M14 Clinical seminar: ADRs and Drug interactions
Adverse drug reactions
1. A patient prescribed methotrexate has a blood test and the result is as follows:
Neutrophils 1.3 x 10
9
/L
Platelets 100 x 10
9
/L
What could have caused this result and what action should be taken?
2. A patient with a previous anaphylactic reaction to amoxicillin is prescribed
cefalexin by a junior doctor, what would concern you about this prescribing?
3. A patient is admitted to hospital with an acute exacerbation of COPD. They are
prescribed:
Amoxicillin 500mg tds
Nebulised salbutamol
Prednisolone 40mg od
The patient’s daughter rings to ward to find out how her mum has been
overnight. The nursing staff reports that she has been very agitated overnight,
confused and irritable. The daughter reports that this is out of character for her
mum. What could have caused these symptoms?
4. A patient is receiving treatment for hypertension. The doctor has recently added
doxazosin 2mg daily to her prescription and since doing so she has felt dizzy on
standing and very lightheaded when getting out of the bath, she has also had to
get up to go to the loo several times through the night. Why do you think this is
happening?
5. A patient is prescribed tramadol 50mg 1-2 qds prn and ferrous sulphate 200mg 1
tds. He comes to the pharmacy asking for advice as he has constipation, how
would you respond?
6. Why might a patient prescribed chlorpromazine for schizophrenia also be
prescribed procyclidine?
7. A patient has been prescribed olanzapine for two years has a routine blood test
and is found to have a raised fasting blood sugar. Why could this have occurred?
8. A patient has started to develop gynaecomastia after taking cimetidine for
several months. How should this be managed?
9. A patient stabilised on furosemide 80mg od for peripheral oedema has recently
had a blood test at her GP which showed low potassium levels. Her oedema, for
the most part, is under control. How should this be managed?
