Drug of the Day Flashcards

1
Q

Theophylline

A

Drug class: Phosphodiesterase Inhibitor/Adenosine Inhibitor

Common indications: Asthma

Other Important Drugs in Class: Aminophylline

Mechanism of action: Inhibits action of phosphodiesterase and adenosine, relaxing bronchial smooth muscle; inhibits T-Cell proliferation and cytokine production

Important adverse drug reactions: NV; Insomnia; Anxiety; Tachycardia; Arrhythmia

Contraindications: Serum levels should be monitored

Important drug-drug interactions: CYP1A2

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2
Q

Sitagliptin

A

Drug class: DPP-4 Inhibitors/Glitptin

Common indications: T2DM

Mechanism of action: Prevents action of DPP-4 (to degrade Incretins/GLP-1), thus increasing Incretin action - ↑insulin secretion, increasing satiety.

Important adverse drug reactions: GI Upset; Pancreatitis (1%)

Contraindications: Pregnancy; Hx of Pancreatitis

Important drug-drug interactions: Other hypoglycaemic agents; Loop and Thiazide-like Diuretics (↑glucose reabsorption)

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3
Q

Canagliflozin

A

Drug class: SGLT-2 Inhibitor/Gliflozin

Common indications: T2DM

Other Important Drugs in Class: Dapagliflozin

Mechanism of action: Inhibits SGLT-2, preventing glucose reabsorption

Important adverse drug reactions: UTI and genital infection; Thirst and polyuria; hypotension; WEIGHT LOSS

Contraindications: Hypovolaemia; Hypotension

Important drug-drug interactions: Antihypertensives; Antidiabetics

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4
Q

Mesalazine

A

Drug class: Salicylate

Common indications: Ulcerative Colitis

Other Important Drugs in Class: Sulfasalazine

Mechanism of action: 5ASA inhibits prostaglandin synthesis and reduces migration of inflammatory cells in the bowel wall

Important adverse drug reactions: Nausea; Dyspepsia; Leukopenia

Contraindications: N/A

Important drug-drug interactions: N/A

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5
Q

Warfarin

A

Drug class: Vitamin K Antagonist

Common indications: VTE; AFw/E; PE

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits reduction of oxidised Vit K, preventing production of II, VII, IX, and X

Important adverse drug reactions: Bleeding

Contraindications: Pregnancy (Teratogen)

Important drug-drug interactions: CYP2C19; Highly protein bound (NSAIDs); Cephalosporins (eliminate Vit K production by bacteria)

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6
Q

Protamine Sulphate

A

Drug class: ATIII Inhibitor

Common indications: Heparin Overdose

Other Important Drugs in Class: N/A

Mechanism of action: Inhibition of ATIII

Important adverse drug reactions: Clotting

Contraindications: N/A

Important drug-drug interactions: N/A

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7
Q

Rituximab

A

Drug class: Anti-CD20

Common indications: RA; SLE; Lymphoma

Other Important Drugs in Class: N/A

Mechanism of action: Binds to CD20, found on acative B-cells, causing B cell apoptosis

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

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8
Q

Insulin Dosing

A
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9
Q

Tranexamic Acid

A

Drug class: Antifibrinolytic

Common indications: Bleeding

Other Important Drugs in Class: N/A

Mechanism of action: Prevents action of plasmin

Important adverse drug reactions: Clotting

Contraindications: N/A

Important drug-drug interactions: N/A

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10
Q

Pioglitazone

A

Drug class: Thiazolidinediones/Glitazones

Common indications: T2DM

Other Important Drugs in Class: Rosiglitazone

Mechanism of action: Activates PPAR-Γ, which sensitises muscle and adipose tissue to insulin, decreases gluconeogensis

Important adverse drug reactions: GI upset; Fluid retention; Fracture Risk; Bladder Cancer; WEIGHT GAIN

Contraindications: Heart Failure (fluid retention)

Important drug-drug interactions: other hypoglycaemic agents

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11
Q

Digoxin

A

Drug class: Class V Antiarrhythmic/Cardiac Glycoside

Common indications: HF; Fast AF

Other Important Drugs in Class: N/A

Mechanism of action: Increases vagal tone -> slows AVN conduction

Important adverse drug reactions: Arrhythmias; N+V; blurred/yellow vision

Contraindications: N/A

Important drug-drug interactions: Diuretics (hypokalaemia increases toxicity of digoxin); CYP3A4 inhibitors

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12
Q

Losartan

A

Drug class: Angiotensin-II Receptor Antagonist

Common indications: Hypertension; Heart Failure; Diabetic Nephropathy

Other Important Drugs in Class: Candesartan

Mechanism of action: Antagonises AngII - decreases aldosterone and causes vasodilation

Important adverse drug reactions: Hypotensive Crisis; Hyperkalaemia (low aldosterone); Cause or worsen CKD/AKI

Contraindications: Renal Artery Stenosis; AKD; Pregnancy; CKD - Caution

Important drug-drug interactions: Potassium-increasing Drugs; NSAIDs

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13
Q

Rivaroxaban

A

Drug class: Xa DOAC

Common indications: VTE

Other Important Drugs in Class: Apixaban; Edoxaban

Mechanism of action: Inhibit both free and bound Xa

Important adverse drug reactions: Bleeding

Contraindications: N/A

Important drug-drug interactions: CYP3A4

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14
Q

Lactulose

A

Drug class: Osmotic Laxative

Common indications: Constipation

Other Important Drugs in Class: Movicol(Macrogol)

Mechanism of action: Draw fluid in (Lactulose); Retain the fluid they came with (Movicol/Macrogol)

Important adverse drug reactions: Cramping; Distention; Flatulence

Contraindications: N/A

Important drug-drug interactions: N/A

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15
Q

Omeprazole

A

Drug class: Proton Pump Inhibitor

Common indications: Peptic Ulcer Disease; GORD; Dyspepsia

Other Important Drugs in Class: Lansoprazole

Mechanism of action: Irreversibly inhibits the proton pump, preventing gastric acid secretion

