Medication Flashcards
Clozapine
Rx resistant (after x2 with X11 atypical for 6-8/52 each)
SEs
Common- weight gain, sedation, BP changes, fever, nausea, constipation, excess saliva.
Serious- WCC drop (1:100), myocarditis
Increased seizure risk in epileptics
Benefits- effective/ less EPSEs
Bloods weekly 1st 18/52, 2nd fortnightly 1yr, 3rd 1/12ly
Pre Rx Ecg
Gradual increase in initial doses. Must try to remember to take doses and if miss > 48hr need to regin titration
Interactions
Smoking reduces levels, caffeine increases
Can be augmented
Lithium
Bipolar and recurrent depression
Often used when other mood stabilisers haven’t worked
Not easiest to take therapeutic window
Need regular blood tests
Kidney and thyroid function tests
pre-treatment ECG
Common side effects
Mild tremor stomach cramps diarrhoea mild first polyuria metallic taste
Long-term side-effects
Hypothyroidism, weight gain, potential renal damage
Caution if dehydrated eg D and V
Interacts with Diuretics ACE inhibitors and NSAIDS
Travel can be risky to you to relapse of illness and physical illness
Hypothyroidism
Trial for at least six months
Teratogenic - +x400 ebsteins anomaly
.6-.8 or .9-1.2 if previous relapse
Check levels five days after commencing and five days after each dose change blood samples taken 12 hours post dose
Initially weekly then build up
Li and UEs 3 monthly
TFTs 6-12 monthly
Long-term renal effectsu
Anti-dementia drugs
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