Counselling Week 1 (Amiodarone, Amlodipine, Apixaban, Digoxin, Metoprolol)

Question 1

This medicine is amiodarone and the brand we have given you is called …?

Answer 1

Tablets 100mg (aratac, cordarone)

Tablets 200mg (aratac, cordarone X, rithmik)

Question 2

Mode of action and indication of amiodarone (3 marks)

Answer 2

It is used for severe tachyarrhythmia which includes atrial fibrillation and ventricular tachycardia.

This medication works on the heart by slowing electrical signals. It will help control a fast or irregular heartbeat and therefore make your heart beat normally.

This medication will take a few weeks to work.

Question 3

Dose and directions for use (C/A labels) for amiodarone (3 marks)

Answer 3

Take ONE tablet (200mg) three times a day for ONE week followed by ONE tablet twice daily for ONE week –> loading dose

Take ONE tablet (100-200mg) once daily (400mg daily may be required for VA) –> maintanence dose

start with maintanence dose in non-urgent cases

CAL 5,8,18.

• Avoid excessive sun exposure while being treated with this medicine (8)
• Avoid eating grapefruit or drinking grapefruit juice while being treated with this medicine (18)

Question 4

AE (common, serious, allergic) of amiodarone (3 marks)

Answer 4

All medications can cause side effects, but not everyone will experience them. Nausea and vomitting tend to occur early. Taste disturbances such as metallic taste and loss of taste can happen occasionally and blue-grey pigmentation of the skin.

Some rarer side effects include hair loss and a allergic rash. If any sort of vision impairment occurs, please see a doctor.

Long term use of this drug can affect the thyroid and liver, your doctor will be monitoring this with tests every 6 months.

Question 5

Lifestyle/self-care of Amiodarone (2 marks)

Answer 5

This medication can cause photosensitivity and skin issues so please avoid sun exposure, wear protective clothing and use suncreen with SPF of 30 or higher that contains titanium or zinc oxide.

To prevent an upset stomach, take this medication with food.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 6

This medication is amlodipine and the brand we have given you is called …?

Answer 6

Amlodipine, Amlo, Nordip, Norvasc (5mg)

Amlodopine, Amlo, Nordip, Norvasc (10mg)

Question 7

Mode of action and indication of amlodipine (3 marks)

Answer 7

This medication works on your heart to reduce your blood pressure by relaxing blood vessels and increasing blood supply to the heart.

This medication ised for hypertension and angina. It does not provide immediate relief of chest pain from angina.

Question 8

Dose and directions for use (C/A labels) for amlodipine (3 marks)

Answer 8

Take ONE tablet (5mg) once daily, increasing after one to two weeks to one tablet daily (10mg). if it is necessary to increase your dosage, this will be reviewed by your doctor

CAL: 9,16,18

Do not stop take this medicine suddenly, consult with your doctor firsrt

This medicine may cause dizziness, especially when getting up from lying down. it is best to monitor this.

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

Question 9

AE (common, serious, allergic) of amlodipine (3 marks)

Answer 9

All medications can cause side effects, but not everyone will experience them. Intially nausea, headache, tiredness and dizziness can happen.

Some rarer side effects include taste disturbances and swelling of the face, lips, and mouth.

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

Question 10

Lifestyle/self-care of Amlodipine (2 marks)

Answer 10

If you are feeling dizzy or tired, avoid driving or using machines

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

If you feel dizzy, lie down until the symptoms pass. If frequently dizzy, inform your doctor.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 11

This medicine is apixaban and the brand we have given you is called …?

Answer 11

2.5 mg and 5mg = Eliquis

Question 12

Mode of action and indication of apixaban (3 marks)

Answer 12

This medication works by stopping a blod clot forming and therefore prevents stroke.

It is used to treat and prevent clots occuring in a venous thromboembolism, prevent blood clots after a hip or knee surgery, and prevent stroke and blood clots in atrial fibrilation.