Important adverse drug reactions: GI Disturbance; Headache; Dizziness; Drowsiness

Contraindications: Osteoporosis

Important drug-drug interactions: CYP2C19; Can increase effects of Warfarin and Phenytoin

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16
Q

Lisinopril

A

Drug class: Angiotensin Converting Enzyme Inhibitor

Common indications: Hypertension

Other Important Drugs in Class: Ramipril

Mechanism of action: Prevents conversion of Ang-I to Ang-II. Prevents Aldosterone release and peripheral Vasoconstriction. Supresses ADH, and potentiates Bradykinin

Important adverse drug reactions: CAPTOPRIL - Cough (Dry, Bradykinin); Angioedema (↑Afro-Caribbean); Proteinuria; Taste Disturbances/Teratogenic in 1st Trimester; Other (Fatigue, Headache); Potassium ↑; Renal Impairment; Itch; Low BP

Contraindications: Renal Artery Stenosis; AKD; Pregnancy; CKD; Idiopathic Angioedema

Important drug-drug interactions: ↑K drugs; NSAIDs; Other Hypotensives

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17
Q

Levetiracetam

A

Drug class: Synaptic Vesicle Inhibitor

Common indications: Focal and Generalised Seizures

Other Important Drugs in Class: N/A

Mechanism of action: Stops release of neurotransmitters into synapse and reduces neuronal activity

Important adverse drug reactions: NV; Dizziness

Contraindications: N/A

Important drug-drug interactions: N/A

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18
Q

Insulin

A

Drug class: Insulin

Common indications: Diabetes Mellitus

Other Important Drugs in Class: N/A

Mechanism of action: Replaces missing Insulin - binds to Insulin receptors

Important adverse drug reactions: Hypoglycaemia; Lipodystrophy

Contraindications: Hypoglycaemia; Renal Impairment

Important drug-drug interactions: Thiazides, Sterroids; Thyroid medications; Rifampin (increase insulin requirements); Alcohol, NSAIDs, Sulfonylureas, Warfarin (decrease insulin requirements); ß-blockers mask hypoglycaemia

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19
Q

Levodopa

A

Drug class: Dopamine Precursor

Common indications: Parkinson Disease

Other Important Drugs in Class: N/A

Mechanism of action: Converted to dopamine in CNS

Important adverse drug reactions: NV; Psychosis; Tachycardia; Dyskinesia

Contraindications: N/A

Important drug-drug interactions: Pyridoxine increases breakdown; MAOi - risk of hypertensive crisis

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20
Q

Bisoprolol

A

Drug class: ß-Adrenoceptor Blocker/Class II Antiarrhythmic

Common indications: Hypertension; SVT; Sinus Tachycardia

Other Important Drugs in Class: Labetalol; Metoprolol

Mechanism of action: Blocks NAd, causing ↓HR and ↓Contractility. Decreases Automaticity

Important adverse drug reactions: Bronchospasms; Heart Block; Raunaud’s; Lethargy; Impotence; Mask Tachycardia

Contraindications: Asthma; COPD; Haemodynamic Instability; Hepatic Failure

Important drug-drug interactions: Non-dihydropyridine CCBs (can causes asystole)

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21
Q

Aprepitant

A

Drug class: Neurokinin-1 RAntagonist

Common indications: Antiemesis (Chemotherapy)

Other Important Drugs in Class: N/A

Mechanism of action: Prevent action of substance P at CTZ; boosts effects of 5HT3R Antagonist; Anxiolytic and Antidepressant

Important adverse drug reactions: Headache; Diarrhoea; Stevens-Johnson

Contraindications: N/A

Important drug-drug interactions: N/A

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22
Q

Infliximab

A

Drug class: Anti-TNFα mAb

Common indications: RA; Psoriasis; IBD

Other Important Drugs in Class: Adalimumab

Mechanism of action: Inhibits TNFα - reduces inflammation, angiogenesis, and joint destruction

Important adverse drug reactions: Reactivation of TB

Contraindications: Latent TB

Important drug-drug interactions: N/A

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23
Q

Furosemide

A

Drug class: Loop Diuretic

Common indications: Fluid overload in HF; Acute Pulmonary Oedema; Nephrotic Syndrome

Other Important Drugs in Class: Bumetanide

Mechanism of action: Block N/K/2Cl, increasing Sodium and Water loss. (Sodium reabsorption increased later along the nephron, compensated by K loss)

Important adverse drug reactions: Dehydration; Hypotension; Hypokalaemia; Hyponatraemia; Hyperuricaemia; Arrhythmia; Tinnitus; ↑Cholesterol and Triglyceride

Contraindications: Hypokalaemia; Hyponatraemia; Gout; Hepatic Encephalopathy

Important drug-drug interactions: Aminoglycosides (both Ototoxic); Digoxin; Lithium (retains lithium)

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24
Q

Montelukast

A

Drug class: Leukotriene Receptor Antagonist

Common indications: Long Term Asthma control; Asllergic Rhinitis

Other Important Drugs in Class: N/A

Mechanism of action: Blocks LK1R, preventing airway inflammation and bronchoconstriction

Important adverse drug reactions: Headache; GI distrubance; Hyperactivity; Dry Mouth

Contraindications: N/A

Important drug-drug interactions: N/A

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25
Q

Ivabradine

A

Drug class: Class V Antiarrhythmic

Common indications: Sinus Tachycardia (often in HF and angina)

Other Important Drugs in Class: N/A

Mechanism of action: Blocks If channels, reducing SAN firing

Important adverse drug reactions: N/A

Contraindications: Pregnancy (teratogen)

Important drug-drug interactions: N/A

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26
Q

Selegiline

A

Drug class: Monoamine Oxidase B Inhibitor

Common indications: Parkinsons Disease

Other Important Drugs in Class: Rasagaline; Safinamide

Mechanism of action: Inhibitor MAOB, preventing dopamine degradation

Important adverse drug reactions: Nausea; Psychosis

Contraindications: N/A

Important drug-drug interactions: Opiods; SSRIs; Tricyclics

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27
Q

Oestradiol

A

Drug class: Oestrogen Receptor Agonist

Common indications: HRT; Contraception; Primary Osteoporosis

Other Important Drugs in Class: Premarin

Mechanism of action: Activates ER - stimulates growth of endometrium and breast, stimulates PR production; decreases bone resorption

