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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
Mesalazine risks
``` GI upset Headache Blood abnormalities Renal impairment Oligospermia Hypersensitivity ```
26
Amiodarone use
Tachyarrhythmia control (AF, atrial flutter, SVT, VT, refractory VF)
27
Amiodarone risks
``` Hypotension Pneumonitis Hepatitis HR changes AV block Hyper/othyroidism ```
28
Amiodarone interactions
Diltiazem, digoxin, verapamil - increased risk of AV block and bradycardia
29
Ramipril drug type
ACE inhibitor
30
Ramipril use
Hypertension Chronic HF Ischaemic HD Diabetic nephropathy and CKD with proteinuria
31
Ramipril risks
``` Hypotension Persistent dry cough Hyperkalaemia Cause/worsening of renal failure Angioedema Anaphylaxis ```
32
Ramipril contraindications
Pregnancy/breastfeeding | AKI, CKD, renal artery stenosis
33
Losartan drug type
Angiotensin receptor blocker
34
Losartan use
Hypertension (when ACE-is aren't tolerated due to cough) Chronic HF IHD Diabetic nephropathy and CKD with proteinuria
35
Losartan risks
Hypotension Hyperkalaemia Cause/worsening of renal failure
36
Losartan contraindications
Pregnancy/breastfeeding | AKI, CKD, renal artery stenosis
37
Sertraline drug type
SSRI antidepressant
38
Sertraline use
Moderate to severe depression Panic disorder OCD
39
Sertraline risks
``` 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 ```
40
Sertraline contraindications
Epilepsy PUD Youth (due to increased suicide)
41
Sertraline interactions
MAO inhibitors (risk of serotonin syndrome)
42
Amitriptyline drug type
TCA antidepressant
43
Amitriptyline use
``` Moderate to severe depression where SSRIs are ineffective Neuropathic pain (unlicensed) ```
44
Amitriptyline risks
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
45
Amitriptyline contraindications
``` Elderly CVD Epilepsy Constipation Increased intraocular pressure ```
46
Amitriptyline interactions
MAO inhibitors (risk of serotonin syndrome)
47
Mirtazepine drug type
Pre-synaptic alpha 2 antagonist | Antidepressant
48
Venlaxafine drug type
5-HT and NA reuptake inhibitor (SNRI) | Antidepressant
49
Mirtazepine use
Major depression where SSRIs aren't tolerated
50
Venlafaxine use
Generalised anxiety disorder
51
Mirtazepine risks
GI upset - diarrhoea, constipation, nausea, weight change CNS effects - headache, strange dreams, insomnia, confusion, convulsions Hyponatraemia Serotonin syndrome Suicidal thought and behaviour
52
Venlaxafine risks
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
53
Mirtazepine contraindications
Hepatic/renal impairment | Elderly
54
Venlaxafine contraindications
Hepatic/renal impairment Elderly CVD - due to risk of arrhythmias
55
Metoclopramide drug type
``` D2 antagonist (does cross BBB) Antiemetic ```
56
Metoclopramide use
Prophylaxis and treatment of nausea and vomiting | Reduced gut motility
57
Metoclopramide risks
Diarrhoea | EPS - movement abnormalities potentially leading to acute dystonic reaction
58
Domperidone drug type
``` D2 antagonist (does not cross BBB) Antiemetic ```
59
Domperidone use
Prophylaxis and treatment of nausea and vomiting | Reduced gut motility
60
Domperidone risks
Diarrhoea
61
Cyclizine drug type
H1 receptor antagonist (antihistamine) | Anti-emetic
62
Cyclizine use
Prophylaxis and treatment of nausea and vomiting | Motion sickness and evrtigo
63
Cyclizine risks
``` Antihistamine - drowsiness Anticholinergic - dry throat and mouth Tachycardia Palpitations BPH - due to anticholinergic properties risking urinary ret ```
64
Cyclizine contraindications
Hepatic encephalopathy (due to sedative effect)
65
Prochlorperazine drug type
Phenothiazine Antiemetic Antipsychotic
66
Prochlorperazine use
Prophylaxis and treatment of nausea and vomiting Vertigo Treatment of psychotic disorders (e.g. schizophrenia)
67
Prochlorperazine risks
Drowsiness Postural hypotension D2 receptor blockade - EPS, including acute dystonic syndrome and tar dive dyskinesia Prolonged QT interval
