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Common Drug Explanations > Common Drug Explanations > Flashcards

Common Drug Explanations Flashcards

1
Q

How should you organize your explanation of drugs to patients?

A

ATHLETICS

  • Action
  • Timeline
  • How to take
  • Length of treatment
  • Effects (time before)
  • Tests
  • Important side effects
  • Complications and contraindications
  • Supplementary advice
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2
Q

What is the action of SSRIs?

A

Antidepressants alter the balance of some of the chemicals in the brain.

SSRI antidepressants mainly affect a chemical called serotonin.

An altered balance of serotonin and other chemicals is thought to play a part in causing depression and other conditions.

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3
Q

What is the timeline of SSRI treatment?

A

once daily

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4
Q

How do you take SSRIs?

A

Tablet form

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5
Q

What is the length of SSRI treatment?

A

Stop 3-6mo after feeling better (taper off)

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6
Q

How long before there’s an effect of the SSRI treatment?

A

4-6 weeks

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7
Q

What tests need to be done to monitor SSRIs?

A

None

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8
Q

What are some important side effects to note of SSRIs?

A
  • GI upset (diarrhea, nausea, vomiting)
  • Appetite + weight change
  • Headaches
  • Drowsiness (can take at night)
  • Anxiety for 2w
  • Withdrawal
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9
Q

What are some complications of SSRIs?

A

None

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10
Q

What are some contraindications for SSRIs?

A
  • Suicide risk (refer)

- Past psychiatric illness

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11
Q

What supplemental advice can you give someone for SSRIs?

A

www.mind.org.uk

NHS website

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12
Q

What is the action of methotrexate?

A

It is a disease-modifying drug which reduces inflammation and suppresses the immune system.

Early use improves outcome and symptoms.

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13
Q

What is the timeline of treatment with methotrexate?

A
  • Once weekly with folic acid at another time.
  • Take at same time each week
  • Build up dose slowly.
  • Taken long-term if effective.
  • Takes 3-12wks to work.
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14
Q

How do you take methotrexate?

A

Tablet usually

Injection also available

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15
Q

How long is treatment with methotrexate?

A

Long term

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16
Q

How long before there are effects of the methotrexate treatment?

A

3-12wks

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17
Q

What tests are done to monitor methotrexate levels?

A

FBC, LFTs, U&Es

  • Before starting
  • Every 2wks until therapy stabilized
  • Every 2-3mo afterwards
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18
Q

What are important side effects of methotrexate?

A
  • Alopecia
  • Headache
  • GI disturbance
  • Myelosuppresion
    1. Infection (go to A&E if you have fever/other infection signs)
  1. Unexpected bleeding/bruising/purpura
  2. Anemia
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19
Q

What are complications of methotrexate use?

A
  1. Myelosupression
  2. Liver toxicity (careful of alcohol)
  3. Pulmonary toxicity (tell us if you get SOB)
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20
Q

What are contraindications for methotrexate use?

A
  1. Pregnancy (including male!)
  2. Hepatic impairment
  3. Breast-feeding
  4. Active infection
  5. Immunodeficiency
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21
Q

What is some supplemental advice for methotrexate use?

A
  • No NSIADs/aspirin
  • Get annual flu jab
    arthritisresearch. org.uk
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22
Q

What is the action of lithium?

A

Mood stabiliser.

Exact mechanism unknown.

Thought to enter the cells and interfere with chemical release + second messenger systems.

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23
Q

What is the timeline of lithium treatment?

A

1-2x daily depending on the brand

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24
Q

How do you take lithium treatment?

A

Tablet, capsule, or syrup

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25
Q

What is the length of lithium treatment?

A

Lifelong usually (if works)

Regular reviews by psychiatrist

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26
Q

How long before lithium treatment works?

A

1-2 weeks

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27
Q

What tests need to be done for lithium treatment?

A

Before starting: FBC, U&Es, TFTs, bHCG, ECG

  • Check lithium level after 5d, then every week until stable for 4wks, then every 3mo
  • Check TFTs, U&Es, Ca2+ every 6mo
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28
Q

What are the important side effects of lithium?

A
  • GI (abdo pain, nausea)
  • Metallic taste
  • Fine tremor
  • Water symptoms (thirst, polyuria, impaired urinary concentration, weight gain, oedema)

Lithium toxicity symptoms
1. GI (anorexia, vomiting, diarrhea)

  1. Neuromuscular (dysarthria, dizziness, ataxia, in coordination, muscle twitching, tremor)
  2. Others (drowsiness, apathy, restlessness)
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29
Q

What are complications of lithium treatment?

