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Drugs > Drugs > Flashcards

Drugs Flashcards

1
Q

Acetylcysteine use

A

Paracetamol OD
Mucolytic
Renal damage prevention from contrast medium

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2
Q

Activated charcoal use

A

Drug ODs

Poisonings

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3
Q

Adenosine use

A

Supraventricular tachycardia

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4
Q

Acetylcysteine risks

A

Anaphylactoid reaction

Bronchospasm

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5
Q

Adenosine risks

A

Induced bradycardia

Asystole

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6
Q

Adenosine contraindications

A 
Bradycardia
Hypotension
Coronary ischaemia
Asthma
COPD
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7
Q

Adrenaline use

A

Cardiac arrest
Anaphylaxis
Small bleeding control
Prolongation of local anaesthesia (e.g. lidocaine)

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8
Q

Adrenaline risks

A 
Cardiac arrest via HTN induction
Anaphylaxis
Arrythmias, MIs
Tachycardia
Palpitations
Dizziness
Sweating
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9
Q

Spironolactone drug type

A

Aldosterone antagonist

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10
Q

Adrenaline drug type

A

Adrenoceptor agonist

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11
Q

Adenosine drug type

A

G-protein coupled receptor agonist

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12
Q

Spironolactone risks

A

Hyperkalaemia
Stevens-Johnson syndrome
Gynaecomastia
Liver impairment

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13
Q

Spironolactone contraindications

A

Hyperkalaemia

Addison’s disease

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14
Q

Allopurinol use

A

Prevention of acute gout

Prevention of hyperuricaemia

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15
Q

Allopurinol drug type

A

Xanthine oxidase inhibitor

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16
Q

Doxazosin/tamsulosin drug type

A

Alpha blocker

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17
Q

Doxazosin/tamsulosin use

A

BPH symptom improvement
Add-on in resistant HTN
Pre-surgery in pheochromocytoma

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18
Q

Doxazosin/tamsulosin risks

A

Postural hypotension
Dizziness
Syncope

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19
Q

Gentamicin drug type

A

Aminoglycoside

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20
Q

Gentamycin use

A

Severe sepsis
Pyelonephritis/complicated UTI
Endocarditis

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21
Q

Gentamycin risks

A

Nephrotoxicity

Ototoxicity

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22
Q

Gentamycin interactions

A

Loop diuretics - nephrotoxicity

Cephalosporins - ototoxicity

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23
Q

Mesalazine drug type

A

Aminosalicylate

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24
Q

Mesalazine use

A

Mild to moderate UC

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25
Q

Mesalazine risks

A 
GI upset
Headache
Blood abnormalities
Renal impairment
Oligospermia
Hypersensitivity
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26
Q

Amiodarone use

A

Tachyarrhythmia control (AF, atrial flutter, SVT, VT, refractory VF)

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27
Q

Amiodarone risks

A 
Hypotension
Pneumonitis
Hepatitis
HR changes
AV block
Hyper/othyroidism
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28
Q

Amiodarone interactions

A

Diltiazem, digoxin, verapamil - increased risk of AV block and bradycardia

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29
Q

Ramipril drug type

A

ACE inhibitor

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30
Q

Ramipril use

A

Hypertension
Chronic HF
Ischaemic HD
Diabetic nephropathy and CKD with proteinuria

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31
Q

Ramipril risks

A 
Hypotension
Persistent dry cough
Hyperkalaemia
Cause/worsening of renal failure
Angioedema
Anaphylaxis
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32
Q

Ramipril contraindications

A

Pregnancy/breastfeeding

AKI, CKD, renal artery stenosis

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33
Q

Losartan drug type

A

Angiotensin receptor blocker

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34
Q

Losartan use

A

Hypertension (when ACE-is aren’t tolerated due to cough)
Chronic HF
IHD
Diabetic nephropathy and CKD with proteinuria

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35
Q

Losartan risks

A

Hypotension
Hyperkalaemia
Cause/worsening of renal failure

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36
Q

Losartan contraindications

A

Pregnancy/breastfeeding

AKI, CKD, renal artery stenosis

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37
Q

Sertraline drug type

A

SSRI antidepressant

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38
Q

Sertraline use

A

Moderate to severe depression
Panic disorder
OCD

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39
Q

Sertraline risks

A 
GI upset, appetite and weight disturbance
Hypersensitivity
Hyponatraemia
May increase suicidal behaviour
Reduced seizure threshold
Prolonged QT interval/arrhythmias
Increased risk of bleeding
Withdrawal symptoms
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40
Q

Sertraline contraindications

A

Epilepsy
PUD
Youth (due to increased suicide)

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41
Q

Sertraline interactions

A

MAO inhibitors (risk of serotonin syndrome)

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42
Q

Amitriptyline drug type

A

TCA antidepressant

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43
Q

Amitriptyline use

A 
Moderate to severe depression where SSRIs are ineffective
Neuropathic pain (unlicensed)
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44
Q

Amitriptyline risks

A

Antimuscarinic blockade - dry mouth, constipation, urinary ret, blurred vision
Serotonin/alpha blockade - sedation, hypotension
Cardiac effects - arrhythmias, QT elongation
Neuro - convulsions, hallucinations, mania
Dopamine - breast changes, sexual dysfunction, tremor
OD - severe hypotension, arrhythmias, convulsions, coma, resp failure
Withdrawal symptoms

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45
Q

Amitriptyline contraindications

A 
Elderly
CVD
Epilepsy
Constipation
Increased intraocular pressure
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46
Q

Amitriptyline interactions

A

MAO inhibitors (risk of serotonin syndrome)

