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Pass the PSA: Session 1 9 January 2024Learning objectives ● Navigating medicines complete (drug monographs, treatment summaries) ● Prescribing ○ fluids: maintenance, resus, hypoglycaemia, hyperkalaemia, hypocalcaemia ○ insulin ○ asthma/COPD exacerbation ○ contraception ● Drug monitoring ○ blood work ○ clinical factors (obs, weight, symptom control, etc) Number of Recommended Section Questions Marks per Question Overall Timing Prescribing 8 10 45-50 mins Prescription Review 8 4 20 mins Planning Management 8 2 8 mins Providing Information 6 2 6 mins Calculation Skills 8 2 10 mins Adverse Drug Reactions 8 2 8 mins 8 2 Drug Monitoring 8 mins Data Interpretation 6 2 6 minsPrescribing ● 8 questions ● 10 marks each: 5 for correct drug, 5 for correct dose/route/frequency ● Topics:Prescribing ●Drug monitoring ● 8 questions ● 2 marks each, total 16 marks ● Topics:Calculation skills ● 8 questions ● 2 marks each, total 16 marks ● Topics:Access to BNF ● Through BNF and BNFc itself ● Also through Medicines Complete Questions 30 seconds per markQuestion 1 Case presentation Prescribing request A 42-year-old woman presents to A&E with severe upper Write a prescription for ONE IV fluid that is most appropriate quadrant pain and vomiting for the past 2 days. PMH: to treat her hypotension and tachycardia. gallstones, asthma, eczema. DH: Trimbow inhaler MDI, (use the hospital IV fluid prescription form provided) salbutamol sulfate 100micrograms MDI, hydrocortisone 1% cream On examination She is drowsy and pale. Temperature 37.8ºC, HR 120bpm PRESCRIPTION FORM rhythm regular, BP 88/56, RR 18breaths/min, O2 Infusion fluid saturations 98% on room air. Warm peripheries, bounding [insert fluid] pulses, normal heart sounds. Investigations Volume Route Hb 132 (115-165), WCC 25.6 x10^9L (3.0-10.0), Na+ 146 (137-144), K+ 4.2 (3.5-5.3), U 9.8 (2.5-7.0), Cr 110μmol/L [insert volume] IV Duration Infusion rate (mL/min) (60-110) ECG shows sinus tachycardia, no ischaemic changes [insert duration] - CXR normal Prescriber [your name] Date Time 19:00 09/01/2025Question 2 Case presentation Prescribing request A 69-year-old man is on the stroke ward having experienced Write a prescription for ONE IV fluid that is most appropriate right hemiplegia and dysphagia starting around 24 hours ago. as the next bag to maintain his hydration whilst he is nil by He is NBM due to an unsafe swallow. PMH: diabetes, hypertension. DH: atorvastatin 80mg ON, metformin 500mg mouth. TDS, amlodipine 5mg OD, aspirin 300mg OD (use the hospital IV fluid prescription form provided) On examination Temperature 36.5ºC, HR 80bpm rhythm regular, BP 142/88, JVP not visible, RR 11 breaths/min, O2 saturations 96% on PRESCRIPTION FORM room air. Heart sounds normal. No peripheral oedema. Catheterised; urine output 80ml/hour since admission. Infusion fluid Estimated weight 80kg. [insert fluid] Investigations Volume Route Hb 145 (115-165), WCC 4.2 x10^9L (3.0-10.0), Na+ 142 (137-144), K+ 3.7 (3.5-5.3), U 3.5 (2.5-7.0), Cr 87μmol/L (60-110), [insert volume] IV eGFR 68mL/min. Random glucose 6.2mmol/L. CT head without contrast: left middle cerebral artery infarct. Duration Infusion rate (mL/min) IV fluids received so far: 1) Sodium chloride 0.9%/potassium chloride 0.15% [insert duration] - solution 1000mL over 12 hours Prescriber [your name] Date Time 19:00 2) Sodium chloride 0.9%/potassium chloride 0.15% solution 