Safe Prescribing

Question 1

Side effects of STEROIDS?

Answer 1

Stomach ulcers
Thin Skin
oEdema
Right and left heart failure
Osteoporosis
Infection e.g. candida
Diabetes (first hyperglycaemia)
Cushings Syndrome

Question 2

Contraindications of NSAIDS?

Answer 2

No urine (i.e. renal failure)
Systolic dysfunction (i.e. heart failure)
Asthma
Indigestion (any cause)
Dyscrasia (clotting abnormality)

Question 3

Cause bradycardia in hypertension

Answer 3

Beta blockers

Calcium Channel Blockers

Question 4

Cause electrolyte disturbances in hypertension

Answer 4

Angiotensin converting enzyme inhibitors

Diuretics

Question 5

Side effects of diuretics?

Answer 5

Renal failure

Thiazide: gout
Potassium-sparing: gynaecomastia

Question 6

Replacement Fluid options?

Answer 6

0.9% saline unless:

hypernatraemic/hypoglycaemic = 5% dextrose

Ascites = human-albumin solution

Question 7

Replacement fluids if reduced urine output?

Answer 7

500 mL

Question 8

Replacement fluids if reduced urine output and tachycardia?

Answer 8

1L

Question 9

Replacement fluids if reduced urine output, tachycardia and signs of shock?

Answer 9

2L

Question 10

How much replacement fluid is needed per 24hrs for

a) normal adult?
b) elderly?

Answer 10

a) 3L i.e. over eight hours

b) 2L i.e. 12 hourly

Question 11

Normal dose for VTE prophylaxis?

Answer 11

LMWH

e.g. dalteparin 5000 units daily s/c

Question 12

When should you avoid metoclopramide?

Answer 12

1) Pts w/PD - exacerbates symptoms

2) Young women - risk of dyskinesia

Question 13

Top two treatments for anti-emetics?

Answer 13

1) Cyclizine 50mg eight hourly IM/IV/PO

2) Metoclopramide 10mg eight hourly IM/IV (if heart failure)