Essential Drugs Flashcards
1
Q
Allopurinal
Generic Indication Side effects Initiating treatment monitoring Dose pregnancy/Bfeeding hepatic renal
A
- xenthine oxidase inhibitor
- Gout
- gout, GI, rash +fever, agranulocytosis
- 2 weeks postgout, NSAID,colchi (3months),
- water uric acid<0.36, UnE,FBC monthly
- 100-300mg, start 100mg
- preg: avoid, BF: safe
- reduce
- reduce
2
Q
Amytriptyline
Generic Indication Side effects Initiating treatment monitoring Dose pregnancy/Bfeeding hepatic renal
A
- tricyclic antidepressant
- depression, pain
- arrythmia, sedation (night), ACH, suicide, GI, sun sensitivity.
- CVD? (risk arrythmia), other SSRI’s?
- review effect?
- 30-200mg
- congenital, BF okay
- more sedative
- nil
3
Q
Aspirin
A
- acetylsalicylic acid
- many
- bleeding, allergy, asthma, kidney,
- asthma? GI bleeding?
- no monitoring
- 75-325mg/d
- hemorrhage, PDA, REYE’s
- GI bleed
- renotoxic
4
Q
bendrofluazide
A
- thiazide diuretic
- HTN etc
- post hypotension, diabetes, arrythmia, rash, lipid UnE, glucose, lipid
- UnE, glucose, lipid
- 2-10mg
- preg: bone marrow failure, BF: okay
- nil
- nil
5
Q
Codein
A
- opiate
- pain
- nausea, constipation, abdo pain, sedation,
- constipation? Sedation? Laxatives
- review pain, constipation
- up to 300mg
- neonatal withdrawal
- accumulate
- reduce
6
Q
diazepam, zopiclone, lorazepam
A
- Antianxiolytic/hypnotics
- Anxiety, Insomnia, Muscle spasm
- sedation, amnesia, addiction, ataxia
- risk of injury from sedation
- monitor symptomatic
- up to 30mg/d
- withdrawal, avoid BF
- reduce
- reduce
7
Q
doxazosin, terazosin
A
- Alpha-blocker
- Prostate hypertrophy, Hypertension
- drowsiness, headaches and dizziness
8
Q
diclofenac
A
- NSAID
- pain/inflammation
- Bleeding, peptic ulcer, renal toxic,
- GI bleed, renal funciton, omeprazole? renal function
- 75-150mg/d
- prolong labour, PDA close
- GI bleed
- toxic
9
Q
digoxin
A
- digoxin
- atrial fibrillation, atrial flutter and sometimes heart failure
- palpitation, syncope, SOB, diarhoea
- UnE
- weekly digoxin level 0.8-2ng/ml, UNE, LFT
- 75-150mg/d adjust dose,
- BF safe.
- …
- reduce
10
Q
diltiazem
A
- calcium channel blockers
- hypertension, angina pectoris, and some types of arrhythmia.
- bradycardia, palpitaitons, postural hypo, edema, rash
- heart failure?
- HR/BP
- 60mg TID
- avoid
- reduce
- start low
11
Q
cilazapril, enalapril, quinapril
A
- ACE Inhibitor
- Hypertension, Heart failure, Diabetic nephropathy, Chronic kidney disease, Post-MI
- angioedema, postural hypo?, agranulocytosis
- peripheral vascular disease
- BP/creatinine/FBC
- 5mg-40mg/d
- defects, BF: neonatal hypo
- accumulation
- reduce
12
Q
erythromycin
A
- Macrolide
- Atypical: Mycoplasma and legionellosis
- GI upset, jaundice, rash, palpitations
- OC? Finish course
- symptoms
- up to 4g/d
- okay
- hepatotoxicity
- max 1.65G (ototoxic)
13
Q
ethanol
A
- alcohol
- …
- sedation, euphoria, aggression, depression, ataxia
- …
- serum alcohol
- …
- Fetal alcohol syndrome
- toxic
- …
14
Q
fluoxetine
A
- SSRI
- Depression, Panic disorder
- GI, insomnia, suicidality, low sodium, impotence, rash
- other serotonin
- suicidality
- 20-60mg/d
- avoid
- reduce
- updose: deafness
15
Q
frusemide
A
- Loop diuretics
- Congestive HF, oedema
- GI disturbance, postural hypo, rash
- UnE, LFT
- UnE, LFT
- up to 120mg
- maternal hypovolaemia, safe BF
- low K: encephalopathy
- …
16
Q
gentamicin
A
- aminoglycoside antibiotic
- bacterial infections, particularly those caused by Gram-negative organisms
- hearing loss, kidney, GI, rash
- …
- UNE, gent level,
- 3-5mg/kg daily
- ototoxic, nephrotoxic
- gent level
- reduce dose
17
Q
glicazide
A
- sulfonylurea/hypoglycemic
- …
- hypogly, GI, rash, low sodium
- blood sugar, weight
- blood sugar
- 40mg-320mg
- neonatal hypo
- low dose
- low dose
18
Q
glyceryl trinitrate, isosorbide, perhexiline
A
- Antianginal
- Angina postural
- hypo, palpitations, headache
- sit down
- sit, 2 spray x2, ambulance.
