PSA 1 Flashcards
Why is “furosemide 80 mg PO twice daily” a potential error in elderly patients?
High doses can cause dehydration, electrolyte imbalances, and acute kidney injury in frail elderly patients. Start at a lower dose (e.g., 20-40 mg).
Why is “metformin in a patient with eGFR <30 mL/min” contraindicated?
Increased risk of lactic acidosis due to impaired renal clearance of metformin.
Why is “verapamil and beta-blockers co-prescribed” a serious error?
?bradycardia
What do you monitor in a patient on sulfasalazine?
FBC (risk of bone marrow suppression) and LFTs.
What is monitored for tacrolimus?
Trough blood levels, renal function (nephrotoxicity), and blood pressure.
What needs monitoring for sodium valproate?
LFTs (risk of hepatotoxicity) and FBC (risk of thrombocytopenia).
What is the treatment for MRSA colonization?
Mupirocin nasal ointment and chlorhexidine body wash.
What is the preferred treatment for gonorrhoea?
Ceftriaxone 1 g IM as a single dose.
What is the duration of antibiotic therapy for infective endocarditis?
4-6 weeks depending on the organism and valve involvement.
What is the chloride concentration in 0.9% saline?
154 mmol/L.
When is 5% dextrose contraindicated?
In hypovolemia or shock, as it does not replace electrolytes or expand plasma volume effectively.
What are the side effects of carbimazole?
Agranulocytosis, rash, and hepatotoxicity.
What is the therapeutic range for phenytoin?
10-20 mg/L.
What are signs of aspirin overdose?
Tinnitus, hyperventilation, metabolic acidosis, and confusion.
What is the dose of tramadol for moderate pain?
50-100 mg PO every 4-6 hours (max 400 mg/day).
What is the maximum dose of amitriptyline for neuropathic pain?
75 mg/day (start at 10-25 mg at night and titrate).
How do you adjust morphine dosing in renal impairment?
Reduce the dose and increase dosing intervals; consider alternatives like fentanyl if severe.
What is the antihypertensive of choice in pre-eclampsia?
Labetalol (first-line) or nifedipine.
Which antiepileptics are contraindicated in pregnancy?
Sodium valproate (teratogenic; causes neural tube defects).
What is the first-line treatment for constipation in a breastfeeding mother?
Bulk-forming laxatives (e.g., ispaghula husk) or lactulose.
Write a PRN prescription for cyclizine for nausea.
Cyclizine 50 mg PO/IV every 8 hours PRN for nausea (max 150 mg/day). - PO nausea, IV vomiting
What is the maximum daily dose of hyoscine butylbromide (Buscopan)?
80 mg/day (20 mg four times daily).
What is the dose of hydrocortisone in acute asthma?
100 mg IV every 6 hours.
How do you treat hypercalcemia of malignancy?
IV fluids (0.9% saline), followed by IV bisphosphonates (e.g., zoledronic acid).
