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Y4 > Drugs > Flashcards

Drugs Flashcards

1
Q

GHB

A

Gamma-hydroxy-butyrate

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2
Q

Omeprazole

A

PPI
MoA: irreversible blockade of H+/K+ ATPase on gastric parietal cell
cytochrome P450 inhibitor = raised INR = bleeding risk
SEs: hyponatraemia (via SIADH), hypomagnesaemia, increased risk of osteoporosis and fractures (due to calcium & magnesium malabsorption), increased risk of C. difficile infection, microscopic colitis

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3
Q

Lansoprazole

A

PPI
MoA: irreversible blockade of H+/K+ ATPase on gastric parietal cell
SEs: hyponatraemia, hypomagnesaemia, increased risk of osteoporosis and fractures (due to calcium & magnesium malabsorption), increased risk of C. difficile infection, microscopic colitis

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4
Q

Ramipril

A

ACEi
Check serum creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels
SEs: dry cough (due to effects on bradykinin), angioedema (hypersensitivity reaction hence stop ACEi), hyperkalaemia, 1st dose hypotension (seen if pt taking diuretic)
Contraindicated in pregnancy/breastfeeding (risk of renal failure, foetal abnormalities e.g. cranial/cardiac defects, or oligohydramnios), renovascular disease, aortic stenosis (may cause hypotension)
Stopped prior to surgery

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5
Q

Lisinopril

A

ACEi
Check serum Creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels
SEs: dry cough (due to effects on bradykinin), angioedema (hypersensitivity reaction hence stop ACEi), hyperkalaemia, 1st dose hypotension (seen if pt taking diuretic)
Contraindicated in pregnancy/breastfeeding (risk of renal failure, foetal abnormalities e.g. cranial/cardiac defects, or oligohydramnios), renovascular disease, aortic stenosis (may cause hypotension)
Stopped prior to surgery

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6
Q

Enalapril

A

ACEi
Check serum Creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels
SEs: dry cough (due to effects on bradykinin), angioedema (hypersensitivity reaction hence stop ACEi), hyperkalaemia, 1st dose hypotension (seen if pt taking diuretic)
Contraindicated in pregnancy/breastfeeding (risk of renal failure, foetal abnormalities e.g. cranial/cardiac defects, or oligohydramnios), renovascular disease, aortic stenosis (may cause hypotension)
Stopped prior to surgery

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7
Q

Candesartan

A

Angiotensin-II receptor blockers
Blocks AT1 receptor (subtype of the angiotensin II receptor)
Check serum Creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels

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8
Q

Irbesartan

A

Angiotensin-II receptor blockers
Blocks AT1 receptor (subtype of the angiotensin II receptor)
Check serum Creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels

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9
Q

Losartan

A

Angiotensin-II receptor blockers
Blocks AT1 receptor (subtype of the angiotensin II receptor)
Check serum creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels
SEs: diarrhoea, abdominal pain, dizziness

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10
Q

Amlodipine

A

Dihydropyridine calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
SEs: ankle oedema, headache, constipation, diarrhoea, flushing

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11
Q

Verapamil

A

Non-dihydropyridine calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
Used for cluster headache prophylaxis (poss. due to vasodilatory effect on cerebral arteries)
SEs: Heart failure, constipation, hypotension, bradycardia, flushing
Avoid if pt is on a beta blocker (risk of complete heart block), or if pt is known to have heart failure

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12
Q

Diltiazem

A

Calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
SEs: Hypotension, bradycardia, heart failure, ankle swelling

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13
Q

Nifedipine

A

Dihydropyridine calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
SEs: flushing, headache, ankle swelling

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14
Q

Bumetanide

A 
Loop diuretics
Inhibits resorption in LoH 
Mainly used for HTN with CKD
Hypokalaemia may lead to hypotension
Cause or exacerbate gout
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15
Q

Furosemide

A 
Loop diuretics
Inhibits resorption in LoH 
Mainly used for HTN with CKD
Hypokalaemia may lead to hypotension
Cause or exacerbate gout
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16
Q

Isosorbide mononitrate

A

Nitrates
Used to relieve angina
Tolerance may develop with standard release ISMN requiring a change in dose regime hence asymmetric dosing interval should be used

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17
Q

Glyceryl trinitrate

A

Nitrates

Used sublingually for angina attacks

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18
Q

Alfuzosin

A

Alpha adrenergic receptor antagonist
Causes vasodilation by inhibiting alpha-related vasoconstriction
Does not elevate glucose but increased insulin sensitivity may lower lipids
May cause postural hypotension in elderly

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19
Q

Doxazosin

A

Alpha adrenergic receptor antagonist
Causes vasodilation by inhibiting alpha-related vasoconstriction
Does not elevate glucose but increased insulin sensitivity may lower lipids
May cause postural hypotension in elderly

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20
Q

Tamsulosin

A

Alpha adrenergic receptor antagonist
Causes vasodilation by inhibiting alpha-related vasoconstriction
Does not elevate glucose but increased insulin sensitivity may lower lipids
May cause postural hypotension in elderly

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21
Q

Atenolol

A

Beta blockers
Used for stable angina tx (can be used in HF pt)
Avoid in HTN due to increased T2DM risk
Avoid in asthmatics
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

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22
Q

Bisoprolol

A

Beta blockers
Can be used as rate control in AF
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

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23
Q

Metoprolol

A

Beta blockers
Can be used as rate control in AF
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

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24
Q

Ipratropium bromide

A

Anti-muscarinic bronchodilators

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25
Q

Tiotropium

A

Anti-muscarinic bronchodilators

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26
Q

Betamethasone

A

Inhaled corticosteroid
Can be used topically for mild drug hypersensitivity reaction or drug eruption rash
SEs: risk of idiopathic intracranial HTN

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27
Q

Seretide

A

Fluticasone + Salmeterol

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28
Q

Salbutamol

A

Beta 2 agonist

Bronchodilator

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29
Q

Quetiapine

A

Atypical (2nd generation) antipsychotic

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30
Q

Olanzapine

A

Atypical (2nd generation) antipsychotic

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31
Q

Chlordiazepoxide

A

Benzodiazepine

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32
Q

Diazepam

A

Benzodiazepine

Used for anxiety disorders

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33
Q

Lorazepam

A

Benzodiazepine

Used for anxiety disorders

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34
Q

Midazolam

A

Benzodiazepine

Used for anxiety disorders

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35
Q

Temazepam

A

Benzodiazepine

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36
Q

Domperidone

A

D2 antagonist

Anti-emetic

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37
Q

Metoclopramide

A 
D2 antagonist (central dopamine antagonist)
Used for gastrointestinal causes of nausea/vomiting
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38
Q

