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Section 2 - Prescription Review

Introduction

In Section 2, you will be presented with a list of repeat prescriptions for a patient. You will be required to identify incorrect drug dosages, administration frequencies, routes of administration, and recognize significant drug interactions from this list.

Question Style	MCQ
Total Questions	8
Marks per Question	2 (Total of 16 marks)
Advised Time per Question	1 minute

Example Question

Case presentation

A 80 year old man is admitted to the geriatrics ward following a collapse. He has a history of hypertension and ischaemic heart disease. On examination, he is dehydrated and hypotensive. His current regular medicines are listed below.

Question

Select TWO prescriptions that are most likely to have contributed to his dehydration.
(Mark them with ticks)

MANAGEMENT OPTIONS

A. Bendroflumethiazide 5mg oral (PO) daily

B. Prazosin 1mg oral (PO) nightly

C. Simvastatin 20mg oral (PO) nightly

D. Spironolactone 25mg oral (PO) daily

E. Atenolol 500mg oral (PO) daily

▶Show Solution

Source: PSA

Tips for this section

Scan for any obvious dosing errors

Common errors include units (mg vs mcg) and frequency of doses (daily, weekly, monthly).
If the question provides a body weight, it may indicate that the dose is weight-dependent

Keep in mind that most of the information provided in the question will be relevant to reaching the answer. If a question contains a patient’s body weight while other questions do not, it might suggest that this is a crucial piece of information.
Use the drug interaction checker on BNF / Medicines Complete for quick checks.

This is a really useful and quick way to search for interactions. Note that you can type up as many drugs as you like in the drug interaction checker, and it will automatically check all the interactions for you.
Ctrl F is your friend! Check for specific side effects

If you are looking for specific side effects, you can use ctrl F and search up key terms. Note that some side effects are more common in certain medications than others, so it is worth checking all the medications and side effects listed.
This section can be very time consuming, do not get bogged down

Questions are not very convoluted and can perform well even with ‘common sense’ approach. See what works best. You might consider leaving this section until the end, if that works best for you.

How to Approach This Section

Do not spend much time trying to ‘work out’ what the answer might be

In these types of questions, it is often the case that you will either know the answer immediately or not know at all. As you practice you will develop a sense of common side-effects or types of prescription errors that are frequently encountered – quickly running through this “checklist” is one method of approaching these questions.
Read the question and scan through the prescription list to see if there are any obvious errors that you can notice
Depending on the type of question, use control F or the drug interaction checker to find the answer

Start by looking up the medications you are most unsure about. If you don’t know where to start, just work your way from top to bottom through the prescription list.