Medication administration in NMC OSCE exam is another head ache for some of the candidates appearing. Usually there will be only two or three medication to be administered. But you have to take care of things like known allergies of patient, inlegible prescription and about medication already administered. In some cases weight of patient will be given which will be less than 50 kgs in which you cannot give Paracetamol. Keeping in mind of all these small things make you pass your NMC OSCE exam. In this article let me introduce you about common medications that are used in NHS hospitals across UK and about their indications and possible side effects which you have to tell to the patient during your implementation station.

Common Medications, their Indication and Possible Side Effects used in NMC OSCE Implementation Station. Common Medications

Cocodamol

given for mild to moderate pain

Side Effect – Abdominal pain, constipation, if overdosed Liver damage and Hypothermia

Paracetamol

For mild to moderate pain and pyrexia

Side Effect – Skin reactions and malaise

Ibuprufen

For pain and inflammation

Side Effect – Dizziness, Drowsiness

Codeine

For mild to moderate pain

Side Effect– Abdominal pain and Constipation

Enalapril

For Hypertension

Side Effect – Blurred Vision, Dyspnoea

Digoxin

Used as cardiac glycoside, increases myocardial contraction, reduces conductivity with AV node

Side Effect – Dizziness, blurred vision, arrythmias

Verapamil 

For Angina and Hypertension

Side Effect – Head Ache, Dizziness, Constipation

Bisoprolol

Antihypertensive and angina medication

Side Effect – Cramps, depression, muscle weakness

Co amoxiclav

In infections (Antibiotic – pencillin group)

Side Effect – Nausea, Vomiting, Diziness, head ache

Amozicillin 

Antibiotic for infection (Pencillin group)

Side Effect – Nausea, Vomiting

Pencillin

Antibiotic for infection

Side Effect  – Fever,Diarrhoea, Anaphylaxis

Glicazide 

Antidiabetic for Type 2 DM

Side Effect – Hypoglycemia

Metformin

Antidiabetic with less chance of going in hypoglycemia

Side Effect – Abdominal pain, nausea, vomiting, taste disturbance

Levothyroxine

Thyroxine Sodium (For hypothyroidism)

Side Effect – Heat intolerance, diarrhoea, fever and flushing

Cyclizine

Antisickness medication for nausea, vomiting and vertigo

Side Effect – Drowsiness and dizziness

Ondansetron

For Nausea and Vomiting (Anti emetic)

Side Effect – Head ache, constipation, flushing

Prednisolone 

For exacerbation of COPD, mild to moderate acute asthma, inflammatory disease (group – corticosteroids)

Side Effects – Increased Blood Sugar Levels

Vitamin K 

For patients with major bleeding who are on warfarin

Side Effects – Anaphylactic Reactions

Warfarin

For prophylaxis of embolization, treatment of venous thrombosis and Pulmonary Embolism

Side Effects – Bleeding

Hydroxocobalmin

Pernicious/macrocytic anemia (Vitamin B12 supplement)

Side Effect – Nausea, rash, fever, hypersensitivity reactions

Calcium Carbonate

Hypocalcemia

Side Effect – GI Disturbances, hypercalcemia

Trimethoprim 

Antibiotic (mainly for UTI)

Side Effect – Diarrhoea, nausea, vomiting, stomach upset, loss of apetite, head ache

Sertraline 

Antidepressant for depression, anxiety, panic disorder

Side Effect – Nausea, tremors, headaches, dizziness, diarrhoea, loss of apetite, anorexia, fatigue, insomnia, mood changes, aggression and sweating

Bisoprolol/Attenolol

For hypertension, angina, arrhythmias, heart failure and anxiety

Side Effect – Postural Hypotension, Bradycardia, dizzyness, bronchospasm, fatigue, coldness of extremities, sleep disturbances

Amlodipine 

Antihypertensive and angina prophylaxis

Side Effects – Abdominal pain, nausea, palpitation, flushing, oedema, headache, dizziness, sleep disturbances, fatigue, Shortness of Breath

Diclofenac 

NSAID used for Pain and inflammation

Side Effect – Nausea and Vomiting, Dizziness, head ache and pain, constipation, indigestion

Codeine Phosphate 

Opioid analgesic

Side Effect – Dizziness, tremors, abdominal cramps, constipation

Gabapentin

Anticonvulsant (Antiseizure medication)

Side Effect – Dizziness, head aches, constipation, nausea and vomiting

Metaclopramide 

Antiemetic and an upper GI Stimulant

Side Effect – Dizziness, head aches, constipation, nausea and drowsiness

Ferrous Sulphate 

Antianemic nutritional supplement (Iron Supplement)

Side Effect – Head Ache, dizziness, abdominal cramps, constipation, black stools

Furosemide 

Diuretic and antihypertensive (Water Medication)

Side Effect – Head aches, dizziness, constipation, abdominal cramps, nausea and vomiting

Omeprazole 

Proton pump inhibitor, anti ulcer medication

Side Effect – Head Ache, dizziness, abdominal pain, constipation

Salbutamol

Bronchodilator

Side Effect – Palpitations, tachycardia, chest discomfort, sore throat, dizziness, tremors, nausea, loss of apetite

Beclomethasone

Corticosteroid

Side Effect – Fever, difficulty breathing, body ache, tightness of chest, dry throat, cough

Actimel

Probiotic suppliment for patients on antibiotics

Common pitfalls

– BP Medications – Ask for BP and PR before administering it

– Digoxin – Ask for PR before administering it

– Paracetamol – Confirm weight is above 50KGs before administering, note for frequency of dose prescribed

– Always check stat and prn medications already administered. Don’t give it again if its not within the frequency times

– Always check for legible prescriptions

– If patient is on oxygen, confirm current saturation with examiner and keep it ongoing if less than target saturation

– If patient is on IV fluids, confirm that patients cannula site is devoid of redness, inflammation etc using WIP score and check Batch number, expiry date of iv fluid. Also check for total running time prescribed.

– Don’t forget to identify patient again before giving first medication

– Also Don’t sign before examiner is telling you that patient has swallowed the medication

– Don’t forget to put the correct code on medications not administered and write the medication name along with reason for not administering at the back of the drug chart. Common Medications

– Don’t forget to check allergies before administering any medication

– There is no problem in giving two BP medications at same time

– IF you are unsure about giving any of the medications prescribed, DONT DO IT and verbalize that i will escalate the matter to concerned doctor and will act accordingly.

Conclusion

Hopes this article throws light into common medication used during Implementation station of NMC OSCE. Always bear in mind that if you are unsure about any medication, don’t give it.