Medicines knowledge, 1 Flashcards
1
Q
Amiodarone
- drug class
A
- antiarrhythmic
2
Q
Amiodarone
- common indication
A
- treatment & prophylaxis of tachyarrhythmias
- ventricular tachycarhida & AF
3
Q
Amiodarone
- doses
A
- starting orally at 200mg TDS for 1 week, then 200 mg BD for 1 week
- maintenance dose, orally at 100-200mg OD
- 400mg may be needed especially for ventricular arrhythmias
- take with meals
4
Q
Amiodarone
- key counselling points
A
- Avoid sun exposure, wear protective clothing and use sunscreen (eg broad-spectrum, factor 30 or 50+ sunscreen containing zinc or titanium oxides) when outside
- Amiodarone interacts with grapefruit juice and many other drugs; avoid grapefruit juice
- Tell your doctor if you develop shortness of breath or a dry cough, problems with your vision, weight loss, muscle weakness or worsening of your heart symptoms
- ADV
- nausea & vomitting (especially while loading)
- blue/ greyish skin discolour changes
- hyper/ hypothyroidism (first 2 years)
- blurred vision
- taste disturbances, metallic taste or loss of taste
- fatigue
5
Q
Amiodarone
- monitoring
A
- Monitor for heart rate
- Monitor liver function by doing test at baseline and very 6 months
- Monitor for adverse effects such as cough and shortness of breath
- need regular blood tests, ECGs and chest x-rays while taking amiodarone
6
Q
Amlodipine
- drug class
A
- dihydropyridine calcium channel blocker
7
Q
Amlodipine
- common indications
A
- hypertension
- angina
8
Q
Amlodipine
- doses
- directions
A
- adult dose, child>6yo: initially 2.5–5 mg OD, increasing if necessary after at least 1–2 weeks to a MAX of 10 mg OD
- Elderly, hepatic impairment: Adult, initially 2.5 mg OD
- take at the same time each day, more effective & help you remember when to take it
- with or without food, doesn’t matter
9
Q
Amlodipine
- key counselling points
- adverse effects
A
- nausea, patient may experience vasodilatory effects such as headache, dizziness, flushing, palpitations & peripheral oedema
- this medicine may cause dizziness, especially when getting up from lying down. Lie down until the symptoms pass if feeling dizzy
- Avoid drinking large amounts of alcohol as it can make you more dizzy or sleepy while on this medication and also it increases blood pressure
- raises K+ levels, tell pharmacist or Dr before starting any supplements/ vitamins
10
Q
Amlodipine
- adversee effects
- referral
A
- all medicines can cause adverse effects, but not everyone will experience them
- most common adv is dizziness, you mau feel dizzy in the morning but it should subside in a couple of days as your body gets used to the medicine
- if you get any unexplained dry cough or palpitions, see Dr
11
Q
Amlodipine
- monitoring
A
- Monitor blood pressure
- sx improvement
- Monitor for adverse effects such as skin reactions and difficulty breathing
- falls risk
- peripheral oedema
- tinnitus
12
Q
Apixaban
- drug class
A
- DOAC: direct-acting oral anti-coagulant
- factor Xa inhibitor
13
Q
Apixaban
- common indications
A
- prevention of stroke
- prevention of VTE following hip or knee replacement
- treatment of acute VTE & prevention of subsequent VTE
14
Q
Apixaban
- doses
A
- prevention of VTE after hip/ knee replacement
- 2.5mg BD, starting 12-24 hours after surgery
- continue for 10-24 days after knee replacement OR 32-38 days after hip replacement
- treatment of acute VTE and prevention of subsequent VTE
- 10mg BD for 7 days, then 5mg BD
- may reduce dose after 6 months to 2.5mg BD
15
Q
Apixaban
- key counselling points
A
- take at the same time each day; use a calendar or reminder on phone, and mark off after taking the dose
- see Dr for regular checks
- swallow whole with a glass of water
- Do not take aspirin or anti-inflammtory medicines while being treated with this medicine
- ADV
- common: nausea, signs of bleeding
- infrequent: thrombocytopenia, abnormal liver function tests
- rare: allergic reactions
16
Q
Apixaban
- monitoring
A
- monitor for any LESS COMMON unexplained bruising, bleeding, pink, red or dark brown urine or red faeces
- monitor for COMMON tiredness, paleness, light headness, headache (low iron in blood), constipation, diarrhoea
- monitor renal function regularly (especially in elderly)
- LFT
17
Q
Digoxin
- drug class
A
- antiarrhythmic
- cardiac glycoside
18
Q
Digoxin
- common indications
A
- atrial fibrillation
- heart failure
19
Q
Digoxin
- doses
A
- Adult
- loading, Oral/IV, 250–500 micrograms every 4–6 hours according to response, up to a total of 1.5 mg
- maintenance, 125–250 micrograms once daily
- take at the same time each day
- with or without food doesn’t matter
20
Q
Digoxin
- key counselling points
A
- tell your doctor or pharmacist that you are taking digoxin before using any other medicines including over-the-counter and herbal products
- can take with or without food, but its best to take it at the same time each day
- digoxin has a narrow therapeutic range; adverse effects are related to its plasma concentration and very few occur at <0.8 microgram/L
- common: NVD, anorexia or loss of appetite, stomach pains, blurred vision, drowsines, skin rxns
- infrequent: depression
- rare: seizures, confusion, psychosis, gynaecomastia (long-term use)
- Limit alcohol consumption while using this medication as it may make you more drowsy
21
Q
Digoxin
- monitoring
A
- Caution in patients with hypokalaemia, increases sensitivity to digoxin
- blood for digoxin level to be taken atleast 6 hours after the 1st dose
- Monitor for adverse effects such as chest pain and shortness of breath, worsening heart symptoms such as palpitations
- regularly assess for digoxin toxicity
- sx improvement
22
Q
Metoprolol
- drug class
A
- cardioselective beta-1 receptor beta blocker
23
Q
Metoprolol
- common indications
A
- hypertension
- angina
- MI
- tachyarrhythmias
- chronic HF with reduced ejection fraction
24
Q
Metoprolol
- doses
A
- hypertension
- 50-100mg OD initially, 50-100mg OD or BD maintenance
- angina
- 25-50mg BD, 50-100mg BD or TDS
- tachyarrhythmias
- 25-100mg BD, orally
- MI
- 25-50mg BD
- with or without food doesn’t matter
25
Q
Metoprolol
- key counselling points
A
- can cause dizziness or tiredness at the start of treatment, if you know that this affects you, don’t drive
- if you feel dizzy, get up gradually from sitting or lying to minimise this effect; sit or lie down if you become dizzy
- common ADV: N/D, cold extremeties, abnormal vision
- rare or infrequent ADV: hallucinations, insomnia, nightmares, depression, heart block, rash
26
Q
Metoprolol
- monitoring
A
- monitor for adverse effects such as numbness in arms and legs, abnormal vision, hallucinations (abnormal thinking), nightmares, orthostatic hypotension, skin reactions, sunburn happening more quickly than usual
- monitor ECG and BP continuously during IV administration
- Elderly patients especially need to be monitored to stop their blood pressure falling too far