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47
Q

Mirtazepine drug type

A

Pre-synaptic alpha 2 antagonist

Antidepressant

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48
Q

Venlaxafine drug type

A

5-HT and NA reuptake inhibitor (SNRI)

Antidepressant

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49
Q

Mirtazepine use

A

Major depression where SSRIs aren’t tolerated

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50
Q

Venlafaxine use

A

Generalised anxiety disorder

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51
Q

Mirtazepine risks

A

GI upset - diarrhoea, constipation, nausea, weight change
CNS effects - headache, strange dreams, insomnia, confusion, convulsions
Hyponatraemia
Serotonin syndrome
Suicidal thought and behaviour

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52
Q

Venlaxafine risks

A

GI upset - diarrhoea, constipation, nausea, weight change
CNS effects - headache, strange dreams, insomnia, confusion, convulsions
Hyponatraemia
Serotonin syndrome
Suicidal thought and behaviour
Prolonged QT interval

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53
Q

Mirtazepine contraindications

A

Hepatic/renal impairment

Elderly

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54
Q

Venlaxafine contraindications

A

Hepatic/renal impairment
Elderly
CVD - due to risk of arrhythmias

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55
Q

Metoclopramide drug type

A 
D2 antagonist (does cross BBB)
Antiemetic
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56
Q

Metoclopramide use

A

Prophylaxis and treatment of nausea and vomiting

Reduced gut motility

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57
Q

Metoclopramide risks

A

Diarrhoea

EPS - movement abnormalities potentially leading to acute dystonic reaction

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58
Q

Domperidone drug type

A 
D2 antagonist (does not cross BBB)
Antiemetic
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59
Q

Domperidone use

A

Prophylaxis and treatment of nausea and vomiting

Reduced gut motility

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60
Q

Domperidone risks

A

Diarrhoea

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61
Q

Cyclizine drug type

A

H1 receptor antagonist (antihistamine)

Anti-emetic

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62
Q

Cyclizine use

A

Prophylaxis and treatment of nausea and vomiting

Motion sickness and evrtigo

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63
Q

Cyclizine risks

A 
Antihistamine - drowsiness
Anticholinergic - dry throat and mouth
Tachycardia
Palpitations
BPH - due to anticholinergic properties risking urinary ret
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64
Q

Cyclizine contraindications

A

Hepatic encephalopathy (due to sedative effect)

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65
Q

Prochlorperazine drug type

A

Phenothiazine
Antiemetic
Antipsychotic

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66
Q

Prochlorperazine use

A

Prophylaxis and treatment of nausea and vomiting
Vertigo
Treatment of psychotic disorders (e.g. schizophrenia)

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67
Q

Prochlorperazine risks

A

Drowsiness
Postural hypotension
D2 receptor blockade - EPS, including acute dystonic syndrome and tar dive dyskinesia
Prolonged QT interval

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68
Q

Prochlorperazine contraindications

A

Severe liver disease (hepatotoxicity)
QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)
BPH - due to anticholinergic properties risking urinary ret

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69
Q

Ondansetron drug type

A

5-HT3 receptor antagonist (serotonin)

Antiemetic

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70
Q

Ondansetron risks

A

Constipation, diarrhoea, headaches (rare)

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71
Q

Ondansetron contraindications

A

QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)

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72
Q

Nystatin drug type

A

Antifungal

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73
Q

Fluconazide drug type

A

Antifungal

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74
Q

Nystatin risks

A

Local irritation

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75
Q

Fluconazide risks

A 
GI upset
Severe hepatic toxicity
Prolonged QT (arrhythmia)
Headache
Hypersensivitiy
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76
Q

Fluconazide contraindications

A

Renal impariemtn
Liver disease
Pregnancy

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77
Q

Fluconazide interactions

A

Acts as CYP450 inhibitor

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78
Q

Loratedine drug type

A

Antihistamine

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79
Q

Loratedine uses

A

Allergies (hay fever)
Pruritus and urticaria
Anaphylaxis adjunct (with adrenaline)
Nausea and vomiting - antiemetic

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80
Q

Loratedine contraindications

A

Severe liver disease (risk of hepatic encephalopathy)

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81
Q

Loperamide drug type

A

Antimobility

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82
Q

Loperamide use

A

Symptomatic treatment for diarrhoea (in IBS, viral gastroenteritis)

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83
Q

Loperamide risks

A

GI - constipation, abdo cramping, flatulence

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84
Q

Loperamide contraindications

A

Acute UC - risk of megacolon, perforation, C diff colitis

Acute bloody diarrhoea (dysentry, E coli)

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85
Q

Codeine phosphate drug type

A

Antimobility

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86
Q

Codeine phosphate use

A

Symptomatic treatment for diarrhoea (in IBS, viral gastroenteritis)

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87
Q

Codeine phosphate risks

A

GI - constipation, abdo cramping, flatulence

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88
Q

Codeine phosphate contradindications

A

Acute UC - risk of megacolon, perforation, C diff colitis

Acute bloody diarrhoea (dysentry, E coli)

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89
Q

Ipratropium drug type

A

Antimuscarinic

Bronchodilator

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90
Q

Ipratropium use

A

COPD - relieve/prevent breathlessness (La/Sa)

Asthma - Sa: adjuvant with salbutamol, La: co-admin with high dose corticosteroids and B2 agonists

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91
Q

Ipratropium risks

A

Dry mouth

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92
Q

Ipratropium contraindications

A

Angle-closure glaucoma - increased IOP

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93
Q

Atropine drug type

A

Antimuscarinic (CVS/GI)

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94
Q

Atropine use

A

Severe bradycardia - inc HR
IBS - antispasmodic effect
Dying patient - reduced respiratory secretions

