Counselling Week 2 (Warfarin, Oxycodone, Pregabalin, Tramadol, Levothyroxine)

Question 1

This medicine is wafarin and the brand we have given you is called …?

Answer 1

Coumadin (1mg, 2mg,5mg)

Marevan (1mg,3mg,5mg)

Question 2

Mode of action and indication of warfarin (3 marks)

Answer 2

Warfarin helps prevent blood clots forming, it increases the time it takes for blood to clot. Reduces the chances of stroke, heart attack and other health problems.

It is used in people who are at risk of developing blood clots or those that already have a blood clot

Question 3

Dose and directions for use (C/A labels) for (3 marks)

Answer 3

Take ONE tablet (5mg) once daily for 2 days then adjust according to INR. Can take 1-10mg once daily.

CAL 5,10b,21

• Ask doctor or pharmacist before using any other medicines including over the counter medicines or health products (5)
• Do not take aspirin or anti-inflammatory medicines while being treated with this medicine (10b)
• Special handling and disposal required (21)

Question 4

AE (common, serious, allergic) of warfarin (3 marks)

Answer 4

All medications can cause side effects, but not everyone will experience them. Bleeding may occur.

Rarer side effects include skin necrosis, alopecia and rash

Tell your doctor if you have red or black faeces

Question 5

Lifestyle/self-care of Warfarin (2 marks)

Answer 5

your health professional will organise for you to have regular blood tests that help check how well the warfarin is working

Avoid excessive alcohol consumption; 1–2 standard drinks daily is generally safe.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 6

This medication is oxycodone and the brand we have given you is called …?

Answer 6

Oxycodone, endone, oxycontin, novacodone

5,10,15,20,30,40,80mg

Question 7

Mode of action and indication of oxycodone (3 marks)

Answer 7

This medication works by binding to opioid receptors which are found in your central nervous system (brain and spine), this changes your perception of pain and gives you relief from pain.

It is used to manage moderate to severe pain

Question 8

Dose and directions for use (C/A labels) for oxycodone (3 marks)

Answer 8

Acute pain: 5–15 mg every 4 hours (1 tablet every 4 hours as tablet comes in strength of 5,10,15mg)

Chronic non-cancer pain: oral 5–10 mg twice daily (1 tablet twice daily)

CAL: 1,18

• This medicine may cause drowsiness and may increase the effects of alcohol. Do not drive a motor vehicle or operate machinery.
• Avoid eating grapefruit or drinking grapefruit juice while on this medicine

Question 9

AE (common, serious, allergic) of oxycodone (3 marks)

Answer 9

All medications can cause side effects, but not everyone will experience them. Initially drowsiness, dizziness and constipation may occur.

Rarer side effects include seizures

Please see a doctor if you have difficulty to breathe properly –> respiratory depression (dont say this tho….duh)

Question 10

Lifestyle/self-care of Oxycodone (2 marks)

Answer 10

Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly

If you are very sleepy or have trouble staying awake, stop taking the medication and tell your doctor immediately.

Medication makes you feel more drowsy and may increase the effects of alcohol, do not drive.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 11

This medicine is pregabalin and the brand we have given you is called …?

Answer 11

Lypralin, lyrica, lyzalon, neuroccord –> 25mg,75mg, 100mg, 300mg

Question 12

Mode of action and indication of pregabalin (3 marks)

Answer 12

The way pregabalin works is not exactly understood but it may control brain chemicals and stopping signals to nerves so pain and seizures are reduced.

It is used for neuropathic pain and focal (partial) seziures

Question 13

Dose and directions for use (C/A labels) for pregabalin (3 marks)

Answer 13

Neuropathic pain: 1 tablet at night (75mg) at night for one week then 150mg daily in or two doses.

> maximum of 2 tablets (150mg) twice daily

Focal (partial) seizures: 1 tablet twice daily (75mg), increase after one week to one tablet (150mg) twice daily.

> maximum of 2 tablets (150mg) twice daily

Question 14

AE (common, serious, allergic) of pregabalin (3 marks)

Answer 14

All medications can cause side effects, but not everyone will experience them. Some of these adverse effects may include dizziness, drowsiness, constipation and dry mouth

Rarer side effects include severe skin reactions and low urine output

Please see a doctor if you have swelling of the face and lips or other parts of the body.

Question 15

Lifestyle/self-care of Pregabalin (2 marks)

Answer 15

Pregabalin may also increase the effects of alcohol so limit alcohol consumption

This medicine may cause drowsiness or dizziness; if affected, do not drive or operate machinery.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 16

This medicine is tramadol and the brand we have given you is called …?

Answer 16

Tramal SR, tramedo SR, zydol SR

50mg, 100mg, 150mg, 200mg

Question 17

Mode of action and indication of tramadol (3 marks)

Answer 17

This medicine binds to receptors in the central nervous system and blocks pain signals to the rest of the body. It also alters chemicals in the brain which causes pain relief.

It is used for severe pain, acute and chronic pain

Question 18

Dose and directions for use (C/A labels) for tramadol (3 marks)

Answer 18

Conventional product, oral: Take 1 or 2 tablets (50–100 mg) every 4–6 hours when necessary; maximum 400 mg daily.

Controlled release tablet, 50–200 mg every 12 hours; maximum 400 mg daily.

CAL label:** **1,5

• This medicine may cause drowsiness and may increase the effects of alcohol, if affected do not drive a motor vehicle or operate machinery
• Ask your doctor or pharmacist before using any other medicine including over the counter medicines or health products

Question 19

AE (common, serious, allergic) of tramadol (3 marks)

Answer 19

All medications can cause side effects, but not everyone will experience them. Some of these may include weakness and sweating

Some rarer side effects include severe skin reactions

Please see a doctor if there is shortness of breath or difficulty breathing

Question 20

Lifestyle/self-care of tramadol (2 marks)

Answer 20

Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.

This medication may make you feel drowsy and may increase the effects of alcohol. If you are affected, do not drive

If you are very sleepy or have trouble staying awake, stop taking the medication and tell your doctor immediately.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 21

This medicine is levyothyroxine and the brand we have given you is called …?

Answer 21

25,50,75,100,125,200 mcg

eltorxin,eutroxsig,oroxoine

Question 22

Mode of action and indication of levothryoxine (3 marks)

Answer 22

This medicine contains a thyroid hormone which is used as a replacement therapy of thyroid hormone deficiency.

It t is used for hypothyroidism where there isn’t enough thyroxine in the body and this hormone is important for controlling metabolism. Also used for TSH-responsive tumours where there needs to be thyroid hormone in the body to be treated.

Question 23

Dose and directions for use (C/A labels) for levothyroxine (3 marks)

Answer 23

Oral, usual range, 50–200 micrograms once daily –> 1 tablet daily if 50mcg or 200mcg daily as it comes in this strength.

CAL labels: 3b, 4a

• ​Take on an empty stomach at least half an hour before meals and at bedtime
• Do not take dairy prodcuts, antacids or mineral supplements within two hours of each dose of this medicine

Question 24

AE (common, serious, allergic) of levothyroxine (3 marks)

Answer 24

All medications can cause side effects, but not everyone will experience them. Some of these side effects may include muscle cramps, headache and diarrhoea.

Rarer side effects include excessive weight loss

Please contact a doctor if you experience severe skin rashes

Question 25

Lifestyle/self-care of Levothyroxine (2 marks)

Answer 25

Tell your doctor if symptoms of hyperthyroidism occur, eg palpitations, excitability, insomnia, flushing, sweating or weight loss

Take levothyroxine on an empty stomach, preferably before breakfast.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?