Counselling Week 3 (Carbamazepine, Levetiracetam, Tiotropium +/- combinations, Fluticasone +/- combinations, Prednisolone)

Question 1

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

Answer 1

Tegretol, 100mg 200mg 200mg 400mg

Question 2

Mode of action and indication of carbamazepine (3 marks)

Answer 2

It is thought to work by controlling brain chemicals which send signals to nerves so that seizures do not happen.

• used to control epilpesy (repeated seizures)
• to control bipolar disorder
• trigeminal neuralgia

Question 3

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

Answer 3

Take ONE (100mg) tablet twice daily, increase dose if necessary. Maintanence dose is 400mg to 1.2 g in 2 or more doses.

CAL labels: 5,9,13,18,21

Ask doc or pharmacist before using any OTC medicine (5)

Do not stop taking this medicine suddenly (9)

Do not remove from original packaging until dose required (13)

Avoid eating grapefruit or drinking grapefuit juice (18)

Speical handling and disposal required (21)

Question 4

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

Answer 4

All medications can cause side effects, but not everyone will experience them. Drowsiness, dizziness, headache, constipation may occur

Rarer side effects include severe skin reactions (esp in asian people)

Please see a doctor if you have thoughts of harming yourself

Question 5

Lifestyle/self-care of Carbamezapine (2 marks)

Answer 5

Take with food to help prevent stomach upset.

Carbamazepine may also increase the effects of alcohol.

Question 6

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

Answer 6

kevtam or keppra or kerron or levertiracetam

250mg, 500mg, 1000mg

Question 7

Mode of action and indication of levetiracetam (3 marks)

Answer 7

It is thought to work by controlling brain chemicals which send signals to nerves so that seizures do not happen.

It used for epilepsy

Question 8

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

Answer 8

Take TWO tablets (250mg) twice daily for 2 weeks –> monotherapy

Take TWO tablets (500mg) twice daily –> adjunctive therapy

Doctor may increase it later on.

CAL labels (1 and 9)

This medicine may cause drowsiness and may increase the effects of alcohol, do not drive if affected (1)

Do not stop taking this medicine suddenly (9)

Question 9

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

Answer 9

All medications can cause side effects, but not everyone will experience them. Initially drowsiness, dizziness and headache can occur.

Some rarer side effects include severe skin reactions

Please see a doctor if you have thoughts of harming yourself

Question 10

Lifestyle/self-care of Levetiracetam (2 marks)

Answer 10

Levetiracetam may also increase the effects of alcohol, so limit alcohol consumption

If feeling dizzy or drowsy, do not drive.

Question 11

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

> include combination

Answer 11

braltus, spiriva = DPI

spiriva = inhaler

> tiotropium with olodaterol (spiolto)

Question 12

Mode of action and indication of tiotropium (3 marks)

Answer 12

Improves breathing by relaxing the air passages that carry air to and from the lungs.

Use in chronic obstructive pulmonary disease (COPD) and asthma

Question 13

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

Answer 13

Adult, DPI 1 capsule inhaled once daily.

Spiriva Respimat: Adult, 2 inhalations (of 2.5 micrograms) once daily.

CAL labels: 22

use only with approved or recommended device

Question 14

Tiotropium with olodaterol (LABA)

Answer 14

Adult, 2 inhalations (2.5/2.5 micrograms) once daily.

Question 15

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

Answer 15

All medications can cause side effects, but not everyone will experience them. Some of these side effects may be dry mouth or throat irritation

Rarer side effects include allergy (rash)

Please see a doctor if you have shortness of breath

Question 16

Lifestyle/self-care of Tiotropium (2 marks)

Answer 16

Clean the mouthpiece at least once a week

Do not allow powder or mist to come in contact with your eyes

Question 17

What should tiotropium (LAMA) always be used with in asthma?

Answer 17

Use with ICS (beclometasone, budesonide)

Question 18

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

> include combinations

Answer 18

DPI 100mcg dose: arnuity (ellipta inhalation device)

DPI 200mcg dose: arnuity (ellipta inhalation device)

fluticasone furoate with umeclidinium and vilanterol (trelegy)

fluticasone furoate with vilanterol (breo)

Question 19

Mode of action and indication of fluticasone (3 marks)

Answer 19

This medicine belongs to a group of medicines known as corticosteroids, it is known as preventer, and may take upto a week to work. By using it everyday, the medicine reduces swelling and irritation in the walls of the small air passages in your lungs.

It is used in asthma and chronic obstructive pulmonary disease (COPD)

Question 20

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

Answer 20

ONE inhalation once daily including for combinations

CAL label 14 = rinse mouth with water after each use

Question 21

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

Answer 21

All medications can cause side effects, but not everyone will experience them. An abnormal voice (dysphonia) and bruising may occur.

Rarer side effects include allergic reactions and rash

Please see your doctor if you have breathing difficulties

Question 22

Lifestyle/self-care of fluticasone (2 marks)

Answer 22

Make sure that your doctor has given you an asthma action plan

Use this medicine every day even if you are feeling better

Question 23

In case they ask fluticasone propionate…

Answer 23

Fluticasone propionate

Fluticasone propionate with formoterol (Flutiform®)

Fluticasone propionate with salmeterol (eg Seretide®)

• Use twice daily

Question 24

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

Answer 24

Panafortelone, predsolone, solone

tablet: 1mg, 5mg, 25mg

Question 25

Mode of action and indication of prednisolone (3 marks)

Answer 25

This medications works by entering inflammatory cells and blocking the inflammatory reaction. It will only prevent or reduce symptoms of your condition, not cure it.

It is used for many different conditions, these include skin problems + arthritis + chronic asthma + chronic pulmonary obstructive pulmonary disease + gout

Question 26

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

Answer 26

For acute asthma and copd exacerbation, take 40-50mg once daily for 5-14 days

For autoimmune or inflammatory disease, take initially 5-60 mg one daily

CAL labels 9, B

• Do not stop taking this medicine abruptly, unless advised by your doctor
• Take with or soon after food

Question 27

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

Answer 27

All medications can cause side effects, but not everyone will experience them. Some of these may include a increase in blood pressure and weight gain

Rarer side effects include tendon rupture (achilles tendon)

Please see your doctor if you have severe stomach or intestinal pain.

Question 28

Lifestyle/self-care of Prednisolone (2 marks)

Answer 28

Take the tablets with food to help reduce stomach upset.

Tell all doctors, surgeons and dentists treating you that you are taking corticosteroids –> dose may have to be increased if ill or have surgery

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?