Counselling points

Question 1

Main counselling points to include with AMIODARONE?

Answer 1

Tell your doctor if you experience any of these symptoms:
-WEIGHT LOSS
-SHORTNESS OF BREATH or DRY COUGH
-Problems with your VISION
-Muscle weakness or worsening of your heart condition.

Your skin will become more sensitive to the sun, use SPF 50+ and wear protective clothing,

You will need regular blood tests, ECG’s and chest X-rays.

Question 2

What are the main counselling points for phenytoin?

Question 3

What are the main counselling points for digoxin?

Question 4

What are the main counselling points for methotrexate?

Question 5

After initiation of cholesterol lowering therapy, when are levels next checked?

Answer 5

Lipids should be measured every FOUR to SIX weeks during dose titration.

Maximum effect is achieved after FOUR weeks.

Question 6

If a patient is on a maintenance dose of cholesterol lowering therapy, how often should they have their levels screened?

Answer 6

Every SIX months.

Question 7

Which statins are more effective if taken at night time?

Answer 7

PRAVASTATIN & SIMVASTATIN
(shorter acting statins)

Question 8

What are the main counselling points of all statins?

Answer 8

Seek medical advice promptly if your urine is dark (brown) or if you have any muscle pain, tenderness or weakness.

Other common side effects include, GI upset, headache,

Question 9

What are the main counselling points of buprenorphine patches?

Answer 9

-Write the date and time of application on the patch
-apply to dry, non-irritated, hairless skin on upper torso
-remove after 7 days and put a new patch on a different area
-do not allow the patch to come into contact with direct sources of heat

Question 10

What counselling points are important to include when informing a patient on how to take their controlled release morphine capsules or tablets?

Answer 10

Controlled release capsules (Kapanol and MS mono) may be opened and the pellets sprinkled on soft food or mixed with 30mL of water.

MS contin tablets must be swallowed whole.

Question 11

Counselling points for impetigo and mupirocin ointment?

Answer 11

Remove crusts at least twice daily or before applying mupriocin
Apply topically to crusted areas every 8 hours for 5 days.

Question 12

What referral point should be included when counselling on allopurinol?

Answer 12

If you develop a rash or other signs of allergy, stop the medication and see your doctor.

Question 13

What is an important referral point to mention to a patient when counselling on clindamycin?

Answer 13

If you get diarrhoea, stop the antibiotic immediately and see your doctor.
This is a rare side effect, but if it does occur you need to stop the medication straight away.

Question 14

How often should urate levels be tested whilst being titrated or started on a xanthine oxidase inhibitor?
And then how often during maintenance?

Answer 14

Every 2-5 weeks during titration
Then every 6 months.

Question 15

What are the main counselling points of agomelatine?

Answer 15

-You may feel DIZZY or SLEEPY, don’t drive until you know how it effects you.
-stop the medication immediately and tell your doctor if you get DARK URINE, PALE stools or YELLOW skin or eyes (this may be a sign of liver injury).
-you will need blood tests to check your liver function at weeks 3, 6, 12 and 24.

Question 16

Are LMWH given SC or IM?

Answer 16

They are to be administered subcutaneously to reduce the risk of a haematoma

Question 17

What are the counselling points of phosphate binders?

Answer 17

• Take at the start of each meal, if you skip a meal then skip your dose.
• Tell your doctor if you become constipated.

Question 18

What are the counselling points of span K?

Answer 18

Take potassium chloride with a meal and plenty of fluid to reduce risk of GI irritation

Question 19

How long should a steroid cream be used on a baby for nappy rash?

Answer 19

3-5 days only

Question 20

What main counselling point should be included when framycetin (soframycin) ear drop?

Answer 20

If you develop ringing in the ears, hearing loss or difficulty with balance, stop using this medication and tell your doctor.
Consider referral to an ENT specialist if prolonged (>10 days) or repeated courses of treatment are required.

(Aminoglycosides are associated with ototoxicity)

Question 21

How long should thyroid levels be checked for a patient being treated for hypothyroidism?

Answer 21

In primary hypothyroidism, monitor TSH and T4 levels every 6–8 weeks and adjust levothyroxine dosage to achieve required TSH (low–mid-normal range); then monitor annually (more frequently in children). Additional monitoring may be required, eg with significant weight change, use of interacting drugs, pregnancy (see above).

Question 22

How should the oral biphosphonates be taken?

Answer 22

Take the tablet on the same day each week 30 minutes BEFORE food, with a full glass of water and remain upright for during this time and until after you eat.

Question 23

Which of the selective alpha blockers for BPH needs to be taken twice daily?

Answer 23

Prazosin, it has a short duration of action and therefore needs to be taken twice daily, compared with the rest of its class which have once daily dosing.

Question 24

What is the process for using clobetasol (clobex) shampoo?

Answer 24

Apply to dry scalp, wash your hands afterwards and leave in for 15 minutes. Then rinse and shampoo.

Apply once daily for up to four weeks.

Question 25

How often should pts have their blood tests when taking colchicine ULT prophylaxis?

Answer 25

Before using colchicine, then ONE month after, then SIX months and then annually.

Question 26

What are the counselling points of allopurinol?

Answer 26

Take with food to reduce stomach upset.
Stop this medication if RASH or other signs of allergy develop and tell your doctor immediately.
Blood tests should occur every 2-5 weeks during dose titration.
You will probably get more gout flares in the first few months of taking this medicine. This doesn’t mean the treatment isn’t working. Eventually flares will improve and and disappear if you keep on taking it.

Question 27

When should a patient be referred when requesting a triptan prescription or S3 product often?

Answer 27

If they are using the triptan on more than 10 days per month.

Question 28

What is the interval for depo-medrocyprogesterone?

Answer 28

Every 3 months

Question 29

What is the interval for the etonogestrel implant (implanon)?

Answer 29

Every 3 years

Question 30

How long does the levonogestrel IUD (mirena) provide contraception for?

Answer 30

5 years

Question 31

Which oral contraceptives have a 3 hour time window in which they need to be taken every day for contraceptive effect?

Answer 31

Levonorgestrel (microlut) AND
Norethisterone (Noriday or primolut)

Question 32

How long does the copper IUD provide contraception for?

Answer 32

5-10 years

Question 33

What do you tell a patient to do if they have missed their COC dose?

Answer 33

If less than 24 hours, take it as soon as you remember and then take the next pill at the usual time, contraception will not be affected.

If more than 24 hours, the pill will not be as effective but still take it as soon as you remember, then take the next dose at the usual time (even if it means taking 2 in one day or at the same time). Use another contraceptive method for 7 days.

Question 34

What is the dosing interval of nuvaring?

Answer 34

THREE weeks and then remove for a ONE week break, then insert a new ring and repeat.

Question 35

What are the shared counselling points of TCA’s?

Answer 35

• You may get side effects such as DRY EYES AND MOUTH, BLURRED VISION and DROWSINESS. They may be troublesome but usually lessen and disappear after about 7 days.
• Try taking this medicine at night to reduce day time drowsiness

Question 36

What are the counselling points of lithium?

Answer 36

-regular blood tests are important during treatment
-be alert for signs and symptoms of lithium toxicity