GI System Flashcards

1
Q

Mebeverine

A

Antispasmodic
IBS
200mg BD

Symptomatic relief: max. single dose is 135 mg, max. daily dose is 405 mg;

For uses other than symptomatic relief of irritable bowel syndrome: max. single dose is 100 mg and max. daily dose is 300 mg.

Suspension not for children under 10, Tablet/MR capsule not for use in children.

Avoid in pregnancy
Side effects: mild, rarely causes problem, allergy (itchy rash, swelling), angiodema/face oedema

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2
Q

Peppermint Oil

A

Relief of abdominal colic and distension, particularly in IBS

1–2 capsules 3 times a day for up to 3 months if necessary, capsule to be swallowed whole with water; Manufacturer advises capsules should not be broken or chewed because peppermint oil may irritate mouth or oesophagus. (Colpermin, Mintec)

> Do not take indigestion remedies 2 hours before or after you take this medicine
Take 30 to 60 minutes before food
Swallow this medicine whole. Do not chew or crush

Caution: Sensitivity to Menthol

Side Effects: Heartburn, indigestion

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3
Q

Mesalazine

A

Aminosalicylate

Treatment of mild to moderate ulcerative colitis, acute attack

> 2.4g in divided doses (Asacol MR 400)
2.4g-4.8g in divided doses (Asacol MR 800)
2.4g-4.8g OD or divided doses (Octasa)
4g OD or divided doses (Pentasa tablets: Manufacturer advises tablets may be halved, quartered, or dispersed in water, but should not be chewed.
Pentasa granules: Manufacturer advises granules should be placed on tongue and washed down with water or orange juice without chewing
In Children: Expert sources advise contents of one sachet should be weighed and divided immediately before use; discard any remaining granules.)

Hepatic/Renal Impairment: caution in mild to moderate, avoid in severe

MR tablet: Take with or just after food, or a meal, Swallow this medicine whole. Do not chew or crush

GR tablet: Do not take indigestion remedies 2 hours before or after you take this medicine, Swallow this medicine whole. Do not chew or crush

MR granules: Swallow this medicine whole. Do not chew or crush

Hepatic/Renal impairment: caution in mild to moderate, avoid in severe
>Renal function should be monitored before starting, at 3 months, and annually during treatment

Breast feeding: diarrhoea in breast-fed infant

Contra-indicated: blood clotting abnormalities

Stick to same brand

Side Effects: gastrointestinal symptoms, aches and pains, blood disorder: unexplained bleeding, bruising, red or purple discolourations of the skin (purpura), sore throat, a high temperature (fever), or if you feel generally unwell (malaise).

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4
Q

Sulfasalazine

A

Treatment of acute and mild to moderate and severe ulcerative colitis I Active Crohn’s disease

1-2g QDS until remission occurs

Maintenance
500mg QDS

Doses in children upon body weight

> Tablet: This medicine may colour your urine. This is harmless
GR Tablet: Do not take indigestion remedies 2 hours before or after you take this medicine, This medicine may colour your urine. This is harmless, Swallow this medicine whole. Do not chew or crush

Caution: G6PD deficiency, asthma, hepatic toxicity

Monitoring: full blood count, renal/liver function

Hepatic: caution
Renal: caution in mild to moderate, avoid in severe

Drink plenty of water

Side Effects: nausea, loss of appetite, diarrhoea, abdominal pain, headache, rash, dizzy, Gives body fluids (such as tears and urine) a yellow/orange colour. This is harmless. >More severe: Trouble sleeping (insomnia). Altered Taste. Bleeding disorder. Allergy, Jaundice.

***HAS BEEN CONFUSED WITH SULFADIAZINE, CARE TO BE TAKEN WHEN DISPENSED

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5
Q

Beclometasone dipropionate

A

Corticosteroid

Adjunct to aminosalicylates in acute mild to moderate ulcerative colitis

5mg daily max duration of treatment of 4 weeks, dose to be taken in the morning

Hepatic: Avoid in severe

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6
Q

Budesonide

A

Glucocorticoid, anti-inflammatory effects

Mild to moderate Crohn’s disease affecting the ileum or ascending colon

9mg OD for 8 weeks, to be taken in the morning, reduce dose gradually over two weeks following treatment (Budenofalk)

