PRESCRIPTION REVIEW

Question 1

PRESCRIBING ERROR
what are the 3 main things to check first?

Answer 1

• dose/units (mcg, mg, g)
• frequency/timing (OD, BD, TDS, QDS, divided doses, PRN, weekly, monthly)
• route (PO, IV, SC etc)

Question 2

PRESCRIBING ERROR
which drugs are commonly prescribed in micrograms?

Answer 2

• levothyroxine
• tamsulosin
• digoxin
• naloxone
• fludrocortisone
• inhalers
• GTN spray
• ipratropium nebs

Question 3

PRESCRIBING ERROR
which medications are commonly prescribed in grams?

Answer 3

• paracetamol
• lithium
• calcium carbonate
• NAC

Question 4

PRESCRIBING ERROR
which medications are commonly prescribed in the morning?

Answer 4

• diuretics
• steroids

Question 5

PRESCRIBING ERROR
which medications are prescribed at night?

Answer 5

• statins
• night sedation

Question 6

PRESCRIBING ERROR
which medications are prescribed weekly?

Answer 6

• bisphosphonates
• methotrexate/folic acid
• patches

Question 7

PRESCRIBING ERROR
which medications need to be prescribed at the same time each day?

Answer 7

parkinsons meds

Question 8

SIDE EFFECTS
which medications cause hypoglycaemia?

Answer 8

• insulin
• sulphonylureas

Question 9

SIDE EFFECTS
which medications cause hyperglycaemia?

Answer 9

• steroids
• antipsychotics
• thiazides
• beta blockers
• tacrolimus

Question 10

SIDE EFFECTS
which medications cause constipation?

Answer 10

• opioids
• iron
• CCBs (amlodipine, verapamil)
• some diuretics
• antiemetics (ondansetron, metoclopramide)
• some antiepileptics
• some parkinsons meds
• antacids containing calcium
• anticholinergics (antidepressants, antihistamines, incontinence meds, antipsychotics)

Question 11

SIDE EFFECTS
which medications cause diarrhoea?

Answer 11

• antibiotics (c.diff)
• colchicine
• metformin
• PPIs
• antacids containing magnesium
• laxatives

Question 12

SIDE EFFECTS
which medications cause urinary retention?

Answer 12

• opioids
• anticholinergics

Question 13

SIDE EFFECTS
which medications cause urinary incontinence?

Answer 13

• alpha blockers
• diuretics
• anticholinesterase inhibitors
• clozapine

Question 14

SIDE EFFECTS
which medications cause confusion?

Answer 14

• opioids
• sedatives
• anticholinergics

Question 15

SIDE EFFECTS
which medications cause falls?

Answer 15

• benzodiazepines
• antidepressants (esp TCAs and SNRIs)
• MAO
• antipsychotics
• opiates
• most antihypertensives
• parkinsons meds (ropinirole, selegeline)
• antiepileptics

Question 16

SIDE EFFECTS
which medications cause gout?

Answer 16

• diuretics

Question 17

SIDE EFFECTS
which medications cause osteoporosis?

Answer 17

• steroids
• PPIs
• LHRH agonist (bureslin, goreslin)

Question 18

SIDE EFFECTS
which medications cause hypertension?

Answer 18

• NSAIDs
• steroids
• oral contraceptives
• mirabegron

Question 19

SIDE EFFECTS
which medications cause high cholesterol?

Answer 19

• steroids
• thiazides

Question 20

SIDE EFFECTS
which medications cause hypokalaemia?

Answer 20

• loop diuretics (furosemide, bumetanide)
• thiazides
• steroids
• salbutamol

Question 21

SIDE EFFECTS
which medications cause hyperkalaemia?

Answer 21

• K sparing diuretics (spironolactone, eplerone, amiloride, triamterene)
• ACE inhibitors
• ARBs
• unfractioned heparin / LMWH
• blood transfusion

Question 22

SIDE EFFECTS
which drugs cause hyponatraemia?

Answer 22

• SSRIs (sertraline, citalopram, fluoxetine)
• TCAs
• carbamazepine
• opiates
• PPIs

Question 23

SIDE EFFECTS
which drugs can cause hypernatraemia?

Answer 23

• lithium
• demeclocycline

Question 24

which medications should be continued if intercurrent illness?

Answer 24

• steroids (double dose)

Question 25

which medications should be stopped during intercurrent illness?

Answer 25

- metformin - statins - gliflozins

Question 26

which medications should be stopped if trying to conceive?

Answer 26

-some antiepileptics - some antipsychotics - isotretinoin - methotrexate - warfarin (women of childbearing age should avoid handling crushed or broken tablets of finasteride)

Question 27

when do you stop anticoagulants before surgery?

Answer 27

- DOACs = 48 hrs before - clopidogrel = 7 days before - warfarin = bridging plan with LMWH

Question 28

which drugs are likely to worsen parkinsons disease?

Answer 28

- typical antipsychotics (haloperidol, chlorpromazine) - atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine) - antiemetics (metoclopramide, chlorpromazine, prochloperazine) - antidepressants (phenelzine, amoxapine, isocaroxazid)

Question 29

which drugs can worsen myasthenia gravis?

Answer 29

- antibiotics - beta-blockers - local anaesthetics - sedating drugs

Question 30

which drugs can worsen heart failure?

Answer 30

- NSAIDs - CCBs - pioglitazone

Question 31

which drugs can worsen psoriasis?

Answer 31

- beta blockers - lithium - some antibiotics

Question 32

which drugs impair renal function?

Answer 32

DAMN - diuretics - ACEi and ARBs - Metformin - NSAIDs

Question 33

which drugs cause oral candidiasis?

Answer 33

- oral inhaled corticosteroids - antibiotics - immunosuppresants

Question 34

which drugs can cause euglycaemic DKA?

Answer 34

- SGLT2s (-gliflozins)