Medication Counselling Flashcards
How would you explain Methrorexate?
- explain RA - immune system is activates in joints
- Methotrexate dampens the immune system from attacking the joint
What monitoring is required for methotrexate?
CXR before start
FBC/UE/LFT 2 weekly then 2 monthly
How long does Methotrexate take to effect?
4/6 months
How is methotrexate taken?
Weekly via tablet or infection
What SE are there for MTX?
Alopecia
Headaches
GI disturbance - Nausea (BUT FOLIC ACID)
What Important SE?
Myelosupression - infection, bleeds
Liver and pulmonary toxicity - Alcohol
What contraindications are there for MTX?
Immunodeficiency
Pregnancy - contraception
What supplementary advice for MTX?
- anual flu jab
Leaflet
How would you explain Biphosphonates?
Osteoporosis -Bones have less minerals which make them weeker
Biphsophonates - Give you more minerals helping to keep bones strong
How is biphosphonates taken?
as a tablet or drink which is taken every week.
- Swalow with full glass of water
- remain upright for 30 mins
- At least 30mins before food
What SE for biphosphonates?
Headache
Indigestion/ heartburn
Diarrhoea/contripation
Monitoring for biphosphonates?
Initially dental check
Contraindications for biphosphonates?
pregnancy dysphagia peptic ulcer low Ca Severe CKD
How would explain SSRIs?
Depression - imbalance of chemical in brain
SSRI - increase a chemical called serotonin
How to take SSRI?
Tablet to be taken once per day. May take 4w to feel better
SE of SSRI?
GI upset Sexual dysfunction Drowsiness Dry mouth Initially anxiety 2w
Important side effects for SSRI?
Withdraw gradually:
Mood changes
Restlessness
Constipation/diarrhoea
Contraindications to SSRIs?
Exclude mania/ bipolar depression
Monitoring for SSRIs?
nil
How would you explain Lithium treatment?
Bipolar - mania and depression
Li - stabilises a persons mood, decreases risk of suicide
Mechanism unclear
How is lithium taken?
1-2 tablet taken daily
Takes 1-2 weeks for affect
SE of Li?
Water - polydipsia and polyuria
GI - nausea
Tremor
What should be watched out for in Li treatment?
Li toxicity
What contraindications are their Li therapy?
pregnancy
Severe renal
Addisons
What advice should be given to a person on Li?
drink plenty of water
What monitoring is needed
Before - ECG, Bloods, beta HCG
Regular monitoring of Li
TFT UE, Ca - 6m
How would you explain levodopa?
PD - low amounts of a chemical in brain which initiates movement called dopamine
Levodopa - tops up dopamine relieving symptoms
How is levodopa taken?
Take in a tablet 3-4 times per day
Take with food to reduce nausea but will feel benefit quickly
How long is levodopa dopa effective?
Decreases over time. end dose deterioration over 5 years with on off effect. Addition of other medication which help levodopa work…
SE of levodopa treatment?
Psychosis
Dyskinsia
Postural hypotension
Nausea - But Domperidone
Contraindications to levodopa therapy?
Glaucoma
How do atypical antipsychotics?
Schizophrenia is an overactivity of chemical brain leading to symptoms
Atypical tries to bring back a balance of chemicals in the brain.
How are atypical antipsychotics taken?
Daly tablet or depot injection.
Starts at low dose then titrate up.
What should be done for a patient who has a developed a rash while on allopurinol?
Stop taking allopurinol seat medical attention - allopurinol hypersensitivity
