Medicines knowledge & Counselling, 3 Flashcards

1
Q

Carbamazepine

  • drug class
A
  • antiepileptic/ anticonvulsant
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2
Q

Carbamazepine

  • indication
  • moa
A
  • Epilepsy
    • including simple and complex focal (partial) seizures
  • bi polar disorder
  • work by regulating the way messages in the brain are passed on by nerves so that seizures don’t happen
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3
Q

Carbamazepine

  • dose & directions
A
  • for epilepsy
    • Adult, oral, initially 100 mg BD increase daily dose gradually by 100–200 mg every 2–4 weeks according to response
    • Usual range, 400 mg – 1.2 g daily in 2 or more doses; up to 2 g daily may be required
  • for BPAD
    • Adult, oral, initially 400 mg daily in divided doses; increase gradually according to response, up to 1.6 g daily
  • take with food- have one with breakfast & one with dinner
  • may cause drowsiness or dizziness and may increase the effects of alcohol; do not drive or operate machinery, if you are unsure about this you can take your first dose in the evening & judge from there
  • do not stop taking this medication suddenly unless your Dr tells you to
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4
Q

Carbamazepine

  • key counselling points
  • adverse effects
A
  • take with food
  • commo adv: drowsiness, ataxia (impaired balance or coordination), dizziness, blurred vision and headache
  • referral: if you develop a rash or a skin reaction, sore throat, fever, mouth ulcers, bruising or bleeding occur
  • this medicine interacts with grapefruit juice and many other drugs; avoid grapefruit juice
  • may also increase the effects of alcohol
  • take with food to help prevent stomach upset
    • swallow controlled release tablets whole; do not chew or crush them
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5
Q

Carbamazepine

  • Adverse effects & referral
A
  • all medications can cause adverse effects, but not everyone will experience them, the most common of carbemazepine are drowsiness, headache, blurred vision & dry eyes
    • they should wear out in 2-3 weeks as your body gets use to the medication
  • its also common for this medication to cause an increase in your appetite, leading to weight gain and constipation
  • less commonly it may cause diarrhoea, abdominal pain & nausea
  • If you develop any skin rash, redness, blisters or peeling skin, accompanied by fever, chills, headache, stop the medication & tell your doctor immediately
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6
Q

Carbamazepine

  • monitoring
A
  • sx improvement
  • seizures
  • acute mania
  • BMD monitoring, and vitamin D and calcium supplements to prevent osteomalacia and osteoporosis, in patients on long-term treatment, particularly those at higher risk, eg elderly patients
  • monitor skin rxns
  • stop if bone marrow depression occurs
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7
Q

Carbamazepine

  • Lifestyle & self care
A
  • its important to keep in mind of other ways to manage epilepsy
  • learn about the type of epilepsy you have
  • keep a record of your seizures and triggers & try to avoid things that trigger your seizures
    • may be stress, inadequate sleep, alcohol, caffeine
  • teach others how to help if you have a seizure
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8
Q

Levetiracetam

  • drug class
A
  • antiepileptic
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9
Q

Levetiracetam

  • indication
  • moa
A
  • Monotherapy of focal (partial seizures)
  • Adjunctive therapy of myoclonic seizures
  • belongs to a group of medicines called antiepileptics
  • used to control epilepsy- a condition where you have repeated seizures (fits)
  • it works by controlling some chemicals in your brain which send signals to nerves so that seizures do not happen
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10
Q

Levetiracetam

  • dose & directions
A
  • Monotherapy: initially 250 mg twice daily for 2 weeks, then increase to 500 mg twice daily; then increase dose according to response by 250 mg twice daily every 2 weeks, up to 1.5 g twice daily
  • Adjunctive therapy: Oral/IV, initially 500 mg twice daily; then increase dose according to response, by 500 mg twice daily every 2–4 weeks, up to 1.5 g twice daily
  • starting at a low dose, one tablet twice daily & gradually increase after 2 weeks until it is most effective & causing the lease adverse effects
  • swallow whole with water
  • taken twice daily, one in the morning and one in the evening at the same time each day
  • taking it at the same time each day will have the best effect. It will also help you remember when to take it
  • it does not matter if you take it with or without food
  • it can cause drowsiness & may increase the effects of alcohol, dont drive or operate machinery
  • do not stop taking this medicine suddenly unless your Dr tells you to
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11
Q

