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Drugs - third year > Compact Drug R/V > Flashcards

Compact Drug R/V Flashcards

1
Q

Amitriptyline

A

Is a tricyclic antidepressants

used to be used for depression but is better for neuropathic pain

with SE like dry mouth, drowsiness, hypotension, urinary retention, blurred, vision, constipation, GORD, ECG changes

interactions, don’t use with monoamine oxidase inhibitors they do the same thing

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2
Q

SSRIs

A

Citalopram and fluxetine

First line for depression

SE:
GI Sx commonest
risk of bleeding, consider PPI
QT prolong

Interactions
NSAIDS consider PPI, even aspirin
warfarin/heparin
Triptans

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3
Q

Benzodiazipines

A

Diazepam - increase effect of inhibitory GABA and increases frequency of chloride channels

Sedation

Easily addictive - prescribe for 2-4wks only
Benzodiazepine withdrawal syndrome if withdrawn quickly

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4
Q

acetycholinesterase inhibitors

A

Donepezil

Dementia

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5
Q

Bisphosphonates

A

Alendronate

decrease demyelation in bone and inhibit osteoclasts by reducing reabsorption and promoting apoptosis

uses: Osteoporosis and hypercalcaemia

SE: increased risk of fracture, esophagus and osteonecrosis of jaw

patients sit up or stand for 30minz when taken - the fuck,,

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6
Q

biguanides

A

Metformin
1st line for DM T2

increases sensitivity of insulin and decreases gluconeogensis

SE: GI Sx commonest. no hypoglycemia and improves weight

interactions: CKD, MI,SEPSIS, AKI, IV contrast, alcohol abuse

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7
Q

Sulphonylureas

A

Gliclazide
T2DM

promotes production of insulin for pancreas

SE GI upset weight gain and hypoglycaemia hyponatreamia

increased risk of hypoglycaemia when take with other DM drugs

loops, thiazide, and predinisolone reduce efficacu

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8
Q

insulin

A

classified in source and duration of actiion

usese DM hyperkalaemia

mod promotes glucose inside cells. promotes K inside cells temporarly

SE - hypoglycemia, weight gain, lipodystrophy

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9
Q

thyroid hormones

A

levothyroxine(orally only)

hypothyroidism

Se - hyperthyroid Sx, AF, worse angina

interactions P450 and DM
absorption reduced by iron

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10
Q

Carbimazole

A

hyperthyroidism

reduces production of T3 and T4

agranulocytosis and crosses placenta, can be given at very low doses in pregnancy

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11
Q

ACE-i

A

Ramipril lisinopril
inhibit angiotensin i to ii

SE COUGH hyperkalaemia, angioedema, first dose hypotension

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12
Q

digoxin

A

positively inotropic - increase strength of contraction

SE gynacomastia

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13
Q

spironolactone

A

aldosterone antagonist

SE gynacomastia and hyperkalaemia

avoid in pregnancy

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14
Q

Levodopa

A

for parkinsonism
usually combined with decarboxylase

SE postural hypotension
dyskinesia ‘on-off’ effect cardiac arrhythmias n/v psychosis reddish discolouration of urine upon standing

Dry mouth!

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15
Q

Carbamazepine

A

anticonvulsant
epilepsy - 1st line for focal/partial seizures and 2nd line for GTCS

binds to Na channels

dizzy and ataxia, drowsy, SIADH, steven johnson syndrome, visual dysturbance
pregnancy caution
p450 inducer

SE - diploplia

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16
Q

Phenytoin

A

epilepsy
binds to Na channels too

facial changes! Nystagmus!
allergy
resp/cvs collapse
gradual
p450 inducer
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17
Q

Sodium valproate

A

anticonvulsant
epilepsy

increases GABA activity

SE Nausea Increase W and A pancreatitis hyponatreamia
avoid in 1st trimester of pregnancy

Weight gain! And tremor!! Anorexia! Alopecia!

