Drug Counselling

Question 1

Warfarin

1. explain the drug to patient
2. contra-indications (3)
3. how the treatment works
4. monitoring
   start at -
   what is INR and when is it checked?
5. side effects
   - big one! (seek med advice if [6])
   - rogue ones in a group
6. Interactions (5)

Answer 1

1. explain the drug to patient
   - A blood thinner to prevent clots from forming and therefore
   - You’re at a higher risk because (you’ve had one, you have AF, you’re
2. contra-indications
   - preg
   - risk of major bleeding
   - actively bleeding
3. how the treatment works
   - Inhibits Vit K which helps with clotting the blood
4. monitoring
   - Blood test checks something called INR
   - INR = normal is 1, we want yours higher (mention range) means your blood is thinner and less likely to clot
   - initially start at 5mg every evening
   Check on days 3,4,5 (we’ll give you an anti-coag book)
   - when stable up to every 12 weeks

Also monitor more freq. when you change a dose or change to health or liver

5. side effects
   - Bleeding is a risk - reversal agent vit K and prothrombin
   - Seek medical help if - head injury, prolonged nose bleed, unusual headache, blood in urine/vomit/stool, black stool, severe bruising
   - Diarrhoea, rash, nausea, hair loss
6. It has many interactions therefore:
   - mention to any medical professional that you’re on warfarin when adding another drug
   - dont drastically change your diet of kale, spinach, cranberry juice
   - alcohol binges and NSAIDs

Question 2

DOAC

1. explain the drug to patient
2. contra-indications
3. how the treatment works
4. monitoring
   start at -
   what is INR and when is it checked?
5. side effects
   - big one! (seek med advice if [6])
   - rogue ones in a group
6. Interactions (5)