SECTION 1 - INPATIENT PRESCRIBING EXERCISE
Please review the patient details below and then download the document included at the bottom of this webpage titled 'Prescribing Charts'. You can then review the charts included in the document, searching for errors and filling any gaps. Following this, learning points and corrected charts can be found in the second part of the document.
PATIENT DETAILS:
- Joe Patient dob 18/03/1945, weight 60 kg, height 170 cm and ex-heavy smoker is brought in by ambulance with increasing shortness of breath, chest crepitations, high volume purulent sputum, falling oxygen saturations and pyrexia. He has no known allergies.
- His medication prior to admission is:
- Tiotropium capsules for inhalation 18 micrograms od
- Symbicort 400/12 Turbohaler one puff bd
- Furosemide 20 mg om
- Salbutamol inhaler 2 puffs prn
- It is confirmed that this is an infected exacerbation of his COPD and he is to be treated with nebulisers, antibiotics, steroids and increased diuretic therapy
- After an hour he is not responding, and intravenous aminophylline is recommended
- 5 hours later, the next morning his breathing has improved
- His potassium (K+) has dropped to 3 mmol/L and he develops atrial fibrillation (AF)
- His K+ deficit is corrected intravenously
- Electrical cardioversion fails and oral amiodarone is started
- On account of his CHA₂DS₂-VASc and HASBLED score, anticoagulation is recommended to reduce his risk of stroke
- Clotting screen, U&Es, FBC and LFTs are within normal range
- The pharmacist has calculated the creatinine clearance as 65 mL/minute
Note: there are many different versions of hospital prescriptions and administration charts. Before starting it may be useful to familiarise yourself with all the different sections of the drug chart you will be using in your current role.
DOWNLOAD: Prescribing Charts