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AABCDEFFGHHIILMMNNPPPPPPPQSSVV AMINOSALICYLATES and CARBAMAZEPINE [NB - Check renal function before starting an oral aminosalicylate, then at 3 months, then annually (more frequently in renal impairment]. Advice This medication can rarely affect blood-making cells [which are used for carrying oxygen, fighting infection and controlling bleeding]. So if you develop a sore throat, mouth ulcers, unexplained bruising or bleeding, a rash, fever or any other signs of infection, report this to your doctor immediately. Further information from patient.co.uk ASPIRIN [when taken for CVD - suddenly stopping aspirin increases risk of MI] Suddenly stopping aspirin can be dangerous. Do not stop taking aspirin [unless you develop side effects like bleeding] without advice from the doctor. B12 foods BISPHOSPHONATES Tablets should be swallowed whole with at least 200 ml of water on an empty stomach immediately after getting up in the morning. Stay fully upright for at least 30 minutes or one hour. Avoid any food, drink or other medicines during this time. Stop taking the tablets and get advice from the doctor if you develop any symptoms of the oesophagus [food pipe] such as difficulty or pain on swallowing, chest pain, or new or worsening heartburn. Maintain good oral hygiene and have regular dental check-ups. Please report any mouth symptoms such as loose teeth, pain, or swelling. Report any thigh pains as this can rarely be due to fracture of the femur [thigh bone]. CARBIMAZOLE Inform the doctor immediately if you develop a sore throat, mouth ulcers, bruising, fever, malaise, or any non-specific illness. → Back to the top CONTACTS Crisis response 0161 716 3806 DESMOPRESSIN Avoid excess water intake (including water swallowed during swimming). Stop desmopressin if you develop vomiting or diarrhoea (until you are back to normal). If you are taking this for night wetting, drink as little as possible from one hour before you take it, to eight hours afterwards. Guidelines recommend that you try stopping desmopressin for at least 1 week, once you have been on it for 3 months, to see whether the symptoms have improved. → Back to the top END OF LIFE CARE FINASTERIDE Notes: Cases of male breast cancer have been reported. Patients or their carers should be told to promptly report to their doctor any changes in breast tissue such as lumps, pain, or nipple discharge. Advice Report any changes in breast tissue, breast lumps, breast pain or nipple discharge. FUNGAL NAIL INFECTION Advice report any possible side effects to the doctor. If you develop a blistering skin rash, or jaundice (yellowing of your skin or the whites of your eyes), you should speak with your doctor straightaway. These are rare but possibly serious side-effects of terbinafine. More information [printable]GOUT PREVENTING GOUT The following may help losing weight (if overweight) a balanced, healthy diet avoid excessive red meat, seafood , alcohol or sugar-sweetened soft drinks [oily fish reduces the risk of heart disease so do not cut it out completely] Vitamin C supplements [1000mg-1500mg a day] and/or allopurinol could prevent reapeat attacks. Maintain adequate hydration [drink up to 2 litres of water a day unless medical reasons not to e.g. heart failure]. This is especially important with fluid loss e.g. due to exercise or hot weather. TREATMENT elevation [eg if gout is in the foot, lie on a settee with feet on a cushion] try ice packs in a towel for up to 20 minutes about 4 times a day over the counter painkillers can help but gout often needs stronger painkillers from the doctor medications like anti-inflammatories, colchicine or opiates like tramadol [discuss options with doctor or pharmacist] There is an increased risk of high blood pressure, pre-diabetes [insulin resistance] and heart disease with gout. It is therefore a good idea to have a BP check at least annually and address any lifestyle changes [diet, exercise, weight loss etc]. You should also have a cholesterol and glucose test at least once. → Back to the top HEART FAILURE If you GAIN 2kg [about 4 pounds] in weight HYDROXYCHLOROQUINE This drug can sometimes affect the eyes. Please report any worsening vision or visual symptoms like blurred vision to the doctor. INHALERS Blue inhalers are usually 'relievers'. They open the airways and should work within a few minutes. Use as needed for cough or wheezing, usually up to 2 puffs 4 times a day. In emergencies you can use 10 puffs in a spacer but then speak to a health professional soon especially if the symptoms are not improving. If you need to use it more frequently, talk to the doctor or practice nurse soon. Brown/beige/white/red/orange inhalers are usually 'preventers'. They are usually used regularly to prevent shortness of breath and wheezing. If you have a preventer inhaler that contains a steroid (eg beclometasone, fluticasone) you should rinse your mouth with water after using it. This prevent thrush that can be a side effect. If you are using both preventer and reliever inhalers, use the reliever a few minutes before the preventer if possible. This is because the reliever opens the airways and allows the preventer to get down into the lungs easier. → Back to the top IRON TABLETS Drinking orange juice or taking other vitamin C-containing foods with
→ Back to the top LETROZOLE Caution: susceptibility to osteoporosis. MALARONE Start malarone 1or 2 days before entering endemic area and continue until 1
MEDISCAN
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METHOTREXATE [Reports of blood dyscrasias (including fatalities) and liver cirrhosis with low-dose methotrexate]NITRATES There is a temporary supply problem with some isosorbide mononitrate tablets.
