Medicines Knowledge Week 1 (Amiodarone, Amlodipine, Apixaban, Digoxin, Metoprolol) Flashcards
Amiodarone drug class (1 mark)
antiarrhythmic
Amiodarone Indication (2 marks)
treatment & prophylaxis of tachyarrhythmias which include ventricular tachycarhida & Atrial fibrillation
Amiodarone dosage range and timing (2 marks)
Loading, oral 200 mg 3 times daily for 1 week, followed by 200 mg twice daily for 1 week.
Maintenance, oral 100–200 mg once daily (400 mg daily may be required, especially for ventricular arrhythmias)
Amiodarone Counselling (3 marks)
Avoid sun exposure, wear protective clothing and use sunscreen (SPF 30 plus sunscreen containing zinc or titanium oxides) when outside
Need regular blood tests, ECGs and chest x-rays while taking amiodarone
Amiodarone interacts with grapefruit juice and many other drugs; avoid grapefruit juice
Amiodarone monitoring (2 marks)
Monitor for heart rate
Monitor liver function by doing test at baseline and every 6 months
Monitor for adverse effects such as cough and shortness of breath
Amlodipine drug class (1 mark)
dihydropyridine calcium channel blocker
Amlodipine common indications (2 marks)
hypertension
angina
Amlodipine dosage range and timing (2 marks)
Adult, child >6 years, oral: 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 once daily.
Amlodipine counselling (3 marks)
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.
Please see a doctor if you have difficulty breathing or severe skin reaction.
Amlodipine monitoring (2 marks)
Monitor blood pressure
Monitor for adverse effects such as skin reactions and difficulty breathing
Apixaban drug class (1 mark)
DOAC: direct-acting oral anti-coagulant
Factor Xa inhibitor
Apixaban common indications (2 marks)
It is used to treat and prevent clots occuring in a venous thromboembolism
Prevent blood clots after a hip or knee surgery
Prevent stroke and blood clots in patients with atrial fibrilation
Apixaban dosage range and timing (2 marks)
prevention of clots after hip/ knee replacement: Oral 2.5mg BD, starting 12-24 hours after surgery
prevention of emboli in AF: Oral 5 mg twice daily.
Apixaban counselling (3 marks)
Avoid eating grapefruit or drinking grapefruit juice while being treated with this medicine
Do not take aspirin or anti-inflammtory medicines while being treated with this medicine
Take at the same time each day; use a calendar or reminder on phone, and mark off after taking the dose
Apixaban Monitoring (2 marks)
Monitor for adverse effects such as black stools or blood in the stools
Monitor renal function regularly (especially in elderly)
Digoxin Drug Class (1 mark)
antiarrhythmic drug
> cardiac glycoside
Digoxin indications (2 mark)
AF and atrial flutter
Heart failure
Digoxin dosage range and timing (2 marks)
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
Digoxin counselling (3 marks)
Tell your doctor or pharmacist that you are taking digoxin before using any other medicines including over-the-counter and herbal products
You can take digoxin with or without food, but its best to take it at the same time each day.
Limit alcohol consumption while using this medication as it may make you more drowsy
Digoxin monitoring (2 marks)
Caution in patients with hypokalaemia as it increases sensitivity to digoxin
Monitor for adverse effects such as chest pain and shortness of breath
Metoprolol drug class (1 mark)
cardioselective beta-1 receptor beta blocker
Metoprolol common indications (2 marks)
Hypertension
angina
MI
tachyarrhythmias
chronic HF with reduced ejection fraction
prevention of migraine
Metoprolol dosage range and timing (2 marks)
Hypertension: 50-100mg OD initially, 50-100mg OD or BD maintenance
Angina: 25-50mg BD, 50-100mg BD or TDS
Tachyarrhythmias: 25-100mg BD
MI: 25-50mg BD
Prevention of migraine: 50-75 mg BD
Metroprolol counselling (3 marks)
Can cause dizziness or tiredness at the start of treatment, if you know that this affects you, don’t drive.
Limit alcohol consumption while using this medication, alcohol will make dizziness or light-headedness worse.
Dress warmly during cold weather, especially if you will be outside for a long time, this medication makes you more sensitive to cold temperatures.
Metoprolol monitoring (2 marks)
Monitor heart rate
Monitor for adverse effects such as rash and muscle cramps
If being treated for diabetes, monitor blood sugar regularly
