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Core Drug Lists > 204 Core Drugs > Flashcards

204 Core Drugs Flashcards

1
Q

Core Drug : NSAIDs
Mechanism?
Indication?
Side effects?

A

Non-opioid analgesics
The main mechanism of action of NSAIDs is the inhibition of the enzyme cyclooxygenase (COX)
Used for mild to moderate pain and in inflammatory conditions
Side effects - GI toxicity - irritation, ulcers, bleeding, colitis, upper GI bleeding, nephrotoxicity

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2
Q 
Core Drug : Aspirin
Drug class?
Mechanism? 
Indication? 
Side effects?
A

NSAIDS
Use for pain and inflammation limited by
- GI toxicity
- Tinnitus – mechanism obscure, usually reversible
- Reye’s syndrome (fulminant hepatic failure in children)
Anti-platelet effect
- Primary and secondary prevention eg stroke and MI
- Treatment of acute MI and stroke

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3
Q 
Core Drug : Ibuprofen
Drug class?
Mechanism? 
Indication? 
Side effects?
A

NSAIDs
Ibuprofen available over the counter is demonstrably the least associated with side-effects
but can include - Irritation
Ulcers (gastric 15-30%, duodenal 10%)
Bleeding, Colitis, upper GI bleeding
Used for mild to moderate pain and inflammation

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4
Q 
Core Drug : Ciclosporin
Drug class?
Mechanism? 
Indication? 
Main toxicities?
A

Ciclosporin belongs to a group of medicines called immunosuppressants - DMARDs
Inhibits calcineurin, which in turn reduces T lymphocyte activity
Similar indications to aza/ metho, but used more in Dermatology and transplantation
Main toxicities
- Nephrotoxic
- Hepatotoxic
- Gum hyperplasia
- Hirsuitism
Note tacrolimus (newer formulation) is easier to take, and available for topical use (esp eczema)

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5
Q 
Core Drug : Azathioprine
Drug class?
Mechanism? 
Indication? 
what upset is very common?
A

Azathioprine is a type of medicine called an immunosuppressant (DMARD).
Inhibits thiopurine S methyltransferase (TPMT), so also inhibits purine synthesis
Similar indications to methotrexate; more widely used in transplantation compared to methotrexate
Toxicities similar to methotrexate; GI upset very common when starting

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6
Q 
Core Drug: Methotrexate
Drug class?
Mechanism? 
Indication? 
Side effects?
A

Methotrexate belongs to the class of chemotherapy drugs called antimetabolites. (DMARDs)
Competitive inhibitor of dihydrofolate reductase (DHR), therefore anti-folate action
Folate needed for purine synthesis in DNA
This reduces T cell activity, and also (in higher doses) tumour synthesis
Main indications
Rheumatoid arthritis
Psoriasis
Crohns disease
Main toxicities
Hepatotoxicity
Leucopenia
Pulmonary fibrosis
Teratogenic
NOTE weekly dosing; errors have caused major toxicity

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7
Q

What DMARD has weekly dosing?

A

Methotrexate - NOTE weekly dosing; errors have caused major toxicity

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8
Q

Core Drug: Infliximab
Drug class?
Mechanism?
Indication?

A

TNF blocker - Infliximab – partially humanized mouse monoclonal anti-hTNF-a antibody
Used for Rheumatoid arthritis
NICE only approves infliximab, if combined with MTX
- Combined with MTX, they give excellent joint protection
Also used for the treatment of Crohn’s disease, ulcerative colitis, plaque psoriasis, ankylosing spondylitis

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9
Q

First choice DMARD, the gold standard

A

Methotrexate

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10
Q

Side effects of DMARDs

A 
Nausea
Loss of appetite
Diarrhoea
Rash, allergic reactions
Headache
Hair loss
Risk of infections (pneumonia)
Hepatotoxicity (metabolism) 
Kidney toxicity (route of elimination)
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11
Q

The TNF-blockers

- combined with … they give excellent joint protection

A

Combined with MTX, they give excellent joint protection

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12
Q

Core Drug: Rituximab
Drug class?
Mechanism?
Indication?

A

Partially humanized anti-CD20 mAb - Rituximab opsonized B-cells are attacked and killed by three mechanisms:
1)Complement mediated cytotoxicity
2-3) Antibody-dependent cell mediated cytotoxicity (ADCC) – FcgR or CR mediated opsonic phagocytosis
4) Apoptosis

Treatment of Rheumatoid arthritis (Also used for the treatment of SLE) and some cancers

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13
Q

Core Drug: Allopurinol
Drug class?
Mechanism?
Indication?

A

Allopurinol is a medicine used to lower levels of uric acid in your blood
mainly used for the long-term treatment and prevention of gout

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14
Q

Core Drug: Colchicine
Drug class?
Mechanism?
Indication?

A 
Colchicine is in a class of medications called anti-gout agents - used for an Acute gout attack
Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s)
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15
Q

acute gout attack drug vs long term?

A

Colchicine - acute gout attack

allopurinol - long term

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16
Q

Core Drug: Chlorphenamine
Drug class?
Mechanism?
Indication?

A

H1 Antihistamines - Inverse agonists at H1 histamine receptor
Best used before exposure to allergen
1st generation - Considerable sedation, drug interactions

17
Q 
Core Drug: Alendronate 
Drug class?
Mechanism? 
Indication? 
Side effects?
A

Alendronate is used to treat and prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who have undergone menopause (‘‘change of life,’’ end of menstrual periods) and to treat osteoporosis in men
Inhibit osteoclast-mediated bone-resorption
Side effects - stomach pain; acid reflux; constipation; diarrhea; upset stomach; nausea; muscle and joint pain.

18
Q

Postmenopausal women are at increased risk for …

A

Postmenopausal women are at increased risk for osteoporosis.

19
Q

Core Drug: Pamidronate
Drug class?
Mechanism?
Indication?

A

Pamidronate belongs to a group of drugs called bisphosphonates.
Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone turnover.
By intravenous infusion
Indication - Hypercalcaemia of malignancy, Paget’s disease

20
Q

Core Drug: Disodium etidronate
Drug class?
Mechanism?
Indication?

A

Etidronate is used to treat a certain type of bone disease called Paget’s disease. This disease weakens and deforms bones

21
Q

Osteoporosis drugs (…) are the most common treatment for Paget’s disease of bone

A

Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget’s disease of bone

Core Drug Lists (12 decks)

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