QuestionMultiA
QuestionChoice
33772
c
Ibuprofen;400mg micrograms;oral (PO);PRN
QuestionChoice
33773
d
Cetirizine;10mg;oral (PO);PRN
QuestionChoice
33771
b
Tramadol hydrochloride;100mg;oral (PO);6-hourly
QuestionChoice
33777
h
Morphine sulphate;10mg;intravenous (IV);6- hourly
QuestionChoice
33775
f
Paracetamol;1g;oral (PO);6-hourly
QuestionChoice
33776
g
Ondansetron;4mg;intravenous (IV);Daily
QuestionChoice
33774
e
Tamsulosin;400 micrograms;oral (PO);Daily
QuestionChoice
33770
a
Prednisolone;10mg;oral (PO);Daily
QuestionComment
tamsulosin also causes cosntipatin
7432
QuestionComment
It can but it is listed as an uncommon side effect in the BNF, the other 3 answers given (tramadol, ondansetron and morphine) are the 3 most likely to cause constipation as it is listed as a common or very common side effect in the BNF for those drugs
16520
User
subscriber
Odor Poisoning
User
subscriber
Dr Brighton
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
2710
Withholding drugs in AKI
Topic
13
Neurosurgery
1. Opioids (tramadol and morphine sulphate) act on 𝜇-opioid receptors in the myenteric plexus to slow down bowel movements, which can lead to constipation. Ondansetron commonly causes constipation by delaying the colonic transit although the exact mechanism remains unclear. Cetirizine, tamsulosin and ibuprofen rarely cause constipation.
2. Systemic corticosteroids (prednisolone) commonly cause fluid retention via the stimulation of mineralocorticoid receptors, which lead to sodium and water retention.
6777
b g h
a
Case presentation: A 65-year-old man on the urology ward underwent a left-sided nephrectomy 2 days ago. Since the surgery, he had not been able to open his bowels. PH Benign prostatic hyperplasia, Osteoarthritis of left knee, Giant cell arteritis, mild hayfever, Back pain. DH His current regular medicines are listed (below).


**On Examination**
HR 84/min regular rhythm, BP 130/80 mmHg, symmetrical bipedal pitting oedema to mid calves

Question 1: Select the THREE prescriptions that are most likely to be contributing to his constipation (mark them with a tick in column A).
Question 2: Select the ONE prescription that is most likely to be contributing to his fluid retention (mark it with a tick in column B).