Co-careldopa

A

Levodopa/carbidopa

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39
Q

Co-beneldopa

A

Levodopa

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40
Q

Diclofenac

A

NSAID
MoA: inhibit cyclooxygenase to reduce prostaglandin and thromboxane A2 production
SEs: urticaria, tinnitus
do not use with any form of cardiovascular disease e.g. IHD, PAD, cerebrovascular disease, HF

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41
Q

Ibuprofen

A

NSAID
MoA: inhibit cyclooxygenase to reduce prostaglandin and thromboxane A2 production
SEs: urticaria, tinnitus

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42
Q

Codeine

A

Weak/moderate opioid

SEs: urticaria

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43
Q

Dihydrocodeine

A

Weak/moderate opioid

SEs: urticaria

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44
Q

Fentanyl

A

Opioid

SEs: urticaria

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45
Q

Morphine

A

Opioid

SEs: urticaria

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46
Q

Oxycodone

A

Opioid

SEs: urticaria

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47
Q

Citalopram

A

SSRIs
Used for IBS if pt resistant to TCAs
cytochrome P450 inhibitor = raised INR = bleeding risk
IBS dose: 20-40mg PO OD

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48
Q

Fluoxetine

A

SSRIs

cytochrome P450 inhibitor = raised INR = bleeding risk

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49
Q

Amitriptyline

A

Tricyclic antidepressant
Used for IBS if laxatives, loperamide or antispasmodics have not helped
IBS dose: 10-25mg PO OD at bedtime

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50
Q

Dosulepin

A

Tricyclic antidepressant

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51
Q

Gelofusine

A

Colloid

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52
Q

Volplex

A

Colloid

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53
Q

Cephalexin/cefalexin

A

1st gen Cephalosporin

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54
Q

Cefuroxime

A

2nd gen Cephalosporin

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55
Q

Ceftriaxone

A

3rd gen Cephalosporin

1st line for gonorrhoea (IM)

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56
Q

Clarithromycin

A

Macrolides

Can interact with statins to cause statin-induced myopathy

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57
Q

Erythromycin

A

Macrolide antibiotic

Can interact with statins to cause statin-induced myopathy

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58
Q

Amphotericin

A

Anti-fungal

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59
Q

Fluconazole

A

Anti-fungal

Interacts with warfarin hence close INR monitoring required

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60
Q

Nystatin

A

Anti-fungal

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61
Q

Amoxicillin

A

Penicillin

SEs: urticaria

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62
Q

Co-amoxiclav

A

Penicillin
Used for human and animal bites if the skin has been broken and blood is drawn
SEs: urticaria

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63
Q

Flucloxacillin

A

Penicillin
1st line tx for Erysipelas (500-1000mg QDS PO 5-7d) and most skin infections, 1st line for otitis externa
SEs: urticaria

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64
Q

Penicillin G

A

Penicillin
Benzylpenicillin - used IM as 1st line tx for syphilis
SEs: urticaria

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65
Q

Penicillin V

A

Penicillin
Phenoxymethylpenicillin
SEs: urticaria

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66
Q

Doxycycline

A 
Tetracycline antibiotic
V. cheap drug
Avoid in pregnancy 
Can be used in malaria tx and prophylaxis
Used as alternative drug for syphilis tx
SEs: idiopathic intracranial HTN
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67
Q

Artesunate

A

Anti-protozoal

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68
Q

Chloroquine

A

Anti-protozoal

Anti-malarial drug

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69
Q

Quinine sulphate

A

Anti-protozoal

Used for treatment of malaria

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70
Q

Dexamethasone

A

Corticosteroids
Mild anti-emetic effects hence may be given preoperatively to surgical patients
SEs: risk of idiopathic intracranial HTN

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71
Q

Hydrocortisone

A

Corticosteroids

SEs: risk of idiopathic intracranial HTN

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72
Q

Prednisolone

A

Topical corticosteroid
1st line treatment for ITP (high dose required)
SEs: risk of idiopathic intracranial HTN

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73
Q

Mesalazine

A

Aminosalicylates

SEs: steven-johnson syndrome

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74
Q

Loperamide hydrochloride

A

Anti-motility drug used for acute diarrhoea

Dose: 4mg initially, 2mg after each loose stool (max 16mg/day) for 5days

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75
Q

Ranitidine

A

Histamine (H2) receptor antagonists

Used if PPI poorly tolerated for dyspepsia

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76
Q

Macrogol

A

Osmotic laxatives

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77
Q

Lactulose

A 
Osmotic laxative
Used for constipation
May be given to IBS sufferer
Synthetic disaccharide with a sweet taste which can increase bloating in some patients
10-20 g (15-30 mL) PO OD
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78
Q

Senna

A

Stimulant laxative

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79
Q

Docusate sodium

A

Stimulant laxative

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80
Q

Spironolactone

A

Aldosterone antagonist
K+ sparing diuretic, used in Conn’s
Not licensed for HTN use but starting dose is 12.5mg (1/2 tablet)
SEs: hyperkalaemia, gynaecomastia

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81
Q

Perindopril

A

ACEi
Check serum Creatinine and potassium levels pre-treatment, after 7 days and 1 month, and whenever dose increased to exclude renal artery stenosis and monitor potassium levels
SEs: dry cough (due to effects on bradykinin), angioedema (hypersensitivity reaction hence stop ACEi), hyperkalaemia, 1st dose hypotension (seen if pt taking diuretic)
Contraindicated in pregnancy/breastfeeding (risk of renal failure, foetal abnormalities e.g. cranial/cardiac defects, or oligohydramnios), renovascular disease, aortic stenosis (may cause hypotension)
Stopped prior to surgery

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82
Q

Atropine sulfate

A

Antimuscarinic/anticholinergic
Used for IBS as an antispasmodic
GI spasm dose: 0.6-1.2mg OD at night
Also used for bradycardia

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83
Q

Hyoscine butylbromide

A

Antimuscarinic/anticholinergic
Used for IBS as an antispasmodic to relieve symptomatic GI smooth muscle spasm
Dose: 10mg PO TDS (up to 20mg QDS)