Side Effects: muscle twitching, oedema, oral disorder, diarrhoea, GI disorders

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7
Q

Teduglutide

A

Amino Acid and Derivative

glucagon-like peptide-2 (GLP-2), preserves mucosal integrity by promoting growth and repair of the intestine

Short Bowel Syndrome

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8
Q

Macrogol 3350

A

Osmotic Laxative
(Laxido, Movical)

Onset 24-48hrs

Bowel cleansing

Moviprep: 1L for 2 doses

Plenvu: 500mL for 2 doses

1st dose on evening before procedure, 2nd dose on morning of procedure

Chronic Constipation
Child 12-17: FS 1-3 satchets, HS 2-6
Adult: FS 1-3 satchets, HS 2-6

full strength: 13.125g, half strength/paediatric 6.563g

Caution: CVD impairment, 2 FS or 4HS in any one hour

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9
Q

Isphaghula Husk

A

Bulk-Forming Laxative
(increases faecal mass which stimulates peristalsis)

Constipation
up to 11 yrs: 2.5-5mL BD, dose to be given as a half or whole level spoonful in water, preferably after meals, morning and evening

12-Adult: 1 satchet BD

1 satchet equal to 2 level 5mL spoonful

To be taken with at least 150mL

Contra: faecal impaction, intestinal obstruction, reduced gut motility

Adequate fluid intake

Fybogel

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10
Q

Lactulose

A

Osmotic Laxative

Constipation

Adult: 15mL BD

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11
Q

Docusate Sodium

A

Softening Laxative

Oral onset: 1-2 days, Rectal within 20 min

Chronic Constipation

Oral:
up to 11 yrs: 12.5-25 mg TDS (oral solution)
12-Adult: 500mg in divided doses

Rectum: 120mg for 1 dose

Contra: abdominal obstruction
Caution: excess use of stimulant can cause diarrhoea and hypokalaemia

Dioctyl

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12
Q

Liquid Parrafin

A

Softening Laxative

Constipation
10-30mL daily at night

Side effect: anal irritation, contact dermatitis, rectal discharge of drug, granuloma (cluster of white blood cells)

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13
Q

Bisacodyl

A

Stimulant Laxative
Acts in 10-12hrs, suppository in 20-60min

Constipation
4-17yrs: 5-20mg ON
Adult: 5-10mg, increased to 20mg ON

Rectum:
2-17yrs: 5-10mg OM
Adult: 10mg OM

may be used for constipation but higher dose not licensed in children

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14
Q

Co-danthramer

A

Stimulant Laxative

Constipation in Palliative Care (standard stregnth capsule)

6-11yrs: 1 capsule ON, oral suspension 2.5-5mL ON
12-Adult: 1-2capsules OD, oral suspension 5-10mL ON

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15
Q

Glycerol

A

Stimulant Laxative

1-11months: 1g as required
Children1-11yrs: 2g suppository as required
12-Adult 4g suppository as required

Moisten suppository before insertion

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16
Q

Senna

A

Stimulant Laxactive

Constipation
6-17 yrs: 7.5-30mg OD
Adult: 7.5-15mg ON (max. 30mg) start dose low then gradual increase

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17
Q

Naloxegol

A

Opiod Receptor Antagonist
(Moventig)
decreases the constipating effects of opioids without altering central analgesic effects

25mg OM

concurrent use of CYP3A4 inhibitors

SE: abdominal pain, diarrhoea, flatulence, headache, vomitting, nausea

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18
Q

Loperamide HCl

A

Antidiarrohoeals

Initially 4mg, followed by 2mg for up to 5 days, dose to be taken after each stool (max 16mg)

not licensed in children under 8

***REPORTS OF SERIOUS CARDIAC ADVERSE REACTIONS (QT PROLONGATION, CARDIAC ARREST, TORSADES DE POINTES) WITH HIGH DOSES WITH ABUSE/MISUSE, NALOXONE ANTIDOTE

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19
Q

ALGINIC ACID

A

Alginate Antacid

Management of GORD
Gaviscon Infant
uptown 4.5kg: 1 dose as req
4.5+: 2 doses as req

contra: intestinal obstruction, preterm neonates, excess water loss

renal impairment: avoid antacids with large amounts of sodium in patients with fluid retention