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18
Q

Lamotrigine

A

anticonvulsants

Na channel blocker

steven johnson syndrome

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19
Q

NSAIDs

A

naproxen, diclofenac, ibuprofen
inhibit enzyme cox
pain and inflammation

SE peptic ulcer
AKI stop
CVS events - dicolfenac
allergy

interact - aspirin, corticosteroids, warfarin, SSRI, ACE diuretics

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20
Q

paracatemol

A

non-opioid
acute and chronic pain
fever

poor inhibitor of cyclooxygenase

SE few - OD

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21
Q

weak opioids

A

codeine
Mild to moderate pain

metablosed in liver to morphine the anatgonised micro opioids receptors
Tramadol is synthetic and moderate opioid

nausea, costipation, drowsiness, resp depress

codeine and dihydrocodeine never give IV (like anaphlyaxis)

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22
Q

strong opioids

A

morhpine, oxycodone
acute severe pain, chronic pain, SOB, pulmonary oedema

activate opioid micro receptors

SE resp depress, N/V, constipation, pupillary constriction. tolerance, dependance, withdrawl Sx

avoid in billary colic
dnt use with other sedating drugs

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23
Q

WHO analgesic ladder

A

1st
Paracetamol

2nd
Paracetamol + codeine +/- NSAID
codeine or co-codamol, co-dydramol, tramadol

3rd
Paracetamol + opioid +/- NSAIDs

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24
Q

Allopurinol

A

xanthine oxidase inhibitor

Gout

only start after 2wks of gout settle but never start during or never stop during

give NSAID or colchincine when starting it

interacts with Azathioprine

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25
Antacids
Gaviscon layer SE constipation diarrhea
26
H2 antagonists
Ranitidine peptic ulcer, GORD reduce gastric acid secretion few SE ranitidine no interactions
27
PPI
lansoprazole, omeprazole Works by blocking H/K ATP system aka the proton pump which normally secretes H+ It blocks it irreversibly SE- rare - hypomagnasemia if long term interactions
28
anitdiarrheals
loperamide diarrhea agonist of opioid micro receptors SE very few no interactions
29
Aminosalicylates
Mesalazine 1st line UC, replaced sulfasalazine sulfasalazine - RA 5-aminosalicylic acid (5-ASA) - release rare SE is blood disorder, but seerious
30
Antiemetics
Metoclopremide - causes parkinsonism N and V and reduce gut motility block serotonin signals to CNS SE rare - depression, blood disorders, movement disorders
31
Loop diuretics
Furosemide inhibits Na/K/Cl reabsorption in loop of henle also increases prostaglandin levels causing vasodilation, while NSAIDs block prostaglandin synthesis. SE dehydration and hypotension. increases Cl. electrolytes disturbances. hearing loss and tinnitus.
32
Thiazides
Blocks resoprtion in thiazide dependant NaCl channels. SEGout, decrease insulin secretion and peripheral insulin sensitivity. Careful with DM
33
Potassium sparing diuretics
Increased K can cause leg cramps and arrythmias works by blocking aldesterone
34
Beta blockers
``` dont use in Asthma/COPD cradiac failure bradycardia complete heart block ``` SE - impotence
35
CCB
Amlodopine(puffy feet) diltiazem verapamil can cause Oedema, swollen ankles Same as Beta blockers - except asthma/COPD
36
antidysarrythmiacs
Amiadarone cant use in preg or 2nd or complete Hrt Block SE: pulmonary fibrosis, thyroid, abnormal liver tests, prolong QT
37
Aspirin and clopidogrel
works as NSAID and antiplatelet SE: tinnitus, asthma, GI bleeding and ulcers caution in children <16
38
Heparin
Heparins and fondaparinux can be use in preg inhibits thrombin and Xa CI: severe liver disease, bleeding disorders, severe HTN SE: bleeding, increased K , osteoporosis
39
Warfarin
Aka coumarin inhibits hepatic production of vitamin K cant use in preg reversed by giving K
40
Statins
HMG CoA reductase inhibitors SE rhabdomyolysis increased liver AST/ALT muscle aches cant use in preg
41
Beta2 agonists
SE: Tremor anxiety palpitations
42
Anticholinergics
work by blocking Ach parasympathetic system Eg- tiotropium and ipratropium SE - dry mouth, blurred vision, poor coordination, GORD
43
Corticosteroids
cant use in preg SE: Mood changes, easy bruising, cushings, oedema and HTN, DM, cataracts
44
Mucolytics