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84
Q

Clopidogrel

A

Antiplatelet, P2Y12 receptor antagonist
75mg given lifelong post-TIA/Stroke (after initial 2 weeks of aspirin)
Used to reduce cardiovascular risk e.g. in peripheral arterial disease (along with a statin)

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85
Q

Lercanidipine

A

Dihydropyridine calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
SEs: ankle oedema and headache

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86
Q

Digoxin

A

Cardiac glycoside
Use: rate control in atrial fibrillation, symptom improvement in HF (due to positive inotropic effect)
MoA: reduces conduction through AVN, increases force of contraction (by inhibiting Na+/K+ ATPase pump in cardiac muscle and vagus stimulation)
Narrow therapeutic index but regular monitoring not required, except in suspected toxicity (8-12hrs after last dose)
SEs: toxicity causes xanthopsia(yellow/green-tinted vision), arrhythmias, low K+/Mg+
Tx of severe digoxin toxicity = digibind
Toxicity more likely with hypokalaemia

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87
Q

Direct Oral Anticoagulants (DOACs) Rivaroxaban

A 
Reversible factor Xa inhibitors 
Dabigatran
Edoxaban
Apixaban
Rivaroxaban
Prevents conversion of prothrombin to thrombin and prolongs clotting time to prevent thrombus formation
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88
Q

Bendroflumethiazide

A

Thiazide-like diuretic

SEs: hypercalcaemia & hypocalciuria

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89
Q

Indapamide

A

Thiazide diuretic
Used for HTN treatment
SEs: hypercalcaemia & hypocalciuria

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90
Q

Alteplase

A

Fibrinolytics

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91
Q

Simvastatin

A

Statin
Used for angina
May cause statin-induced myopathy, higher risk if pt on macrolide
Not safe in pregnancy

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92
Q

Atorvastatin

A

Statin
Used for angina
1st line for secondary prevention of CVD = 80mg (high dose)
Not safe in pregnancy

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93
Q

Pravastatin

A

Statin
Used for angina
Not safe in pregnancy

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94
Q

Warfarin

A 
Vitamin K antagonist
Not safe in pregnancy
Warfarin interacts with fluconazole 
Careful monitoring of INR is required
Preferred anticoagulant for mitral stenosis
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95
Q

Salmeterol

A

Beta 2 agonist

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96
Q

Beclometasone

A

Inhaled corticosteroid

SEs: risk of idiopathic intracranial HTN

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97
Q

Fluticasone

A

Inhaled corticosteroid

SEs: risk of idiopathic intracranial HTN

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98
Q

Budesonide

A

Inhaled corticosteroid

SEs: risk of idiopathic intracranial HTN

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99
Q

Cyclizine

A

H1 receptor antagonist

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100
Q

Cetirizine

A

H1 receptor antagonist

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101
Q

Loratadine

A

H1 receptor antagonist

Antihistamine

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102
Q

Fexofenadine

A

H1 receptor antagonist

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103
Q

Chlorphenamine

A

H1 receptor antagonist
Symptomatic relief of allergy such as hay fever (allergic rhinitis), urticaria, food allergy, drug reactions
4mg every 4-6hrs PO (max. 24mg)
OR 10mg IV/IM for emergency relief (max. 4x)

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104
Q

Montelukast

A

Leukotriene receptor antagonist

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105
Q

Carbocysteine

A

Mucolytics

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106
Q

Donepezil

A

Acetylcholinesterase inhibitor

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107
Q

Venlafaxine

A

Selective serotonin-norepinephrine reuptake inhibitor

Used for major depression, panic disorder, generalised anxiety disorder, and social anxiety

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108
Q

Mirtazapine

A

Antidepressant

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109
Q

Citalopram

A

SSRI
cytochrome P450 inhibitor = raised INR = bleeding risk
Used for depressive disorders, panic disorders, social phobia, and OCD

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110
Q

Sertraline

A

SSRI
cytochrome P450 inhibitor = raised INR = bleeding risk
SEs: steven-johnson syndrome

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111
Q

Metoclopramide

A

D2 antagonist

Anti-emetic

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112
Q

Domperidone

A

D2 antagonist anti-emetic

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113
Q

Ondansetron

A

5HT3 antagonist that acts on the chemoreceptor trigger zone area of the medulla oblongata
May be given post-operatively to patients for anti-emetic effects
Used for chemotherapy-induced nausea/vomiting
SEs: constipation and prolonged QT interval

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114
Q

Haloperidol

A

1st generation anti-psychotic
Dopamine receptor antagonist
Used for raised ICP causes of nausea

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115
Q

Risperidone

A

Atypical (2nd generation) anti-psychotic

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116
Q

Tramadol

A

Weak/moderate opioids

SEs: urticaria

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117
Q

Sumatriptan

A

5HT1 receptor agonist

Used for acute management of cluster headaches and migraines with high flow oxygen

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118
Q

Zopiclone

A

Z-drug hence used for insomnia in short term

SEs: dry mouth, bitter taste, skin reactions

119
Q

Clotrimazole

A

Antifungal

120
Q

Ketoconazole

A

Antifungal

121
Q

Aciclovir

A

Antiviral
Used for Herpes Zoster (shingles) tx: 800mg 5x/day PO 7d
Also used for herpes simplex virus

122
Q

Piperacillin sodium/tazobactam sodium

A

Anti-pseudomonal penicillin

SEs: urticaria

123
Q

Amoxicillin

A

Broad spectrum penicillin

SEs: urticaria

124
Q

Co-amoxiclav

A

Broad spectrum penicillin

SEs: urticaria

125
Q

Flucloxacillin

A

Penicillinase-resistant penicillins

SEs: urticaria

126
Q

Ciprofloxacin

A

Quinolone
cytochrome P450 inhibitor = raised INR = bleeding risk
Not safe in pregnancy/breastfeeding or for G6PD pt

127
Q

Moxifloxacin

A

Quinolone

Not safe in pregnancy

128
Q

Metformin

A

Biguanide
Use contraindicated if eGFR < 30
SEs: constipation, diarrhoea, vomiting, nausea

129
Q

Bisphosphonates

A

Prevents bone resorption hence used for osteoporosis mx
E.g., alendronate 10mg PO OD, risedronate 5mg PO OD, IV zoledronic acid
Important to check renal function before prescribing,
SEs: oesophageal ulceration (commonest side effect), jaw osteonecrosis (aka avascular necrosis), atypical femoral fracture