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95
Q

Atropine risks

A

PSNS blockade - reduced secretions, tachycardia, constipation
Reduced detrusor activity - urinary ret
Blurred vision
Central - drowsiness, confusion

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96
Q

Atropine contraindications

A

Angle-closure glaucoma - increased IOP

Arrhythmias

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97
Q

Oxybutinin drug type

A

Antimuscarinic (GU)

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98
Q

Oxybutinin risks

A

PSNS blockade - dry mouth, achy, constipation, blurred vision

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99
Q

Oxybutinin contraindications

A

UTI
Angle-closure glaucoma - increased IOP
Arrhythmias
Urinary ret

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100
Q

Haloperidol

A

1st generation antipsychotic

D2 antagonist

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101
Q

Haloperidol use

A

Treatment of severe psychomotor agitation causing dangerous/violent behaviour
Schizophrenia
Bipolar disorders (acute mania)
Palliative - nausea and vomiting

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102
Q

Oxybutinin use

A

Reduction of urinary frequency, urgency and incontinence in overactive bladder

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103
Q

Haloperidol risks

A 
EP effects (PD mimicry) - acute dystonia, neuroleptic malignant syndrome, tardive dyskinesia
Drowsiness, hypotension, QT prolongation, erectile dysfunction
Hyperprolactinaemia
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104
Q

Haloperidol contraindications

A

Elderly
Dementia
PD
Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)

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105
Q

Risperidone drug type

A

Atypical antipsychotic

D2 antagonist

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106
Q

Risperidone use

A

Urgent treatment of psychomotor agitation
Schizophrenia
Bipolar disorder - acute mania

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107
Q

Clozapine drug type

A

Atypical antipsychotic

D2 antagonist

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108
Q

Risperidone risks

A 
Sedation
EPS
Metabolic disturbance - weight gain, DM, lipid changes
Prolonged QT
Hyperprolactinaemia
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109
Q

Clozapine risks

A

Sedation
EPS
Metabolic disturbance - weight gain, DM, lipid changes
Prolonged QT
Hyperprolactinaemia
Severe neutrophil deficiency - agranulocytosis, myocarditis

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110
Q

Risperidone contraindications

A

CVD

Severe heart disease

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111
Q

Clozapine contraindications

A

CVD
Severe heart disease
Neutropaenia

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112
Q

Risperidone interactions

A

Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)

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113
Q

Clozapine interactions

A

Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)

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114
Q

Aspirin drug type

A

NSAID

COX2 inhibitor

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115
Q

Aspirin use

A

Acute coronary syndrome, acute ischaemic stroke (increases platelet aggregation inhibition)
Prevention of thrombotic arterial events in CVS, cerebrovascular and peripheral artery disease
Reduces risk of intracardiac thrombus and embolic stroke - AF
Control of mild to moderate pain and fever

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116
Q

Aspirin risks

A

GI irritation, ulceration, haemorrhage
Hypersensitivity reactions - bronchospasm
OD - tinnitus, life threatening CVS and respiratory collapse

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117
Q

Aspirin contraindications

A

Hypersensitivity
This trimester of pregnancy
Pre-existing gastric ulceration/gout

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118
Q

Aspirin interactions

A

Antiplatelets (e.g. clopidogrel)

Anticoagulants (e.g. heparin, warfarin)

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119
Q

Diazepam drug type

A

Benzodiazepine

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120
Q

Lorazepam drug type

A

Benzodiazepine

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121
Q

Midazolam drug type

A

Benzodiazepine

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122
Q

Diazepam use

A

Seizures, status epilepticus
Alcohol withdrawal reactions
Short-term - severe disabling anxiety and insomnia

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123
Q

Lorazepam use

A

Seizures, status epilepticus
Alcohol withdrawal reactions
Short-term - severe disabling anxiety and insomnia

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124
Q

Midazolam use

A

Seizures, status epilepticus
Alcohol withdrawal reactions
Short-term - severe disabling anxiety and insomnia

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125
Q

Diazepam risks

A

Dose dependent drowsiness, sedation and coma
OD - airway obstruction, death
Dependence, withdrawal reaction

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126
Q

Lorazepam risks

A

Dose dependent drowsiness, sedation and coma
OD - airway obstruction, death
Dependence, withdrawal reaction

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127
Q

Midazolam risks

A

Dose dependent drowsiness, sedation and coma
OD - airway obstruction, death
Dependence, withdrawal reaction

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128
Q

Diazepam contraindications

A

Respiratory impairment
Neuromuscular disease
Liver failure - hepatic encephalopathy

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129
Q

Lorazepam contraindications

A

Respiratory impairment
Neuromuscular disease
Liver failure - hepatic encephalopathy

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130
Q

Midazolam contraindications

A

Respiratory impairment
Neuromuscular disease
Liver failure - hepatic encephalopathy

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131
Q

Diazepam interactions

A

Other sedative drugs (e.g. alcohol, opioids)

CYP450 inhibitors reduces elimination

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132
Q

CYP450 inhibitors

A 
Amiodarone
Diltiazem
Macrolides
Fluconazole
Protease inhibitors
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133
Q

Lorazepam interactions

A

Other sedative drugs (e.g. alcohol, opioids)

CYP450 inhibitors reduces elimination

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134
Q

Midazolam interactions

A

Other sedative drugs (e.g. alcohol, opioids)

CYP450 inhibitors reduces elimination

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135
Q

Salbutamol

A

B2 agonist

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136
Q

Salbutamol use

A

Asthma - Sa: breathlessness, La: with inhaled CSs
COPD - breathlessness relief
Hyperkalaemia with insulin, glucose and calcium gluconate

