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Exercise in pregnancy — MRCGP AKT MCQ

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HardExercise PrescriptionExercise in pregnancyMRCGP AKT

A patient mistakenly takes several extra colchicine tablets. Two hours later he feels well and asks whether he can remain at home because no gastrointestinal symptoms have appeared. What is the appropriate response?

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Correct answer: C — Refer for immediate medical assessment despite the absence of symptoms

The best answer is “Refer for immediate medical assessment despite the absence of symptoms”. Colchicine has a narrow therapeutic window and is extremely toxic in overdose. The authorised product information states that all patients should be referred for immediate medical assessment even when early symptoms are absent. Gastrointestinal toxicity may be delayed, and life-threatening multiorgan dysfunction, marrow suppression, dysrhythmia and respiratory failure can follow 24 to 72 hours later. There is no antidote and haemodialysis is ineffective because of the large apparent distribution volume, so observation at home is unsafe.

Reference: Colchicine 500 microgram tablets: Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/100968/smpc