Understanding your take home medications from the surgical ward. Information for Patients

Transcription

1 Understanding your take home medications from the surgical ward Information for Patients i

2 Information for Patients Please read this leaflet before taking the medications that have been prescribed for you. It provides important information and a guide on how best to take each medication once you get home Most Important things to know: Take each medicine as directed by your prescriber (e.g. doctor) Do not exceed the maximum daily dose for each medicine Be aware of the side effects that you may experience whilst taking each medicine. This booklet provides basic information on the main types of medication that you may be prescribed on discharge from hospital. It should not be used as a substitute for talking to your doctor, pharmacist or nurse about any questions you may have regarding your medication. Always read the patient information leaflet for each medication you take. 2

3 Painkillers (Analgesia) Is it normal to be experiencing pain after surgery? Pain is a normal consequence of surgery and is experienced by most patients. Which painkillers should I take? Your doctor may prescribe more than one kind of painkiller to be used in combination and the most common types of painkillers used are described in this booklet. How should I take the painkillers? Painkillers are usually prescribed to take when required which means you take them as per the dosage on the label and when you are in pain. Remember not to exceed the maximum daily dosage on the written instructions. What if the painkillers do not sufficiently control my pain? If you are taking the full amount of painkillers that you have been prescribed but you are still experiencing pain then please speak to your GP for advice. What if my painkillers are causing me to experience constipation? Certain painkillers cause constipation and therefore you may be prescribed laxatives. If your constipation does not improve whilst taking laxatives then contact your GP for advice but please remember that constipation can be reduced by maintaining a healthy diet. Eating plenty of fruit and vegetables and drinking at least 2 litres of water per day will be beneficial with this (unless your doctor has advised otherwise). 3

4 Paracetamol Side effects Reduces mild to moderate pain and fever. Take ONE or TWO tablets every four to six hours when required. Do not take more than 8 tablets in 24 hours. Take at regular intervals when necessary and do not exceed stated dose. It is unlikely you will get side effects from paracetamol as long as you take the recommended dose. Do not take with any other paracetamol containing product such as co-codamol. Anti-inflammatory drugs (e.g. Ibuprofen) How they work Side effects Reduce pain, fever and inflammation by inhibiting enzymes in your body. Take as prescribed by your doctor. Take at the state intervals when necessary and do not exceed maximum dose. Nausea and vomiting (sickness), heart burn and stomach pain if you get these contact your GP or pharmacist. Take with food report any side effects relating to your digestive tract by contacting your GP. Not generally suitable for patients with heart problems, kidney problems or asthma. 4

5 Tramadol Reduces pain and is a stronger pain killer than paracetamol. Take 50 to 100mg every four to six hours when required. Do not take more than 8 capsules in 24 hours. Take at regular intervals, when necessary, do not exceed stated dose. Side effects You may feel sick, light headed or sleepy. You can rarely develop hallucinations if this happens stop taking the medicine and contact your GP. Should not normally be given with antidepressants. If you are on warfarin this medication can affect you INR. If you have epilepsy this medication can precipitate seizures. If you have any concerns please talk to your doctor before taking. 5

6 Weak opioids (e.g. codeine, dihydrocodeine) How they work Reduce pain, stronger pain killer than paracetamol Works well in combination with paracetamol Take ONE or TWO tablets every four to six hours when required. Do not take more than 8 tablets in 24 hours. Side effects Take at regular intervals when necessary. Do not exceed stated dose. Common effects include nausea & vomiting (sickness), dizziness and constipation. Do not take with any other codeine containing product such as co-codamol (contains paracetamol and codeine). You may need to be prescribed a laxative alongside this medication if you are experiencing constipation. 6

7 Strong opioids (include morphine) How they work Used to treat severe, long term pain by preventing pain signals from reaching the brain. The dosage for strong opioids will vary according to your pain intensity and the type of preparation you have been prescribed. Morphine comes in long acting or short acting preparations. Take according to the instructions on your label. Side effects Take with or without food. Alcohol should be avoided when first taking as this may cause sleepiness and poor concentration. Side effect may include nausea, vomiting, dizziness and constipation. Breathing at night can sometimes be affected please contact your GP if you experience this. Drowsiness and dizziness can be increased when taking with alcohol and other sedating medication. Please exert caution when driving as these painkillers can affect your concentration. Various brands which contain the same active medication may be prescribed, e.g. Zomorph and MST. 7

8 Nausea and vomiting Is it normal to experience nausea and vomiting? Nausea & vomiting (sickness) is a common symptom which can occur as a result of a medical condition, a variety of medications used to treat an underlying condition (including pain killers and antibiotics) or through the use of anaesthetics if you have had a surgical procedure. the medication The medications used to treat the condition are called antiemetic's. You may have been given this medication in the form of an injection as part of your stay on the ward. The medications used to treat nausea and vomiting are usually for short term use whilst you are recovering. If you are taking the full amount and still experiencing symptoms of nausea and vomiting, please speak to your Doctor for advice. 8