- 2 spray
- okay, benefit:risk
19
Q
haloperidol
A
- typical antipsychotic/dopamine inverse agonist
- schizophrenia and acute psychotic states and delirium
- drowsy, sexual dysfunction, FAT, bradykinesia/dyskinesia, rash, NMS
- ECG, lipids glucose
- ECG, lipids, glucose.
- 3-10mg
- avoid if possible.
- monitor serum
- cerebral sensitivity
20
Q
heparin
A
- anticoagulant
- many
- HIT, hyperkalaemia, haemorrhage
- platelets, UNE
- APTT, platelets, UNE
- 0.5-5mg bid/tid
- okay
- APTT mon.
- APTT mon.
21
Q
insulin
A
- insulin
- diabetes
- hypo, fat hypertophery, hypersensitivity, rash
- vary sites in abdo, jelly bean,
- blood sugar
- fetal hypo
- reduced
- reduced
22
Q
propofol, lignocaine
A
- …
- Anaesthetics
- arrythmia, anaphylaxis, methhaemoglobin, CNS (tingling numbness, coma)
- …
- ECG?
- 3mg/kg+adrenaline= 7mg/kg
- okay
- increased side effects
- accumulation
23
Q
metformin
A
- biguanide
- diabetes
- gi upset, anorexia, taste disturbance, rash, lactic acidosis
- LFT, UnE, lactic acidosis stop dehydrated
- LFT, Une, blood sugar,
- 0.5g-2g
- okay
- caution, lactic acidosis
- lactic acidosis
24
Q
metoprolol
A
- β1 receptor blocker
- many
- bradycardia, postural hypotension, fatigue, sexual dysfunction, asthma
- asthma?
- BP, HR
- 100mg-400mg/d
- IUGR, beta blockade
- reduce
- …
25
Q
metronidazole
A
- …
- used particularly for anaerobic bacteria and protozoa
- disulfram like, photosensitivity GI, taste, oral mucositis
- alcohol intake?
- high dose, >10 days, FBC 2g daily(up to 6dose/d)
- avoid
- reduce
- …
- …
26
Q
morphine
A
- …
- …
- sedation, psychosis, addiction, GI, resp dep
- constipation? Sedation?
- review pain, GCS, constipation
- 40mg/d titrate up
- baby withdrawal
- reduce
- reduce
27
Q
omeprazole
A
- PPI
- GORD/NSAIDs-induced gastric upset
- GI, headache, gynaecomastia, interstitial nephritis, SJS
- 30mins bfbf
- UnE, LFT
- up to 80mg
- not harmful
- <=20mg/d
- …
28
Q
paracetamol
A
- …
- …
- liver damage in Overdose!, rare: rash, blood disorders,
- other paracetamol? Avoid alcohol
- review pain/fever
- up to 4g/d, kids 15mg/kg q6h
- not harmful
- <3g/d
- …
29
Q
penicillin
A
- …
- …
- anaphylaxis, diarrhoea, convulsions
- penicillin sensitivity?
- clinical improvement
- up to 4g/d
- not harmful
- …
- …
30
Q
phenytoin
A
- antiepileptic
- ….
- bleeding, anaphylax, leucopenia, GI, sleep, paresthesia, behaviour avoid calcium/ alcohol cose to dose. phenytoin level 24 hrly, adjust to 4-6mg/kg 15-20mg/kg, OD/BID neural tubal defects reduce
31
Q
prednisone
A
- corticosteroid
- …
- fat, mood, glucose, infection, bone,
- infections?
- withdraw slowly, let doc know
- 20mg- 120?
- IUGR long term, Bf ok
32
Q
salbutamol
A
- β2-adrenergic receptor agonist
- …
- palpitations, tremor, sweating, muscle cramps
- spacer, before exercise?
- 3 puffs, see doc.
- PRN
- prolong labour
- …
- …
33
Q
simvastatin
A
- HMG-CoA reductase
- …
- GI, fatigue, muscle pain, rhabdomyalosis
- LFT, lipids
- 20mg-80mg
- congenital, breast feeding avoid
- monitor
- reduce
- …
34
Q
valproate
A
- anticonvulsant
- epilepsy, anorexia nervosa, panic attack, anxiety disorder, posttraumatic stress disorder, migraine and bipolar disorder
- suicidality, GI, twitching, flu-like symptoms, SJS
- start 600mg, increase 200mg /3d.
- LFT FBC, coagulation 1st 6months
- 1-2g/d
- malformations! breast feeding okay.
- avoid
- reduce dose
35
Q
warfarin
A
- …
- …
- bleeding, GI, jaundice, skin necrosis,
- start 2-5mg/d +hep 6d, adjust> 12 week check.
- INR 2-3
- maintainenence 2-10mg
- malformations! Haemorrhage risk
- monitor INR
- monitor INR