Medicines Knowledge Week 1 (Amiodarone, Amlodipine, Apixaban, Digoxin, Metoprolol)

Question 1

Amiodarone drug class (1 mark)

Answer 1

antiarrhythmic

Question 2

Amiodarone Indication (2 marks)

Answer 2

treatment & prophylaxis of tachyarrhythmias which include ventricular tachycarhida & Atrial fibrillation

Question 3

Amiodarone dosage range and timing (2 marks)

Answer 3

Loading, oral 200 mg 3 times daily for 1 week, followed by 200 mg twice daily for 1 week.

Maintenance, oral 100–200 mg once daily (400 mg daily may be required, especially for ventricular arrhythmias)

Question 4

Amiodarone Counselling (3 marks)

Answer 4

Avoid sun exposure, wear protective clothing and use sunscreen (SPF 30 plus sunscreen containing zinc or titanium oxides) when outside

Need regular blood tests, ECGs and chest x-rays while taking amiodarone

Amiodarone interacts with grapefruit juice and many other drugs; avoid grapefruit juice

Question 5

Amiodarone monitoring (2 marks)

Answer 5

Monitor for heart rate

Monitor liver function by doing test at baseline and every 6 months

Monitor for adverse effects such as cough and shortness of breath

Question 6

Amlodipine drug class (1 mark)

Answer 6

dihydropyridine calcium channel blocker

Question 7

Amlodipine common indications (2 marks)

Answer 7

hypertension

angina

Question 8

Amlodipine dosage range and timing (2 marks)

Answer 8

Adult, child >6 years, oral: initially 2.5–5 mg OD, increasing if necessary after at least 1–2 weeks to a MAX of 10 mg OD

Elderly, hepatic impairment: Adult, initially 2.5 mg once daily.

Question 9

Amlodipine counselling (3 marks)

Answer 9

This medicine may cause dizziness, especially when getting up from lying down. Lie down until the symptoms pass if feeling dizzy.

Avoid drinking large amounts of alcohol as it can make you more dizzy or sleepy while on this medication and also it increases blood pressure.

Please see a doctor if you have difficulty breathing or severe skin reaction.

Question 10

Amlodipine monitoring (2 marks)

Answer 10

Monitor blood pressure

Monitor for adverse effects such as skin reactions and difficulty breathing

Question 11

Apixaban drug class (1 mark)

Answer 11

DOAC: direct-acting oral anti-coagulant

Factor Xa inhibitor

Question 12

Apixaban common indications (2 marks)

Answer 12

It is used to treat and prevent clots occuring in a venous thromboembolism

Prevent blood clots after a hip or knee surgery

Prevent stroke and blood clots in patients with atrial fibrilation

Question 13

Apixaban dosage range and timing (2 marks)

Answer 13

prevention of clots after hip/ knee replacement: Oral 2.5mg BD, starting 12-24 hours after surgery

prevention of emboli in AF: Oral 5 mg twice daily.

Question 14

Apixaban counselling (3 marks)

Answer 14

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medicine

Do not take aspirin or anti-inflammtory medicines while being treated with this medicine

Take at the same time each day; use a calendar or reminder on phone, and mark off after taking the dose

Question 15

Apixaban Monitoring (2 marks)

Answer 15

Monitor for adverse effects such as black stools or blood in the stools

Monitor renal function regularly (especially in elderly)

Question 16

Digoxin Drug Class (1 mark)

Answer 16

antiarrhythmic drug

> cardiac glycoside

Question 17

Digoxin indications (2 mark)

Answer 17

AF and atrial flutter

Heart failure

Question 18

Digoxin dosage range and timing (2 marks)

Answer 18

loading: Oral/IV, 250–500 micrograms every 4–6 hours according to response, up to a total of 1.5 mg

> maintenance, 125–250 micrograms once daily

Question 19

Digoxin counselling (3 marks)

Answer 19

Tell your doctor or pharmacist that you are taking digoxin before using any other medicines including over-the-counter and herbal products

You can take digoxin with or without food, but its best to take it at the same time each day.

Limit alcohol consumption while using this medication as it may make you more drowsy

Question 20

Digoxin monitoring (2 marks)

Answer 20

Caution in patients with hypokalaemia as it increases sensitivity to digoxin

Monitor for adverse effects such as chest pain and shortness of breath

Question 21

Metoprolol drug class (1 mark)

Answer 21

cardioselective beta-1 receptor beta blocker

Question 22

Metoprolol common indications (2 marks)

Answer 22

Hypertension

angina

MI

tachyarrhythmias

chronic HF with reduced ejection fraction

prevention of migraine

Question 23

Metoprolol dosage range and timing (2 marks)

Answer 23

Hypertension: 50-100mg OD initially, 50-100mg OD or BD maintenance

Angina: 25-50mg BD, 50-100mg BD or TDS

Tachyarrhythmias: 25-100mg BD

MI: 25-50mg BD

Prevention of migraine: 50-75 mg BD

Question 24

Metroprolol counselling (3 marks)

Answer 24

Can cause dizziness or tiredness at the start of treatment, if you know that this affects you, don’t drive.

Limit alcohol consumption while using this medication, alcohol will make dizziness or light-headedness worse.

Dress warmly during cold weather, especially if you will be outside for a long time, this medication makes you more sensitive to cold temperatures.

Question 25

Metoprolol monitoring (2 marks)

Answer 25

Monitor heart rate

Monitor for adverse effects such as rash and muscle cramps

If being treated for diabetes, monitor blood sugar regularly