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137
Q

Salbutamol risks

A

SNS activation - tachycardia, palpitations, anxiety, fine tremor
Promotes glycogenolysis - increased serum glucose concentrations
La: muscle cramps

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138
Q

Salbutamol contraindications

A

CVD - provocation of angina

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139
Q

Salbutamol interactions

A

Beta blockers

Concomittant use with theophylline and CSs can lead to hypokalaemia

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140
Q

Bisoprolol drug type

A

Beta blocker

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141
Q

Atenolol drug type

A

Beta blocker

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142
Q

Propranolol drug type

A

Beta blocker

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143
Q

Metoprolol drug type

A

Beta blocker

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144
Q

Bisoprolol use

A

IHD - first line for symptoms of angina and acute coronary symptoms
Chronic HF
AF - reduces ventricular rate and maintains sinus rhythm
HTN with CCBs, ACEis and thiazide diuretics

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145
Q

Atenolol use

A

IHD - first line for symptoms of angina and acute coronary symptoms
Chronic HF
AF - reduces ventricular rate and maintains sinus rhythm
HTN with CCBs, ACEis and thiazide diuretics

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146
Q

Propranolol use

A

IHD - first line for symptoms of angina and acute coronary symptoms
Chronic HF
AF - reduces ventricular rate and maintains sinus rhythm
HTN with CCBs, ACEis and thiazide diuretics

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147
Q

Metoprolol use

A

IHD - first line for symptoms of angina and acute coronary symptoms
Chronic HF
AF - reduces ventricular rate and maintains sinus rhythm
HTN with CCBs, ACEis and thiazide diuretics

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148
Q

Bisoprolol risks

A

Fatigue, cold extremities, headache, sleep disturbance

GI disturbance

149
Q

Atenolol risks

A

Fatigue, cold extremities, headache, sleep disturbance

GI disturbance

150
Q

Propranolol risks

A

Fatigue, cold extremities, headache, sleep disturbance

GI disturbance

151
Q

Metoprolol risks

A

Fatigue, cold extremities, headache, sleep disturbance

GI disturbance

152
Q

Bisoprolol contraindications

A

Asthma - bronchospasm
HF, heart block
Hepatic failure (dosage reduction)

153
Q

Atenolol contraindications

A

Asthma - bronchospasm
HF, heart block
Hepatic failure (dosage reduction)

154
Q

Propranolol contraindications

A

Asthma - bronchospasm
HF, heart block
Hepatic failure (dosage reduction)

155
Q

Metoprolol contraindications

A

Asthma - bronchospasm
HF, heart block
Hepatic failure (dosage reduction)

156
Q

Alendronic acid drug type

A

Bisphosphonate

157
Q

Alendronic acid use

A

Osteoporotic fragility fracture prevention
Myeloma, BC with bony mets - reduce fracture risk
Paget’s disease - decrease bone turnover

158
Q

Alendronic acid risks

A

Oesophagitis
Hypophosphataemia
Osteonecrosis of jaw
Atypical femoral fracture

159
Q

Alendronic acid contraindications

A

Severe renal impairment, hypocalcaemia
Upper GI disorders
Risky in smokers and dental disease

160
Q

Calcium carbonate/gluconate drug type

A

Calcium supplement

161
Q

Cholecalciferol drug type

A

Vitamin D supplement

162
Q

Calcium carbonate/gluconate use

A

Osteoporosis
CKD - treat and prevent secondary hyperPTism and renal osteodystrophy
Severe hyperkalaemia to prevent arrhythmias
Hypocalcaemia

163
Q

Cholecalciferol use

A

Osteoporosis

Vitamin D def - rickets, osteomalacia

164
Q

Calcium carbonate/gluconate risks

A

Dyspepsia

Constipation

165
Q

Cholecalciferol risks

A

Dyspepsia

Constipation

166
Q

Calcium carbonate/gluconate interactions

A

Reduced absorption of iron, bisphosphonates, tetracyclines, levothyroxine

167
Q

Cholecalciferol interactions

A

Reduced absorption of iron, bisphosphonates, tetracyclines, levothyroxine

168
Q

Amlodipine drug type

A

Calcium channel blocker

169
Q

Diltiazem drug type

A

Calcium channel blocker

170
Q

Verapamil drug type

A

Calcium channel blocker

171
Q

Amlodipine use

A 
HTN - reduce risk of stoke, MI, death
Stable angina (alt to B blockers)
172
Q

Diltiazem use

A

HTN - reduce risk of stoke, MI, death

SVT arrhythmias - control HR

173
Q

Verapamil use

A

HTN - reduce risk of stoke, MI, death

SVT arrhythmias - control HR

174
Q

Amlodipine risks

A

Ankle swelling
Flushing
Headache
Palpitations

175
Q

Verapamil risks

A

Constipation
Bradycardia
Heart block/failure

176
Q

Diltiazem risks

A 
Ankle swelling
Flushing
Headache
Palpitations
Constipation
Bradycardia
Heart block/failure
177
Q

Verapamil contraindications

A

Reduced LV function and AVN delay

178
Q

Diltiazem contraindications

A

Reduced LV function and AVN delay

179
Q

Amlodipine contraindications

A

Avoid in unstable angina to prevent reflex tachycardia

180
Q

Carbamazepine drug type

A

Anticonvulsant

181
Q

Carbamazepine use

A

Epilepsy - focal seizures, primary generalised seizures
Trigeminal neuralgia - pain control
Bipolar prophylaxis

182
Q

Carbamazepine risks

A

GI upset
Neuro - dizziness, ataxia
Hypersensitivity - skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis
ADH like effect - oedema, hyponatraemia

