Drug names Flashcards
Imatinib, nilotinib, dasatinib, erlotinib
Tyrosine kinase inhibitors
First line for CML- imatinib
Side effects: rash, cytopenia, fluid retention, abnormal LFTs.
Atenolol, bisoprolol, metoprolol, propranolol
Beta blockers
Hypertension, angina, arrhythmias
Water-soluble beta-blockers (such as atenolol, celiprolol hydrochloride, nadolol, and sotalol hydrochloride) less likely to enter the brain, cause less sleep disturbance and nightmares. Excreted by the kidneys and dosage reduction is often necessary in renal impairment.
Contraindicated in heart block and unstable HF
Contraindicated in asthma (bronchospasm)
Non selective- propranolol
Selective- atenolol
Ramipril, lisinopril, captopril, enalapril
ACEi
Hypertension- first line in diabetes, aged under 55, caucasian
Ramipril: 1-2.5 mg once daily
S.E. dry cough, first dose hypotension (take at night), angioedema
CI- AKI, pregnancy
Hyperkalaemia
Triple whammy - diuretic, NSAID, ACEi- AKI
Monitor renal function and electrolytes
Citalopram, fluoxetine, sertraline, paroxetine
SSRI
Depression 1st line; better tolerated and safer in overdose
Angina or MI = sertraline
Serotonin syndrome- flushing
QT prolongation with citalopram
S.E. Palpitations, tachycardia, dry mouth
Increased bleeding risk- interaction with NSAIDs and anticoagulants
Omeprazole, lansoprazole
PPI
Dyspepsia/ GORD
Reduce gastric acid
S.E. Hypomagnesemia
Osteoporosis / increased risk of fractures
Vitamin deficiency
C diff risk
Ipratropium, tiotropium
Muscarinic receptor antagonists
Asthma/COPD
Add on therapy for severe exacerbations
Adults and children aged 12 years and older — 20 to 40 micrograms 3 to 4 times daily.
Cautioned in glaucoma
Dry mouth- interact with anticholinergics
Ibuprofen, naproxen, diclofenac, indomethacin, aspirin
NSAID
Pain, RA
CI: Active GI bleeds, history of gastric ulcer, severe HF, severe renal impairment, severe hepatic impairment. COX-2 not suitable for patients with ischaemic heart disease
S.E. GI bleeds- require gastroprotection if taking long term, ulceration, dyspepsia
Renal impairment
Interact with alendronate, ACEi, anticoagulants, SSRI, beta-blockers, corticosteroids, ciclosporin, fluconazole, lithium, furosemide, methotrexate, spironolactone, ciprofloxacin, bendroflumethiazide
Monitoring: renal function, blood pressure, liver function, haemoglobin
Amlodipine, felodipine
Calcium channel blockers
Hypertension
55 and over, black, no diabetes
CI: HF, severe hypotension
S.E: Vasodilatory adverse effects (facial flushing, headaches, postural hypotension, and ankle swelling)
Interactions: Antiarrhythmics, anticoagulants, antifungals, antiretrovirals, carbamazepine, beta-blocker, ciclosporin, digoxin, macrolide antibiotics, statins
Selegiline, moclobemide, phenelzine, isocarboxazid
MAOI
Depression- use by specialist- after TCA fail
Interaction with food - cheese reaction
Interact with tyramine and increase BP
Don’t give with SSRI - increased serotonin syndrome risk
Diazepam, clobazam, lorazepam, temazepam
Benzodiazepine
Anxiety- first line
Methotrexate, sulfasalazine, azathioprine, leflunomide, penicillamine
DMARD
RA, IBD
Methotrexate-
once weekly
take folic acid on alternative day
blood disorders- sore throat, bruising, fever
Azathioprine- Patients and their carers should be warned to report immediately any signs or symptoms of bone marrow suppression such as inexplicable bruising, bleeding or infection.
Nausea is common in early treatment, usually resolves after a few weeks. Can be managed by using divided doses, taking with or after food, prescribing anti-emetic or temporarily reducing the dose. Not significant enough to warrant an immediate referral. Measure TPMT activity.