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NON-STEROIDAL ANTI-INFLAMMATORY DRUGS [NSAIDs] These drugs slightly increase the risk of heart, stomach or kidney problems so try to limit usage when possible. Diclofenac may have the highest risk and ibupofen may be the safest. Paracetamol, though sometimes less effective , is much safer. PHENYTOIN Patients or their carers should be told how to recognise signs and symptoms of blood or skin disorders and advised to seek immediate medical attention if symptoms such as fever, rash, mouth ulcers , bruising or bleeding develop. Severe, progressive or symptomatic leucopenia may occur [withdraw the drug]. Advice Seek immediate medical advice if the following symptoms occur:- - a RASH , sore throat, mouth ulcers, unexplained bruising or bleeding, fever or any other signs of infection. PREDNISOLONE Suddenly stopping these can be dangerous. Do not stop taking these without advice from the doctor. Advice for a patient on oral corticosteroids? From CKS → Back to the top PRIVATE REFERRALS Phone a local private hospital. Ask for a consultant in the speciality you need. Make an appointment. Then inform our receptionists to get them to run off the letter to this consultant/specialist. Collect letter to take along to your appointment. You may need to check with your medical insurance to see what they will/won't cover. PRIVATE HOSPITALS BMI - The Beaumont Hospital, Old Hall Clough, Chorley New Road, Bolton 01204 404404 BMI The Highfield Hospital, Manchester Road, Rochdale, OL11 4LZ 0808 101 0337 BMI The Alexandra Hospital, Mill Ln, Cheadle 0161 428 3656 Spire Hospital Russell Road, Manchester, Lancashire M16 8AJ 0161 226 0112 → Back to the top POSTCOITAL CONTRACEPTION ADVICE Take this tablet as soon as possible. PIOGLITAZONE Contact a health professional immediately if you get symptoms such as nausea, vomiting, abdominal pain, fatigue or dark urine. Also report promptly any blood in the urine, painful urination, or a sense of urgency when needing to pass urine. [NB- Before initiating treatment with pioglitazone, patients should be assessed for risk factors of bladder cancer (including age, smoking status, exposure to certain occupational or chemotherapy agents, or previous radiation therapy to the pelvic region) and any macroscopic haematuria should be investigated. The safety and efficacy of pioglitazone should be reviewed after 3–6 months and pioglitazone should be stopped in patients who do not respond adequately to treatment. Patients already receiving treatment with pioglitazone should be assessed for risk factors of bladder cancer and treatment should be reviewed after 3–6 months, as above.] → Back to the topPPIs Latest guidelines recommend that patients reduce or stop medications like omeprazole if their condition allows it. This is due to data which shows an slight risk of osteoporosis when they are taken longterm. Please speak to, or see the GP to discuss this,if this has not been dealt with and you think your condition will allow a trial of a lower dosage or stopping as appropriate. Pre PSA counselling As well as a blood test, he will also need to have a rectal examination.→ Back to the top QUININE Guidelines recommend that longterm treatment with quinine should be avoided if possible.
SCABIES ADVICE Malation FOR HEAD LICE:
Permethrin SITAGLIPTIN Please report promptly any persistent, severe abdominal pain when on sitagliptinSTATINS Please report promptly any unexplained muscle pain tenderness or weakness→ Back to the top VALPROATE [e.g. Epilim , Depakote] Notes: [monitor liver VITAMIN Dfunction before therapy and during first 6 month. Measure full blood count and ensure no undue potential for bleeding before starting and before surgery. Patients or their carers should be told how to recognise signs and symptoms of blood or liver disorders and pancreatitis. Withdraw treatment immediately if persistent vomiting and abdominal pain, anorexia, jaundice, oedema, malaise, drowsiness, or loss of seizure control]. Advice Seek immediate medical advice if the following symptoms occur:- - abdominal pain, nausea, vomiting, fatigue, dark urine,sore throat, mouth ulcers, unexplained bruising or bleeding, a rash, fever or any other signs of infection. → Back to the top VITAMIN D Please ensure taht every prescription you get for vitamin D has been hand-written → Back to the top Back to EZGP Home |