183
Q

Carbamazepine contraindications

A

Pregnancy - birth defects

Cross-sensitivity with phenytoin - anti epileptic hypersensitivity syndrome

184
Q

Carbamazepine interactions

A

CYP450 induction

Lowers seizure threshold with other anti-epileptics

185
Q

Cephalosporin drug type

A

Beta lactam antibiotic

186
Q

Carbapenem drug type

A

Beta lactam antibiotic

187
Q

Cephalosporin use

A

2/3 line treatment for urinary/RTIs

Very severe/complicated infections

188
Q

Carbapenem use

A

2/3 line treatment for urinary/RTIs

Very severe/complicated infections

189
Q

Cephalosporin risks

A

GI upset
Colitis due to death of normal gut flora and C diff promotion
CNS toxicity and seizures

190
Q

Carbapenem risks

A

GI upset
Colitis due to death of normal gut flora and C diff promotion
CNS toxicity and seizures

191
Q

Cephalosporin contraindications

A

Caution in those at risk of C diff infection
Allergy, anaphylaxis
Caution in epilepsy, renal impairment

192
Q

Carbapenem contraindications

A

Caution in those at risk of C diff infection
Allergy, anaphylaxis
Caution in epilepsy, renal impairment

193
Q

Clopidogrel drug type

A

Antiplatelet

194
Q

Clopidogrel use

A

ACS - rapid inhibition of platelet aggregation to prevent arterial thrombosis
Prevent occlusion of coronary artery stents
Long term 2o prevention of thrombotic arterial events in patients with CVS, cerebrovascular, PAD
Decrease risk of intracardiac thrombus and embolic stroke in AF where warfarin is contraindicated

195
Q

Clopidogrel risks

A

Bleeding
GI upset - dyspepsia, abdo pain, diarrhoea
Thrombocytopaenia

196
Q

Clopidogrel contraindications

A

Significant bleeding
Renal/hepatic impairment
Stop 7-10 days prior to elective surgery

197
Q

Clopidogrel interactions

A

Prodrug requires CYP450 enzymes - limited metabolism with CYP450 inhibitors
Co-administration with other anti platelets, anticoagulants and NSAIDs increases bleeding risk

198
Q

Prednisolone drug type

A

Glucocorticoid

Systemic corticosteroid

199
Q

Prednisolone use

A

Treatment of allergic/inflammatory disorders
Suppression of AI disease - IBD, inflammatory arthritis
Reduction of chemo-associated swelling
Hormone replacement in adrenal insufficiency/hypopituitarism

200
Q

Prednisolone risks

A

Immune suppression
Metabolic - DM, osteoporosis
Cushingoid features - proximal muscle weakness, sin thinning, easy bruising, mood changes
Mineralocorticoid action - HTN, hypokalaemia, oedema
Adrenal atrophy - Addisonian crisis after rapid withdrawal

201
Q

Hydrocortisone drug type

A

Glucocorticoid
Systemic corticosteroid
Topical corticosteroid

202
Q

Dexamethasone drug type

A

Glucocorticoid

Systemic corticosteroid

203
Q

Hydrocortisone use

A

Treatment of allergic/inflammatory disorders
Suppression of AI disease - IBD, inflammatory arthritis
Reduction of chemo-associated swelling
Hormone replacement in adrenal insufficiency/hypopituitarism
Eczema and other inflammatory skin conditions

204
Q

Dexamethasone use

A

Treatment of allergic/inflammatory disorders
Suppression of AI disease - IBD, inflammatory arthritis
Reduction of chemo-associated swelling
Hormone replacement in adrenal insufficiency/hypopituitarism

205
Q

Hydrocortisone risks

A

Immune suppression
Metabolic - DM, osteoporosis
Cushingoid features - proximal muscle weakness, sin thinning, easy bruising, mood changes
Mineralocorticoid action - HTN, hypokalaemia, oedema
Adrenal atrophy - Addisonian crisis after rapid withdrawal

206
Q

Dexamethasone risks

A

Immune suppression
Metabolic - DM, osteoporosis
Cushingoid features - proximal muscle weakness, sin thinning, easy bruising, mood changes
Mineralocorticoid action - HTN, hypokalaemia, oedema
Adrenal atrophy - Addisonian crisis after rapid withdrawal

207
Q

Fluticasone drug type

A

Inhaled corticosteroid

Glucocorticoid

208
Q

Fluticasone use

A

Asthma - inflammation with B2 agonists

COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator

209
Q

Fluticasone risks

A

Immunosuppression - oral candidiasis

210
Q

Budesamide drug type

A

Inhaled corticosteroid

Glucocorticoid

211
Q

Beclometasone drug type

A

Inhaled corticosteroid

Glucocorticoid

212
Q

Budesamide use

A

Asthma - inflammation with B2 agonists

COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator

213
Q

Beclometasone use

A

Asthma - inflammation with B2 agonists

COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator

214
Q

Budesamide risks

A

Immunosuppression - oral candidiasis

215
Q

Beclometasone risks

A

Immunosuppression - oral candidiasis

216
Q

Digoxin drug type

A

Glycoside

217
Q

Digoxin use

A

AF/flutter - reduces ventricular rate

Severe HF - with ACEi and B blocker and either aldosterone antagonist/ARB

218
Q

Digoxin risks

A 
Bradycardia, toxicity - arrhythmias
GI disturbance
Rash
Dizziness
Visual disturbance
219
Q

Digoxin contraindications

A 
2nd deg HB
Ventricular arrhythmias
Renal failure
Hypokalaemia
Hypomagnesaemia
Hypercalcaemia
220
Q

