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AC- PPP2 > Medicines knowledge, 2 > Flashcards

Medicines knowledge, 2 Flashcards

1
Q

Adalimumab

  • drug class
A
  • TNF- alpha antagonist
  • human monoclonal antibody
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2
Q

Adalimumab

  • common indications
  • moa
A
  • rhuematoid arthritis
  • psoriatic arthritis
  • crohns disease
  • ulcerative colitis
  • adalimumab recognises and binds to a protein which is present at higher levels in some inflammatory diseases, to help reduce an inflammtory response
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3
Q

Adalimumab

  • dose & directions
A
  • rheumatoid arthritis
    • SC, 40mg once every 2 weeks
  • psoriasis
    • SC, 80 mg then, starting 1 week later 40 mg once every 2 weeks
  • Crohn’s disease, ulcerative colitis
    • SC, 160 mg on day 0 (or 80 mg on day 0 and day 1), then 80 mg on day 14, then 40 mg once every 2 weeks
    • For ulcerative colitis, the manufacturer recommends stopping treatment if there is no response after 8 weeks and, for Crohn’s disease, to consider stopping treatment if there is no response after 12 weeks
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4
Q

Adalimumab

  • key counselling points
  • adverse effects
A
  • check with your doctor before getting a vaccine- some vaccines should not be given to people receiving a TNF-alpha antagonist
  • common adv: nausea, vomitting, abdominal pain, headache rash, itch
  • your symptoms may start to improve 1-2 weeks after starting, it can take 12-16 weeks for the medicine to reach its max effect
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5
Q

Adalimumab

  • referral
A
  • if you experience any serious side effects such as fever, spre throat, bruising or bleeding, persistent cough, see Dr
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6
Q

Adalimumab

  • monitoring
A
  • blood count, ALT, AST & creatinine before treatment
  • infections
  • blood dyscrasias
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7
Q

Adalimumab

  • lifestyle
A
  • fish oil- omega 3 fatty acids in fish oil can reduce joint swelling, joint pain & stiffness caused by RA, take regularly for 2-3 months before sxs improve
  • heat therapy- relieve pain & stiffness
  • cold therapy- relieve hot & swollen joints
  • OT can help with splints & mechanical aids- hand rails, tap turners
  • try to avoid things that may worsen psoriasis, avoid using soaps which dry & irritate your skin, use soap free cleanser
  • avoid scratching, breaks up the skin- water & blood go up to surface–> blister, itchy
  • moisturise!
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8
Q

Celecoxib

  • drug class
A
  • selective cox 2 NSAID
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9
Q

Celecoxib

  • common indications
  • moa
A
  • rheumatoid arthritis
  • osteoarthritis
  • pain due to dysmenorrhoea or injury (postoperative, musculoskeletal or soft tissue)
  • used to relieve pain & inflammation
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10
Q

Celecoxib

  • dose & directions
A
  • osteoarthritis
    • 200mg daily in 1 or 2 doses
  • rheumatoid arthritis
    • 100mg BD, may increase to 200mg BD
  • can be taken with or without food
  • if you get an upset tummy- take it with food
  • swallow whole with a glass of water
  • similar to OTC anti-inflammatories, avoid taking those aswell
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11
Q

Celecoxib

  • key counselling points
  • adverse effects
A
  • if you need to take an antacid, take it atleast 2 hours before or 2 hours after your dose of celecoxib
  • don’t take aspirin when taking this medicine because it can increase side effects of this medicine
  • don’t take this medicine if you are dehydrated, for example due to vomiting or diarrhoea, because it might increase the likelihood of side effects
  • in osteoarthritis, maximal analgesic and anti-inflammatory effects are usually seen within 2 weeks
  • paracetamol can be used too
  • adv: dyspepsia, headache, nausea, d, pain or discomfort in upper stomach, hypertension
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12
Q

Celecoxib

  • referral
A
  • if you get new or unusual abdominal pain or tenderness, indigestion or heartburn, tell Dr
  • signs of allergic reaction- swelling of face, lips or tongue; rash, difficulty breathing
  • internal bleeding- dark or bloodstained bowel, coffee- coloured vomit, chest pain, swollen ankles, yellowing of eyes or skin, unusual tiredness- Dr
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13
Q

Celecoxib

  • monitoring
A
  • long term tx
    • BP
    • renal function
    • liver function
    • haemoglobin
    • complete blood count
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14
Q

Celecoxib

  • lifestyle
A
  • heat or cold packs to relive pain & stiffnes
  • learn to rest when your body needs rest
  • keep a good posture to reduce stress on joints & muscles
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15
Q

Methotrexate

  • drug class
A
  • folic acid antagonist
  • immunisuppressant
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16
Q

Methotrexate

  • common indication
  • moa
A
  • rheumatoid arthritis
  • psoriasis
  • juvenile idiopathic arthritis
  • crohns disease
  • works by suppressing inflammation & immune responses that cause you discomfort which leads to less pain
17
Q

Methotrexate

  • dose & directions
A
  • psoriasis, RA
    • oral/SC/IM, initially 10-15mg once a week
    • maintenance is 10-25mg once a week
  • crohns disease
    • IM/SC, 25mg once a week
    • maintenance is 15-25mg once a week
  • TAKEN ONCE A WEEK (same day each week)
  • can be taken with food to improve GI tolerability
18
Q

