Workshop 2 Navigating the eBNF, eMC, NetDoctor, MedicinesChest by fla18057

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									    Workshop 2: Navigating the eBNF, eMC,
    NetDoctor, MedicinesChest, and NHS Direct Q&As.


    Use the eBNF, eMC, NetDoctor, MedicinesChest and NHSD Q&As to answer the
    following questions


1    What is the starting dose      eBNF: Monograph for Doxazosin: Dose: Hypertension, 1
     of doxazosin for               mg daily, increased after 1-2 weeks to 2mg once daily,
     hypertension?                  and thereafter to 4 mg once daily, if necessary; max. 16
                                    mg daily

                                    eMC: SPC for Cardura®: 4.2 Posology and method of
                                    administration: Hypertension: Cardura is used in a once
                                    daily regimen: the initial dose is 1mg, to minimise the
                                    potential for postural hypotension and/or syncope.
                                    Dosage may then be increased to 2mg after an additional
                                    one or two weeks of therapy and thereafter, if necessary
                                    to 4mg. The majority of patients who respond to Cardura
                                    will do so at a dose of 4mg or less. Dosage can be
                                    further increased if necessary to 8mg or the maximum
                                    recommended dose of 16mg.

                                    eMC: PIL for Cardura®:
                                    How to take your medicine
                                    The usual dose of Cardura is one tablet each day.
                                    If you are taking Cardura for the first time the normal dose
                                    is 1mg daily. After this the usual dose is 2mg or 4mg
                                    daily. In some circumstances this may be increased to a
                                    maximum of 8mg daily if you are being treated for
                                    prostate enlargement, or to a maximum of 16mg if you
                                    are being treated for high blood pressure.

                                    NetDoctor: No information

                                    MedicinesChest: No information

                                    NHSD Q&As: No information

2    What active ingredient         eBNF: [Search for Flamatak®: see under entries for
     does Flamatak MR®              Voltarol®] Identified that Flamatak® exists as Flamatak
     contain and how much?          100 MR® and Flamatak 75 MR® containing 100mg and
                                    75mg of diclofenac sodium respectively.

                                    eMC: No information


    Role Preparation for Nurse Advisors: Handling Medicines Calls     November 2007 V1.0
                                    NetDoctor: Monograph for Flamatak MR®: Identified as
                                    Diclofenac sodium but no strength

                                    MedicinesChest: No information

                                    NHSD Q&As: No information

3    Can I buy Almogran® in         eBNF: Entry for Almogran®: POM (prescription only
     the chemist?                   medicine)

                                    eMC: SPC for Almogran® 12.5 tablets: 11. Legal
                                    category: POM (prescription only medicine)

                                    eMC: PIL for Almogran® 12.5 tablets: No Information

                                    NetDoctor: Monograph for Almogran®: Prescription only
                                    (POM - prescription only medicine)

                                    MedicinesChest: No information

                                    NHSD Q&As: No information

4    Name three side effects        eBNF: Monograph for Penicillamine: Side effects: Many
     of Distamine®.                 noted including initially nausea, anorexia, fever, and skin
                                    reactions.

                                    eMC: SPC for Distamine® 125mg film-coated tablets: 4.8
                                    Undesirable effects: Nausea, anorexia, fever and rash
                                    may occur early in therapy.

                                    eMC: PIL Distamine® 125mg Distamine tablets
                                    sometimes cause the following side effects in some
                                    people. Increasing the dose very slowly will help to
                                    control these side effects.
                                    When you start taking the tablets you may feel sick or
                                    even be sick. You may lose your appetite or notice that
                                    food tastes different. These side effects usually wear off,
                                    but tell your doctor if they trouble you.

                                    NetDoctor: Monograph for Distamine®: Side effects list
                                    includes nausea, decreased appetite, fever (pyrexia), skin
                                    rashes.

                                    MedicinesChest: No information

                                    NHSD Q&As: No information




    Role Preparation for Nurse Advisors: Handling Medicines Calls      November 2007 V1.0
5    What ingredients does          eBNF: Entry for Asilone®: Suspension , sugar-free, dried
     Asilone® antacid liquid        aluminium hydroxide 420 mg, simeticone 135 mg, light
     contain, and how much?         magnesium oxide 70 mg/5 mL (low Na+)

                                    eMC: No information

                                    NetDoctor: Entry for Asilone® antacid liquid: Aluminium
                                    hydroxide, activated dimeticone, light magnesium oxide.
                                    No information on amounts.