Infliximab, adalimumab, etanercept, golimumab
bDMARD
RA
Prescribe by brand
Allopurinol, colchicine, febuxostat
Gout-
Colchicine: can be used for short term prophylaxis during initial therapy with allopurinol. For the treatment of acute gout, a maximum of 12 tablets should be prescribed per course, and the course should not be repeated within three days. The most common side effects are diarrhoea, nausea, vomiting and abdominal pain
Isoniazid, rifampicin, ethambutol, pyrazinamide
TB
Rifampicin- enzyme inducer, discolours urine orange/red. Watch out for signs of liver toxicity i.e. nausea, vomiting, malaise, jaundice.
Atorvastatin, simvastatin, lovastatin, pravastatin, rosuavastatin, fluvastatin
Statins- inhibit HMG CoA reductase
Hypercholesterolemia
Take at night (simvastatin)
CI: liver disease, pregnancy
S.E. rhabdomyolysis, myalgia, myopathy, hyperglycemia
Interactions: amiodarone, ciclosporin, danazol, CCB (max 20mg simvastatin), erythromycin, ezetimibe, fibrates, HIV protease inhibitors, azole antifungals, grapefruit, St Johns Wort
Monitor: HbA1C, LFT, lipid profile, creatine kinase
Loperamide
Diarrhoea
Opioid
Carbamazepine, sodium valproate, lamotrigine, phenytoin, phenobarbital, pregabalin, gabapentin
Anti-epileptics/ anti-convulsants
Epilepsy
Neuropathic pain
Carbamazepine- SJS
Valproate- PPP
Dexamethasone, prednisolone, hydrocortisone, beclomethasone
Corticosteroids
CI: current system infection
Caution: diabetes mellitus, hypertension, and hepatic impairment
Take with breakfast to mimic natural release
Gradual reduction
S.E: Adrenal suppression, osteoporosis, reduced growth in children, weight gain, moon face, cushings syndrome, peptic ulceration, hyperglycaemia,
Dexamethasone test
Carry steroid card
PPI if risk of GI problems
Monitoring: Blood pressure, Body weight, Body mass index (BMI), Height (children and adolescents), Optometrist assessment for glaucoma and cataract, HbA1c or fasting glucose level, triglycerides, and potassium.
Falls risk, osteoporosis risk
Interactions: anticoagulants, antiepileptics, antidiabetic, antifungal, ART, live vaccines, macrolides, methotrexate, NSAIDs, rifampicin, isoniazid, hypokalemia
Propylthiouracil, carbimazole
Hyperthyroidism
Carbimazole can cause agranulocytosis and so sore throat and blood dyscrasias should be monitored
Propylthiouracil preferred in pregnancy
Levothyroxine, liothyronine
Hypothyroidism
Salbutamol, salmeterol, formoterol
B2 agonists/ bronchodilators
Asthma/ COPD
Salbutamol- headaches, muscle cramps, max dose 4, reliever, 5/10 minutes onset
Hyoscine, cinnarizine
Motion sickness
Theophylline, aminophylline
Methylxanthines
Asthma
Prescribe by brand
Narrow TI- 10–20 mg/litre
Affected by smoking
Hypokalaemia
Nausea
Montelukast, zafirlukast
Leukotriene receptor antagonists
Asthma
Montelukast — 10 mg once daily in adults and children aged 15 years and older, 5 mg once daily in children aged 6–14 years, and 4 mg once daily in children aged 6 months to 5 years. Doses to be taken in the evening.
Zafirlukast — 20 mg twice daily in adults and children aged 12 years and older. Not licensed for use in younger children.
