Prescription Writing Practice

Anaphylaxis to Intravenous Co-amoxiclav

Write a prescription for anaphylaxis (adverse drug reaction to co-amoxiclav) and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.

medium8 scoring rules

Patient
65 years, female, 70 kg
Diagnosis
Anaphylaxis (adverse drug reaction to co-amoxiclav)
Renal function
eGFR 80 mL/min/1.73m²
Allergies
co-amoxiclav
Current medicines
atorvastatin 20 mg once daily; metformin 500 mg twice daily

The scenario

Patient B-217 is a 65-year-old female, weight 70 kg, admitted with community-acquired pneumonia. She has no known drug allergies and her regular medicines are atorvastatin 20 mg once daily and metformin 500 mg twice daily. She has normal renal function (creatinine 0.9 mg/dL, eGFR 80 mL/min/1.73m2). Thirty minutes ago she received her first intravenous dose of co-amoxiclav. She now complains of feeling light-headed and itchy. On examination: skin has widespread urticarial wheals; she is wheezy throughout both lung fields; blood pressure 78/40 mmHg; heart rate 132 bpm; respiratory rate 28/min; SpO2 88% on room air; temperature 36.8°C. Airway is patent, she is alert but distressed. You are the foundation doctor called to the patient. Prescribe the immediate management for anaphylaxis in this patient. Include drug doses, routes, and subsequent medications you would give. Also state what you would record and what would be prescribed before discharge.

Your task

The patient was admitted with community-acquired pneumonia. She has a background of type 2 diabetes and hypercholesterolaemia. She is not pregnant.

What gets marked

  • Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
  • Dose, route, frequency and duration against the range for this patient.
  • Renal and hepatic dose adjustment where this patient's numbers demand it.
  • Allergy cross-reactivity and interactions with the medicines already on the chart.
  • The instructions and monitoring you write, not only the drug you pick.

8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.

Log in to prescribe for "Anaphylaxis to Intravenous Co-amoxiclav"

A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.

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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.