Medication Counselling

Question 1

How would you explain Methrorexate?

Answer 1

• explain RA - immune system is activates in joints

- Methotrexate dampens the immune system from attacking the joint

Question 2

What monitoring is required for methotrexate?

Answer 2

CXR before start

FBC/UE/LFT 2 weekly then 2 monthly

Question 3

How long does Methotrexate take to effect?

Answer 3

4/6 months

Question 4

How is methotrexate taken?

Answer 4

Weekly via tablet or infection

Question 5

What SE are there for MTX?

Answer 5

Alopecia
Headaches
GI disturbance - Nausea (BUT FOLIC ACID)

Question 6

What Important SE?

Answer 6

Myelosupression - infection, bleeds

Liver and pulmonary toxicity - Alcohol

Question 7

What contraindications are there for MTX?

Answer 7

Immunodeficiency

Pregnancy - contraception

Question 8

What supplementary advice for MTX?

Answer 8

• anual flu jab

Leaflet

Question 9

How would you explain Biphosphonates?

Answer 9

Osteoporosis -Bones have less minerals which make them weeker

Biphsophonates - Give you more minerals helping to keep bones strong

Question 10

How is biphosphonates taken?

Answer 10

as a tablet or drink which is taken every week.

• Swalow with full glass of water
• remain upright for 30 mins
• At least 30mins before food

Question 11

What SE for biphosphonates?

Answer 11

Headache
Indigestion/ heartburn
Diarrhoea/contripation

Question 12

Monitoring for biphosphonates?

Answer 12

Initially dental check

Question 13

Contraindications for biphosphonates?

Answer 13

pregnancy 
dysphagia 
peptic ulcer
low Ca
Severe CKD

Question 14

How would explain SSRIs?

Answer 14

Depression - imbalance of chemical in brain

SSRI - increase a chemical called serotonin

Question 15

How to take SSRI?

Answer 15

Tablet to be taken once per day. May take 4w to feel better

Question 16

SE of SSRI?

Answer 16

GI upset 
Sexual dysfunction 
Drowsiness
Dry mouth
Initially anxiety 2w

Question 17

Important side effects for SSRI?

Answer 17

Withdraw gradually:
Mood changes
Restlessness
Constipation/diarrhoea

Question 18

Contraindications to SSRIs?

Answer 18

Exclude mania/ bipolar depression

Question 19

Monitoring for SSRIs?

Answer 19

nil

Question 20

How would you explain Lithium treatment?

Answer 20

Bipolar - mania and depression

Li - stabilises a persons mood, decreases risk of suicide

Mechanism unclear

Question 21

How is lithium taken?

Answer 21

1-2 tablet taken daily

Takes 1-2 weeks for affect

Question 22

SE of Li?

Answer 22

Water - polydipsia and polyuria
GI - nausea
Tremor

Question 23

What should be watched out for in Li treatment?

Answer 23

Li toxicity

Question 24

What contraindications are their Li therapy?

Answer 24

pregnancy
Severe renal
Addisons

Question 25

What advice should be given to a person on Li?

Answer 25

drink plenty of water

Question 26

What monitoring is needed

Answer 26

Before - ECG, Bloods, beta HCG Regular monitoring of Li TFT UE, Ca - 6m

Question 27

How would you explain levodopa?

Answer 27

PD - low amounts of a chemical in brain which initiates movement called dopamine Levodopa - tops up dopamine relieving symptoms

Question 28

How is levodopa taken?

Answer 28

Take in a tablet 3-4 times per day Take with food to reduce nausea but will feel benefit quickly

Question 29

How long is levodopa dopa effective?

Answer 29

Decreases over time. end dose deterioration over 5 years with on off effect. Addition of other medication which help levodopa work...

Question 30

SE of levodopa treatment?

Answer 30

Psychosis Dyskinsia Postural hypotension Nausea - But Domperidone

Question 31

Contraindications to levodopa therapy?

Answer 31

Glaucoma

Question 32

How do atypical antipsychotics?

Answer 32

Schizophrenia is an overactivity of chemical brain leading to symptoms Atypical tries to bring back a balance of chemicals in the brain.

Question 33

How are atypical antipsychotics taken?

Answer 33

Daly tablet or depot injection. Starts at low dose then titrate up.

Question 34

What should be done for a patient who has a developed a rash while on allopurinol?

Answer 34

Stop taking allopurinol seat medical attention - allopurinol hypersensitivity