Medicines Knowledge Week 4 (Levodopa +/- Carbidopa or Benserazide, Pramipexole, Diazepam, Escitalopram, Lithium) Flashcards
Levodopa with benserazide or carbidopa drug class
“other drugs for parkinsons disease”
Levodopa +/- Carbidopa or Benserazide indication
Parkinsons disease
Levodopa +/- Carbidopa or Benserazide dosage range and timing
Oral, initially 50–100 mg 2 or 3 times daily; adjust gradually according to response and tolerance. Doses of up to 2 g (given in 3 or more doses) daily may be needed.
Levodopa +/- Carbidopa or Benserazide Counselling (3 marks)
Take this medicine at the same time each day and in the same way (eg always before food).
Mdication may cause drowsiness; if affected do not drive or operate machinery.
Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.
Levodopa +/- Carbidopa or Benserazide monitoring
Monitor for adverse effects such as allergic reactions including angioedema
Monitor for overuse of levodopa which includes psychiatric effects such as psychosis and impulse control disorders
Pramiprexole drug class
Dopamine agonist
Pramiprexole indication
Parkinsons disease
Restless leg syndrome
Pramipexole dosage range and timing
Parkinsons disease: Initially, 125 micrograms 3 times daily for a week, then 250 micrograms 3 times daily for a week, then 500 micrograms 3 times daily. Maximum of 1.5mg 3 times daily.
Restless leg syndrome: Initially 125 micrograms at night 2-3 hours before bedtime. Maximum of 750 micrograms once daily.
Pramipexole counselling
Take tablets with food to lessen the chance of nausea or stomach upset.
Tell your doctor if you notice any change in your behaviour, eg overspending, gambling or excessive sexual activity.
This medicine may cause dizziness or drowsiness; if affected, do not drive or operate machinery.
Pramipexole monitoring
Monitor for psychiatric adverse effects such as hallucinations and confusion
Warn patients and carers of the possibility of impulse control disorders which include gambling,overspending and binge eating.
Diazepam drug class
Benzodiazepine
Diazepam indications
Short term managment of anxiety and management
Acute alcohol withdrawal
Benzodiazepine withdrawal
Status epilepticus
Premedication
Diazepam dosage range and timing
Anxiety/agitation: Oral, 2–5 mg as a single dose. Dose may be repeated, if necessary, up to a maximum of 10 mg daily.
Pre-medication: IV –> 0.1-0.2 mg/kg
Diazepam counselling
You may feel drowsy while taking this medication, drowsiness may persist the following day
Avoid alcohol and other medications that may cause drowsiness while taking this drug
If you stop the medicine suddenly, you may have unpleasant effects (eg feeling anxious, difficulty sleeping)
Diazepam monitoring
Monitor for adverse effects such as allergic reactions and rash
Monitor renal function
Escitalopram drug class
Selective serotonin reuptake inhibitor (SSRI)
Escitalopram indications
Major depression
Generalised anxiety disorder
Social phobia
Obsessive-compulsive disorder
Escitalopram dosage range and timing
Adult, oral 10 mg once daily, increased if needed after 2–4 weeks to a maximum of 20 mg once daily.
- Maintenance doses >10 mg are not usually necessary.
Escitalopram counselling (3 marks)
This medicine is usually taken in the morning.
Do not stop taking this medicine suddenly unless your doctor tells you to.
Do not drive or operate machinery until you know how this medicine affects you.
Escitalopram monitoring
Monitor patients for increases suicidal thoughts and behaviour, as this can occur after starting antidepressants
Monitor for adverse effects such as taste disturbances and parasthesia
Lithium drug class
Drugs for bipolar disorder (mood stabiliser)
Lithium indications
Treatment of acute mania
Prevention of manic or depressive episodes in bipolar disorder
Augmentation for treatment-resistant depression
Lithium dosage range and timing
Acute mania: 750-1000mg daily in divided doses, increase dose by 250-500mg daily if necessary
Prophylaxis: 250-1000mg daily in divided doses for 2 weeks
> adjust according to serum concentration
Lithium counselling
Take with food
Maintain a normal diet with regular salt and fluid intake.
Regular blood tests are important during treatment
Lithium monitoring
Monitor for signs and symptoms of lithium toxicity such as extreme thirst, frequent urination, nausea and vomiting. If these occur, stop taking the tablets and seek medication attention immediatelty.
Monitor weight, renal and thyroid function at baseline then every 3-6 months.