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 of doxazosin for hypertension? / eBNF: Monograph for Doxazosin: Dose: Hypertension, 1 mg daily, increased after 1-2 weeks to 2mg once daily, and thereafter to 4 mg once daily, if necessary; max. 16 mg dailyeMC: 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 does Flamatak MR® contain and how much? / eBNF: [Search for Flamatak®: see under entries for Voltarol®] Identified that Flamatak® exists as Flamatak 100 MR® and Flamatak 75 MR® containing 100mg and 75mg of diclofenac sodium respectively.
eMC: No information
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 the chemist? / eBNF: Entry for Almogran®: POM (prescription only 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 of Distamine®. / eBNF: Monograph for Penicillamine: Side effects: Many 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
5 / What ingredients does Asilone® antacid liquid contain, and how much? / eBNF: Entry for Asilone®: Suspension , sugar-free, dried aluminium hydroxide 420 mg, simeticone 135 mg, light 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 pseudoephedrine be taken together safely? / eBNF:Interaction search – tree structure demonstrates phenelzine is an MAOI: MAOIs and pseudoephedrine – 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: PILNo 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
7 / When can I drink alcohol again after taking a course of metronidazole? / eBNF: No information.
eMC: SPC for Flagyl® tablets 200mg, 400mg: 4.5 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 lithium be taken together safely? / eBNF: Interaction search for ibuprofen and lithium – potentially hazardous; ibuprofen reduces excretion of 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
- non-steroidal anti-inflammatory drugs. These are used for rheumatism and for other pains. You 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)
MedicinesChest: No information
NHSD Q&As: No information
Role Preparation for Nurse Advisors: Handling Medicines CallsNovember 2007 V1.0
9 / Can azithromycin be used in a patient with liver disease? / eBNF: Monograph for azithromycin: Contraindications: Hepatic impairment.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 inLiver disease.
MedicinesChest: No information
NHSD Q&As: No information
10 / I am taking simvastatin 10mg, one tablet every day for my high cholesterol – does it matter what time I take it? / eBNF: Monograph for simvastatin: Dose: primary hypercholesterolaemia, combined hyperlipidaemia, 10–20 mg daily at night, adjusted at intervals of at least 4 weeks; usual range 10–80 mg once daily at night
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 Cystopurin® for cystitis? / eBNF: No information
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.
NHSD Q&As: No information.
12 / Can paracetamol be taken with amoxicillin? / eBNF: No information
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 have lactose in them? / eBNF: No information
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 Reminyl® solution, how long does it last? / eBNF: No information
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
MedicinesChest: No information
NHSD Q&As: No information
15 / Does food affect the absorption of levofloxacin? / eBNF: No information.
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 methotrexate tablets. Can I still drive? / eBNF: Monograph for methotrexate: Side effects: Drowsiness is listed.
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 CallsNovember 2007 V1.0