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AC- PPP2 > Medicines knowledge, 1 > Flashcards

Medicines knowledge, 1 Flashcards

1
Q

Dapagliflozin

  • drug class
A
  • sodium-glucose co-transporter 2 inhibitors- SGLT
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2
Q

Dapagliflozin

  • common indications
  • moa
A
  • type 2 diabetes
  • symptomatic heart failure with reduced ejecton fraction
  • its a medication that is used to help control your blood glucose (sugar) levels, it lowers the level of your blood sugar by removing the excess sugar from the body in the urine
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3
Q

Dapagliflozin

  • dose & directions
  • c&A labels
A
  • adult, oral, 10mg daily
  • with or without food doesn’t matter
  • at any time of the day
  • swallow whole with a glass of water
  • taking tablets at the same time each day wll have the best effect, it’ll also help you remember when to take the tablets
  • c&a: 10a, 21
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4
Q

Dapagliflozin

  • key counselling points
  • adv
A
  • important you drink plenty of water to control your thirst, in order to avoid dehydration
  • if you test urine sugar, it will be high: not a sign of worsening diabetes
  • both men and women may be more likely to get a genital infection (eg thrush) while taking this medication; maintaining good hygiene is important to reduce the chance of this happening
  • all medications have side effects but not everyone will experience them
  • common adv: genital infxns, thirst, nausea, constipation
  • hypoglycaemia: doesnt normally cause hypoglycaemia, but you may experience if it you take other medications (insulin or sulfonyurea)
    • signs include: weakness, shaking, lightheadedness, dizziness, headache, hunger, numbness around lips or tongue
    • if you experience this: need to raise BGL immediately (eat 5-7 jellybeans, eating 3 tsp of honey, 2-3 concentrated glucose tablets)
    • unless you’re within 10-15 of next meal, follow up with extra carbs (biscuits, fruit or milk)
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5
Q

Dapagliflozin

  • referral
A
  • if you think you may have an infection- painful urination especially if you have a fever and pain, tenderness or swelling in the genital area- refer
  • if you develop severe vomitting, abdominal pain or SOB, please seek medical attention immediately
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6
Q

Dapagliflozin

  • lifestyle
A
  • maintain good toiletting hygiene
  • drink plenty of fluids to prevent excessive thirst
  • impt to have a healthy diet, eat a variety of veges, fruits, wholegrain/ wholemeal foods (fish, lean meat, eggs, nuts)
    • limit foods high in fat, sugar, salt
  • choose foods and drinks with no added sugar eg diet food and drinks
  • no more than 10 standard drinks a week, no more than 4 a day
  • check BGL as advised by diabetes healthcare team
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7
Q

Dapagliflozin

  • monitoring
A
  • urine tests
  • hba1c
  • signs of infection
  • weight gain
  • renal function
  • correct monitoring and recording of BGL
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8
Q

Metformin

  • drug class
A
  • biguanide
  • antidiabetic
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9
Q

Metformin

  • common indication
  • moa
A
  • type 2 diabetes
  • it works to reduce high levels of blood sugar by helping your body make better use of the insulin (helps regulate blood sugar levels) produced by your pancreas
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10
Q

Metformin

  • dose & directions
A
  • usual starting dose is 500mg once or twice a day with breakfast and evening meal
  • can be increasedup to 850mg 2-3 times daily
  • maximum 3g/day
  • CR 500mg once daily
  • take with or after food to prevent getting an upset stomach
  • for CR take in morning, if still upset tummy take in the evening
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11
Q

Metformin

  • Key counselling points
  • adv
A
  • take with or after food to reduce upset stomach
  • can’t crush or chew tablets
  • slow onset of effect, may take up to 2 weeks to control BSL
  • all medicine can cause side effects but not everyone will experience them
  • can initially cause D, N, loss of appetite; often decreases or disappears with continued use
  • alcohol affects BSL- limit alcohol with this medicine & avoid drinking on an empty stomach
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12
Q

