Medicines management and safe prescribing

Question 1

Which anti-emetics are used for post-op nausea and vomiting?

Answer 1

Ondanestron
Dexamethasone
Haloperidol
Cyclizine

Question 2

How and when is adrenaline used in anaphylaxis?

Answer 2

500 micrograms, using adrenaline 1 in 1000 (1 mg/mL) injection in the anterolateral aspect of the thigh (intramuscular)

Question 3

What dose of adrenaline is used in Cardiopulmonary resucitation?

Answer 3

1 mg every 3–5 minutes as required, a 1 in 10 000 (100 micrograms/mL) solution is recommended.

Question 4

What dose is recommended of amiodarone in Ventricular fibrillation for CPR?

Answer 4

Initially 300 mg
Then 150 mg if required

Question 5

When is amiodarone used in arrhythmias?

Answer 5

when other drugs are ineffective or contra-indicated

Question 6

What dose is recommended of amiodarone for arrhythmias?

Answer 6

200 mg 3 times a day for 1 week, then reduced to 200 mg twice daily

Usually stays at 200mg once daily as maintenance dose

Question 7

When is adenosine indicated?

Answer 7

Rapid reversion to sinus rhythm of paroxysmal supraventricular tachycardias, including Wolff-Parkinson-White syndrome

Question 8

What dose of adenosine is used for reversion to sinus rhythm?

Answer 8

Initially 6 mg, administer into central or large peripheral vein with ECG monitoring

followed by 12 mg after 1–2 minutes if required,

then 12 mg after 1–2 minutes if required

Question 9

Which bronchodilator is offered first line management for all patients with COPD?

Answer 9

Bronchodilator - SABA e.g. salbutamol or SAMA e.g. ipratropium bromide

Question 10

What is considered “step-up” management of COPD patients not responding to SABA/SAMAs?

Answer 10

consider treatment with a long-acting beta2 agonist (LABA) and an inhaled corticosteroid (ICS)

LABA - salmeterol

Question 11

Management of acute exacerbation of asthma attack

Answer 11

Inhaled salbutamol (bronchodilator)

Oral prednisolone

Nebulised ipratropium bromide if no improvement

Magnesium sulfate can be used in severe asthma

Question 12

What dose of Chlordiazepoxide is used in moderate alcohol dependence/withdrawal?

Answer 12

10–30 mg 4 times a day
Reduced over 5–7 days

Question 13

What dose of Chlordiazepoxide is used in alcohol withdrawal with severe dependence?

Answer 13

10–50 mg 4 times a day
10-40mg as requires in the first 2 days, reduced over 7-10 days

Question 14

What is the initial management of Hyperkalaemia?

Answer 14

30 mL, calcium gluconate 10% IV
Insulin + dextrose infusion

Question 15

What is the initial management of acute coronary syndrome?

Answer 15

GTN (Sublingual or buccal)
IV morphine
Loading dose of Aspirin
Offer of a second anti-platelet i.e. clopidogrel/ticagrelor

Question 16

What is the general management for status epilepticus?

Answer 16

buccal midazolam or rectal diazepam in the community.

If intravenous access is available, intravenous lorazepam can be used.

Question 17

What are the 2 commonly used local and regional anaesthetics?

Answer 17

Lignocaine
Bupivacaine

Question 18

VTE prophylaxis in medical patients

Answer 18

Low molecular weight heparin as a first-line option, or fondaparinux sodium as an alternative, for a minimum of 7 days.