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20
Q

Sodium Alginate with Potassium Bicarbonate

A

Alginate Antiacid

Acidex/Gaviscon Advance
Management of mild symptoms of dyspepsia and GORD

up to 11: under medical advice only
12-Adult: 5-10ML after meal/bedtime

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21
Q

Co-magaldrox

A

Aluminium and Magnesium

Maalox/Mucogel
Dyspepsia: 10-20mL taken 20-60 min after eating/bedtime or when required

renal impairment: effervescent preparations of analgesics contain citrates which increases aluminium absorption=risk of aluminium toxicity

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22
Q

Simeticone

A

Antifoaming Drugs

Infacol
Colic/Wind Pains
1month-1yr: 0.5-1mL with/after each feed

Windeze

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23
Q

Bismuth Subsalicylate

A

Antacid

Helicobacter Pylori eradication

525mg QDS for 7 days

children under 16 at risk of Reyes syndrome

SE: black stools, black tongue/saliva

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24
Q

Famotidine

A

H2-Receptor Antagonist

Treatment of Benign gastric and duodenal ulceration
40mgON 4-8 week

Maintenance treatment of duodenal ulceration 20mgON

Reflux Oesophagits
20-40mg BD 6-12 weeks

SE: constipation, diarrhoea, dizzy, fatigue, headache

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25
Cimetidine Nizatidine Ranitidine
H2 Receptor Antagonist Benign duodenal ulceratoin/benign gastric ulceration/NSAID associated ulceration C:400mg BD N: 300mg ON R: 75, 150, 300 OD/BD Hepatic: increase risk of confusion, reduce does Renal: reduce to 200mg QDS if eGFR 30-50mL/min/1.73m2
26
Misoprostol
Prostaglandins and Analogues Cytotec Benign duodenal ulceratoin/benign gastric ulceration/NSAID induced peptic ulcer 400mcg BD Prophylaxis 200mcg 2-4times daily
27
Esomeprazole Lansoprazole Omeprazole Pantoprazole Rabeprazole
Proton Pump Inhibitor ***Very low risk of subacute cutaneous lupus: lesions in sun-exposed areas can occur from weeks/months/years after exposure of drug can increase the risk of fractures when used in high doses for over a year in elderly, risk of osteoporosis may mask symptoms of gastric cancer increased risk of C. difficile
28
Sodium Alginate with Calcium Carbonate and Sodium Bicarbonate
Alginate Antacid Acidex/Gaviscon/Peptac/Rennie GORD 6-11: 5-10mL after meal/bedtime 12-Adult: 10-20mL after meal/bedtime
29
H. Pylori Triple Therapy
comprises a PPI and 2 antibacterials for 7 days 1st: a proton pump inhibitor, plus amoxicillin, and either clarithromycin or metronidazole PENICILIN ALLERGY: A proton pump inhibitor, plus clarithromycin, and metronidazole. 2nd: A proton pump inhibitor, plus amoxicillin, and either clarithromycin or metronidazole (whichever not used in first line)
30
Dicycloverine Hal
Antimuscarinic Symptomatic relief of GI disorders characterised by smooth muscle spasm Adult: 10-20mg TDS Contra: child under 6 months SE: decreased appetite, thirst, fatigue Avoid in breastfeeding mothers, apnoea reported in infants (muscle/soft tissue in throat relax and causes total blockage of airways)
31
Hyoscine Butylbromide
Antimuscarinic Symptomatic relief of gastro-intestinal or genito-urinary disorders characterised by smooth muscle spasm IBS ***Buscopan injection: serious risk of tachycardia, hypotension, and anaphylaxis in patients with underlying cardiac disease Buscopan
32
Alverine Citrate
Antispasmodics Symptomatic relief of gastro-intestinal disorders characterised by smooth muscle spasm 12-17: 60-120mg 1-3 times Adult: 60-120mg 1-3 times
33
Cholic Acid Ursodeoxycholic Acid
Bile Acids Inborn errors of primary bile acid synthesis (initiated by specialist) Dissolution of gallstones Avoid in chronic liver disease
34
Orlistat