1000ml over 12 hours 09/01/2025Question 3 Case presentation Prescribing request A 30-year-old woman is in the Emergency Department with Write a prescription for ONE IV fluid that is most appropriate worsening irritability and drowsiness. Her GCS has dropped to treat her symptoms. from 15 to 9 since admission. PMH: T1DM, DH: NovoRapid 6 units SC TDS with meals, Lantus (use the hospital IV fluid prescription form provided) 20 units SC OD On examination She is unresponsive and appears clammy. Temperature 36.8ºC, HR 99bpm rhythm regular, BP 110/70, RR 16breaths/min, O2 PRESCRIPTION FORM saturations 98% on room air. Infusion fluid Investigations A VBG is done: [insert fluid] pH 7.40 (7.35–7.45), pCO₂ 5.3 kPa (4.7–6.0), HCO₃⁻ 24 mmol/L Volume Route (22–26), Base Excess 0 mmol/L (-2 to +2), Lactate 1.2 mmol/L (0.5–2.0), Glucose 2.2 mmol/L (4–7 fasting), Sodium 138 mmol/L [insert volume] IV (135–145), Potassium 4.0 mmol/L (3.5–5.0), Chloride 102 Duration Infusion rate (mL/min) mmol/L (98–107), pO₂ 6.5 kPa (4.5–6.7 venous) [insert duration] - Prescriber [your name] Date Time 19:00 09/01/2025Question 4 Case presentation Prescribing Request: A 23-year-old woman presents to the Emergency Write a prescription for the initial insulin therapy Department with a 1-day history of abdominal pain, required to treat her diabetic ktoacidosis (DKA). Use the nausea, and vomiting. PMH none. DH none. provided hospital insulin infusion chart. On Examination: (use the hospital IV fluid prescription form provided) Drowsy GCS14. Temperature 37.8°C, HR 120 bpm, BP 95/65, RR 26 breaths/min, O2 Sats 98% breathing air. Weight 60kg. Capillary Blood Glucose: 22 mmol/L, Ketones: 5.8 mmol/L PRESCRIPTION FORM Clinical Signs: Dry mucous membranes, Kussmaul Medication breathing, no focal signs of infection Investigations [insert medication] Arterial blood gas: pH 7.15, HCO₃⁻ 12 mmol/L, Anion Gap 22 Dose Route mmol/L Na+ 132 mmol/L, K+ 4.8 mmol/L, U 6.2 mmol/L, Creatinine [insert dose] [insert route] 98 µmol/L Frequency Duration Once only Continuous Prescriber [your name] Date Time 19:00 09/01/2025Question 5 Case presentation Prescribing request A 34-year-old man presents to the emergency department with Write a prescription for ONE medication that is most a 2-day history of worsening shortness of breath, chest appropriate to treat his symptoms. tightness, and wheezing. He reports that he has been using his reliever inhaler more frequently but with little effect. He feels (use the hospital prescription form provided) increasingly fatigued and states that his symptoms are worse at night. Past Medical History (PMH): Asthma, hay fever. PRESCRIPTION FORM Drug History (DH): Clenil Modulite 100 microgram INH two puffs twice daily, salbutamol 100 microgram INH as required. Medication Social History (SH): Non-smoker, works as a primary school teacher, no alcohol consumption. [insert medication] Dose Route On Examination: Temperature: 36.9°C, 122/min, regular, [insert dose] [insert route] Blood Pressure (BP): 125/80 mmHg, Respiratory Rate (RR): 30/min, Oxygen Saturation (O2 sat): 95% breathing 15L via Frequency non-rebreathe mask, Unable to complete sentences, Bilateral diffuse expiratory wheeze. [insert frequency] Prescriber [your name] Date Time 19:00 09/01/2025Question 6 A 65-year-old woman presents to the emergency department Prescribing request with a two-day history of worsening shortness of breath and Write a prescription for