Important adverse drug reactions: Breast Tenderness; Thromboembolism; Impaired glucose tolerance; Endometrial cancer; Ovarian cancer; Breast cancer

Contraindications: Ovarian, Breast, or Endometrial malignancy; Hx of thromboembolism or CAD

Important drug-drug interactions: Other medications that increase thromboembolism

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28
Q

Fondaparinux

A

Drug class: Synthetic ATIII Agonist

Common indications: VTE

Other Important Drugs in Class: N/A

Mechanism of action: Activates ATIII, inhibiting Xa

Important adverse drug reactions: Bleeding

Contraindications: N/A

Important drug-drug interactions: N/A

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29
Q

Ispaghula Husk

A

Drug class: Bulk Forming Laxative

Common indications: Constripation

Other Important Drugs in Class: Methylcellulose

Mechanism of action: Fibre

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

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30
Q

Alteplase

A

Drug class: Fibrinolytic

Common indications: Acute Ischaemic Stroke

Other Important Drugs in Class: Streptokinase

Mechanism of action: Increases plasmin production (tPA/Streptokinase)

Important adverse drug reactions: Bleeding

Contraindications: N/A

Important drug-drug interactions: Antiplatelets and anticoagulants

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31
Q

Celecoxib

A

Drug class: COX-2 Inhibitor/NSAID

Common indications: OA; RA

Other Important Drugs in Class: Etoricoxib

Mechanism of action: Inhibitor of COX-2, with less COX-1 action. Does not share antiplatelet action

Important adverse drug reactions: Decreased GFR; Peptic Ulceration; Worsens IBD

Contraindications: N/A

Important drug-drug interactions: N/A

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32
Q

Codeine

A

Drug class: Opiod Moderate Agonist

Common indications: Pain; Cough; Diarrhoea

Other Important Drugs in Class: N/A

Mechanism of action: Converted into Morphine by CYP2D6; activates µ-Opiod R

Important adverse drug reactions: Respiratory Depression (worse in children); Constipation

Contraindications: Hepatic Failure; Respiratory Distress; Raised ICP; Opiod Use

Important drug-drug interactions: Fluoxetine (CYP2D6 inhibitor)

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33
Q

Cyclizine

A

Drug class: H1R Antagonist

Common indications: Antiemesis (motion sickness, morning sickness)

Other Important Drugs in Class: Promethazine; Diphenhydramine

Mechanism of action: Inhibits Vestibular Nuclei and CTZ

Important adverse drug reactions: Sedation; Excitation; Antimuscarinic; Cardiac Toxicity

Contraindications: Extremes of age

Important drug-drug interactions: N/A

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34
Q

Tiotropium

A

Drug class: Long Acting Muscarinic Antagonist

Common indications: Severe Asthma and COPD

Other Important Drugs in Class: Ipratropium (SAMA)

Mechanism of action: Antagonises mAChR, preventing broncoconstriction

Important adverse drug reactions: Cough; Nasal Dryness and Irritation

Contraindications: N/A

Important drug-drug interactions: N/A

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35
Q

Morphine

A

Drug class: Opiod Strong Agonist

Common indications: Pain; Diarrhoea

Other Important Drugs in Class: Fentanyl

Mechanism of action: Activates µ-Opiod R; causes Histamine release (less in fentanyl)

Important adverse drug reactions: Respiratory Depression; Vomiting; Miosis (all less in fentalyl)

Contraindications: Asthmatics (W); Hepatic Failure; Respiratory Distress; Raised ICP; Opiod Use

Important drug-drug interactions: N/A

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36
Q

Trihexyphenidydyl

A

Drug class: Central Anticholinergic

Common indications: Parkinsons Disease

Other Important Drugs in Class: Orphenadrine; Procyclidine

Mechanism of action: Blocks cholinergic receptors in basal ganglia

Important adverse drug reactions: Urinary retention; Dry mouth; Constipation

Contraindications: N/A

Important drug-drug interactions: Other anticholinergics

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37
Q

Ibuprofen

A

Drug class: Non-selective Non-Steroidal Anti-Inflammatory Drug

Common indications: Inflammatory Disorders; Pyrexia; Pain

Other Important Drugs in Class: Naproxen

Mechanism of action: Anti-inflammatory

Important adverse drug reactions: GI Irritation; GI Bleeding; Haemorrhage; Hypersensitivity; Reduces GFR

Contraindications: Hypersensitivity; 3rd Trimester (closes DA)

Important drug-drug interactions: ACEi; ARBs; Diuretics

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38
Q

Pramipexole

A

Drug class: Dopamine Receptor Agonist

Common indications: Parkinsons Disease

Other Important Drugs in Class: Apomorphine; Ropinirole; Rotigotine

Mechanism of action: Agonises D2R in basal ganglia

Important adverse drug reactions: NV; Dizziness; Psychosis; Impusle Control Disorders

Contraindications: Psychosis; Impulse Control Disorder

Important drug-drug interactions: Dopamine Antagonist

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39
Q

Diltiazem

A

Mix of Dihydropyridine and Phenylalkylamines

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40
Q

5-Flurouracil

A

Drug class: Pyrimidine Antimetabolite

Common indications: Cancer

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits thymidylate synthetase, stopping cell growth

Important adverse drug reactions: Vomiting; Stomatitis; Alopecia; anaemia; leukopenia

Contraindications: N/A

Important drug-drug interactions: N/A

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41
Q

Tamoxifen

A

Drug class: ER Antagonist and Partial Agonist

Common indications: ER+ Breast Cancer

Other Important Drugs in Class: Clomifene (for treating infertility - promotes ovulation by ↑GnRH)

Mechanism of action: Inhibits ER in breast tissue, suppressing breast tumour growth