Levetiracetam

  • key counselling points
  • adverse effects
A
  • swallow whole with water
  • taken twice daily, one in the morning and one in the evening at the same time each day
  • all medications can cause side effects, but not everyone will experience them
  • some common adverse effects are drowsiness, dizziness and headache
  • less commonly it may cause skin rashes or reactions, if you develop any rash, itching or hives on the skin, stop and tell Dr immediately
  • can also cause mood changes, such as depression, nervousness, aggression, anger, anxiety, confusion, hallucination and irritability–> tell Dr
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12
Q

Levetiracetam

  • adverse effects
A
  • all medications can cause side effects, but not everyone will experience them
  • some common adverse effects are drowsiness, dizziness and headache
    • they should wear out in 2-3 weeks as your body gets use to the medication
  • less commonly it may cause skin rashes or reactions, if you develop any rash, itching or hives on the skin, stop and tell Dr immediately
  • can also cause mood changes, such as depression, nervousness, aggression, anger, anxiety, confusion, hallucination and irritability–> tell Dr
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13
Q

Levetiracetam

  • monitoring
A
  • monitor for adverse effects such as severe skin reactions
  • caution in patients with history of psychiatric problems
  • seizures
  • mood changes
  • kidney & liver function
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14
Q

Levetiracetam

  • lifestyles & selfcare
A
  • its important to keep in mind of other ways to manage epilepsy
  • learn about the type of epilepsy you have
  • keep a record of your seizures and triggers & try to avoid things that trigger your seizures
  • may be stress, inadequate sleep, alcohol, caffeine
  • teach others how to help if you have a seizure
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15
Q

Tiotropium

  • drug class
A
  • long acting muscarinic agent, LAMA
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16
Q

Tiotropium

  • indication
  • MOA
A
  • COPD & maintenance treatment of moderate- severe asthma
  • will help relax the air passages that carry air to and from the lungs and will help keep the air passages in the lungs open and make breathing easier for you
17
Q

Tiotropium

  • dose & directions
A
  • COPD
    • Spiriva handihaler- just tiotropium is 1 18mcg capsule, inhaled OD
    • Spiriva respimat- just tiotropium is 2 inhalations of 2.5mcg OD
    • Spiolto respimat- 2 inhalations of (2.5mcg tiotropium with 2.5mcg olodaterol) OD
  • Asthma
    • Spiriva respimat- just tiotropium is 2 inhaltions of 2.5mcg OD
  • take at the same time each day, this way it’ll have the best effect
  • Respimat- hold inhaler upright, turn base in direction of arrows until it clicks& open the cap until it snaps fully open
    • breathe out gently away from the inhaler
    • place mouthpiece in mouth & close lips to form a good seal, without covering the air vents
    • breathe in slowly and deeply through mouth and at same time press down on dose button
    • keep breathing for 5 seconds or as long as comfortable
    • while holding breathe remove inhaler from mouth
    • breathe out gently away from inhaler
    • click cap shut
    • 2 inhalations for respimat
18
Q

Tiotropium

  • key counselling points
  • adverse effects
A
  • don’t allow the powder or mist to come into contact with your eyes
  • tell your doctor if you notice any eye pain or discomfort
  • dont’ drive or operate machinery until you know how this medicine affects you, it can cause dizziness or affect your vision
  • rinse mouth after use
  • common effects experienced may be dry mouth & throat irritation
  • if you forget to use your Spiolto Respimat, use it as soon as you remember
    • if it is almost time for your next dose, skip the dose you missed and inhale just one dose at your usual time the next day
19
Q

Tiotropium

  • adverse effects
A
  • common effects experienced may be dry mouth & throat irritation
  • rarer side effects to be aware of are blurred vision, dizziness, constipation or urinary retention
  • if you experience sore throat, palpitations, shaking or tremors stop and tell DR
20
Q

Tiotropium

  • monitoring
A
  • renal impairment, caution
  • asthma, COPD control, improvement
  • signs of OD such as high or low blood pressure, dizziness, light-headedness
    • shaking or tremors
    • nervousness or feeling anxious
21
Q

Tiotropium

  • lifetsyle/selfcare
A
  • always carry a reliever with you
  • if you needs to use it more than 2 days a week, your asthma may not be well controlled, discuss w Dr
  • don’t smoke and avoid other people smoke
22
Q

