Case Study 5
Use your BNF (paper or app) to answer the following questions
Check the marker pointers that make an excellent answer and we’ve given you some common pitfalls to watch out for!
1. A 72-year-old man reports hearing loss during a prolonged inpatient stay due to an infection and has other co-morbidities. He had been treated with co-amoxiclav, gentamicin, furosemide, digoxin and aspirin.
What is the most likely cause of his hearing loss?
2. A 79-year-old man who is a resident in a care home, develops profuse diarrhoea with faecal incontinence. His recent medications include tamsulosin, atorvastatin, gentamicin, aspirin, co-amoxiclav and ramipril. His stool is positive for C difficile toxin showing that he has C difficile infection.
What medication is most likely to have increased his risk of C difficile infection?
3. Look up monographs for the following antibiotics and determine which need to be issued with a specific advisory label relating to taking with food. Why is it necessary for some antibiotics to be taken on an empty stomach?
Flucloxacillin, Clindamicin, Penicillin V oral solution, Cefalexin, Metronidazole
4. A 65-year-old man comes to the pharmacy complaining of itchiness and you note that he is jaundiced. He is currently on candesartan, amlodipine, aspirin, metformin and has recently had a 2-week course of flucloxacillin for a skin and soft tissue infection. What is the likely cause of his jaundice?
5. Look up monographs for the following antibiotics and determine which need to be issued with caution if a patient is on the combined oral contraceptive.
Amoxicillin, Rifampicin, Ciprofloxacin, Vancomycin, Co-trimoxazole
6. A-seven-year-old-child diagnosed with otitis media is prescribed Flucloxacillin oral solution at a dose of 250mg four times daily for 5 days.
What is the total dose of flucloxacillin the child is being administered daily?
What is the correct dose of flucloxacillin in mls the patient should be administered per dose?
What is the total amount of oral solution required to last the patient 5 days?
What instructions should be provided to the patient on dispensing?