Drugs Flashcards
Name 3 drugs that can be used to sedate delirious patients
Haloperidol, lorazepam, olanzapine
Name a hormone or small molecule drug used to treat chronic myeloid leukaemia
Imatinib
Name a selective oestrogen receptor modulator (SERM) used in breast cancer treatment
Tamoxifen
When is ovarian ablation used?
As a systemic hormone therapy in premenopausal breast cancer patients
Name 2 non-steroidal aromatase inhibitors used in breast cancer
Anastrozole, letrozole
Name a steroidal aromatase inhibitor used in breast cancer
Exemestane
Name an oestrogen antagonist used in breast cancer
Fulvestrant
Name 2 biological therapies used in breast cancer that bind to Her-2 receptors
Trastuzumab, lapatinib
What therapies might be used alongside an oestrogen antagonist in breast cancer?
Bisphosphonates, denosumab (binds to RANK-L to decrease survival of osteoclasts)
Name an intercalating chemotherapy drug the inserts into dsDNA
Doxorubicin
Name a drug used in immunotherapy for cancer that ‘cuts the breaks’ and enhances the T cell response
Iplimumab
What does implimumab do?
Immunotherapy for cancer. Enhances T cell response to cancer
What is denosumab?
A therapy that binds to RANK-L receptors in bone and decreases survival of osteoclasts. Decreases bone resorption
What is exemestane?
A steroidal aromatase inhibitor used in the treatment of breast cancer
What is anastrozole?
A non-steroidal aromatase inhibitor used in the treatment of breast cancer
Treatment of diabetic ketoacidosis
Resuscitation (0.9% IV saline)
Insulin (0.1units/kg/hr IV)
Potassium (20mmol/l IV)
What is metformin?
A biguanide oral diabetic medication that lowers glucose output from liver and increases uptake into skeletal muscle and adipocytes
What is the 1st line drug in type 2 diabetes?
Metformin, orally, 2-3 times per day with food
Name 3 sulphonylureas
Gliclazide, glipizide, glibenclamide
What is gliclazide?
A sulphonylurea drug for diabetes
Binds to K+ channels and closes them, Ca2+ enters and insulin leaves pancreatic cells
SE of sulphonylureas?
Hypoglycaemia, weight gain
Name a thiazolidenodione
Pioglitazone
What is pioglitazone?
A thiazolidenodione diabetic drug
Action of thiazolidenodiones?
Increased transcription of insulin sensitive genes in adipocytes, increased glucose uptake and use, increased lipogenesis
Name 2 DPP4-inhibitors
Sitagliptin, saxagliptin
What is sitagliptin?
A DPP4-inhibitor
Action of DPP-4 inhibitors?
Stops GLP-1 degredation, increased insulin and decreased glucagon and glucose
Glucose dependent action, weight loss
Name a GLP-1 analogue
Exenatide
What is exenatide?
A GLP-1 analogue
Action of GLP=1 analogues?
Increased insulin, decreased glucagon and glucose, decreased food intake
Name an SGLT-2 inhibitor
Dapagliflozin
What is dapagliflozin?
An SGLT-2 inhibitor
Action of SGLT-2 inhibitors?
Inhibits reabsorption of glucose in proximal convoluted tubule
Sugary urine, weight loss
How do you treat a chronic/subacute endocarditis?
Amoxicillin IV
What is the usual therapy for endocarditis?
Vancomycin + gentamicin + rifampicin
How do you treat endocarditis with severe sepsis or a penicillin allergy?
Vancomycin + gentamicin
Which malarial prophylaxis is given 1 tab a day, 1 day before and 1 week after return?
Atovaquone + proguanil
What is malarone?
Atovaquone plus proguanil
What malarial prophylaxis causes photosensitivity rashes in 20% of the population?
Doxycycline
How long do you take doxycycline for malarial prophylaxis?
1 week before and 4 weeks after
Main SE of mefloquine?
Neuropsychiatric effects
How long do you take mefloquine for for malaria prophylaxis?
3 weeks before, 4 weeks after
What are common vaccinations legally required for travel?
Yellow fever, meningococcal ACWY, Polio
What vaccination is legally required for the Hajj pilgrimage?
Meningococcal ACWY (Plus polio and yellow fever if from country at risk)
Treatment of Ebola?
Supportive care, IV fluids, antimalarials and antibiotics
Treatment of non-severe P.flaciparum malaria?
Quinine + 2nd agent
Malarone (proguanil + atovaquone)
Co-artem (artesunate + halofantine)
Treatment of sever P.falciparum malaria?
IV Quinine, IV artesunate
Treatment of P.vivax malaria?
