Osce Drugs

What class is acetaminophen, and what is it for?

Analgesic and antipyretic; used for mild–moderate pain and fever.

What is an Analgesic?

A medication that reduces pain.

What is an Antipyretic?

A medication that lowers fever.

What do I assess before giving acetaminophen?

Liver function, patient’s alcohol use, and total daily dose (max 4 g/day).

What is the maximum daily dose of acetaminophen?

4 g/day (many hospitals use 3 g/day for safety).

When would I hold acetaminophen?

Liver disease, alcohol intoxication, or if the patient already reached the max daily dose.

What are the side effects of acetaminophen?

Nausea

Rash

Liver toxicity (most important, watch for RUQ pain or jaundice)

What should I teach the patient about acetaminophen?

Avoid alcohol; don’t take other meds that contain acetaminophen.

What class is digoxin and what is it used for?

Cardiac glycoside; used for heart failure and atrial fibrillation.

What is a Cardiac Glycoside?

A medication that makes the heart beat stronger and slower.

What is Atrial Fibrillation?

The top chambers of the heart shakes causing it to beat fast and irregular.

What must I check BEFORE giving digoxin?

Apical pulse for 1 full minute and potassium level (Low K+ levels increase toxicity risk).

When do I hold digoxin?

If HR is less than 60 bpm or patient shows signs of toxicity.

What is the therapeutic digoxin level?

0.5–2.0 ng/mL.

What are the signs of digoxin toxicity?

Nausea, vomiting, anorexia, confusion
Yellow or green vision halos.

What are the side effects of digoxin?

Bradycardia

Arrhythmias

GI upset

What do I teach patients taking digoxin?

Check pulse daily, never double a missed dose, report nausea/vomiting or vision changes.

What class is metoprolol and what is it used for?

Beta-1 selective blocker; used for hypertension, angina, heart failure, and arrhythmias.

What is a Beta-1 selective blocker?

A medication that slows the heart and lowers blood pressure by blocking stress signals to the heart.

What is Angina?

Chest pain caused by the heart not getting enough oxygen.

What do I assess before giving metoprolol?

Heart rate and blood pressure.

When do I hold metoprolol?

If HR is less than 60 bpm or SBP is less than 90.

What are the side effects of metoprolol?

Bradycardia

Hypotension

Fatigue

Dizziness

Masked hypoglycemia (important for diabetics)

Why be cautious when giving metoprolol to diabetics?

It masks hypoglycemia symptoms.

What are the signs/symptoms of hypoglycaemia?

Shaking, sweating, hunger, dizziness.

What patient education is needed for metoprolol?

Change positions slowly, don’t stop abruptly, monitor HR/BP.