Prescribing Flashcards
What is the drug treatment for Impetigo?
BNF recommends oral Flucloxacillin for widespread impetigo.
More isolated areas can be treated with topical Fusidic acid.
Drug treatment for acute pulmonary oedema?
Furosemide, 40mg IV.
Example of examination: bibasal crepitations, heart sounds 1 + 2 + 3. JVP 6 - 7 cm, bipedal oedema noted.
Drug treatment for patient with acute adrenal insufficiency due to withdrawal of prednisolone?
Dexamethasone 3.4mg IV
OR
Hydrocortisone 100mg IV
Drug treatment to control secretions on patient with end of life care?
Glycopyrronium 200mcg S/C
Secretions can be troublesome and an anti-cholinergic agent like Glycopyrronium (especially given in the subcutaneous route in drowsy patients) can be very helpful. An alternative is hyoscine hydrobromide/butylbromide, which also helps with vomiting, however Glycopyrronium is often used first as it is more effective for respiratory secretions.
Drug treatment for breathlessness on patient on end of life care?
Morphine 2.5 - 5mg S/C
Breathlessness can initially be treated with supplementary oxygen and sometimes with a fan in the room. However when this is not enough morphine can be used as well. The oral route is ideal in patients who can tolerate this. If patient is not tolerating orally, the subcutaneous can be considered.
Benzodiazepines are also useful for the treatment of breathlessness.
Medication for prevention of pneumococcal infection in paediatric patient with sickle cell anaemia?
Phenoxymethylpenicillin, oral 250mg, twice a day.
Prophylactic penicillin is usually given to children at least until age 5 years and often after that as well to decrease risk of pneumoccocal infection due to functional asplenia.
Drug treatment for 35y/o man with sharp central chest pain, worse on lying back and better on sitting forward. ECG shows widespread ST elevation.
Ibuprofen 600 - 800mg, Oral, 8 hourly (TDS)
Clinical symptoms of pericarditis. Cause of pericarditis is most often infective (viral or bacterial). Autoimmune diseases can also cause this presentation. The first line choice is usually ibuprofen but other NSAIDs are acceptable.
First line drug treatment for rate control of AF?
The first line treatment for someone without evidence of HF is either a beta-blocker or calcium channel blocker.
Drug treatment for chlamydia?
- Doxycycline 100mg twice daily for seven days.
However if pregnant, doxycycline is contraindicated in pregnancy, alternatives”
- Erythromycin 500mg twice daily for 14 days
OR
- Amoxicillin 500mg three times a day for seven days
Most appropriate immediate drug for anaphylaxis?
Adrenaline 1:1,000 0.5mg (500 micrograms) IM
Treatment of limited impetigo?
Treatment of limited impetigo affecting small areas of the skin is to use topical hydrogen peroxide 1% cream. If unsuitable (eg around eyes) offer topical antibacterial (fusidic acid).
Medication for end of life agitation?
Agitation can be controlled by benzodiazepines like Midazolam. The subcutaneous route is usually preferred due to its controlled release of drug to the patients.
Note: Haloperidol or levomepromazine would not be appropriate in a patient with parkinsons.
Drug treatment for clostridium difficile infection?
Oral metronidazole is often used as first ine therapy. The duration should be 10 to 14 days. Dose is 400mg TDS (500mg tds also acceptable).
Second line treatment is oral Vancomycin.
First line antibiotic for low-severity community acquired pneumonia?
Amoxicillin, 500mg, Oral, 8-hourly (TDS), 5 days.
Drug treatment for old man with urinary retention while he awaits surgery? (BPH)
Tamsulosin 400 micrograms, Oral, Daily.
Medical therapy may help with symptoms whilst surgical options are considered. Tamsulosin is an alpha blocker which causes smooth muscle relaxation.
19y/o woman with anaemia, nine weeks pregnant. Drug treatment?
Ferrous sulphate, 200mg, Oral, 2 - 3 times daily.