Carbocysteine dissolves mucus making it thinner
45
Theophyllines
Relaxes smooth muscles Increases HR, BP Narrow TI SE- seizures, headaches, insomnia Metabolised by cytochrome p450 - COPD Rx with erythromycin
46
5 alhpa redutase inhibitors
Finasteride 2nd line BPH MOD - reduce size of bladder by inhibiting intracellurlar enzyme 5a-reductase. converts testesterone to its active metabolite dihydrotestosterone SE Impotence, reduced libido, gynacomastia, breast cancer in men No interactions
47
Alpha blockers
Doxazocin 1st line BPH or HTN when all other Rx failed MOD - A1 adrenoreceptors causes vasodilation and reduced resistance to bladder outflow SE Postural hypotension Dizzyness and syncope Interactions - careful when combining with other antihypertensive drugs
48
Drugs causing GORD
Tricyclic antidepressants anticholinergics nitrates
49
Penicillins
Peptidoglycans many infections soft RTI amoxicillin, tazobactam, augmentin, co-amoxiclav - Cdiff risk and cholestatic jaundice
50
Nitrofurantoin
Metabolites UTI No interactions SE - Dark urine
51
Trimethoprim
inhibits folate synthesis Doxycycline UTI - 1st 1st trimester of pregnancy
52
Tetracyclines
30s subunit Acne and other infections photosensitivity and discoloration/ hypoplasia of tooth enamel
53
Cephalosporins
Cephradine/cefradine, cefuroxime peptidoglycans broad spectrum Cdiff risk, Blactam allergy peylonephritits
54
Quinolones
Ciprofloxacin, levofloxacin rapid resistance inhibit DNA synthesis SE QT and arrythmias, tendon rupture P450 inhibitor
55
Aminoglycosides
Gentamicin 30s irreversible inhibition Nephrotoxicity and ototoxicity
56
glycopeptides
Vancomycin - requires monitoring peptidoglycan endocarditis or 2nd Cdiff SE IV thrombophlebiits, red man syndrome
57
Macrolides
Erythromycin, clarithromycin 50s inhibition severe gram-ve infections 1st line penicillin substitute P450 inhibitor
58
Metronidazole
DNA passive then degredation Cdiff 1st line P450 inhibitor Only for anaerobes
59
Oxygen
Hypoxaemia, Pneumothorax, carbon monoxide poisoning Problems with mask warning- chronic T2 resp failure (severe COPD), high oxygen may cause respiratory acidosis, therefore aim 88-92 no interactions
60
Laxatives
stimulant Senna Constipation and faecal impaction MOD - increase H2O and elecrolyte secretion --> increased volume of colonic contents --> promotes peristasis no interactions
61
Nitrates
isosorbide mononitrate, glyceryl trinitrate angina Rx or prophylaxis with CCB/B-blocker. pulmonary oedema with furosemide and O2 MOD - nitrates - nitric oxide --> reduces intracellular Ca in smooth muscle cells SE flushing, headache, hypotension, tolerance Interact- never with phosphodiasterase inhibitors (sildenafil-viagra) and caution with other antihypertensives
62
Amiodarone
AF, atrial flutter, SVT, VT, VF, usually used when other meds inaffective MOD- Na/Ca/K channels blocked and antagonism of a- and B- adrenergic receptors. reduces ventricular rate in AF and atrial flutter SE - long half life, thrombophlebitis, QT interval, thyroid changes, skin grey discoloration, fatty liver disease Interact - less effective warfarin verapamil and diltiazem, digoxin
63
NOACs
Apixaban, Rivroxiban, dabigatran Prevention of VTE after surgery In AF pts to prevent stroke DVT and PE Rx and reduce risk recurrence MOD - directly blocks Xa --> blocks conversion of thrombin to prothrombin Dabigatran - directly inhibits thrombin SE - bleeding nausea hypotension Interactions- other blood thinners and severe HTN
64
Mineralcorticoids
fluid retention hypertension
65
Glucocorticoids
endocrine: impaired glucose regulation, increased appetite/weight gain, hirsutism, hyperlipidaemia Cushing's syndrome: moon face, buffalo hump, striae musculoskeletal: osteoporosis, proximal myopathy, avascular necrosis of the femoral head immunosuppression: increased susceptibility to severe infection, reactivation of tuberculosis psychiatric: insomnia, mania, depression, psychosis gastrointestinal: peptic ulceration, acute pancreatitis ophthalmic: glaucoma, cataracts suppression of growth in children intracranial hypertension
66
clindamycin
avoided in elderly because of Cdiff risk >65
67
Drugs causing GORD
Biphosphonates
68
Biphosphonates
Commonest SE is irritation, inflamation, ulceration of oesophagus

Drugs - third year (28 decks)

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