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PRES 3 > Prescriptions > Flashcards

Prescriptions Flashcards

1
Q

Insulin prescribing rules

A

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)

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2
Q

Child, 10y, 30kg, Otitis Media with symptoms worsening rapidly/significantly

A

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
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3
Q

Adult, community-acquired pneumonia, (CURB 65: 0)

A

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

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4
Q

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?

A

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

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5
Q

Prescribe a medication for nausea caused by constipation due to opiate use

A

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

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6
Q

Prescribe a medication for nausea caused by chemotherapy

A

No known drug allergies (NKDA)

ONDASETRON 8mg tablet
Take 1 tablet 1-2h before treatment, then 8mg 12/12h for up to 5 days

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7
Q

Palliative care, to reduce excessive respiratory secretions

A

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

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8
Q

female, UTI, pregnant (3rd trimester)

A

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

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9
Q

male, complicated UTI

A

No known drug allergies (NKDA)

TRIMETHOPRIM 200mg tablet
Take 1 tablet by mouth twice daily (BD) for 7 (seven) days

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10
Q

female, UTI, pregnant (1st trimester)

A

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

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11
Q

Pain

A

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)

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12
Q

Palliative care, confusion/restlessness

A

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

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13
Q

40y, depression, prescribe an antidepressant

A

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

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14
Q

COPD, prescribe Salbutamol inhaler as required

A

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

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15
Q

HPT initial treatment, >55y, black, in use of IBUPROFEN

A

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

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16
Q

HPT initial treatment, <55y

A

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

17
Q

Vomiting prescription

A

nausea following chemo: ondansetron
nausea due to brain metastases: cyclising
hypercalcaemia-induced nausea: haloperidol
nausea due to constipation by opiate use: metoclopramide

18
Q

As required medications (PRN) - “SOS”

A

SALBUTAMOL (COPD)
MORPHINE SULPHATE (PAIN)
CYCLIZINE (NAUSEA/VOMITING)
MIDAZOLAM (CONFUSION/RESTLESSNESS)
HYOSCINE-BROMIDE (RESPIRATORY SECRETIONS)
PARACETAMOL (PAIN)
METOCLOPRAMIDE (NAUSEA/VOMITING)

19
Q

Prescribe Insulin, allergic to PENICILLIN

A

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

20
Q

Adult, community-acquired pneumonia, (CURB 65 1-2)

A

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
21
Q

Adult, community-acquired pneumonia, (CURB 65 >= 3)

A

No known drug allergies (NKDA)

Administer Benzylpenicillin* prior to transfer 1.2g IV/IM + Urgent hospital admission

  • or: AMOXICILLIN 500mg 2 tablets by mouth
22
Q

Penicillin Allergy: symptoms to CONTRAINDICATE use

A

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

23
Q

Penicillin Allergy: symptoms/features that permite future use

A

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

24
Q

Cross (X)

A

Hold, do not give)

25
Q

Tick or circle

A

Timings

26
Q

Sleeping t (|——-)

A

STOP

27
Q

Box (square)

A

Review before giving

28
Q

Zigzag line

A

Stopped completely

29
Q

Zigzag line + error

A

Error/mistake

30
Q

Alcohol dependence low risk patient -> prescription of Thiamine

A

Thiamine 300mg tablet
Take 1 tablet by mouth OD
Supply for 5 (five) days

*Then, Thiamine 100mg 1 tablet by mouth OD

PRES 3 (12 decks)

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