Section 4: Providing information Flashcards
How long do SSRIs take to work?
SSRIs can take up to 6 weeks before patients see an improvement, may worsen depression before alleviating it
What are some side effects of SSRIs?
The most common is a dry mouth. May also lead to serotonin syndrome (if on multiple SSRIs, ecstasy) ~ agitation, pyrexia, hallucinations
What are the side effects/ risks of ACE inhibitors?
Increased risk of hyperkalemia
Teratogenic, switch for labetalol in pregnancy
What is important advice to give patients starting on clozapine?
If the patient experiences a sore throat or feels unwell, they should seek medical attention (risk of agranulocytosis - only try if 2 others antipsychotics have failed)
Note: regular monitoring is required (but not most important!)
What must be checked before starting azathioprine?
Check TPMT activity/ levels. If absent, azathioprine is contraindicated.
What drugs cause agranulocytosis?
Carbimazole, clozapine, carbamazepine + azathioprine
What anti-microbials are safe in pregnancy?
Penicillin and cephalosporins
When do you avoid trimethoprim and nitrofurantoin in pregnancy?
Avoid trimethoprim in 1T (try tri in 3T)
Avoid nitrofurantoin in 3T
What do you avoid when taking metronidazole?
Alcohol. Combination can cause profuse vomiting.
How long before major surgery do you stop the COCP?
4 weeks before major surgery were long period of immobility predicted
If a patient misses 1 pill and is 4h late for her 2nd pill at the start of the pack, what advice would you give her?
Ensure she takes both pills now (only considered late if >24h after) and carry on as normal. No need for emergency contraception. Carry on with the normal 7 day pill break.
What is important to tell patients taking MTX?
Avoid conception while taking it and for 6 months after (both men and women)
A patient on ramipril for hypertension is planning pregnancy. What do you do with her antihypertensive Tx?
Stop ramipril - it can be teratogenic. Replace with labetalol before conception.
What is an important side effect of tamoxifen to warn patients about?
Tamoxifen increases the risk of VTE. Look out for signs of DVT e.g. leg swelling, pain, readness.
What cancer does tamoxifen lead to increased risk of?
Endometrial cancer. May also be implicated in increased cervical cancer risk e.g. polyps.