Question 13

Dose and directions for use (C/A labels) for apixaban (3 marks)

Answer 13

Prevention of emboli in AF: ONE (5mg) tablets twice daily

Prevention of VTE after hip/knee replacement: ONE (2.5mg) tablets twice daily

Treatment of acute VTE and preventing VTE: TWO (5mg) tablet twice daily for 7 days then ONE (5mg) twice daily

CAL: 10b and 18

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

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

Question 14

AE (common, serious, allergic) of apixaban (3 marks)

Answer 14

All medications can cause side effects, but not everyone will experience them. Nausea may occur early on in when using this medication. Rarer side effects include allergic reactions such as difficulty breathing, swelling of the face and rash.

Please see a doctor if you have black stools or blood in your stools.

Question 15

Lifestyle/self-care of Apixaban

Answer 15

You can crush the tablets and mix them in water or apple juice, take it within 4 hours.

Tell your dentist that you are taking this medicine

Take the medication at the same time everyday

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 16

This medicine is digoxin and the brand we have given you is called …?

Answer 16

Tablet 62.5 mcg (lanoxin PG, sigmaxin PG)

Tablet 250 mcg (lanoxin, sigmaxin)

Question 17

Mode of action and indication of digoxin (3 marks)

Answer 17

This medication works on your heart by slowing down the rate at which your heat beats and increasing the force of your heart when it beats.

It is used for atrial fbrilation, atrial flutter and heart failure.

Question 18

Dose and directions for use (C/A labels) for digoxin (3 marks)

Answer 18

Loading dose: ONE/TWO (250mcg) tablets four times a day

Maintanence dose: TWO (62.5mcg) - ONE (250mcg) tablets once daily

CAL: 5

Ask you doctor or pharmacist before using any other medicines, this includes over the counter medicines or complementary medicines.

Question 19

AE (common, serious, allergic) of digoxin (3 marks)

Answer 19

All medications can cause side effects, but not everyone will experience them. Some of these adverse effects may include blurred vision, nausea and headache.

Rarer side effects include seizures and pyschosis

Please see your doctor if you have chest pain or shortness of breath

Question 20

Lifestyle/self-care of Digoxin (2 marks)

Answer 20

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

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

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?

Question 21

This medicine is metoprolol and the brand we have given you is called …?

Answer 21

50mg –> betaloc, lopresor, metrol, minax, minstrom

100mg –> betaloc, lopresor, metrol, minax, minstrom

Question 22

Mode of action and indication of metoprolol (3 marks)

Answer 22

This medication works by widening blood vessels in the body, and decreasing the heart’s need for blood and oxygen. Therefore the work that heart has to do is reduced.

It is used for hypertension, to prevent angina, tachyarrythmia, after a heart attack and prevention of migraine.

Question 23

Dose and directions for use (C/A labels) for metoprolol (3 marks)

Answer 23

HTN: ONE (50mg) tablet daily or ONE (50mg) tablet twice day. The dose may increase according to the doctor.

Angina: HALF a tablet (25mg) or ONE tablet (50mg) twice daily. The dose may increase according to the doctor.

Tachyarrythmia: HALF a tablet or TWO tablet (50mg) twice daily

MI (maintanence): HALF a tablet or ONE tablet (50mg) twice daily

Migraine: ONE tablet (50mg) twice daily

CAL LABELS: 9,12,16

Do not stop taking this medicine suddenly unless advised by doctor

This medicine may affect mental alertness and coordination. If affected, do not drive vehicle or operate machinery.

This medicine may cause dizziness especially when standing up quickly.

Question 24

AE (common, serious, allergic) of metoprolol (3 marks)

Answer 24

All medications can cause side effects, but not everyone will experience them. Some of these side effects may include fatigue, abnormal vision and nausea.

Rarer side effects include alopecia (hair loss) and rash

Please see your doctor if you have chest pain and swelling of the legs due to fluid buildup.

Question 25

Lifestyle/self-care of metoprolol (2 marks)

Answer 25

If you feel dizzy, get up gradually from sitting or lying. Sit down if you becoem dizzy.

Limit the consumption of alcohol while on this medication as it can increase the drowsiness effect.

Questions + CMI (1 mark)

I have printed information for you about this medication, is there anything you would like me to explain more? Do you have any questions?