Where you are
You are an FY2 in A&E.Who the patient is
Mr. John Smith, aged 55, was admitted with breathlessness and cough.
He was diagnosed with asthma.
He was diagnosed with community acquired pneumonia in the hospital.
Consultant has reviewed the patient and planned to start him on clarithromycin 500mg PO BD for 5
days.Other information
Other regular medications:
Salbutamol 100 microgram (1-2 puff PRN) up to 8 puffs.
Seretide 250 Evohaler 1 puff BD
Ipratropium Bromide 20 (1 puff BD)
Prednisolone 30mg PO OD 5 days
Aspirin 75mg PO OD
Ramipril 2.5mg PO DO
Levothyroxine 50 microgram PO OD
Atorvastatin 20mg PO ODWhat you must do
Write down the prescription for the above medications.Special note
Patient is allergic to Penicillin. Reaction is rash.
Shortcut:
- Antibiotic: Clarithromycin: 500mg PO BD 5 days
Additional information: Review after 48 hours - Stop Atorvastatin
Explanation:
- Incase a patient is allergic to penicillin and has been prescribed co amoxiclav PO.
You’ ll change it to Clarithromycin: 500 mg PO BD for 5 days - If co amoxiclav is prescribed IV , thats your clue to prescribe IV as:
Clarithomycin 500 mg IV BD for first 2 days
Clarithromycin 500 mg PO BD for next 3 days
You will stop the statin for duration of antibiotic and prescribe other medication as such.