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Precautions from Isosorbide mononitrate?
- Treatment with sildenafil - contraindicated
- Anaemia - contraindicated if severe
- Hypovolaemia - contraindicated
Adverse effects of isosorbie mononitrate?
headache, flushing, hypotension
Dose of isosorbide mononitrate?
30–60 mg once daily, increased up to 120 mg once daily if necessary.
Counselling for isosorbide mononitrate?
- Swallow whole; do not crush or chew the tablet.
- This medicine may make you feel dizzy on standing. Get up gradually from sitting or lying to minimise this effect; sit or lie down if you become dizzy.
- take at the time of day when angina is most frequent, eg at night for nocturnal angina or in the morning for daytime angina
- twice daily dosing with isosorbide mononitrate is not recommended, as there will be no nitrate-free interval and tolerance will be more likely to develop
- isosorbide mononitrate is not recommended for treatment of acute episodes of angina because of its slow onset of action
Indications for prednisolone?
- Where corticosteroids are indicated, eg acute asthma, autoimmune or inflammatory disease, acute transplant rejection, acute gout and croup
- According to specialist protocol, eg for multiple myeloma, lymphoma, some leukaemias
Precautions from corticosteroids?
- Peptic ulcer disease - may be reactivated
- Diabetes - may worsen diabetes control
- Infection - prednisolone increases risk of infections
Adverse effects from short term prednisolone use?
gi distrubances, nausea, fluid retention, mood distrubances -- could go both ways
Adverse effects from long term prednisolone use?
Hypertension, osteoporosis, fat redistribution, skiin thinning, easy brusing, hyperglycaemia
Dose of prednisolone?
5-60mg daily, taper dose according to response
Counselling for Prednisolone?
- Take with food to help reduce stomach upset.
- Tell your doctor immediately if you have any signs of infection.
- This medication may affect your mood, eg you may feel more happy or sad than usual.
- It may also cause problems with sleeping;
- Do not stop taking this medicine unless your doctor tells you to.
- The dose may need to be reduced gradually when stopping treatment.
- Tell all doctors, surgeons and
- dentists treating you that you are taking corticosteroids (or have taken them in the past) because if you become ill or are going to have surgery your dose of medicine may need to be increased.
- Consider wearing a Medic Alert® bracelet and carrying a card with the details of your treatment.
What is levodopa usually given in combination with?
carbidopa or entacapone
What are precautions of levodopa?
- Peptic ulcer disease - may aggravate
- Treatment with dopamine antagonists -- avoid combination
- closed angle glaucoma -- contraindicated
- Treatment with a non-selective MAOI -- contraindicated
Adverse effects of dopamine?
anorexia, nausea, vomiting, orthostatic hypotension, dyskinesia, episodes of sudden unpredictable loss of mobility ('off' effect), agitation, insomnia, drowsiness, hallucination and confusion (especially in the elderly)
dark discolouration of the urine
Dose of levodopa?
what can occur with low dose?
- 50–100 mg 3 times daily, may give upt 2g daily
- N&V may occur with low dose
Counselling for levodopa?
- Take each day at the same time and in the same way
- this medicaiton may cause drowsiness
- Get up slowly since you may get dizzy
- Do not stop taking medication suddenly
Precautions of methotrexate?
- Boen marrow supression - contraindicated
- Peptic ulceration - contraindicated
- Infection (if serious or uncontrolled -- contraindicated) May reactivate hepatitis or inactive TB
Dose of methotrexate?
- 7.5 mg once each week for 6 weeks.
- Maintenance, 5–25 mg once each week
Counselling of methotrexate?
- Medication should be taken once a week on the same day each week; it must not be taken every day.
- Tell your doctor if you have a cough, difficulty breathing or signs of infection.
- Use of some medications with methotrexate may lead to toxicity; tell your doctor and pharmacist that you are taking this drug.
- Avoid excessive or prolonged sun exposure, wear protective clothing and use sunscreen.
- May take 2 months to see any benefit
- Blood tests
Indications for solfenacin?
Urinary urge incontience
Precautions for solfenacin?
- Risk factors for prolonged QT interval -- may increase QT interval
- Renal impairment
Dose of solfenacin?
5 mg once daily, can increase to 10mg swallow whole.
Precautions of moclobemide?
- Bipolar disorder
- Treatment with other drugs which increase serotonin levels
Adverse effects of moclobemide?
nausea, dry mouth, constipation, diarrhoea, anxiety, restlessness, insomnia, dizziness, headache
Dose of meclobemide
300 mg daily in 1 or 2 doses with or soon after food. Max dose 600mg
Counselling of moclobemide?
- Take doses no later than early afternoon or you may have trouble sleeping at night.
- Although moclobemide is unlikely to affect your ability to drive or operate machinery, be careful with these types of tasks until you know how you are affected.
- Warn a family member that depressive flares can occur sooin after
Indicatisons for mometasone?
Inflammatory skin conditions - eczema and psoriasis
Precautions of mometasone?
Diabetes -- can increase blood glucose concentration through systemic absorption
Adverse effeects of mometasone?
delayed wound healing, rash, allergic contact dermatitis
dose of mometasone?
enough to cover the affected area once a day
Counselling for mometasone?
- Apply enough to cover affected areas. Smooth gently into skin, preferably after bathing.
- use for the shortest time necessary