A
  1. Renal toxicity
  2. Nephrogenic diabetes insipidus
  3. Hypothyroidism
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30
Q

What are the contraindications to lithium treatment?

A
  • 1st trimester pregnancy
  • Breast feeding
  • Cardiac disease
  • Significant renal impairment
  • Addison’s disease
  • Low sodium diets
  • Untreated hypothyroidism
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31
Q

What supplementary advice can you give someone on lithium treatment?

A

www.bipolaruk.org.uk

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32
Q

What is the action of atypical anti-psychotics?

A

Schizophrenia is caused by an over-activity of chemicals in transmission of messages in the brain.

Olanzapine works by blocking the receptors in the brain that are involved in tramsitting these messages between nerve cells.

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33
Q

What is the timeline of olanzapine treatment?

A

Tablet daily or depot injection every 2-4wks

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34
Q

How do you take olanzapine?

A

Tablet or depot injection

Start at a small dose and build up over 1-2 weeks.

Dose adjusted depending on person’s response.

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35
Q

How long is olanzapine treatment for?

A

Long term (keeps symptoms from returning)

Tell doctor if wanting to get pregnant

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36
Q

How long before olanzapine starts working/see effects?

A

Several days or weeks

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37
Q

What tests need to be done with olanzapine treatment?

A

Occasional LFTs (may impair liver function)

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38
Q

What are important side effects of olanzapine?

A
  1. Anti-dopaminergic
    - Tardive dyskinesia
    - Tremor
    - Movement disorders
  2. Anticholinergic
    - Constipation
    - Dry mouth
  3. Antihistaminergic
    - Weight gain
    - Drowsiness/dizziness
  4. Anti-adrenergic
    - Hypotension
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39
Q

What are complications with olanzapine treatment?

A
  1. Neuroleptic malignant syndrome (high fever + muscle rigidity)
  2. Agranulocytosis (swelling of mouth/throat or rash)
  3. Withdrawal
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40
Q

What are the contraindications for olanzapine treatment?

A
  • Liver failure
  • Phaeochromocytoma

Cautions:

  • Epilepsy
  • DM
  • Glaucoma
  • Heart, prostate, kidney problems
  • Pregnancy
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41
Q

What supplementary advice can you give someone on olanzapine?

A

www.rethink.org

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42
Q

What is the action of levodopa?

A

Levodopa works to replace some of the dopamine your brain is no longer able to make.

This will help to reduce your symptoms, particularly your rigidity and slow movements.

Given with carbidopa (inhibits peripheral levodopa degeneration)

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43
Q

What is the timeline of levodopa treatment?

A

3-4x daily with food (reduces nausea)

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44
Q

How is levodopa taken?

A

Tablet

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45
Q

What is the length of levodopa treatment?

A

As long as it works effectively

After 5 years most suffer end dose deterioration (works for shorter time) and on-off effect (fluctuate between severe parkinsonism + repetitive involuntary movements)

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46
Q

How long before there’s an effect with levodopa?

A

Fast acting

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47
Q

What tests must be done when on levodopa?

A

None

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48
Q

What are some side effects of levodopa?

A
  • Psychosis
  • Nausea/vomiting
  • Dyskinesia
  • Postural hypotension

*Other drugs help with these: domperidone (peripheral dopamine antagonist) + selegiline (inhibits dopamine degeneration in CNS so lower levodopa dose can be used)

49
Q

What are the complications of levodopa treatment?

A
  1. End-dose deterioration

2. On-off effects

50
Q

What are the contraindications for levodopa treatment?

51
Q

Where can one find supplemental info on levodopa?

A

parkinsons.org.uk

52
Q

What is the action of bisphosphonates?

A

Prevents bone from being broken down and by helping to rebuild new bone.

Remember lifestyle factors can also help with this: exercise, no smoking, eating a well-balanced diet

53
Q

What is the timeline of taking bisphosphonates?

A

Once weekly or smaller dose daily

54
Q

How are bisphosphonates taken?

A

Swallow tablet with full glass of water.

Take at least 30min before food or anything other than water.

Be upright for 30min after swallowing (big tablet)

55
Q

How long do you need to stay on bisphosphonates?

56
Q

How long before you feel the effects of bisphosphonates?