68
Prochlorperazine contraindications
Severe liver disease (hepatotoxicity) QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs) BPH - due to anticholinergic properties risking urinary ret
69
Ondansetron drug type
5-HT3 receptor antagonist (serotonin) | Antiemetic
70
Ondansetron risks
Constipation, diarrhoea, headaches (rare)
71
Ondansetron contraindications
QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)
72
Nystatin drug type
Antifungal
73
Fluconazide drug type
Antifungal
74
Nystatin risks
Local irritation
75
Fluconazide risks
``` GI upset Severe hepatic toxicity Prolonged QT (arrhythmia) Headache Hypersensivitiy ```
76
Fluconazide contraindications
Renal impariemtn Liver disease Pregnancy
77
Fluconazide interactions
Acts as CYP450 inhibitor
78
Loratedine drug type
Antihistamine
79
Loratedine uses
Allergies (hay fever) Pruritus and urticaria Anaphylaxis adjunct (with adrenaline) Nausea and vomiting - antiemetic
80
Loratedine contraindications
Severe liver disease (risk of hepatic encephalopathy)
81
Loperamide drug type
Antimobility
82
Loperamide use
Symptomatic treatment for diarrhoea (in IBS, viral gastroenteritis)
83
Loperamide risks
GI - constipation, abdo cramping, flatulence
84
Loperamide contraindications
Acute UC - risk of megacolon, perforation, C diff colitis | Acute bloody diarrhoea (dysentry, E coli)
85
Codeine phosphate drug type
Antimobility
86
Codeine phosphate use
Symptomatic treatment for diarrhoea (in IBS, viral gastroenteritis)
87
Codeine phosphate risks
GI - constipation, abdo cramping, flatulence
88
Codeine phosphate contradindications
Acute UC - risk of megacolon, perforation, C diff colitis | Acute bloody diarrhoea (dysentry, E coli)
89
Ipratropium drug type
Antimuscarinic | Bronchodilator
90
Ipratropium use
COPD - relieve/prevent breathlessness (La/Sa) | Asthma - Sa: adjuvant with salbutamol, La: co-admin with high dose corticosteroids and B2 agonists
91
Ipratropium risks
Dry mouth
92
Ipratropium contraindications
Angle-closure glaucoma - increased IOP
93
Atropine drug type
Antimuscarinic (CVS/GI)
94
Atropine use
Severe bradycardia - inc HR IBS - antispasmodic effect Dying patient - reduced respiratory secretions
95
Atropine risks
PSNS blockade - reduced secretions, tachycardia, constipation Reduced detrusor activity - urinary ret Blurred vision Central - drowsiness, confusion
96
Atropine contraindications
Angle-closure glaucoma - increased IOP | Arrhythmias
97
Oxybutinin drug type
Antimuscarinic (GU)
98
Oxybutinin risks
PSNS blockade - dry mouth, achy, constipation, blurred vision
99
Oxybutinin contraindications
UTI Angle-closure glaucoma - increased IOP Arrhythmias Urinary ret
100
Haloperidol
1st generation antipsychotic | D2 antagonist
101
Haloperidol use
Treatment of severe psychomotor agitation causing dangerous/violent behaviour Schizophrenia Bipolar disorders (acute mania) Palliative - nausea and vomiting
102
Oxybutinin use
Reduction of urinary frequency, urgency and incontinence in overactive bladder
103
Haloperidol risks
``` EP effects (PD mimicry) - acute dystonia, neuroleptic malignant syndrome, tardive dyskinesia Drowsiness, hypotension, QT prolongation, erectile dysfunction Hyperprolactinaemia ```
104
Haloperidol contraindications
Elderly Dementia PD Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)
105
Risperidone drug type
Atypical antipsychotic | D2 antagonist
106
Risperidone use
Urgent treatment of psychomotor agitation Schizophrenia Bipolar disorder - acute mania
107
Clozapine drug type
Atypical antipsychotic | D2 antagonist
108
Risperidone risks
``` Sedation EPS Metabolic disturbance - weight gain, DM, lipid changes Prolonged QT Hyperprolactinaemia ```
109
Clozapine risks
Sedation EPS Metabolic disturbance - weight gain, DM, lipid changes Prolonged QT Hyperprolactinaemia Severe neutrophil deficiency - agranulocytosis, myocarditis
110
Risperidone contraindications
CVD | Severe heart disease
111
Clozapine contraindications
