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OSCE
-Buster: Amitriptyline - Counselling
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09.05.05 (3 years ago)
#1
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Miss Jones has been started on amitryptylline for depression. She doesn’t know why she is taking the tablets and has some concerns. Talk to her and address her concerns.
Hello Miss Jones, I am Dr. A to attend you. I understand that you have been started on a tablet called amitryptylline and that you want to ask some questions. What is it that you would particularly like to know so that I can answer your specific questions?
I dont understand why my GP prescribed me this drug?
Well, Miss Jones, Amitriptyline primarily is used to treat depression, especially when you are experiencing difficulty sleeping and a loss of appetite.
[Note: Amitriptyline is also used to treat enuresis in children and occasionally to treat trigeminal neuralgia].
How does it work?
Amitriptyline belongs to the group of medicines known as tricyclic antidepressants. In depression there is a misbalance with the chemicals in the brain and this leads the person to feel low. Amitryptylline readjusts these chemicals and brings your mood back to normal.
Is it safe for anyone to start on this if he/she is feeling depressed?
Well, No Miss Jones! It should always be started under direction of your doctor.
Before starting on amitriptyline make sure you inform us clearly about certain facts like:
-if you are pregnant, trying for a baby or breast-feeding
-if you suffer from heart, liver or thyroid problems
-if you suffer from epilepsy, hypotension (low blood pressure), phaeochromocytoma (a growth on the adrenal glands), glaucoma, if you are experiencing or have ever experienced difficulty urinating (passing water), psychoses (mental problems), porphyria (a blood disorder) or diabetes
-if you are prone to dizziness or fainting, particularly when getting up from a lying or sitting position
-if you have ever had an allergic reaction to this or any other medicine in the past
-if you are taking any other medicines, including those available to buy without a prescription.
How should I take this drug?
Always read the manufacturer’s information leaflet, if possible, before beginning treatment. Take amitriptyline exactly as directed by your doctor. Try and take amitriptyline at the same times each day to avoid missing any doses.
Wat if i miss a dose?
If you do forget to take a dose, take it as soon as you remember and take the next dose at the usual time. If it is almost time for your next dose, leave out the missed dose and continue taking it at the normal times.
Wat if my mood does not improve with the dose prescribed? Can I double the dose then?
Well, Miss Jones, it may take several weeks before you begin to feel the benefits of this treatment. Never take more than the prescribed dose.
If you suspect that you or someone else has taken an overdose of amitriptyline contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty.
So once I start feeling ok, can I stop the drug then?
Do not stop taking amitriptyline without speaking to your doctor first. Stopping treatment suddenly can cause problems and your doctor will probably want to reduce your dose gradually.
Wat sort of side effects are associated with this drug?
Amitriptyline can cause drowsiness and blurred vision; Make sure your reactions are normal and u not feeling drowsy, before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert or able to see properly.
Try to avoid alcohol as it will increase feelings of drowsiness; If you do drink alcohol, drink only in moderation and be aware of its effects on you.
Before having any kind of surgery, including dental and emergency treatment, tell your doctor, dentist or surgeon you are taking amitriptyline.
Amitriptyline can cause a dry mouth. If you experience this try chewing sugar-free gum, cramming
pieces of ice or sugar-free sweets. If dry mouth becomes too troublesome, you can always contact us.
Amitriptyline may cause some people to sweat more than they usually do. If you experience this, take care not to become overheated during exercise or hot weather.
Amitriptyline can cause some people to become more sensitive to sunlight than they usually are. Try to avoid sunlight and sunbeds or use a suncream higher than factor 15 until you know how your skin reacts.
If you have diabetes, make sure you check your blood sugar levels regularly as amitriptyline can affect the levels of sugar in your blood.
At any point of time, after staring this drug, if you experience fever (high temperature), loss of consciousness, stiffness of the muscles, paleness of the skin, a fast heartbeat, incontinence (passing water without control from the patient) or jaundice (yellowing of the skin and whites of the eyes) - you should see us at once.
does this info address all ur concerns? do u hav any more questions regarding amitriptyline?
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