QuestionMultiA
QuestionChoice
33885
h
Prochlorperazine;75mg;Oral (PO);Daily
QuestionChoice
33884
g
Metoclopramide hydrochloride;10mg;Oral (PO);8-hourly when required
QuestionChoice
33882
e
Digoxin;187.5mg;Oral (PO);Daily
QuestionChoice
33878
a
Co-careldopa;125mg;Oral (PO);8-hourly
QuestionChoice
33879
b
Enalapril maleate;10mg;Oral (PO);12-hourly
QuestionChoice
33883
f
Ibuprofen;400mg;Oral (PO);6-hourly when required
QuestionChoice
33880
c
Rivaroxaban;20mg;Oral (PO);Daily
QuestionChoice
33881
d
Carvedilol;3.125mg;Oral (PO);12-hourly
QuestionComment
why is co-careldopa not written 25/100mg?
17102
User
subscriber
Juice Gas
QuestionComment
is that not a whopping dose of digoxin??

61650
User
subscriber
Lung Contusion
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
2724
Dosing error & drugs worsening Parkinson’s
Topic
74
Elderly Care
1. Both metoclopramide and prochlorperazine are dopamine D2 receptor antagonists that can precipitate and worsen parkinsonian symptoms. Hence, BNF advises that they should be used with caution in patients already diagnosed with Parkinson’s disease.
2. The maintenance dose of digoxin for atrial fibrillation is 125–250 micrograms daily. Hence, the dose prescribed is likely to be a transcription error of the micrograms to mg.
6791
g h
e
Case presentation: A 75-year old man attends the Parkinson clinic with increasing frequencies of involuntary movement. PH: Parkinson’s disease, Atrial fibrillation, Congestive Heart Failure, Migraine, Schizophrenia DH: His current regular prescriptions are listed below


**On examination**: Pill-rolling resting tremor seen on right hand, cog-wheel rigidity, bradykinesia, micrographia
**Vital signs**: BP 122/78, Temperature 36.5°C, HR 80, O2 Sat 99% (room air), RR 18

Question 1: Select the TWO prescriptions that are most likely to be a cause for the worsening of his Parkinson’s signs and symptoms? (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)