CVD Severe heart disease Neutropaenia
112
Risperidone interactions
Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)
113
Clozapine interactions
Other QT prolonging drugs (e.g. antipsychotics, quinine, SSRIs)
114
Aspirin drug type
NSAID | COX2 inhibitor
115
Aspirin use
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
116
Aspirin risks
GI irritation, ulceration, haemorrhage Hypersensitivity reactions - bronchospasm OD - tinnitus, life threatening CVS and respiratory collapse
117
Aspirin contraindications
Hypersensitivity This trimester of pregnancy Pre-existing gastric ulceration/gout
118
Aspirin interactions
Antiplatelets (e.g. clopidogrel) | Anticoagulants (e.g. heparin, warfarin)
119
Diazepam drug type
Benzodiazepine
120
Lorazepam drug type
Benzodiazepine
121
Midazolam drug type
Benzodiazepine
122
Diazepam use
Seizures, status epilepticus Alcohol withdrawal reactions Short-term - severe disabling anxiety and insomnia
123
Lorazepam use
Seizures, status epilepticus Alcohol withdrawal reactions Short-term - severe disabling anxiety and insomnia
124
Midazolam use
Seizures, status epilepticus Alcohol withdrawal reactions Short-term - severe disabling anxiety and insomnia
125
Diazepam risks
Dose dependent drowsiness, sedation and coma OD - airway obstruction, death Dependence, withdrawal reaction
126
Lorazepam risks
Dose dependent drowsiness, sedation and coma OD - airway obstruction, death Dependence, withdrawal reaction
127
Midazolam risks
Dose dependent drowsiness, sedation and coma OD - airway obstruction, death Dependence, withdrawal reaction
128
Diazepam contraindications
Respiratory impairment Neuromuscular disease Liver failure - hepatic encephalopathy
129
Lorazepam contraindications
Respiratory impairment Neuromuscular disease Liver failure - hepatic encephalopathy
130
Midazolam contraindications
Respiratory impairment Neuromuscular disease Liver failure - hepatic encephalopathy
131
Diazepam interactions
Other sedative drugs (e.g. alcohol, opioids) | CYP450 inhibitors reduces elimination
132
CYP450 inhibitors
``` Amiodarone Diltiazem Macrolides Fluconazole Protease inhibitors ```
133
Lorazepam interactions
Other sedative drugs (e.g. alcohol, opioids) | CYP450 inhibitors reduces elimination
134
Midazolam interactions
Other sedative drugs (e.g. alcohol, opioids) | CYP450 inhibitors reduces elimination
135
Salbutamol
B2 agonist
136
Salbutamol use
Asthma - Sa: breathlessness, La: with inhaled CSs COPD - breathlessness relief Hyperkalaemia with insulin, glucose and calcium gluconate
137
Salbutamol risks
SNS activation - tachycardia, palpitations, anxiety, fine tremor Promotes glycogenolysis - increased serum glucose concentrations La: muscle cramps
138
Salbutamol contraindications
CVD - provocation of angina
139
Salbutamol interactions
Beta blockers | Concomittant use with theophylline and CSs can lead to hypokalaemia
140
Bisoprolol drug type
Beta blocker
141
Atenolol drug type
Beta blocker
142
Propranolol drug type
Beta blocker
143
Metoprolol drug type
Beta blocker
144
Bisoprolol use
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
145
Atenolol use
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
146
Propranolol use
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
147
Metoprolol use
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
148
Bisoprolol risks
Fatigue, cold extremities, headache, sleep disturbance | GI disturbance
149
Atenolol risks
Fatigue, cold extremities, headache, sleep disturbance | GI disturbance
150
Propranolol risks
Fatigue, cold extremities, headache, sleep disturbance | GI disturbance
151
Metoprolol risks
Fatigue, cold extremities, headache, sleep disturbance | GI disturbance
152
Bisoprolol contraindications
Asthma - bronchospasm HF, heart block Hepatic failure (dosage reduction)
153
Atenolol contraindications
Asthma - bronchospasm HF, heart block Hepatic failure (dosage reduction)
154
Propranolol contraindications
