Communicating Information

Question 1

What important information to give a young woman about Ramipril? Elderly?

Answer 1

ACE inhibitors are teratogenic
Change to labetalol before conception

Precautions need to be taken if diarrhoea or vomiting as it increases the risk of AKI
Can cause renal failure
Monitor renal function 1-2 weeks following initiation

Question 2

What important information about tamoxifen?

Answer 2

Anti-oestrogen
Can cause venous thromboembolism - report any le swelling, pain or redness
Increased risk of endometrial cancer

Question 3

What important information about gliclazide?

Answer 3

Sulfonylureas

Can cause Hypoglycaemia - eat regularly and avoid missing meals

Question 4

What important info about methotrexate?

Answer 4

Take once weekly
Risk of infection higher - report any infection
Do not conceive while on methotrexate
Regular monitoring of white blood cells is required given risk of neutropenia
Do not use folate antagonists 0trimethorpim with methotrexate
USe folic acid alongside methotrexate

Question 5

What important info about warfarin

Answer 5

Can interact with other drugs
Rsk of bleeding
Acute alcohol intoxication causes enzyme inhibition - increased warfarin action - increased INR
Chronic excess alcohol causes enzyme induction - reduced warfarin action - reduced INR
Monthly blood testss fro INR once stable
Aim for 2-3 INR unless mechanical prosthetic valves - 3.5

Question 6

What info for long term steroid therapy

Answer 6

Increased risk fo DM - monitor BM regularly
Increased risk of osteoporosis - bisphosphonate if > 3 months
Small increased risk of gastric irritation and ulcers - consider PPI
Do not stop steroids suddenyl due to risk of Addisonian crisis
Risk of hypertension

Question 7

Info for bisphosphonates

Answer 7

Take in the morning 30 minutes before breakfast
Do not take at same time as calcium tablet
Take sitting up and remain upright for 30 minutes at least
Take with a full glass of water

Question 8

Info for insulin

Answer 8

May be required to increase dose in illness as blood glucose increases when unwell
If oral intake is reduced risk fo hypoglycaemia
Rotate injection sites to avoid lipodystrophy

Question 9

Info for SSRIs

Answer 9

can take up to 6 weeks for improvement
Makes you more photosensitive (citalopram)
Can make ou feel worse immdiately after starting
Serotonin syndrome - temperatiure, agitation, hallucination - attend hospital
Dry mouth