Lipase Inhibitor, Peripherally Acting Antiobesity Products 120mg TDS Alli (without prescription, no more than 6 months): 60mg TDS blocks enzyme that digests fat, undigested fat is not absorbed and therefore eliminated through stool reduce your fat intake to 30% goal is a 5% (or more) weight loss within three months of starting orlistat, should not continue if not lost SE: flatulence, oily stools, loose/increased stools, oily spotting, urgency to use restroom use other methods of contraceptive as you may have severe diaherroa
35
Benzyl benzoate with bismuth oxide, bismuth subgallate, hydrocortisone acetate, Peru balsam and zinc oxide
Corticosteroid Haemorrhoids/Pruritus ani by rectum using ointment apply twice daily for no longer than 7 days applied morning and night, additional dose applied after bowel movement Anusol HC ***corticosteroids: rare risk of central chorioretinopathy with local as well as systemic administration
36
cinchocaine with hydrocortisone
corticosteroid haemorrhoids proctosedyl ointment/uniroid-hc ointment apply twice daily (externally or by rectum) and after a bowel movement, no more than 7 days suppositories insert 1 at night, morning, and after a bowel movement
37
cinchocaine with prednisolone
corticosteroid sheriproct ointment apply BD for 5-7 days, 3-4 times on the first day, then once daily for a few days after symptoms have cleared
38
Pancreatin
pancreatin enzyme compensate for reduced/absent endocrine secretion, assist digestion of starch, fat and protein Creon 1-2 capsules with meal or mixed with acidic/soft food SE: constipation, nausea, vomitting, abdominal distension
39
Digoxin
Cardiac Glycoside Maintenance for atrial fibrillation 125-250mcg OD Heart failure 62.5-125mcg OD (reduce for elderly) Caution: hypercalcaemia, hyperkalaemia, hypermagneseamia SE: diarrhoea, dizziness, nausea, vomitting, vision disorder (blurry) Monitor concentration in renal impairment
40
Tranexamic Acid
Antifibrinolytics, Antihaemorrhagics Local fibrinolysis Menorrhagia 1g TDS for up to 4 days, initiated when menstruation has started
41
Emicizumab
Haemostatic, Antimhaemorrhagics monoclonal antibody Prophylaxis of haemorrhage in haemophilia A
42
Dried prothrombin complex
coagulation proteins, blood and related products Treatment and peri-operative prophylaxis of haemorrhage in patients with congenital deficiency of factors II, VII, IX, or X if purified specific coagulation factors not available, Treatment and peri-operative prophylaxis of haemorrhage in patients with acquired deficiency of factors II, VII, IX, or X (e.g. during warfarin treatment)
43
Factor VIIa (recombinant) Factor VIII fraction, dried Factor IX fraction, dried Factor XIII fraction, dried Fibrinogen, dried
coagulation proteins
44
Andexanet alfa
antidote and chelator recombinant form of human factor Xa Reversal of apixaban or rivaroxaban in life-threatening or uncontrolled bleeding
45
Idarucizumab
monoclonal antibody rapid reversal of dabigatrarin for emergency procedures
46
Aspirin
anti platelet CVD (secondary prevention) 75mg OD Management of unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI)/suspected transient ischaemic attack 300mg
47
Clopidogrel
antiplatelet Transient ischaemic attack for patients with aspirin hypersensitivity, or those intolerant of aspirin despite the addition of a proton pump inhibitor, Acute ischaemic stroke for patients with aspirin hypersensitivity, or those intolerant of aspirin despite the addition of a proton pump inhibitor, Prevention of atherothrombotic events in peripheral arterial disease or within 35 days of myocardial infarction, or within 6 months of ischaemic stroke 75mg OD
48
Dipyridamole
anti platelet Secondary prevention of ischaemic stroke (not associated with atrial fibrillation) and transient ischaemic attacks (used alone or with aspirin), Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves 200mg BD
49
Apixaban