130
Q

Sitagliptin

A

Dipeptidyl peptidase-4 inhibitors (DPP4) = indirectly reduces insulin secretion
T2DM
100mg PO OD
safe for use in pts at risk of hypoglycaemia as monotherapy

131
Q

Linagliptin

A

Dipeptidyl peptidase-4 inhibitors (DPP4) = indirectly reduces insulin secretion
T2DM
5mg PO OD

132
Q

Ethinylestradiol with levonorgestrel AKA combined ethinylestradiol

A

Oestrogen

133
Q

Desogestrel

A

Progestogen

134
Q

Oestradiol

A

Oestrogen

135
Q

Gliclazide

A

Sulphonylureas
Safe to use with low eGFR but, lower dose required
Not safe in pregnancy

136
Q

Levothyroxine

A

Thyroid hormone replacement used in hypothyroidism (e.g., Hashimoto’s thyroiditis)
Starting dose: 50-100mcg od (25mcg OD for elderly or IHD pt)
If pt pregnant, increase dose by 50%
SEs: hyperthyroidism (over treatment), reduced bone mineral density, worsening of angina, atrial fibrillation

137
Q

Finasteride

A

5-alpha reductase inhibitor

Use: benign prostatic hyperplasia

138
Q

Doxazosin

A

Alpha-adrenoceptor blocker

Used for hypertension

139
Q

Tamsulosin

A

Alpha-adrenoceptor blocker causing smooth muscle in the prostate to relax which improves urinary flow
Used for benign prostatic hyperplasia

140
Q

Solifenacin

A

Anti-muscarinic (genitourinary use)

141
Q

Tolterodine

A

Anti-muscarinic (genitourinary use)

142
Q

Oxybutynin

A

Anti-muscarinic (genitourinary use)

Used for urinary urge, frequency, incontinence in overactive bladder

143
Q

Sildenafil

A

Phosphodiesterase (type 5) inhibitor

SEs: blue-tinted vision (cyanopsia)

144
Q

Azathioprine

A

Anti-proliferative immunosuppressant

Used in chronic ITP for pregnant women, used for myasthenia gravis

145
Q

Tamoxifen

A

Breast cancer tx

146
Q

Allopurinol

A

Xanthine oxidase inhibitor which reduces uric acid levels
Gout and hyperuricaemia prophylaxis = 100mg PO OD
cytochrome P450 inhibitor = raised INR = bleeding risk
Do not start use during acute attacks, but if already pt is already on allopurinol, it can be continued during acute attacks

147
Q

Naproxen

A

NSAID
MoA: inhibit cyclooxygenase to reduce prostaglandin and thromboxane A2 production
SEs: urticaria, tinnitius

148
Q

Hypromellose

A

Ocular lubricants (artificial tears)

149
Q

Lidocaine/lignocaine

A 
Local anaesthetic
Reversible sodium channel blocker
Strengths: 0.5%, 1%, 2%
Administered subcutaneously 
Takes effect within 5-10 minutes
Duration: 30-120 minutes
Maximum adult dose: 3mg/kg
Side effects: anaphylaxis, convulsions, paraesthesia or anxiety
If IV injection, can cause life threatening cardiac arrhythmias and cardiovascular instability
150
Q

Latanoprost

A

Prostaglandin analogue

151
Q

Ferrous sulphate/fumarate

A

Iron supplements
200mg PO BD/TDS for 3months for IDA
SEs: diarrhoea, constipation, nausea, dark stool, abdominal discomfort

152
Q

Doxorubicin hydrochloride

A

Chemotherapy agent used for Non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, breast cancer, and many other cancers
Aka anthracycline chemotherapeutic agents as extracted from Streptomyces bacterium

153
Q

Metaramine

A

Potent sympathomimetic amine used to increase systolic and diastolic blood pressure
Indication: prevent or reverse acute hypotensive state with spinal anaesthesia
Action: alpha-1 adrenergic receptor agonist, mild beta receptor agonist

154
Q

Adrenaline

A

(epinephrine)

155
Q

Propanolol

A

Beta blocker
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events

Used for sympathetic nervous system overactivity e.g. generalised anxiety disorder and hyperthyroidism (symptom management)
May be used as migraine prophylaxis
May cause depressive symptoms

156
Q

Felodipine

A

Calcium channel blocker
Dihydropyridine calcium channel blocker
Reduce calcium ion flow to vascular smooth muscle cells to vasodilate, reducing BP, and reducing the force and rate of the heart beat to prevent angina
SEs: Flushing, headache, ankle swelling

157
Q

Amiodarone

A

Anti-arrhythmic
Blocks potassium rectifier channels in heart responsible for repolarisation of heart
300mg IV given during shockable rhythm defibrillation
cytochrome P450 inhibitor = raised INR = bleeding risk
SEs: risk of idiopathic intracranial HTN, thyroid dysfunction (hypo/hyper), long QT, pulmonary fibrosis, peripheral neuropathy, bradycardia

158
Q

Alginates

A

Blood

159
Q

Adenosine

A

Blood

160
Q

Aspirin

A

Acetylsalicylic acid
Inhibits cyclooxgenase (COX) 1 & 2 enzymes to reduce prostaglandin and thromboxane A2 production
Provides pain relief, reduces fever and inflammation
Used for angina
Following ischaemic stroke/TIA, 300mg aspirin is given for 2 weeks then clopidogrel is used. If clopidogrel is contraindicated, aspirin and modified-release dipyridamole are used instead for secondary prevention of TIA/ischaemic stroke
SEs: urticaria (histamine production stimulated due to inhibition of PG and thromboxane A2 production) steven-johnson syndrome

161
Q

Unfractionated heparin

A

Activates antithrombin III which forms a complex to inhibit thrombin (factor IIa), factor IXa, Xa, XIa, XIIa
Administered intravenously
Used if high risk of bleeding e.g. perioperatively as can be terminated rapidly (short action)
regular monitoring of APTT required
SEs: bleeding, heparin-induced thrombocytopaenia, osteoporosis, hyperkalaemia

