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AC- PPP1 > Medicines knowledge & counselling, 4 > Flashcards

Medicines knowledge & counselling, 4 Flashcards

1
Q

Levodopa +/- carbidopa benserazide

  • drug class
A
  • precursor of dopamine
  • dopa decarboxylase inhibitor
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2
Q

Levodopa +/- carbidopa benserazide

  • indication
  • MOA
A
  • symptoms of parkinsons disease
  • the three main symptoms are shaking (tremor), muscle stiffness, and slow and unsteady movement. People with Parkinson’s disease often walk with a shuffle as they have difficulty in initiating movement
  • the symptoms of Parkinson’s disease are caused by a lack of dopamine, a naturally occurring chemical produced by certain brain cells. Dopamine relays messages in the part of the brain that controls muscle movement
  • When too little dopamine is produced, slowness of movement results.
  • APO-Levodopa/Carbidopa contains two active ingredients, levodopa and carbidopa
  • Levodopa is a chemical closely related to dopamine which allows the body to make its own dopamine. Carbidopa makes sure that enough levodopa gets to the brain where it is needed
  • medicine is most helpful in improving slow movement and muscle stiffness. It is also frequently helpful in treating shaking, difficulty in swallowing and drooling
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3
Q

Levodopa +/- carbidopa/ benserazide

  • dose
  • directions
A
  • levodopa + carbidopa/ benserazide 50+12.5mg TDS, increasing up to 100+25mg TDS over 1 to 2 weeks
  • your doctor will then adjust this dose depending on the severity of your condition, your response to treatment and whether you are taking other medicines
  • Swallow the tablets with a full glass of water
  • take your medicine at about the same time each day, taking it at the same time each day will have the best effect & will also help you remember when to take it
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4
Q

Levodopa +/- carbidopa/ benserazide

  • key counselling points
  • adverse effects
A
  • you may feel light-headed or dizzy while taking this medicine. If you feel light-headed, dizzy or faint, get up slowly when getting out of bed or standing up
  • standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure. If this problem continues or gets worse, tell your doctor
  • common side effects include N/V, abdominal pain, constipation orthostatic hypotension, headache, dizziness
  • Be careful not to eat a diet high in protein. The amount of levodopa absorbed by the body may be impaired if you eat a diet high in protein. Ask your doctor, pharmacist or dietician to check your diet.
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5
Q

Levodopa +/- carbidopa/ benserazide

  • adverse effects
  • referral
A
  • all medicines can cause adverse effects but not everyone will experience them
  • most common SE are orthostatic hypotension, abdominal pain, hallucinations & confusion
  • usually mild and short lived
  • as levodopa works in the brain you may experience psychiatric side effects such as hallucinations and confusion, these occur rarely
  • if you experience any serious effects such as abnormal uncontrolled movements including muscle twitching or spasms, which may or may not resemble your Parkinson’s symptoms or dream abnormalities, please contact Dr
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6
Q

Levodopa +/- carbidopa/ benserazide

  • monitoring
A
  • monitor PD sxs, gait, tremor, unsteady movement
  • adverse effects, N/V, dyskinesia, decreased appetite, insomnia, agitation
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7
Q

Levodopa

  • lifestyle/self care
A
  • reduce protein intake
  • suggest walking aids
  • recommend gait & balance training, exercise programs and physiotherapy- tai chi TO INCREASE STRENGTH & MOBILITY
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8
Q

Pramipexole

  • drug class
A
  • dopamine agonist
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9
Q

Pramipexole

  • indication
  • MOA
A
  • parkinsons disease
  • restless leg syndrome
  • belongs to a group of drugs called dopamine agonists & is used to treat symptoms of Parkinson’s disease
  • the drug binds to cells in the brain and it relays messages in the part of the brain that help control movement
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10
Q

Pramipexole

  • dose
  • directions
A
  • conventional tabs
    • initially 125mcg TDS for a week then 250mcg TDS for a week then 500mcg TDS
    • if necessary increase dose each week by 250mcg TDS up to max of 1.5mg TDS
  • ER, CR tabs
    • initially 375mcg OD for a week then 750MCG OD then 1.5mg OD
    • if necessary increase dose each week by 750mcgup to a max of 4.5mg OD
  • swallow whole with some water, with or without food doesn’t matter
  • take it at about the same time each day, taking it at the same time each day will have the best effect & t will also help you remember when to take it
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11
Q

Pramipexole

  • key counselling points
  • adverse effects
A
  • swallow whole, with or without food doesn’t food but can take tablets with food to lessen the chance of nausea or stomach upset
  • take at same time each day
  • this medicine may cause dizziness or 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
  • common adv: forgetfullness, visual disturbances, worsening of restless leg syndrome
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12
Q

Pramipexole

  • adverse effects
  • referral
A
  • all medicines can cause side effects but not everyone will experience them
  • the most common side effects are forgetfullness (memory loss) & visual disturbances
  • if you experience any serious side effects such as memory loss, change in your behaviour, eg overspending, gambling, hypersexuality or binge eating please contact Dr immediately
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13
Q

Pramipexole

  • monitoring
A
  • monitor patient closely when discontinuing a dopamine agonist, a withdrawal syndrome may occur
  • impulse control disorders
    • gambling, hypersexuality, overspending, binge eating
  • psychiatric adverse effects
    • hallucinations and confusion
  • kidney function
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14
Q

Pramipexole

  • self care & monitoring
A
  • suggest walking aids
  • recommend gait & balance training, exercise programs and physiotherapy- tai chi TO INCREASE STRENGTH & MOBILITY
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15
Q