Factor XA Inhibitor, Antithrombotic drug direct inhibitor of factor XA Prophylaxis of recurrent deep-vein thrombosis, Prophylaxis of recurrent pulmonary embolism 2.5 mg twice daily, following completion of 6 months anticoagulant treatment. Prophylaxis of stroke and systemic embolism in non-valvular atrial fibrillation and at least one risk factor (such as previous stroke or transient ischaemic attack, symptomatic heart failure, diabetes mellitus, hypertension, or age 75 years and over) 5 mg twice daily, alternatively 2.5 mg twice daily, reduced dose used in patients with at least two of the following characteristics: age 80 years and over, body-weight 60 kg or less, or serum creatinine 133 micromol/litre and over. ***direct-acting oral coagulants (DOACS): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
50
Edoxaban
factor XA inhibitor, antithrombolytic direct and reversible inhibitor of factor XA up to 60kg: 30mg OD 61+: 60mg OD (max dose 30 mg with cico sporin, dronedarone, erythromycin, or ketoconazole
51
Rivaroxaban
antithrombolytic, factor XA inhibitor Prophylaxis of venous thromboembolism following knee/hip replacement surgery 10mg OD Treatment of deep-vein thrombosis, Treatment of pulmonary embolism Initially 15mg BD to be taken with food, for duration of treatment, consult product literature. Prophylaxis of stroke and systemic embolism in patients with non-valvular atrial fibrillation and with at least one of the following risk factors: congestive heart failure, hypertension, previous stroke or transient ischaemic attack, age ≥ 75 years, or diabetes mellitus 20mg OD **(Xarelto) 15mg and 20mg should be taken with food
52
Dalteparin sodium Enoxaparin sodium Heparin Tinzaparin sodium
heparins, antithrombitic drugs
53
Dabigatran etexilate
thrombin inhibitor, direct
54
Warfarin
Vitamin K antagonists Prophylaxis of embolisation in rheumatic heart disease and atrial fibrillation, Prophylaxis after insertion of prosthetic heart valve, Prophylaxis and treatment of venous thrombosis and pulmonary embolism, Transient ischaemic attacks ***direct acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonist, INR should be monitored
55
Carvedilol (a,b) Labetalol (a,b) Nadolol (ns) Propranolol (ns) Atenolol (s) Bisoprolol Metoprolol
Beta-adrenoceptor blocker hypertension P: 80mg BD A: 25-50mg B: 5-10mg OD (max 20) Adjunct HF, 1.25 (1), 2.5 (1), 3.75 (10, 5 (4), 7.5 (4), 10 **atenolol can be confused with amlodipine ***propranolol can be confused with prednisolone
56
Amlodipine Diltiazem Felodipine Lercaidipine Nifedipine Verapamil
Calcium channel blockers A: 5-10mg F: 5mg OD, Elderly: 2.5 OD Prophylaxis/treatment of angina, Hypertension
57
Bendroflumethizide Co-amilozide Indapamide
Thiazides and related diuretics B: Hypertension: 2.5mg, Oedema 5-10mg CA: 2.5/25, 5/50 contra: hyperkalaemia I: 2.5mg IR/1.5MR
58
Enalapril maleate Lisinopril Perindopril Ramipril
Angiotensin-converting Enzyme inhibitor Caution: afro-caribbean, diabetic, agranulocytosis
59
Candesartan Irbesartan Losartan Valsartan
Angiotensin II Receptor Antagonists
60
Aliskiren
Renin Inhibitor Essential hypertension either alone or in combination with other antihypertensives 150mg OD
61
Hydralazine HCl Minoxidil
Vasodilator Moderate to Severe Hypertension, Heart Failure
62
Midodrine HCl
Vasoconstrictor, Sympathomimetics Pro-drug Severe orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other forms of treatment are inadequate
63
Eplerenone Spirnolactone Amiloride HCl
Diuretic>Potassium-Sparring Diuretic>Aldosterone Antagonist Adjunct in stable patients with left ventricular ejection fraction ≤40% with evidence of heart failure, following myocardial infarction (start therapy within 3–14 days of event), Adjunct in chronic mild heart failure with left ventricular ejection fraction ≤30% Initially 25 mg daily, then increased to 50 mg daily, increased within 4 weeks of initial treatment. Contra: hyperkalaemia ***causes potassium retention, potassium supplement not to be given thiazide: relieve oedema due to HF to reduce blood pressure loop: in pulmonary oedema due to left ventricular failure/chronic heart failure
