Drugs Flashcards
Parkinson’s (4 classes)
- Levodopa
- Ropinerole, Carbergoline, Bromocriptine
(D agonists) - Selegiline (MOA-B inhibitors)
- Entacapone, Tolcapone (COMTi)
Bell’s Palsy (2)
- Prednisolone within 72hrs
- Artificial tears
Trichomonas
- Oral Metronidazole 5-7 days
Scarlet Fever (2)
- IV Penicillin
- Azythromycin if allergic
Treatment for Syphilis (1)
- Benzathine Penicillin
TIA and Stroke (3)
- Aspirin 300mg
2nd Prevention:
- Clopidogrel 75mg
- Control RFs - statins, DM drugs and HTN drugs
Antiemetic suitable for Parkinson’s Disease (1)
- Domperidone (histamines worsen it)
Wernicke’s Encephalopathy (1)
- Pabrinex - Vit B n C
Hyperemesis Gravidarum (2)
- Oral Cyclizine / Promethazine (Antihistamines)
- Ondansteron or Metoclopramide (5HTs)
slight risk of cleft palate in 1st tri
IF SEVERE DEHYDRATION
3. Fluids + Electrolytes + Pabrinex - replace Vit B and C if wernickes
Viral Induced Wheeze (2)
- SABA
- ICS +/- LTRA (Monteleukast)
Post-Partum Thyroiditis (2)
Hyper thyroid stage managed with:
1. Propanolol
(not overactive thyroid so not carbimazole, this is purely symptomatic Tx)
Hypothyroid stage:
2. Thyroxine
PPH
(After ABCDE, Fluid resus, Mechanical palpation of uterus etc..)
- IV Oxytocin
- Ergometrine (CI HTN)
- Carboprost (CI Asthma)
- Misoprostol
Basically you’re trying to get the uterus to contract heavily to occlude/tamponade bleeding
Surgery from there on
Brain Abscess (3)
- Cefotaxime (IV 3rd Gen Cephalosporin)
AND - Metronidazole (covers fungal? i think….)
- Dexamethasone - Raised ICP Mx
Thread Worm (1)
- Mebendazole (and hygiene measures, FOR WHOLE HOUSEHOLD)
Whooping Cough (1)
- Macrolide - Clarithromycin or Azithromycin
14 day course
MUST BE WITHIN 21 DAYS OF Sx ONSET
Admit kids under 6 months, notifiable disease, 48hr school exclusion after ABx, Household PPx
Eclampsia (Seizures)
- MgSO4 for 24hrs post seizure or delivery
Pre-Eclampsia
- Labetalol (Nifedipine if Asthmatic)
Delivery of baby is definitive Tx
Adenomyosis (1)
- GnRH agonists (leuprolide)
Plus a hysterectomy eventually
Atrophic Vaginitis (2)
- Moisturisers and emollients
- Topical Oestrogen Cream
Medical Termination of Ectopic Pregnancy (1)
- Methotrexate
Endometrial Cancer in frail elderly women
- Progestogen therapy (basically bc surgery is CI)
Endometrial Hyperplasia (1)
- High dose progestogens or IUS
Endometriosis (3)
- NSAIDS +/- Paracetamol
- COCP
- GnRH analogues - induce pseudo-menopause
Drugs aint super useful tbh but could reduce symptoms
HMB
(3 for if contraception needed, 1 for if not, 1 for rapid stopping of HMB)
Requires Contraception:
1. IUS
- COCP
- Long acting Progestogens
Does NOT require contraception:
4. Mefenamic Acid 500mg or Tranexamic Acid
Rapid termination of HMB
5. Norethisterone
Medical termination/support of a miscarriage(1)
- Misoprostol
PID (4)
- Oral Ofloxacin
AND - IM Ceftriaxone
AND - Oral Doxycycline
AND - Oral Metronidazole
Basically, blast it with broad specs
PCOS (6)
General:
1. COCP - could help induce regular bleeds
Hirsutism:
COCP benefits this
- Eflornithine
- Spironolactone under specialists
Infertility:
4. Clomifene - Specialists and is debated
- Metformin
- Gonadotrophins
PMS (2)
Moderate:
1. 3rd gen COCP
Severe
2. SSRIs
Termination of Normal Pregnancy (1)
<9 wks:
1. Mifepristone (anti-progesterone) + prostaglandins to stimulate contractions
after which its surgery
Which psych drug class increases risk of gi bleed if taken with NSAIDS (thus requiring PPI co-prescription)
