half to one tablet every four minutes until pai is relieved (300-600mcg)
Sublingual spray 400-800mcg (1-2 sprays)
5mg patch for upto 14 days
Cuonselling for GNT patch?
Apply to clean, dry skin on the chest area or upper arm.
ensure a nitrate-free period of 10–12 hours each day with long-acting glyceryl trinitrate (patch) to avoid tolerance
Sublingual tablets counselling?
Place half to one tablet under your tongue; do not swallow it;
after the pain has been relieved, you may spit out or swallow what is left of the tablet to avoid adverse effects such as headache.
It is important to store these tablets properly or they may not work as well.
Keep them in the original glass bottle away from moisture, heat and light.
Do not carry them close to your body. Write the date on the bottle when you open it and discard any unused tablets 3 months later.
Use during episodes of angina or before an activity expected to bring on angina
.Sit or lie down before use as it may cause dizziness.
Counselling for GTN spray?
Prime the spray before using it for the first time by pressing the nozzle 5 times, spraying it into the air.
Prime it with 1 spray if it hasn't been used for 7 days. Prime it with 5 sprays if it hasn't been used for more than 4 months.
When ready to use, aim the spray under the tongue and press the nozzle once; do not inhale the spray.
Call an ambulance if symptoms are severe, get worse quickly or last for 10 minutes.
Precautions of methadone?
Risk factors for QT prolongation
Ongoing substance use - contraindicated
Adverse effects of methadone?
prolonged QT interval, torsades de pointes
Collapse or sudden death may occur, most frequently within the first 2 weeks of starting methadone maintenance.
This may be due to excessive
methadone dose for an individual, and/or the presence of other CNS depressants or rare cardiovascular effects.
Dose of methadone?
20-30mg daily then increase or reduce
Counselling for methadone?
It takes a few days to gain the full effect of a dose of methadone.
In the meantime, you may feel uncomfortable but should not take opioids, alcohol or benzodiazepines as this increases the risk of overdose, can affect assessment of your symptoms, and it will take longer to tailor your dose.
Methadone may cause drowsiness particularly when
starting treatment or if the dose is increased; do not drive or operate machinery if you are affected.
Tell any doctor or dentist who is treating you that you are on the methadone program so they can prescribe appropriately.