64
Sacubitril with valsartan
Angiotensin II Receptor Antagonist Entresto Symptomatic chronic heart failure with reduced ejection fraction (in patients not currently taking an ACE inhibitor or angiotensin II receptor antagonist, or stabilised on low doses of either of these agents) Initially 24/26 mg twice daily for 3–4 weeks, increased if tolerated to 49/51 mg twice daily for 3–4 weeks, then increased if tolerated to 97/103 mg twice daily. Symptomatic chronic heart failure with reduced ejection fraction (in patients currently stabilised on an ACE inhibitor or angiotensin II receptor antagonist) Initially 49/51 mg twice daily for 2–4 weeks, increased if tolerated to 97/103 mg twice daily, consider a starting dose of 24/26 mg if systolic blood pressure less than 110 mmHg.
65
Colesevelam HCl Coletyramine
Bile Acid Sequestrants Primary hypercholesteroleamia as an adjust to dietary measures Caution: interference with absorption of fat-soluble vitamins (A, D, K, folic acid)
66
Ezetimibe
Cholesterol Absorption Inhibitor, Lipid modifying drugs
67
Bezafibrate Fenofibrate
Fibrates, Lipid Modifying drugs contra: GB disease, photosensitivity
68
Atorvastatin Pravastatin Rosuvastatin Simvastatin
Statins, Lipid Modifying drugs S: ON No grapefruit juice. avoid getting pregnant SE: unusual cramps/pains (sign of muscle inflammation)
69
Ranolazine
Piperazine derivatine As adjunctive therapy in the treatment of stable angina in patients inadequately controlled or intolerant of first-line antianginal therapies Initially 375 mg twice daily for 2–4 weeks, then increased to 500 mg twice daily, then adjusted according to response to 750 mg twice daily; reduced if not tolerated to 375–500 mg twice daily. Caution: Body-weight less than 60 kg; elderly; moderate to severe congestive heart failure; QT interval prolongation Common: Asthenia (abnormal weakness); constipation; headache; vomiting
70
Ticagrelor
Antiplatelet drug, antithrombotic Prevention of atherothrombotic events in patients with acute coronary syndrome [in combination with aspirin] Contra: Active bleeding; history of intracranial haemorrhage
71
Alteplase Streptokinase
Fibronolytics (breaks up thrombi)
72
Glyceryl trinitrate Isosorbide dinitrate/mononitrate
Nitrates (role in angina)
73
Adrenoline/epinephrine
Cardiopulmonary Resuscitation/acute anaphylaxis
74
Bumetanide Furosemide Co-amilofruse
Loop Diuretics B: 1mg F:20-40mg CA: 2.5/20, 10/80
75
Mannitol
Osmotic Diuretic IV
76
Pentoxifylline (Trental)
Peripheral Vasodilator Peripheral vascular disease, venous leg ulcer 400mg 2-3 times
77
Ipratroprium bromide Glycopyrronium bromide Tiotropium (Braltus) Tiotropium with olodaterol (Spiolto Respimat) 2 puffs OD Umeclidinium (Incruse Ellipta) 55mcg OD Umeclidinium (Anoro Ellipta) 1 inhalation OD
Antimuscarinic COPD Caution: QT prolongation SE: risk of infection, insomnia, pain ***Braltus: risk of inhalation of capsule if placed in the mouthpiece of the inhaler (store capsule in screw-top bottle) ***pressurised metered dose inhalers: risk of airway obstruction from aspiration of loose objects
78
Formotertol fumerate (Easyhaler), 12 hr duration Indacaterol Salmeterol
BEta2 adrenoreceptor agonist, selective, long-acting ***added only if standard-dose corticosteroids fail to control asthma, not use in deteriorating asthma, used in low dose, not for exercise-relief, reviewed clinically Caution: high dose dangerous in children
79
Salbutamol (3-5hr duration) (Salamol, Ventolin Accuhaler, Airomir Autohaler) Terbutaline sulfate (Bricanyl)
BEta2 adrenoreceptor agonist, selective, short-acting S: muscle cramps T: hypotension, muscle spasm
80