ONE drug that is the most productive cough. appropriate additional treatment. Past Medical History (PMH): Chronic obstructive pulmonary (use the hospital prescription form provided) disease (COPD), type 2 diabetes mellitus, osteoarthritis. Drug History (DH): Metformin 500 mg PO twice daily, salbutamol 100 microgram inhaler as required, Fostair 100/6 microgram inhaler twice daily. PRESCRIPTION FORM On Examination: Temperature: 37.5°C, Heart Rate (HR): Medication 92/min, regular, Blood Pressure (BP): 140/85 mmHg, Respiratory Rate (RR): 30/min, Oxygen Saturation (O2 sat): 88% [insert medication] breathing air, Using accessory muscles of respiration, Bilateral Dose Route wheeze and scattered crackles on auscultation. [insert dose] [insert route] She is commenced on oxygen, salbutamol, and ipratropium Frequency bromide nebulisers. [insert frequency] Prescriber [your name] Date Time 19:00 09/01/2025Question 7 A 58-year-old woman is commenced on atorvastatin Which of the following is the most appropriate for the secondary prevention of cardiovascular investigation to monitor for adverse effects of disease following a recent myocardial infarction. atorvastatin after 3 months of treatment? Past Medical History (PMH): Hypertension, a) Creatine kinase ischemic heart disease. Drug History (DH): Bisoprolol 5 mg once daily, b) Liver function tests aspirin 75 mg once daily, ramipril 10 mg once daily. c) Full lipid profile d) Full blood count e) Urea and electrolytesQuestion 8 A 50-year-old woman is commenced on levothyroxine for At what time intervals should thyroid-stimulating hormone primary hypothyroidism. (TSH) be checked during the first year of levothyroxine therapy? Past Medical History (PMH): Autoimmune thyroiditis, hypertension. Drug History (DH): Amlodipine 5 mg once daily. a) Every 4 weeks until stable b) Every 3 months until stable c) At 6 months, then repeated at 12 months d) Every 6-8 weeks e) Every 2 weeks for the first 3 months, then every 6 monthsQuestion 9 A 29 year old woman is being reviewed in an Outpatient Psychiatry clinic following recent Select the most appropriate parameter to monitor at discharge a week ago from the ward due to this point in time whilst the patient undergoes this new treatment: Schizoaffective Disorder with depression. The clinic is to review her Clozapine medication due to previous treatment resistance to Olanzapine and a) Fasting Blood Glucose Risperidone. b) Weight Past Medical History (PMH): Hypothyroidism, Appendicitis c) Full lipid profile Drug History (DH): Levothyroxine 50 micrograms OD d) Full blood count e) Platelet count Investigations TSH 4.2 mU/L (0.4-5.0)Question 10 Case presentation Prescribing request An 8-year-old child with a history of epilepsy presents to What volume (mL) of phenytoin sodium should be the emergency department in status epilepticus. A loading administered per dose (to 2 d.p.)? dose of phenytoin is administered. You are asked to prescribe a maintenance dose of phenytoin sodium. The child weighs 24 kg. Phenytoin sodium is available as 250 mg/5 mL ampoules.AnswersQuestion 1 Case presentation Prescribing request A 42-year-old woman presents to A&E with severe upper quadrant pain and vomiting for the past 2 days. PMH: Write a prescription for ONE IV fluid that is most appropriate gallstones, asthma, eczema. DH: Trimbow inhaler MDI, to treat her hypotension and tachycardia. salbutamol sulfate 100micrograms MDI, hydrocortisone (use the hospital IV fluid prescription form provided) 1% cream On examination She is drowsy and pale. Temperature 37.8ºC, HR 120bpm PRESCRIPTION FORM rhythm regular, BP 88/56, RR 18breaths/min, O2 Infusion fluid saturations 98% on room air. Warm peripheries, bounding Sodium chloride 0.9% pulses, normal heart sounds. Investigations Volume Route Hb 132 (115-165), WCC 25.6 x10^9L (3.0-10.0), Na+ 146 (137-144), K+ 4.2 (3.5-5.3), U 9.8 (2.5-7.0), Cr 110μmol/L 500 mL IV Duration Infusion rate (mL/min) (60-110) ECG shows sinus tachycardia, no ischaemic changes 15 m 33.3 CXR normal Prescriber [your name] Date Time 09/01/202 19:00 5Other acceptable answers Plasma-Lyte 148 solution (5) 500ml over 2 min/5min/10min/15min (5) Sodium chloride 0.9% solution (5) 500ml over 20 min (3) Ringers’ solution (5) Hartmann’s solution (5) https://www.nice.org.uk/guidance/cg174/c Explanation (1) hapter/Recommendations#resuscitation-2Explanation (2) https://prescribingsafetyassessment.ac.uk/ https://www.nice.org.uk/guidance/cg174/r esources/composition-of-commonly-used- Explanation (3) crystalloids-table-191662813Question 2 Case presentation Prescribing request A 69-year-old man is on the stroke ward having experienced Write a prescription for ONE IV fluid that is most appropriate right hemiplegia and dysphagia starting around 24 hours ago. as the next bag to maintain his hydration whilst he is nil by He is NBM due to an unsafe swallow. PMH: diabetes, hypertension. DH: atorvastatin 80mg ON, metformin 500mg mouth. TDS, amlodipine 5mg OD, aspirin 300mg OD (use the hospital IV fluid prescription form provided) On examination Temperature 36.5ºC, HR 80bpm rhythm regular, BP 142/88, JVP not visible, RR 11 breaths/min, O2 saturations 96% on PRESCRIPTION FORM room air. Heart sounds normal. No peripheral oedema. Catheterised; urine output 80ml/hour since admission. Infusion fluid Estimated weight 80kg. Glucose 5%/Potassium chloride 0.3% solution Investigations Volume Route Hb 145 (115-165), WCC 4.2 x10^9L (3.0-10.0), Na+ 142 (137-144), K+ 3.7 (3.5-5.3), U 3.5 (2.5-7.0), Cr 87μmol/L (60-110), 1000 mL IV eGFR 68mL/min. Random glucose 6.2mmol/L. CT head without contrast: left middle cerebral artery infarct. Duration Infusion rate (mL/min) IV fluids received so far: 1) Sodium chloride 0.9%/potassium chloride 0.15% 12 h 1.38 solution 1000mL over 12 hours Prescriber [your name] Date Time 2) Sodium chloride 0.9%/potassium chloride 0.15% solution 1000ml over 12 hours 09/01/202 19:00 5Other acceptable answers Glucose 5%/potassium chloride 0.15% 1000mL over 8h/10h/12h (5) solution (5) 500mL over 4h/6h (5) 1000mL over 6h (4) 500ml over 3h (4)Explanation (1) Daily requirements: Received so far: Water: 25–30ml/kg/24hr Sodium chloride 0.9%/potassium chloride Na+: 1mmol/kg/24hr 0.15% solution 2000mL : K+:1mmol/kg/24hr ● 2000ml water Glucose: 50-100g/24hr ● (2x154)=308mmol Na+ ● (2x20)=40mmol K+ ● 0g glucose Weight 80kg: Water: 2000-2400ml water Na+: 80mmol Glucose 5%/Potassium chloride 0.3% solution over 12 hours K+: 80mmol ● 50g glucose 50-100g glucose ● 0.3% = 40mmol PotassiumExplanation (2)Explanation (3) Before prescription (at 24hrs) After prescription (at 36hrs) Ideal by 36hrs 2000ml water 3000ml water 3000ml water 308mmol Na+ 308mmol Na+ 120mmol Na+ 40mmol K+ 80mmol K+ 120mmol K+ 0g glucose 50g glucose 75-150g glucoseQuestion 3 Case presentation Prescribing request A 30-year-old woman is in the Emergency Department with worsening