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Bal (PPP2) > Medicines Knowledge Week 1 (Dapagliflozin, Metformin +/- combinations, Clopidogrel +/- combinations, Enoxaparin, Nitrates: Oral and Sub-lingual) > Flashcards

Medicines Knowledge Week 1 (Dapagliflozin, Metformin +/- combinations, Clopidogrel +/- combinations, Enoxaparin, Nitrates: Oral and Sub-lingual) Flashcards

1
Q

Dapagliflozin drug class

A

Sodium-glucose co-transporter 2 inhibitor (SGLT2 inhibitor)

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2
Q

Dapagliflozin indication (2 marks)

A

Type 2 diabetes

Symptomatic heart failure with reduced ejection fraction, adjunct to standard treatment

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3
Q

Dapagliflozin dosage range and timing (2 marks)

A

Adult, oral 10 mg once daily

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4
Q

Dapagliflozin Counselling (3 marks)

A

Your urine will test positive for glucose while you are taking this medicine.

Make sure you drink enough water to control your thirst, in order to avoid dehydration.

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. Ask your doctor, pharmacist or diabetes educator if you need more information or if you think you may have an infection, especially if you have a fever and pain, tenderness or swelling in the genital area.

This medicine can be taken with or without food.

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5
Q

Dapagliflozin monitoring (2 marks)

A

Monitor blood glucose levels while on this medication, this includes HbA1c levels and fasting blood glucose levels.

Monitor for signs of thrush. This includes fever and pain, tenderness or swelling in the genital area.

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6
Q

Metformin drug class

A

Biguanide

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7
Q

Metformin indication

A

Type 2 diabetes

Polycstic ovarian syndrome for management of infertility and metabolic features

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8
Q

Metformin dosage range and timing

A

Immediate release (normal renal function): 500 mg orally, twice daily as an initial dose, increase daily dose slowly according to response, up to 2 g, daily in divided doses.

Modified release (normal renal function): 500 mg orally, daily with evening meal as an initial dose, increase daily dose slowly according to response, up to 2 g daily.

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9
Q

Metformin counselling

A

Take with or after food to reduce stomach upset.

Tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss.

Drinking alcohol can affect control of your diabetes. It can also increase the risk of serious side effects. Limit your alcohol intake, avoid binge drinking and have something to eat when you drink alcohol.

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10
Q

Metformin monitoring

A

Monitor blood glucose levels

Monitor weight

Monitor for adverse effects such as rash, abdominal pain, fatigue, cramps and loss of appetite

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11
Q

Metformin with glibenclamide drug class

A

Metformin: biguanide

Glibenclamide: sulfonylurea

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12
Q

Metformin with glibenclamide indication

A

Type 2 diabetes

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13
Q

Metformin with glibenclamide dosage range and timing

A

Adult, initially 1 tablet of 500 mg metformin with 2.5 mg glibenclamide daily with breakfast.

  • Increase by 1 tablet (of this strength) every 2 weeks or longer according to response.

Maximum dose, 1 tablet of 500 mg metformin with 5 mg glibenclamide 3 times a day.

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14
Q

Metformin with glibenclamide counselling

A

Make sure that you, and your friends and family, know how to recognise and treat hypoglycaemia (low blood glucose); ask your doctor or diabetes educator if you are unsure.

  • Signs of hypolgycaemia include: hunger, irritability, sleepiness, sweating, trembling, weakness and shaking.
  • Treat hyplogycaemia (fast acting carbs)

> 6-7 jellybeans

> 1/2 can of regular soft drink

> 1/2 glass of fruit juice

> 3 teaspoons of sugar or honey

long acting carbs: slice of bread, glass of milk or a piece of fruit

  • Take with food to minimise risk of low blood glucose
  • Drinking alcohol decreases your blood glucose. It can also mask warning symptoms of hypoglycaemia. Avoid binge drinking and have something to eat when you drink alcohol.
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15
Q

Metformin with glibenclamide monitoring

A

Monitor for signs of hypoglycaemia. Sweating, hunger, mood changes and irritability.

Monitor blood glucose levels

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16
Q

Metformin with saxagliptin, sitgaliptin, alogliptin, linaglaptin, vildagliptin drug class

(ALSSV)

A

Biguanide and dipeptidyl peptidase 4 inhibitors (DPP4 inhbitors)

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17
Q

Metformin with saxagliptin, sitgaliptin, alogliptin, vildagliptin indication

A

Type 2 diabetes

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18
Q

Metformin with saxagliptin, sitgaliptin, alogliptin, linagliptin, vildagliptin dosage range and timing

(ALSSV)

A

Metformin and alogliptin:

  • Adult, 1 tablet (of any strength) twice daily with or after food. (12.5 mg with metformin in either 500mg, 850mg or 1000mg)

Metformin and linagliptin:

  • Adult, 1 tablet (of any strength) twice daily with or after food. (2.5mg with metformin in either 500mg, 850mg or 1000mg)

Metformin and saxagliptin:

  • Adult, 1 tablet (of any strength) once daily or 2 tablets of 2.5 mg/1000 mg once daily.

