A 25-year-old woman with epilepsy visits the well woman clinic complaining of weight gain, acne, and hair loss. Her thyroid function is within normal limits. She is concerned that her epilepsy medication may be the culprit. Which of the following medications is the most probable cause?
An older man with dementia is experiencing recurrent falls. He has a past medical history of ischaemic heart disease, angina, essential hypertension, Parkinson’s disease and gout. He is on regular diltiazem, ramipril, bendroflumethiazide, levodopa and allopurinol. When you review him, his heart rate is 45 beats per minute and his blood pressure is 90/55 mmHg.
Which of the patient’s regular medication is likely to be responsible for his recurrent falls?
A 55-year-old patient presents with complaints of dyspnea upon exertion. A chest X-ray reveals fibrosis, and the patient reports increasing fatigue and malaise with a pale appearance. Further testing shows an elevated thyroid-stimulating hormone (TSH) level. What medication is this patient currently taking?
A 43-year-old woman presents to the Emergency Department with palpitations. The patient has a history of hypertension and is taking lisinopril, but is otherwise healthy. She reports a fluttering sensation in her chest but denies any shortness of breath.
Upon examination, the patient’s pulse is 160 bpm and regular. Her blood pressure is 136/94 mmHg, and her oxygen saturation is 98% on room air. There is no evidence of pedal edema, and her chest is clear.
An electrocardiogram (ECG) reveals sinus tachycardia with narrow complexes. Vagal maneuvers are attempted but prove ineffective.
What would be the most appropriate next step in treating this patient?
A 25-year-old woman presents to the Emergency department in a collapsed state after taking an overdose of 50x100mg amitriptyline tablets. On arrival, her Glasgow coma scale is 9, blood pressure is 90/60 mmHg, pulse is 102 beats per minute and regular, and her chest is clear. Her laboratory investigations reveal a Na+ level of 135 mmol/l, K+ level of 5.1 mmol/l, HCO3- level of 15.1 mmol/l, urea level of 10.5 mmol/l, creatinine level of 155 µmol/l, and pH of 7.25. During examination, she experiences a short tonic clonic seizure.
What is the most important medication to administer next?
A 70-year-old woman comes to your clinic complaining of ankle swelling. She has started taking a new medication for her blood pressure. She believes that this medication is responsible for her ankle oedema and wants you to investigate. What is the medication most likely to have caused her ankle swelling?
A 32-year-old female patient presents with an overdose of an unknown quantity of an unknown drug, which she took 4 hours earlier. During your assessment, she complains of severe ‘ringing’ in her ears. She has a resting respiratory rate of 24/min. Chest examination is clear.
Which one of the following drugs is she most likely to have taken?
A 7-month-old baby weighing 8.5 kg has been admitted to the hospital due to a respiratory infection. The doctor has prescribed an intravenous antibiotic for the baby. The loading dose recommended is 3 mg/kg, and the maintenance dose is 0.75 mg/kg to be given every 12 hours. What is the correct dosing regimen to prescribe for this baby?
A 7-year-old boy weighing 26 kg has been diagnosed with epilepsy and needs to be prescribed an anticonvulsant medication called Fitamil. The medication must be taken twice daily and the dosage is based on weight. The loading dose is 4 mg/kg and the maintenance dose is 0.8 mg/kg to be given every 12 hours. What is the correct dosing regimen for this child?
A 63-year-old man who is receiving treatment for alcoholism presents with a week-long history of pins and needles in his right arm. He continues to consume over 20 units of alcohol per day and is taking disulfiram and citalopram. On examination, there are no signs of weakness, abnormal movements, or changes in tone, and his sensation is intact in all dermatomes. A blood test reveals a clinically significant result of Mg2+ 0.5 mmol/L (0.65 – 1.05). The patient is prescribed oral magnesium sulfate, and his doctor informs him of a potential side effect of the medication. What side effect is the patient likely to be warned about?