                                    MedicinesChest: Entry for Asilone® antacid liquid:
                                    Spearmint flavoured sugar-free suspension containing in
                                    5ml: Aluminium hydroxide 420 mg, Dimethicone activated
                                    (Simethicone) 135 mg, Light magnesium oxide 70 mg

                                    NHSD Q&As: No information

6    Can phenelzine and             eBNF: Interaction search – tree structure demonstrates
     pseudoephedrine be             phenelzine is an MAOI: MAOIs and pseudoephedrine –
     taken together safely?         potentially hazardous; risk of hypertensive crisis when
                                    MAOIs given with pseudoephedrine.

                                    eMC: SPC for Non-drowsy Sudafed Decongestant
                                    Tablets® which contain Pseudoephedrine Hydrochloride
                                    60.00 mg: 4.5 Interaction with other medicinal products
                                    and other forms of interaction: Concomitant use of Non-
                                    Drowsy Sudafed Decongestant Tablets with tricyclic
                                    antidepressants, sympathomimetic agents (such as
                                    decongestants, appetite suppressants and amfetamine-
                                    like psychostimulants) or with monoamine oxidase
                                    inhibitors, which interferes with the catabolism of
                                    sympathomimetic amines, may occasionally cause a rise
                                    in blood pressure.

                                    eMC: PIL No PILs available

                                    NetDoctor: Monograph for Sudafed 12 hour relief®: How
                                    can this medicine affect other medicines? You should not
                                    take this medicine if you are currently taking a
                                    monoamine oxidase inhibitor (MAOI) antidepressant (eg
                                    phenelzine, isocarboxazid, tranylcypromine or
                                    moclobemide), or if you have taken one of these
                                    medicines in the last 14 days. This is because the
                                    combination could cause a dangerous rise in blood
                                    pressure.

                                    MedicinesChest: No information

                                    NHSD Q&As: No information


    Role Preparation for Nurse Advisors: Handling Medicines Calls    November 2007 V1.0
7    When can I drink alcohol       eBNF: No information.
     again after taking a
     course of                      eMC: SPC for Flagyl® tablets 200mg, 400mg: 4.5
     metronidazole?                 Interaction with other medicinal products and other forms
                                    of interaction: Patients should be advised not to take
                                    alcohol during metronidazole therapy and for at least 48
                                    hours afterwards because of the possibility of a
                                    disulfiram-like (antabuse effect) reaction.

                                    eMC: PIL for Flagyl® S Suspension
                                    You are advised not to drink any alcohol whilst taking
                                    Flagyl® S suspension, and for 48 hours after finishing
                                    your course of the suspension, as this might cause
                                    unpleasant side-effects, such as nausea and vomiting,
                                    abdominal pain, hot flushes, palpitations, and headache.

                                    NetDoctor: Entry for Flagyl® tablets (Metronidazole):
                                    Warning: You should not drink alcohol while taking this
                                    antibiotic, and for at least 48 hours after finishing the
                                    course, as this can cause unpleasant symptoms such as
                                    hot flushes, abdominal cramps, nausea, vomiting,
                                    headache and palpitations.

                                    MedicinesChest: No information

                                    NHSD Q&As: UKMi Q&A N14.2: When can patients start
                                    drinking alcohol after finishing metronidazole? Fully
                                    referenced answer.

8    Can ibuprofen and              eBNF: Interaction search for ibuprofen and lithium –
     lithium be taken together      potentially hazardous; ibuprofen reduces excretion of
     safely?                        lithium (increased risk of toxicity).

                                    eMC: SPC for Camcolit 250 tablets®: 4.5 Interaction with
                                    other medicinal products and other forms of interaction
                                    Serum lithium concentrations may increase during
                                    concomitant therapy with non-steroidal anti-inflammatory
                                    drugs, or tetracycline, possibly resulting in lithium toxicity.
                                    Serum lithium concentrations therefore should be
                                    monitored more frequently if NSAID or tetracycline
                                    therapy is initiated or discontinued.