Important adverse drug reactions: Nausea; Hot flushes; Menstrual Irregularities; ↑risk of stroke, PE, and Uterine Cancer

Contraindications: Pregnancy; Lactation

Important drug-drug interactions: Oestrodiol

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42
Q

Treatment Path for Hypertension

A

Step 1: HTN w/ T2DM - ACEi or ARB

HTN w/o T2DM, <55 and not Black - ACEi or ARB

HTN w/o T2DM, >55 - CCB

HTN w/o T2DM, Black - CCB

Step 2: Original + (other class or Thiazide)

Step 3: ACEi or ARB + CCB + Thiazide

Step 4: K >4.5 - + α- or ß-Blocker

K > 4.5 - MRA

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43
Q

Metformin

A

Drug class: Biguanide

Common indications: T2DM

Mechanism of action: Decreases Hepatic Gluconeogensis (but not all). Increases insulin sensitivity. Exclusively excreted by kidneys

Important adverse drug reactions: GI Upset

Contraindications: Stage 4 or 5 CKD (<30 eGFR); Alcohol Intoxication

Important drug-drug interactions: ACEi or NSAIDs (impair renal function); Loop and Thiazide-like Diuretics (↑glucose reabsorption)

44
Q

Cyclophosphamide

A

Drug class: Alkylating Agent

Common indications: NH Lymphoma; myeloma; Leukaemia; RA; SLE

Other Important Drugs in Class: N/A

Mechanism of action: Cross-links DNA by bonding to guanine residues; prevents DNA replication and transcription. PRODRUG - converted by CYP2C19 to active

Important adverse drug reactions: Haemorrhagic Cystitis (prevented by using aggressive hydration and/or Mesna); Risk of cancers; Infertility

Contraindications: N/A

Important drug-drug interactions: CYP2C19

45
Q

Buprenorphine

A

Drug class: Mixed Opiod Agonist/Antagonist

Common indications: Pain; Opiod Addiction

Other Important Drugs in Class: N/A

Mechanism of action: High affinity for µR but low E(max); Antagonist at kR

Important adverse drug reactions: Respiratory Depression; Hypotension; Nausea; Dizziness

Contraindications: Hepatic Failure; Respiratory Distress; Raised ICP

Important drug-drug interactions: N/A

46
Q

Amiodarone

A

Drug class: Class III Antiarrhythmic

Common indications: Most arrhythmias (last line)

Other Important Drugs in Class: Sotalol

Mechanism of action: Blocks K+, Na+, Ca2+, and ß-receptors; increases refractory period; decreases Phase 0 speed; increases threshold; decreases phase 4; decreases speed of AV conduction

Important adverse drug reactions: in long term use - Pulmonary fibrosis, hepatitis, increases LDL; optic neuritis; photosensitivity; thyroid disease

Contraindications: N/A

Important drug-drug interactions: Digoxin; other Antiarrhythmics

47
Q

Targets for Cholesterol

A

<5.0 mmol/L Total Cholesterol

<4.0 mmol/L Non-HDL

<2.0 mmol/L LDL

40% reduction of Non-HDL at 3 months

48
Q

Spironolactone

A

Drug class: Mineralocorticoid Receptor Antagonist (Aldosterone)

Common indications: Hypertension; Primary Hyperaldosteronism; Severe Heart Failure; Hypokalaemia

Other Important Drugs in Class: N/A

Mechanism of action: Blocks action of Aldosterone at nephron, preventing upregulation of Na/K ATPase. This prevents sodium reabsorption and potassium secretion, increasing sodium and water loss.

Important adverse drug reactions: Hyperkalaemia; Gynaecomastia; Impotence (males)

Contraindications: Hyperkalaemia; Addison’s Disease/Crisis

Important drug-drug interactions: Potassium increasing drugs; pregnancy

49
Q

Sulfasalzine

A

Drug class: DMARD

Common indications: RA; Infection

Other Important Drugs in Class: Mesalazine

Mechanism of action: Conjugate of 5ASA and sulfapyridine. 5ASA inhibits T-cell proliferation and neutrophil degranulation.Sulfa group fights infection

Important adverse drug reactions: Myelosuppression; hepatitis

Contraindications: N/A

Important drug-drug interactions: N/A

50
Q

Nabilone

A

Drug class: Cannabinoid

Common indications: Antiemesis (Chemotherapy)

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits CTZ

Important adverse drug reactions: Dizziness; Drowsiness

Contraindications: N/A

Important drug-drug interactions: N/A

51
Q

Alirocumab

A

Drug class: PCSK9 Inhibitor

Common indications: Hypercholesterolaemia

Other Important Drugs in Class: Evolocumab (Inclisiran)

Mechanism of action: Inhibits PCSK9, preventing LDLR degredation

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions:N/A

52
Q

Beclometasone

A

Drug class: Inhaled Corticosteroid

Common indications: Asthma; Allergic Rhinitis; COPD

Other Important Drugs in Class: Fluticasone; Budesonide

Mechanism of action: Prevent production of IL-1 and IL-6, reducing mucosal inflammation. ↑ß2 expression

Important adverse drug reactions: local immunosuppressive action (candidiasis, hoarse voice)

Contraindications: Pneumonia risk in COPD

Important drug-drug interactions: N/A at normal doses

53
Q

Dalteparin

A

Drug class: Low Molecular Weight Heparin

Common indications: DVT; PE

Other Important Drugs in Class: Enoxaparin

Mechanism of action: Potentiates ATIII, inhibiting Xa and IIa

Important adverse drug reactions: Bleeding; Thrombocytopenia

Contraindications: N/A

Important drug-drug interactions: Anticoagulants

54
Q

Mycophenolate Mofetil

A

Drug class: Purine Analogue

Common indications: Trnasplantation; SLE; Vasculitis

Other Important Drugs in Class: N/A

Mechanism of action: Inhibition of DNA replication in T and B cells

Important adverse drug reactions: NVD; Infection; Myelosuppression

Contraindications: N/A

Important drug-drug interactions: N/A

55
Q

Hyoscine Hydrobromide

A

Drug class: M1R Antagonist

Common indications: Antiemesis (motion sickness, bowel obstruction, those who can’t take tablets)

