Prescriptions Flashcards
Insulin prescribing rules
Insulin as per insulin prescription chart at all relevant times on the main inpatient drug chart; must write UNITS; Specify brand name; indicate the device (disposable pen, pen cartridge, vial); write pre-breakfast/lunch/dinner (if taken pre-meal)
Child, 10y, 30kg, Otitis Media with symptoms worsening rapidly/significantly
No known drug allergies (NKDA)
AMOXICILLIN 125mg/5mL ORAL SUSPENSION
Give 10mL by mouth three times daily (TDS)
Supply for 5 (five) days
Ps.: Dose = weight(kg)/3 -> 30/3 = 10mL
*if allergic to PENICILLIN: CLARITHROMYCIN 250mg tablet
Give 1 tablet 250mg by mouth twice daily (BD)
Supply for 5 (five) days
- 2nd choice option: if symptoms worsen on a first-choice antibiotic taken for at least 2 to 3 days: CO-AMOXICLAV 125/31.25 mg in 5mL Oral Suspension
Give 10mL by mouth three times daily (TDS)
Supply for 5 (five) days
Adult, community-acquired pneumonia, (CURB 65: 0)
No known drug allergies (NKDA)
AMOXICILLIN 500mg
Take 1 tablet by mouth three times daily (TDS)
Supply for 5 (five) days
- 2nd choice option: DOXYCYCLINE 200mg tablet
Take 1 tablet by mouth once a day (OD)
Supply for 5 (five) days
*if allergic to PENICILLIN:
CLARITHROMYCIN 500mg tablet
Take 1 tablet by mouth twice daily (BD)
Supply for 5 (five) days
Palliative care patient, oesophageal cancer , currently still in pain despite taking max. doses of both tramadol and codeine.
1) Prescribe some pain relief for 1 week duration
2) After medication prescribed, report drowsy and twitching of upper arm. What is the likely cause?
3) Her GCS drops from 15 to 6. What will you prescribe her?
Q1)
No known drug allergies (NKDA)
MORPHINE SULPHATE 5mg (max. dose PO 40-60, SC 20-30)
To be given 4 hourly (QDS) in SC infusion as required for pain
Max. 30mg daily
CYCLIZINE
150mg in SC continuous infusion to be given over 24 hours
Max. 150mg daily
MORPHINE SULPHATE 10mg/5mL oral solution (max. dose PO 40-60, SC 20-30)
Take 10mL 4 hourly (QDS) as required for pain
Max. 60mg daily
Supply for 100 (one hundred) mL
CYCLIZINE 50mg tablet
Take 1 tablet up to three times daily (TDS)
Max. 150mg daily
Q2) Opioid toxicity
Q3) Naloxone
Prescribe a medication for nausea caused by constipation due to opiate use
No known drug allergies (NKDA)
METACLOPROMIDE 10MG tablet
Take 1 tablet three times daily (TDS)
METACLOPROMIDE
30-100mg to be given in SC infusion over 24 hours
Prescribe a medication for nausea caused by chemotherapy
No known drug allergies (NKDA)
ONDASETRON 8mg tablet
Take 1 tablet 1-2h before treatment, then 8mg 12/12h for up to 5 days
Palliative care, to reduce excessive respiratory secretions
No known drug allergies (NKDA)
HYOSCINE HYDROLBROMIDE 400micrograms/mL Solution for Injection
1mL (400micrograms) every 4 hours as required, hourly use is occasionally necessary, particularly in
excessive respiratory secretions
▶ BY CONTINUOUS SUBCUTANEOUS INFUSION ▶ Adult: 1.2–2 mg/24 hours
female, UTI, pregnant (3rd trimester)
No known drug allergies (NKDA)
TRIMETHOPRIM 200mg tablet
Take 1 tablet by mouth twice daily (BD) for 3 (three) days
FOLIC ACID 400micrograms tablet
Take 1 tablet by mouth one daily (OD) for 3 (three) days
male, complicated UTI
No known drug allergies (NKDA)
TRIMETHOPRIM 200mg tablet
Take 1 tablet by mouth twice daily (BD) for 7 (seven) days
female, UTI, pregnant (1st trimester)
TTT: Trimethoprim only in the Third Trimester
No known drug allergies (NKDA)
NITROFURANTOIN 100mg tablet
Take 1 tablet by mouth twice daily (BD) for 3 (three) days
Pain
No known drug allergies (NKDA)
PARACETAMOL 500mg tablet