Asthma - bronchospasm HF, heart block Hepatic failure (dosage reduction)
155
Metoprolol contraindications
Asthma - bronchospasm HF, heart block Hepatic failure (dosage reduction)
156
Alendronic acid drug type
Bisphosphonate
157
Alendronic acid use
Osteoporotic fragility fracture prevention Myeloma, BC with bony mets - reduce fracture risk Paget's disease - decrease bone turnover
158
Alendronic acid risks
Oesophagitis Hypophosphataemia Osteonecrosis of jaw Atypical femoral fracture
159
Alendronic acid contraindications
Severe renal impairment, hypocalcaemia Upper GI disorders Risky in smokers and dental disease
160
Calcium carbonate/gluconate drug type
Calcium supplement
161
Cholecalciferol drug type
Vitamin D supplement
162
Calcium carbonate/gluconate use
Osteoporosis CKD - treat and prevent secondary hyperPTism and renal osteodystrophy Severe hyperkalaemia to prevent arrhythmias Hypocalcaemia
163
Cholecalciferol use
Osteoporosis | Vitamin D def - rickets, osteomalacia
164
Calcium carbonate/gluconate risks
Dyspepsia | Constipation
165
Cholecalciferol risks
Dyspepsia | Constipation
166
Calcium carbonate/gluconate interactions
Reduced absorption of iron, bisphosphonates, tetracyclines, levothyroxine
167
Cholecalciferol interactions
Reduced absorption of iron, bisphosphonates, tetracyclines, levothyroxine
168
Amlodipine drug type
Calcium channel blocker
169
Diltiazem drug type
Calcium channel blocker
170
Verapamil drug type
Calcium channel blocker
171
Amlodipine use
``` HTN - reduce risk of stoke, MI, death Stable angina (alt to B blockers) ```
172
Diltiazem use
HTN - reduce risk of stoke, MI, death | SVT arrhythmias - control HR
173
Verapamil use
HTN - reduce risk of stoke, MI, death | SVT arrhythmias - control HR
174
Amlodipine risks
Ankle swelling Flushing Headache Palpitations
175
Verapamil risks
Constipation Bradycardia Heart block/failure
176
Diltiazem risks
``` Ankle swelling Flushing Headache Palpitations Constipation Bradycardia Heart block/failure ```
177
Verapamil contraindications
Reduced LV function and AVN delay
178
Diltiazem contraindications
Reduced LV function and AVN delay
179
Amlodipine contraindications
Avoid in unstable angina to prevent reflex tachycardia
180
Carbamazepine drug type
Anticonvulsant
181
Carbamazepine use
Epilepsy - focal seizures, primary generalised seizures Trigeminal neuralgia - pain control Bipolar prophylaxis
182
Carbamazepine risks
GI upset Neuro - dizziness, ataxia Hypersensitivity - skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis ADH like effect - oedema, hyponatraemia
183
Carbamazepine contraindications
Pregnancy - birth defects | Cross-sensitivity with phenytoin - anti epileptic hypersensitivity syndrome
184
Carbamazepine interactions
CYP450 induction | Lowers seizure threshold with other anti-epileptics
185
Cephalosporin drug type
Beta lactam antibiotic
186
Carbapenem drug type
Beta lactam antibiotic
187
Cephalosporin use
2/3 line treatment for urinary/RTIs | Very severe/complicated infections
188
Carbapenem use
2/3 line treatment for urinary/RTIs | Very severe/complicated infections
189
Cephalosporin risks
GI upset Colitis due to death of normal gut flora and C diff promotion CNS toxicity and seizures
190
Carbapenem risks
GI upset Colitis due to death of normal gut flora and C diff promotion CNS toxicity and seizures
191
Cephalosporin contraindications
Caution in those at risk of C diff infection Allergy, anaphylaxis Caution in epilepsy, renal impairment
192
Carbapenem contraindications
Caution in those at risk of C diff infection Allergy, anaphylaxis Caution in epilepsy, renal impairment
193
Clopidogrel drug type
Antiplatelet
194
Clopidogrel use
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
Clopidogrel risks
Bleeding GI upset - dyspepsia, abdo pain, diarrhoea Thrombocytopaenia
196
Clopidogrel contraindications
Significant bleeding Renal/hepatic impairment Stop 7-10 days prior to elective surgery
197
Clopidogrel interactions