Oral chloroquine Oral primaquine (check for G6PD deficiency)
What do you do before giving primaquine?
Check for G6PD deficiency
Which anti-malarial agent is the only one that cures malaria and eliminates liver hyponozoites?
Primaquine
Name the 6 types of antiretrovirals
Fusion/entry inhibitors Integrase inhibitors Reverse transcriptase inhibitors Non nucleoside reverse transcriptase inhibitors Protease inhibitors Maturation inhibitors
Name 4 NRTIs
AZT
Lamivudine
Tenofovir
Abacavir
What is lamivudine?
A reverse transcriptase inhibitor for HIV treatment
What is tenofovir?
A reverse transcriptase inhibitor for HIV treatment
Name 2 protease inhibitors for HIV
Indinivir, ritonavir
Name an integrase inhibitor for HIV
Raltegravir
Name an NNRTI for HIV
Efavirenz
What is HAART?
Highly active anti-retroviral therapy
3 drugs of at least 2 different classes
Treatment of bacterial meningitis?
Ceftriaxone/cefoxiane IV
Chloramphenicol is alternative
Treatment of MRSA?
Vancomycin
Treatment of CKD?
ACEi, ANG-II blockers in younger patients
Calcium channel blockers in over 55s
Treatment of CKD mineral bone disorders?
Vit D replacement Dietary phosphate reduction Phosphate binders (eg Ca salts) Calcimimetics Parathyroiectomy
Treatment of hepatic encephalopathy?
Exclude diabetes, alcohol withdrawl, hyponatraemia, drugs
Modify microbiota (lactulose, rifaxamin, probiotics)
Laxatives, nutrition
Treatment of alcoholic hepatitis?
Alcohol abstinence
Prednisolone/pentoxifyllene
First line treatment for OA?
Physio, exercise, weight loss if obese
Paracetamol, topical NSAIDs
What treatment is now not recommended for osteoporosis due to the risk of stroke, CHD and breast cancer?
HRT
What drug is used for vertebral osteoporosis?
Raloxifene
What class of drug is regularly prescribed for osteoporosis in post menopausal women and acts by inhibiting bone resorption?
Bisphosphonates
Name the first and second line bisphosphonates use in osteoporosis
Alendronate
Risedronate
Name 2 bisphosphonates that are given IV
Pamidronate, zoledronate
What is alendronate?
Bisphosphonate, given daily to inhibit bone resorption in post menopausal women with osteoporosis
Name a synthetic parathyroid drug
Teriparatide
What is teriparatide?
Synthetic parathyroid drug used to increase bone formation and increase bone mass and strength back to normal. Used in steroid induced osteoporosis
What drug is used in steroid induced osteoporosis?
Teriparatide, synthetic parathyroid
How do you work out maintenance fluids for a child weighing 32 kg?
100ml/kg/day for first 10kg = 1000ml
50ml/kg/day for 10-20kg = 500ml
20ml/kg/day for 20+kg = 240ml
=1740ml/day = 72.5ml/hour
How much potassium do neonates need per day?
1-3 mmol/kg
How much sodium do neonates need per day?
2-6 mmol/kg
What can be prescribed for nausea and vomiting in palliative care?
Metoclopramide, haloperidol
Name 3 anti-emetics
Cyclizine, levomapromazine, metoclopramide
What is cyclizine?
Antiemetic anticholinergic and antihistaminic
Works on vomiting centre
Can cause dry mouth and drowsiness
What is levomapromazine
Anti-emetic
Acts on 5HT2, D2, Ach and H2 receptors
Used as sedative in last hours of life
What is metoclopramide?
Anti-emetic, prokinetic
DA antagonist and 5HT4 agonist
Given by continuous sub cutaneous infusion
Name 2 antipasmodics
Hyoscine butylbromide
Octreotide
What is hyoscine butylbromide?
An antipasmodic muscarinic antagonist
What is octreotide?
Antipasmodic, somatostatin analogue, decreases secretions
Name a tricyclic antidepressant used to treat neuropathic pain
Amitriptyline
Name an anticonvulsant used to treat neuropathic pain
Gabapentin
Name a steroid used to treat neuropathic pain
Dexamethasone
Name 3 drugs used to treat neuropathic pain
Amitriptyline, gabapentin, dexamethasone
Treatment of PCP pneumonia
Co-trimoxazole +/- steroids
Treatment of Toxoplasosis gondii
Sulfadiazine + pyrimethamine
Treatment of Kaposi’s sarcoma
Anti retrovirals and chemotherapy
Treatment of TB
Isoniazid, rifampicin, pyrazinamide, ethambutol/streptomycin