Questions 11 to 15 relate to the following case:  A practice pharmacist is carrying out routine medication reviews and discovers that a patient, Mrs. JN, has been inadvertently co-prescribed edoxaban and rivaroxaban following an unprovoked pulmonary embolism (PE) 2 weeks ago. The patient is contacted and confirms they have been taking both medications for 2 weeks; they state they feel well and haven’t experienced any signs of bleeding or bruising. The patient is advised to stop taking rivaroxaban and the pharmacist decides to investigate how the error has happened.  

Miss LR has been started on intravenous Tazocin® for pyelonephritis. After around 30 minutes, she starts to develop a severe rash, difficulty breathing and swelling of the face.   What type of adverse drug event is this? 

Miss LR is found to have diabetic ketoacidosis (DKA) and is started on an intravenous insulin infusion.  Which statement is CORRECT? 

Mrs. JN is quite concerned about the risk of bleeding and asks whether edoxaban has a reversal agent.  Which statement is CORRECT? 

Which of the following medication-related incidents is classified as a ‘Never Event’ by NHS Improvement? 

Following this, which would be the MOST APPROPRIATE course of action? 

As part of the investigation, the team review the human factors that contributed to the medication incident. Which of the following statements is CORRECT? 

A 75-year-old patient with severe cellulitis is started on intravenous daptomycin. Their regular medications include:  Atorvastatin 40 mg daily  Metformin 500 mg twice daily  Ramipril 10 mg daily  Aspirin 75 mg daily   Which is the MOST APPROPRIATE action regarding their medication regimen? 

Which is NOT a sign of theophylline toxicity? 

Questions 21 to 40 are individual questions and do not relate to any previous case.