Beclometasone dipropionate (Clenil modulite, Qvar (fine particles, twice a potent as clenil) Beclometasone with formoterol (Fostair nexthaler, Fostair) Becloemtasone with formoterol and glypyrronium (Trimbow) Budesonide with formoterol (Duoresp spiromax, Symbicort turbohaler) Fluticasone with formoterol (Flutiform) Fluticasone with salmertol (Sereflo, Seretide 250 Evohaler, Seretide 500 Accuhaler) Fluticasone with umeclidinium and vilanterol (Trelegy Ellipta) Fluticasone with vilanterol (Relver Ellipta 184/22, 92/22)
Corticosteroid SE: oral candidiasis
81
Montelukast
Leukotriene Receptor Antagonist 6 months-5yrs: 4mg in the evening 6-14: 5mg ON 15-adult: 10mg ON ***reminder of the risk of neuropsychiatric reactions (speech impairment, OCD)
82
Aminophylline (Phyllocontin continus) Theophylline (Uniphyllin Continus) Nebuliser solutions (hypertonic sodium chloride solutions)
Xanthanes SE: arrythimias, diarrhoea, dizziness, GORD, tremor
83
Acrivastine (Benadryl) Cetirizine HCl Fexofenadine (Allevia) Levocetirizine HCl (isomer of cetirizine) Loratidine (Clarityn)
Antihistamine, non-sedating A: (12-adult) 8mg TDS C: 2-5: 2.5mg BD 6-11: 5mg BD 12-adult: 10mg OD seasonal allergy F: 6-11: 30mg BD 12-Adult: 120mg OD chronic allergy 12-adult: 180 mg OD L: 5mg OD Lora: child ups 11 under 31kg: 6mg OD 10mg OD
84
Chlorphenamine maleate (Puritan) Hydroxyzine HCl Promethazine Hal (Phenergan)
Antihistamine, sedating C: ***children under 6 should not be given OTC cough and cold with chlorphenamine H: ***risk of QT-interval prolongation and torsade de pointes (contraindicated in patients with risk factors, avoid use in elderly)
85
Carbocisteine
Reduction of sputum viscosity (helpful in COPD) capsule: two 375 mg capsules three times a day, reduced when symptoms improve to one 375 mg capsule four times daily liquid: 15 ml (750 mg) three times a day, reduced when symptoms improve to 10 ml (500 mg) three times a day. satchet: one sachet three times a day, reduced when symptoms improve to one sachet twice a day. CHILD DOSE 2-5 years is: 1.25-2.5 ml (62.5-125 mg) four times daily. 5-12 years is: 5 ml (250 mg) three times daily. **be aware of double strength for children SE: GI bleed, skin reaction
86
Dornase alfa Ivacaftor Lumacaftor with ivacaftor Mannitol
Cystic Fibrosis (main sign pulmonary disease) should be offered mucolytic
87
Pholcodine (Day nurse)
Cough Suppressant, Cough and cold preparation ***increased risk of the very rare event of a severe allergic reaction (anaphylaxis) to muscle relaxants (neuromuscular blocking agents) that are used during general anaesthesia in surgery use with caution in hepatic/renal impairment
88
Donepezil HCl (reversible acetylcholinesterase inhibitor) Galantamine Rivastigmine (4.6 or 9.5 patches) Memantine (Dopaminergic, NMDA receptor antagonist)
Centrally Acting Anticholinesterases Mild to Moderate dementia in Alzheimer's disease 5mg ON SE: aggression, agitation, decrease appetite transdermal less likely to cause SE DGR as mono therapies
89
Carbamazepine (Tegretol)/Oxcarbazepine Ethosuximide Ganapentin/Pregabalin Lamotrigine Levetiracetam and Brivaracetam Phenobarbital/Primidone (Barbiturate) Phenytoin (interacts with folic) Refinamide Valproate Clobazam (Benzo, all epilepsy)
Antiepileptics C: 1st line for generalised tonic-clonic seizures E: 1st line in absence seizures G/P: focal seizures L: 1st line for focal seizures LB: mono therapy in focal seizures PP: tonic-clonic and focal but may be sedative P: avoid in absence/myoconic, use in tonic-clonic and focal R: seizures in Lennox-Gastaut syndrome V: generalised epilepsy, tonic-clonic seizures C: adjunctive therapy ***gabapentin: risk of severe respiratory depression, abuse and dependence ***phenytoin: risk of death and severe harm in IV ***pregabalin: risk of abuse and dependence **valproate: contraindicate in women and girls of childbearing age unless pregnancy prevention program are met
90