Prodrug requires CYP450 enzymes - limited metabolism with CYP450 inhibitors Co-administration with other anti platelets, anticoagulants and NSAIDs increases bleeding risk
198
Prednisolone drug type
Glucocorticoid | Systemic corticosteroid
199
Prednisolone use
Treatment of allergic/inflammatory disorders Suppression of AI disease - IBD, inflammatory arthritis Reduction of chemo-associated swelling Hormone replacement in adrenal insufficiency/hypopituitarism
200
Prednisolone risks
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
Hydrocortisone drug type
Glucocorticoid Systemic corticosteroid Topical corticosteroid
202
Dexamethasone drug type
Glucocorticoid | Systemic corticosteroid
203
Hydrocortisone use
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
Dexamethasone use
Treatment of allergic/inflammatory disorders Suppression of AI disease - IBD, inflammatory arthritis Reduction of chemo-associated swelling Hormone replacement in adrenal insufficiency/hypopituitarism
205
Hydrocortisone risks
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
Dexamethasone risks
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
Fluticasone drug type
Inhaled corticosteroid | Glucocorticoid
208
Fluticasone use
Asthma - inflammation with B2 agonists | COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator
209
Fluticasone risks
Immunosuppression - oral candidiasis
210
Budesamide drug type
Inhaled corticosteroid | Glucocorticoid
211
Beclometasone drug type
Inhaled corticosteroid | Glucocorticoid
212
Budesamide use
Asthma - inflammation with B2 agonists | COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator
213
Beclometasone use
Asthma - inflammation with B2 agonists | COPD - prevents exacerbations with B2 agonists or La: antimuscarinic bronchodilator
214
Budesamide risks
Immunosuppression - oral candidiasis
215
Beclometasone risks
Immunosuppression - oral candidiasis
216
Digoxin drug type
Glycoside
217
Digoxin use
AF/flutter - reduces ventricular rate | Severe HF - with ACEi and B blocker and either aldosterone antagonist/ARB
218
Digoxin risks
``` Bradycardia, toxicity - arrhythmias GI disturbance Rash Dizziness Visual disturbance ```
219
Digoxin contraindications
``` 2nd deg HB Ventricular arrhythmias Renal failure Hypokalaemia Hypomagnesaemia Hypercalcaemia ```
220
Digoxin interactions
Increased risk of toxicity with loop/thiazide diuretics
221
Dipyridamole drug type
Antiplatelet
222
Dipyridamole use
Cerebrovascular disease - stroke prevention after TIA/iscahemic stroke
223
Dipyridamole risks
``` Headache Flushing Dizziness Increased bleeding risk, thrombocytopaenia GI symptoms ```
224
Dipyridamole contraindications
IHD Aortic stenosis HF
225
Furosemide drug type
Loop diuretic
226
Furosemide use
Breathlessness relief in pulmonary oedema | Fluid overload reduction in chronic HF/other oedematous states
227
Furosemide risks
Dehydration and hypotension Loss of electrolytes Change in endolymph composition in inner ear - hearing loss, tinnitus
228
Furosemide contraindications
Hypovolaemia, dehydration Caution in hepatic encephalopathy Gout Reduced electrolytic state
229
Amiloride drug type
Potassium sparing diuretic
230
Amiloride use
Combination therapy for hypokalaemia arising from loop/thiazide diuretics
231
Amiloride risks
``` GI upset Dizziness Hypotension Urinary symptoms Electrolyte disturbance ```
232
Amiloride contraindications
Severe renal impairment Hyperkalaemia Hypokalaemia Volume depletion
233
Amiloride interactions
Not to be used with other potassium elevating drugs/supplements Renal clearance of digoxin/lithium may be affected
234
Bendroflumethazide drug type
Thiazide diuretic
235
Indapamide drug type
Thiazide diuretic
236
Bendroflumethazide use
HTN (Where CCB CI) solo or add-on
237
Indapamide use
HTN (Where CCB CI) solo or add-on
238
Bendroflumethazide risks
Hyponatraemia Hypokalaemia - cardiac arrhythmias Sexual dysfunction
239
Indapemide risks
Hyponatraemia Hypokalaemia - cardiac arrhythmias Sexual dysfunction
240