SSRIs
Urge Incontinence (2)
after bladder retraining,
- Antimuscarinics - Oxybutynin, tolterodine or darifenacin
- Mirabegron (B3-agonist, avoid if frail)
Only antiemetic suitable for Parkinson’s disease
- Domperidone (doesn’t cross BBB)
Other anti-histamines like cyclizine or prochlorperazine may worsen PD
Stress Incontinence (1)
after pelvic floor exercises:
- Duloxetine (SnRI)
*(increase ser and nor conc in pudenal nerve = increased sphincter stimulation - better sphincter)
Fibroids (6)
To manage Menorrhagia:
- IUS (LNG-IUS) - (only for small ones)
- NSAIDS - Mefenamic acid
- Tranexamic acid
- COCP
- Oral Progesterone / injectable
To Shrink Fibroids:
6. GnRH agonists - shrink by inducing pseudo-menopause since fibroids are E2 sensitive
Vaginal Candidiasis (Thrush) (3)
- Oral Fluconazole
- Clotrimazole intravaginal pessary
- Topical imidazole for vulvar Sx
oral Tx CI in Pregnancy
FOR RECCURENT:
fluconazole on a weird regimine - dont bother basically
Acute Dystonia (Oculogyric crisis / Torticollis) (1)
- Procyclidine
Tardive Dyskinesia (1)
- Tetrabenazine
Side Effects of Typical Antipsychotics (11)
Again, just to have as notes, not necessarily to learn by wrote, but you need to know each individually well as psych questions are pretty pharm specific
- Parkinsonism
- Acute Dystonia
- Tardive Dyskinesia
- Akathisia
- Antimuscarinic: dry mouth etc
- Weight gain, sedation
- Raised Prolactin
- Impaired Glucose metabolism
- Reduced Seizure Threshold
- Neuroleptic Malignant Syndrome
- Haloperidol is a QTc drug
Tardive Dyskinesia (1)
- Tetrabenazine
Suppression of Lactation (1)
- Cabergoline
(Dopamine Receptor Agonist and Dopamine inhibits Prolactin release)
Chickenpox EXPOSURE in pregnancy
If in doubt over mums immuno status, varicella ABs need checking
if </= to 20wks:
1. VZIG given
if >20 wks:
2. Antivirals - oral acyclovir 7 to 14 days post exposure
Puerperal Pyrexia/Endometritis (2)
- Clindamycin
AND
- Gentamicin
Contracted chickenpox in Pregnancy (1)
Seek specialist help
- Oral Acyclovir if >20wks within 24hrs of rash
if less than 20 wks, use is cautionary as potential risks to baby
Chorioamnionitis (1)
Prompt delviery and:
- IV broad spec ABxs
Epilepsy drugs in Pregnancy
Benefits of controlling epilepsy > risks to foetus
- Folic acid 5mg (which is higher dose) as higher risk of NTDs
- Valproate: risk of NTDs
- Carbamazepine: least teratogenic of older antiepileptics
- Phenytoin: cleft palate and needs vit k in last month to prevent newborn clotting disorders
- Lamotrigine: lower risk seemingly
Indications for high dose Folic Acid (5mg vs 400mcg) (3)
- Partner with NTD or previous NTD baby or strong FHx
- Antiepileptic drug use, has DM, Coeliac or Thalassaemia
- BMI > 30
*Still take till 12th week
Gestational DM (2)
If <7mmol/L at diagnosis then start trial of diet and exercise for 2 weeks, if failed then:
- SHORT ACTING Insulin
then - Metformin if still not controlled
If already >7mmol/L at diagnosis
1. Start the Insulin straight away
Mx of pre-existing DM in pregnancy (3)
- Stop hypoglycaemic agents except Metformin
- Start Insulin (Short acting)
- FOlic acid 5mg till wk 12
tight glycaemic control needed
Group B Streptococcus infection - Pregnancy (1 drug, 4 indications)
- BenPen (BenzylPenecillin)
Intrapartum Antibiotic Prophylaxis (IAP) should be offered to women who:
- Detected GBS in this pregnancy
- Previous GBS pregnancy
- All Preterm labours / PROMs