162
Q

Carbamazepine

A

Anti-epileptic
Chemically similar to the tricyclic antidepressant drugs
MoA: binds to sodium channels increasing their refractory period
1st line tx for partial seizures
Also used for bipolar disorder and trigeminal neuralgia
Ineffective in absence seizures
cytochrome P450 inducer hence INR may be reduced
SEs: steven-johnson syndrome, cytochrome P450 inducer, dizziness, drowsiness, ataxia, headaches, hyponatraemia secondary to SIADH, leucopenia (myelosuppression and agranulocytosis), visual disturbances (diplopia)
May exhibit autoinduction causing return of seizures 3-4weeks after treatment initiation
Not safe in pregnancy

163
Q

Nicotine

A

Used for smoking cessation

164
Q

Methadone

A

Used for substance dependence

165
Q

Gabapentin

A

Analgesic

Used for neuropathic pain e.g. diabetic neuropathy, allodynia, hyperalgesia

166
Q

Pregabalin

A

Analgesic

Used for anxiety disorders

167
Q

Lamotrigine

A

Anti-epileptic agent
2nd line tx for generalised and partial seizures
MoA: sodium channel blocker
SEs: steven-johnson syndrome

168
Q

Levetiracetam

A

Anti-epileptic

SEs: hyponatraemia, anxiety, insomnia, mood changes, confusion, hallucinations, impaired concentration

169
Q

Paracetamol

A

Analgesic

170
Q

Sodium valproate

A

Anti-epilpetic
Not safe in pregnancy
cytochrome P450 inhibitor = raised INR = bleeding risk
SEs: suicidal behaviour, behavioural changes, impaired concentration, hallucination, agitation, hyponatraemia

171
Q

Chloramphenicol

A

Anti-septic agent

172
Q

Metronidazole

A

Antibiotic and anti-protozal activity
Forms reactive cytotoxic metabolites in bacteria
1st line tx for giardiasis - 250mg PO TDS for 5-7d
Also used for amoebic dysentery and bacterial vaginosis
SEs: disulfiram-like reaction with alcohol

173
Q

Nitrofurantoin

A

Antibiotic commonly used for uncomplicated UTIs
Standard course for uncomplicated UTIs = 3d (women)
Course of complicated UTIs = 7d (pregnant women & men)

174
Q

Trimethoprim

A

Antibiotic
Used for UTI treatment in non-pregnant women and men
Not safe in pregnancy due teratogenic effects

175
Q

Vancomycin

A

Antibiotic

176
Q

Insulin

A

Promotes uptake of glucose from bloodstream into cells

177
Q

Methotrexate

A

Dihydrofolate reductase inhibitor
Conventional DMARD
Used of immunological disorders e.g. rheumatoid arthritis (First line agent)
Used for immunosuppressive action in myasthenia gravis
SEs: mouth ulcers, liver toxicity, bone marrow suppression, pulmonary fibrosis
Not safe in pregnancy

178
Q

Calcium

A

Important for bones

179
Q

Vitamin D

A

Important for bones

180
Q

Folic acid

A

Vitamin

181
Q

Thiamine hydrochloride

A

AKA Vitamin B1
Vitamin supplement used in alcohol dependence patient to prevent Wernicke’s encephalopathy
Essential for aerobic metabolism, cell growth, transmission of nerve impulses and acetylcholine synthesis

182
Q

Vitamin B12

A

Important

183
Q

Vitamine B6

A

Important

184
Q

Hypromellose

A

Ocular lubricant (artificial tears)

185
Q

Emollients

A

Moisturisers

186
Q

N-acetylcysteine

A

Used for paracetamol overdose

187
Q

Activated charcoal

A

Used for overdoses of recreational drugs

188
Q

Naloxone

A

Used to reverse effects of opioid overdose

189
Q

Duloxetine

A

Serotonin/norepinephrine reuptake inhibitor
Used for urinary incontinence associated with stress
Pts typically do not respond to reduction in caffeine intake and pelvic floor exercises before duloxetine is tried
SEs: nausea, dizziness, headache, insomnia, dry mouth

Also acts as an antidepressant hence used for nerve pain in fibromyalgia tx with a starting dose of 60mg PO OD

190
Q

Volatile anaesthetic agents

A

Isoflurane
Sevoflurane
Desflurane
Methoxyflurane (nephrotoxicity, used for patient controlled analgesia short term)
Nitrous oxide (gas under RTP)
Halothane (no longer used in US, can cause hepatotoxicity, medium duration)
Enflurane (proconvulsive, medium duration)

Effects: respiratory depression, decreased arterial blood pressure, decreased cerebral metabolic demand, increased cerebral blood flow, decreased RR, myocardial depression
SEs: nausea and vomiting, malignant hypothermia, postoperative shivering

191
Q

Sevoflurane

A

Liquid under RTP hence requires a vaporizer
Medium duration hence takes a little longer for pt to come round compared to desflurane
May cause malignant hyperthermia
Commonly used due to rapid onset and recovery
AEs: interacts with soda lime → nephrotoxic breakdown products (known as compounds A–E)

192
Q

Isoflurane

A

Liquid under RTP hence requires a vaporizer
Long duration
Most potent of the fluranes

193
Q

Desflurane

A

Inhaled anaesthetic (induction agent)
Liquid under RTP hence requires a vaporizer
Pungent odour and may irritate airways
Short duration
AEs: sympatho-adrenergic reaction (↑ BP & HR)

194
Q

Propofol

A

Fast acting
Very potent
Obtunds airway reflexes

195
Q

Ketamine

A

Induction agent
Painkiller
Protects airway reflexes and less apnoeic effect
Used in paediatrics and out of hospital settings e.g. battlefield

196
Q

Thiopentone

A

Induction agent
Used for rapid sequence induction due to fast onset and 1 arm-brain circulation
Reduced use due to adverse effects

197
Q

Suxamethonium

A

Fast acting, depolarising nicotinic receptor agonist (muscle relaxant)
Binds to nicotinic acetylcholine receptors at the NMJ to depolarise motor end plate causing flaccid paralysis of skeletal muscles
Short acting effects as plasma cholinesterases break down suxamethonium in 5-10mins

198
Q

Sugamadex

A

Reversal agent/antidote used for vecuronium and rocuronium

199
Q

Non-depolarising muscle relaxants

A

Consider to be competitive (nicotinic acetylcholine receptor antagonists)
Used for longer procedures
Atracurium
Rocuronium
Vecuronium
Cisatracurium - fewer SEs than atracurium; Hofman elimination (temp. and pH dependent degradation)

200
Q

Atracurium reversal

A

Requires:
Anti- acetylcholinesterase agent e.g. neostigmine or pyridostigmine
AND
Anticholinergic agent e.g. atropine or glycopyrrolate to prevent muscarinic effects of the anticholinesterase

