Counselling points/ points of interest

Question 1

Codeine

Question 2

Omeprazole

Answer 2

May mask the symptoms of gastric cancer - watch out for symptoms such as vomitting, weight loss, adbominal pain, nausea and GI bleeding
Associated with clostridium difficile infections therefore discontinue therapy as soon as possible
Associated with increased risk of fracture and osteoporosis
In hepatic impairment no more than 20mg daily
Tablets and capsules contain enteric coated granules which must not be crushed

Question 3

Amlodipine

Answer 3

Different salts available but no clinical difference

Question 4

Aspirin

Answer 4

Proton pump inhibitor should be considered to reduce risk of GI bleeds
Take with or after food
75mg tablets may be sold to public in packs up to 100
Avoid severe hepatic and renal impairment

Question 5

Bisoprolol

Answer 5

Monitor lung function in patients with asthma/COPD
Avoid abrupt withdrawal
Caution in diabetes, may mask symptoms of hypoglycaemia

Question 6

Chloramphenicol

Answer 6

Sold as P medicine for bacterial conjunctivitis for adults and children over 2 years old with a maximum duration of 5 days
Grey baby syndrome when treatment used in the third trimester and in children under 2 years old
Avoid during pregnancy and breasftfeeding
IV/oral use only for severe life threatening infections as associated with seropus haematological side effects
Avoid repeated courses and prolonged treatment

Question 7

Chlorphenamine

Answer 7

Children and the elderly are more susceptible to side effects
May cause drowsiness, if affected do not drive or operate machinary
POM restrictions does not apply where administration is for saving life in emergency
Sedating antihistamines should be avoided in severe liver disease - increased risk of coma
Caution in epilepsy, prostatic hypetrophy, urinary retention and those susceptoble to angle-closure glaucoma

Question 8

Clotrimazole

Answer 8

Different strengths of cream are licensed for different indications
Oral antifungal treatment should be avoided during pregnancy
Pregnant women need a longer duration of treatment, usually about 7 days, to clear the infection
Cunselling point: cream and pessaries may damage latex condoms and diaphragms

Question 9

Doxazosin

Answer 9

Modified release preparations should not be crushed

Question 10

Fluconazole

Question 11

Furosemide

Question 12

Hydrocortisone

Question 13

Hyoscine butylbromide

Question 14

Hyoscine hydrobromide

Question 15

Ibuprofen

Question 16

Indapamide

Question 17

Loperamide

Question 18

Losartan

Question 19

Macrogols

Question 20

Nicotine

Question 21

Paracetamol

Question 22

Propranolol

Question 23

Ramipril

Question 24

Senna

Question 25

Sildenafil

Question 26

Spironolactone

Question 27

Sumatriptan

Question 28

Tamsulosin