Paeds Vivas · clinical-pharmacology-and-therapeutics
Analgesics and antipyretics — branching viva
A branching viva following one febrile, uncomfortable child through the choice of analgesic and antipyretic, the weight-based calculation of a paracetamol and ibuprofen dose with the adult ceiling, the position on alternating agents, the safety restrictions on aspirin and on codeine and tramadol, and the escalation to an opioid for severe pain with the monitoring that must accompany it.
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Target exams
RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Prompt
A five-year-old is admitted overnight after a fall from play equipment with a greenstick fracture of the radius, and is also mildly febrile with a viral upper respiratory tract infection. The examiner releases information in stages. The candidate must choose and dose the analgesic and antipyretic, work the weight-based paracetamol and ibuprofen doses aloud and apply the adult cap, take a position on alternating agents, respect the aspirin and codeine restrictions, escalate to an opioid for severe pain with the right monitoring, and recognise the signs that would prompt naloxone.
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References8Show ledgerHide ledger
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- [12]Parikh JM, Amolenda P, Rutledge J, et al. An update on the safety of prescribing opioids in pediatrics Expert Opin Drug Saf, 2019.PMID 30650988