57
Q

What tests must be done for bisphosphonates?

A

Dental checkups - before starting then regularly

B/c risk of osteonecrosis of jaw

58
Q

What are side effects of bisphosphonates?

A
  • Headache
  • Heartburn, bloating, indigestion
  • GI (diarrhea, constipation, black stools, abdominal pain)
59
Q

What are complications of taking bisphosphonates?

A

Osteonecrosis of the jaw

60
Q

What are contraindications to bisphosphonates?

A
  1. Pregnancy
  2. Dysphagia
  3. Stomach ulcers
  4. Severe renal impairment
61
Q

Where can one find more info about bisphosphonates

A

www.Nos.org.uk

62
Q

What is the action of warfarin?

A

Thins the blood.

It does this by blocking vitamin K - the vitamin used by the body to make proteins that cause the blood to clot.

63
Q

What is the timeline of taking warfarin?

A

Once daily (usually in the evening)

64
Q

How do you take warfarin?

65
Q

How long is warfarin treatment?

A 
3mo = DVT
6mo = PE
Lifelong = AF
66
Q

How long before you feel the effects of warfarin?

67
Q

What tests must be done when on warfarin?

A
  • Start 5mg for 4 days then test INR on day 5 + 8 adjusting dose accordingly
  • Started concomitantly with LMWH if immediate effect is required
  • Then regularly check INR by anti-coagulation clinic (regularity determined by INR stability)
68
Q

What are important side effects of warfarin?

A
  1. Bleeding (bruises, dark stool, cuts take longer to heal)
  2. Diarrhea
  3. Rash
  4. Hair loss
  5. Nausea
  • Many drug interactions
  • Mainly with cytochrome P450 inhibitors/inducers, steroids
69
Q

What are complications of warfarin?

70
Q

What are contraindications for warfarin?

A
  • Pregnancy
  • Hemorrhagic stroke
  • Significant bleeding

*Caution in patients at high risk of falls

71
Q

What is some supplementary advice for those on warfarin?

A

Avoid liver, spinach, cranberry juice, alcohol binges

No NSAIDs/aspirin

Give anticoagulant book

72
Q

What is the action of levothyroxine?

A

A synthetic version of the normal hormone produced by the thyroid gland called thyroxine.

It is given to bring your thyroxine levels back up to normal

73
Q

What is the timeline of levothyroxine?

A

Once daily before breakfast

74
Q

How do you take levothyroxine?

75
Q

How long do you take levothyroxine for?

76
Q

What tests must be done when on levothyroxine?

A
  • Start test does then review in 2-3 weeks
  • TSH test every 2-3mo until stable
  • When TSH level stable, check annually
77
Q

What are the side effects of levothyroxine?

A

Rare when thyroxine level stable as it’s replacing a normal hormone.

May be hyperthyroid symptoms if level is too high

  • Vomiting
  • Diarrhea
  • Headache
  • Palpitations
  • Heat intolerance

Or hypothyroid symptoms if level is too low

78
Q

What are complications and contraindications to levothyroxine treatment?

79
Q

What is supplementary advice for levothyroxine?

A

Free prescriptions for everything if taking levothyroxine

80
Q

What is the action of a statin?

A

Statins stop the liver making cholesterol

Cholesterol is one of the things which predisposes to artery problems causing heart disease, stroke, and kidney disease

(Its important to also address other risk factors when talking to the patient)

81
Q

What is the timeline of statin treatment?

A

Once daily in the evening

82
Q

How do you take a statin?

83
Q

What is the length of statin treatment?

84
Q

When do you feel the effects of statins?

A

Decreases risk over many years

85
Q

What are the tests when taking a statin?

A

Review in 4w then every 6mo

LFTs before starting, at 3mo and at 12mo (statins cause altered LFTs)

86
Q

What are important side effects of statins?

A
  1. Muscle pains
  2. Hair loss
  3. Itching

Also nausea, sickness, diarrhea, abdominal pain

87
Q

What are complications of statin treatment?

A

Rhabdomyolysis

88
Q

When is a statin contraindicated?

89
Q

What is supplementary advice when taking a statin?

A

Avoid grapefruit juice

www.bhf.org.uk

90
Q

What is the action of metformin?

A

Increases the sensitivity of cells to insulin, thereby allowing the body to make better use of the lower insulin levels.

91
Q

What is the timeline of metformin treatment?

A

Once daily with breakfast (may be increased to 2x daily)

92
Q

How is metformin taken?

