POM to P drugs Tamsulosin and Sumatriptan 2 Flashcards
what is Tamsulosin used for?
1) Used for the treatment of prostate enlargement, also known as benign prostatic hyperplasia (BPH)
2) Unknown cause, but ageing and long-term exposure to testosterone and particularly dihydrotestosterone are important contributing factors
what is tamsulosins mechanism of action
1) Tamsulosin is an alpha1-adrenoceptor antagonist (‘alpha1-blocker’)
2) Alpha1-blockers relax smooth muscle in benign prostatic hyperplasia
what are the symptoms of benign prostatic hyperplasia (BPH) ?
Lower urinary tract symptoms (LUTs), such as:
1) Urinary hesitancy
2) Weak stream
3) Frequent urination
4) Urgency
what are the symptoms of benign prostatic hyperplasia (BPH) ?
1) Needing to wait before starting to pee
2) Stop and start when pee
3) Push/strain to pee
4) Bladder never feels completely empty
5) Dribbling at the end
6) Pee more often
7) Getting up to pee at night
what is OTC tamsulosin indicated for? what do you need to do before you supply? what is the dose?
1) OTC tamsulosin - Flomax relief® is indicated for treatment of functional symptoms of benign prostatic hyperplasia (BPH) in males aged 45 to 75 years
2) A pharmacy questionnaire will be used to screen customers for LUTS and to rule out conditions that would require referral to a GP
3) Dose: a single 400 microgram SLOW RELEASE capsule should be swallowed whole after the same meal each day
4) The OTC tamsulosin supply model requires both pharmacist and GP involvement. Pharmacy staff will assess eligibility through for initial supply (up to 6 weeks initial treatment: 14-pack followed by a further 28-pack if appropriate) whilst the GP confirms diagnosis and suitability for long-term OTC treatment
Medical review is required for the diagnosis of BPH . what must all patients do within 6 weeks of starting the treatment using Tamsulosin?
- what should a patient do if the symptoms do not improve within 14 days?
- what should pharmacist check Following initial treatment
1) Medical review is required for the diagnosis of BPH
All patients must see their doctor within 6 weeks of starting treatment, for assessment of their symptoms and confirmation that they may continue to take OTC tamsulosin from their pharmacist
2) If urinary symptoms have not improved within 14 days of starting treatment, or are getting worse, the patient should stop taking tamsulosin and be referred to the doctor
3) Following initial treatment, pharmacists should establish (e.g. by asking the patient) that the doctor has carried out a clinical assessment within the 6 week timeframe and confirmed suitability for further supply
Pharmacists should advise customers to consult a doctor for a clinical review every 12 months
what Non-Pharmacological advice can you provide to patients who suffer from BPH?
1) Avoid drinking any liquids for one to two hours before going to bed (help to improve symptoms of nocturia)
Stop drinking alcohol or caffeine, or limit consumption of them (they can irritate the bladder and make symptoms worse)
2) Regular exercise can improve symptoms
3) Increasing the amount of fruit and fibre eaten to avoid constipation, which can put pressure on the bladder
4) Avoid unnecessary use of cold and allergy medicines such as decongestants and anti-histamines, which can affect muscles in the bladder
discuss the Special warnings/precautions with regards to Tamsulosin.
- what are the adverse effects?
1) Reduced blood pressure can occur in individual cases during treatment with OTC tamsulosin,
2) ‘Intraoperative Floppy Iris Syndrome’ (IFIS) has been observed during cataract surgery in some patients on or previously treated with tamsulosin
3) Adverse effects:
- Dizziness
- Uncommon side effects: headache, palpitations, postural hypotension, rhinitis, constipation, diarrhoea, nausea, vomiting, rash, pruritus, urticaria, abnormal ejaculation, asthenia (weakness).
- Also: drowsiness, blurred vision, dry mouth or oedema
what is Sumatriptan used for and how does it work?
Sumatriptan belongs to a group of medicines called ‘triptans’ – it is classed as a 5HT1 receptor agonist. It acts on the receptors in the brain to stabilise the blood vessels which are involved in migraine attacks. Triptans are used for the treatment of migraine, not prevention
what is the pharmacy supply of Imigran® indicated for?
Pharmacy supply of sumatriptan (Imigran®) is indicated for the acute treatment of migraine attacks with or without aura in adults aged 18-65 years, with a stable and well established pattern of symptoms
- you need to assess the patient before supply. a questionnaire needs to be filled in
what is a Migraine?
1) Migraine is a condition resulting from spasm and subsequent over dilation of certain arteries in the brain
2) Causing recurrent throbbing headache that characteristically affects one side of the head
3) Migraines are associated with other features that distinguish it from a normal headache such as nausea, vomiting and changes in vision and hearing
outline the Counselling points you would cover when supplying Sumatriptan
1) Advise patients to take a single tablet as soon as possible after the onset of a migraine headache although it is effective if taken at any stage of the headache.
2) If the 1st dose of sumatriptan is ineffective, a further dose is unlikely to be effective and should not be taken
If symptoms return after initial relief, a 2nd dose can be taken after 2 hours
3) Patients experiencing 4 or more attacks per month or requesting 4 or more packs per month should be referred to their GP
4) Excessive use of triptans may lead to chronic daily headache or exacerbation of headache
discuss the Benefits of supplying Sumatriptan OTC ?
1) Triptans should be taken as early as possible in a migraine attack
2) Infrequent attacks and may therefore be unlikely to always have supplies
3) No need to waste time visiting the doctor
4) The impact of migraine, through missed work, distress, altered mood, and reduced quality of life, may therefore be reduced
