Practice Questions Please attempt these questions and bring to the SAHD on 1 st April 2011.

Practice Questions

Please attempt these questions and bring to the SAHD on 1st April

2011

Intravenous Fluids

• It is worth your while looking at what fluids and volumes that are available for use on the wards

• If you get a chance, pop into a treatment room and have a look at what is there

• Prescribe the following intravenous infusions using the supplied sections of the drug kardex

Intravenous infusions

• Co-amoxiclav 1.2g IV infusion for three days

• Gentamicin 5mg/kg IV infusion OD in a 60kg patient. To be reviewed at 24 hours

• Pantoprazole 40mg IV infusion OD

• Benzylpenicillin 600mg QDS IV infusion

• Tobramycin IV Infusion in a 66.7kg patient

Infusions

• Include any information that will enable the drug to be given safely

• Includes– Drug name, route, frequency,– Infusion fluid and rate– Signature and date

Typical fluids include

• Sodium Chloride 0.9%, glucose 5%, Hartmann’s

• 100ml, 250ml, 500ml, 1litre bags

• Not all fluids are available in each size – always check!

• Some BNF instructions include reconstitution

• You don’t need to worry about this when prescribing – concentrate on the final fluid volume (unless your reconstitution volume is significant)

“Intermittent in sodium chloride 0.9% or Water for injections.

Dilute with 100ml infusion fluid and give over 30-40 minutes.”

To ensure the patient only receives the 3 days you want, block off any remaining boxes

“Intermittent or via drip tubing in glucose 5% or sodium chloride 0.9% .

Suggested volume for intermittent infusion 50-100ml given over 20-30 minutes (given over 60 minutes for once daily dose regimen).”

“Intermittent in Glucose 5% or Sodium Chloride 0.9%

…dilute with 100ml infusion fluid; give 40mg over 15 minutes”

“Intermittent in Glucose 5% or Sodium Chloride 0.9%. Suggested volume 100ml given over 30-60minutes. Continuous infusion not usually recommended.”

“Intermittent or via drip tubing in Glucose 5% or Sodium Chloride 0.9%.

For adult intermittent infusion suggested volume 50-100ml…given over 20-60 minutes”

Controlled drugs prescriptions

• For each prescription, the patient’s details are– Name: Adam Robinson– Address: 2 Clifford Bridge Road, Coventry– Date of Birth: 01/01/1944– Hospital number: AA1133454– Allergies: Nil known

• What would you write on the TTO form when sending a patient home on the following?

• Two weeks worth of modified release oxycodone 80mg BD.

• A one week supply of hydromorphone SR 4mg BD and hydromorphone 1.3mg up to 4 hourly when required.

• Fentanyl lozenges 200micrograms 2 hourly when required for 5 days.

• Buprenorphine 35 microgram/hour patches for one month.

• A one month supply of morphine sulphate SR 20mg BD.

Two weeks worth of modified release oxycodone 80mg BD.

• Prescribe:– Oxycodone MR tablets – 80mg BD– Supply 28 (twenty eight) x 80mg tabs

A one week supply of hydromorphone SR 4mg BD and hydromorphone 1.3mg up to 4

hourly when required.

• Prescribe– Hydromorphone MR Capsules– 4mg BD– Supply 14 (fourteen)

AND– Hydromorphone 1.3mg Caps– Take 1 capsule 4 hourly when required– Supply 28 (twenty eight)

Fentanyl lozenges 200micrograms 2 hourly when required for 5 days.

• Fentanyl 200microgram lozenges

• Suck one lozenge 2 hourly when required for pain relief

• Supply 30 (thirty)

Buprenorphine 35 microgram/hour patches for one month.

• Burprenorphine 35microgram/hour patches

• Apply one patch every 96 hours

• Supply 8 (eight) patches

A one month supply of morphine sulphate SR 20mg BD.

• Prescribe– Morphine sulphate SR 10mg tablets– Take 2 BD– Supply 120 (one hundred and twenty) x 10mg

tablets