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits Vestibular Nuclei and CTZ

Important adverse drug reactions: Sedation; Memory problems; Glaucoma; Dry mouth; Constipation

Contraindications: N/A

Important drug-drug interactions: N/A

56
Q

Bisacodyl

A

Drug class: Stimulant Laxative

Common indications: Constipation

Other Important Drugs in Class: Senna; Docusate Sodium

Mechanism of action: Increase intestinal motility

Important adverse drug reactions: Cramping; Nausea

Contraindications: N/A

Important drug-drug interactions: N/A

57
Q

Salmeterol

A

Drug class: Long Acting ß2 Agonist (LSABA)

Common indications: Add on therapy in Asthma; prevents nocturnal and exercise induced attacks

Other Important Drugs in Class: Formoterol (LFABA)

Mechanism of action: Agnosies ß2R

Important adverse drug reactions: Adrenergic - tachycardia, palpitations, anxiety, tremor, ↑glycogenolysis, ↑renin

Contraindications: Should only be prescribed alongside ICS (can mask airway inflammation alone)

Important drug-drug interactions: ß-Blockers

58
Q

Sodium Valproate

A

Drug class: GABA potentiator

Common indications: Seizures; Manic phase of bipolar

Other Important Drugs in Class: N/A

Mechanism of action: Increases GABA synthesis and prevents GABA degradation - decreasing nerve firing

Important adverse drug reactions: NV; Dizziness; Sedation

Contraindications: Pregnancy (Spina bifida, impaired cognitive development)

Important drug-drug interactions: CYP2C9 inhibitor

59
Q

Medroxyprogesterone Acetate

A

Drug class: Progesterone agonist

Common indications: HRT; Contraceptive

Other Important Drugs in Class: Hydroxyprogesterone

Mechanism of action: Decreases endometrial hyperplasia in pts recieving oestrogen (HRT); Prevents contraception by altering cervical mucus and creating hostile endometrium

Important adverse drug reactions: Amenorrhoea; Breakthrough bleeding; Dysmenorrhoea

Contraindications: N/A

Important drug-drug interactions: N/A

60
Q

Inclisiran

A

Drug class: PCKS9 Inhibitor

Common indications: Hypercholesterolaemia

Other Important Drugs in Class: (Alirocumab, Evolocumab)

Mechanism of action: siRNA that inhibits translation of PCSK9

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

61
Q

Pyridostigmine

A

Drug class: Cholinesterase Inhibitor

Common indications: myasthenia Gravis; Reversal of nondepolarising neuromuscular blockers

Other Important Drugs in Class: Neostigmine

Mechanism of action: Preventing of Acetylcholine degradation at NMJ

Important adverse drug reactions: SSLUDGE

Contraindications: N/A

Important drug-drug interactions: Atropine

62
Q

Ciclosporin

A

Drug class: Calcineurin Inhibitor

Common indications: Transplantation; Atopic Dermatitis; Psoriasis

Other Important Drugs in Class: Tacrolimus

Mechanism of action: Preventing IL-2 production

Important adverse drug reactions: Infection; Eye Inflammation; Renal Toxicity

Contraindications: Renal Impairment

Important drug-drug interactions: CYP3A4 metabolised

63
Q

Salbutamol

A

Drug class: Short Acting ß2 Agonist

Common indications: Symptom relief in Asthma and COPD; Prevention of bronchospasm prior to exercise

Other Important Drugs in Class: Terbutaline

Mechanism of action: Agnoises ß2R, reversing bronchoconstriction

Important adverse drug reactions: Adrenergic - tachycardia, palpitations, anxiety, tremor, ↑glycogenolysis, ↑renin

Contraindications: N/A

Important drug-drug interactions: ß-Blockers; other adrenergic drugs

64
Q

Treatment Plan for Heart Failure

A

HFpEF - Manage Co-morbidities, Cardiac Rehabilitation programme

HFrEF - ACEi/ARB and ßB (+ MRA if needed), Cardiac Rehabilitation programme

65
Q

Naloxone

A

Drug class: Opiod Antagonist

Common indications: Opiod Overdose

Other Important Drugs in Class: N/A

Mechanism of action: Antagonises µR

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

66
Q

Exenatide

A

Drug class: GLP-1R Agonist/Incretin Mimetics

Common indications: T2DM

Other Important Drugs in Class: Liraglutide

Mechanism of action: Activate GLP-1R and resistant to degradation by DPP-4. ↑insulin secretion, ↓glucagon secretion, ↓gluconeogenesis, ↑satiety and ↓gastric emptying

Important adverse drug reactions: GI upset; Decreased appetite; WEIGHT LOSS

Contraindications: Renal Failure

Important drug-drug interactions: Antidiabetics

67
Q

Lamotrigine

A

Drug class: Sodium Channel Blocker

Common indications: Seizures

Other Important Drugs in Class: Movicol

Mechanism of action: Block sodium and glutamate

Important adverse drug reactions: Ataxia; Dizziness; Photosensitivity

Contraindications: N/A

Important drug-drug interactions: CYP2C9

68
Q

Clopidogrel

A

Drug class: ADP Receptor Antagonist

Common indications: Prophylaxis of Stroke, MI, Peripheral Vascular Disease

Other Important Drugs in Class: Ticagrelor (reversible, already active; rapid); Prasugrel (activated by liver; rapid)

Mechanism of action: Irreversibly inhibits binding of ADP to P2Y12 receptor - prevents activation of GPIIb/IIIa, preventing platelet aggregation. Activated by liver and slow working

Important adverse drug reactions: Bleeding; GI Upset; Thrombocytopenia

Contraindications: High bleed risk patients; Renal or Hepatic Impairment

Important drug-drug interactions: Requires CYP Activation (inhibited by Ciprofloxacin, Omeprazole, Erythromycin, some SSRIs, other PPIs); other antiplatelets or anticoagulants

