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Workshop Handling Medicines Calls - analgesics

By Grace Warren,2014-04-30 01:05
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Workshop Handling Medicines Calls - analgesics

    Self Directed Learning: Handling calls about Analgesia

    Case Scenario 1

    Question I’m going on holiday and have some Motilium? to take with me. If I need to

    can I take paracetamol as well?

    PERSON MEDICINES What further

    background Who is asking? Medicines (name, dose, frequency)?

    information do Lady 26 years Motilium 10mg tablets

    you need to Anadin Paracetamol

    clarify the New or worsening symptoms?

    question and Why asking? No

    minimise the risks Patient has seen interaction with

    when advising the Any allergies/medical Motilium? on the leaflet for her

    caller? conditions? paracetamol tablets.

    She takes Motilium? on holiday just in No

    case she has sickness or vomiting and

    also takes Anadin Paracetamol for any

    pain, aches or hangovers!

    Gather the further background information BEFORE searching for information.

    MedicinesChest Online: What information

    sources would Anadin Paracetamol White capsule shaped tablet containing paracetamol you use? 500mg

    BNF and Stockleys Drug Interactions - via MedicinesComplete

    http://www.medicinescomplete.com/mc/)

    No interactions listed between paracetamol and domperidone (Motilium?)

    eMC: http://emc.medicines.org.uk/

    Search Domperidone

    Motilium 10mg tablets [Domperidone] nil re interaction with paracetamol

    Domperamol? (Discontinued) contains Paracetamol 500mg and

    domperidone 10mg for migraine.

    Search Paracetamol

    ANADIN PARACETAMOL? - 4.5 Interaction with other medicinal products

    and other forms of interactions.

    Metoclopramide and Domperidone: The absorption of paracetamol is

    increased by metoclopramide and domperidone. However, concurrent use

    need not be avoided.

    MIDRID?

    Metoclopramide and domperidone accelerate absorption of paracetamol.

    PANADOL ULTRA?

    The speed of absorption of paracetamol may be increased by

    metoclopramide or domperidone.

    Role Preparation for Nurse Advisors: Handling Medicines Calls November 2007 v1.0

    What advice No interaction is reported in the standard interaction texts. There was even would you give? a preparation on the market for migraine, Domperamol?, that contained

     domeperidone and paracetamol in combination, but this has been Or would you discontinued.

    refer? However, several manufacturers of paracetamol products suggest that

     domperidone may speed up the rate at which paracetamol is absorbed. This

    could be seen as an advantageous interaction.

    Role Preparation for Nurse Advisors: Handling Medicines Calls November 2007 v1.0

Self Directed Learning: Handling calls about

    Analgesia

    Case Scenario 2

    Question A lady phones NHSD. She wants to know if she can take Paramol (which

    she has in the house) for a really bad headache.

    PERSON MEDICINES What further

    background Who is asking? 25mg thyroxine/day.

    information do 30 years old lady. Took 8x Paramol? soluble yesterday. you need to

    clarify the New or worsening symptoms?

    question and No

    minimise the risks

    when advising the Any allergies/medical

    caller? conditions?

    No allergies

    Hypothyroid

    Pregnancy (stage, going well)?

    no

    Gather the further background information BEFORE searching for information.

    MedicinesChest: What information

    sources would Paramol? soluble

    you use? Contains: Paracetamol 500 mg, Dihydrocodeine tartrate 7.46 mg

    REASONS SHE MAY NOT TAKE DRUG - Need to check for:

    1. DRUG - DISEASE problem (contraindication/caution)

    2. DRUG DRUG problem (interaction)

    eBNF

     4 Central nervous system > 4.7 Analgesics > 4.7.2 Opioid analgesics >

     DIHYDROCODEINE TARTRATE

    Cautions - see under Morphine Salts and notes above; interactions:

    Appendix 1 (opioid analgesics)

    Contra-indications - see under Morphine Salts and notes above

    MORPHINE SALTS

    Contraindications none relevant

    Cautions - hypotension, hypothyroidism

    Interaction search: there are no documents listings interactions between

    dihydrocodeine and levothyroxine searched.

    eMC PIL: Paramol?

    4.4 Special warnings and precautions for use Dosage should be reduced

    in the elderly, in hypothyroidism, chronic hepatic disease and renal

    insufficiency.

    If you need to use this medicine for more than three days at a time, see your

    doctor or pharmacist. Taking dihydrocodeine regularly, for a long time, can

    lead to addiction. Taking a painkiller for headaches too often, or for too long,

    can make them worse.

Role Preparation for Nurse Advisors: Handling Medicines Calls November 2007 v1.0

    What advice Paramol contains paracetamol and dihydrocodeine. Paracetamol alone would you give? would be preferable.

Or would you If caller not happy with that could REFER for further info re ‘caution’ found:

    refer? Dihydrocodeine should be taken with caution if hypothyroid. Manufacturers

     advice is to reduce the dihydrocodeine dose if hypothyroid but

    ; this product already has a low dose and

    ; the patients hypothyroidism should be controlled on

    thyroxine

    So should not be a problem for one-off treatment.

    Advise about potential side effects (listed in patient information leaflet inside

    the pack or BNF/ eMC)

    Role Preparation for Nurse Advisors: Handling Medicines Calls November 2007 v1.0

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