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