- Pyrexia in labour of >38 degrees
Foetus born to Hep B +ve mother (2)
- Vaccination
- Hep B IVIG
Outline SSRI Withdrawal Syndrome (5)
- GI disturbance - diarrhoea
- Headaches/electric shock feelings
- Paraesthesia
- Sweating
- Restlessness and mood changes
HIV in Pregnancy (2)
- ART for mum throughout regardless of prior usage
- Zidovudine infusion 4 hrs pre C-section
Neonate:
2. Zidovudine
1. Triple ART therapy for 4-6 wks
DONT BREASTFEED
Induction of Labour (IoL) (2)
surgical membrane sweep +/-
- Vaginal Prostaglandin E2
- Maternal oxytocin infusion
other methods are surgical and therefore not in these flashcards - check textbook chapter on passmed
Uterine Hyperstimulation (1)
If possible remove vaginal prostaglandins and offer tocolysis with:
- Terbutaline
Intrahepatic Cholestasis of Pregnancy (2)
induce labour at 37-38 wks
- Ursodeoxycholic acid
- Vit K supplements
Anaemia in pregnancy (1 with 3 thresholds)
- Ferrous Sulfate
treat if if:
1st trimester - hb < 110
2nd/3rd trimester - hb < 105
Post-partum - hb < 100
Jaundice in Pregnancy (1)
- Ursodeoxycholic acid for Sx relief
Cord Prolapse (1)
Mainly surgical, this card is to remind you that you can use tocolytics to reduce contractions and reduce risk of it prolapsing acutely again
VTE in Pregnancy
- 4 or more RFs means LMWH PPx
AVOID DOACS
Acute Stress Disorder (1)
following Trauma-focused CBT
1. Benzodiazepines
(only prescribe short term for acute agitation and sleep disturbance)
Alcohol Withdrawal (2)
- Long acting Benzodiazepines - Chlordiazepoxide or Diazepam
- Carbamazepine also effective
Key Side-effects of Typical Antipsychotics (10 - less to memorize, more to read through and remind yourself)
- Parkinsonism - (such that they are CI in Parkinson’s and dimentia)
- Acute Dystonia/dystonic reaction - (torticolis, oculogyric crisis)
- Akathisia
- Tardive Dyskinesia (chewing jaw, choreoid movements)
- Increase CVA and VTE risk
- Antimuscarinic SEs: dry mouth, blurred vision, urinary retention, constipation
- Sedation and weight gain
- Neuroleptic Malignant Syndrome: pyrexia, muscle stiffness
- Reduced seizure threshold
- Impaired glucose tolerance
- Raised Prolactin
- QT interval lengthening -haloperidol
Key SE of Clozapine (1)
- Agranulocytosis - dropped white cells and subsequent easy infection and immunosuppression
requires monitoring and is affected by smoking cessation or increase
The atypical antipsychotic with the best SE profile?
Aripiprazole
MoA of Benzodiazepines
Increase Frequency of chloride channel opening on GABA receptors (opens them more often - Frenzos - Frequency)
Otitis Media (1)
- Amoxicillin
In practice nothing is given its conservative and self limiting - NNT is like 35 or something and GPs dont give this but this is the medschool answers for SBAs
SEs of MOA-B inhibitors (4)
- Hypertensive Crisis
- Nausea
- Insomnia
- Dyspnoea
Class of antibiotics safe at any stage of pregnancy (1)
- Cephalosporins
eg: NOT
Nitrofurantoin (avoid in 3rd tri -haem anaemia and G6PD def)
Sulphonamides (3rd tri - kernicterus)
Tetracyclines (teeth staining and skeletal issues)
Trimethoprim (folate antagonist - NTDs)
Medication used in Sickle Cell to manage complications (2)
- Prophylactic Penicillin
- Hydroxycarbamide - prevent crisis
Med given to reverse DOAC/NOAC anticoagulation (1)
- Beriplex
Med given to reverse heparin effects (1)
- Protamine
Paracetamol Overdose (1)
N-acetylcysteine (NAC or acetadote) - replenishes glutathione stores