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Indications of Prazosin?
Hypertension & symptom relief in benign prostatic hypertrophy
Precautions of prazosin?
- heart failure, volume depletion,
- treatment with diuretics, ccb's
adverse effects of prazosin?
hallucinations, confusion, nightmares, dizziness
incontinence, nausea, vomiting
dose of prazosin?
- 1mg daily for 7 days
- maintainance of 2-20mg
for BPH - 0.5mg twice daily, then icrease upto 2mg
Indications for clonidine?
- menopausal flushing
Precautions for clonidine?
- Depression - may be exacerbated
- Diabetes - may cause a rise in blood glucose levels
- CHD - may be worsened
Adverse effects of clonidine?
dizziness, drowsiness, headache, depression, nausea, constipation.
fluid retention, disturbed mental state
Counselling of clonidine
may increase effects of alcohol
withdrwal syndrome can develop if you withdraw too fast
Dose of clonidine?
- HTN - 50-100mcg twice daily
- menopausal flushing - 25mcg twice daily, increasing to 50-75mcg
Indications of carbimazole?
- Graves' disease
- Short-term treatment before thyroid surgery, or before and after radioactive iodine treatment
- Thyroid storm
adverse effects of carbimazole?
itching, rash, nausea, vomiting, gastric discomfort, headache, arthralgia
Dose of carbimazole?
20–40 mg daily (up to 60 mg daily in severe cases) in divided doses for 3–4 weeks.
Counselling of carbimazole?
Tell your doctor immediately if you develop a fever, mouth ulcers, sore throat, rash, severe fatigue, nausea, abdominal pain or jaundice.
What are the indications for dexamphetamine?
precautions of dexamphetamine and methylphenidate?
cardiovascular issues, hyperthyroidism, glaucoma, anxiety, agitation, -- may worsen
C/I for dexamphetamine and methylphenidate?
- substance misuse
- treatment with or within 14 days of ceasing a MAOI
- active psychotic disorder
Adverse effects of dexamphetamine and methylphenidate?
headache, nausea, loss of appetite, anxiety, insomnia, dry mouth, tachycardia, palpitations, changes in BP
dose of dexamphetamine?
2.5–10 mg daily max 30mg daily
for narcolepsy - 10mg in the morning
Dose of methylphenidate?\
5–10 mg daily given in 1 or 2 doses; increase by 5–10 mg daily each week to a maximum of 40 mg daily
- Adult - 10 mg each morning; increase at weekly intervals as clinically indicated by 5–10 mg daily. Max 60mg
- Narcolepsy -- 5mg twice daily initially max 30mg
counselling for dexamphetamine and methylphenidate?
- Avoid taking doses after early afternoon if you have trouble sleeping at night (this may make you feel drowsy next day).
- This medicine may also
- make you feel dizzy; do not drive or operate machinery if you are affected.
Contraindications for disulfiram?
Ischaemic heart disease or severe myocardial disease
Indications for carmellulose drops?
- Dry eye
- relief of occular irritation
Adverse effects of carmellulose drops?
Dose of artificail tears?
One drop every 1-12 hours when required
Indications of donepezil?
Precautions of donepazil?
- GI or ureteric obstruction—contraindicated.
- Active peptic ulcer—contraindicated.
- Historyof peptic ulcer disease, seizures, Parkinson's disease, asthma, obstructive pulmonary disease—risk of aggravation.
- Treatment with drugs with anticholinergic effects
- antagonises therapeutic effect; avoid combination.
Adverse effects from donepazil?
- nausea, vomiting, diarrhoea, anorexia, abdominal pain, dyspepsia, headache, insomnia, vivid dreams, tremor, muscle cramps, urinary incontinence,
- increased sweating,
Dose of donepezil?
5mg once daily before bedtime for a minimum of 4 weeks, increase to 10mg daily
Counbselling of donepezil?
This medicine may cause dizziness or drowsiness; if you are affected, avoid operating machinery.
Indications for GTN?
- Prevention and treatment of stable angina
- Heart failure associated with acute MI (infusion)
Adverse effects of GTN?
headache, flushing, palpitations, orthostatic hypotension, fainting, peripheral oedema
Dose of GTN?
- 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.