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AC- PPP1 > Medicines knowledge & counselling, 5 > Flashcards

Medicines knowledge & counselling, 5 Flashcards

1
Q

Amitriptyline

  • drug class
A
  • tricyclic anti depressant
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2
Q

Amitriptyline

  • indication
  • MOA
A
  • major depression
  • adjuvant in pain management
  • migraine prevention
  • works by correcting the imbalance of certain chemicals in the brain. These chemicals are involved in controlling mood. By correcting this imbalance, TCAs can help relieve the symptoms of depression
  • some people notice an improvement in their depressive symptoms after 3 or 4 days however it may take up to 4 weeks
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3
Q

Amitriptyline

  • dose & directions
A
  • depression: oral 25–75mg daily, increasing by 25–50mg every 2–3 days to 75–150mg daily. Maximum 300 mg daily
  • pain: oral 10–25mg at night initially; titrate up to a maximum night time dose of 75 mg in migraine and 150 mg in pain management
  • with or without food doesn’t matter
  • take at the same time each day
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4
Q

Amitriptyline

  • key counselling points
  • adverse effects
A
  • swallow whole, with or without food doesn’t matter
  • try taking at night to reduce daytime drowsiness
  • may increase the effects of alcohol
  • you may feel dizzy on standing when taking this medicine. Get up gradually from sitting or lying to minimise this effect; sit or lie down if you become dizzy
  • may get side effects such as blurred vision, drowsiness and dry mouth. They may be troublesome but may lessen or disappear after about 7 days
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5
Q

Amitriptyline

  • adverse effects
  • referral
A
  • all medicines can cause adverse effects but not everyone will experience them
  • the most common adverse effects of amitriptyline are drowsiness and dry mouth
  • they may be troublesome but may lessen or disappear after about 7 days as your body gets used to it
  • it may also cause an increase in your appetite, leading to weight gain and constipation
  • less commonly may cause increased sweating, nausea, changes in sex drive
  • tell Dr if you experience signs of frequent infections such as fever, chills, sore throat or mouth ulcers, yellowing of the eyes or skin (jaundice)
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6
Q

Amitriptyline

  • monitoring
A
  • sx improvement
  • check BP (supine and standing) before and after starting treatment and after each dose change
  • suicidal thoughts and behaviour can occur soon after starting antidepressants, particularly in young people; monitor patients frequently and carefully early in treatment
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7
Q

Amitriptyline

  • lifestyle & selfcare
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
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8
Q

Venlafaxine

  • drug class
A
  • SNRI
  • serotonin and noradrenaline reuptake inhibitor
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9
Q

Venlafaxine

  • indications
  • MOA
A
  • major depression
  • generalised anxiety disorder
  • panic disorder
  • social phobia
  • Venlafaxine is used to treat major depression, and to prevent it coming back. It is also used to treat panic attacks and anxiety
  • belongs to a group of medicines called serotonin-noradrenaline reuptake inhibitors (SNRIs)
  • it increases the level of serotonin and noradrenaline in the brain, helping to restore your feeling of wellness
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10
Q

Venlafaxine

  • dose
  • directions
A
  • oral 75mg OD; if required, increase to 150mg OD
  • although most people will respond to doses of 150mg daily or less, doses of up to 225mg daily may be needed in some cases
    • little is known about efficacy and safety above 225mg daily
  • best taken in the morning however if it makes you drowsy you can take the first dose at night
  • best taken with food to prevent stomach upset
  • swallow whole
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11
Q

Venlafaxine

  • key counselling points
  • adverse effects
A
  • eat with food to prevent stomach upset
  • be careful driving or operating machinery until you know how this medicine affects you
  • do not stop taking this medicine suddenly unless your doctor tells you to
  • common adv: nausea, dry mouth, constipation, yawning, sweating, dizziness
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12
Q

Venlafaxine

  • adverse effects
  • referral
A
  • all medicines can cause adverse effects but not everyone will experience them
  • the most common adverse effects of venlafaxine are nausea, dry mouth, constipation, yawning, sweating, dizziness
  • these may wear off as your body gets used to it
  • it may cause a decrease in appetite leading to weight loss
  • if you develop, blurred vision, cloudy urine or problems passing urine, muscle spasms or rash, tell Dr
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13
Q

Venlafaxine

  • monitoring
A
  • worsening symptoms
  • BP
  • suicidal ideation
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14
Q

Venlafaxine

  • lifestyle/self care
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
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15
Q

Aripiprazole

  • drug class
A
  • second generation antipsychotic
  • atypical antipsychotic
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16
Q

Aripiprazole

  • indication
  • MOA
A
  • schizophrenia
  • BPAD as monotherapy
    • can be used with lithium or valproate in acute mania
      *
17
Q

Aripiprazole

  • dose
  • directions
A
  • schizo: oral 10-15mg OD, don’t increase dose for atleast 2 weeks after starting, need to achieve steady state
  • BPAD: oral 15-30mg OD
18
Q