201
Q

Emergency anaesthetic drugs

A

Ephedrine (alpha 1/2 and beta 1 agonist) to ↑BP and ↑HR
Metaraminol (alpha 1 agonist) to ↑BP
Used for BP or HR drops intra-operatively

202
Q

Atracurium

A

Non-depolarising muscle relaxant
Metabolized mostly by Hofmann elimination
May stimulate histamine release (causing hypotension and bradycardia), and laudanosine (CNS stimulant provoking seizures) during degradation

Reversal of effects achieved by anticholinesterase agents such as neostigmine or pyridostigmine

203
Q

Ispaghula

A

Laxative
Used for constipation
May be given to IBS sufferer

204
Q

Linaclotide

A

14 amino acid peptide
Binds and activates guanylate cyclase C receptor on luminal surface of enterocyte
Used for any type of IBS to reduce pain and increase intestinal secretion and transit

205
Q

Side effects of antimuscarinics e.g. atropine sulfate, hyoscine butylbromide

A 
Constipation
Dizziness
Drowsiness
Dry mouth
Dyspepsia
Flushing
Headache
Nausea
Palpitations
Skin reactions
Tachycardia
Urinary disorders
Vision disorders;
Vomiting
206
Q

Mebeverine hydrochloride

A

Direct-acting intestinal smooth muscle relaxants
Relieves abdominal pain or spasm in IBS
Dose: 135mg PO TDS 20mins before meals (up to 150mg)
SEs: angioedema, face oedema, skin reaction

207
Q

Paroxetine

A

SSRI
Used for IBS if pt resistant to TCAs
IBS dose: 20-40mg PO OD
cytochrome P450 inhibitor = raised INR = bleeding risk

208
Q

SSRI side effects

A 
Anxiety
Arrhythmias & palpitations
Concentration impairment
Confusion & memory loss
Dizziness or drowsiness
Haemorrhage
Menstrual cycle irregularities
Nausea (dose-related) & vomiting
QT interval prolongation
209
Q

Calcineurin inhibitors

A

Class of 3 drugs: cyclosporine, tacrolimus, and pimecrolimus
Inhibit phosphatase calcineurin through different mechanisms to block T cell proliferation
May be used for minimal change disease or focal segmental glomerulosclerosis
Used as immunosuppression therapy for allograft transplantation
Cyclosporine has the worst side effects including serious infections, lymphoma, nephrotoxicity and hepatotoxicity

210
Q

Rituximab

A

Monoclonal antibodies that bind to CD20 surface antigen on B lymphocytes to cause cell lysis and induce cell death by apoptosis
Thought to reduce B cell activity leading to platelet autoantibody, and upregulate regulatory T cells in ITP
Used for ITP (2nd line), CLL, non-Hodgkin’s lymphoma, RA (4th line), sarcoidosis
SEs: night sweats and thrombocytopenia
Avoid in pregnancy

211
Q

Penicillamine

A

Aids the elimination of copper ions in Wilson’s disease (hepatolenticular degeneration)
1.5-2g daily in divided doses initially, maintenance dose of 0.75-1g daily (administered orally)

212
Q

Carvedilol

A

Beta blocker
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

213
Q

Esmolol

A

Beta blocker
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

214
Q

Nebivolol

A

Beta blocker
Avoid in asthmatics and HF pts
SEs: erectile dysfunction, bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

215
Q

IV immunoglobulin

A

Used to rapidly increase platelet function and count in ITP if pt is actively bleeding or if an urgent invasive procedure is required

216
Q

Anti-D immunoglobulin

A

Can be used to increase platelet function in ITP but associated with many risks, hence no longer commonly used in UK

217
Q

Fostamatinib

A

Spleen tyrosine kinase inhibitor used for ITP
Blocks IgG antibody receptor signalling in WBCs to stop immune destruction of platelets
Avoid in pregnancy; only used in adults

218
Q

Mycophenolate mofetil

A

May be used in ITP if chronic or persistent

Immunosuppressive agent that boosts platelet count

219
Q

Thrombopoeitin receptor agonist (2nd gen)

A

E.g. romiplostim and eltrombopag
Used for chronic ITP
Require indefinite administration to prevent platelet count returning to basal levels
Avoid in pregnancy

220
Q

Cephalosporins

A 
Beta lactam antibiotics
1st gen: cefalexin, cefazolin
2nd gen: cefuroxime, ceftoxitin
3rd gen: ceftriaxone, ceftazidime
4th gen: cefpirome, cefepime
5th gen: ceftaroline, ceftolozane
221
Q

Monobactam

A

Aztreonam

222
Q

Carbapenems

A

Meropenem
Imipenem
Ertapenem

223
Q

Aminoglycosides

A 
Gentamicin
Kanamycin
Neomycin
Tobramycin
Streptomycin
Amikacin
MoA: bind to a protein in the 30S ribosomal subunit of the bacterium to cause misreading of mRNA codons resulting in defective protein synthesis; BACTERICIDAL
Not safe in pregnancy
224
Q

Tinnitus is a side effect of which medications?

A

NSAIDs e.g. Naproxen, aspirin
Aminoglycosides
Loop diuretics

225
Q

Sulphonamides

A

Antibiotics
Avoid in pregnancy
SEs: risk of idiopathic intracranial HTN

226
Q

Phenytoin

A

Anti-epileptic tx
cytochrome P450 inducer hence INR may be reduced
SEs: steven-johnson syndrome
Not safe in pregnancy

227
Q

Sevelamer

A

Non-calcium based phosphate binder

Used for hyperphosphataemia in patients with CKD mineral bone disease

228
Q

Calcium acetate

A

Calcium-based phosphate binder
Used for hyperphosphataemia
SE: hypercalcaemia

229
Q

Calcium carbonate

A

Calcium-based phosphate binder
Used for hyperphosphataemia
SE: hypercalcaemia

230
Q

Dialysis

A

Initiation for CKD-MBD determined by impact of symptoms of uraemia on daily living, uncontrollable fluid overload, or eGFR of 5-7ml/min/1.73m2

231
Q

Tranexamic acid

A

Antifibrinolytic that reversibly binds to lysine receptor sites on plasminogen or plasmin to prevent plasmin from breaking down fibrin
Used for menorrhagia
Within the first 3hours of major bleeding trauma, a 1g IV bolus of tranexamic acid can be given followed by a 1g slow infusion over 8hrs

