Key Counseling Points - Pain/GU Flashcards
Baclofen
Because of the possibility of sedation, patients should be cautioned regarding the operation of motor vehicles or dangerous machinery while taking it. Patients should be cautioned that the CNS effects may be additive to those of alcohol and other CNS depressants.
Buprenorphine/Naloxone
Use a stool softener and/or laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants. Do not crush or swallow the sublingual tablet. Place the tablet under the tongue until it is dissolved. If you take ≥2 tablets at a time, place all of the tablets under the tongue together. If this is uncomfortable, place 2 tablets at a time under the tongue and repeat the process until all tablets have been taken. If you are using the sublingual film, place the film under the tongue until it is dissolved. If you need to take an additional film, place the new film on the opposite side from the first film. Do not chew, swallow, or move the film after placing it under the tongue.
Carisoprodol
Patients should avoid consuming alcohol. Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects. Patients withdrawing from prolonged therapy should be monitored carefully for withdrawal symptoms, including seizures.
Celecoxib
May take with food or milk to decrease GI upset. May open capsule and pour into a teaspoon of applesauce.
Codeine/Acetaminophen
If using chronically, use laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
Cyclobenzaprine
Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects. Take extended-release capsule same time each day.
Diclofenac
Take with food or milk to decrease GI upset.
Etodolac
Take with food or milk to decrease GI upset.
Fentanyl Transdermal
Use laxative for constipation prevention, may cause drowsiness therefore avoid driving or other tasks with motor coordination, avoid alcohol and other CNS depressants, apply to clean dry skin avoiding skin breaks, remove old patch when new patch applied, febrile patients may have increased absorption, monitor carefully.
Hydrocodone (w/o acetaminophen)
Use a stool softener and/or laxative for preventing constipation with chronic use. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid concomitant use of alcohol and other CNS depressants.
Ibuprofen
Take with food or milk to decrease GI upset. Counsel patients with heart failure to avoid NSAIDs as they may cause fluid retention which can exacerbate heart failure.
Indomethacin
Take with food or milk to decrease GI upset. Counsel patients with heart failure to avoid NSAIDs as they may cause fluid retention which can exacerbate heart failure.
Lidocaine
Instruct patients on the appropriate application process. Leave patches on skin for no >12 h within a 24-h period. Caution patients to administer only as directed, to intact skin, without covering with occlusive dressing or tight clothes.
Meloxicam
Take with food or milk to decrease GI upset. For suspension, shake gently before using. Avoid use around 20 wk gestation. Pregnant women should consult HCP before using.
Methadone
Use a motility-promoting laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants. Seek medical attention if short of breath or extremely drowsy. Breast-feeding women should monitor child for signs of sedation and respiratory depression.
Methocarbamol
Avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects.
Morphine
Use stimulant laxative for prevention of opioid-induced constipation, may cause drowsiness therefore avoid driving or other tasks requiring motor coordination, avoid alcohol and other CNS depressants, extended-release products must not be crushed or chewed as it can increase risk of respiratory depression, ER capsule can be opened and sprinkled on soft food but must be swallowed whole and not chewed.
Nabumetone
Take with food or milk to decrease GI upset.
Naproxen
Take with food or milk to decrease GI upset.
Oxycodone
Use laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants.
Pentosan
Take 1 h before or 2 h after meals with a full glass of water. Use caution and monitor for bleeding if using concomitant NSAIDs or aspirin-containing products.
Tramadol
Use a laxative for preventing constipation if used chronically. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants. Extended-release products must not be crushed or chewed but may be taken with or without food, and always the same way to avoid variability in absorption.
Tizanidine
Patients should take the drug in the same way (fasting or fed) every time to avoid inconsistent absorption patterns and resulting changes in efficacy and adverse effects. Effect of food on extent of absorption differs for tablets and capsules. Abrupt discontinuation can cause rebound HTN and tachycardia. Taper dose by 2-4 mg/d if used at high dose (20-28 mg daily) or for an extended period of time. Should avoid concurrent use with opioids. Capsules and tablets are not interchangeable.
Darifenacin
This drug may cause anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Heat prostration (due to decreased sweating) can occur when used in a hot environment. Can be taken with or without food. Seek medical attention for signs and symptoms of angioedema (swelling of tongue or laryngopharynx, difficulty breathing, etc).
Dutasteride
Symptoms may not improve for up to 6 months after starting treatment. Do not donate blood while taking or for 6 months after stopping dutasteride, as it may be transfused to a pregnant woman. Women who are pregnant or may become pregnant should avoid touching or handling this medicine. This medicine can get into the body through the skin and may prevent development of genitalia in an unborn male baby.
Finasteride
If using for hair loss, you may need to take this medicine for at least 3 months before you see an effect. If using for an enlarged prostate, you may need to take this medicine for up to 6 months to see the full effect. Women who are pregnant or may become pregnant should avoid touching or handling this medicine because this medicine can get into the body through the skin and may prevent development of genitalia in an unborn male baby. Pregnant women should also avoid semen of a man taking finasteride. Report any shortness of breath, breast swelling, or breast mass to your health care provider.
Mirabegron
Monitor BP and HR and contact HCP for faster heartbeat or elevations in BP, bladder irritation or difficulty with urination.
Oxybutynin
This drug may cause anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Heat prostration (due to decreased sweating) can occur when used in a hot environment.
Sildenafil
Take 30 min-4 h prior to anticipated sexual activity, but do not take more frequently than once q24h.
Solifenacin
This drug may cause anticholinergic effects, including constipation, urinary retention, blurred vision, dyspepsia, or xerostomia. Heat prostration (due to decreased sweating) can occur when used in a hot environment and/or exercise.
Tadalafil
If taking as needed, take 30 min prior to anticipated sexual activity. Do not take more frequently than once q24h. Avoid driving or other activities that require mental alertness until the drug’s effects have been determined. Seek medical attention if severe skin rash, chest pain, erection lasting >4 h, tinnitus, dizziness, or shortness of breath.
Tamsulosin
Administer 30 min after same meal daily as fasting increases bioavailability by 30%. Avoid activities requiring coordination until drug effects are realized, as drug may cause vertigo or dizziness. Rise slowly from a sitting/lying position, as this drug may cause orthostatic hypotension. Syncope or loss of consciousness is possible with 1st dose or dose increases, especially if in an upright position.
Tolterodine
Avoid activities requiring mental alertness or coordination until drug effects are realized as blurred vision, dizziness, and drowsiness may occur, swallow extended-release capsule whole, do not crush, break, or chew, in a high environmental temperature heat prostration can occur with drug use (fever and heat stroke due to decreased sweating), if symptoms occur the drugs should be discontinued and supportive measures instituted.
Vardenafil
Take 60 minutes prior to anticipated sexual activity. Do not take more frequently than once every 24 hours. The orally disintegrating tablet should be placed on the tongue immediately upon removal from packaging; the tablet should be taken whole and not crushed or split; do not take with any liquids. Oral tablets can be taken without regard to food. If an erection lasts > 4 hours, seek medical attention. Advise patients that lifestyle modifications (smoking cessation and weight loss) can also improve sexual functioning. Seek medical attention if experiencing chest pain, erection lasting > 4 hours, tinnitus, dizziness, or shortness of breath.
Phenazopyridine
Drug may discolor urine and sclera to red or orange causing staining of undergarments and contact lenses. Take drug with food to minimize gastric irritation.
