UMP Y5

prescribing in elderly care - constipation.

What are the options?

What if the patient has opioid induced constipation?

Stimulant - Senna, Bisacodyl

- CI in bowel obstruction!), rectal glycerol suppository

Osmotic - Lactulose, Macrogol (draws water from large bowel)

- not recommended if patient feeling bloated + beware of dehydration!

Softener - Docusate

- [docusate is both softener and stimulant)

Bulking - Ispaghula husk

- if inadequate fiber intake

- take at least 72 hours to work)

if opioid induced constipation:

- osmotic laxative + stimulant laxative

- Avoid bulk-forming laxatives

prescribing in elderly care - what medications can cause acute confusion

hi

prescribing in paediatrics how to prescribe fluids

100 ml/kg/day for the first 10kg of weight

50 ml/kg/day for the next 10kg of weight

20 ml/kg/day for weight over 20kg

prescribing in paediatrics what to include for a prescription for a solution

1. drug name and name of formulation

2. dose, frequency and route

3. how much to supply

prescribing in paediatrics fluids

prescribing in pregnancy preconception advice

• Avoid valproate and carbamazepine

• Lamotrigine, levetiracetam are lower risk

• Folic acid 5mg od preconception to 12 weeks to

reduce NTD risk

• Aspirin 150mg od for hypertension in pregnancy

risk reduction by 12 weeks of pregnancy

prescribing in pregnancy UTI

nt (alphabetical)

avoid trimethoprim in first trimester (bc it is a folate antagonist)

avoid nitrofurantoin in late third trimester

prescribing in pregnancy what antiemetics to give

- cyclizine

- prochlorperazine

- metoclopramide

- ondansetron

prescribing in pregnancy what medications to avoid

W → Warfarin

A → ACE inhibitors / ARBs

R → Retinoids (Isotretinoin)

F → Folate antagonists (Methotrexate, Trimethoprim in 1st trimester). Nitrofurantoin in late 3rd trimester

I → Isotretinoin (again reinforces retinoids)

L → Lithium

M -> Metoclopramide for >5 days (acute dystonic reaction)

T → Tetracyclines

V → Valproate and carbamazepine