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Flashcards in Prescribing Safely Deck (13):

How does prescribing differ in children?

• Calculations of drug doses depend on age, weight or surface area of a child


Four things you need to prescribe specifically in children, when prescribing fluids?

- Fluid type (concentration)
- Volume (e.g. 500mL bag)
- Rate (mL/hour)
- Additives if required

- Need daily U&Es


How do you calculate fluids based on weight, over 24 hours?

• For every kg up to 10kg 100mL/kg/day
• For every kg between 10‐20 kg 50mLkg/day
• For every kg over 20kg 20mL/kg/day


How do you calculate fluid deficit in dehydrated children?

%dehydration x weight x 10= total fluid deficit (mls)

This represents the extra fluid that is needed so should be added to total maintenance requirements.


The usual fluid for neonates?

10% dextrose


Two types of adverse drug reactions?

Type A: pharmacological mechanism of drug causing an effect e.g. badycardia caused by Beta-Blockers, predictable and related to dose.

Type B: idiosyncratic/immunological, not predictable and not necessarily related to dose


Percentage of hospital admissions in the UK caused by ADRs?



Main regulatory agency in the UK for medicines?

The MHRA - The medical and healthcare products regulatory agency


Why is post-marketing surveillance (pharmacovigilance) important?

Clinical trials will often only pick up common S/Es


Steps in assessing someone with a suspected ADR?

1. Assess the nature and severity of the ADR

2. Take a history of the presenting symptoms including timing and dose.

3. Take a complete drug history.

4. Review the ADR profile of the drug. - has it been reported before, how common is it.

5. Consider further examination and investigations.


Steps in managing a suspected ADR?

1. Assess the reaction:
- Arrange emergency admission if ADR is life threatening

2. Review and discuss treatment with the individual.
- Consider stopping/alternative/changing dose

3. Manage symptoms.


Minimum requirement of information to be reported on a yellow card?

- One piece of patient information

- Names of suspected drug/drugs

- Brief description of the ADR

- Contact details of reporter


What drug reactions are particularly important to report?


Elderly people

Black triangle products (new drugs being monitored)

Serious reactions

Congenital abnormalities

Herbal remedies