Stage 1 OSCE medications

indications, side effects, contraindications and counselling points

aspirin indications

anti-inflammatory analgesic which can:

• relieve pain and swelling

• bring down high body temperatures

• prevent recurrence of heart attacks/strokes by thinning the blood

released slowly, so not suitable for short-term relief of pain

aspirin side effects

stop taking and tell doctor if experience skin rashes, itching or difficulty breathing

common: nausea and vomiting, pain or discomfort in stomach or lower chest, bleeding

aspirin contraindications

allergic

problem of blood not clotting properly/bleeding problems

if ever had cerebral haemorrhage

if in last 3 months of pregnancy or breastfeeding

if have ever had ulcer in stomach or small intestine

not for children under 16 years unless on advice of doctor

aspirin counselling points

if take in high dose/over long period of time, can irritate stomach lining

if consume excessive amounts of alcohol whilst taking, may increase risk of causing bleeding in stomach/intestines

cetirizine indications

anti-allergic medication used for:

• relief of nasal and ocular symptoms of seasonal and perennial allergic rhinitis (eg, hay fever)

• relief of urticaria (hives - itchy skin welts

cetirizine side effects

sleepiness

headache, dizziness

diarrhoea, nausea, dry mouth

fatigue

cetirizine contraindications

allergic

severe kidney disease requiring dialysis

not for children under 6

should be avoided in pregnant women

cetirizine counselling points

observe response to drug if intending to drive or operate machinery - can cause drowsiness

chloramphenicol indications

bacterial infections that affect the front surfaces of the eye

most commonly acute bacterial conjunctivitis

white of eye is red/eyelids red or swollen

sticky discharge which can make eye difficult to open in the morning

eye may feel ‘gritty’ or ‘irritated’

chloramphenicol side effects

allergic reactions

changes in blood leading to severe tiredness or easy bruising

discolouration or clouding of eye surface

chloramphenicol contraindications

allergic to chloramphenicol or any ingredients

problems with blood during previous treatment with chloramphenicol

family history of blood problems

wear contact lenses - do not wear during course of treatment

chloramphenicol counselling points

talk to doctor/pharmacist if:

• eyesight affected

• pain within eye

• more sensitive to light than usual

• eye looks cloudy

wait until vision is clear before driving or using machines

chlorphenamine indications

active ingredient maleate, an antihistamine which can help relieve the symptoms:

• itchiness

• redness

• swelling

• tenderness

caused by:

• hayfever/other allergies (eg, pets)

• nettle rash and hives

• skin allergies and dermatitis

• heat rash

• reactions to food or medicines

• insect bites and stings

• itchy rash of chickenpox

chlorphenamine side effects

most commonly drowsiness

chlorphenamine contraindications

allergic

have taken medicines for depression known as monoamine oxidase inhibitors (MAOIs, eg, phenelzine) within last 14 days

pregnant, planning to become pregnant or are breastfeeding

chlorphenamine counselling points

advised not to drink alcohol with this medicine

can make you feel drowsy, dizzy or have blurred vision - make sure not affected before you drive or operate machinery

contain lactose

what is clotrimazole?

1% cream

antifungal agent which fights the cause of fungal skin infections

clotrimazole indications

ringworm

athlete’s foot

fungal nappy rash

fungal sweat rash

thrush

clotrimazole side effects

signs of allergic reaction include rash and swallowing or breathing problems

clotrimazole contraindications

known allergy or sensitivity to clotrimazole or any other ingredients in medicine (see section 6)

clotrimazole counselling points

do not smoke or go near naked flames - risk of severe burns

for external use on infected area only

do not suddenly stop using as may cause symptoms of the infection to return

keep infected area clean and wash hands after treating

what is co-codamol?