Bendroflumethazide interactions
Effectiveness reduced by NSAIDs | Avoid other potassium sparing drugs
241
Indapemide interactions
Effectiveness reduced by NSAIDs | Avoid other potassium sparing drugs
242
Levodopa drug type
Dopaminergic
243
Levodopa use
Late PD + DA agonists
244
Levodopa risks
Nausea, drowsiness, confusion, hallucinations, hypotension | Weaning off effect, partially overcome by increasing dose
245
Levodopa interactions
Given with peripheral dopa-carboxylase inhibitor to reduce conversion to DA outside brain (reduces nausea)
246
Alteplase drug type
Fibrinolytic | Thrombolytic
247
Alteplase use
Acute ischaemic stroke Acute STEMI with antiplatelets and anticoagulants Massive PE with haemodynamic instability
248
Alteplase risks
Nausea and vomiting Bruising, hypotension, serious bleeding, cariogenic shock, cardia arrest, arrhythmias Allergic reaction Cerebral oedema
249
Alteplase contraindications
Factors predisposing bleeding (recent haemorrhage, disorders, trauma, severe HTN, PUD) Previous streptokinase treatment (anti-streptokinase abs)
250
Alteplase interactions
Increased haemorrhage risk with anticoagulants | Increased anaphylaxis reactions with ACEis
251
Streptokinase drug type
Fibrinolytic | Thrombolytic
252
Streptokinase use
Acute ischaemic stroke Acute STEMI with antiplatelets and anticoagulants Massive PE with haemodynamic instability
253
Streptokinase risks
Nausea and vomiting Bruising, hypotension, serious bleeding, cariogenic shock, cardia arrest, arrhythmias Allergic reaction Cerebral oedema
254
Streptokinase contraindications
Factors predisposing bleeding (recent haemorrhage, disorders, trauma, severe HTN, PUD) Previous streptokinase treatment (anti-streptokinase abs)
255
Streptokinase interactions
Increased haemorrhage risk with anticoagulants | Increased anaphylaxis reactions with ACEis
256
Gabapentin drug type
Anticonvulsant
257
Pregabalin drug type
Anticonvulsant
258
Gabapentin use
Focal epilepsies - usually as add-on Neuropathic pain Migraine prophylaxis
259
Pregabalin use
Focal epilepsies - usually as add-on Neuropathic pain Generalised anxiety disorder
260
Gabapentin risks
Drowsiness, dizziness, ataxia
261
Pregabalin risks
Drowsiness, dizziness, ataxia
262
Gabapentin contraindications
Renal impairment - reduce dosage
263
Pregabalin contraindications
Renal impairment - reduce dosage
264
Gabapentin interactions
Sedative effects increased with other sedating drugs
265
Pregabalin interactions
Sedative effects increased with other sedating drugs
266
Ranitidine drug type
H2 receptor antagonist | Antihistamine
267
Ranitidine use
PUD (PPIs preferred) | GORD/dyspepsia
268
Ranitidine risks
Very few - bowel disturbance, headache, dizziness
269
Ranitidine contraindications
Renal impairment - reduce dosage | Can disguise symptoms of gastric cancer
270
Tinzaparin drug type
Heparin | LMWH
271
Tinzaparin use
Venous thromboembolism prophylaxis DVT, PE treatment ACS - improve revascularisation, prevent intracoronary thrombus progression
272
Tinzaparin risks
Bleeding Injection site reactions Thrombocytopaenia (rare)
273
Tinzaparin contraindications
Caution in patients with increased risk of bleeding (clotting disorders, severe uncontrolled HTN, recent surgery/trauma)
274
Aspart drug type
Insulin
275
Glargine drug type
Insulin
276
Aspart use
Insulin replacement in T1DM, blood glucose control T2DM Diabetic emergencies (e.g. DKA) Hyperkalaemia with glucose
277
Glargine use
Insulin replacement in T1DM, blood glucose control T2DM Diabetic emergencies (e.g. DKA) Hyperkalaemia with glucose
278
Aspart risks
Hypoglycaemia - risk of coma and death | Lipohypertrophy when administered chronically in same place
279
Glargine risks
Hypoglycaemia - risk of coma and death | Lipohypertrophy when administered chronically in same place
280
Aspart contraindications
Renal impairment reduces clearance
281
Glargine contraindications
Renal impairment reduces clearance
282
Aspart interactions
