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Flashcards in Explanation Station Deck (26):
1

Corticosteroids

A – Suppresses disease process by increasing steroid levels in our body. Our body makes steroids and these stop inflammation

T – Dependant on why you’re taking them

H – Tablet/Inhaler/IV, don’t stop suddenly as can cause problems, carry a steroid card, other protective drugs may be given e.g. PPI or Bisphosphonates

L - Dependant on why you’re taking them

E – 1 or 2 days till you will feel effects

T – No monitoring, may test specifically for disease e.g. Peak flow in asthma or Inflammatory levels in Crohns

I – Immunosuppression (See doctor as soon as you think you’re ill), Diabetes, Osteoporosis, Mood Problems (Psychosis), High Blood pressure, Adrenal Insufficiency causing adrenal crisis

C – Infection, Children

S – Patient UK/NHS Choices

2

Bisphosphonates

A – Stop bone being broken down and helps to rebuild new bone. Helps lifestyle changes you are making e.g. exercise and good diet

T – Once weekly

H – Swallow with a full glass of water on an empty stomach at begging of day. Sit up for 30 mins after.

L – 5-year review

E – You Won’t notice an effect

T – Dental check ups of jaw before and regularly

I – Osteonecrosis of the Jaw, Headache, Heartburn, Bloating, Diarrhoea, Constipation, Blood in stools (Black), Abdominal Pain

C – Pregnancy, Stomach ulcers, Trouble swallowing, Renal Impairment

S – Patient UK/NHS Choices

3

Warfarin

A – Thins the blood, blocking vitamin K which helps the blood clot

T – Once daily, usually at night

H – Tablet

L – 3 months DVT, 6 months PE, Lifelong for AF

E – 2/3 days, may need warfarin bridging

T – Start 5mg, test clotting levels at 5 days and 8 days and adjust dose as required. Regular INR required

I – Bleeding (see doctor immediately with any bleeding), Diarrhoea, Rash, Hair loss, Nausea, Lots of drug interactions, check with doctor before any medication even over the counter.

C – Pregnancy, Stroke, Bleeding, High falls risk

S – Patient UK/NHS Choices

4

Thrombolysis

A – Clot buster drug, however only works when given quickly

T – One Off

H – IV

L – One off

E – Immediate

T – High dependency area monitoring every 15 mins for observations and bleeding

I – Allergic reaction, bleeds, hypotension, nausea, vomiting

C – Bleeding, Haemorrhagic stoke, Previous streptokinase use

S – Patient UK/NHS Choices

5

Statins

A – Stop your liver making cholesterol. Cholesterol is one of the things that blocks up arteries causing heart, stroke and kidney disease. Other risk factors are important as well.

T – Once daily in the evening

H – Tablet, Can’t take with Grapefruit juice as increases levels causing side effects

L – Lifelong

E – You won’t notice effects but decreases risk over many years

T – Review by doctor in 4 weeks and every 6 months. LFT’s before starting, 3 months and 12 months

I – Rhabdomyolysis, Muscle pains, Hair Loss, Itching, Nausea, Vomiting, Diarrhoea and abdominal pain

C – Pregnancy

S – Patient UK/NHS Choices

6

Clopidogrel

A – Reduces long term risk of CVS disease. Prevents formation of clots that cause heart attacks and strokes

T – Once daily, loading dose needed in emergency treatment

H – Tablet

L – 12 months, Do not stop taking, especially for stents that may occlude

E – Can take 1 week to take effects

T – Come and see doctor for side effects

I – Bleeding Diarrhoea, Constipation, rarely can cause clots

C – Active bleeding, Stopped 7 days before surgery

S – Patient UK/NHS Choices

7

NSAIDs

A – Anti-inflammatory drug, reduces symptoms of pain, swelling or fever.

T – Tablet

H – Stop taking if acutely unwell or renal problems.