                                    eMC: PIL for Camcolit 250 tablets®:
                                    Consult your doctor before taking Camcolit if you are
                                    taking any of the following medications:
                                         diuretics (water tablets)
                                         anti-depressants called tricyclics or tetracyclics
                                           antibiotics called tetracyclines
                                         non-steroidal anti-inflammatory drugs. These
                                           are used for rheumatism and for other pains. You

    Role Preparation for Nurse Advisors: Handling Medicines Calls        November 2007 V1.0
                                            can also get pain killers of this type without a
                                            prescription, so check with your pharmacist before
                                            you buy them. Aspirin and paracetamol do not
                                            react with lithium.
                                           for heart rhythm disorders (quinidine, lidocaine,
                                            flecainide, amiodarone, sotalol)
                                           for the treatment of leukaemia (arsenic trioxide)
                                           for the treatment of nausea and vomiting
                                            (dolasetron)
                                           for the treatment of an infection given into a vein
                                            (erythromycin)
                                           for the treatment of malaria (mefloquine)

                                    NetDoctor: Monograph for Camcolit®: How can this
                                    medicine affect other medicines? The following medicines
                                    may increase the level of lithium in the blood, causing an
                                    increased risk of lithium side effects or toxicity: List
                                    includes - non-steroidal anti-inflammatory drugs
                                    (NSAIDs), such as indomethacin, diclofenac, ibuprofen,
                                    celecoxib.

                                    MedicinesChest: No information

                                    NHSD Q&As: No information


9    Can azithromycin be             eBNF: Monograph for azithromycin: Contraindications:
     used in a patient with          Hepatic impairment.
     liver disease?
                                     eMC: SPC for Zithromax® capsules, suspension®: 4.2
                                     Posology and method of administration Hepatic failure:
                                     Since azithromycin is metabolised in the liver and
                                     excreted in the bile, the drug should not be given to
                                     patients suffering from severe liver disease. No studies
                                     have been conducted regarding treatment of such
                                     patients with azithromycin.

                                     eMC: PIL for Zithromax® capsules
                                     Before you take your medicine
                                     If the answer to any of the questions below is YES do not
                                     take Zithromax®. Go back and see your doctor.
                                     Have you ever had an allergic reaction, skin rash or
                                     wheezing after taking Zithromax® or any other macrolide
                                     antibiotic such as erythromycin?
                                     Do you have liver problems?
                                     Are you taking any ergot derivatives such as ergotamine
                                     (used to treat migraine)?

                                     NetDoctor: Monograph for Zithromax®: Not to be used in
                                     Liver disease.

    Role Preparation for Nurse Advisors: Handling Medicines Calls      November 2007 V1.0
                                      MedicinesChest: No information

                                      NHSD Q&As: No information

10    I am taking simvastatin         eBNF: Monograph for simvastatin: Dose: primary
      10mg, one tablet every          hypercholesterolaemia, combined hyperlipidaemia, 10–20
      day for my high                 mg daily at night, adjusted at intervals of at least 4 weeks;
      cholesterol – does it           usual range 10–80 mg once daily at night
      matter what time I take
      it?                             eMC: SPC for Zocor® 10mg, 20mg, 40mg and 80mg film-
                                      coated tablets: 4.2 Posology and method of
                                      administration: The dosage range is 5 - 80 mg/day given
                                      orally as a single dose in the evening.

                                      eMC: PIL for Zocor® 10mg, 20mg, 40mg and 80mg film-
                                      coated tablets:
                                      You should take your tablets exactly as advised by your
                                      doctor or pharmacist. The usual starting dose is 20 or 40
                                      mg a day, given as a single dose in the evening. It is
                                      recommended that Zocor® is taken in the evening, or at
                                      night, so that it will be working when the body is
                                      producing the most cholesterol. Your doctor may adjust
                                      your dose to a maximum of 80 mg per day, given as a
                                      single dose in the evening.

                                      NetDoctor: Monograph for simvastatin: How does it
                                      work? As the body produces most cholesterol at night,
                                      statins are generally more effective if taken at night.