Digoxin interactions

A

Increased risk of toxicity with loop/thiazide diuretics

221
Q

Dipyridamole drug type

A

Antiplatelet

222
Q

Dipyridamole use

A

Cerebrovascular disease - stroke prevention after TIA/iscahemic stroke

223
Q

Dipyridamole risks

A 
Headache
Flushing
Dizziness
Increased bleeding risk, thrombocytopaenia
GI symptoms
224
Q

Dipyridamole contraindications

A

IHD
Aortic stenosis
HF

225
Q

Furosemide drug type

A

Loop diuretic

226
Q

Furosemide use

A

Breathlessness relief in pulmonary oedema

Fluid overload reduction in chronic HF/other oedematous states

227
Q

Furosemide risks

A

Dehydration and hypotension
Loss of electrolytes
Change in endolymph composition in inner ear - hearing loss, tinnitus

228
Q

Furosemide contraindications

A

Hypovolaemia, dehydration
Caution in hepatic encephalopathy
Gout
Reduced electrolytic state

229
Q

Amiloride drug type

A

Potassium sparing diuretic

230
Q

Amiloride use

A

Combination therapy for hypokalaemia arising from loop/thiazide diuretics

231
Q

Amiloride risks

A 
GI upset
Dizziness
Hypotension
Urinary symptoms
Electrolyte disturbance
232
Q

Amiloride contraindications

A

Severe renal impairment
Hyperkalaemia
Hypokalaemia
Volume depletion

233
Q

Amiloride interactions

A

Not to be used with other potassium elevating drugs/supplements
Renal clearance of digoxin/lithium may be affected

234
Q

Bendroflumethazide drug type

A

Thiazide diuretic

235
Q

Indapamide drug type

A

Thiazide diuretic

236
Q

Bendroflumethazide use

A

HTN (Where CCB CI) solo or add-on

237
Q

Indapamide use

A

HTN (Where CCB CI) solo or add-on

238
Q

Bendroflumethazide risks

A

Hyponatraemia
Hypokalaemia - cardiac arrhythmias
Sexual dysfunction

239
Q

Indapemide risks

A

Hyponatraemia
Hypokalaemia - cardiac arrhythmias
Sexual dysfunction

240
Q

Bendroflumethazide interactions

A

Effectiveness reduced by NSAIDs

Avoid other potassium sparing drugs

241
Q

Indapemide interactions

A

Effectiveness reduced by NSAIDs

Avoid other potassium sparing drugs

242
Q

Levodopa drug type

A

Dopaminergic

243
Q

Levodopa use

A

Late PD + DA agonists

244
Q

Levodopa risks

A

Nausea, drowsiness, confusion, hallucinations, hypotension

Weaning off effect, partially overcome by increasing dose

245
Q

Levodopa interactions

A

Given with peripheral dopa-carboxylase inhibitor to reduce conversion to DA outside brain (reduces nausea)

246
Q

Alteplase drug type

A

Fibrinolytic

Thrombolytic

247
Q

Alteplase use

A

Acute ischaemic stroke
Acute STEMI with antiplatelets and anticoagulants
Massive PE with haemodynamic instability

248
Q

Alteplase risks

A

Nausea and vomiting
Bruising, hypotension, serious bleeding, cariogenic shock, cardia arrest, arrhythmias
Allergic reaction
Cerebral oedema

249
Q

Alteplase contraindications

A

Factors predisposing bleeding (recent haemorrhage, disorders, trauma, severe HTN, PUD)
Previous streptokinase treatment (anti-streptokinase abs)

250
Q

Alteplase interactions

A

Increased haemorrhage risk with anticoagulants

Increased anaphylaxis reactions with ACEis

251
Q

Streptokinase drug type

A

Fibrinolytic

Thrombolytic

252
Q

Streptokinase use

A

Acute ischaemic stroke
Acute STEMI with antiplatelets and anticoagulants
Massive PE with haemodynamic instability

253
Q

Streptokinase risks

A

Nausea and vomiting
Bruising, hypotension, serious bleeding, cariogenic shock, cardia arrest, arrhythmias
Allergic reaction
Cerebral oedema

254
Q

Streptokinase contraindications

A

Factors predisposing bleeding (recent haemorrhage, disorders, trauma, severe HTN, PUD)
Previous streptokinase treatment (anti-streptokinase abs)

255
Q

Streptokinase interactions

A

Increased haemorrhage risk with anticoagulants

Increased anaphylaxis reactions with ACEis

256
Q

Gabapentin drug type

A

Anticonvulsant

257
Q

Pregabalin drug type

A

Anticonvulsant

258
Q

Gabapentin use

A

Focal epilepsies - usually as add-on
Neuropathic pain
Migraine prophylaxis

259
Q

Pregabalin use

A

Focal epilepsies - usually as add-on
Neuropathic pain
Generalised anxiety disorder

260
Q

Gabapentin risks

A

Drowsiness, dizziness, ataxia

261
Q

Pregabalin risks

A

Drowsiness, dizziness, ataxia

262
Q

Gabapentin contraindications

A

Renal impairment - reduce dosage

263
Q

Pregabalin contraindications

A

Renal impairment - reduce dosage

264
Q

Gabapentin interactions

A

Sedative effects increased with other sedating drugs

265
Q

Pregabalin interactions

A

Sedative effects increased with other sedating drugs

266
Q

Ranitidine drug type

A

H2 receptor antagonist

Antihistamine

267
Q

Ranitidine use

A

PUD (PPIs preferred)

GORD/dyspepsia

268
Q

Ranitidine risks

A

Very few - bowel disturbance, headache, dizziness

269
Q

Ranitidine contraindications

A

Renal impairment - reduce dosage

Can disguise symptoms of gastric cancer

270
Q

Tinzaparin drug type

A

Heparin

LMWH

271
Q

Tinzaparin use

A

Venous thromboembolism prophylaxis
DVT, PE treatment
ACS - improve revascularisation, prevent intracoronary thrombus progression