L – Long term not recommended generally as can cause pepti ulcers and CVS

E – 3 weeks until total effect felt

T – Clinical assessment

I – Indigestion (Stop taking drugs if this occurs and seek medical help), Renal impariement, Increased risk of CVS disease, Fluid retention, Bronchospasm in asthma

C – Asthma, Renal failure, Liver failure, Peptic Ulcers

S – Patient UK/NHS Choices

8

Opioids

A – Highly effective painkiller, acts on our bodies pain stopping receptors

T –May need to take anti-emetic at the same time

H – Different types, tablet, IV, oral liquid

L – May need to be increased over time as can become more resistant. Dependant on pain

E – Very Quick, Tablets take longer

T – Review with doctor in a couple of weeks

I – Respiratory depression , Addiction, Constipation, Nausea and vomiting, Neurological depression

C – Liver and renal failure doses adjusted

S – Patient UK/NHS Choices

9

Methotrexate

A – Disease modifying drug that reduces inflammation and suppresses the immune system. Early use improves long term disease remission

T – Once weekly with folic acid at another time in the week. Build up dose slowly

H – Tablet

L – Long term

E – 4-6 months till full effect

T – FBC, U&E, LFT’s Before, 2 weeks and every 2 months once stable

I – Alopecia, Headaches, GI Problems, Myelosuppression (Infection – Go to A&E, Bleeding, Anaemia),Liver Toxicity, Pulmonary Fibrosis

C – Pregnancy (Male or female), Breast feeding, Liver impairment, Infection, Immunodeficiency

S – Patient UK/NHS Choices

10

Thiazide diuretics

A – Water tablet for high blood pressure, helps with leg swelling. Makes you pee out more water lowering blood pressure.

T – Daily

H – Tablet

L – Long term

E – Immediate

T – Measure blood pressure, measure U&E before treatment, at 2 weeks and after changing dose

I – Hyponatraemia, Hypokalaemia, Arrhythmias, Impotence in men, Gout if prone

C – Hyponatraemia, Hypokalaemia, Gout, Avoid use of NSAIDS

S – Patient UK/NHS Choices

11

Loop diuretics

A – Increase the amount of urine you produce, getting rid of excess water

T – As needed

H – Oral or IV

L – Short term for fluid overload

E – Immediate

T – Measure U&E’s to assess for electrolyte levels and body weight

I – Dehydration, Hypotension, Low electrolytes, Hearing loss, tinnitus

C – Dehydration, Hypokalaemia, Hyponatraemia, Gout, Hepatic encephalopathy

S – Patient UK/NHS Choices

12

ACE inhibitor

A – Lowers blood pressure, relaxing blood vessels and reducing strain on the heart.

T – Daily before bed

H – Tablet

L – Lifelong

E – Not noticed

T – U&E before treatment, 2 weeks and when changing dose

I – Dry Cough, Hypotension (first dose), Hyperkalaemia, Renal Failure, Angiooedema (Go and see doctor and stop taking them)

C – NSAID use can damage kidneys,

S – Patient UK/NHS Choices

13

Amiodarone

A – Blocks K+ channels slowing the heart down

T – Dependant on dose, multiple times a day

H – Tablet

L – It lasts in your body, so when stopped may have effects for months

E – Symptoms should respond quickly

T – CXR, Renal, Liver, TFT testing. TFT and liver every 6 months

I – Thyroid Problems, Hypotension, Pneumonitis, Bradycardia, AV node block, Hepatitis, Photosensitive Rash

C – Hypotension, Heart Block, Thyroid disease

S – Patient UK/NHS Choices

14

Amlodipine/Verapamil

A – Relaxes how hard your heart beats and relaxed your vessels rescuing pressure

T – Daily

H – Tablet

L – Long term

E – You won't notice them

T – Based on treatment effectiveness

I – Ankle Swelling, Flushing, headache, palpitations, Tachycardia

C – Severe aortic stenosis

S – Patient UK/NHS Choices

15

Adenosine

A – Drug will reset the heart. They will feel terrible for 30 seconds

T – Only today – 6, 12 ,12

H – IV

L – Today only

E – Immediate

T – Very close cardiac monitoring

I – Bradycardia, Asystole, Sense of impending doom

C – Hypotension, MI, Acute heart failure, Asthma, COPD

S – Patient UK/NHS Choices

16

Spironolactone

A – Pushes fluid back to where it should be and reduce fluid levels

T – Daily

H – Tablet

L – Dependant on cause

E – Quickly

T – Regular blood tests for hyperkalaemia and renal function

I – Growth of nipples, tenderness and impotent in men, Hyperkalaemia

C – Renal Failure, Addison’s, Hyperkalaemia, Pregnancy, Breastfeeding

S – Patient UK/NHS Choices

17

PPIs

A – Reduces stomach acid, improving symptoms and helping any ulcers to heal

T – Daily – Every morning

H –Tablet

L – 7 days for infection (H. Pylori), 1 month’s trial for heart burn

E – Quick

T – Long term use check Mg levels at 1 year as can cause hypo magnesia

I – GI side effects, Headache, Increased risk of fractures long term

C – Osteoporosis, Rule out gastric cancer symptoms first

S – Patient UK/NHS Choices

18

Levothyroxine

A – A synthetic version of a normal hormone produced buy the thyroid gland. Given to bring levels back to normal