232
Q

Disulfiram

A

Used to cause sensitivity to alcohol in alcohol dependent patients
Inhibits acetaldehyde dehydrogenase
Alcohol consumption results in headache, palpitations, head and neck flushing, N&V, sweating

233
Q

Valaciclovir

A

Antiviral
Used for Herpes zoster (shingles) tx: 1g TDS PO 7d
SEs: N&V, photosensitivity, Microangiopathic haemolytic anaemia

234
Q

Antibiotics effective against carbapenemases

A

Colistin - SEs: nephro & neurotoxicity
Tigecycline - low serum levels hence, not effective in sepsis
Fosfomycin - high IV dose required typically poorly tolerated

235
Q

Antibiotics effective against inducible chromosomal cephalosporinase

A

Carbapenems
Temocillin
Aminoglycosides
Ciprofloxacin

236
Q

Antibiotics effective against pseudomonas

A 
Ciprofloxacin
Gentamicin
Meropenem
Piperacillin-Tazobactam
Amikacin
Levofloxacin
237
Q

Antibiotics effective against MRSA

A 
Doxycycline
Vancomycin
Teicoplanin
Rifampicin
Trimethoprim
Sodium fusidate
238
Q

Praziquantel

A

Tx for tapeworm (Taenia solium) and schistosomiasis

SEs: N&V, abdo cramping

239
Q

Ciclosporin(e)

A

Calcineurin inhibitor
Used for RA, Crohn’s, focal glomerulosclerosis, minimal change disease, psoriasis, myasthenia gravis
SEs: risk of idiopathic intracranial HTN, serious infections, lymphoma, nephrotoxicity and hepatotoxicity

240
Q

Labetalol

A

Beta blocker with arteriolar vasodilating action hence reduces peripheral resistance
Given IV in management of type B aortic dissection to reduce BP
SEs: bronchospasm, sleep disturbances, cold peripheries, fatigue
Beta-blockers can theoretically suppress all of the adrenergically mediated symptoms of hypoglycemia and thus can lead to unawareness of hypoglycemic events
May cause depressive symptoms

241
Q

Imidazole derivatives

A

E.g. ketoconazole
Antifungal agents
SEs: steven-johnson syndrome

242
Q

Varenicline

A

Selective nicotine receptor partial agonist
Used for smoking cessation - start 1 week before cessation and gradually increase dose
SEs: appetite change, dry mouth, taste disturbance, dizziness, drowsiness, headache, abnormal dreams, depression, suicidal thoughts, sleep disorders, panic, dysarthria

243
Q

Bupropion

A

Noradrenaline–dopamine reuptake inhibitor and a nicotinic receptor antagonist
Used for smoking cessation - higher quit rate seen (30%)
SEs: seizures (1:1000), insomnia, headache, Steven Johnson syndrome

244
Q

Magnesium sulphate

A

Given IV for acute severe or life-threatening asthma attacks

245
Q

Nicorandil

A

Potassium channel activator which has a vasodilatory effect on the coronary arteries
Used for angina
Side-effects include headache, flushing
and anal ulceration

246
Q

Prochlorperazine

A

Dopamine receptor antagonist
Antiemetic agent used for vestibular problems
Used for psychotic delusions

247
Q

Orlistat

A

Lipase inhibitor hence reduces dietary fat absorption
Used for weight loss in overweight or obese patients
SEs: oily faecal incontinence, anorectal haemorrhage, cholelithiasis, diverticulitis, hepatitis

248
Q

Terbutaline

A

Short-acting beta 2 agonist (bronchodilator)

Used in asthma

249
Q

Aminophylline

A

Used IV for asthma attacks after senior consultant involvement

250
Q

Dobutamine

A

Beta 1 agonist
Increases contractility and HR (inotrope)
Used for BP drop intra-operatively

251
Q

Interferon alpha

A

Cytokine produced by leucocytes, binds to type 1 receptors, and cause anti-viral effects
Interferon typically released by the body in response to viral infections and neoplasia
Use: tx for hepatitis B & D, Kaposi’s sarcoma, metastatic renal cell cancer, hairy cell leukaemia
SEs: flu-like symptoms, depression

252
Q

Interferon beta

A

Cytokine produced by fibroblasts, binds to type 1 receptors, and cause anti-viral effects
Interferon typically released by the body in response to viral infections and neoplasia
Reduces frequency of relapsing-remitting MS

253
Q

Interferon gamma

A

Cytokine produced by natural killer cells and T helper cells, binds to type 2 receptors to cause immunomodulatory effects (macrophage activation)
Use: chronic granulomatous disease, osteopetrosis
Interferon typically released by the body in response to viral infections and neoplasia

254
Q

Pyridostigmine

A

Long-acting acetylcholinesterase inhibitor
Reduces the breakdown of acetylcholine in the neuromuscular junction
Use: myasthenia gravis

255
Q

Cyclophosphamide

A

Alkylating agent

Use: immunosuppressive action for myasthenia gravis

256
Q

Flecanide

A

Class Ic anti-arrhythmic

Use: supraventricular and ventricular tachycardias

257
Q

Propylthiouracil

A

Anti-thyroid drug
Not used as first line due to small risk of liver damage
Used if carbimazole cannot be tolerated

258
Q

Carbimazole

A

Anti-thyroid drug
1st line tx for hyperthyroidism (e.g. Graves’ disease)
SEs: neutropenia (agranulocytosis) hence pt must present to hospital if fever, sore throat, mouth ulcers are seen

259
Q

Ticagrelor

A

P2Y12 receptor antagonist, antiplatelet

Used in STEMI mx with aspirin, unfractionated heparin, and PCI

260
Q

Prasugrel

A

P2Y12 receptor antagonist, antiplatelet

May be used in STEMI mx with aspirin, unfractionated heparin, and PCI

261
Q

Tissue plasminogen activator

A

AKA tPA

May be used as thrombolysis in STEMI mx if PCI unavailable

262
Q

Tenecteplase

A

May be used as thrombolysis in STEMI mx (instead of PCI) as easier to administer than alteplase