Metformin and sitagliptin:

  • Adult, 1 tablet (of any strength) twice daily –> janumet normal

> comes in 50/500, 50/850, 50/1000

  • Adult, 1 tablet of 100 mg/1000 mg or 2 tablets of 50 mg/1000 mg once daily. –> janumet controlled release

Metformin and vildagliptin:

  • 1 tablet (of any strength) twice daily.

> come in 50/500, 50/850, 50/1000

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19
Q

Metformin with saxagliptin, sitgaliptin, alogliptin, linagliptin, vildagliptin counselling

(ALSSV)

A

Take with or after food to reduce stomach upset.

Tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss.

Drinking alcohol can affect control of your diabetes. It can also increase the risk of serious side effects. Limit your alcohol intake, avoid binge drinking and have something to eat when you drink alcohol.

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20
Q

Metformin with saxagliptin, sitgaliptin, alogliptin, linagliptin, vildagliptin monitoring

(ALSSV)

A

Monitor blood glucose levels and hypoglycaemia

Monitor weight

Monitor for adverse effects such as rash, abdominal pain, fatigue, headache, cramps and loss of appetite

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21
Q

Metformin with dapagliflozin, empagliflozin, etruglifozin drug class

A

Biguanide and sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors)

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22
Q

Metformin with dapagliflozin, empagliflozin, etruglifozin indication

A

type 2 diabetes

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23
Q

Metformin with dapagliflozin, empagliflozin, etruglifozin dosage range and timing

A

Metformin with dapagliflozin

  • Adult, 1 tablet of 10/500 mg or 10/1000 mg once daily or 2 tablets of 5/1000 mg once daily.

Metformin with empagliflozin

  • Adult, 1 tablet (of any strength) twice daily, with or after food.

> comes in 5/500, 5/1000, 12.5/500, 12.5/1000

Metformin with etruglifozin

  • Adult, 1 tablet (of any strength) twice daily, with or after food.

> comes in 2.5/500, 2.5/1000, 7.5/500, 7.5/1000

24
Q

Metformin with dapagliflozin, empagliflozin, etruglifozin counselling

A

Take with or after food to reduce stomach upset.

Tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss.

Drinking alcohol can affect control of your diabetes. It can also increase the risk of serious side effects. Limit your alcohol intake, avoid binge drinking and have something to eat when you drink alcohol.

25
Q

Metformin with dapagliflozin, empagliflozin, etruglifozin monitoring

A

Monitor blood glucose levels and hypoglycaemia

Monitor weight

Monitor for adverse effects such as rash, abdominal pain, fatigue, headache, cramps and loss of appetite

26
Q

Clopidrogrel drug class

A

P2Y12 antagonist

27
Q

Clopidrogrel drug indication

A

History of symptomatic atherosclerosis

Acute coronary syndrome with aspirin

Prevention of vascular ischaemic events

28
Q

Clopidrogrel dosage range and timing

A

Prevention of vascular ischaemic events

  • 75mg once daily

ACS

  • Oral, loading dose 300mg, then 75mg once daily with aspirin, continue for 1–12 months or longer; seek specialist advice.

Placement of coronary stent

  • Oral, loading dose 300–600 mg at least 6 hours before the procedure, then 75 mg once daily with aspirin; continue for 1–12 months or longer; seek specialist advice
29
Q

Clopidogrel counselling

A

Avoid grapefruit juice as it may decrease the efficacy of clopidogrel

The main side effect of clopidogrel is bleeding more easily than normal. You may have nosebleeds, heavier periods, bleeding gums or bruising.

You can drink alcohol with clopidogrel. But do not drink too much while taking this medicine. It can irritate your stomach.

30
Q

Clopidogrel monitoring

A

Monitor for severe side effects such as rash, red blood in stools, swelling of the face, throat and lips.

Monitor for side effects such as bleeding and bruising

31
Q

Clopidogrel with aspirin drug class

A

P2Y12 antagonist and antiplatelet

32
Q

Clopidogrel with aspirin indications

A

ACS (acute coronary syndrome) → (MI)

History of symptomatic atherosclerosis

Secondary prevention of MI or unstable angina

MI, unstable angina or after cardiac stent insertion

33
Q

Clopidogrel with aspirin dosage range and timing

A

Adult, 1 tablet once daily.