Risk of hypoglycaemia with other hypoglycaemic agents
283
Glargine interactions
Risk of hypoglycaemia with other hypoglycaemic agents
284
Methylcellulose drug type
Bulk forming laxative
285
Lactulose drug type
Osmotic laxative
286
Phosphate enema drug type
Osmotic laxative
287
Senna drug type
Stimulant laxative
288
Lidocaine/lignocaine drug type
Amide
289
Lidocaine/lignocaine use
Local anaesthesia | Uncommon - anti arrhythmic drug in VT/VF refractory to cardiac inversion
290
Lidocaine/lignocaine risks
Initial stinging on administration Systemic - drowsiness, restlessness, tremor, fits Cardiovascular toxicity - hypotension, arrhythmias
291
Lidocaine/lignocaine interactions
Co administration with vasoconstrictor (e.g adrenaline) may increased duration of use
292
Metformin use
T2DM - control of blood glucose, potentially with other hypoglycaemic drugs (e.g. sulphonylureas)
293
Metformin risks
GI upset - nausea, vomiting, taste distrubance, anorexia, diarrhoea Lactic acidosis
294
Metformin contraindications
Severe renal impairment, AKI Severe tissue hypoxia Acute alcohol intoxication, chronic alcohol overuse
295
Sulphonylurea use
T2DM with or without metformin
296
Sulphonylurea risks
GI upset Hypoglycaemia Hypersensitivity reaction - hepatic toxicity, rash, fever, haematological abnormalities
297
Methotrexate drug type
DMARD
298
Methotrexate use
RA Chemotherapy - leukaemia, lymphoma, solid tumours Psoriasis, including psoriatic arthritis
299
Methotrexate risks
Mucosal damage - sore mouth, GI upset Bone marrow suppression - neutropaenia Hypersensitivity - cutaneous, hepatitis, pneumonitis
300
Methotrexate contraindications
Pregnancy - teratogen | Renal impairment
301
Methotrexate interactions
Toxicity increased when prescribed with renal inhibitory drugs (e.g. NSAIDs, penicillins) Caution with other folate antagonists (trimethoprim, phenytoin)
302
Naloxone use
Opioid OD reversal
303
Naloxone drug type
Competitive opioid receptor inhibitor
304
Naloxone risks
May lead to withdrawal in opioid dependent individual - pain, restlessness, nausea and vomiting, dilated pupils, cold, dry skin (cold turkey)
305
Naloxone contraindications
Lower doses in palliative care to reduce risk of pain restoration
306
Nicorandil use
Prevention/treatment of chest pain in stable angina if CCBs and B blockers are CI/ineffective
307
Nicorandil drug type
Potassium channel activator
308
Nicorandil risks
``` Flushing Dizziness Headache Hypotension GI disturbance - nausea, vomiting, ulceration ```
309
Nicorandil contraindications
Caution with poor LV function, hypotension and pulmonary oedema
310
Nicorandil interactions
Phosphodiesterase inhibitors - increased hypotensive effect
311
GTN drug type
Nitrate
312
GTN use
Sa - acute angina | La - angina prophylaxis
313
GTN risks
``` Flushing Dizziness Headache Hypotension GI disturbance - nausea, vomiting, ulceration Potential tolerance ```
314
GTN contraindications
Severe aortic stenosis, haemodynamic instability, hypotension
315
GTN interactions
Phosphodiesterase inhibitors - enhance and prolong hypotensive effect
316
Naproxen drug type
NSAID
317
Ibuprofen drug type
NSAID
318
Naproxen use
As needed for mild to moderate pain +/- paracetamol | Regular treatment for inflammation related pain
319
Ibuprofen use
As needed for mild to moderate pain +/- paracetamol | Regular treatment for inflammation related pain
320
Naproxen risks
GI toxicity CV events - MI, stroke Hypersensitivity - bronchospasm, angioedema Fluid retention - worsens HTN, HF
321
Ibuprofen risks
GI toxicity CV events - MI, stroke Hypersensitivity - bronchospasm, angioedema Fluid retention - worsens HTN, HF
322
Naproxen contraindications
Severe renal impairment, HF, liver failure, NSAID hypersensitivity Risky in PUD, GI bleeding, CVD
323
Ibuprofen contraindications
Severe renal impairment, HF, liver failure, NSAID hypersensitivity Risky in PUD, GI bleeding, CVD
324
Naproxen interactions
Other drugs increase adverse effects - aspirin, CSs, anticoagulants, SSRIs, ACEis, diuretics