Metformin

  • referral
A
  • if they suddenly develop chills, abdominal pain or discomfort, sleepiness, difficulty breathing or muscle pains- refer
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13
Q

Metformin

  • monitoring
A
  • blood glucose concentration
  • rash
  • serum vitamin b12 levels
  • liver function
  • renal function
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14
Q

Metformin

  • lifestyle
A
  • alcohol affects BSL- limit alcohol with this medicine & avoid drinking on an empty stomach
  • impt to have a healthy diet, eat a variety of veges, fruits, wholegrain/ wholemeal foods (fish, lean meat, eggs, nuts)
  • limit foods high in fat, sugar, salt
  • choose foods and drinks with no added sugar eg diet food and drinks
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15
Q

Metformin +/- combinations

  • indications
  • drug class
A
  • type 2 diabetes
  • glibenclamide- sulfonylurea
  • saxagliptin, sitgaliptin, alogliptin, linaglaptin, vildagliptin- dipeptidyl peptidase 4 inhibitors (DPP4 inhbitors)
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16
Q

Metformin +/- combinations

  • moa
A
  • glibenclamide
    • stimulates insulin release to get better control of BGL
  • gliptins- linagliptin, saxagliptin, sitagliptin, alogliptin
    • increase insulin release to control blood glucose levels, decreases amount of sugar made by the body
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17
Q

Metformin +/- combinations

  • doses & directions
A
  • alogliptin/ linagliptin/saxagliptin
    • Adult, 1 tablet (of any strength) twice daily with or after food
    • alogliptin/ metformin, 12.5 mg/500 mg, 12.5mg/850mg, 12.5 mg/1000 mg
    • linagliptin/metformin, 2.5 mg/500 mg, 2.5mg/850mg, 2.5mg/1000mg
  • sitagliptin
    • Adult, 1 tablet (of any strength) twice daily with food –> janumet normal
    • Adult, 1 tablet of 100 mg/1000 mg or 2 tablets of 50 mg/1000 mg once daily. –> janumet controlled release
    • comes in 50/500, 50/850, 50/1000
  • saxagliptin
    • Adult, 1 tablet (of any strength) once daily or 2 tablets with or after food of 2.5 mg/1000 mg once daily.
18
Q

Metformin +/- combinations

  • referral
A
  • glibenclamide
    • if you develop itchy, red, swollen patches on your skin
  • gliptins
    • rash or hives, severe tummy pain
19
Q

Metformin+/- combinations

  • key counselling points
  • adverse effects
A
  • glibenclamide
    • take with food to minimise risk of low blood glucose
    • hypoglycaemia signs: tremor, hunger, irritability, sleepiness, sweating, weakness and shaking,
      • treat with 6-7 jellybeans, 1/2 can of regular soft drink, 1/2 glass of fruit juice
    • adv: N, abdominal pain, heartburn/ D
  • gliptins- DPP4 inhibitors
    • take with or after food to reduce stomach upset
    • adv: headaches, muscle or joint pain
    • tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss
20
Q

Metformin +/- combinations

  • monitoring
A
  • correct monitoring of BGL
  • renal function
  • signs of pancreatitis
21
Q

Metformin +/- combinations

  • lifestyle/ selfcare
A
  • impt to have a healthy diet, eat a variety of veges, fruits, wholegrain/ wholemeal foods (fish, lean meat, eggs, nuts)
  • limit foods high in fat, sugar, salt
  • choose foods and drinks with no added sugar eg diet food and drinks
22
Q

Clopidogrel

  • drug class

Aspirin

  • drug class
A
  • p2y12 antagonist
  • thienopyridine
  • antiplatelet drug
  • aspirin
    • antiplatelet
    • anti inflammatory
    • analgesic
23
Q

Clopidogrel

  • common indications
  • moa

Aspirin

  • common indications
  • moa
A
  • clopidogrel= hx of atherosclerosis
  • acute coronary syndrome (reduced blood flow to heart) wirh aspirin
  • prevent platelets (small blood cells) from clumping together to reduces chances of blood clots forming (thrombosis)
  • aspirin= ACS in those already taking aspirin and clopidogrel
  • moa same as above
24
Q

