Counselling Week 4 (Lis/Dexamfetamine, Mirena, Implanon NXT Implant, Yaz, Micronelle 20ED, Estalis Sequi Patches, Angeliq 1/2 tablets) Flashcards
This medicine is lis/dexamfetamine and the brand we have given you is called….
Lisdexamfetamine: vyvanse
Dexamfetamine: dexamfetamine
Mode of action and indication of lis/dexamfetamine
The active ingredient in this drug is called dexamfetamine/lisdexamfetamine. It belongs to a group of medicines called central nervous system stimulants.
Children suffering from ADHD may have trouble learning or doing school work, and may become aggressive or unmanageable at school or at home. This medication helps improve attention and shuts out distraction allowing the child to concentrate. It does this by altering certain chemicals in the brain.
Lisdex: can also be used for Binge Eating Disorder (BED)
Dexamfetamine: can also be used for people with narcolepsy
Dose and directions for use (C/A labels) for lis/dexamfetamine (3 marks)
Lisdexamfetamine:
comes in 20,30,40,50,60,70mg capsules
>ADHD
Adult, child >6 years, oral 20–30 mg once each morning; if necessary, increase the daily dose by 20 mg at intervals of at least a week. Maximum dose 70 mg daily.
>Binge eating disorder
Adult, oral 30 mg once each morning; increase the daily dose by 20 mg at intervals of at least a week to the usual dose of 50 or 70 mg daily. Maximum dose 70 mg daily. Initial treatment period 12 weeks.
Dexamfetamine:
comes in 5mg only
>ADHD
If total daily dose >5 mg, give in 2 or 3 doses (morning, lunch and afternoon).
6–12 years, oral, initially 2.5 mg in the morning for 1 week; increase daily dose by 2.5–5 mg each week, according to response and tolerability, to a usual range of 0.5–1 mg/kg (maximum 40 mg) daily.
>12 years, oral, initially 5 mg in the morning for 1 week; increase daily dose by 5 mg each week as clinically indicated to a usual range of 0.5–1 mg/kg (maximum 40 mg) daily.
Narcolepsy
Adult, oral, initially 10 mg each morning; gradually increase as clinically indicated to a maximum of 60 mg daily in divided doses.
CAL labels
5: Ask your doctor or pharmacist before using any other medicine including over the counter medicines or health products
12: This medicine may affect mental alertness and/or coordination. If affected, do not drive a motor vehicle or operate machinery.
AE (common, serious, allergic) of Lis/dexamfetamine (3 marks)
All medications can cause side effects, but not everyone will experience them. Some common side effects include nausea, diarrhoea, dry mouth, loss of appetite, weight loss, anxiety
Rarer side effects include rashes and liver dsyfunction
Please see a doctor if you experience chest pain, shortness of breath of irregular heart beat.
Lifestyle/self-care of Lis/dexamfetamine (2 marks)
Avoid taking doses after early afternoon if you have trouble sleeping at night (this may make you feel drowsy next day). This medicine may also make you feel dizzy; do not drive or operate machinery if you are affected.
This medication interacts with other medications including over the counter medicines, make sure you tell your doctor or pharmacist before taking any new medications.
Your cardiovascular function will be monitored alongside height and weight.
Also, monitor to see if the psychostimulant is having an effect in the patient. This includes improved attention, focus and ability to concentrate.
Also monitor to see if the medication is having too much of an effect, this includes if the child becomes withdrawn and doesn’t want to socialise.
This medicine is levonorgestrel and the brand we have given you is called
Mirena -→ it is a intrauterine device
Mode of action and indication of Mirena (3 marks)
Mirena is used for a variety of different conditions, this includes contraception OR Hormone Replacement Therapy in combination with oestrogen OR Heavy Menstrual Bleeding.
>It is placed inside the womb where it slowly releases the hormone over a period of five years or until it is replaced
It is used in hormone replacement therapy to protect the effects of estrogen which can cause excessive growth of the lining from the womb. It does this by making the lining of the womb insensitive to circulating oestrogen.