69
Q

Atropine

A

Drug class: Class V Antiarrhythmic/mAChR inhibitor

Common indications: Bradycardia; AV block; Irritable Bowel; Anticholinesterase poisoning; Ocular inflammation

Other Important Drugs in Class: Ipratropium; oxybutynin; solifenacin

Mechanism of action: Blocks mAChR

Important adverse drug reactions: Tachycardia; Mydriasis; delirium

Contraindications: N/A

Important drug-drug interactions: delays gastric emptying; additive anticholinergic effects with antihistamines and tricyclics

70
Q

Dabigatran

A

Drug class: IIa DOAC

Common indications: VTE

Other Important Drugs in Class: N/A

Mechanism of action: Inhibitor of IIa

Important adverse drug reactions: Bleeding

Contraindications: N/A

Important drug-drug interactions: CYP3A4

71
Q

Doxazosin

A

Drug class: α1-Adrenoreceptor Blocker

Common indications: DPH; Hypertension

Other Important Drugs in Class: N/A

Mechanism of action: Block NAd at α1, decreasing peripheral resistance

Important adverse drug reactions: Postural Hypotension; Dizziness; Syncope; Headache; Fatigue

Contraindications: Postural Hypotension

Important drug-drug interactions: Dihydropyridine CCB (↑ risk of Oedema)

72
Q

Paracetamol

A

Drug class: Analgesic and Antipyretic

Common indications: Pyrexia; Pain

Other Important Drugs in Class: N/A

Mechanism of action: Inhibition of COX-2 in CNS; not known

Important adverse drug reactions: Can cause hepatic failure in overdose

Contraindications: Chronic Alcohol Use (W)

Important drug-drug interactions: Additive renal toxicity with salicylates and NSAIDs

73
Q

Amlodipine

A

Drug class: Dihydropyridine type Calcium Channel Blockers

Common indications: Hypertension

Other Important Drugs in Class: Nifedipine; Nimodipine

Mechanism of action: Blocks CCBs in Vascular Smooth Muscle, preventing Vasoconstriction

Important adverse drug reactions: Hypotension; Ankle Oedema; Flushing; Headaches; Palpitations (compensatory tachycardia)

Contraindications: Unstable Angina; Severe Aortic Stenosis

Important drug-drug interactions: Simvastatin (amlodipine weakly inhibits CYP3A4, increases [statin])

74
Q

Metoclopramide

A

Drug class: D2R Antagonist

Common indications: Antiemesis (GORD, Ileus, Motion Sickness, VErtigo, Chemotherapy, Palliation)

Other Important Drugs in Class: Domperidone; Chlorpromazine; Haloperidol

Mechanism of action: Increases ACh; Promotes gastric emptying; Increases peristalsis; Act on CTZ

Important adverse drug reactions: Galactorrhoea; Extra-pyramidal effects; (Domperidone - sudden cardiac death)

Contraindications: N/A

Important drug-drug interactions: N/A

75
Q

Paclitaxel

A

Drug class: Mitotic Inhibitor

Common indications: Cancer

Other Important Drugs in Class: N/A

Mechanism of action: Prevents depolymerisation of microtubles of spindle

Important adverse drug reactions: NVD; alopecia; Myelosuppression; Peripheral Neuropathy

Contraindications: N/A

Important drug-drug interactions: N/A

76
Q

Methotrexate

A

Drug class: Folate Reductase Inhibitor

Common indications: Leukaemias; Solid cancers; Psoriasis; Crohns; RA

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits dihydrofolate reductase; prevents DNA replication. In non-malignant disease - not known

Important adverse drug reactions: Mucositis; Myelosuppression; Hepatitis; Infection

Contraindications: Pregnancy (Teratogen and Abortifacient)

Important drug-drug interactions: Other myelosuppressives; V. highly protein bound - sulfonylureas, NSAIDs, Warfarin

77
Q

Cisplatin

A

Drug class: Reactive Platinum Compound

Common indications: Cancer

Other Important Drugs in Class: N/A

Mechanism of action: Cross-links DNA strands

Important adverse drug reactions: NV; Renal toxicity; ototoxicity and Tinnitus; Anaemia

Contraindications: N/A

Important drug-drug interactions: N/A

78
Q

Dipyridamole

A

Drug class: Phosphodiesterase inhibitor/A2R inhibitor

Common indications: Secondary prophylaxis of Stroke and TIA

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits A2R, preventing platelet aggregation. Inhibits phosphodiesterase, preventing cAMP degradation -> inhibiting expression of GPIIb/IIIa

Important adverse drug reactions: V+D; Dizziness

Contraindications: N/A

Important drug-drug interactions: Other antiplatelets and anticoagulants; Adenosine

79
Q

Ezetimibe

A

Drug class: Choleterol Absorption Inhibitors

Common indications: Hypercholesterolaemia (adjunt to statin)

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits NPC1L1, reducing Cholesterol Absorption

Important adverse drug reactions: Abdo Pain; GI Upset; Angioedema

Contraindications: Hepatic Failure

Important drug-drug interactions: Statin (slightly increased risk of rhabdomyolysis); Ciclosporin

80
Q

Abciximab

A

Drug class: GPIIb/IIIa inhibitor

Common indications: Prophylaxis of TE

Other Important Drugs in Class: N/A

Mechanism of action: Prevents fibrinogen and vWF binding to GPIIb/IIIa

Important adverse drug reactions: Bleeding

Contraindications: N/A

Important drug-drug interactions: other antiplatelets and anticoagulants

81
Q

Gaviscon

A

Drug class: Alginate + Antacid

Common indications: Dyspepsia

Other Important Drugs in Class: N/A

Mechanism of action: Sodium Alginate - forms film preventing reflux. AlOH/MgCO3 - buffers acid

Important adverse drug reactions: Mg salts causes diarrhoea and Al salts cause constipation

Contraindications: Na and K containing preparations can worsen renal failure; High sucrose in some - T2DM

Important drug-drug interactions: Can reduce absorption of many drugs; Increases in urine alkalinity increases aspirin excretion

