Drugs Flashcards
Methotrexate
Dihydrofolate-reductase Inhibitor.
Inhibits Folate Synthesis, causing immunosuppression.
-Taken once weekly
-Used commonly in rheumatological conditions
-Used for cancer
Drugs for Temporal Arteritis
Steroid: Prednisolone (For Inflammation)
Bisphosphonate: Alendronate (For bone loss)
Calcipotriol (For bone-loss from steroids)
Alendronic Acid
Bisphosphonate: Inhibits cholesterol pathway (HMG-CoA)
-Used to prevent bone loss
-Side effects: Oesophagitis
Spironolactone
K+ Sparing Diuretic / Aldosterone Antagonist
Acts on Na+/K+ Channels in DCT/Collecting Duct.
-Used in hypokalemia
-Used in Aldosteronism (Conn’s)
Digoxin
Class V Vaughen-Williams Antiarythmetic:
Blocks K+/Na+ Channels.
Aspirin
COX-1 Irreversible inhibitor and COX-2 depressor.
Reduces Thromboxane-A2, reducing platelet activation.
-300mg for ACS / Stroke (After confirmed ischaemic)
-75mg OD for:
——Stroke/MI Risk-reduction
——Essential Thrombocythaemia / Polycythaemia
——Temporal Arteritis prophylaxis
-Risk of peptic ulcers (Fewer protective prostaglandins)
Furosemide
Loop Diuretic
Blocks NA-K-Cl Channels in the Loop of Henle
Causing elevated excretion of salts and water.
-Used in heart failure (HF)
-May cause hypokalaemia.
Warfarin
Vitamin K-Recycling Inhibitor
Blocks formation of CF II, VII, IX, and X
-Give vitamin K + Prothrombin complex to reverse
-Target INR 2-3 generally
-Spinach contains VitK: Reduces Warfarin function.
-Prefered over DOACs in metalic valves.
Drugs for ACS
MONA(TAS)
-Morphine - [Alleviate pain]
-Oxygen - [Prevent hypoxia - only if <94% sats]
-Nitrates - [Vasodilate]
-Aspirin 300mg - [Reduce Thromboxane A2]
-(Thromolytics) - Alteplase - [Breakdown clot within 4.5 hours]
-(Anticoagulants) - LMWH - [Thrombin inhibiton]
-(Stool-Softeners) - Senna - [For morphine]
Drugs for Hypertension
1: ACEI/ARB (<55 / T2DM) OR CCB/Thiazide-Like-Diur (>55 / Black)
2: +CCB/Thiaz-Like-Diur (<55 / T2DM) OR +Thiaz-Like-Diur/CCB (>55/Black)
3: Add the third option from above
4: +Spironolactone (Low K+) OR +ßB/∂B (Norm K+)
Heparin
Anti-Thrombin activator.
Reduces Xa production and inhibits thrombin.
-Uses include; Stable PE, AF, DVT.
Chlorphenamine
Anti-Histamine
Reduces body’s reaction to IgE/Mast-Cell Activation.
Trimethoprim
Dihydrofolate-reductase inhibitor.
Interferes with DNA synthesis in bacteria.
-Used for UTIs in non-pregnant people (Nitrofurantoin would be preferred here instead).
Nitrofurantoin
Damages bacterial DNA
Heavily concentrated in the urine
-Used first line in UTIs for pregnant women.
-Avoid using at full-term.
Riluzole
Na+ Channel blocker
Reduces the release of glutamate from neurons and increases uptake
-Used to improve ALS prognosis.
Pyridostigmine
Long ACh-Esterase Inhibitor (-Tigmine)
Elevates synaptic levels of ACh.
-Treatment for Myasthenia Gravis (MG)
Edrophonium
Short ACh-Esterase Inhibitor
Elevates synaptic levels of ACh
-Diagnosis of Myasthenia Gravis (MG)
Drugs for diagnosing and treating Myasthenia Gravis?
Diagnosis:
-Edrophonium (SA ACh-Esterase-Inhibitor)
-Test to see if symptoms improve.
-Atropine in case of DUMBELS (Cholinergic crisis)
Treatment:
-Pyridostigmine (LA ACh-Esterase-Inhibitor)
Levothyroxine
Manufactured Thyroxine (T4)
-Used to treat hypothyroidism (Myxoedema)
ß-Interferon
Cytokine (That can be exogenously produced)
Reduces the number of white cells which cross the BBB.
-Used to treat multiple sclerosis (MS)
Pegylated ∂-interferon 2a
Manufactured Cytokine
-Used to treat Hep-B and Hep D
-May be used for Hep-C (DAA preferred)
Acyclovir
Antiviral
Reacts with virus then reacts with host cell to prevent DNA replication.
-Used for Encephalitis
-Used for Herpes/Varicella Zoster.
-May be effective against CMV, EBV, HSV, and Varicella.
Rifampicin
DNA-Dependent RNA-Polymerase inhibitor
Antibiotic
-“4 for 2 and 2 for 4” [or 10 with CNS])
-6 Months treatment for TB
-ALSO used alongside Vancomycin for MRSA
-Side effect: Red urine (R for Red)
Isoniazid
Antibiotic
Inhibits mycobacterium cell wall synthesis.