> tab, clopidogrel 75 mg, aspirin 100

34
Q

Clopidogrel with aspirin counselling

A

Avoid grapefruit juice as it may decrease the efficacy of this medication

The main side effect of this medication is bleeding more easily than normal. You may have nosebleeds, heavier periods, bleeding gums or bruising.

You can drink alcohol with this medicaiton. But do not drink too much while taking this medicine. It can irritate your stomach.

Don’t take any other products containing aspirin while taking this medication.

35
Q

Clopidogrel with monitoring

A

Monitor for severe side effects such as rash, red blood in stools, swelling of the face, throat and lips.

Monitor for side effects such as bleeding and bruising

36
Q

Enoxaparin drug class

A

Low molecular weight heparin

37
Q

Enoxaparin indications

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

38
Q

Enoxaparin dosage range and timing

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.

Treatment of VTE

  • SC, 1 mg/kg twice daily, or 1.5 mg/kg once daily until adequate oral anticoagulation is established.

Unstable angina

  • Adult, SC 1 mg/kg twice daily
39
Q

Enoxaparin counselling

A

Tell your doctor immediately if you have any signs of bleeding (eg nosebleeds, black or tarry bowel motions, or unexplained bruising) during and after treatment.

Other drugs that can affect the clotting process may increase the risk of bleeding; avoid combinations or monitor closely. Low-dose aspirin (75–150 mg daily) may be used where indicated.

Like most LMWHs, Clexane is not recommended while you are breastfeeding.

40
Q

Enoxaparin monitoring

A

Monitoring of blood clotting factors required by doctor

Monitoring for severe adverse effects such as skin necrosis and alopecia with long term use

41
Q

Isosorbide dinitrate drug class

A

Nitrate

42
Q

Isosorbide dinitrate indications

A

Prevention and treatment of angina

43
Q

Isosorbide dinitrate dosage range and timing

A

Treatment of acute angina

  • sublingual: adult 5-10mg

Prevention of acute angina before a precipitating activity

  • sublingual: adult 5-10mg taken 10 minutes before activity
44
Q

Isosorbide dinitrate counselling

A

Use during episodes of angina or before an activity expected to bring on angina.

Sit or lie down before use as the drug may cause dizziness.

Call an ambulance if symptoms are severe, get worse quickly or last for 10 minutes.

Place 1 or 2 tablets under your tongue; do not chew tablets; after angina has been relieved, you may spit out what is left of the tablet to avoid adverse effects such as headache.

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.

45
Q

Isosorbide dinitrate monitoring

A

Monitor blood pressure and heart rate

Monitor for adverse effects such as headache, fainting and heart palpitations

46
Q

Isosorbide mononitrate drug class

A

Nitrate

47
Q

Isosorbide mononitrate indications

A

Prevention of angina

48
Q

Isosorbide mononitrate dosage range and timing

A

Adult, oral, initially 30–60 mg once daily, increased if necessary up to 120 mg once daily.

> take at the time of day when angina is most frequent, eg at night for nocturnal angina or in the morning for daytime angina

49
Q

Isosorbide mononitrate counselling

A

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.

Swallow whole; do not crush or chew the tablet.

This medication is not recommended for acute episdoes of angina because it takes a while to work –> only used for prevention of angina

50
Q

Isosorbide mononitrate monitoring

A

Monitor blood pressure and heart rate

Monitor for adverse effects such as headache, fainting and heart palpitations

51
Q

Glyceryl trinitrate drug class

A

Nitrate

52
Q

Glyceryl trinitrate indication

A

Prevention and treatment of stable angina

53
Q

Glyceryl trinitrate dosage range and timing

A

Prevention of acute angina before a precipitating activity

  • Sublingual spray, adult, 400 micrograms (1 spray) 5–10 minutes before activity
  • Sublingual tablet, adult, 300–600 micrograms 5–10 minutes before activity.

Acute angina

  • Sublingual spray, adult, 400–800 micrograms (1 or 2 sprays); repeat after 5 minutes if necessary to a maximum of 3 sprays.
  • Sublingual tablet, adult, 300–600 micrograms repeated every 3–4 minutes until pain is resolved, to a maximum of 1800 micrograms.
54
Q

Glyceryl trinitrate counselling

A

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.

sublingual tablets: 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.

sublingual spray: Prime the spray before using it for the first time by pressing the nozzle 5 times, spraying it into the air

55
Q

Glyceryl trinitrate monitoring

A

Monitor blood pressure and heart rate.

Monitor for adverse effects such as headache, fainting and heart palpitations

Bal (PPP2) (14 decks)

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