263
Q

Flumazenil

A

GABA receptor antagonist

Used to reverse the effects of a lorazepam overdose

264
Q

Baclofen

A

GABA receptor agonist

265
Q

Alpha receptor agonists

A

Phenylephrine/oxymetazoline = decongestants

Topical brimonidine = glaucoma tx

266
Q

Ropinirole

A

Dopamine receptor agonist used for Parkinson’s disease

267
Q

Bromocriptine

A

Dopamine receptor agonist

Used for prolactinoma treatment and galactorrhoea (excessive milk production), may be used for acromegaly

268
Q

Pilocarpine

A

Muscarinic agonist

Used for glaucoma

269
Q

Rifampicin

A

cytochrome P450 inducer hence INR may be reduced
Effective against MRSA
SE: orange tears and urine

270
Q

Pyridoxine

A

Vitamin B6 supplement

Used for sideroblastic anaemia

271
Q

Roaccutane

A

Used for severe acne

Can cause depressive symptoms

272
Q

Erythropoietin

A

haematopoietic growth factor secreted by the kidney in response to cellular hypoxia that stimulates the production of erythrocytes
Used to treat anaemia associated with CKD and cytotoxic therapy
Poor response to therapy if pt has iron deficiency anaemia
SEs: accelerated hypertension potentially leading to encephalopathy and seizures (blood pressure increases in 25% of patients), bone aches, flu-like symptoms, skin rashes, urticaria, pure red cell aplasia (due to antibodies against erythropoietin), raised PCV increases risk of thrombosis (e.g. Fistula), iron deficiency 2nd to increased erythropoiesis

273
Q

Low molecular weight heparin

A

Activates antithrombin III to form a complex that inhibits factor Xa
Administered subcutaneously
E.g., dalteparin/enoxaparin/tinzaparin sodium
Long action compared to UH; monitoring not routinely required but can monitor anti-factor Xa if indicated
Used in venous thromboembolism tx and prophylaxis, acute coronary syndrome (and MI tx)
SEs: bleeding, hyperkalaemia, lower risk of HIT and osteoporosis than UH

274
Q

Clozapine

A

Antipsychotic used for schizophrenia and psychosis in Parkinson’s disease
D1, D2, 5HT2A, alpha 1 and muscarinic receptor antagonist
SE: neutropenia

275
Q

Ocreotide

A

Somatostatin analogue which blocks growth hormone

Used for acromegaly tx

276
Q

Pegvisomant

A

Growth hormone antagonist

Used for acromegaly tx

277
Q

Bromocriptine

A

Dopamine agonist used to suppress growth hormone

Used for acromegaly tx

278
Q

Exenatide

A

GLP-1 receptor agonist = inhibits glucagon secretion
T2DM drug
safe for use in pts at risk of hypoglycaemia as monotherapy

279
Q

Pioglitazone

A

Used for T2DM as 15-30mg PO OD
glitazone class
Monitor LFTs
safe for use in pts at risk of hypoglycaemia as monotherapy

280
Q

Danaparoid sodium

A

Heparinoid
Typically used for DVT prophylaxis in pt undergoing general or orthopaedic surgery
Can be used for pt who have developed heparin-induced thrombocytopaenia

281
Q

Fondaparinux

A

Synthetic pentasaccharide that inhibits factor Xa (synthetic heparin)
Used for STEMI, NSTEMI, DVT, PE tx
Prophylaxis in major orthopaedic surgery of the hip or leg, or abdominal surgery

282
Q

Denosumab

A

Monoclonal antibodies against RANK ligand which reduce osteoclastic activity
Used in osteoporosis mx
If stopped, rebound increase in bone turnover may be seen hence, must start bisphosphonate
SEs: soft tissue infections in heavily immunocompromised pt, jaw osteonecrosis

283
Q

Teriparatide

A

Recombinant PTH which promotes bone formation
SC injection OD for 2yrs for secondary prevention of osteoporosis if T < -3.5
Half-life of 6hrs causes sig. bone density increase
Long term use associated with osteosarcoma hence <2yrs
Contraindications: hyperparathyroidism, bone cancer, previous radiotherapy, renal impairment
SEs: increase bone turnover therefore bisphosphonates when stopping

284
Q

Raloxifene

A

Selective oestrogen receptor modulators
Used for osteoporosis mx
SEs: leg cramps, VTE

285
Q

levofloxacin

A

Quinolone

Not safe in pregnancy/breastfeeding or for G6PD pt

286
Q

Leflunomide

A

Conventional DMARD
Disrupts pyrimidine production (needed for RNA/DNA)
Used for RA (one of 1st line agents)
SEs: mouth ulcers, raised BP, liver toxicity, bone marrow suppression, peripheral neuropathy
Not safe in pregnancy

287
Q

Sulfasalazine

A

conventional DMARD
First line agent in rheumatoid arthritis
Safe in pregnancy if taken with folic acid supplements
SEs: reduced sperm count, bone marrow suppression

288
Q

TNF inhibitors

A

Adalimumab, infliximab, etanercept
3rd line for RA, type of biological DMARD
MoA: inhibit TNF-mediated inflammation
SEs: ↑ risk of severe infection/sepsis, TB/HepB reactivation risk

289
Q

Tocilizumab

A

IL-6 receptor antagonist

biological agent used in rheumatoid arthritis (fourth line agent)

290
Q

Hydroxychloroquine

A

Anti-malarial agent
Immunosuppressive action by disrupting Toll-like receptor antigen presentation
Used in mild/palindromic RA
Safe in pregnancy
SEs: reduced visual acuity (macular toxicity), nightmares

291
Q

Colchicine

A

Used as 2nd line agent for acute attacks of gout
Dose: 1.2mg PO then 0.6mg 1hr later (max. 1.8mg)
Can be used in renal impairment if eGFR > 10 mL/minute/1.73 m2
SEs: dose-related diarrhoea therefore reduced dose slightly if reported

292
Q

Naftidrofuryl oxalate

A

5HT2 receptor antagonist results in peripheral vasodilation
Used for intermittent claudication in peripheral arterial disease if pt shows no improvement with lifestyle management & refuses surgery
Stop if no improvement after 3-6mo

293
Q

Cholestyramine

A

Bile acid sequestrant hence, binds to bile acids to prevent reabsorption
Used for pruritus associated with partial biliary obstruction and primary biliary cirrhosis & primary CHD prevention in men with primary hyperlipidaemia (35-39yo)
SE: vitamin ADEK deficiency, hypoprothrombinaemia, night blindness

294
Q

Ursodeoxycholic acid

A

Used for primary biliary cirrhosis and breaks down gallstones

Y4 (7 decks)

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