-“4 for 2 and 2 for 4” [or 10 with CNS])
-6 Months treatment for TB
-Side effect: Jaundice + Per(I)pheral Neuropathy
Ethambutol
Antibiotic
Inhibits mycobacterium cell wall synthesis.
-“4 for 2 and 2 for 4” [or 10 with CNS])
-2 Months treatment for TB
-Side effect: Visual issues (E for Eye)
Pyrazinamide
Antibiotic
Elevates TB intracellular H+
-“4 for 2 and 2 for 4” [or 10 with CNS])
-2 Months treatment for TB
-Side effect: Gout
Drugs for TB and the duration:
RIPE
-“4 for 2 and 2 for 4” [or 10 with CNS])
Rifampicin: 6 Months - Red Urine
Isoniazid: 6 Months
(Use these two for a further 10 months if CNS involvement).
Pyrazinamide: 2 Months
Ethambutol: 2 Months - Eye issues
Calcipotriol
Vitamin D
-Used alongside long-term steroids
-Used 1st-line for osteoporosis with Ca2+ and alendronate.
-Used for Hypocalcaemia
-Used for Psoriasis
Drugs for COPD
Quit smoking + Flu vaccines then:
-1: SABA (Salbutamol) [Blue inhaler] and/OR SAMA (Ipatropium)
-2: + LABA (Salmeterol) + LAMA (Tiotropium) + Stop SAMA
-3: + ICS [Earthy inhaler]
-4: + Oxygen
Salbutamol
Short-Acting-Beta2-Agonist (SABA)
Induces Gs > Adenylate Cyclase > cAMP > PKA
PKA inhibits MLC-Kinase causing dilation.
-“Blue inhaler”.
-Used for asthma exacerbations
-Used for COPD after smoking cessation
Salmeterol
Long-Acting-Beta-Agonist (LABA)
Induces Gs > Adenylate Cyclase > cAMP > PKA
PKA inhibits MLC-Kinase causing dilation.
-“Pinky-Red inhaler”
-Used 4th for asthma control (After SABA, ICS, and LTRA)
-Used 2nd for COPD after SABA and smoking cessation
Ramipril
Angiotensin-Converting-Enzyme Inhibitor (ACE-I)
Reduces sympathetic response and water retention
“-PRIL”
-Used 1st line for <55s or diabetics with hypertension. (/ARBs)
-Used for dilated cardiomyopathy
-Used 2nd line for heart failure (/ARBs)
-Used 2nd line for >55s with hypertension (/ARBs)
-Side effects: Dry cough
Losartan
Angiotensin-II-Receptor Blocker (ARB)
Reduces aldosterone release and water retention
“-SARTAN”
-Used 1st line for <55s with hypertension. (/ACEIs)
-Used 2nd line for heart failure (/ACEIs)
-Used 2nd line for >55s with hypertension /ACEIs)
Amlodipine
Dihydropyridine Calcium-Channel Blocker (CCB)
Specifically inhibits vessel SM calcium-channels
>Reduced calmodium and muscle contraction
“-PINE”
-Used 1st line for hypertension (>55 / Black)
-Used 2nd line for hypertension (<55 / DM)
-Side effects: Peripheral Oedema
Drugs for Osteoperosis
-1: VitD + Calcium + Alendronic Acid
-2: Denozumab
Denozumab
Monoclonal Antibody inhibiting RANK-Ligand
Inhibits osteoclastic activity = less resporption
-Used 2nd line for osteoporosis (After Ca, VitD, and bisphosphonates)
Drugs for Gout
Acute flare-up: Colchicine (aCute for Colchicine)
Long-Term: Allopurinol (LOng alLOpurinol)
Drugs for Gullian Barre
Intravenous immunoglobulins
-Replace the damaging immunoglobulins that are produced after the causative infection.
Drugs for PE
Is the patient haemodynamically unstable?
-Alteplase / Streptokinase (Thrombolytic)
Is the patient haemodynamically stable?
-Apixaban (Anti-Platelet DOAC)
-OR LMWH if unsuitable for DOAC.
Drugs for Crohn’s Disease
Prevent relapse: Azathioprine (Thiopurine)
Induce Remission: Prednisolone (Corticosteroids)
Drugs for Ulcerative Colitis
Send into remission and prevent relapse:
-Sulfasalasine (Aminosalicylic acid)
If severe:
-IV Prednisolone
Remove the entire colon if needed.
Azathioprine
Thiopurine.
Immunosuppression via blocking the formation of white cells.
-Used for Crohn’s
-Used for SLE
-Used for transplantation
Carbimazole
Inhibits tyrosine-coupling and forming T3/T4
-Used for hyperthyroidism
-May cause agranulocytosis (watch for a sore throat)
Mannitol
Sugar-alcohol that acts as an osmotic diuretic in the blood.
Opens the blood-brain barrier.
-Used for raised ICP.
-Used for glaucoma
Metformin
Biguanide- Increases liver sensitivity to insulin.