By making the lining of the womb insensitive to circulating oestrogen, this stops the growth of the lining of the womb which results in a reduction in the volume and duration of menstrual bleeding.
The hormone in Mirena prevents pregnancy by making cervical mucus thicker so that the sperm cannot get through to fertilise the egg and by controlling the womb lining so that it is not thick enough to become pregnant.
Dose and directions for use (C/A labels) for Mirena (3 marks)
Mirena is inserted and removed by a professional experienced in the use of Intrauterine Systems
The system should be inserted within seven days from the beginning of your period.
When Mirena is used to to protect the lining of the womb during Estorgen Replacement Therapy, it can be inserted anytime if you do not have monthly bleeding or else during the last days of menstruation or withdrawal bleeding.
CAL labels
This medicine may make you feel drowsy or dizzy; if affected, do not drive or operate machinery and take the dose at bedtime where possible.
AE (common, serious, allergic) of Mirena (3 marks)
All medications can cause side effects but not everyone will experience them, some common side effects include reduced menstrual flow, post-insertion pain or cramps
Rarer side effects include decreased libido
Please see a doctor if you experience excessive abdominal pain or vaginal bleeding.
Lifestyle/self-care of Mirena (2 marks)
At first your periods may be prolonged or irregular and spotting may occur; with time, periods usually become lighter or even stop. If they become heavier this may mean the IUD has come out.
See a doctor if you have signs of an infection, such as fever, unusual vaginal discharge or pain low in your abdomen because the IUD can increase the chance of pelvic inflammatory disease. It is most likely in the 3 weeks after the IUD is fitted (but can happen at other times).
Make sure you know how to check for presence and length of IUD string each month or after a period as it may be expelled unnoticed. Contact your doctor if you cannot feel the string (especially if you have severe pain).
This medicine is Etonogestrel and the brand we have given you is called…
Implanon NXT
Mode of action and indication of Implanon NXT (3 marks)
Implanon NXT is used to prevent pregnacy, it is placed under the skin of the non-dominant upper arm.
It prevents pregnancy in two ways, it prevent the release of an egg cell from the ovaries (this is known as ovulation). It also thickens the cervical mucus thus making it difficult for sperm to enter the womb.
Replace every 3 years.
Dose and directions for use (C/A labels) for Implanon (3 marks)
Implanon NXT must be inserted and removed by a doctor. A small scar may remain as a result. The doctor will give you a local anaesthetic prior to inserting the Implanon.
Implanon NXT protects you against pregnacy for a period of three years, but if you are overweight, the doctor may advise you to replace the implant earlier.
No preceding hormonal contraceptive: insertion should be done on day 1-5 of normal menstrual bleeding to rule out pregnancy.
If the implant is placed after the fifth day of menses then you should use an additional contraceptive method (such as a condom for the first 7 days after insertion).
Changing from a COC: insert implant at any time; additional contraception is not required.
CAL label
This medicine may make you feel drowsy or dizzy; if affected, do not drive or operate machinery and take the dose at bedtime where possible.
AE (common, serious, allergic) of implanon NXT (3 marks)
All medications can cause side effects, but not everyone will experience them. Some common side effects that may occur include irregular bleeding, breast tenderness and pain, acne and headache
Rarer side effects include loss of libido
You should see a doctor immediately if you experience severe symptoms of a severe allergic reaction such as swollen face, tongue or throat or hives and trouble breathing.
Lifestyle/self-care of Implanon NXT implant (2 marks)
If you cannot feel the implant, use additional contraception and contact your doctor.
This implant wont protect against sexually transmitted infections, only condoms and safe sex practices can protect you from these diseases.
Changes in bleeding pattern usually occur and can include irregular bleeding, prolonged bleeding or periods stopping.
Effectiveness may be reduced by some medicines; check with your doctor or pharmacist before starting or stopping any medicines, including herbal (particularly St John’s wort) and over-the-counter products.
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?
This medicine is drospirenone and ethinylestradiol. The brand we have given you is called….
