QuestionMultiA
QuestionChoice
33846
a
Perindopril arginine;8mg;oral (PO);Daily
QuestionChoice
33852
g
Atorvastatin;20mg;oral (PO);Daily
QuestionChoice
33847
b
Salbutamol;200micrograms;inhaled (INH);as required
QuestionChoice
33853
h
Bisoprolol;20mg;oral (PO);12-hourly
QuestionChoice
33850
e
Amlodipine;5mg;oral (PO);Daily
QuestionChoice
33848
c
Ipratropium bromide;40micrograms;inhaled (INH);8-hourly
QuestionChoice
33851
f
Bendroflumethiazide;2.5mg;oral (PO);Daily
QuestionChoice
33849
d
Prednisolone;30mg;oral (PO);Daily
QuestionComment
Prednisolone can lead to fluid retention for sure, but I don't know regarding angioedema.

43433
User
subscriber
Samuel
QuestionComment
why wouldnt amlodipine be correct - is it becuase it only causes peripheral oedema and not angioedema 

59540
QuestionComment
well duh
61365
User
subscriber
Iwasinthe212
User
subscriber
Hypertension Kinase
QuestionComment
if in a question, theres a few cuases of oedema - how woudl you narrow it down 
59541
User
subscriber
Hypertension Kinase
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2720
Dosing error & angioedema
Topic
75
GP
1. ACEi (perindopril arginine) and tetracycline (oxytetracycline) commonly cause angioedema with the former more common in the Afro-Carribean population. Calcium channel blockers (amlodipine) also cause angioedema but are not common.
2. Bisoprolol fumarate, given for the treatment of hypertension is given at 5-10mg daily with a maximum dose of 20mg daily. Hence, the correct prescription for 20mg should be daily instead of 12-hrly.
6787
a
h
Case presentation: A 70-year-old Afro-Carribean gentleman presents to the GP for his annual flu vaccine. PH Infective exacerbation of COPD, for which he has been receiving treatment for the past 5 days, Hypertension. DH His current regular medicines are listed (below).


**On Examination** Red swellings beneath the surface of his eyelid consistent with angioedema.

Question 1: Select the ONE prescription that is most likely to be contributing to the angioedema (mark them with a tick in column A)
Question 2: Select the ONE prescription that contains a serious dosing error (mark it with a tick in column B).