Morphine cautions

Answer 7

Adrenocortical insufficiency, asthma, convulsive disorders, biliary tract disease, hypotension, hypothyroidism, impaired respiratory function, IBD, myasthenia gravis (muscle weakness), obstructive bowel disorders, shock, dependence.

Question 8

Common side effects of morphine

Answer 8

Biliary spasm, bradycardia, confusion, constipation, dependence, difficulty with micrurition, dizziness, drowsiness, dry mouth, dysphoria, euphoria, flushing, hallucinations, headache, hypotension, miosis, mood changes, muscle rigidity, nausea, oedema, palpitation, postural hypotension, pruritus, rash, respiratory depression, sexual dysfunction, sleep disturbances, sweating, tachycardia, ureteric spasm, urinary retention, urticaria, vertigo, visual disturbances, vomiting.

Question 9

Unknown frequency side effects of morphine

Answer 9

Adrenal insufficiency, hyperalgesia, hypogonadism

Question 10

Morphine-specific side effects

Answer 10

Abdominal pain, agitation, amenorrhoea, anorexia, asthenia, bronchospasm, delirium, disorientation, dyspepsia, exacerbation of pancreatitis, excitation, hypertension, hypothermia, inhibition of cough reflex, malaise, muscle fasciculation, myoclonus, nystagmus (dancing eyes), paraesthesia, paralytic ileus, raised intracranial pressure, restlessness, rhabdomyolysis, seizures, syncope, taste disturbance.

Question 11

Morphine directions for administration

Answer 11

Dilute with 5% or 10% glucose or 0.9% NaCl

Question 12

Antidote for morphine overdose and dose

Answer 12

Naloxone Hydrochloride, 100mcg/kg (up to 2mg); repeat every 1 minute if no response up to 2mg.

Question 13

Ondansetron mechanism of action

Answer 13

5HT3 receptor antagonist blocking 5HT3 receptors in the GI tract and CNS

Question 14

Dose of ondansetron for prevention of post op nausea and vomiting

Answer 14

100mcg/kg (max 4mg) over 30 seconds+.

Question 15

Dose of ondansetron for treatment of post op nausea and vomiting.

Answer 15

100mcg/kg IV (max 4mg) over 30 seconds +.

Question 16

Ondansetron contraindications

Answer 16

Congenital long QT syndrome.

Question 17

Ondansetron cautions

Answer 17

Adenotinsillar surgery, subacute intestinal obstruction, susceptibility to QT interval prolongation (including electrolyte disturbances).

Question 18

Ondansetron common side effects

Answer 18

Constipation, flushing, head ache, injection site reactions

Question 19

Ondansetron uncommon side effects

Answer 19

Arrhythmias,bradycardia, chest pain, hiccups, hypotension, movement disorders, seizures.

Question 20

Ondansetron rare and very rare side effects

Answer 20

Dizziness, transient visual disturbances and transient blindness.

Question 21

Ondansetron directions for administration

Answer 21

For IVinfusion: dilute to a concentration of 320-640 much/ml with 5% glucose or 0.9% NaCl, give over 15 minutes+.

Question 22

Omeprazole drug action

Answer 22

Inhibit gastric acid secretion by blocking the hydrogen-potassium adenosine triphisphatase enzyme system (proton pump) of the gastric parietal cell.

Question 23

Omeprazole dose for 10-19 kg (2-17 years)

Answer 23

10mg once daily

Question 24

Omeprazole dose for 20kg+ (2-17 years)

Answer 24

20mg once daily

Question 25

Omeprazole MHRA safety information

Answer 25

Very low risk of subacute cutaneous lupus erythematosus

Question 26

Omeprazole cautions

Answer 26

May increase risk of GI infections; patients at risk of osteoporosis.

Question 27

Omeprazole common side effects

Answer 27

Abdominal pain, constipation, diarrhoea, flatulence, GI disturbances, headache, nausea, vomiting.

Question 28

Omeprazole uncommon side effects

Answer 28

Arthralgia, dizziness, dry mouth, fatigue, myalgia, paraesthesia, peripheral oedema, pruritus, rash, sleep disturbances.

Question 29

Omeprazole rare side effects

Answer 29

Alopecia, anaphylaxis, blood disorders, bronchospasm, confusion, depression, fever, gynaecomastia, hallucinations, hepatitis, hypersensitivity reactions, hypomagnesaemia, hyponatremia, interstitial nephritis, jaundice, leucocytosis, leukopenia, pancytopenia, photosensitivity, Stevens-Johnson syndrome, stomatitis, sweating, taste disturbances, thrombocytopenia, toxic epidermal necrolysis, visual disturbances.

Question 30

Omeprazole Administration instructions

Answer 30

Swallow whole
Disperse Losec MUPS tablet in water
Mix capsule contents or Losec with fruit juice or yoghurt
Enteral administration - capsule contents or Losec in large volume of water - allow to stand for 10 minutes before administration.