Drugs Flashcards
Ramipril
Category: ACE-I
MoA: Lower BP via ACE inhibition thus lower Angiotensin II
Use: HTN, CHF, CV events prophylaxis (at risk pts)
Side-Effects: dry cough, faintness, dizziness, NVD
Monitoring: Renal function and electrolytes (hyperkalemia)
Dose: 1.25 - 2.5mg (night)
Aspirin
Category: NSAID and anti-platelet
MoA: Inhibits COX1 and COX2 enzymes in production of thromboxanes and prostaglandins
Use: pain and fever, ischaemic events (TIA, STEMI, NSTEMI, Acute ischaemic stroke), secondary prevention of CVD
Side Effects: dyspepsia, hemorrhage
Monitoring/ caution: active peptic ulceration; bleeding disorders
Dose: Post acute CV event (300mg once), CVD secondary prevention (75mg daily), pain/pyrexia (300-900mg every 4-6 hours, max 4g p/d)
Furosemide
Category: Loop Diuretic
MoA: NKCC2 antagonist in TAL of loop of Henle
Use: Oedema (e.g. CCF, kidney impairement etc.), resistant HTN, cerebral oedema (IV)
Side Effects: Dizziness, headache, nausea, gout (hyperuricemia), hyperglycemia
Monitoring: electrolytes (risk of hypokalemia, hyponatremia, hypochloremia)
Caution: High dose + rapid administration = ototoxic (tinnitus + deafness)
Dose: 40mg daily (oedema), 40-80mg (resistant hypertension)
Senna
Category: Stimulant Laxative
MoA: Senna metabolites stimulate peristalsis and reduced H20 reabsorption by large intestine
Use: Constipation
Side Effects: NVD, albuminuria, abdo pain, urine discolouration (yellow/red-brown)
Contra-indications: Intestinal obstruction, undiagnosed abdo pain
Dose: 7.5 - 15mg daily (max dose 30mg) bedtime
Tiotropium
Category: LAMA (long acting muscarinic antagonist)
MoA: antagonises M3 muscarinic receptors on smooth muscle cells and submucosal glands. reduction in smooth muscle contraction and mucus secretion → bronchodilatory effect.
Use: Maintenance inhaler in COPD, Severe asthma
Side Effects: dry mouth; cough; headache; nausea; arrhythmias; dizziness
Cautions: Heart failure, arrhythmia
Dose: 5micrograms (2xpuffs)
AKA “Spiriva”
Salmeterol
Category: LABA
MoA: agonist of β2 adrenoreceptors, causing SM relaxation
Use: Maintenance and prevention of asthma (with ICS); maintenance of COPD
Side Effects: dizziness, sinus infection, and migraine headaches. !!Increased heart rate, dyspneoa
Cautions: caution with arythmias, hypokalaemia,
Monitoring: hypokalaemia; blood glucose in DM pts.
Dose: 50 micrograms twice daily
Haloperidol
Category: Typical Antipsychotic and Anti-emetic
MoA: Not fully understood; dopamine D2 receptor competitive antagonist (D2 antagonism in chemoreceptive trigger zone of brain = anti-emetic effect)
Use: prophylaxis of postoperative nausea/vomiting, Schizophrenia, acute delerium, mania in bipolar disorder, tic disorders (e.g. Tourette’s)
Side Effects: extra-pyramidal (akathisia, dsytonia, muscle rigidity), depression, vision disorders, hypersalivation, weight gain
Monitoring/Caution: Electrolytes, ECG (before treatment and with IM doses)
Contra-indications: congenital long QT syndrome, dementia with Lewy bodies, Hx of ventricular arrhythmia, Parkinson’s, Qtc-interval prolongation, recent MI, uncompensated CHF
Dose: Anti-emetic (1 - 2mg 1-2 times a day) Anti-psychotic (2-10mg daily in 1-2 divided doses)
Orlistat
Category: Lipase Inhibitor
MoA: Inhibits gastric + pancreatic lipases, thus preventing breakdown of triglycerides in intestine into free absorable fatty-acids (triglycerides are excreted in faeces)
Use: Adjunct to lifestyle changes in obesity (BMI ≥ 30 kg/m2) management OR in pts with BMI ≥ 28 kg/m2 + presence of other risk factors
Side Effects: abdo pain, didarrhoea, steatorrhoea (fatty stools), GI disorders
Contraindications: cholestasis, chronic malabsorption syndrome
Dose: 120mg up to 3 times daily – taken before, during or up to 1hr after each main meal (Higher doses don’t produce more potent effects)
Discontinue after 12 weeks if weight loss is not >5% since start of treatment