9 Ondansetron Blocks the effect of natural chemical called serotonin. 4mg three times a day or 8mg twice daily. Side effects Swallow the tablets whole, with water. If you have been given the film formulation allow the film to dissolve on the tongue before swallowing. Constipation, headache and feeling flushed If you have any concerns please talk to your doctor before taking. Cyclizine Blocking a chemical messenger in the brain, which helps to reduce or prevent vomiting. One tablet of 50mg three times a day. Side effects Swallow the tablets whole. Side effects include drowsiness, blurred vision, dry mouth and constipation. The injection formulation of this medication may give you palpitations and may be irritant near the injection site. 9

10 Acid suppressant Why do you need acid suppressants? You stomach naturally produces acid to helps digest your food. In some medical conditions and after taking certain medications, acid production can be increased, which can irritate the lining of the stomach. This can cause pain, bloating and bleeding. How will the medication help? Acid suppressants are used to reduced the acid production in your stomach which will reduce your symptoms and aid healing. 10

11 Lansoprazole Side effects Reduces acid production in the stomach. Lansoprazole is 15 to 30mg once a day. Swallow the whole capsule with water Dispersible tablets of lansoprazole can be dissolved on the tongue. Side effects include gastrointestinal disturbances such as diarrhoea and abdominal pains. The doctor may prescribe different doses to those specified above, please follow the instructions on the medication package that has been given to you. Omeprazole Reduces acid production in the stomach. Omeprazole is 20 to 40mg once a day. Side effects Swallow the whole capsule with water. Side effects include gastrointestinal disturbances such as diarrhoea and abdominal pains. The doctor may prescribe different doses to those specified above, please follow the instructions on the medication package that has been given to you. 11

12 Clot prevention Why do I need to take this medication? After an operation the blood is more likely to clot which is where the cells clump together to form a mass and can block the vessels in the body. This is caused by the inflammation and stress the body goes through during and after surgery and also the immobility you may have when being bed-bound after the operation. These medicines help to thin the blood by increasing the time it takes for a clot to develop in the body but not all patients who have had surgery will require clot prevention medication. If you have had abdominal surgery the usual duration is four weeks in total from the day of your operation. 12

13 Dalteparin (Fragmin) Dalteparin reduces the activity of a component of our blood called thrombin, which is an important factor in clotting. Usually the dose is 5,000 units or 2,500 units ONCE a day. This usually entails injecting the entire contents of the syringe provided, unless directed otherwise. Main side effects Dalteparin is injected subcutaneously which literally means under the skin. An area of the skin on the buttocks or abdomen can be pinched together and used as the site of injection. Side effects include increased bleeding time and you should contact your GP if you develop a bleed. Try to take at the same time per day e.g. at 6pm. Administer the medication for the duration instructed by your doctor or as documented on the label. Check with your doctor, nurse or pharmacist if you are prescribed any other medicines that thin the blood and can increase the risk of bleeding. 13

14 Laxatives Why do I need to take this medication? There are two main reasons why laxatives are usually required after general surgery. Firstly, the anaesthetic medicines used during the operation can cause the bowel to relax and slow down which means that when you wake up, it can be some time before your bowels open. Secondly, pain relief such as opioids (e.g. codeine, tramadol and morphine) commonly cause constipation. When and how do I take this medication? Take these medicines as your doctor has prescribed. They are usually required regularly after the operation. Senna Senna is a stimulant laxative which means it causes the bowel muscles to contract which pushes stools through the bowels. Senna is best taken at night and the normal dose is ONE (7.5mg) or TWO (15mg) tablets. Senna is available as tablets or as a liquid. The tablets should be swallowed with water. Main Side effects Mainly diarrhoea as senna increases bowel movement. It can also cause stomach pain. Patients can become reliant on senna to pass stools effectively and can develop constipation again once stopping the medicine. 14

15 Lactulose Lactulose acts as an osmotic laxative. When it is taken and reaches your bowels, the sugar content draws water into the stool and makes it softer and easier to pass. Lactulose is measured in the oral cup provided and is taken at varied doses depending on the severity of constipation. Pour lactulose into the oral cup provided and drink. This medicine can usually take several days to have an effect. Main Side effects Flatulence, diarrhoea and bloating. Ensure you are drinking plenty of fluids alongside taking this medicine unless you have been directed otherwise by your doctor. May take 2-3 days to work. Macrogol compound powder (Movicol / Laxido) Movicol acts as an osmotic laxative. When it is taken and reaches your bowels, the medication draws water into the stool and makes it softer. Movicol is variably ONE or TWO sachets as needed. Mix each sachet with roughly the required amount of water indicated on the box. The contents of the sachets are mixed with water or juice before being consumed. Main Side effects Flatulence, diarrhoea and bloating. Ensure you are drinking plenty of fluids alongside taking this medicine unless you have been directed otherwise by your doctor. May take 2-3 days to work. 15

