Prescription Review

Question 1

Drugs to stop before surgery

Answer 1

I LACK OP
Insulin
Lithium
Anticoagulants/platelets
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACE inhibitors

Question 2

What to check during a prescription review

Answer 2

PReSCRIBER
patient details
reaction (allergy)
Sign the front of the chart
Contraindications
Route of each drug
IV fluids if needed
Blood clot prophylaxis if needed
Emetic - antiemetic if needed
Relief - pain relief if needed

Question 3

How much fluid to give if tachycardic or hypotensive?

Answer 3

500ml bolus 0.9% NaCl

Question 4

How much fluid is maintenance fluids?

Answer 4

3L per 24 hours
2L if elderly

1L of 0.9% saline and 2L of 5% dextrose (1 salty and 2 sweet)

Question 5

What antiemetic to avoid in Parkinsons and young women?

Answer 5

metoclopramide

Question 6

1st line antiemetic and dose

Answer 6

50mg 8 hourly IM/IV/oral

Question 7

What antiemetic to avoid during heart failure?

Answer 7

cyclizine - worsens fluid retention
Use metoclopramide 10mg 8 hourly

Question 8

When should ACE inhibitors be taken?

Answer 8

In the evening - can cause postural hypotension

Question 9

What drugs contribute to hyperkalaemia?

Answer 9

Heparins
ACE
tacrolimus

Question 10

What drugs to stop in AKI

Answer 10

ACE/ARBs
Allopurinol

Question 11

What drugs can cause hyperglycaemia?

Answer 11

Prednisolone

Question 12

When should nitrofurantoin not be used?

Answer 12

eGFR less than 45

Question 13

When should DOACs be taken

Answer 13

with food