QuestionMultiA
QuestionChoice
33933
e
Ibuprofen;400mg;Oral (PO);8-hourly when required
QuestionChoice
33935
g
Omeprazole;20 mg;Oral (PO);Daily
QuestionChoice
33932
d
Paracetamol;1 g;Oral (PO);6 -hourly
QuestionChoice
33934
f
Phenoxymethylpenicillin;5 mg;Oral (PO);6-hourly
QuestionChoice
33929
a
Enalapril maleate;20 mg;Oral (PO);Daily
QuestionChoice
33931
c
Simvastatin;40mg;Oral (PO);Nightly
QuestionChoice
33930
b
Metformin hydrochloride;500 mg;Oral (PO);Three times daily
QuestionComment
Wouldn't ibuprofen also be avoided during pregnancy?
6438
QuestionComment
No so it says avoid unless benefit outweigh the risk. Simvastatin is like a big no no
17383
User
subscriber
Fungal Tyrosine
User
subscriber
Gland Botox
QuestionComment
Ibuprofen 4 hourly would mean they could have it 6 times in a day...? 4 times a day is the maximum is it not?
6856
User
subscriber
Giggy G
QuestionComment
Ibuprofen is avoid in 1st and 2nd trimesters unless essential which is the same guidance as ACE?
61657
QuestionComment
I think pregnancy is a complete C/I for ACEi
61722
User
subscriber
CT Kinase
User
subscriber
Epidermis Benign
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
2731
Contraindicated in pregnancy & dosing error
Topic
76
Obstetrics and Gynaecology
1. BNF advises that angiotensin-converting enzyme inhibitor (ACE-i) like enalapril ACE should be avoided in pregnancy unless essential. This is because it may adversely affect fetal and neonatal blood pressure control and renal function. ACE-I has also been reported to cause skull defects and oligohydramnios
-BNF advises that all vitamin K agonists should be avoided in first trimester of pregnancy. Warfarin may cross the placenta and increase the risk of congenital malformations and neonatal haemorrhage, especially during the last few weeks of pregnancy and at delivery.
-BNF advises that statins should be avoided in pregnancy due to the increased risk of congenital anomalies. The decrease in synthesis of cholesterol is thought to affect fetal development. Hence, BNF recommends the discontinuation of statin 3 months before attempting to conceive.
2. The correct dose of phenoxymethylpenicillin for otitis media should be 500 mg to 1 g every 6 hours and not 5 mg 6-hourly.
6798
a c
f
Case presentation: A 36-year old woman presents to her GP with amenorrhoea. She reports that her period was supposed to due three weeks ago. She is quite concerned about this because her menstrual cycle has always been regular. Besides that, she notices that she has put on some weight and feels nauseous regularly. PH: Hypertension, Type 2 diabetes mellitus, Hypercholesterolemia, venous thromboembolism, otitis media, constipation DH: Her current regular prescriptions are listed below


**On examination**:
Chest is clear with no added lung sounds. Heart sounds I + II + 0. Abdomen soft and non tender. Normal pelvic examination, normal breast examination

**Investigation**:
Positive human chorionic gonadotrophin (HCG) pregnancy test

Question 1: Select the TWO prescriptions that should be avoided in the context of a pregnancy? (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)