POM to P Supply (Sumatriptan, Mini Pill & Sildenafil) Flashcards
(23 cards)
What other symptoms can accompany migraines?
N+V
Sensitivity to light/sound/movement
With or without aura
Speech disturbances
What are some triggers of a migraine?
Bright lights
Strong smells
Certain foods e.g. alcohol, cheese
Eye strain
Stress
Hormonal changes
Travel
How should sumatriptan 50mg be taken?
As soon as possible after the onset of a migraine
If migraine symptoms recur after taking the first sumatriptan tablet, what should the patient do?
A 2nd tablet may be taken at least 2h after the 1st tablet
When do you refer a patient with a migraine who wishes to buy sumatriptan?
<18yrs or >65yrs
>50yrs experiencing a migraine for the first time
Patients who’ve had their first ever migraine within the last 12 months
Patients who have >4 attacks /month
If their migraine lasts >24h
If a woman if on the COC
Treatment failure
Patients with >3 CVD risk factors
What CVD risk factors make a patient not suitable for buying sumatriptan?
If they have >3 of the following:
Men >40 yrs
Post-menopausal women
Hypercholesterolaemia
Smoker
Obese
Diabetes
Family history of heart disease
What are some contra-indications of sumatriptan?
Hypertension
Using prophylactically
Allergy to sulphonamides
Previous MI/angina/coronary vasospasms/cardiac arrhythmia
Hepatic/renal impairment
Epilepsy
What are some drug interactions associated with sumatriptan?
Ergotamine
MAO inhibitors
St Johns wort
SSRI - seek DR if lack of co-ordination occurs
What age is sildenafil 50mg licensed for?
> 18 years old
What is sildenafil used for?
Erectile dysfunction
How does sildenafil work?
It is a phosphodiesterase type-5 inhibitor and acts by increasing blood flow to the penis
How should sildenafil 50mg be taken?
One tablet 1h before sexual activity (empty stomach better)
Max. 1 tablet a day
What are some contraindications for the supply of sildenafil?
Allergy to excipients
Taking with ritonavir
Taking with nitrates e.g. nicorandil/NO
Severe CVD disorder
Hepatic impairment
Hypotension
<18 yrs
Deformations of the penis
What are some common side effects of sildenafil?
Headache
Flushing
Dizziness
Visual disturbances
Priapism - painful erections lasting >4h
What sugar is contained in the film coating of sildenafil?
Lactose - so check for allergies
Can a patient drink alcohol with sildenafil?
Advise not to drink large amounts with it as it can effect the mans ability to get an erection
What pharmacy advice can you give for a patient who’s taking sildenafil for the first time?
Weight management
Smoking cessation
Diet advice
Physical activity
Alcohol reduction
Reducing stress/anxiety
What is Gina 10mcg vaginal tablets used for?
Local treatment of vaginal dryness and irritation during menopause
Who can we supply gina to?
> 50 years old
Period over a year ago
Symptoms of dryness, soreness, itching, burning, painful intercourse
What is the dosing of gina 10mcg vaginal tablets?
Initial dose: 1 tablet inserted daily for 2 weeks
Maintenance dose: 1 tablet inserted twice a week leaving 3/4 days between each dose
When should a woman come back to the pharmacy if she has purchased gina?
After finishing the first pack at 7 weeks
When should you not supply gina again after the patients 2nd visit to the pharmacy?
If symptoms worsen
No improvement in symptoms after second pack
What are some contraindications for the supply of gina?
Allergy to ingredients - estradiol/lactose
Endometrial cancer
Undiagnosed genital bleeding
Acute liver disease
Active/recent thromboembolic disease
Current vaginal infections
If on other local oestrogen therapy, e.g. Vagifem