active ingredients are paracetamol and codeine phosphate

codeine is an opioid analgesic which can cause addiction

co-codamol indications

those over 12 years old for short-term relief of moderate pain that is not relieved by other painkillers such as paracetamol or ibuprofen alone

headache, neuralgia, migraine, toothache, period pains, rheumatic pains (muscle pains and backache)

co-codamol side effects

drug withdrawal

allergic reactions

co-codamol contraindications

allergic to paracetamol, codeine, other opioid analgesics or ingredients

drink excessive amounts of alcohol

recent head injury

breast-feeding or pregnant

have had a drug addiction

co-codamol counselling points

should not be taken for more than 3 days

codeine can cause addiction if taken for more than 3 days - can give withdrawal symptoms (restlessness, anxiety) when stop taking it - do not suddenly stop taking

do not take anything else containing paracetamol whilst taking

do not drink alcohol whilst taking - increases sedative effects

can cause drowsiness or changes in vision - do not drive until you know how it affects you (or use tools/machines)

prescriber will give a plan to gradually decrease the dose

esomeprazole indications

adults and children 12 and above:

• ‘gastro-oesophageal reflux disease (GORD) - pain, inflammation and heartburn

• ulcers in the stomach or upper part of gut infected with H. pylori bacteria

adults:

• stomach ulcers caused by NSAIDs (or to stop them forming)

• too much acid in stomach caused by a growth in the pancreas

• prolonged treatment after prevention of rebleeding of ulcers with IV esomeprazole

esomeprazole side effects

common - headache, effects on your stomach, nausea or vomiting

uncommon - fracture of hip, wrist or spine

esomeprazole contraindications

allergic to omeprazole or other ingredients, any PPIs

taking a medicine containing nelfinavir (to treat HIV infection)

breastfeeding

can caused dizziness and blurred vision - do not drive etc if affected by this

intolerance to sucrose

esomeprazole counselling points

can take at any time of day, with or without food

swallow capsules whole with a drink of water

do not chew or crush tablets - this can damage pellets in medicine which stop it being broken down by stomach

fexofenadine indications

adults and children 12 and over

relieve symptoms that occur with hay fever such as sneezing, itchy, runny or blocked nose, and itchy, red and watery eyes

better for working or driving as no risk of drowsiness

fexofenadine side effects

common: headache, drowsiness, nausea, dizziness

tell doctor immediately and stop taking if experience allergic reaction (swelling)

fexofenadine contraindications

allergic to fexofenadine or any other ingredients in medicine

pregnant (unless necessary), not recommended whilst breastfeeding

fexofenadine counselling points

check don’t make feel sleepy or dizzy before driving (unlikely)

wait 2 hours between taking fexofenadine and any indigestion remedies containing Al or Mg

do not take double dose if missed

what is hydrocortisone cream?

smooth white cream for application to skin only

belongs to group of medicines called corticosteroids

hydrocortisone indications

reduce inflammation in a variety of inflammatory skin conditions, such as:

mild to moderate eczema

dermatitis caused by irritants or allergens

insect bite reactions

hydrocortisone side effects

signs of allergic reaction - rash, itchy skin, swelling, difficulty breathing

steroid withdrawal reaction if used for prolonged periods of time

hydrocortisone contraindications

allergic to hydrocortisone or any other ingredients

have bacterial infection, viral infection or fungal infection of the skin

do not use on face or near your eyes, or on broken skin

hydrocortisone counselling points

do not cover the area with a plaster or dressing after application

do not apply to chest area if breastfeeding

do not exceed stated dose

wash hands thoroughly before use

use for maximum 7 days

ibuprofen indications

in adults and children 12 and over, relief of:

headaches and migraine pain

dental pain and neuralgia

period pain

rheumatic, muscular and back pain

feverishness and symptoms of cold and flu

ibuprofen side effects

stop taking and tell your doctor if experience:

indigestion, heartburn or feeling sick

pains in your stomach or other abnormal stomach problems

ibuprofen contraindications

allergic to ibuprofen or any other ingredients

allergic to aspirin or other painkillers

previously had bleeding in GI system caused by NSAIDs/have a stomach ulcer

taking other NSAID painkillers or more than 75mg aspirin daily

have heart problems/high blood pressure

last 3 months of pregnancy

ibuprofen counselling points

avoid during first 6 months of pregnancy

avoid with corticosteroid tablets, quinolone antibiotics or drugs that are prescribed (see list)

if side effects like dizziness, drowsiness or blurred vision, should avoid driving

may hide signs of infections such as fever and pain

what is loperamide?