-1st line for T2DM
-Side effects: Lactic acidosis
Insulin
Stimulates uptake of glucose into hepatocytes and inhibits gluconeogenesis.
-1st line for T1DM
-Last resort for T2DM
-Can be used with dextrose in hyperkalemia.
-May cause hypoglycemia.
Gliclazide
Sulfonylurea - Increases ß-cell excretion of insulin by blocking K+/ATPase channels
-2nd/3rd line for T2DM
-May cause weight gain
-May cause Hypoglycaemia
Sitagliptin
DDP4-Inhibitor: Increases incretin levels which inhibit glucagon.
-2nd/3rd line for T2DM
-Weight-neutral.
Dapagliflozin
SGLT2-Inhibitor: Increases urine glucose excretion.
-2nd/3rd line for T2DM
-May cause weight-loss
-May cause Hypoglycemia.
Drugs for Cushing’s
Ketoconazole - Reduces Cortisol and Aldosterone production.
Metyrapone - Reduces Cortisol and Aldosterone production.
Drugs for oesophageal varices
1st: Vasopressin or similar (Vasoconstrict)
Drugs for Asthma
1st: SABA e.g. Salbutamol
2nd: Weak ICS e.g. Beclamethosone
3rd: LTRA e.g. Montelukast
4th: Stop LTRA and go for LABA e.g. Salmeterol
5th: Strong ICS e.g Beclamethosone
Montelukast
Leukotriene Receptor Antagonist
Reduces airway inflammation
-3rd Line for Asthma treatment after SABA and ICS.
Drugs for migraine
Mild-Moderate: Paracetamol and NSAIDs
With Aura, acute: Sumatriptan (Triptan - Avoid in CVD/Preggo)
Vomiting: Metoclopramide (Anti-Emetic - D2-Antagonist)
Preventative: Propanolol / Topiramate (For asthmatics, avoid if taking COCP).
Drugs for Heart Failure
1st: ACE-I and Beta-Blocker
2nd/Reserved EF: Thiazides
3rd: Possibly Amiodarone / Digoxin
Adenosine
Binds Adenosine receptors causing complete heart block and SM dilation.
-Used for Supra-ventricular tachycardia AFTER Valsalva maneuver.
Prednisolone
GLUCOcorticoid which has anti-inflammatory, hyperglycaemic, and sympathetic effects.
-Side effects: Cushing’s Syndrome + Bone Loss
-Used in many inflammatory diseases, primarily rheumatological conditions.
Hydrocortisone
CORTICOsteroid which has both glucocorticoid and mineralocorticoid properties.
-Literally the same molecule as cortisol.
-Same uses as glucocorticoids but also can be used in Addison’s disease.
Fludrocortisone
Primarily a MINERALOcorticoid which acts as an aldosterone analogue.
-Used in adrenal insufficiencies.
Sumatriptan
Triptan that activates serotonin receptors causing Vasoconstriction + Reduced nociceptive neurotransmitters.
-Used to stop migraines and cluster headaches
Clozapine
Dopamine Antagonist
-Used to treat schizophrenia
-Common cause of drug-induced Parkinsonism.
Drugs for Epilepsy
Generalized:
-Nonpregnant: Sodium Valproate
-Pregnant/Female in general: Lamotrigine
Partial:
-Lamotrigine or Carbamazapine
Benzylpenicillin
B-Lactam commonly used in the community.
-Used for Neisseria prophylaxis
-Used to treat Syphilis.
S. Aureus Endocarditis
Vancomycin
+Rifampcin if MRSA
Bendroflumethiazide
Diuretic
DCT Na/Cl Blocker
Ipatropium
Short-Acting Muscarinic Antagonist
Inhaled: Blocks M3 receptors and causes bronchodilation.
-Can be used 1st line for COPD with salbutamol.
Loperamide
Agonist to μ-Opiod receptor.
-Used to harden stools and reduce diarrhea
-2nd line drug (3rd line treatment) for IBS.
-Used acutely for bowel obstruction.
Octreotide
Somatostatin Analog
-Used for acromegaly.
-Used to ease symptoms and slow growth of carcinoid tumors.
Anti-Folates
Phenytoin
Methotrexate
Trimethoprim
Dopamine Agonists
Bro, Rope. Per, Pram, Rot
Bromocriptine
Ropinirole
Pergolide
Pramipexole
Rotigotine
Lithium
Therapeutic Range: 0.4-1, measured 12h after dose taken.
Toxic: >1.5
Measured Every Week until stable
Measured Every 3m x4 (1y)
Measured Every 6m Onwards.
“Weekly visit to the stable, where I’ll be visiting my 4 s 3-month ponies. I’ll be learning to ride them when they’re 6m old.
Macrolides
Azythromycin, Clarythromycin, Erythromycin.
-Antibiotics often used as alternatives to b-Lactams.
-Use Erythromycin in pregnancy
-All tend to stimulate the stomach and GI tract which means:
—–1. Are used 1st for dysmotility in systemic sclerosis.
—–2. Are a RF for Pyloric Stenosis in infants.
