Group 2 Key Counseling Points and Clinical Pearls

Question 1

What are the key patient counseling points/clinical pearls for albuterol?

Answer 1

Instruct patient on inhaler technique (priming and shaking well before use)
Wash mouthpiece and air dry weekly to prevent blockage
Contact prescriber if more is needed than usual to control symptoms
Hold breath for at least 10 seconds
Do not use as chronic therapy treatment without an anti-inflammatory agent

Question 2

What are the key patient counseling points/clinical pearls for azelastine?

Answer 2

Can cause severe drowsiness, avoid alcohol, driving, heavy machinery
Review proper instillation technique, priming on first use and if not used for >3 days
Blow nose prior to use and keep tip clean
Don’t spray into the septum, may cause temporary taste disturbance

Question 3

What are the key patient counseling points/clinical pearls for budesonide?

Answer 3

Advise patient on proper inhalation technique
Gently swirl nebulizer solution before use, use immediately after opening to prevent contamination
Once nebulizer foil is open the 5 containers inside only good for 2 weeks
Deliver nebulized solution over 5-15 minutes
Rinse mouth with water and spit to prevent oral thrush
Not indicated for acute asthma attacks, respules only for kids

Question 4

What are the key patient counseling points/clinical pearls for budesonide/formeterol?

Answer 4

Advise patient on proper inhalation technique
If more than 1 inhalation prescriber, wait 1 min between doses and shake well in between
Rinse mouth with water and spit to prevent oral thrush
Wash mouthpiece and air dry weekly
Long-acting beta agonist (LABAs) can increase asthma related deaths and hospitalizations, only used for not adequately controlled on long term asthma control medication

Question 5

What are the key patient counseling points/clinical pearls for cetirizine?

Answer 5

May cause dizziness or sedative effects, avoid activities that may require alertness and coordination until sedation effects are known

Question 6

What are the key patient counseling points/clinical pearls for dicyclomine?

Answer 6

May cause drowsiness, avoid driving or operating heavy equipment
Chronic use not recommended
Dangerous for infants

Question 7

What are the key patient counseling points/clinical pearls for docusate?

Answer 7

May require several days (12-72 hours) of treatment before softening is noticeable
Take single daily dose or divided if desired
Discontinue and contact Dr if rectal bleeding occurs or no bowel movement after proper use
Don’t use with products containing mineral oil
Reduces straining, recommended for post op pt

Question 8

What are the key patient counseling points/clinical pearls for esomeprazole?

Answer 8

Take 1 hour before meals for best effect
Dont take multiple PPI at once
After chronic use wean slowly, reduce dose 50% for 2-4 weeks

Question 9

What are the key patient counseling points/clinical pearls for famotidine?

Answer 9

Take at bedtime
May take with food or antacids
Shake suspension well before use
Do not take with additional PPI or H2 antagonists

Question 10

What are the key patient counseling points/clinical pearls for fluticasone (nasal)?

Answer 10

Advise patients on proper administration technique
Instruct patient to monitor for signs of toxicity (fatigue, weakness)
May be a scent
First line therapy for allergic rhinitis, effective treatment of nasal symptoms with limited systemic absorption

Question 11

What are the key patient counseling points/clinical pearls for fluticasone (inhaled)?

Answer 11

Proper administration technique for specific product
Rinse mouth with water after each use to prevent oral infections

Question 12

What are the key patient counseling points/clinical pearls for fluticasone/salmeterol?

Answer 12

Proper administration technique for specific product
Rinse mouth with water after each use to prevent oral infections
LABAs should not be used alone
Med guide required

Question 13

What are the key patient counseling points/clinical pearls for fluticasone/umeclidinium/vilanterol?

Answer 13

Rinse mouth with water and spit to avoid fungal infection
Use as prescribed one puff a day, not meant to rescue

Question 14

What are the key patient counseling points/clinical pearls for fluticasone/vilanterol?

Answer 14

Rinse mouth with water and spit to avoid fungal infection
Does not treat acute symptoms

Question 15

What are the key patient counseling points/clinical pearls for ipratropium/albuterol?

Answer 15

Instruct patient on proper inhaler technique
Wash mouthpiece in warm water and air dry daily
Store at room temp, avoid excess heat and moisture
Use in caution with patients that have bladder neck onbstruction, narrow glaucoma or BPH
Med guide required

Question 16

What are the key patient counseling points/clinical pearls for levocetirizine?

Answer 16

May cause dizziness or sedative effects, avoid activities requiring mental alertness or coordination until effects are known

Question 17

What are the key patient counseling points/clinical pearls for loratadine?

Answer 17

Avoid allergic triggers
Use scheduled doses instead of PRN, symptoms should improve in 3-4 days but require 14 days for benefit
May cause drowsiness or sedation, use caution diriving operating heavy machinery until effects are known
Can cause additive sedation with alcohol
Use with caution in patients with severe hepatic or renal dysfunction

Question 18

What are the key patient counseling points/clinical pearls for meclizine?

Answer 18

Take with food to decrease GI symptoms
May cause drowsiness, use with caution until effects known
Avoid alcohol and other CNS depressants
Use with caution in patients with asthma, glaucoma, or enlargement of the prostate gland
Do not crush or chew, unless indicated
Avoid therapy duplication in OTC
Take 1 hour before travel for motion sickness

Question 19

What are the key patient counseling points/clinical pearls for montelukast?

Answer 19

Patients with asthma or allergic rhinitis should take in the evening
Not indicated for acute asthma attacks
Report increased use of short-acting inhaled bronchodilators, do not increase or decrease dose of other asthma mediations without Dr instruction
Not first line treatment

Question 20

What are the key patient counseling points/clinical pearls for omeprazole?

Answer 20

Take 1 hour before meals for best effect
Do not duplicate therapy with OTC meds
Increase risk of fractures, use with caution in those with osteoporosis

Question 21

What are the key patient counseling points/clinical pearls for ondansetron?

Answer 21

Dry hands before handling ODT, only open blister pack when ready to take
Don’t need to drink water
Can be used in combo for chemo vomiting treatment

Question 22

What are the key patient counseling points/clinical pearls for pantoprazole?

Answer 22

Can be taken with or without food, best if taken before meals to reduce acid production caused by food
Seek medical care for severe headache or blistering skin rash
Do not duplicate therapy with OTC products

Question 23

What are the key patient counseling points/clinical pearls for promethazine?

Answer 23

Avoid alcochol
May cause drowsiness, avoid driving or tasks requiring motor cordination
Use caution in elderly
May take with food or milk to reduce GI effects

Question 24

What are the key patient counseling points/clinical pearls for sucralfate?

Answer 24

Take on empty stomach and do not take any other meds within 2-4 hours
Shake suspension well and store at room temp

Question 25

What are the key patient counseling points/clinical pearls for tiotropium?

Answer 25

Not intended as rescue therapy
May cause increase HR, dry mouth, constipation, urinary difficulty and retention, respiratory tract infection, and sinusitis
Capsules are for inhalation, instruct correct use
Effects may take 1-2 months
HandiHaler only for COPD, Respimat for asthma and COPD