QuestionMultiA
QuestionChoice
10028476
a
Metformin;500mg;oral (PO);Daily
QuestionChoice
10028481
f
Gliclazide;40mg;oral (PO);Daily
QuestionChoice
10028483
h
Tamsuolosin;400mcg;oral (PO);Daily
QuestionChoice
10028479
d
Amlodipine;5mg;oral (PO);Daily
QuestionChoice
10028480
e
Colchicine;500mg;oral (PO);8-hourly
QuestionChoice
10028482
g
Paracetamol;500mg;oral (PO);PRN
QuestionChoice
10028477
b
Clindamycin;600mg;intravenous (IV);12-hourly
QuestionChoice
10028478
c
Ramipril;5mg;oral (PO);Daily
Concept
Chapter
2693
6071
Drugs causing diarrhoea (clindamycin, colchicine), dosing error (colchicine dose)
Topic
321
Elderly Care
1. Diarrhoea is a well recognised side-effect of both clindamycin and colchicine, and patients should be informed of this before initiating the latter as it is often a reason for non-compliance. Given the patient is being given intravenous clindamycin they should also have a stool sample taken to rule out C.difficile infection.
2. Colchicine is used to manage acute gout in patients with renal impairment in preference to allopurinol. It is important to recognise it is prescribed as *micrograms* not milligrams as in the prescription above.
18096
b e
e
Case presentation: A 73-year-old man is admitted to the acute medical ward with cellulitis. While an inpatient he also developed swelling and pain in his right knee and was commenced on medication for presumed gout.  One day after starting this medication he started to experience non-bloody diarrhoea.


**PH** Gout, Hypertension, Type 2 Diabetes, Gout, Chronic kidney disease, Osteoarthritis, Benign Prostatic Hyperplasia

**DH** His current regular medicines are listed (below).

Allergies - Penicillin (anaphylaxis)

**On Examination**
Afebrile, HR 84/min regular rhythm, BP 137/80 mmHg, mildly tender swollen right knee.

Question 1: Select the TWO prescriptions that are most likely to be contributing to his diarrhoea. (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).