82
Q

Unfractionated Heparin

A

Drug class: Heparin Anticoagulant

Common indications: VTE; PE; AFw/E

Other Important Drugs in Class: N/A

Mechanism of action: Bind to Antithrombin III, causing destruction of IIa and Xa - PARENTERAL

Important adverse drug reactions: Bleeding; Thrombocytopenia

Contraindications: N/A

Important drug-drug interactions: other Anticoagulants

83
Q

Verapamil

A

Drug class: Non-Dihydropyridine Calcium Channel Blocker (Phenylalkylamine)/ Class IV Antiarrhythmic

Common indications: Hypertension; Angina; SVT; Prevention of Migrane Headache

Other Important Drugs in Class: N/A

Mechanism of action: Blocks Calcium entry in Heart Tissue, decreasing Phase 2; and preventing Phase 0 in the SAN and AVN

Important adverse drug reactions: Constipation; Bradycardia; Heart Block; Heart Failure

Contraindications: Poor LV Function; AV Nodal Conduction Delay

Important drug-drug interactions: ß-Blockers; Other Hypotensives; Other Antiarrhythmics

84
Q

Azathioprine

A

Drug class: Purine analogue

Common indications: SLE + Vasculitis maintenance therapy; IBD; (6-MP - Leukaemia, Lymphoma)

Other Important Drugs in Class: N/A

Mechanism of action: Inhibits purine biosynthesis; blocks S phase. Metabolised by TPMT - highly polymorphic gene, so test TPMT first

Important adverse drug reactions: Myelosuppression; Risk of malignancy; Infection; Hepatitis - test LFT

Contraindications: Low TPMT

Important drug-drug interactions: Allopurinol inhibits degradation

85
Q

Indapamide

A

Drug class: Thiazide-like Diuretic

Common indications: Hypertension

Other Important Drugs in Class: Bendroflumethiazide

Mechanism of action: Inhibits Na/Cl Symporter - decreases Na and H2O reabsorption. ?reduces sensitivity to vasoconstrictors

Important adverse drug reactions: Hypokalaemia; Hyponatraemia; Hyperuricaemia; Arrhythmia; Hyperglycaemia; Hypercholesterolaemia; Hyperlipidaemia

Contraindications: Hypokalaemia; Hyponatraemia; Gout

Important drug-drug interactions: NSAIDs; Potassium-lowering drugs

86
Q

Lidocaine

A

Drug class: Local Anaesthetic

Common indications: Anaesthetic

Other Important Drugs in Class: Bupivicaine; Procaine; Ropivicaine

Mechanism of action: Blocks Na conduction

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

87
Q

Diazepam

A

Drug class: Benzodiazapine

Common indications: Anxiety; Status epilepticus; Alcohol withdrawal; Light Anasthaesia

Other Important Drugs in Class: Lorazepam; Midazolam

Mechanism of action: Activate GABAa, hyperpolarising neurones

Important adverse drug reactions: Drowsiness; Dizziness’ Lethargy; Cognitive and psychomotor impairment

Contraindications: N/A

Important drug-drug interactions: Additive effects with alcohol; CYP2C19 and CYP3A4

88
Q

Loperamide

A

Drug class: Opiod Agonist

Common indications: Diarrhoea

Other Important Drugs in Class: Codeine

Mechanism of action: Activates µ-Opiod R - decreasing tone of smooth muscle and reduccing peristalsis

Important adverse drug reactions: Constripation; Drowsiness

Contraindications: Pregnancy

Important drug-drug interactions: N/A

89
Q

Entacapone

A

Drug class: Catechol-O-methyl Transferase Inhibitor

Common indications: Parkinsons Disease

Other Important Drugs in Class: Opicapone

Mechanism of action: Inhibits levodopa breakdown by COMT

Important adverse drug reactions: Dyskinesia; NVD; Discoloured urine

Contraindications: N/A

Important drug-drug interactions: Erythromycin inhibits biliary excretion

90
Q

Vincristine

A

Drug class: Vinka Alkaloid

Common indications: Cancer

Other Important Drugs in Class: N/A

Mechanism of action: Prevents assembly of microtubules and spindle

Important adverse drug reactions: NV; Alopecia; Peripheral Neuropathy

Contraindications: N/A

Important drug-drug interactions: Decreases antibody response to live virus vaccines

91
Q

Prednisolone

A

Drug class: Corticosteroid

Common indications: Inflammatory disease; Allergery; Asthma; Neoplasia; Autoimmunity; Antiemesis (perioperative, chemotherapy, palliation)

Other Important Drugs in Class: Dexamethasone; Hydrocortisone; Betamethasone

Mechanism of action: Prevent IL-1 and IL-6 production; Inhibit T-cell activation

Important adverse drug reactions: Infection; Impaired wound healing; Adrenal suppression; Sarcopenia; Cushings

Contraindications: Immunosuppression

Important drug-drug interactions: Antiinflammatorys

92
Q

Atorvastatin

A

Drug class: Statin

Common indications: Hypercholesterolaemia; Hyperlipidaemia

Other Important Drugs in Class: Simvastatin

Mechanism of action: HMG-CoA Reductase Inhibitor - reduces Cholesterol synthesis. This causes upregulation of LDLR

Important adverse drug reactions: GI Disruption; Nausea; Headache; Myalgia; Rhabdomyolysis; Increased Liver Enzymes

Contraindications: Renal or Hepatic Impairment; Pregnancy; Breastfeeding

Important drug-drug interactions: CYP 3A4 (Amiodarone, Diltiazem, Macrolides); Amlodipine

93
Q

Carbidopa

A

Drug class: Decarboxylase Inhibitor

Common indications: Parkinsons Disease

Other Important Drugs in Class: Benserazide

Mechanism of action: Inhbits degradation of levodopa

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: N/A

94
Q

Ranitidine

A

Drug class: H2R Antagonist

Common indications: Peptic Ulcer DIsease; GORD; Dyspepsia

Other Important Drugs in Class: N/A

Mechanism of action: Antagonises H2 receptors, preventing action of Histamine to increase local acid secretion

