QuestionPrescription
QuestionComment
Why not dabigatran?
39918
QuestionComment
They said they did not want a needle so not SC. 
40081
User
subscriber
Acute DNA
User
subscriber
Recessive Myopathy
QuestionComment
There was no option for apixaban 2.5 mg tablets (it only showed 5 and 10 mg), and also frequency was fixed on "daily" so I couldn't change it to 'twice daily'
60436
User
subscriber
Aortic Aneurysm
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
2693
Post-Operative Thromboprophylaxis 
Topic
13
Neurosurgery
## Drug choice feedback

As this patient is needle phobic, Low Molecular Weight Heparins (LMWHs) are not appropriate as these are delivered by subcutaneous injection. Alternatives include low-dose aspirin, Apixaban and Rivaroxaban.

Venous thromboembolism (VTE) prophylaxis is a common topic for PSA questions. Make sure to read the details of the question carefully and use the BNF treatment summary guidance on venous thromboembolism prophylaxis carefully.

## Dose/Route/Frequency/Duration feedback

Apixaban/Aspirin/Rivaroxaban should be given at a 2.5mg/75mg/10mg dose as an oral tablet for 10-14 days when given for VTE prophylaxis.
10056
PrescriptionAnswer
PrescribeAnswerData
10 mg
PrescribeAnswerData
rivaroxaban 10 mg tablets
PrescribeAnswerData
2 weeks
PrescribeAnswerData
daily (OD)
PrescribeAnswerData
oral (PO)
PrescriptionAnswer
PrescribeAnswerData
75 mg
PrescribeAnswerData
aspirin 75 mg tablets
PrescribeAnswerData
2 weeks
PrescribeAnswerData
daily (OD)
PrescribeAnswerData
oral (PO)
PrescriptionAnswer
PrescribeAnswerData
2.5 mg
PrescribeAnswerData
apixaban 2.5 mg tablets
PrescribeAnswerData
2 weeks
PrescribeAnswerData
twice daily (BD)
PrescribeAnswerData
oral (PO)
Case Presentation: A 68-year-old female patient is on the orthopaedic ward after having an elective knee replacement for osteoarthritis. She is now 10 hours post-surgery. She is needle phobic and categorically refuses any further injections. 




## PH
Hypothyroidism


## DH
Levothyroxine 75mg OD


## On examination
The patient looks well at rest.


Weight 72kg


HR 86, RR 18, BP 128/84, Temperature 36.8°C


## Investigations


||||
|---------------------------|:-------:|--------------------|
|Sodium|138 mmol/L|135 - 145|
|Potassium|4.5 mmol/L|3.5 - 5.3|
|Urea|5.0 mmol/L|2.5 - 7.8|
|Creatinine|100 µmol/L|60 - 120|
|eGFR|80 mL/min/1.73m<sup>2</sup>|> 60|


# Prescribing Request


Write a prescription for one drug for prophylaxis of venous thromboembolism in this patient.