Common Drug Explanations Flashcards
How should you organize your explanation of drugs to patients?
ATHLETICS
- Action
- Timeline
- How to take
- Length of treatment
- Effects (time before)
- Tests
- Important side effects
- Complications and contraindications
- Supplementary advice
What is the action of SSRIs?
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.
What is the timeline of SSRI treatment?
once daily
How do you take SSRIs?
Tablet form
What is the length of SSRI treatment?
Stop 3-6mo after feeling better (taper off)
How long before there’s an effect of the SSRI treatment?
4-6 weeks
What tests need to be done to monitor SSRIs?
None
What are some important side effects to note of SSRIs?
- GI upset (diarrhea, nausea, vomiting)
- Appetite + weight change
- Headaches
- Drowsiness (can take at night)
- Anxiety for 2w
- Withdrawal
What are some complications of SSRIs?
None
What are some contraindications for SSRIs?
- Suicide risk (refer)
- Past psychiatric illness
What supplemental advice can you give someone for SSRIs?
www.mind.org.uk
NHS website
What is the action of methotrexate?
It is a disease-modifying drug which reduces inflammation and suppresses the immune system.
Early use improves outcome and symptoms.
What is the timeline of treatment with methotrexate?
- 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.
How do you take methotrexate?
Tablet usually
Injection also available
How long is treatment with methotrexate?
Long term
How long before there are effects of the methotrexate treatment?
3-12wks
What tests are done to monitor methotrexate levels?
FBC, LFTs, U&Es
- Before starting
- Every 2wks until therapy stabilized
- Every 2-3mo afterwards
What are important side effects of methotrexate?
- Alopecia
- Headache
- GI disturbance
- Myelosuppresion
1. Infection (go to A&E if you have fever/other infection signs)
- Unexpected bleeding/bruising/purpura
- Anemia
What are complications of methotrexate use?
- Myelosupression
- Liver toxicity (careful of alcohol)
- Pulmonary toxicity (tell us if you get SOB)
What are contraindications for methotrexate use?
- Pregnancy (including male!)
- Hepatic impairment
- Breast-feeding
- Active infection
- Immunodeficiency
What is some supplemental advice for methotrexate use?
- No NSIADs/aspirin
- Get annual flu jab
arthritisresearch. org.uk
What is the action of lithium?
Mood stabiliser.
Exact mechanism unknown.
Thought to enter the cells and interfere with chemical release + second messenger systems.
What is the timeline of lithium treatment?
1-2x daily depending on the brand
How do you take lithium treatment?
Tablet, capsule, or syrup
What is the length of lithium treatment?
Lifelong usually (if works)
Regular reviews by psychiatrist
How long before lithium treatment works?
1-2 weeks
What tests need to be done for lithium treatment?
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
What are the important side effects of lithium?
- 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)
- Neuromuscular (dysarthria, dizziness, ataxia, in coordination, muscle twitching, tremor)
- Others (drowsiness, apathy, restlessness)
What are complications of lithium treatment?
- Renal toxicity
- Nephrogenic diabetes insipidus
- Hypothyroidism
What are the contraindications to lithium treatment?
- 1st trimester pregnancy
- Breast feeding
- Cardiac disease
- Significant renal impairment
- Addison’s disease
- Low sodium diets
- Untreated hypothyroidism
What supplementary advice can you give someone on lithium treatment?
www.bipolaruk.org.uk
What is the action of atypical anti-psychotics?
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.
What is the timeline of olanzapine treatment?
Tablet daily or depot injection every 2-4wks
How do you take olanzapine?
Tablet or depot injection
Start at a small dose and build up over 1-2 weeks.
Dose adjusted depending on person’s response.
How long is olanzapine treatment for?
Long term (keeps symptoms from returning)
Tell doctor if wanting to get pregnant
How long before olanzapine starts working/see effects?
Several days or weeks
What tests need to be done with olanzapine treatment?
Occasional LFTs (may impair liver function)
What are important side effects of olanzapine?
- Anti-dopaminergic
- Tardive dyskinesia
- Tremor
- Movement disorders - Anticholinergic
- Constipation
- Dry mouth - Antihistaminergic
- Weight gain
- Drowsiness/dizziness - Anti-adrenergic
- Hypotension
What are complications with olanzapine treatment?
- Neuroleptic malignant syndrome (high fever + muscle rigidity)
- Agranulocytosis (swelling of mouth/throat or rash)
- Withdrawal
What are the contraindications for olanzapine treatment?
- Liver failure
- Phaeochromocytoma
Cautions:
- Epilepsy
- DM
- Glaucoma
- Heart, prostate, kidney problems
- Pregnancy
What supplementary advice can you give someone on olanzapine?
www.rethink.org
What is the action of levodopa?
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)
What is the timeline of levodopa treatment?
3-4x daily with food (reduces nausea)
How is levodopa taken?
Tablet
What is the length of levodopa treatment?
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)
How long before there’s an effect with levodopa?
Fast acting
What tests must be done when on levodopa?
None