Take 1 tablet every 4-6hours
Max. 4grams per day
PARACETAMOL 10MG/ML SOLUTION FOR IV INFUSION
1grams (one 100mL bag) every 4-6 hours to be administer IV over 15minutes
Max. 4grams per day (3g in patients with risk factors for hepatotoxicity)
Palliative care, confusion/restlessness
No known drug allergies (NKDA)
MIDAZOLAM HYDROCHLORIDE 5mg/mL BY SUBCUTANEOUS INFUSION
10mg (2mL) to be given subcutaneously over 24 hours, adjusted according
to response
Max. dose 20-60mg (4-6mL) in 24hours
40y, depression, prescribe an antidepressant
No known drug allergies (NKDA)
CITALOPRAM 20mg tablet
Take 1 tablet by mouth once daily (OD)
Max. 40mg daily after review in 3-4 weeks
Supply for 28 (twenty-eight) days
*Alternative:
FLUOXETINE 20mg tablet
Take 1 tablet by mouth once daily (OD)
Max. 60mg daily after review in 3-4 weeks
COPD, prescribe Salbutamol inhaler as required
No known drug allergies (NKDA)
SALBUTAMOL inhaler 5mg
Inhalation up to max. 4 hourly as required (QDS)
SALBUTAMOL aerosol 100-200micrograms
Inhalation up to max. 4 hourly as required (QDS) for persistent symptoms
HPT initial treatment, >55y, black, in use of IBUPROFEN
No known drug allergies (NKDA)
AMLODIPINE 5mg tablet
Take 1 tablet by mouth once daily (OD) every morning
Supply for 28 (twenty-eight) days
Change IBUPROFEN to PARACETAMOL due to HPT
*ABCD rule HPT:
<55y: LISINOPRIL
>55y or black: AMLODIPINE / THIAZIDE DIURETIC
HPT initial treatment, <55y
No known drug allergies (NKDA)
LISINOPRIL 10mg tablet
Take 1 tablet by mouth once daily (OD) every morning
Max. 60mg daily
Supply for 28 (twenty-eight) days
*ABCD rule HPT:
<55y: LISINOPRIL
>55y or black: AMLODIPINE / THIAZIDE DIURETIC
Vomiting prescription
nausea following chemo: ondansetron
nausea due to brain metastases: cyclising
hypercalcaemia-induced nausea: haloperidol
nausea due to constipation by opiate use: metoclopramide
As required medications (PRN) - “SOS”
SALBUTAMOL (COPD)
MORPHINE SULPHATE (PAIN)
CYCLIZINE (NAUSEA/VOMITING)
MIDAZOLAM (CONFUSION/RESTLESSNESS)
HYOSCINE-BROMIDE (RESPIRATORY SECRETIONS)
PARACETAMOL (PAIN)
METOCLOPRAMIDE (NAUSEA/VOMITING)
Prescribe Insulin, allergic to PENICILLIN
Allergic to PENICILLIN (causes a rash all over the body)
NOVORAPID 5 UNITS PEN CARTRIDGE
Apply three times daily (TDS) subcutaneously pre-breakfast, pre-lunch, pre-dinner.
Supply for 28 (twenty-eight) days
Adult, community-acquired pneumonia, (CURB 65 1-2)
No known drug allergies (NKDA)
1) AMOXICILLIN 500mg
Take 1 tablet by mouth three times daily (TDS)
Supply for 5 (five) days
2) CLARITHROMYCIN 500mg tablet
Take 1 tablet by mouth twice daily (BD)
Supply for 5 (five) days
- 2nd choice option:
1) DOXYCYCLINE 200mg tablet
Take 1 tablet by mouth once a day (OD)
Supply for 5 (five) days
Adult, community-acquired pneumonia, (CURB 65 >= 3)
No known drug allergies (NKDA)
Administer Benzylpenicillin* prior to transfer 1.2g IV/IM + Urgent hospital admission
- or: AMOXICILLIN 500mg 2 tablets by mouth
Penicillin Allergy: symptoms to CONTRAINDICATE use
Anaphylaxis
Angioedema
Acute Urticaria occurring closely in time with penicillin administration
Wheeze; Airway swelling
Severe generalized skin reactions (Stevens Johnson Syndrome; TEN; AGEP)
Haemolytic anaemia, interstitial nephritis, hepatitis
Penicillin Allergy: symptoms/features that permite future use
Late onset non-severe skin reactions
Viral exanthema (delayed onset, prolonged urticaria in the context of intercurrent infection)
Gastrointestinal upset
Family History of Penicillin Allergy
History of asthma or other allergic diseases
Cross (X)
Hold, do not give)