325
Tramadol drug type
Weak opioid
326
Codeine drug type
Weak opioid
327
Tramadol use
Mild to moderate pain
328
Codeine use
Mild to moderate pain
329
Tramadol risks
GI disturbance - nausea, constipation Drowsiness, pupillary constriction OD - respiratory, neuro depression Tolerance, dependence, withdrawal
330
Codeine risks
GI disturbance - nausea, constipation Drowsiness, pupillary constriction OD - respiratory, neuro depression Tolerance, dependence, withdrawal
331
Tramadol contraindications
Respiratory disease Renal impairment Hepatic impairment Uncontrolled epilepsy
332
Codeine contraindications
Respiratory disease Renal impairment Hepatic impairment
333
Tramadol interactions
Other sedating drugs - antipsychotics, benzodiazepines, SSRIs Other drugs that lower seizure threshold
334
Codeine interactions
Other sedating drugs - antipsychotics, benzodiazepines, SSRIs
335
Co-codamol drug type
Compound opioid
336
Co-codamol use
Mild to moderate pain
337
Morphine drug type
Strong opioid
338
Oxycodone drug type
Strong opioid
339
Morphine use
Severe pain
340
Oxycodone use
Severe pain
341
Paracetamol use
Acute/chronic moderate pain with our without fever
342
Paracetamol risks
OD - hepatotoxicity
343
Paracetamol contraindications
Caution in those with chronic alcohol overuse, malnutrition, LBW, severe hepatic impairment CYP450 inducers increase risk of liver failure when co-administered
344
Phenytoin drug type
Anti-epileptic
345
Phenytoin use
Control of seizures in status epileptics where benzodiazepines are ineffective Reduce frequency of generalised or focal seizures in epilepsy
346
Phenytoin risks
``` Change in appearance - skin coarsening, acne, hirsuitism Neuro - cerebellar toxicity (DANISH) Haematological disorders, osteomalacia Hypersensitivity OD - CV collapse, respiratory depression ```
347
Phenytoin contraindications
Low safety window Risky in those with hepatic impairment Caution in pregnancy - co-administer with folic acid
348
Phenytoin interactions
Enzyme induction reducing concentration and efficacy of CYP450 metabolised drugs
349
Lansoprazole drug type
Proton pump inhibitor
350
Lansoprazole use
Prevention and treatment of PUD, including NSAID associated ulcers Symptomatic relief of dyspepsia and GORD H pylori eradication
351
Lansoprazole risks
``` GI disturbance Headache Increased risk of C diff infection Prolonged treatment leads to hypomagnesaemia Gastric cancer masking ```
352
Lansoprazole contraindications
Prolonged course increases fracture risk, caution in osteoporosis
353
Lansoprazole interactions
May reduce anti platelet effect of clopidogrel by activating CYP450 enzymes
354
Omeprazole drug type
Proton pump inhibitor
355
Omeprazole use
Prevention and treatment of PUD, including NSAID associated ulcers Symptomatic relief of dyspepsia and GORD H pylori eradication
356
Omeprazole risks
``` GI disturbance Headache Increased risk of C diff infection Prolonged treatment leads to hypomagnesaemia Gastric cancer masking ```
357
Omeprazole contraindications
Prolonged course increases fracture risk, caution in osteoporosis
358
Omeprazole interactions
May reduce anti platelet effect of clopidogrel by activating CYP450 enzymes
359
Atorvastatin drug type
Statin
360
Atorvastatin use
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
Atorvastatin risks
Generally well tolerated Headache GI disturbance Myopathy, rhabdomyolysis
362
Atorvastatin contraindications
Caution in hepatic and renal impairment | Avoid in pregnancy or breastfeeding
363
Atorvastatin interactions
Metabolism reduced by CYP450 inhibitors leading to accumulation of statin
364
Carbimazole use
Graves disease
365
Metyrapone use
Cortisol inhibition in Cushing's syndrome
366
Ketoconazole use
Cortisol inhibition in Cushing's syndrome
367
Cabergaline use
D2 agonist in acromegaly
368
Bromocriptine use
D2 agonist in acromegaly

Drugs (6 decks)

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