Drug of the Day Flashcards
Theophylline
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
Sitagliptin
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)
Canagliflozin
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
Mesalazine
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
Warfarin
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)
Protamine Sulphate
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
Rituximab
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
Insulin Dosing
Tranexamic Acid
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
Pioglitazone
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
Digoxin
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
Losartan
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
Rivaroxaban
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
Lactulose
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
Omeprazole
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
Lisinopril
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
Levetiracetam
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
Insulin
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
Levodopa
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
Bisoprolol
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)
Aprepitant
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
Infliximab
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
Furosemide
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)
Montelukast
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
Ivabradine
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
Selegiline
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
Oestradiol
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
Fondaparinux
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
Ispaghula Husk
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
Alteplase
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
Celecoxib
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
Codeine
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)
Cyclizine
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
Tiotropium
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
Morphine
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
Trihexyphenidydyl
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
Ibuprofen
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
Pramipexole
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
Diltiazem
Mix of Dihydropyridine and Phenylalkylamines
5-Flurouracil
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
Tamoxifen
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
Treatment Path for Hypertension
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