antidiarrhoeals

reduces diarrhoea by slowing down an overactive bowel

allows water and salts that are usually lost in diarrhoea to be absorbed by the body

loperamide indications

sudden, short-lived (acute) attacks of diarrhoea in adults and children over 9

sudden flare-ups of long-lasting (chronic) diarrhoea in adults

loperamide side effects

common: headache, dizziness, constipation, nausea, stomach wind

seek medical advice if allergic reaction of bloated stomach/severe constipation

loperamide contraindications

allergic to loperamide or any other ingredinets

severe diarrhoea after taking antibiotics

constipation, blockage of bowel or bloated tummy

bacterial infection of small intestine or colon

should not be taken with other antidiarrhoea preparations

pregnant or breastfeeding

loperamide counselling points

talk to doctor if no improvement in your symptoms within 48 hours of taking loperamide

consult doctor if history of drug abuse (loperamide is an opioid and addiction is observed with opioids as a class)

may cause dizziness or tiredness - avoid driving if feel this way after taking

contains lactose

swallow capsules whole with some liquid

paracetamol indications

in adults and children over age 10, analgesic (painkiller) used for treatment of:

headaches (including migraines and tension headaches)

toothache

nerve pain, backache, muscle pain, joint pain

sore throat

period pain

lower a high temperature

relieve symptoms of cold or flu

paracetamol side effects

allergic reaction (swelling of hands/face which can cause difficulty swallowing/breathing)

paracetamol contraindications

allergic to paracetamol or any other ingredients

taking other medicines containing paracetamol

paracetamol counselling points

do not take other medicines containing paracetamol

do not drink alcohol whilst taking

pseudoephedrine indications

decongestant which acts to relieve a blocked nose and blocked sinuses

to help breathe more easily without causing drowsiness 

for adults and children 12 years or older

pseudoephedrine side effects

most people will not have problems

see a doctor if experience symptoms of allergic reaction

if symptoms don’t go away talk to doctor

pseudoephedrine contraindications

allergic to any of ingredients

heart or circulatory problems/high blood pressure

diabetes or severe kidney disease

taking other medicines containing pseudoephedrine or other decongestants

pregnant or breastfeeding

pseudoephedrine counselling points

swallow tablet with water

if take too many, talk to doctor straight away

senna indications

stimulant laxative for the short-term relief of occasional constipation

difficulty or irregular bowel movements, accompanied by hard, dry motions which can be painful to pass

senna side effects

allergic reaction

stomach pain, cramps or diarrhoea (particularly in patients with an irritable bowel)

senna contraindications

allergic to any ingredients

have blockage of GI tract or bowel

have appendicitis

have persistent or undiagnosed stomach complaints such as stomach pain, nausea and vomiting

severely hydrated

have already taken laxative and still constipated

pregnant or breastfeeding

senna counselling points

tips to prevent constipation happening:

eat a balanced diet including fresh fruit and vegetables

drink enough water so don’t become dehydrated

keep up your exercise and stay fit

overuse may damage health by causing disturbances in electrolyte and mineral balances, or severe dehydration

only use for a few days - rely more on lifestyle changes

sodium alginate, calcium carbonate, magnesium carbonate (eg, Gaviscon) indications

peppermint flavoured oral suspension

reflux supressant

relieves symptoms of:

heartburn and acid indigestion

hoarseness and other voice disorders, sore throat and cough associated with reflux

sodium alginate, calcium carbonate, magnesium carbonate (eg, Gaviscon) side effects

chance of allergic reaction

sodium alginate, calcium carbonate, magnesium carbonate (eg, Gaviscon) contraindications

allergic to any ingredients

sodium alginate, calcium carbonate, magnesium carbonate (eg, Gaviscon) counselling points

if symptoms persist after 7 days consult your doctor

max daily dose contains 23% daily recommended sodium intake - talk to doctor if need on daily basis if advised to have a low salt diet

do not refrigerate