Clopidogrel

  • dose & directions
  • combination
A
  • prevention of vascular ischaemic events
    • oral, 75mg OD
  • acute coronary syndrome
    • oral, loading dose 300mg, then 75mg OD with aspirin; continue for 1–12 months or longer
  • with or without food, doesn’t matter
  • combination= 1 tablet once daily, with or after food
  • clopidogrel 75 mg, aspirin 100 mg
25
Q

Clopidogrel

  • key counselling points
  • for combination too
A
  • avoid grapefruit juice as it may decrease effectiveness of clopidrogrel
  • may cause diarrhoea or rash
  • refer: unexplained bruising, red/ dark brown urine, fatigue
  • can take with paracetamol
  • combination
    • take at about the same time each day, will have the best effect & help you remember when to take it
    • can cause some side effects. Most are likely to be minor and temporary. However, some may be serious and need medical attention
    • Tell your doctor if you notice any of the following and they worry you: diarrhoea, itching, pain or stiffness in the joints
26
Q

Clopidogrel +/- combination

  • referral
A
  • alone: same
  • combination: refer: signs of bleeding (including nose bleeds) or bruising more easily than normal, blood or black bowel motions, diarrhoea with blood, mucus, stomach pain and fever, abdominal or stomach pain
27
Q

Clopidogrel +/- combination

  • lifestyle
A
  • you can drink alcohol with clopidogrel. But try not to drink too much because drinking too much with clopidogrel can irritate your stomach
  • limit alcohol intake to no more than 10 standard drinks a week, with no more than four in a day
  • have blood pressure and cholesterol checkes regularly
  • have a healthy diet- veges, fruits, wholegrains, nuts, lean meats, fish, eggs, beans
28
Q

Clopidogrel

  • monitoring
A
  • signs of bleeding- nose bleeds, unexplained bruising, dark or blood stained bowel motions
  • liver function
  • cholesterol
  • bp
29
Q

Enoxaparin

  • drug class
A
  • low molecular weight heparin
  • anticoagulant
30
Q

Enoxaparin

  • common indications
  • moa
A
  • prevention of VTE in surgical patients and in high-risk medical patients immobilised due to acute illness
  • ​treatment of venous thrombosis
  • treatment of acute STEMI, non-STEMI and unstable angina
  • treatment of VTE, ACS
  • used to prevent clots from getting bigger or stopping new clots from forming following hospital procedures or illness
31
Q

Enoxaparin

  • dose & directions
A
  • prevention of VTE
    • surgical patients, moderate risk, SC 20 mg once daily for 7–10 days or until mobilised, starting 2 hours before surgery
    • surgical patients, high risk, SC 40 mg once daily for 7–10 days or until mobilised, starting 12 hours before surgery
  • treatment of VTE
    • SC, 1 mg/kg twice daily, or 1.5 mg/kg once daily until adequate oral anticoagulation is established
  • inject into a fold of skin on stomach, don’t rub the area after injecting, rotate the injection site
32
Q

Enoxaparin

  • key counselling points
  • adv
A
  • this medicine can cause diarrhoea, nausea, a rash and pain at the injection site (less serious)
  • if you develop abnormal signs of bleeding such as unexplain bruising, nosebleeds, dark or bloodstained stools, REFER
  • store below 25 degrees, don’t freeze & store away from heat, sunlight or moisture
  • keep syringe in pack until its time to use
33
Q

Enoxaparin

  • referral
A
  • if you develop abnormal signs of bleeding such as unexplain bruising, nosebleeds, dark or bloodstained stools, REFER
34
Q