Methotrexate

  • key counselling points
A
  • must be taken once weekly, once the same day each week, NOT DAILY- calendar marking or reminder alarms encouraged
  • 10mg weekly, folic acid supplementation, 24 hours after MTX dose to reduce adv effects of MTX due to folate depletion
  • MTX onset of effect is slow, it can take a few months before a benefit is seen
  • avoid sun exposure, wear protective clothing and use sunscreen as methotrexate may make you more sensitive to sunlight
  • CAL 5, 8, 10a, 20, 21
19
Q

Methotrexate

  • adverse effects
  • referral
A
  • all medicines can cause side effects but not everyone will experience them
  • common: photosensitivity, N/V/D, headache, blurred vision and mucosal ulcers are common; folic acid supplmentation will minimise this
  • tell your dr if you have nausea, mouth ulcers, bruising, yellowing of skin, or signs of infection (fever, sore throat)
20
Q

Methotrexate

  • monitoring
A
  • complete blood count
  • renal & liver function
  • leucopenia
  • thrombocytopenia
  • baseline hep B & C
21
Q

Methotrexate

  • lifestyle
A
  • for pain relief
    • heat therapy (hot packs, warm baths) can relieve pain & stiffness
    • cold therapy (cold packs) can relieve hot and swollen joints
  • rest & joint care
    • have good posture to limit stress on joints and muscles
    • learn to recognise when your body & joints need to rest
    • walking aids & splints can help protect joints- OT
  • healthy lifetsyle
    • keep to a healthy weight to limit stress on joints
    • dietician- foods high in omega-3 fatty acids may help reduce joint dwelling
  • may make you more sensitive to sunlight, avoid sun exposure, wear protective clothing and use sunscreen
22
Q

Allopurinol

  • drug class
A
  • xanthine oxidase inhibitor
23
Q

Allopurinol

  • common indications
  • moa
A
  • symptomatic hyperuricaemia (gout)
  • chronic symptomatic hyperuricaemia
  • works by reducing production of uric acid in the body
  • high levels of uric acid may cause gout attacks or kidney stones
  • allopurinol is used to prevent gout attacks, not to treat them once they occur
24
Q

Allopurinol

  • dose & directions
A
  • started at a low dose 100mg daily and increased monthly by 50-100mg daily, aim at serum urate concentration <0.36mmol/L
  • maintenance, 300-600mg daily (max 900mg) daily
  • may cause an upset tummy, so best taken with or after food to reduce the chances of that
  • take at same time each day
25
Q

Allopurinol

  • key counselling points
  • adverse effects
A
  • take with food to reduce likelihood of upset tummy
  • this medicine may make you feel dizzy or drowsy, be careful when standing or getting up, don’t drive until you know how it affects you
  • you may initially get more gout attacks in the 1st few months of taking this medicine, but it doesn’t mean its not working, this medicine reduces urate in your body & when its low enough, flares will gradually improve & eventually stop if you keep on taking it
  • some adv effects: stomach upset, N/V/D
26
Q

Allopurinol

  • referral
A
  • rash, changes in vision, tingling or numbness of the hands or feet stop and see Dr
27
Q

Allopurinol

  • monitoring
A
  • serum urate levels
  • kidney function
  • liver function
  • rash
28
Q

Allopurinol

  • lifestyle (selfcare)
A
  • ice packs can also help with pain caused by gout! hold an icepack against the inflamed joint to ease pain, apply for 20 mins then remove
  • do you drink alcohol? limit to 2 standard drinks a day, alcohol can trigger gout, esp beer bcoz of lots of purines which is a precursor to uric acid formation in the body
  • NSAIDs or low dose colchicine used for atleast 6m to prevent acute flare when introducing prophylactic tx with ULT in gout
  • ensure you drink plenty of water to prevent kidney stone
29
Q

Mesalazine

  • drug class
A
  • 5-aminosalicylate
  • anti-inflammatory, immunosuppressant
30
Q

Mesalazine

  • common indications
  • moa
A
  • ulcerative colitis
  • crohns disease
  • anti-inflammatory, immunosuppressant to help inflammation of the bowel
31
Q

Mesalazine

  • dose & directions
A
  • ulcerative colitis adult
    • asacol tablet; 2.4g OD or up to 4.8g daily in dividided doses
    • enema; rectally 1g daily
  • crohns disease adult
    • tablet; oral 500mg TDS, maintenance 250mg TDS
    • take atleast 30mins before food
  • swallow tablets or whole without chewing or crushing them
32
Q

Mesalazine

  • key counselling points
  • adverse effects
A
  • different brands of mesalazine are not interchangeable due to difference of each one
  • take doses at regular intervals during the day, if you forget to take a dose, take the next dose at the scheduled time, don’t take a double dose to make up for the dose that you missed
  • adv effect: nausea, abdominal pain, diarrhoea, rash and headaches
33
Q

Mesalazine

  • referral
A
  • if you develop a fever, severe sore throat, unusual bleeding or bruising, severe or bloody diarrhoea, muscle or joint pain stop and see Dr
34
Q

Mesalazine

  • monitoring
A
  • liver function
  • renal function
  • diarrhoea
  • electrolyte imbalance
35
Q

Mesalazine

  • lifestyle (selfcare)
A

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AC- PPP2 (7 decks)

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