Common drug counselling

Question 1

SSRI

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 1

1) Works to increase levels of chemicals in the brain to improve your mood
2) May feel more anxious for a few weeks.
3) Take once a day
4) Take until symptoms better then for 6m. Taper off, do not stop suddenly
5) 4 weeks
6) none

7) GI upset e.g. diarrhoea
Dry mouth
Appetite and weight change
Headaches

Withdrawal

8) bleeding with NSAIDs

suicide risk - check

Question 2

Methotrexate

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 2

1) Disease modifying drug
help symptoms but usually not the progression

Suppress the immune system

2) Take once a week - tablet

3) Take once a week (monday)
Folic acid on a friday

4) Can be lifelong
5) Usually takes 4-6 months

6) Chest x-ray
Liver and kidney function
FBC

check this every 2 weeks until stabilised
then every 2-3 months

7) Ulcers
hair loss
GI upset

infection
anaemia
bruising

8)
myelosupression
liver - CAREFUL WITH ALCOHOL
lung fibrosis - let us know if you become breathless

Contraception

wait 6m before trying for a baby

9) No NSAIDs/ aspirin
annual flu jab

athritisresearch.org.uk

Question 3

Lithium

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 3

1) mood stabilising drug
2) take once or twice a day depending on the brand
3) tablet, capsule or syrup
4) life long?
5) 1-2 weeks
6) LFT, U&E, FBC, TFTs, beta-HCG, ECG

important to check levels after 5 days
then every week until stable for 4 weeks
then every 3 months

7) GI upset - abdo pain and nausea
metallic taste
fine tremor
thirst, polyuria, weight gain, oedema

8) hypoT
renal toxicity

Contraindications - 1st trimester of pregnancy
breast feeding
renal impairment - significant
untreated HypoT

Question 4

Atypical anti- psychotics

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 4

Work by blocking certain receptors in the brain to prevent chemical overactivity

Tablet OR depot injection every 2-4 weeks

Dose increased over 1-2 weeks

Long term

Can take days to weeks for full effects to be shown

May need LFT tests
Regular WBC test in clozapine

SE

1) anti-dopaminergic
2) Anti-cholinergic - dry eyes, mouth and constipation
3) Anti-histaminergic - weight gain, dizziness and drowsyness
4) Anti-adrenergic - hypotension

Watch out for neuroleptic malingnant syndrome - high fever and rigidity

Clozapine - agranulocytosis

contraindicated in liver failure

rethink.org.uk

Question 5

Levodopa

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 5

Replace dopamine to reduce symptoms
given with carbidopa

3-4 times a day with food - SAME time

tablet

Use for as long as it works effectively. May get end dose deterioration or on-off effect after 5 years

fast acting

SE

• postural hypotension
• N&V
• dyskinesias
• psychosis

Contraindicated - glaucoma

Question 6

Bisphosphonates

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 6

Prevent bone from being broken down and builds up bone - remember exercise factors can help

once a week

Full glass of water, sit up for 30 mins, take before food and other tablets

Long term

Important to have regular dental checks

SE

• headache
• heart burn
• bloating
• GI upset

Contraindications

• pregnancy
• dysphagia
• stomach ulcers
• severe renal impairment

Question 7

Levothyroxine

1) Action
2) Timeline
3) How to take
4) Length of treatment
5) Effects - time before
6) Tests
7) Important SE
8) Complications and contraindications
9) Supplementary advice

Answer 7

1) Replaces the hormone you are low in
2) Once a day
3) Before food
4) Life long
5) Few weeks
6) Check your thyroid function
7) (rare) Fast heart rate, may be irregular. Diarrhoea, sweating, heat intolerance
8) -
9) -