Prescribing Scenarios at a Glance

Emma Baker is Professor of Clinical Pharmacology, St. George's, University of London, and Consultant Physician, St. George's Healthcare NHS Trust, London Daniel Burrage is Academic Clinical Fellow, St. George's, University of London, and Specialty Registrar (ST3) in Clinical Pharmacology, General Medicine and Stroke Medicine, St. George's Healthcare NHS Trust, London Dagan Lonsdale is Academic Clinical Fellow, St. George's, University of London, and Specialty Registrar (ST3) in Clinical Pharmacology, General Medicine and Intensive Care Medicine, St. George's Healthcare NHS Trust, London Andrew Hitchings is Clinical Research Fellow, St. George's, University of London, and Specialty Registrar (ST7) in Clinical Pharmacology, General Medicine and Intensive Care Medicine, St. George's Healthcare NHS Trust, London

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• Acknowledgements 7Dedication 7List of abbreviations 8How to use your textbook 10About the companion website 13Introduction: Practical prescribing scenarios 14Please note that the prepared drug charts can be found in the accompanying workbook.Case PageSection 1: The acute take Case Drug chart Answer1 An 82-year-old woman who requires venous thromboembolism prophylaxis 30 1.1 382 A 104-year-old woman with respiratory failure 30 2.1 403 A 64-year-old man with severe acute abdominal pain 31 3.1 414 A 55-year-old woman with atrial fi brillation 31 4.1 435 A 32-year-old man with community-acquired pneumonia 32 5.1 456 A 45-year-old woman with status epilepticus 32 6.1 477 A 27-year-old woman with suspected bacterial meningitis 33 7.1 488 A 31-year-old woman with paracetamol overdose 34 8.1 509 A 59-year-old man with acute pulmonary oedema 35 9.1 5210 A 24-year-old woman with acute asthma 35 10.1 5411 A 57-year-old man who has suddenly deteriorated 36 11.1 5712 An 84-year-old man taking warfarin who has a headache 36 12.1 5913 A 66-year-old man with acute coronary syndrome 37 13.1 6114 A 67-year-old man with an exacerbation of COPD 37 14.1 64Section 2: On call in the hospital Case Drug chart Answer15 A 91-year-old man with hypoglycaemia 68 15.1 8216 A 60-year-old woman requesting night sedation 68 16.1 8317 A 62-year-old man with suspected opioid toxicity 69 17.1 8418 A 58-year-old man who has low blood pressure 69 18.1 8619 A 44-year-old woman who is ‘nil by mouth’ 70 19.1 8820 A 59-year-old man with circulatory compromise 70 20.1 9021 A 15-month-old girl with gastroenteritis 71 21.1 9322 A 5-year-old boy with a painful right arm 71 22.1 9423 A 12-hour-old boy with signs of sepsis 72 23.1 9624 A 60-year-old man who has developed a hot joint 72 24.1 9725 A 65-year-old man with hypokalaemia 73 25.1 9926 A 69-year-old woman being treated with gentamicin 73 26.1 10227 A 69-year-old man anticoagulated with warfarin 74 27.1 10428 A 28-year-old woman with nausea 74 28.1 10529 A 29-year-old man who is in pain following an operation 75 29.1 10730 A 49-year-old man due to undergo surgery 75 30.1 11031 A 79-year-old woman with acute kidney injury 76 31.1 11232 An 85-year-old woman with hospital-acquired pneumonia 77 32.1 11433 A 47-year-old man who has developed an abnormal liver profile 78 33.1 11634 An 83-year-old man who develops diarrhoea 79 34.1 11835 An 88-year-old man with hyperkalaemia 80 35.1 12136 A 69-year-old woman with acute alcohol withdrawal 81 36.1 123Section 3: Routine inpatient review Case Drug chart Answer37 A 69-year-old woman with constipation 128 37.1 13538 A 71-year-old man who has developed a tremor 128 38.1 13639 An 81-year-old woman at risk of fragility fractures 129 39.1 13840 A 23-year-old pregnant woman with pulmonary embolism 129 40.1 14041 A 31-year-old man with increased seizure frequency 130 41.1 14142 A 58-year-old man with diabetes mellitus treated with insulin 130 42.1 14343 A 53-year-old man who wants to stop smoking 131 43.1 14644 A 90-year-old woman on numerous medications 131 44.1 14845 A 54-year-old woman with a peptic ulcer 132 45.1 15046 A 64-year-old woman with chronic kidney disease 132 46.1 15247 A 66-year-old man with palpitations 133 47.1 15448 A 70-year-old man with ST-elevation acute coronary syndrome 133 48.1 15649 A 49-year-old woman with chronic liver disease complaining of pain 134 49.1 15850 An 89-year-old man approaching the end of life 134 50.1 160Appendix 1 Antibiotic guidelines 163Appendix 2 Case summaries 164Index 166