T – Tablet

H – Once daily before breakfast

L – Lifelong

E – Few Weeks

T – Review levels in 2 weeks, then every 2 months, then yearly once stable

I – Rare when levels are stable. Hyperthyroidism when too high or hypo if too low.

C – Na

S – Patient UK/NHS Choices, They get free prescriptions for life

19

Heparin

A – Reduce the risk of blood clots by thinning the blood

T – Daily

H – Subcutaneous injection

L – As long as they are high risk in hospital etc

E – Immediate

T – Rarely required but blood test available

I – Bleeding, Damage at injection sites

C – Trauma, Recent Surgery, uncontrollable severe hypertension, Bleeding Disorders

S – Patient UK/NHS Choices

20

Insulin

A – Replaces the bodies insulin which control sugar levels

T – Different regimes, basal bolus, mixed

H – Injection Subcutaneous

L – Forever

E – Immediate

T – Capillary glucose 4 times a day, HBA1C Annually

I – Hypoglycaemia (Dizziness, Agitation, Nausea, Sweating, Confusion, Coma), Damage at injection sites

C – Dose adjusted in renal failure

S – Patient UK/NHS Choices

21

Metformin

A – Increases the sensitivity of cells to your insulin. Allowing body to make better use of the levels it has.

T – Once daily initially, may go to twice

H – Tablet with a meal at the same time each day

L – Lifelong

E – You will not notice any effects

T – U&E’s before starting then annually

I – Lactic Acidosis (In acute settings) Nausea, Vomiting, Diarrhoea and Abdominal Pina. May notice weight loss.

C – Lactic Acidosis, Renal failure, Low BMI, Contrast media

S – Patient UK/NHS Choices

22

Beta Blocker

A – Slows the heart down, beats less hard.

T – Once daily at the same time

H – Tablet

L – Long term

E – Wont notice

T – HR and symptoms

I – Fatigue, Cold hands, GI, Headache, Nightmares, Impotence, Can cause initial worsening of symptoms in HF

C – Asthma, Only certain types in COPD, Hypotension

S – Patient UK/NHS Choices

23

Salbutamol

A – Relaxes airways and makes it easier to breath

T – As needed, but if using it a lot come see the GP

H – Inhaler

L – Long Term

E – Immediate

T – Symptoms monitoring and peak flow

I – Tachycardia, Palpitations, Anxiety, Tremor

C – Heart Problems

S – Patient UK/NHS Choices

24

Tiotropium/Ipratropium

A – Relaxes airways helping them to breath.

T – Tiotropium (Once Daily – Long acting), Ipratropium (Multiple times a day – Short acting). Inhaler technique

H – Inhaler in short term, Nebuliser in acute attacks

L – Long term or short term

E – Immediate

T – Clinical review

I – Dry Mouth

C – Closed angle Glaucoma

S – Patient UK/NHS Choices

25

Iron Tablets

A – Replace your bodies stores of iron, a mineral required to make blood

T – 1-3 times a day depending on type

H – Tablet – Empty stomach best but this can cause irritation

L – Usually taken for about 4 months (1 month for levels to return, 3 months to replenish stores)

E – 1 month

T – Hb in 1 month

I – GI irritation, Coloured stools, Bad taste

C – Na

S – Patient UK/NHS Choices

26

Mesalazine

A – Reduces production of certain chemicals that your gut procures. These chemicals cause symptoms of UC

T – Depending on severity see instructions on packet

H – Tablet or Enema

L – Long term or short term to reduce symptoms

E – Quick

T – Renal function before, at 3 months and yearly. FBC 3 monthly and then every 6 months to assess blood tests

I – Myelosuppression (Infection – Go to A&E, Bleeding, Anaemia), Liver Toxicity, Pulmonary Fibrosis, Indigestion, Diarrhoea Headaches

C – Na

S – Patient UK/NHS Choices