On-call scenario 3: Introduction

"Hi. I’m a registrar on G9 and I just need some quick advice. I’m trying to prescribe clarithromycin but the e-prescribing system keeps flashing up an interaction with citalopram. What do I do about it?"
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Caller: Peter Deakin, admissions registrar, bleep 2221.
Patient: Maria Lopez, aged 58 years.
Medicines: Citalopram 10mg OD, omeprazole 20mg OD, salbutamol inhaler when required.
Clinical problem: Patient just admitted with community acquired pneumonia (CAP). Doctor needs to prescribe IV clarithromycin 500mg BD. Patient takes citalopram for depression. Proven allergy to penicillins (anaphylaxis).
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