YAZ
Mode of action and indication of YAZ (3 marks)
This medication is used to prevent pregnancy. It is also used to treat moderate acne and symptoms of premenstrual dysphoric disorder (PMDD) in women seeking oral contraception.
It contains an estrogen and progesterone component which mimics the natural hormones produced in your body. These two hormones will inhibit ovulation, and thicken the mucus in your cervix which stops sperm from reaching the egg and thus fertilisation.
Dose and directions for use (C/A labels) for Yaz (3 marks)
In the box of medication you will say 24 active tablets which contain the hormones I previously mentioned, and 4 inactive tablets.
Take 1 tablet once daily at about the same time each day, you can have it with or without food. Take your first tablet from the green area on the blister pack corresponding to the day of the week.
If you are starting YAZ after a natural cycle, and you have not used a hormonal contraceptive in the past month, start on the first day of your period e.g. on the first day of menstrual bleeding
> While taking inactive pills, a withdrawal bleed (similar to a period) should start. However, sometimes this may not occur. Continue taking the pills as normal but consider the possibility of pregnancy if the pill has not been taken correctly or if 2 withdrawal bleeds in a row are missed.
CAL
AE (common, serious, allergic) of YAZ (3 marks)
All medications can cause side effects, but not everyone will experience them. Some common side effects include breast tenderness, headache, and mood changes.
Rarer side effects include high blood pressure and excessive hair growth
If any of the following symptoms occur while on the pill, stop taking it and seek urgent medical advice: severe and sudden pain in the chest, severe headache, sudden blurred vision or loss of sight, unexplained tenderness or pain and swelling in one leg.
Lifestyle/self-care of Yaz (2 marks)
This medication wont protect against sexually transmitted infections, only condoms and safe sex practices can protect you from these diseases.
- If you vomit within 2 hours of taking an active pill*, take another active pill as soon as possible.
- If you are less than 24 hours late taking an active pill, take it as soon as you remember and take the next pill at the usual time; contraception will not be affected.*
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?
This medication is Levonorgestrel with ethinylestradiol and the brand we have given you is called
Micronelle 20ED
>monophasic low dose
Mode of action and indication of Micronelle 20ED (3 marks)
This medication is used to prevent pregnancy.
It contains an estrogen and progesterone component which mimics the natural hormones produced in your body. These two hormones will inhibit ovulation, and thicken the mucus in your cervix which stops sperm from reaching the egg and thus fertilisation.
Dose and directions for use (C/A labels) for Micronelle 20 ED(3 marks)
Swallow the tablet whole with water. It does not matter if you take it before or after food.
On the blister, each tablet is marked with the day of the week on which it is to be taken. Take one tablet daily in the order directed on the blister, at about the same time every day. This will help you remember when to take it.
There are 21 pink active tablets and and 7 inactive tablets.
Start with a pink (active) tablet from the green zone marked with that day of week. Depending on the day of the week, this may be a pink (active) tablet or a white placebo (inactive) tablet.
If you are starting this medicine after a natural cycle, start on the first day of your period (i.e. the first day of menstrual bleeding). Take a pink (active) tablet from the green zone marked with that day of the week.
You may also start on days 2-5 of your period, but you must also use an additional barrier method of contraception (e.g. condom or a cap or diaphragm with spermicide) for the first 7 days of tablet taking.
While taking inactive pills, a withdrawal bleed (similar to a period) should start. However, sometimes this may not occur. Continue taking the pills as normal but consider the possibility of pregnancy if the pill has not been taken correctly or if 2 withdrawal bleeds in a row are missed.
CAL
AE (common, serious, allergic) of Micronelle 20-ED (3 marks)
All medications can cause side effects, but not everyone will experience them. Some common side effects include breast tenderness, headache, and mood changes.
Rarer side effects include high blood pressure and excessive hair growth
If any of the following symptoms occur while on the pill, stop taking it and seek urgent medical advice: severe and sudden pain in the chest, severe headache, sudden blurred vision or loss of sight, unexplained tenderness or pain and swelling in one leg.