H1 receptor antagonist
First-generation antihistamines
Diphenhydramine
Promethazine
Hydroxyzine
Chlorpheniramine
Second-generation antihistamines
Loratadine
Desloratadine
Cetirizine
Levocetirizine
Fexofenadine
Allergic reactions
Hay fever, hives, itching
1st generations cause more sedation
Can cause anticholinergic side effects
H2 receptor antagonists
Ranitidine
Famotidine
Nizatidine
Cimetidine
Reduce stomach acid - peptic ulcers, GORD, ZES
Less effective than PPIs
Verapamil, amiodarone, diltiazem
Anti-arrhythmic calcium channel blocker
Rate limiting
CI: HF, bradycardia, heart block,
Losartan, candesartan, valsartan
ARB
Second-line antihypertensive if ACEi inappropriate
Chlorpormazine, haloperidol, clozapine, risperidone
Antipsychotics
Schizophrenia
Levedopa
Dopamine agonist
Parkinson’s
R-CHOP
Rituximab, cyclophosphamide (bone marrow supression), doxorubicin (cardiomyopathy), vincristine (neuropathy), prednisolone (tumour lysis syndrome- give allopurinol)
NHL
ABVD
Doxorubicin (cardiomyopathy- breathlessness),
bleomycin (pulmonary toxicity, lung fibrosis- breathlessness),
vinblastine (neuropathy- tingling),
dacarbazine (bone marrow suppression)
HL- 28 day cycle
BEACOPP
Blemoycin (pulmonary toxicity, fibrosis), etoposide (bone marrow suppression) , doxorubicin (dilated cardiomyopathy), cyclophosphamide (bone marrow suppression), vincristine (neuroapthy), procarbazine, prednisolone (tumour lysis syndrome)
HL
R-CVP
Rituximab, cyclophoshpamide (bone marrow suppression), vincristine (neuropathy), prednisolone (tumour lysis syndrome)
BR
Bendamustine, rituximab
Glyceryl trinitrate
Angina
Sublingual spray
Can cause headaches
Sildenafil
Viagra
ED
S.E Headaches
Not appropriate for CVD
Interact with GTN
Lithium
Bipolar
Prescribe by brand name
Narrow TI - 0.8-1.2- monitor 12 hours after first dose and 1 week after starting treatment
CI- CVD, renal impairment
S.E. Nausea, vertigo, muscle weakness, diarrhoea, dazed feeling
Long term: thyroid instability, renal impairment
Interactions: diuretics (thiazide), NSAIDs, ACEi, hypokalaemia, haloperidol, carbamazepine, anti-depressants
Toxicity: muscle weakness, ataxia, lack of coordination, tinnitus, dysarthria
Counselling: carry lithium card, regular blood tests, no NSAIDs, vomiting and diarrhoea will increase levels, don’t stop abruptly
Tamsulosin
BPH
Don’t give in hypotension
Can decrease blood pressure
anticholinergic side efefcts
Tranexamic acid
excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation.
alogliptin, linagliptin, saxagliptin, vildagliptin, sitagliptin
DPP-4 inhibitors
T2DM
S.E. Gastrointestinal and URTI
Pioglitazone
Thiazolidinedione
CI in heart failure, increased risk of bladder cancer
Glibenclamide, gliclazide, glimepiride, glipizide, tolbutamide
Sulfonylureas
T2DM
weight gain and hypoglycemia
exenatide, exenatide LAR liraglutide, lixisenatide,dulaglutide, semaglutide
GLP-1 agonists
T2DM
dapagliflozin, canagliflozin, empagliflozin, ertugliflozin
SGLT2 inhibitors
first line if metformin CI and HF
DKA, UTI side effects
weight loss
Tamoxifen
selective estrogen receptor modulator used to prevent breast cancer in women and treat breast cancer in women and men
spironolactone, amiloride, triamterene, aldosterone receptor antagonists and eplerenone
Potassium sparing diuretics
Hyperkalaemia
gynecomastia with spironolactone
Bendroflumethiazide
Thiazide diuretic
Hypokalaemia
Furosemide, bumetanide
Loop diuretics
Pulmonary oedema
S.E Hypokalaemia
Penicillin, amoxicillin, co-amoxiclav, flucloxacillin and phenoxymethylpenicillin
Penicillins
Allergy common
Cefaclor, Cefadroxil, Cefalexin, Cefiderocol, Cefixime, Cefotaxime, Cefradine, Ceftaroline Fosamil, Ceftazidime, Ceftriaxone, Cefuroxime
Cephalosporins- during treatment with cephalosporins, a false positive for glucose in the urine may occur. Should not be given to patients allergic to penicillin. Can be given in pregnancy. Can be prescribed for meningitis. Side effects include diarrhoea which can indicate colitis.
