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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Benzodiazepine withdrawal syndrome if withdrawn quickly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
Q

Antacids

A

Gaviscon
layer
SE constipation diarrhea

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26
Q

H2 antagonists

A

Ranitidine
peptic ulcer, GORD

reduce gastric acid secretion

few SE
ranitidine no interactions

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27
Q

PPI

A

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

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28
Q

anitdiarrheals

A

loperamide
diarrhea

agonist of opioid micro receptors

SE very few
no interactions

29
Q

Aminosalicylates

A

Mesalazine 1st line UC, replaced sulfasalazine
sulfasalazine - RA

5-aminosalicylic acid (5-ASA) - release

rare SE is blood disorder, but seerious

30
Q

Antiemetics

A

Metoclopremide - causes parkinsonism

N and V and reduce gut motility

block serotonin signals to CNS

SE rare - depression, blood disorders, movement disorders

31
Q

Loop diuretics

A

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
Q

Thiazides

A

Blocks resoprtion in thiazide dependant NaCl channels.

SEGout, decrease insulin secretion and peripheral insulin sensitivity. Careful with DM

33
Q

Potassium sparing diuretics

A

Increased K can cause leg cramps and arrythmias

works by blocking aldesterone

34
Q

Beta blockers

A 
dont use in 
Asthma/COPD
cradiac failure
bradycardia
complete heart block

SE - impotence

35
Q

CCB

A

Amlodopine(puffy feet) diltiazem verapamil

can cause Oedema, swollen ankles

Same as Beta blockers - except asthma/COPD

36
Q

antidysarrythmiacs

A

Amiadarone

cant use in preg or 2nd or complete Hrt Block

SE: pulmonary fibrosis, thyroid, abnormal liver tests, prolong QT

37
Q

Aspirin and clopidogrel

A

works as NSAID and antiplatelet

SE: tinnitus, asthma, GI bleeding and ulcers
caution in children <16

38
Q

Heparin

A

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
Q

Warfarin

A

Aka coumarin

inhibits hepatic production of vitamin K

cant use in preg

reversed by giving K

40
Q

Statins

A

HMG CoA reductase inhibitors

SE rhabdomyolysis
increased liver AST/ALT
muscle aches

cant use in preg

41
Q

Beta2 agonists

A

SE: Tremor anxiety palpitations

42
Q

Anticholinergics

A

work by blocking Ach parasympathetic system
Eg- tiotropium and ipratropium

SE - dry mouth, blurred vision, poor coordination, GORD

43
Q

Corticosteroids

A

cant use in preg

SE: Mood changes, easy bruising, cushings, oedema and HTN, DM, cataracts

44
Q

Mucolytics

A

Carbocysteine

dissolves mucus making it thinner

45
Q

Theophyllines

A

Relaxes smooth muscles
Increases HR, BP
Narrow TI

SE- seizures, headaches, insomnia

Metabolised by cytochrome p450 -

COPD Rx with erythromycin

46
Q

5 alhpa redutase inhibitors

A

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
Q

Alpha blockers

A

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
Q

Drugs causing GORD

A

Tricyclic antidepressants

anticholinergics

nitrates

49
Q

Penicillins

A

Peptidoglycans

many infections soft RTI

amoxicillin, tazobactam, augmentin,

co-amoxiclav - Cdiff risk and cholestatic jaundice

50
Q

Nitrofurantoin

A

Metabolites

UTI

No interactions

SE - Dark urine

51
Q

Trimethoprim

A

inhibits folate synthesis

Doxycycline

UTI - 1st

1st trimester of pregnancy

52
Q

Tetracyclines

A

30s subunit

Acne and other infections

photosensitivity and discoloration/ hypoplasia of tooth enamel

53
Q

Cephalosporins

A

Cephradine/cefradine, cefuroxime
peptidoglycans

broad spectrum

Cdiff risk, Blactam allergy

peylonephritits

54
Q

Quinolones

A

Ciprofloxacin, levofloxacin

rapid resistance

inhibit DNA synthesis

SE QT and arrythmias, tendon rupture
P450 inhibitor

55
Q

Aminoglycosides

A

Gentamicin

30s irreversible inhibition

Nephrotoxicity and ototoxicity

56
Q

glycopeptides

A

Vancomycin - requires monitoring
peptidoglycan

endocarditis or 2nd Cdiff

SE IV thrombophlebiits, red man syndrome

57
Q

Macrolides

A

Erythromycin, clarithromycin
50s inhibition

severe gram-ve infections
1st line penicillin substitute

P450 inhibitor

58
Q

Metronidazole

A

DNA passive then degredation

Cdiff 1st line

P450 inhibitor

Only for anaerobes

59
Q

Oxygen

A

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
Q

Laxatives

A

stimulant Senna
Constipation and faecal impaction

MOD - increase H2O and elecrolyte secretion –> increased volume of colonic contents –> promotes peristasis

no interactions

61
Q

Nitrates

A

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
Q

Amiodarone

A

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
Q

NOACs

A

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
Q

Mineralcorticoids

A

fluid retention

hypertension

65
Q

Glucocorticoids

A

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
Q

clindamycin

A

avoided in elderly because of Cdiff risk

> 65

67
Q

Drugs causing GORD

A

Biphosphonates

68
Q

Biphosphonates

A

Commonest SE is irritation, inflamation, ulceration of oesophagus

Drugs - third year (28 decks)

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