Important adverse drug reactions: Diarrhoea; Headache

Contraindications: Renal Impairment

Important drug-drug interactions: N/A

95
Q

Carbamazepine

A

Drug class: Neuronal Na Blocker

Common indications: Partial and Tonic-Clonic Seizures; Trigeminal Neuralgia; Bipolar Disorder

Other Important Drugs in Class: N/A

Mechanism of action: Block Na channels, decreasing firing

Important adverse drug reactions: Ataxia; Drowsiness; Blurred Vision

Contraindications: N/A

Important drug-drug interactions: CYP3A4 inducer and substrate

96
Q

Ondasetron

A

Drug class: 5HT3R Antagonist

Common indications: Antiemesis (everyone - often first line)

Other Important Drugs in Class: Granisetron; Palonosetron

Mechanism of action: Inhibits CTZ; Reduces GI motility and secretions

Important adverse drug reactions: Constipation; Headache; Elevated LFTs; Long QT syndrome; Extra-pyramidal effects

Contraindications: N/A

Important drug-drug interactions: N/A

97
Q

Alendronic Acid

A

Drug class: Bisphosphonate

Common indications: Osteoporosis; Paget’s

Other Important Drugs in Class: Pamidronate Disodium; Zoledronic Acid

Mechanism of action: Prevents osteoclast precursors from attaching to bone; decreases metabolism of osteoclasts

Important adverse drug reactions: N/A

Contraindications: N/A

Important drug-drug interactions: Absorption decreased by Ca2+, Antacids, Food and Drink (not water)

98
Q

Amiloride

A

Drug class: Potassium Sparing Diuretic

Common indications: Prevention and Treatment of Hypokalaemia

Other Important Drugs in Class: (Spironolactone)

Mechanism of action: Blocks ENaC, preventing Sodium absorption (decreasing need for Na/K pump)

Important adverse drug reactions: Hyperkalaemia; Arrhythmia

Contraindications: Addison’s; Potassium Supplements

Important drug-drug interactions: Other K sparing drugs; ACEi; ARBs

99
Q

Phenytoin

A

Drug class: Na Blocker

Common indications: Status Epilepticus; Seizures

Other Important Drugs in Class: N/A

Mechanism of action: Block sodium and glutamate

Important adverse drug reactions: Ataxia; Diplopia; Nystagmus; Hirsutism

Contraindications: N/A

Important drug-drug interactions: Zero order kinetics; CYP3A4 inducer and CYP2C19 substrate

100
Q

Flecanaide

A

Drug class: Class I Antiarrhythmic

Common indications: Supraventricular Tachycardias; PVCs; WPW syndrome

Other Important Drugs in Class: Lidocaine

Mechanism of action: Slows Phase 0; Decreases automaticity; Increases refractory period

Important adverse drug reactions: Pro-arrhythmia; sudden death with chronic use; increased ventricular response to AFib or Flutter; CNS and GI effects

Contraindications: Structural Heart Disease

Important drug-drug interactions: N/A

101
Q

Adenosine

A

Drug class: Class V Antiarrhythmic/Adenodise

Common indications: Termination of Re-entrant Supraventricular Tachycardia

Other Important Drugs in Class: N/A

Mechanism of action: Binds to A1R, blocking Adenylyl Cyclase -> opens K+ channels causing hyperpolarisation in AVN and SAN

Important adverse drug reactions: Transient Asystole (suppression of SAN)

Contraindications: N/A

Important drug-drug interactions: Dipyridamole (A2R inhibitor)

102
Q

Gliclazide

A

Drug class: Sulfonylureas

Common indications: T2DM

Mechanism of action: Closes Pancreatic ß-cell ATP-Sensitive K-channels, preventing K efflux and depolarising ß-cells. Causes influx of Ca, and insulin release.

Important adverse drug reactions: Mild GI Upset; Hypoglycaemia; Weight Gain (action of insulin)

Contraindications: Hepatic or Renal Impairment; Risk of Hypoglycaemia

Important drug-drug interactions: Other hypoglycaemic agents; Loop and Thiazide-like Diuretics

103
Q

Fenofibrate

A

Drug class: Fibric Acid Derivative

Common indications: Hyperlipidaemia; Hypercholesterolaemia

Other Important Drugs in Class: N/A

Mechanism of action: Activates PPARα (transcription factor that ↑LDLR + lipoprotein lipase)

Important adverse drug reactions: Hyperlipidaemia; Hypercholesterolaemia

Contraindications: Cholelithiasis; GI Upset; Myositis

Important drug-drug interactions: Warfarin (increases anticoagulation)

104
Q

Aspirin

A

Drug class: COX-1 selective Non-Steroidal Anti-Inflammatory Drug

Common indications: Prophylaxis of MI, TIA, and Stroke; Inflammatory Disorders; Pyrexia; Pain

Other Important Drugs in Class: N/A

Mechanism of action: Inhibition of prostaglandin synthesis (TXA2 and PGI2); prevents platelet aggregation and pro-inflammation

Important adverse drug reactions: GI Irritation; GI Bleeding; Haemorrhage; Hypersensitivity

Contraindications: Reye’s Syndrome (avoid <16yrs); Hypersensitivity; 3rd Trimester (closes DA)

Important drug-drug interactions: other antiplatelets and anticoagulants

105
Q

CYP Inducers and Inhibitors

A

Inducers - CRAP GPs

Carbamazepines

Rifampicin

Alcohol

Phenytoin

Griseofulvin

Phenobarbitone

Sulfonylureas

Inhibitors - SICKFACES.COM

Sodium Valproate

Isoniazid

Cimetidine

Ketoconazole

Fluconazole

Alcohol and Grapefruit Juice

Chloramphenicol

Erythromycin

Sulfonamides

Cirpofloxacin

Omeprazole

Metronidazole

106
Q

Protein Bound Drugs

A

NSAIDs - displace the rest

Methotrexate

Sulfonylureas

Warfarin