Gentamicin, tobramycin, neomycin
Aminoglycosides
Nephro and ototoxicity- avoid multiple nephrotoxic drugs, monitor renal function
Tetracycline, doxycycline
Tetracyclines
Azithromycin, clarithromycin, erythromycin
Macrolides antibiotic- chest infections
CI - QT prolongation. Caution - AKI
S.E - GI: nausea, abdominal discomfort
Interactions: carbamazepine, CCBs, statins, hypokalaemia, theophylline, warfarin
Ciprofloxacin
Fluoroquinolones- taking NSAIDs at the same time as ciprofloxacin may induce convulsions. Can impair the performance of skilled tasks. Tendinitis is a common side effect for treatment, patients should complete the course and see their GP if symptoms persist after 7 days. Food and/or medicinal products containing calcium, iron and zinc should be avoided for 2 hours before and after a dose.
Meropenem
Carbapenem antibiotic
Vancomycin
Glycopeptide
Narrow TI - 10-20 mg/L
Aztreonam
Monobactam
Linezolid
Oxazolidinones
Rifampicin rifabutin
Rifamycin
Metronidazole, nitrofurantoin, trimethoprim
Antibiotics
Metronidazole + alcohol = disulfram reaction
Nitrofurantoin and trimethoprim - UTI
Abacavir (Ziagen)
Emtricitabine (Emtriva)
Lamivudine (Epivir)
Tenofovir alafenamide (Vemlidy)
Tenofovir disoproxil fumarate (Viread)
Zidovudine (Retrovir)
Nucleotide reverse transcriptase inhibitor
Antiviral
Atazanavir, Darunavir, Lopinavir, Ritonavir
Protease inhibitors
HIV
Doravirine, efavirenz, etravirine, nevirapine
Non-nucleoside reverse transcriptase inhibitors
S.E. rash, nausea, vomiting, diarrhoea
Aciclovir
DNA polymerase inhibitor
Herpes, varicella zoster
Dolutegravir
HIV integrase inhibitor
HIV
Amphotericin, Nystatin
Polyenes antifungals
Amphotericin- Adult patients must be given a test dose of this antifungal prior to their first intravenous infusion in a new course. They then must be observed for at least 30 minutes after the test dose for any signs of anaphylaxis.
Miconazole, clotrimazole, ketoconazole
Imidazoles
Miconazole- athletes foot
clotrimazole- vaginal cream
ketoconazole- shampoo for dandruff
Fluconazole, triconazole, posaconazole, voriconazole
Triazoles
Wide range of superficial and systemic
Caspofungin, micafungin
Echinocandin antibiotic
Aspergillus and candida
Invasive infection and neutropenic infection
Flucytosine
Severe infections
Ciclosporin, tacrolimus
calcineurin inhibitors
immunosuppressants
Take in two divided doses
Blood levels of ciclosporin are increased by grapefruit juice which increases the potential for nephrotoxicity. The solution can however be mixed with orange juice (or squash), apple juice (to improve taste) or with water immediately before taking. This should then be rinsed with more to ensure the full dose is taken. Prescribing and dispensing should be by brand name. If they have to be switched then they must be closely monitored for changes in blood-ciclosporin concentration, serum creatinine, blood pressure and transplant function. Avoid excessive exposure to UV light including sunlight to reduce risk of skin cancer. PUVA should be avoided as it uses Psoralen alongside UV rays which should be avoided to reduce risk of skin cancers.
Ispaghula husk, methylcellulose
Bulk forming laxative
1st line for constipation
Increase stool size, easier to pass
S.E. flatulence, bloating
Senna, glycerol, sodium picosulfate, bisacodyl
Stimulant laxative
S.E. Abdominal pain
Not suitable in pregnancy
6-12 hours onset
Lactulose, magnesium hydroxide, macrogol, polyethylene glycol
Osmotic laxative
S.E. flatulence, abdominal pain, colic
Docusate, arachis oil
Stool softener
Constipation
Nausea
Amitriptyline
Tricyclic antidepressant
More side effects compared to SSRI
Toxic in overdose
More antimuscarinic effects, sedative and cardiotoxicity compared to SSRI
Donepezil
Acetylcholinesterase inhibitor
Alzheimer’s
Dementia
Tofacitinib, baricitinib
JAK inhibitors
RA
Celecoxib
targeting selectivity for COX-2 reduces the risk of peptic ulceration
unsuitable in cardiac patients
Warfarin
Anticoagulant
Bleeding risk
Digoxin
Atrial fibrillation
loading dose of 250 micrograms to 750 micrograms a day for 7 days, followed by a maintenance dose (125 micrograms to 250 micrograms a day)
S.E: Sinoatrial and atrioventricular block.