Enoxaparin

  • lifestyle
A
  • ask your doctor whether there are any activities you should avoid while using this medication., for example certain sports. Sometimes after an injury bleeding may occur inside your body without you knowing about it
  • if you plan to have surgery, tell your doctor or dentist that you are using this medication
  • use with OTC NSAIDs like voltaren, nurofen may interfere with enoxaparin, tell pharmacist or Dr before using them
35
Q

Enoxaparin

  • monitoring
A
  • signs of abnormal bleeding- unexplained bruising, nosebleeds, dark or blood stained stools
  • renal function
  • used with NSAIDs, antocoagulants, antiplatelets
36
Q

Nitrates (GT/ID/IM): oral & sublingual

  • drug class
A
  • nitrates
37
Q

Nitrates (GT/ID/IM): oral & sublingual

  • common indication/MOA
A
  • GTN- prevention and treatment of stable angina, heart failure associated with acute MI
  • ID- prevention and treatment of angina
  • IM- prevention of angina
  • works by widening blood vessels, letting more blood and oxygen reach the heart
38
Q

Nitrates (GT/ID/IM): oral & sublingual

  • dose & directions
A
  • GTN
    • acute angina- sublingual spray, adult, 400–800 micrograms (1 or 2 sprays); repeat after 5 minutes if necessary to a maximum of 3 sprays
    • prevention of acute angina before a precipitating activity- sublingual spray, adult, 400 micrograms (1 spray) 5–10 minutes before activity
  • ID
    • treatment of acute angina- sublingual tab, adult, 5–10 mg
    • Prevention of acute angina before a precipitating activity- sublingual tab, adult, 5–10 mg taken 10 minutes before activity
  • IM
    • adult, oral, initially 30–60 mg once daily, increased if necessary up to 120 mg once daily
    • Swallow whole; do not crush or chew the tablet.
39
Q

Nitrates (GT/ID/IM): oral & sublingual

  • key counselling points
  • adverse effects
A
  • sublingual tablets or spray
    • use during episodes of angina or before an activity expected to bring on angina
    • sit or lie down before use as it may cause dizziness.
    • call an ambulance if symptoms are severe, get worse quickly or last for 10 minutes
  • spray
    • prime the spray before using it for the first time by pressing the nozzle 5 times, spraying it into the air
    • prime it with 1 spray if it hasn’t been used for 7 days
    • prime it with 5 sprays if it hasn’t been used for more than 4 months
    • when ready to use, aim the spray under the tongue and press the nozzle once; do not inhale the spray
  • sublingual tablet
    • place under your tongue; do not swallow
    • after the pain has been relieved, you may spit out or swallow what is left of the dose to avoid adverse effects such as headache
    • it is important to store these tablets properly or they may not work as well. Keep them in the original glass bottle away from moisture, heat and light; close lid tightly. Do not carry them close to your body
  • this medicine may make you feel dizzy on standing. Get up gradually from sitting or lying to minimise this effect; sit or lie down if you become dizzy
  • common side effects: headache, n/v
40
Q

Nitrates (GT/ID/IM): oral & sublingual

  • referral
A
  • call an ambulance if symptoms are severe, get worse quickly or last for 10 minutes
41
Q

Nitrates (GT/ID/IM): oral & sublingual

  • monitoring
A
  • renal function
  • hypotension
  • bp
  • heart rate
  • symptom improvement
  • adverse effects: headache, fainting and heart palpitations
42
Q

Nitrates (GT/ID/IM): oral & sublingual

  • lifestyle (selfcare)
A
  • impt to know warning signs of a heart attack & act quickly to reduce the damage to your heart & increase your chance of survival
    • can come on suddenly or slowly get worse, usually last for atleast 10 minutes
    • you may feel discomfort in your arms, shoulders, neck, jaw or back
    • discomfort in the centre of your chest, can feel like heaviness, tightness or pressure, heart attacks don’t always cause chest discomfort
  • learn & use relaxation techniques to reduce stress
  • limit alcohol intake to no more than 10 drinks a week and 4 in one day
  • exercise at moderate level for atleast 30m, can help relieve feelings of stress

AC- PPP2 (7 decks)

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