                                      MedicinesChest: No information

                                      NHSD Q&As: No information

11    What is the dose of             eBNF: No information
      Cystopurin® for cystitis?
                                      eMC: No information

                                      NetDoctor: Entry for Cystopurin®: How does it work?
                                      The contents of one Cystopurin® sachet should be taken,
                                      dissolved in a glass of water, three times a day for two
                                      days. You should also try and drink as much water as you
                                      can during the treatment, to help flush any bacteria out of
                                      your bladder. Note – NetDoctor does not usually
                                      contain dosage information.

                                      MedicinesChest: Entry for Cystopurin®: Dosage: Adults,
                                      elderly and children over 6 years: 1 sachet dissolved in
                                      200ml cold water taken 3 times daily for 2 days. Not
                                      recommended under 6 years.

     Role Preparation for Nurse Advisors: Handling Medicines Calls       November 2007 V1.0
                                      NHSD Q&As: No information.

12    Can paracetamol be              eBNF: No information
      taken with amoxicillin?
                                      eMC: No information

                                      NetDoctor: No information

                                      MedicinesChest: No information

                                      NHSD Q&As: UKMi Q&A N4.2: Does paracetamol
                                      interact with antibiotics? Fully referenced answer.

13    Do Seroquel® 300 tablets eBNF: No information
      have lactose in them?
                               eMC: SPC for Seroquel®: 6.1 List of excipients: Lactose
                               monohydrate is listed as an excipient in the tablet core.

                                      eMC: PIL for Seroquel®: Your medicine is called
                                      Seroquel. Its active ingredient is quetiapine. Seroquel®
                                      tablets have either 25 milligrams (mg), 100 mg, 150 mg,
                                      200 mg or 300 mg quetiapine in them. Each tablet also
                                      contains several inactive ingredients which allow it to be
                                      made. These are: calcium hydrogen phosphate,
                                      hypromellose, lactose, magnesium stearate,
                                      microcrystalline cellulose, polyethylene glycol, povidone,
                                      sodium starch glycollate and titanium dioxide. The 25 mg,
                                      100 mg and 150 mg tablets also contain ferric oxide.

                                      NetDoctor: No information

                                      MedicinesChest: No information

                                      NHSD Q&As: No information

14    After opening a bottle of       eBNF: No information
      Reminyl® solution, how
      long does it last?              eMC: SPC for Reminyl® Oral solution: 6.3 Shelf life: 2
                                      years. After first opening: 3 months.

                                      eMC: PIL for Reminyl® Oral solution
                                      Medicines can be kept for a limited period only.
                                      Therefore, do not use Reminyl after the expiry date
                                      printed on the packaging. Reminyl oral solution should not
                                      be used for longer than 3 months after the bottle has first
                                      been opened.

                                      NetDoctor: No information


     Role Preparation for Nurse Advisors: Handling Medicines Calls      November 2007 V1.0
                                      MedicinesChest: No information

                                      NHSD Q&As: No information

15    Does food affect the            eBNF: No information.
      absorption of
      levofloxacin?                   eMC: SPC for Tavanic® 250mg tablets: 4.2 Posology and
                                      method of administration: The tablets may be taken
                                      during meals or between meals.

                                      eMC: PIL for Tavanic® 250mg, 500mg tablets
                                      The tablets may be taken during meals or at any time
                                      between meals.

                                      NetDoctor: No information

                                      MedicinesChest: No information

                                      NHSD Q&As: No information

16    I’ve just started on            eBNF: Monograph for methotrexate: Side effects:
      methotrexate tablets.           Drowsiness is listed.
      Can I still drive?
                                      eMC: SPC for Maxtrex® 2.5mg tablets: 4.7 Effects on
                                      ability to drive and use machines: None known.

                                      eMC: PIL for Maxtrex® 2.5mg
                                      No Information

                                      NetDoctor: Monograph for Maxtrex®: Side effects:
                                      Drowsiness is listed.

                                      MedicinesChest: No information

                                      NHSD Q&As: No information




     Role Preparation for Nurse Advisors: Handling Medicines Calls     November 2007 V1.0

								
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