Medicines Knowledge Week 3 (Carbamazepine, Levetiracetam, Tiotropium +/- combinations, Fluticasone +/- combinations, Prednisolone) Flashcards
Carbamazepine drug class
Antiepileptic drug
Carbamazepine Indication (2 marks)
Epilepsy –> simple and complex focal (partial) seizures, and generalised tonic-clonic seizures
Bipolar disorder
Trigeminal neuralgia
Carbamazepine dosage range and timing (2 marks)
Adult, oral, initially 100 mg twice daily; 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.
Carbamazepine counselling
Take with food to help prevent stomach upset.
Carbamazepine may also increase the effects of alcohol.
Do not stop taking this medicine suddenly unless your doctor tells you to.
Carbamezapine monitoring (2 marks)
Monitor bone mineral density and the use of vitamin D and calcium supplements. To prevent osteoporosis.
Monitor for skin reactions.
Levetiracetam drug class
Antiepileptic
Levetiracetam indication
Monotherapy of focal (partial seizures)
Adjunctive therapy of myoclonic seizures
Levetiracetam dosage range and timing
Monotherapy: Initially 250mg twice daily then upto 1.5g twice daily
Adjunctive therapy: Initially 500mg twice daily upto 1.5g twice daily
Levetiracetam counselling
Levetiracetam may also increase the effects of alcohol.
Do not stop taking this medicine suddenly unless your doctor tells you to.
The mixture can be diluted in a glass of water.
Levetiracetam monitoring (2 marks)
Monitor for adverse effects such as severe skin reactions
Caution in patients with history of psychiatric problems
Tiotropium drug class
Anticholinergics –> lama
Tiotropium indication (2 marks)
Chronic obstructive pulmonary disease
Maintenance treatment of moderate to severe asthma along with an ICS
Tiotropium dosage range and timing?
Braltus and Spiriva handihaler: DPI 1 capsule inhaled once daily
Spiriva Respimat: 2 inhalations (of 2.5 micrograms) once daily –> same with asthma
Tiotropium counselling
Do not allow the powder or mist to come into contact with your eyes
Tell your doctor if you notice any eye pain or discomfort
Do not drive or operate machinery until you know how this medicine affects you, it can cause dizziness or affect your vision
Tiotropium monitor
Monitor for adverse effects such as constipation
Caution in patients with bladder obstruction –> symptoms may worsen
Tiotropium is given with …? Dose?
olodaterol –> laba
- Tiotropium with olodaterol: Adult, 2 inhalations (2.5/2.5 micrograms) once daily.
Tiotropium (LAMA) is given with ICS in asthma, what are examples of this?
Beclometasone 250-400mcg
Budesonide 500-800mcg
Ciclesonide 240-320mg
Fluticasone furoate 100mcg
Fluticasone propoionate 250-500mcg
Fluticasone drug class
Inhaled corticosteroid (ICS)
Fluticasone indication
Maintenance treatment of asthma and COPD
Fluticasone dosage range and timing
Adult, child >12 years, Dry Powder Inhaler (DPI) 100–200 micrograms once daily.
Moderate to severe hepatic impairment: DPI 100 micrograms once daily
Fluticasone counselling
- Make sure that your doctor has given you an asthma action plan
- Rinse your mouth with water, gargle and spit out after use.
- Use a spacer with the metered dose inhaler
Fluticasone monitoring
Monitor for adverse effects such as allergic reactions and rash
Caution in patients with hepatic impairment (dose needs to be lowered)
What is fluticasone used with? What are the doses?
Fluticasone furoate with umeclidinium and vilanterol (LAMA and LABA)
> DPI, 1 inhalation (100/62.5/25 micrograms) inhaled once daily –> for CPD
Fluticasone furoate with vilanterol (LABA)
> DPI 100/25 or 200/25 micrograms, 1 inhalation once daily –> for asthma and COPD
Fluticasone counselling
- Use a spacer with the metered dose inhaler.
- Make sure that your doctor has given you an asthma action plan
- Rinse your mouth with water, gargle and spit out after use.
Fluticasone monitoring
Monitor for adverse effects such as rash and angioedema
Caution in patients with hepatic impairment, use a lower dose
Prednisolone drug class
Corticosteroids
Prednisolone indication
autoimmune or inflammatory disease, acute asthma, COPD exacerbation, acute gout
Prednisolone dosage range and timing
Acute asthma, oral 50 mg once daily for 5–10 days.
COPD exacerbation, oral 50 mg once daily for 5–14 days.
Acute gout, oral 20–50 mg once daily for 3–5 days.
Prednisolone counselling
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.
Prednisolone monitoring
Monitor for adverse effects such as severe skin reactions and depression
Caution in patients with diabetes –> corticosteroids may cause hyperglycaermia and worsen diabetes control