PP+401+Revision

=PP 401 Revision=

Which scenarios to consider from the patient's initial request

//Tolerance to temazepam// - can give Valerian for 1-2 days, but recommend they see the doctor to construct a withdrawal plan
 * Requests product to aid sleeping (Valerian etc.)**

//Sertraline taken at night// - suggest they take the sertraline in the morning to reduce effects on sleep

//Fentanyl patch release rate increased// - ask when they replace their patch (should be every three days) - mention that exposure to heat may cause the patch to release more fentanyl that usual
 * Requests product for constipation**

//Lithium toxicity// - ask about medications that may interact with lithium (ACEi, NSAID) - give paracetamol for headache, suggest they keep their fluids up and see the doctor as soon as possible to get their levels checked
 * Requests product for headache and diarrhoea**

//Xenical -// recommend they stop Xenical for 1-2 days to see if the diarrhoea goes away
 * Requests product for diarrhoea (Imodium)**

//Consider diarrhoea's effects on contraceptive pill -// if diarrhoea occurred within 3 hours of taking the pill, its contraceptive effect may have decreased

//Lithium// - suggest they keep their fluids up and see the doctor as soon as possible to get their levels checked

//Sibutramine//
 * Enquiry about weight management with weight loss medication**
 * -** weight loss goal will be achieved if medication is combined with a healthy diet and regular exercise

-** ask if they have taken the contraceptive pill before (explain the difference between the two types) - when contraceptive cover occurs (and how long to wait for it to return when you miss a pill)
 * Prescription for levonorgestrel

- ask how they apply the patch - when they apply the patch (is there a nitrate-free period?) - ask if they have any medications for acute angina attack (spray/sublingual tablet)
 * Requests refund for nitrate patches**

- ask what the doctor had told them about the medication - what the patient has used in the past for their condition - explain that there are many other uses for that particular medication, and its action on the brain may be suitable for your condition (the use of olanzapine in your condition is relatively new and may not have been documented where you read the information) - not all information that you read on the internet is reliable or up to date, so suggest sites such as NPS and beyondblue
 * Patient is worried about medication being prescribed for 'crazy people'**

-** ask why they aren't taking their warfarin as prescribed by the doctor - what medications, OTC and herbal supplements that they are taking (ginseng, garlic, gingko, St John's Wort) - explain that warfarin can cause unexplained bleeding if given at a high dose, and this would require the doctor to adjust the dose accordingly. Simply skipping a dose may reduce these side effects, but lowering the dose too much may cause the medication to be ineffective and can lead to blood clot formation. - ring up the doctor to book an appointment and for their recommendations on what warfarin dose they should be on - make a webster-pak without the warfarin (pack warfarin separately) - possibly continue dose as previously taken to maintain INR levels when they are eventually checked
 * Patient not taking warfarin tablets in Webster-pak
 * -** ask when they had their last INR reading