irritability and drowsiness. Her GCS has dropped Write a prescription for ONE IV fluid that is most appropriate from 15 to 9 since admission. to treat her symptoms PMH: T1DM, DH: NovoRapid 6 units SC TDS with meals, Lantus 20 units SC OD On examination (use the hospital IV fluid prescription form provided) She is unresponsive and appears clammy. Temperature 36.8ºC, HR 99bpm rhythm regular, BP 110/70, RR 16breaths/min, O2 PRESCRIPTION FORM saturations 98% on room air. Infusion fluid Investigations A VBG is done: Glucose 10% solution pH 7.40 (7.35–7.45), pCO₂ 5.3 kPa (4.7–6.0), HCO₃⁻ 24 mmol/L Volume Route (22–26), Base Excess 0 mmol/L (-2 to +2), Lactate 1.2 mmol/L (0.5–2.0), Glucose 2.2 mmol/L (4–7 fasting), Sodium 138 mmol/L 150mL IV (135–145), Potassium 4.0 mmol/L (3.5–5.0), Chloride 102 Duration Infusion rate (mL/min) mmol/L (98–107), pO₂ 6.5 kPa (4.5–6.7 venous) 15m 10 Prescriber [your name] Date Time 09/01/202 19:00 5 maries/hypoglycaemia/uk/treatment-sum Explanation (1) https://bnf.nice.org.uk/treatment-sum Explanation (2) maries/medical-emergencies-in-the-co mmunity/#hypoglycaemiaGlucose 10%? Glucose 10% refers to an intravenous (IV) Glucose 20%? solution containing 10 grams of glucose dissolved in 100 mL of water. In other words, Glucose 50%? it is a 10% weight/volume (w/v) solution of glucose. Similarly, Sodium chloride 0.9% is 0.9 grams of sodium chloride (NaCl) per 100 mL of water (equivalent to 9 grams of sodium chloride per liter (9 g/L)) X% = Xg in 100mlFluid prescribing TipsTop tips: Fluid prescribing ● Four main scenarios for fluid prescriptions: ○ Resuscitation/DKA ○ Correcting electrolyte/glucose imbalances ○ Maintenance ○ Replacing fluid losses Haemodynamic Resuscitation fluids instability? Electrolyte Hypoglycaemia abnormality or G emergency? I I C E Hyperkalaemia Lorem Ipsum R P U L F Hypercalcaemia Lorem Ipsum Replace deficits if Maintenance? needed Lorem IpsumQuestion 4 Case presentation Prescribing Request: A 23-year-old woman presents to the Emergency Write a prescription for the initial insulin therapy Department with a 1-day history of abdominal pain, required to treat her diabetic ktoacidosis (DKA). Use the nausea, and vomiting. PMH none. DH none. provided hospital insulin infusion chart. On Examination: (use the hospital IV fluid prescription form provided) Drowsy GCS14. Temperature 37.8°C, HR 120 bpm, BP 95/65, RR 26 breaths/min, O2 Sats 98% breathing air. Weight 60kg. Capillary Blood Glucose: 22 mmol/L, Ketones: 5.8 mmol/L PRESCRIPTION FORM Clinical Signs: Dry mucous membranes, Kussmaul Medication breathing, no focal signs of infection Investigations Insulin soluble human 100 units/mL (Actrapid®) Arterial blood gas: pH 7.15, HCO₃⁻ 12 mmol/L, Anion Gap 22 injection mmol/L Dose Route Na+ 132 mmol/L, K+ 4.8 mmol/L, U 6.2 mmol/L, Creatinine 98 µmol/L 6 units Intravenous (IV) Frequency Duration Once only Continuous Prescriber [your name] Date Time 19:00 09/01/2025Other acceptable answers Insulin aspart 100 units/mL (NovoRapid®) 6 units IV (5) injection (5) 5 units IV (3) Insulin glulisin 100 units/mL (Apidra®) injection (5) Insulin soluble human 100 units/mL (Humulin S®) injection (5) Insulin lispro 100 units/mL (Humalog®) injection (5) https://abcd.care/joint-british-diabetes-societies-jbds-in Explanation (1) patient-care-groupExplanation (2) https://bnf.nice.org.uk/treatme nt-summaries/insulin/#insulin- Explanation (3) preparations https://bnf.nice.org.uk/drugs/in