QuestionMultiA
QuestionChoice
33839
a
Pramipexole;2mg;oral (PO);12-hourly
QuestionChoice
33840
b
Atenolol;50mg;oral (PO);Daily
QuestionChoice
33845
g
Paracetamol;1000mg;oral (PO);Daily
QuestionChoice
33841
c
Alendronic acid;70mg;oral (PO);Weekly
QuestionChoice
33842
d
Cholecalciferol 200 units + calcium carbonate 750mg (Adcal D3 ®);2 tablets;oral (PO);Daily
QuestionChoice
33844
f
Metformin;500mg;oral (PO);8-hourly
QuestionChoice
33843
e
Lansoprazole;15mg;oral (PO);Daily
QuestionComment
Oral in frequency... seems like an error too...
13580
User
subscriber
Blink
QuestionComment
BNF says common side effect of lansoprazole is insomnia ??
17710
User
subscriber
Gastro CT
QuestionComment
1g of paracetamol oral daily isnt right.. surely it would be qds like in every other question Ive seen?
38101
QuestionComment
it's not the maximum dose sure but it isn't a serious dosing error
40522
User
subscriber
Emma
User
subscriber
Intravenous Ketone
QuestionComment
I put the correct answers but was marked incorrect?
40259
User
subscriber
Pudendal QRS
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
2719
Sleeping disorder & dosing error
Topic
75
GP
1. Pramipexole, a non-ergoline dopamine agonist and systemic beta blockers (atenolol) commonly cause sleeping disorders. Although excess daytime sleepiness and sleep attacks are recognized side effects of pramipexole, the underlying pathophysiology remained controversial. Beta blockers cause night awakening and nightmares, likely due to the inhibition of melatonin secretion, a hormone that is involved in sleep and the body’s circadian clock
2. Pramipexole, given for treatment of Parkinson's Disease has a maximum dose of 3.3mg daily. 2mg 12-hrly is more than the recommended maximum dose and alternative adjuncts should be considered instead.
6786
a b
a
Case presentation: An 80-year-old woman presents to her GP for her medication review, she complains of fatigue due to poor sleep. PH Osteoporosis, Type 2 diabetes, Dyspepsia, Parkinson Disease, hypertension. DH Her current regular medicines are listed (below).


Question 1: Select the TWO prescriptions that are most likely to be contributing to her sleeping disorders (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).