Prescribing

Question 1

Steps for every prescription

Answer 1

PReSCRIBER

• P - written patient details - name, DOB, hospital number on drug chart
• Re - completed allergy section including reaction
• S - sign front of chart
• C - checked routine medications are not contraindicated at the moment
• R - assess route of drugs
• I - prescribe appropriate IV fluids
• B - prescribe appropriate blood clotting prevention
• E - consider an antiemetic
• R - pain relief - ensure not overdosing and has adequate regular/breakthrough

Question 2

what fluids are crystalloids?

Answer 2

• 0.9% saline
• hartmann’s
• 5% dextrose

Question 3

what are the 3 low molecular weight heparins?

Answer 3

• dalteparin (cheapest so most commonly used)
• enoxaparin
• tinzaparin

Question 4

when is thrombolysis for PE indicated and what drug is used?

Answer 4

cardiac arrest

cardiogenic shock (BP < 90, resistant to fluid resus)

alteplase is given

Question 5

which AED is associated with SIADH?

Answer 5

carbamzaepine

Question 6

what helps guide 1st line treatment of T2DM

Answer 6

• normal or under weight - sulphonylurea e.g. gliclazide
• overweight - metformin
• if creatinine > 150 don’t give metformin

Question 7

NICE basic maintenance fluid guidance for requirements

Answer 7

• 25-30 ml/kg of water daily
• 1 mmol/kg of potassium, sodium and chloride daily
• 50-100g glucose daily (limits starvation ketosis, not needs full dietary requirements)