272
Q

Tinzaparin risks

A

Bleeding
Injection site reactions
Thrombocytopaenia (rare)

273
Q

Tinzaparin contraindications

A

Caution in patients with increased risk of bleeding (clotting disorders, severe uncontrolled HTN, recent surgery/trauma)

274
Q

Aspart drug type

A

Insulin

275
Q

Glargine drug type

A

Insulin

276
Q

Aspart use

A

Insulin replacement in T1DM, blood glucose control T2DM
Diabetic emergencies (e.g. DKA)
Hyperkalaemia with glucose

277
Q

Glargine use

A

Insulin replacement in T1DM, blood glucose control T2DM
Diabetic emergencies (e.g. DKA)
Hyperkalaemia with glucose

278
Q

Aspart risks

A

Hypoglycaemia - risk of coma and death

Lipohypertrophy when administered chronically in same place

279
Q

Glargine risks

A

Hypoglycaemia - risk of coma and death

Lipohypertrophy when administered chronically in same place

280
Q

Aspart contraindications

A

Renal impairment reduces clearance

281
Q

Glargine contraindications

A

Renal impairment reduces clearance

282
Q

Aspart interactions

A

Risk of hypoglycaemia with other hypoglycaemic agents

283
Q

Glargine interactions

A

Risk of hypoglycaemia with other hypoglycaemic agents

284
Q

Methylcellulose drug type

A

Bulk forming laxative

285
Q

Lactulose drug type

A

Osmotic laxative

286
Q

Phosphate enema drug type

A

Osmotic laxative

287
Q

Senna drug type

A

Stimulant laxative

288
Q

Lidocaine/lignocaine drug type

A

Amide

289
Q

Lidocaine/lignocaine use

A

Local anaesthesia

Uncommon - anti arrhythmic drug in VT/VF refractory to cardiac inversion

290
Q

Lidocaine/lignocaine risks

A

Initial stinging on administration
Systemic - drowsiness, restlessness, tremor, fits
Cardiovascular toxicity - hypotension, arrhythmias

291
Q

Lidocaine/lignocaine interactions

A

Co administration with vasoconstrictor (e.g adrenaline) may increased duration of use

292
Q

Metformin use

A

T2DM - control of blood glucose, potentially with other hypoglycaemic drugs (e.g. sulphonylureas)

293
Q

Metformin risks

A

GI upset - nausea, vomiting, taste distrubance, anorexia, diarrhoea
Lactic acidosis

294
Q

Metformin contraindications

A

Severe renal impairment, AKI
Severe tissue hypoxia
Acute alcohol intoxication, chronic alcohol overuse

295
Q

Sulphonylurea use

A

T2DM with or without metformin

296
Q

Sulphonylurea risks

A

GI upset
Hypoglycaemia
Hypersensitivity reaction - hepatic toxicity, rash, fever, haematological abnormalities

297
Q

Methotrexate drug type

A

DMARD

298
Q

Methotrexate use

A

RA
Chemotherapy - leukaemia, lymphoma, solid tumours
Psoriasis, including psoriatic arthritis

299
Q

Methotrexate risks

A

Mucosal damage - sore mouth, GI upset
Bone marrow suppression - neutropaenia
Hypersensitivity - cutaneous, hepatitis, pneumonitis

300
Q

Methotrexate contraindications

A

Pregnancy - teratogen

Renal impairment

301
Q

Methotrexate interactions

A

Toxicity increased when prescribed with renal inhibitory drugs (e.g. NSAIDs, penicillins)
Caution with other folate antagonists (trimethoprim, phenytoin)

302
Q

Naloxone use

A

Opioid OD reversal

303
Q

Naloxone drug type

A

Competitive opioid receptor inhibitor

304
Q

Naloxone risks

A

May lead to withdrawal in opioid dependent individual - pain, restlessness, nausea and vomiting, dilated pupils, cold, dry skin (cold turkey)

305
Q

Naloxone contraindications

A

Lower doses in palliative care to reduce risk of pain restoration

306
Q

Nicorandil use

A

Prevention/treatment of chest pain in stable angina if CCBs and B blockers are CI/ineffective

307
Q

Nicorandil drug type

A

Potassium channel activator

308
Q

Nicorandil risks

A 
Flushing
Dizziness
Headache
Hypotension
GI disturbance - nausea, vomiting, ulceration
309
Q

Nicorandil contraindications

A

Caution with poor LV function, hypotension and pulmonary oedema

310
Q

Nicorandil interactions

A

Phosphodiesterase inhibitors - increased hypotensive effect

311
Q

GTN drug type

A

Nitrate

312
Q

GTN use

A

Sa - acute angina

La - angina prophylaxis

313
Q

GTN risks

A 
Flushing
Dizziness
Headache
Hypotension
GI disturbance - nausea, vomiting, ulceration
Potential tolerance
314
Q

GTN contraindications

A

Severe aortic stenosis, haemodynamic instability, hypotension

315
Q

GTN interactions

A

Phosphodiesterase inhibitors - enhance and prolong hypotensive effect

316
Q

Naproxen drug type

A

NSAID

317
Q

Ibuprofen drug type

A

NSAID

318
Q

Naproxen use

A

As needed for mild to moderate pain +/- paracetamol

Regular treatment for inflammation related pain

319
Q

Ibuprofen use

A

As needed for mild to moderate pain +/- paracetamol

Regular treatment for inflammation related pain

320
Q

Naproxen risks

A

GI toxicity
CV events - MI, stroke
Hypersensitivity - bronchospasm, angioedema
Fluid retention - worsens HTN, HF

