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Paeds Casesclinical-pharmacology-and-therapeutics

Paeds Cases · clinical-pharmacology-and-therapeutics

Anticipate before you prescribe — drug interactions and reconciliation

A bedside structured clinical encounter testing anticipation of a cytochrome P450-mediated drug interaction, prediction of the direction and timing of inhibition, choosing among avoid-substitute-adjust-monitor, building a Best Possible Medication History, and performing a safe, plain-language discharge reconciliation.

structured clinical encounter (medication safety leadership)3 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 14-year-old girl four years after liver transplantation is admitted with oral candidiasis and pneumonia, and the team plans to start fluconazole and a macrolide alongside her long-term tacrolimus.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses interaction anticipation, enzyme-based reasoning, the choose-among-management-options decision, building a Best Possible Medication History, and a safe discharge reconciliation. [1] [7]

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References5ShowHide
  1. [1]Li T, Hu B, Ye L, et al. Clinically Significant Cytochrome P450-Mediated Drug-Drug Interactions in Children Admitted to Intensive Care Units International journal of clinical practice, 2022.PMID 36081809
  2. [2]de Wildt SN, Kearns GL, Leeder JS, et al. Cytochrome P450 3A: ontogeny and drug disposition Clinical pharmacokinetics, 1999.PMID 10628899
  3. [6]Feudtner C, Dai D, Hexem KR, et al. Prevalence of polypharmacy exposure among hospitalized children in the United States Archives of pediatrics and adolescent medicine, 2012.PMID 21893637
  4. [7]Merandi J, Sapko M, Catt C, et al. Medication Reconciliation Pediatrics in review, 2017.PMID 28044039
  5. [10]Carroll AR, Johnson JA, Stassun JC, et al. Health Literacy-Informed Communication to Reduce Discharge Medication Errors in Hospitalized Children: A Randomized Clinical Trial JAMA network open, 2024.PMID 38227315
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