COPD exacerbation prescribing

Setting: You are a junior doctor based in the acute medical unit and you have just clerked this patient with your consultant.

Patient: Jemma Rodgers (DOB 22 Jan 1984, Hospital number 711987, Address 19 Micheldever Road, Countydon, CD20 2HD) has been admitted with an exacerbation of COPD. She is wheezy but not requiring oxygen. She has a medical history of COPD and hypertension. She has no drug allergies and weighs 70kg.

She brought her medication boxes with her (click images to enlarge):

Sticker states: one puff twice daily

Sticker states: take one tablet daily

Sticker states take one tablet daily

Task: It is currently 10.30AM. Please write the patient’s drug chart. Please prescribe treatment for her COPD exacerbation: your consultant has requested STAT doses of salbutamol and ipratropium nebulisers, and of prednisolone. Please also prescribe PRN salbutamol nebulisers and regular prednisolone. You must also prescribe her regular medications; however, she has an acute kidney injury (GFR 50) and your consultant has asked you to suspend any potentially nephrotoxic drugs for 48 hours. Venous thromboembolism prophylaxis is not required.

You have 8 minutes and there will be no questions. Your national formulary (e.g. BNF in UK) is available if needed.

Drug chart can be printed here.

There is no patient present in this station.

An example of a correctly completed drug chart can be viewed here.

Submit your answers to get your score.