Explanation (4) sulin/medicinal-forms /Explanation (5) HHS DKA T2DM T1DM Older patients Younger patients BMs ++++ BMs + with acidosis and +ve Presents with severe ketones dehydration Less acute presentationQuestion 5 Case presentation Prescribing request A 34-year-old man presents to the emergency department with a 2-day history of worsening shortness of breath, chest Write a prescription for ONE medication that is most tightness, and wheezing. He reports that he has been using his appropriate to treat his symptoms. reliever inhaler more frequently but with little effect. He feels increasingly fatigued and states that his symptoms are worse at night. (use the hospital prescription form provided) Past Medical History (PMH): Asthma, hay fever. PRESCRIPTION FORM Drug History (DH): Clenil Modulite 100 microgram INH two puffs twice daily, salbutamol 100 microgram INH as required. Drug Social History (SH): Non-smoker, works as a primary school teacher, no alcohol consumption. Salbutamol Dose Route On Examination: Temperature: 36.9°C, 122/min, regular, 5mg Nebuliser Blood Pressure (BP): 125/80 mmHg, Respiratory Rate (RR): 30/min, Oxygen Saturation (O2 sat): 95% breathing 15L via Frequency non-rebreathe mask, Unable to complete sentences, Bilateral diffuse expiratory wheeze. Every 15 min PRN Prescriber [your name] Date Time 09/01/202 19:00 5Ifyou knowwhat to prescribe: Search the drug FIRSTIfyou don’t knowwhat to prescribe Turn to treatment summariesQuestion 6 A 65-year-old woman presents to the emergency department Prescribing request with a two-day history of worsening shortness of breath and Write a prescription for ONE drug that is the most productive cough. appropriate additional treatment. Past Medical History (PMH): Chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus, osteoarthritis. (use the hospital prescription form provided) Drug History (DH): Metformin 500 mg PO twice daily, salbutamol 100 microgram inhaler as required, Fostair 100/6 microgram inhaler twice daily. PRESCRIPTION FORM On Examination: Temperature: 37.5°C, Heart Rate (HR): Drug 92/min, regular, Blood Pressure (BP): 140/85 mmHg, Respiratory Rate (RR): 30/min, Oxygen Saturation (O2 sat): 88% Prednisolone breathing air, Using accessory muscles of respiration, Bilateral Dose Route wheeze and scattered crackles on auscultation. 30mg PO She is commenced on oxygen, salbutamol, and ipratropium Frequency bromide nebulisers. Once daily Prescriber [your name] Date Time 09/01/202 19:00 5Question 7 A 58-year-old woman is commenced on atorvastatin Which of the following is the most appropriate for the secondary prevention of cardiovascular investigation to monitor for adverse effects of disease following a recent myocardial infarction. atorvastatin after 3 months of treatment? Past Medical History (PMH): Hypertension, a) Creatine kinase ischemic heart disease. Drug History (DH): Bisoprolol 5 mg once daily, b) Liver function tests aspirin 75 mg once daily, ramipril 10 mg once daily. c) Full lipid profile d) Full blood count e) Urea and electrolytesQuestion 8 A 50-year-old woman is commenced on thyroid At what time intervals should thyroid-stimulating hormone hormone treatment for primary hypothyroidism. (TSH) be checked during the first year of hormone therapy? Past Medical History (PMH): Autoimmune thyroiditis, hypertension. a) Every 4 weeks until stable Drug History (DH): Amlodipine 5 mg once daily. b) Every 3 months