Aripiprazole

  • key counselling points
  • adverse effects
A
  • takes time to work, it might take several weeks before you notice a difference
  • warn of the possibility of impulse control disorders & monitor for such behaviour- esp if family hx
  • common adv, initially: sedation, headache, light headedness, insomnia, nausea or constipation
  • but decrease with use as body gets used to medicine
19
Q

Aripiprazole

  • adverse effects
  • referral
A
  • all medicines can cause side effects but not everyone will experience them
  • some common adv of aripiprazole that initially might get are headache, light headedness and ocassionally insomnia, if this happens give the dose in the morning rather than at night
  • but they may disappear as your body gets used to the medication
  • if you develop any kind of infection with fever, chills, shortness of breath, cough, chest pain–> Dr
20
Q

Aripiprazole

  • monitoring
A
  • BP
  • lipids
  • liver function
  • full blood picture
  • weight
  • psychotic episodes
21
Q

Aripiprazole

  • self care/ lifestyle
A
  • because this medication can cuase dizziness, patient may be more at risk of a fall- check the home environment
  • check home environment so that you can keep patient and those aroung them safe- for now, try remove anything that he could use to hurt himself and others
  • although this medicine may be necessary at the moment, it doesnt mean that you’ll be on it long term- it may only be needed to get things under control
22
Q

Clozapine

  • drug class
A
  • second generation antipsychotic
  • atypical
23
Q

Clozapine

  • indication/ MOA
A
  • schizophrenia
  • BPAD
  • acute & chronic psychoses
  • this medicine works by correcting the chemical imbalances in the brain to help with improved thinking, feelings and behaviour
24
Q

Clozapine

  • dose/ directions
A
  • 12.5mg OD or BD on day 1, 25mg OD or BD on day 2 then increase as tolerated
  • Usual range is 200–450mg daily (maximum of 900 mg daily)
  • swallow whole with water in the evening
25
Q

Clozapine

  • key counselling points
  • adverse effects
A
  • tell Dr if caffeine, tea cola drink intake changes
  • if you stop smoking, tell Dr
  • tablet brands cannot be swapped
  • need to have regular/ monthly blood tests
  • initiallly, constipation, hypersalivation, nausea, headache & blurred vision
  • yellow skin or eyes, vomitting- Dr
26
Q

Clozapine

  • adverse effects
A
  • all medicines can cause side effects, but not everyone will experience them
  • it can cause drowsiness and initially constipation and increased saliva production, this will generally disappear as your body gets used to the medication
  • if it gets troublesome, speak to Dr
  • if you get feelings of motor restlessness, tremor or involuntary movements of the face, mouth or tongue, see Dr
27
Q

Clozapine

  • monitoring
A
  • blood cell count, WCC
  • LFT
  • cardiac function
  • weight
  • EPSE effects
28
Q

Clozapine

  • lifestyle/selfcare
A
  • tell Dr if caffeine, tea, smoking habits change
  • excessive drooling- towel on pillow, sugar free sweets
29
Q

Donepezil

  • drug class
A
  • acetylcholinesterase inhibitor
30
Q

Donepezil

  • indication
  • MOA
A
  • alzheimers disease
  • It is used to treat mild, moderate and severe Alzheimer’s disease, also called dementia of the Alzheimer’s type
  • this medicine will not cure this disease, but it should help your memory and improve your ability to think more clearly
31
Q

Donepezil

  • dose & directions
A
  • 5mg initially OD for atleast 4 weeks then increase to 10mg OD if necessary
  • take at the same time each day
  • preferably at bed time
  • if you experience insomnia or vivid dreams, can take in the morning
32
Q

Donepezil

  • key counselling points
  • adverse effects
A
  • it may cause dizziness or drowsiness & affect concentration thats why its taken at night
  • common adv: N/V/D, muscle cramps and insomnia- mostly short lived
  • taken for atleast 3 months at max dose to assess response- see Dr
33
Q

Donepezil

  • adverse effects
  • referral
A
  • all medications can cause side effects but not everyone will experience them
  • can cause insomnia so if this occurs give in the morning rather then night
  • it can cause N.V.D and muscle cramps
  • but generally subside as your body gets used to the medicine
  • you may get some headache or uriniary incontinence (keep up the fluids)
  • if you experience severe upper stomach pain, often with nausea, vomiting and fever- tell Dr
34
Q

Donepezil

  • lifestyle/ self care
A
  • this medication can cause dizziness, risk of falls- check home environment- OT can help
  • it is normal for people with alzheimers to experience sleep inversion- awake at night and sleep during the day
    • this can be difficult- keeping him safe at night
  • there is a 24hr helpline with the dementia behaviour management advisory service that can offer support/ advice
  • engage in activity- plan activities you enjoy- dancing, painting, gardening, cooking, singing and other activities can be fun, can help you connect with your loved one, and can help your loved one focus on what he or she can still do
35
Q

Donepezil

  • monitoring
A
  • sx improvement
  • if doses are missed patient should start at initial dose again to prevent sever vomitting
  • compliance
  • cognitive behaviour
  • adverse effects- vivid dreams, NMS
  • dose to be reduced if adv effects persist

AC- PPP1 (6 decks)

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