Medicines Knowledge Week 2 (Warfarin, Oxycodone, Pregabalin, Tramadol, Levothyroxine)

Question 1

Warfarin drug class

Answer 1

Vitamin K antagonist (anticoagulant)

Question 2

Warfarin indications

Answer 2

• Prevention and treatment of VTE
• Prevention of stroke in patients with previous myocardial infarction
• Prevention of stroke in patients with atrial fibrillation

Question 3

Wafarin dosage range and timing

Answer 3

usually 5mg once daily for 2 days then adjust according to INR 2-3 is best

• Maintanence dose = 1-10mg once daily, taken at same time each day.

Question 4

Wafarin counselling

Answer 4

Always take the same brand of tablets

Take tablets at about the same time every day

Tell your doctor if you develop a painful, purplish, bruise-like rash.

Avoid excessive alcohol consumption; 1–2 standard drinks daily is generally safe.

Question 5

Warfarin monitoring

Answer 5

• Regular blood tests, specifically INR with this medicine
• If a blood test result shows an INR above your target range, then your risk of bleeding has increased. If your INR is below your target range, then your risk of developing blood clots has increased
• When you first start taking warfarin you will need to have your INR tested often – eg, every 1 or 2 days for the first week – to work out your correct warfarin dose.

Question 6

Pregabalin drug class

Answer 6

Anticonvulsant/antiepileptic

Question 7

Pregabalin indications

Answer 7

Neuropathic pain

Focal (partial) seizures

Question 8

Pregabalin dosage range and timing

Answer 8

Neuropathic pain: 75mg at night for 1 week then 150mg daily in 1 or 2 doses.

> Maximum of 300mg twice daily

Focal (partial) seizures: 75mg twice daily, increase to 150mg twice daily after 7 days

> Maximum of 300mg twice daily

Question 9

Pregabalin counselling

Answer 9

This medicine may cause drowsiness or dizziness; if affected, do not drive or operate machinery.

Pregabalin may also increase the effects of alcohol

Avoid stopping suddenly –> may cause anxiety, headache and diarrhoea –> reduce dose over at least a week.

Question 10

Pregabalin monitoring

Answer 10

Monitor for signs and symptoms of sucicidal risk

> thoughts or talks of death or suicide

Monitor for muscle pain (rhabdomyolysis)

Question 11

Tramdaol drug class

Answer 11

Opioid analgesic

Question 12

Tramadol indications

Answer 12

Severe pain

Acute or chronic pain

Question 13

Tramadol dosage range and timing

Answer 13

Conventional product, oral 50–100 mg every 4–6 hours when necessary; maximum 400 mg daily

Controlled release tablet, 50–200 mg every 12 hours; maximum 400 mg daily.

Question 14

Tramadol counselling

Answer 14

This medication may make you feel drowsy and may increase the effects of alcohol.

Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.

If you are very sleepy, stop taking this medication and tell your doctor immediately

Question 15

Tramadol monitoring

Answer 15

Monitor for pain improvement, may need alternative opioid

Monitor for dental issues as chronic use can cause dry mouth which increases risk of dental caries

Monitor for constipation. May need to start coloxyl and senna.

Question 16

Levothryoxine drug class

Answer 16

Thyroid hormone

Question 17

Levothyroxine indication

Answer 17

Hypothyroidism

Thyroid hormone replacement in patients with tumours of the thryroid gland

Question 18

Levothyroxine dosage range and timing

Answer 18

Oral, usual range, 50–200 micrograms once daily.

> adjust dose every 6-8 weeks if necessary, acorrding to TSH

Question 19

Levothyroxine counselling

Answer 19

Take on an empty stomach, before breakfast

Tell your doctor if symptoms of hyperthyroidism occur, eg palpitations, excitability, insomnia, flushing, sweating or weight loss

Do not switch with other brands unlesa advised by your doctor

Question 20

Levothyroxine monitoring

Answer 20

Doctor will monitor blood tests to see if thyroid hormone levels are adequate

Caution in patients with heart problems such as high blood pressure

Question 21

Oxycodone drug class

Answer 21

Opioid analgesic

Question 22

Oxycodone indications

Answer 22

Acute or chronic pain

Question 23

Oxycodone dosage range and timing

Answer 23

Acute pain —> Conventional oral product, initially 5–15 mg every 4 hours. Titrate dose according to response.

Chronic non-cancer pain: adult –> Controlled release, oral 5–10 mg twice daily. Adjust dose according to response.

Question 24

Oxycodone counselling

Answer 24

This medication may make you feel drowsy and may increase the effects of alcohol. If you are affected, do not drive or operate machinery.

If you are very sleepy or have trouble staying awake, stop taking the medication and tell your doctor immediately.

Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.

Question 25

Oxycodone monitoring

Answer 25

Monitor for pain improvement, may need alternative opioid

Monitor for dental issues as chronic use can cause dry mouth which increases risk of dental caries

Monitor for constipation. May need to start coloxyl and senna.