A

Take tablet with or immediately after a meal at the same time each day

93
Q

How long is metformin taken for?

A

Lifelong if it works

94
Q

When are the effects of metformin felt?

95
Q

What tests need to be done when on metformin?

A

U&Es before starting, then annually

96
Q

What are side effects of metformin?

A
  • Nausea
  • Diarrhea
  • Abdo pain
  • Weight loss
97
Q

What are complications of metformin?

A

Lactic acidosis

98
Q

What are contraindications for metformin treatment?

A
  1. Renal impairment
  2. Ketoacidosis
  3. Low BMI

NB: metformin must not be taken on the day of, and for 2 days after having general anaesthetic or X-ray contrast media (increase lactic acidosis risk)

99
Q

What is supplementary advice for metformin?

A

If miss a dose, take as soon as remember unless its close to next dose time

www.diabetes.org.uk

100
Q

What is the action of iron tablets (ferrous sulphate)?

A

Replace your body’s store of iron, a mineral required to make red blood cells (which is deficient)

101
Q

What is the timeline of taking iron tablets?

A

1-3 times daily (depending on brand)

102
Q

How do you take iron tablets?

A

Work best if taken on empty stomach but most can be taken with food b/c iron can irritate the stomach

Tablet

103
Q

How long are iron tablets taken for?

A

Usually 4mo

3-4weeks for Hb to normalise, then take for 3mo after that to replenish stores

104
Q

How long before seeing an effect on iron tablets?

105
Q

What tests must be done when on iron tablets?

A

Hb after 3-4 weeks

106
Q

What are side effects of iron tablets?

A
  1. GI irritation
    - Nausea/vomiting
    - Diarrhea
    - abdo pain
  2. Black-coloured stools
  3. Bad taste
107
Q

What are complications/contraindications of iron tablets?

108
Q

What is supplementary advice for iron tablets?

109
Q

What is the action of a salbutamol inhaler?

A
  • Relieves symptoms of asthma/COPD attack

- Inhaler contains a set dose of medication that should end up in your lungs

110
Q

How is an inhaler used?

A
  1. Check expiration date of inhaler
  2. Shake vigorously
  3. Remove lid and check mouthpiece is clean
  4. Stand/sit up straight
  5. Hold inhaler upright with index finger on top and thumb on bottom
  6. Breath out completely
  7. Seal mouth well around mouthpiece
  8. Simultaneously press down on canister while taking slow deep breath in (aim for back of throat, not tongue)
  9. Hold breath for 10s (or as long as possible)
  10. Breath out slowly
  11. Replace cap
  12. Repeat after 1min if required
111
Q

What are the side effects of salbutamol inhalers?

A
  1. Tachycardia
  2. Tremor
  3. Anxiety
  4. Paradoxical bronchospasm
  5. HypoK+
112
Q

What supplementary advice would you offer for someone taking a salbutamol inhaler?

A
  • Go to A&E if symptoms not relieved or are severe
  • See GP/specialist nurse if using inhaler >3x/week
  • Can use spacer if patients finding complicated to use inhaler
113
Q

What is the action of a steroid inhaler?

A
  • Prevent an asthma/COPD attack from happening
  • Use in the morning and evening
  • Rinse mouth out after use

If on high dose steroids (≥250mcg) carry a steroid card!!

114
Q

What are the side effects of a steroid inhaler?

A
  1. Dry mouth
  2. Hoarse voice
  3. Oral thrush

Oral:

  1. Adrenal crisis
  2. Infection
  3. Osteoporosis
  4. GI upset
115
Q

What is the action of GTN spray?

A
  • Relaxes blood vessels increasing blood flow throughout your body and to the heart
  • Take it when you have chest tightness (anginal pain) or pre-emptively when you’re expecting to experience pain (i.e. will be going up a hill)
116
Q

How do you take GTN spray?

A
  1. Sit down
  2. Spray 1-2 sprays under the tongue
  3. Close mouth
  4. Pain should go away within 5min, if not use again
  5. If pain still remains after 15min call an ambulance
117
Q

What are the side effects of GTN spray?

A
  1. Headache
  2. Flushing
  3. Light-headedness (hypotension)
118
Q

What are the contraindications for GTN spray?

A
  1. Hypotensive conditions
  2. Arrhythmias
  3. Raised ICP
  4. Marked anemia

Common Drug Explanations (2 decks)

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