Analgesics
This first-line non-opioid is used for mild pain or fever and is safe in pregnancy.
Brand Name: Paracetamol
Generic Name: Acetaminophen
Rational: Widely available, minimal GI irritation, and safe at therapeutic doses in pregnancy.
Name the broad-spectrum penicillin used for many community infections.
Amoxicillin
Rational: Covers common Gram-positive and some Gram-negative organisms; well-tolerated orally.
IM drug of choice for anaphylaxis.
epinephrine / adrenaline
Rational: Rapid α/β adrenergic effects reverse airway edema and hypotension.
First-choice isotonic crystalloid for fluid resuscitation.
0.9% sodium chloride (normal saline)
Rational: Restores intravascular volume without shifting fluid between compartments.
First-line antipyretic safe in all trimesters of pregnancy.
paracetamol
Rational: No significant teratogenic risk at therapeutic doses.
This IM NSAID is avoided in patients with active peptic ulcer disease due to risk of GI bleeding.
Diclofenac
Rational: NSAIDs reduce renal perfusion and may precipitate renal failure in at-risk patients.
Which IV antibiotic is a β-lactam/β-lactamase inhibitor combo used for serious intra-abdominal infections?
Piperacillin–Tazobactam
Rational: Tazobactam protects piperacillin from β-lactamase, broadening coverage.
Rapid α/β adrenergic effects reverse airway edema and hypotension
Atropine
Rational: Anticholinergic action increases heart rate.
5% glucose solution used to prevent hypoglycaemia in NPO patients; why is it not suitable for resuscitation?
D5W; it rapidly distributes into intracellular space.
Rational: Free water after metabolism of glucose dilutes plasma and doesn’t stay intravascular.
IV antiemetic that is a dopamine antagonist and may cause extrapyramidal side effects.
metoclopramide
Rational: Blocks D2 receptors in the chemoreceptor trigger zone.
A patient receiving this weak opioid combined with paracetamol develops constipation. Name the opioid and one key nursing intervention.
Codeine
Nursing Intervention: increase fluid/fibre intake or give stool softener.
Rational: Codeine’s μ-opioid action slows GI motility, so stool softeners and hydration are important.
This macrolide is preferred for atypical pneumonia; state one important drug–drug interaction.
Azithromycin
caution with QT-prolonging drugs.
Rational: Macrolides can prolong QT interval, increasing arrhythmia risk
IV antiarrhythmic used for refractory ventricular fibrillation.
Amiodarone
Rational: Class III action prolongs repolarization, helping terminate VF.
Balanced electrolyte solution containing potassium; why avoid in renal failure?
Ringer’s lactate; risk of hyperkalemia.
Rational: impaired renal excretion can dangerously raise serum potassium.
Anticholinergic bronchodilator given via nebuliser that complements β2-agonists in acute asthma.
ipratropium bromide
Rational: Inhibits vaguely mediated bronchoconstriction, additive to salbutamol.
Post-operative patient with renal impairment needs strong analgesia. Which opioid is safest and why?
fentanyl
it has no active metabolites and minimal renal clearance.
Rational: Opioid-induced respiratory depression is life-threatening; baseline RR guides dosing.
IV third-generation cephalosporin commonly used for surgical prophylaxis; what major allergy must be screened for?
Ceftriaxone; screen for severe penicillin allergy.
Rational: Cross-reactivity exists between penicillins and cephalosporins.
Hypertonic IV solution for unconscious hypoglycaemic patients; name concentration and reason for large-bore IV.
dextrose 50% (D50); to avoid vein irritation and extravasation injury.
Rational: D50 is highly osmotic; central or large peripheral vein minimizes tissue damage
Potassium supplement given IV; state maximum recommended infusion rate without cardiac monitoring.
Potassium chloride; ≤10 mEq/hr.
Rational: Rapid infusion can cause life-threatening arrhythmias.
IV vasodilator used in hypertensive emergencies; mention one key nursing monitoring parameter.
hydralazine; monitor blood pressure closely.
Rational: Rapid drop in BP can cause reflex tachycardia or ischemia.
A topical analgesic for neuropathic pain that works by stabilizing neuronal membranes
Lidocaine patch.
Rational: Local aesthetic effect decreases ectopic nerve firing, relieving post-herpetic neuralgia.
Aminoglycoside used for severe sepsis; describe the key monitoring needed.
Gentamicin; monitor renal function and hearing.
Rational: Nephrotoxic and ototoxic; serum levels and creatinine guide safe dosing.
Nebulised β2-agonist for acute severe asthma; explain why continuous monitoring of serum potassium is warranted.
Salbutamol; it can lower serum potassium.
Rational: β2-stimulation drives K⁺ into cells, risking hypokalemia and arrhythmias.
Colloid used to expand plasma volume in hypovolemic shock; describe one major risk.
5% albumin; risk of fluid overload/pulmonary edema.
Rational: Oncotic pressure pulls fluid intravascularly, which may precipitate heart failure.
Benzodiazepine given IV for status epilepticus; why give oxygen and monitor airway?
diazepam; risk of respiratory depression.
Rational: CNS depressant effects can suppress breathing, requiring airway support.