Premature ventricular contractions (resulting in bigeminy or trigeminy).
PR prolongation and ST-segment depression.
Non-cardiac adverse effects of digoxin include:
Nausea, vomiting, and (less commonly) diarrhoea. Nausea, in particular, is indicative of overdose.
Visual abnormalities (blurred or yellow vision).
Central nervous system effects, such as weakness, dizziness, confusion, apathy, malaise, headache, depression, and psychosis.
Thrombocytopenia and agranulocytosis (rare).
Gynaecomastia in men following prolonged administration (digoxin has oestrogenic activity).
Interactions: antidepressants, beta-blockers, diuretics, St John’s wort, PPI
Danazol
Heavy menstrual bleeding
Side effects include amenorrhoea, hot flushes, sweating, changes in libido, vaginitis and emotional lability. Danazol also causes androgenic side effects such as acne, oily skin and hair, hirsutism, oedema, weight gain, voice deepening and decreasing breast size. Danazol has to be taken daily.
GnRH analogues- Leuprolide, goserelin (zoladex), triptorelin and histrelin
Breast cancer, cervical cancer, endometriosis
Use of the GnRH analogues may evoke menopausal symptoms such as hot flushes, decreased libido, vaginal dryness (topical vaginal lubricants may be helpful), mood changes and headache.
Mefloquine
Treatment and prophylaxis of malaria. Dose: 250 mg once weekly, dose to be started 2–3 weeks before entering endemic area and continued for 4 weeks after leaving. Adequate contraception should be used during prophylaxis and for 3 months after stopping.
It is common for patients to experience abnormal dreams. Use of mefloquine is contraindicated in depression
Griseofulvin
This antifungal is licensed for oral use in the treatment of fungal infections of the scalp; it may impair the performance of skilled tasks and may enhance the effect of alcohol.
Griseofulvin
This antifungal is licensed for oral use in the treatment of fungal infections of the scalp; it may impair the performance of skilled tasks and may enhance the effect of alcohol.
Baclofen
Spasticity, muscle spasms.
Contraindicated in active peptic ulceration.
Side effects: Confusion; constipation; depression; diarrhoea; dizziness; drowsiness; dry mouth; euphoric mood; hallucination; headache; hyperhidrosis; hypotension; nausea; paraesthesia; skin reactions; urinary disorders; vision disorders; vomiting.
Discontinue over 1-2 weeks
Hydroxychloroquine
RA/ Lupus
Antacids should not be taken within four hours of taking hydroxychloroquine as absorption of the drug may be reduced.
The maximum daily dose would be calculated based on ideal body weight to avoid overdosing.
Hydroxychloroquine should be taken with or after food.
Hydroxychloroquine can affect hearing and balance.
Mrs A should be advised to have regular eye tests.
Sulfasalazine
DMARD for RA
full blood counts should be taken upon initiation of treatment, and at monthly intervals during the first 3 months
liver function tests should be performed at monthly intervals for the first 3 months of treatment
patients should be advised that their urine may show a yellow/orange discolouration
patients should be advised to see his GP should he develop a sore throat or fever during treatment
Quinine
Leg cramps at night
Treatment with quinine should only be considered when non-pharmacological measures have failed
Quinine sulfate must be avoided in patients with tinnitus
It may take up to 4 weeks for the patient to notice any benefit from treatment
The patient should expect to stop treatment at 3-monthly intervals and undergo an assessment to see if quinine is still required
Estramustine
Prostate cancer
Cautioned in cardiovascular disease
Manufacturer advises each dose should be taken not less than 1 hour before or 2 hours after meals and should not be taken with products containing calcium, magnesium or aluminium, including dairy products and antacid medication.