321
Q

Ibuprofen risks

A

GI toxicity
CV events - MI, stroke
Hypersensitivity - bronchospasm, angioedema
Fluid retention - worsens HTN, HF

322
Q

Naproxen contraindications

A

Severe renal impairment, HF, liver failure, NSAID hypersensitivity
Risky in PUD, GI bleeding, CVD

323
Q

Ibuprofen contraindications

A

Severe renal impairment, HF, liver failure, NSAID hypersensitivity
Risky in PUD, GI bleeding, CVD

324
Q

Naproxen interactions

A

Other drugs increase adverse effects - aspirin, CSs, anticoagulants, SSRIs, ACEis, diuretics

325
Q

Tramadol drug type

A

Weak opioid

326
Q

Codeine drug type

A

Weak opioid

327
Q

Tramadol use

A

Mild to moderate pain

328
Q

Codeine use

A

Mild to moderate pain

329
Q

Tramadol risks

A

GI disturbance - nausea, constipation
Drowsiness, pupillary constriction
OD - respiratory, neuro depression
Tolerance, dependence, withdrawal

330
Q

Codeine risks

A

GI disturbance - nausea, constipation
Drowsiness, pupillary constriction
OD - respiratory, neuro depression
Tolerance, dependence, withdrawal

331
Q

Tramadol contraindications

A

Respiratory disease
Renal impairment
Hepatic impairment
Uncontrolled epilepsy

332
Q

Codeine contraindications

A

Respiratory disease
Renal impairment
Hepatic impairment

333
Q

Tramadol interactions

A

Other sedating drugs - antipsychotics, benzodiazepines, SSRIs
Other drugs that lower seizure threshold

334
Q

Codeine interactions

A

Other sedating drugs - antipsychotics, benzodiazepines, SSRIs

335
Q

Co-codamol drug type

A

Compound opioid

336
Q

Co-codamol use

A

Mild to moderate pain

337
Q

Morphine drug type

A

Strong opioid

338
Q

Oxycodone drug type

A

Strong opioid

339
Q

Morphine use

A

Severe pain

340
Q

Oxycodone use

A

Severe pain

341
Q

Paracetamol use

A

Acute/chronic moderate pain with our without fever

342
Q

Paracetamol risks

A

OD - hepatotoxicity

343
Q

Paracetamol contraindications

A

Caution in those with chronic alcohol overuse, malnutrition, LBW, severe hepatic impairment
CYP450 inducers increase risk of liver failure when co-administered

344
Q

Phenytoin drug type

A

Anti-epileptic

345
Q

Phenytoin use

A

Control of seizures in status epileptics where benzodiazepines are ineffective
Reduce frequency of generalised or focal seizures in epilepsy

346
Q

Phenytoin risks

A 
Change in appearance - skin coarsening, acne, hirsuitism
Neuro - cerebellar toxicity (DANISH)
Haematological disorders, osteomalacia
Hypersensitivity
OD - CV collapse, respiratory depression
347
Q

Phenytoin contraindications

A

Low safety window
Risky in those with hepatic impairment
Caution in pregnancy - co-administer with folic acid

348
Q

Phenytoin interactions

A

Enzyme induction reducing concentration and efficacy of CYP450 metabolised drugs

349
Q

Lansoprazole drug type

A

Proton pump inhibitor

350
Q

Lansoprazole use

A

Prevention and treatment of PUD, including NSAID associated ulcers
Symptomatic relief of dyspepsia and GORD
H pylori eradication

351
Q

Lansoprazole risks

A 
GI disturbance
Headache
Increased risk of C diff infection
Prolonged treatment leads to hypomagnesaemia
Gastric cancer masking
352
Q

Lansoprazole contraindications

A

Prolonged course increases fracture risk, caution in osteoporosis

353
Q

Lansoprazole interactions

A

May reduce anti platelet effect of clopidogrel by activating CYP450 enzymes

354
Q

Omeprazole drug type

A

Proton pump inhibitor

355
Q

Omeprazole use

A

Prevention and treatment of PUD, including NSAID associated ulcers
Symptomatic relief of dyspepsia and GORD
H pylori eradication

356
Q

Omeprazole risks

A 
GI disturbance
Headache
Increased risk of C diff infection
Prolonged treatment leads to hypomagnesaemia
Gastric cancer masking
357
Q

Omeprazole contraindications

A

Prolonged course increases fracture risk, caution in osteoporosis

358
Q

Omeprazole interactions

A

May reduce anti platelet effect of clopidogrel by activating CYP450 enzymes

359
Q

Atorvastatin drug type

A

Statin

360
Q

Atorvastatin use

A

Primary prevention of CVD in people >40 y/o with a 10 year CV risk >20%
Secondary prevention of CVD
Primary hyperlipidaemia - primary hypercholesterolaemia, mixed dyslipidaemia, familial hypercholesterolaemia

361
Q

Atorvastatin risks

A

Generally well tolerated
Headache
GI disturbance
Myopathy, rhabdomyolysis

362
Q

Atorvastatin contraindications

A

Caution in hepatic and renal impairment

Avoid in pregnancy or breastfeeding

363
Q

Atorvastatin interactions

A

Metabolism reduced by CYP450 inhibitors leading to accumulation of statin

364
Q

Carbimazole use

A

Graves disease

365
Q

Metyrapone use

A

Cortisol inhibition in Cushing’s syndrome

366
Q

Ketoconazole use

A

Cortisol inhibition in Cushing’s syndrome

367
Q

Cabergaline use

A

D2 agonist in acromegaly

368
Q

Bromocriptine use

A

D2 agonist in acromegaly

Drugs (6 decks)

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