16 Antibiotics Why do I need to take this medication? You may be required to take a course of antibiotics if you have been diagnosed with an infection. You may have been given this medicine as an injection during your hospital stay and may require oral tablets to complete the course. There are many different types of antibiotics available but only the common types are listed here. When and how do I take this medication? Take at regular intervals and make sure you complete the course, even if you start to feel better. If you develop an allergic reaction to your antibiotic such as a rash, swelling or problems with breathing stop taking your medication and seek medical help. Flucloxacillin Flucloxacillin is part of the penicillin class of antibiotics and is useful for skin infections. Usually one to two capsules FOUR times a day. Take half an hour to one hour before meals. Main Side effects Side effects include allergic reactions as listed above, diarrhoea, sickness and vomiting. Make sure you take at regular intervals and complete the course. Do not take this medicine if you have had an allergic reaction to a type of penicillin in the past and you should speak to your doctor, nurse of pharmacist if you have any concerns. 16

17 Co-amoxiclav Co-amoxiclav is part of the penicillin class of antibiotics and is useful for a wide range of Main Side effects Usually one tablet THREE times a day. Take with or just before food / meals. Space doses evenly throughout the day. Side effects include allergic reactions as listed above as well as diarrhoea, sickness, vomiting and thrush. Make sure you take at regular intervals and complete the course. You should not take this medicine if you have had an allergic reaction to a type of penicillin in the past. Speak to your doctor, nurse of pharmacist if you have any concerns. Metronidazole Main Side effects Metronidazole is an antibiotic which is used to treat a variety of infections. Usually one 400mg tablet two to three times a day. Swallow the tablets whole and take with or just after food or a meal with a full glass of water. Nausea, vomiting and facial flushing which can be worsened if taken with alcohol. Avoid alcohol drinks and foods containing alcohol. This medication may also be supplied as a liquid formulation and you should speak to your doctors, nurse or pharmacist if you have any concerns. 17

18 Doxycycline Main Side effects Doxycycline is part of the tetracycline group of antibiotics and is useful for treating a wide range Usually one or two capsules ONCE a day Take on an empty stomach with a full glass of water and take sitting upright as you can irritate the gullet. Side effects include allergic reactions as listed above. Other effects can be diarrhoea, sickness, skin sensitivity and thrush. Doxycycline can be affected by other medications and supplements such as calcium - please ask your doctor or pharmacist if you think your usual medication may be affected. Avoid direct sunlight whilst taking this medication as it can make your skin more sensitive. Trimethroprim Main Side effects Trimethoprim is an antibiotic useful for treating urinary tract infections. Usually one tablet TWICE a day. Try and space doses 12 hours apart. Not affected by food or drink. Feeling sick, vomiting (usually resolve after stopping drug). If you have skin rashes then you should stop using the drug and inform your GP. Can occasionally cause high blood potassium levels. Inform your doctor if you develop any symptoms such as muscle cramps, pain, irregular heartbeat or unusual weakness / tiredness. 18

19 Ciprofloxacin Main Side effects Ciprofloxacin is part of the quinolone class of antibiotics and is useful for a wide range of infections. 250 to 500mg two times a day. Swallow the tablets whole. Make sure you take the medication at regular intervals and complete the course. Side effects include gastro intestinal disturbances such as diarrhoea, nausea and vomiting. Some patients experience dizziness or fainting episodes whilst taking this medication. Ciprofloxacin can be affected by milk, other medications and supplements such as Iron & Zinc please ask your doctor or pharmacist if you think your usual medication may be affected. Useful Contact Numbers If you require further information, talk to your GP for advice. Alternatively, contact our Medicines Information helpline on If you have a query regarding your inpatient stay, contact the ward you were staying on via the hospital switchboard. 19

20 If you have any questions, write them down here to remind you what to ask when you speak to your nurse/doctor. 20

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24 Leaflet Produced: April 2017 Review: April 2019 (Pankhania)SUR Today s research is tomorrow s care We all benefit from research. Leicester s Hospitals is a research active Trust so you may find that research is happening when you visit the hospital or your clinic. If you are interested in finding out how you can become involved in a clinical trial or to find out more about taking part in research, please speak to your clinician or GP. If you would like this information in another language or format, please contact the service equality manager on