until stable c) At 6 months, then repeated at 12 months d) Every 6-8 weeks e) Every 2 weeks for the first 3 months, then every 6 monthsQuestion 9 A 29 year old woman is being reviewed in an Outpatient Psychiatry clinic following recent Select the most appropriate parameter to monitor at discharge a week ago from the ward due to this point in time whilst the patient undergoes this new treatment: Schizoaffective Disorder with depression. The clinic is to review her Clozapine medication due to previous treatment resistance to Olanzapine a) Fasting Blood Glucose and Risperidone. b) Weight Past Medical History (PMH): Hypothyroidism, Appendicitis c) Full lipid profile Drug History (DH): Levothyroxine 50 micrograms OD d) Full blood count e) Platelet count Investigations TSH 4.2 mU/L (0.4-5.0)Therapeuticdrug monitoringQuestion 10 Case presentation Prescribing request An 8-year-old child with a history of epilepsy presents to What volume (mL) of phenytoin sodium should be the emergency department in status epilepticus. A loading administered per dose (to 1 d.p.)? dose of phenytoin is administered. You are asked to 2.4mL or 1.2mL prescribe a maintenance dose of phenytoin sodium. The child weighs 24 kg. Phenytoin sodium is available as 250 mg/5 mL ampoules. d v cQuestion 10 Case presentation Prescribing request An 8-year-old child with a history of epilepsy presents to What volume (mL) of phenytoin sodium should be the emergency department in status epilepticus. A loading administered per dose (to 1 d.p.)? dose of phenytoin is administered. You are asked to prescribe a maintenance dose of phenytoin sodium. The 2.4mL or 1.2mL child weighs 24 kg. Phenytoin sodium is available as 250 mg/5 mL ampoules. d v c 5mg*24kg=120mgQuestion 10 Case presentation Prescribing request An 8-year-old child with a history of epilepsy presents to What volume (mL) of phenytoin sodium should be the emergency department in status epilepticus. A loading administered per dose (to 1 d.p.)? dose of phenytoin is administered. You are asked to prescribe a maintenance dose of phenytoin sodium. The 2.4mL or 1.2mL child weighs 24 kg. Phenytoin sodium is available as 250 mg/5 mL ampoules. 120mg 50 v mg/ml 5mg*24kg=120mgQuestion 10 Case presentation Prescribing request An 8-year-old child with a history of epilepsy presents to What volume (mL) of phenytoin sodium should be the emergency department in status epilepticus. A loading administered per dose (to 1 d.p.)? dose of phenytoin is administered. You are asked to 2.4mL or 1.2mL prescribe a maintenance dose of phenytoin sodium. The child weighs 24 kg. Phenytoin sodium is available as 250 mg/5 mL ampoules. 120mg 2.4ml 50 mg/ml 5mg*24kg=120mgResources for learning ● PSA blueprint: https://prescribingsafetyassessment.ac.uk/resources/PSA-Blueprint-July-2023.pdf ● BPS eLearning ○ 9 free modules ○ Mock papers available to purchase - 3 for £40 ● Geekymedics ○ PSA question bank ● Passmedicine ○ PSA question bank ● https://bnf.nice.org.uk/interactions/appendix-1-interactions/ ● SCRIPT modules ○ https://www.safeprescriber.org/modules/ ○ “Monitoring medicines”, “Toxic tablets”Learning objectives ● Navigating medicines complete (drug monographs, treatment summaries) ● Prescribing ○ fluids: maintenance, resus, hypoglycaemia, hyperkalaemia, hypocalcaemia ○ insulin ○ asthma/COPD exacerbation ○ contraception ● Drug monitoring ○ blood work ○ clinical factors (obs, weight, symptom control, etc)