Managing risk of prescribing

Question 1

Rapid reaction

Answer 1

Rapid drug administration - Red man syndrome following vancomycin

Question 2

Early reaction

Answer 2

occur early in treatment and then tolerance - like Nitrate-induced headaches

Question 3

First dose reactions

Answer 3

occur after first dose - hypotension with ACE inhibitors

Question 4

Intermediate reactions

Answer 4

occur after some delay = longer the delay the less likely - scuh as some alletrgic reactions

Question 5

Late reations

Answer 5

Risk of ADR increases with continued or repeated exposure - also includes withdrawal reactions - withdrawal from corticosteroids

Question 6

DElayed reactions

Answer 6

occur after exposure, even if drug withdrawn - teratogenicity for example

Question 7

Susceptibilities mnemonic

Answer 7

IGASPED

Immunological reactions, Genetics, Age, Sec, Physiology, Exogenous, Disease states

Question 8

reaction to drug - how long observe?

Answer 8

6-12 hours

Question 9

Drugs cross-react with penicillins

Answer 9

Cephalosporins - 3rd gen just use with caution
Carbapenems
Monobactams except aztreonam

Question 10

Anaphylaxis adrenaline dose

Answer 10

<6 150 micrograms (0.15 ml 1:1000)
5-12 300 micrograms (0.3 ml 1:1000)
>12 500 micrograms (0.5 ml 1:1000)
ALL IM - CANNOT GIVE THIS DOSE IV - 1:1000 = 1 mg/ml

Question 11

Following adrenaline give what?

Answer 11

Chlorphenamine (antihistamine) and hydrocortisone

Question 12

Chlorphenamine dose?

Answer 12

< 6 months - 250 micrograms/kg
6 month - 6 years - 2.5 mg
6-12 5mg
>12 years 10 mg

Question 13

Anaphylaxis hydrocortisone dose

Answer 13

<6 months 25 mg
6 month - 6 years 50 mg
6-12 100 mg
>12 200 mg

Question 14

Grades of shock

Answer 14