Medicines Knowledge Week 2 (Warfarin, Oxycodone, Pregabalin, Tramadol, Levothyroxine) Flashcards
Warfarin drug class
Vitamin K antagonist (anticoagulant)
Warfarin indications
- Prevention and treatment of VTE
- Prevention of stroke in patients with previous myocardial infarction
- Prevention of stroke in patients with atrial fibrillation
Wafarin dosage range and timing
usually 5mg once daily for 2 days then adjust according to INR 2-3 is best
- Maintanence dose = 1-10mg once daily, taken at same time each day.
Wafarin counselling
Always take the same brand of tablets
Take tablets at about the same time every day
Tell your doctor if you develop a painful, purplish, bruise-like rash.
Avoid excessive alcohol consumption; 1–2 standard drinks daily is generally safe.
Warfarin monitoring
- Regular blood tests, specifically INR with this medicine
- If a blood test result shows an INR above your target range, then your risk of bleeding has increased. If your INR is below your target range, then your risk of developing blood clots has increased
- When you first start taking warfarin you will need to have your INR tested often – eg, every 1 or 2 days for the first week – to work out your correct warfarin dose.
Pregabalin drug class
Anticonvulsant/antiepileptic
Pregabalin indications
Neuropathic pain
Focal (partial) seizures
Pregabalin dosage range and timing
Neuropathic pain: 75mg at night for 1 week then 150mg daily in 1 or 2 doses.
> Maximum of 300mg twice daily
Focal (partial) seizures: 75mg twice daily, increase to 150mg twice daily after 7 days
> Maximum of 300mg twice daily
Pregabalin counselling
This medicine may cause drowsiness or dizziness; if affected, do not drive or operate machinery.
Pregabalin may also increase the effects of alcohol
Avoid stopping suddenly –> may cause anxiety, headache and diarrhoea –> reduce dose over at least a week.
Pregabalin monitoring
Monitor for signs and symptoms of sucicidal risk
> thoughts or talks of death or suicide
Monitor for muscle pain (rhabdomyolysis)
Tramdaol drug class
Opioid analgesic
Tramadol indications
Severe pain
Acute or chronic pain
Tramadol dosage range and timing
Conventional product, oral 50–100 mg every 4–6 hours when necessary; maximum 400 mg daily
Controlled release tablet, 50–200 mg every 12 hours; maximum 400 mg daily.
Tramadol counselling
This medication may make you feel drowsy and may increase the effects of alcohol.
Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.
If you are very sleepy, stop taking this medication and tell your doctor immediately
Tramadol monitoring
Monitor for pain improvement, may need alternative opioid
Monitor for dental issues as chronic use can cause dry mouth which increases risk of dental caries
Monitor for constipation. May need to start coloxyl and senna.
Levothryoxine drug class
Thyroid hormone
Levothyroxine indication
Hypothyroidism
Thyroid hormone replacement in patients with tumours of the thryroid gland
Levothyroxine dosage range and timing
Oral, usual range, 50–200 micrograms once daily.
> adjust dose every 6-8 weeks if necessary, acorrding to TSH
Levothyroxine counselling
Take on an empty stomach, before breakfast
Tell your doctor if symptoms of hyperthyroidism occur, eg palpitations, excitability, insomnia, flushing, sweating or weight loss
Do not switch with other brands unlesa advised by your doctor
Levothyroxine monitoring
Doctor will monitor blood tests to see if thyroid hormone levels are adequate
Caution in patients with heart problems such as high blood pressure
Oxycodone drug class
Opioid analgesic
Oxycodone indications
Acute or chronic pain
Oxycodone dosage range and timing
Acute pain —> Conventional oral product, initially 5–15 mg every 4 hours. Titrate dose according to response.
Chronic non-cancer pain: adult –> Controlled release, oral 5–10 mg twice daily. Adjust dose according to response.
Oxycodone counselling
This medication may make you feel drowsy and may increase the effects of alcohol. If you are affected, do not drive or operate machinery.
If you are very sleepy or have trouble staying awake, stop taking the medication and tell your doctor immediately.
Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.
Oxycodone monitoring
Monitor for pain improvement, may need alternative opioid
Monitor for dental issues as chronic use can cause dry mouth which increases risk of dental caries
Monitor for constipation. May need to start coloxyl and senna.