Diazepam

  • drug class
A
  • benzodiazepine
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16
Q

Diazepam

  • indication
  • MOA
A
  • short term management for anxiety
  • acute alcohol withdrawal
  • muscle relaxant
  • sedation
  • belongs to a group of medicines called benzodiazepines these medicines are thought to work by their action on brain chemicals to calm and relax you
17
Q

Diazepam

  • dose
  • directions
A
  • oral, 2-5mg as single dose, can be repeated up to max of 10mg daily
  • swallow tablets with water, with or without food doesn’t matter
18
Q

Diazepam

  • key counselling points
  • adverse effects
A
  • you may feel drowsy while taking this medication; drowsiness may persist the following day; avoid driving or operating heavy equipment until you know how you react
  • can take the first dose in the evening to assess how you feel first
  • avoid alcohol while taking this drug
  • if you stop the medicine suddenly, you may have unpleasant effects (eg feeling anxious, difficulty sleeping). Discuss how to stop the medicine with your doctor first.
  • common adv is drowsiness, light headedness & oversedations as it works on chemicals in the brain
19
Q

Diazepam

  • adverse effects
  • referral
A
  • all medicines can cause side effects, but not everyone will experience them
  • this is to be taken short term and this means you are unlikely to experience any serious SE
  • most common effects are drowsiness & oversedation
  • may cause some disturbances in vision
  • if you experience any serious effects such as

headache, hangover feeling in the morning or unpleasant dreams, contact Dr immediately

20
Q

Diazepam

  • monitoring
A
  • dependence
  • duration, assess patient in 2 weeks
    *
21
Q

Diazepam

  • self care/ lifestyle
A
  • relaxation techniques such as meditation, deep breathing and progressive muscle relaxation can be helpful
  • see psychologist to help give strategies to deal with stressful circumstances
  • having a healthy diet and being active also helps
22
Q

Escitalopram

  • drug class
A
  • SSRI
  • selective serotonin reuptake inhibitor
23
Q

Escitalopram

  • indication
  • MOA
A
  • major depression
  • GAD
  • OCD
  • social phobia
  • works on someof the chemicals in your brain to reduce your anxiety
  • depression caused by chemical imbalance in brain, escitalopram corrects this chemical imbalance and may help relieve the symptoms of depression
24
Q

Escitalopram

  • dose
  • directions
A
  • oral, 10mg daily, increasing if needed to max of 20mg OD
  • Usually taken in the morning, however if it makes you drowsy you can take it at night
  • takes time to work, 1-2 weeks to see a difference & up to a month to know if its working effectively
25
Q

Escitalopram

  • key counselling points
  • adverse effects
A
  • takes time to work, 1-2 weeks to see a difference & up to a month to know if its working effectively
  • don’t stop taking this abruptly unless advised by Dr
  • drowsiness- don’t drive or operate machinery until you know how this medicine affects you
  • may cause N, dry mouth, insomnia, headache and sweating
26
Q

Escitalopram

  • adverse effects
  • referral
A
  • all medicines can cause side effects, not everyone will experience them
  • common: N, dry mouth, drowsiness, headache
  • these may subside as your body gets used to the drug
  • if you experience tremor, mental state changes such as confusion, agitation, sweating or fever- DR
27
Q

Escitalopram

  • monitoring
A
  • worsening sxs
    • suicidal ideation
  • sx improvement
  • mood changes
28
Q

Escitalopram

  • selfcare/lifestyle
A
  • continue to see a psychologist, to help give you strategies to deal with stressful and undesirable circumstances
  • having a healthy, active lifestyle also helps improve mood & physical health
  • try to make time for yourself to do something you enjoy
  • relaxation techniques such as meditation, deep breathing and progressive muscle relaxtion can be helpful
29
Q

Lithium

  • drug class
A
  • mood stabiliser
30
Q

Lithium

  • indication
  • MOA
A
  • BPAD
  • acute mania
  • schizophrenia
  • it helps you to have more control over your emotions and helps you cope better
31
Q

Lithium

  • dose
  • directions
A
  • acute: initially 750-1000mg daily in DD, every 12 hours
    • increase dose by 250-500mg daily PRN until sxs resolve
  • prophylaxis: 250–1000 mg daily in divided doses (every 12 hours if using Quilonum SR®) for 2 weeks, then adjust dose according to serum concentration.
  • swallow whole, but don’t take with hot drink
  • can be taken with a meal or snack to prevent stomach upset
32
Q

Lithium

  • key counselling points
  • adverse effects
A
  • don’t drink with hot drink
  • take with food
  • be aware for s&s of lithium toxicity
    • extreme thirst and frequent urination, severe D/V, excessive sweating stop taking the tablets and seek medical attention immediately
  • common adv: muscle weakness, metallic taste in mouth
33
Q

Lithium

  • adverse effects
  • referral
A
  • all medicines can cause side effects but not everyone will experience them
  • some common adv may initially experience include N/D, increased appetite, metallic taste in mouth but these may disappear with continued use as body gets used to drug
  • less commonly it may cause hair loss
  • lithium toxicity- urinating more frequently, extreme thirst, severe D/V, blurred vision- see Dr
34
Q

Lithium

  • monitoring
A
  • lithium toxicity
  • regular blood tests for serum Li+ levels
  • electrolytes, renal
  • suicidal ideation
35
Q

Lithium

  • selfcare/ lifestyle
A
  • important to let family and friends know hoe you’re feeling
  • they might not fully understand what you’re going through but they may be able to give you extra support

AC- PPP1 (6 decks)

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