Immediate management for patient with eclampsia?
Magnesium sulphate 4g, in 0.9% soidum chloride, 5 - 15 minutes, IV.
Immediate treatment is with magnesium suplhate infusion and then to control the blood pressure. After the initial loading dose, a maintenance dose needs to be prescribed as well.
Prescription for 2 nebulised medications for acute asthma?
Salbutamol 5mg
Ipratropium bromide 0.5mg
NEB
Drug treatment for angina?
GTN Spray, 400mcg, Sublingual
Antibiotic for 2 year old child with suspected meningitis?
Ceftriaxone, 80mg/kg, IV
OR
Cefotaxime 50mg/kg IV
Drug treatment for life threatening community acquired pneumonia of patients from a nursing or residential home?
Co-Amoxiclav 1.2g IV
AND
Clarithromycin 500mg IV
Drug treatment for infective conjunctivits.
Chloramphenicol drops 0.5%. 2-hourly. 1 drop per eye
First line treatment is usually chloramphenicol eye drops, it is important to be specific on the strength of the eye drops when prescribing. The frequency is usually advised as 2 hourly during waking house. The duration is usually discussed with the patients- the drops should be used until the infection is controlled and then for a further 48 hours after healing.
The duration can be variable but patient should come to see the GP if not resolved in one week.
Drug treatment for prophylaxis of tuberculosis
Isoniazid, 300mg orally once a day. Duration?
When an active TB infection is found in an adult, all family members who have been in contact with that person usually are also treated with isoniazid regardless of their own skin test results.
Most appropriate first line diuretic for patient with ascites due to liver cirrhosis? (no evidence of infection)
Spirinolactone, 100mg (starting dose), Oral, Daily.
Treatment includes fluid restriction, low salt diet and pharmacological treatment. Spirinolactone is the first line duiretic as it addresses the deranged renin-angiotensin-aldosterone balance. Starting doses of up to 100mg daily are often used.
Second line agents include furosemide.
Treatment for uncomplicated UTI in women?
BNF recommends either Trimethoprim or Nitrofurantoin. The duration of treatment for uncomplicated UTI in women is 3 days.
Drug treatment for Impetigo?
The treatment of limited impetigo, affecting small areas of the skin is to use Topical hydrogen peroxide 1% cream. If topical hydrogen peroxide 1% cream is unsuitable (eg if impetigo is around the eyes), offer a topical antibacterial (fusidic acid).
Topical 1% hydrogen peroxide is usually applied to the affected area two to three times a day for 5 days and fusidic acid 2% is applied for three times a day for a total of 5 days.
What are the different types of laxatives and their examples?
Osmotic laxatives
- examples include lactulose, macrogols and rectal phosphates
Stimulant laxatives
- examples include senna, docusate, bisacodyl and glycerol
- co-danthramer should only be prescribed to palliative patients due to its carcinogenic potential
Bulk-forming laxatives
- examples include ispaghula husk and methylcellulose
Faecal softners
- include arachis oil enemas
- not commonly prescribed
Management for shingles?
Aciclovir 800mg five times daily for 7 days
What is the starting dose of metformin?
500mg PO daily for one week, taken with breakfast.
Start low to minimise side effects.
Then 500mg twice daily for one week, then 500mg three times daily.
Drug management for acute dystonic reaction?
Procyclidine hydrochloride 5mg/ml.
5 - 10 mg IM/IV. Parenteral administration is preferred over oral as there may be unsafe swallow.
First line IV treatment of hypoglycaemia?
Glucose 20% is first line IV treatment for hypoglycaemia. If glucose 20% is not available, glucose 10% is a suitable alternative.
Infusions of 10% (100 - 200ml) or 20% (50 - 100ml) deliver between 10 - 20g of glucose.
I put glucose 20% 100ml over 15 mins and got full marks. Cant find exactly.
Glucose 50% is hypertonic and risks extravasation.