Fluticasone

  • drug class
A
  • corticosteroid
  • anti inflammatory agent
23
Q

Fluticasone

  • indication
  • MOA
A
  • maintenance & treatment of asthma & COPD
  • belongs to a group of drugs called corticosteroids which are used to reduce inflammation
    • they reduce the swelling and irritation in the small air passages in the lungs and so help ease breathing problems
24
Q

Fluticasone

  • dose & directions
A
  • Asthma
    • breo ellipta; fluticasone furoate with vilanterol is DPI 200/25 or 100/25 mcg, 1 inhalation OD
  • COPD
    • fluticasone fuorate with vilanterol is DPI 100/25, 1 inhalation OD
  • Trellegy ellipta, fluticasone furoate, umeclidinium (as bromide) and vilanterol, 1 inhalation 100/ 62.5/25 mcg inhaled OD
  • Ellipta, slide the cover done until you hear a click, breathe out gently, away from the inhaler
    • place mouthpiece in mouth & close lips to form a good seal, don’t cover air vent
    • breathe in steadily and deeply
    • hold breath for 5 seconds or as long as comfortable
    • while holding breath, remove inhaler from mouth
    • breathe out gently, away from inhaler
    • slide cover upwards to cover mouthpiece
25
Q

Fluticasone

  • key counselling points
  • adverse effects
A
  • make sure that your doctor has given you an asthma action plan
  • rinse your mouth with water, gargle and spit out after use
  • common adv include oral thrush, a hoarse voice & facial skin irritation following inhalation
  • if you forget to take it & its almost time for your next dose, skip the dose you missed and use your next dose when you are meant to, otherwise, use it as soon as you remember, then go back to using it as you would normally
  • asthma attack- use reliver; ventolin or asmol
26
Q

Fluticasone

  • adverse effects
A
  • all medications can cause side effects, but not everyone will experience them
    • common side effects for fluticasone include sore, raised patches in the mouth or throat caused by a fungal infection (candidiasis). Rinsing your mouth out with water immediately after using may help stop this side effect developing & irritation in the back of the mouth and throat, facial irritation following inhalation
    • less commonly it may cause a lumpy rash, an irregular heartbeat or swelling of the lips/mouth, tongue or throat- stop and tell Dr
27
Q

Fluticasone

  • monitoring
A
  • immediate breathing difficulties and wheezing
  • adrenal suppression
  • bone density loss
  • glaucoma, cataracts; optomotrist
  • skin thinning & bruising
  • caution in patients with hepatic impairment (dose needs to be lowered)
28
Q

Fluticasone

  • lifestyle/ self care
A
  • use it everyday even if you are feeling better
  • always carry a reliever with you
  • if you needs to use it more than 2 days a week, your asthma may not be well controlled, discuss w Dr
  • don’t smoke and avoid other people smoke
29
Q

Prednisolone

  • drug class
A
  • corticosteroid
  • anti inflammatory
30
Q

Prednisolone

  • indication
  • MOA
A
  • auto-immune inflammatory disease
  • acute gout
  • asthma, COPD exacerbation
  • myeloma
31
Q

Prednisolone

  • dose & directions
A
  • autoimmune or anti-inflammatory disease
    • 5-60mg OD, usual maintenance dose is 2.5-15mg OD
  • acute asthma
    • oral 40-50mg OD for 5-10 days
  • COPD exacerbation
    • oral 40-50mg OD for 5-14 days
  • acute gout
    • oral 20-50mg OD for 3-5 days
  • take the tablets or oral liquid with food to help reduce an upset stomach
32
Q

Prednisolone

  • key counselling points
  • adverse effects
A
  • take the tablets or oral liquid with food to help reduce stomach upset
  • this medication may affect your mood, eg you may feel more happy or sad than usual.
  • do not stop taking this medicine suddenly unless your doctor tells you to
33
Q

Prednisolone

  • adverse effects
A
  • all medications can cause side effects, but not everyone will experience them the most common of prednisolone are increased appetite leading to weight gain, acne, bruising, menstrual irregularities, high BP
34
Q

Prednisolone

  • monitoring
A
  • monitor for adverse effects such as severe skin reactions, infection, sodium and water retention, delayed wound healing
  • monitor for psychiatric effects
    • euphoria, hypomania, depression, disturbances of mood, cognition, sleep and behaviour
  • caution in patients with diabetes –> corticosteroids may cause hyperglycaermia and worsen diabetes control
  • glaucoma & osteoporosis
35
Q

Prednisolone

  • lifestyle/selfcare
A