Lorazepam, Midozolam, Alprazolam, Diazepam Buspirone (seretonin receptor agonist)
Benzodiazepines status epilepticus, anxiety, panic attacks ***Midazolam: mis-selection of high-strength during conscious sedation ***risk of potential fatal respiratory depression
91
Atomoxetine Methyphenidate (Concerta, Delmosart, Equasym, Medikinet)
Centrally Acting Symptathomimetics, CNS Stimulants ADHD
92
Dexamfetamine Lisdexamfetamine mesilate (Elvanse)
Amfetamines ADHD
93
Guanfacine (Intiniv)
Alpha2 adrenoceptor agonist ADHD
94
Valproic Acid (Antiepiletic) Lithium (Priadel)
Manic episodes in bipolar disorder Lithium salts, antiphychotics
95
Isocarboxazid Phenelzine Trancylcypromine
Monoamine-oxidase inhibitor (MOAI), less used than tricyclic/SSRIs food restrictions, tyramine Drepressive illness
96
Citalopram Escitalopram Fluoxetine Paroxetine Sertraline Duloxetine (and noradrenaline) Venlafaxine (vencarm) Trozodone HCl
SSRI
97
Mirtazapine
Tetracyclic antidepressant Major depression
98
Amitriptyline HCl Dosulepin HCl Doxepin Nortriptyline Vortioxetine
Tricyclic antidepressant Depressive Illness
99
Chlorpromazine HCl Flupentixol Haloperidol Prochlorperazine Sulpiride Zuclophenthixol acetate
first generation, antipsychotic schizophrenia ***haloperidol/Zuclophenthixol: preparation for acute apisode not to be confused with depot preparation for maintenance ***Zuclophenthixol acetate confused with Zuclophenthixol decanoate
100
Amisulpiride Aripriprazole clozapine Olanzapine Quetiapine Risperidone
second generation, antipsychotic schizophrenia ***aripripazole: preparation for acute apisode not to be confused with depot preparation for maintenance ***clozapine: fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus (varying degrees of impairment of intestinal peristalsis) ***risperidone confused with ropinirole
101
Procyclidine HCl (antimusc) Trihexyphenidyl HCl (antimusc) Co-beneldopa (dopamine) co-careldopa Ropinirole Rasagiline (MOAIb inhibitor)
Parkinson's disease neurogenative condition, death of dopinergic cells of substantial nigra present with motor symptoms: hypokinesia (folded arms/legs), bradykinesia (slowness of movement), rest tremor, non-motor: dementia, depression incurable progressive condition, treatment to control symptoms and improve quality of life co-careldopa/benserazide: motor symptoms decrease quality of life levodopa, ropinirole, rasagiline: motor symptoms do not affect quality of life treatment with levodopa is associated with impulse control disorder: gambling, binge eating, hyper sexuality
102
Cyclizine Domperidone (Motilium) Metoclopramide HCl Aprepitant (neurokinin receptor antagonist) Ondansetron (seretonin receptor antagonist) Cinnarizine (sedating antihistamine) Hyoscine hydrobromide (Kwells, Scopoderm) motion sickness, antimusc
antiemetic and antonauseants, antihistamine 50mg TDS Dom: dopamine receptor antagonist, lack of efficacy in children met:risk of neurological effects (extrapyramidal disorders (repetitive involuntary movements) and tardive dyskinesia (sudden irregular movements that are not controlled) ondans: increased risk of oral clefts if used in first 12 weeks
103
Betahistine dihydrochloride
Menieres Disease
104
Paracetamol (acetaminophen) Nefopam HCl (centrally acting)
non-opioid anageisc
105
Buprenorphine Co-codamol Codeine Diamorphine Dihydrocodeine Fentanyl Morphine Oxycodone Tapentadol Tramadol HCl
Opioids ***benzos/opiods: risk of respiratory depression **codeine: restricted use in children for morphine toxicity and coughs and colds fentanyl: life threatening and fatal opiod exposure in children
106
Pizotifen Almotriptan/Eletriptan/Frovatriptan/Rizartriptan/Sumatriptan/Zolmitriptan
sedating antihistamine "triptans" headache, prophylaxis of migraine
107
Capsaicin
Plant alkaloids analgesics neuropathic pain apply 3-4 times daily
108
Flurazepam/Loprazolam/Nitrazepam/Temazepam Melatonin/Zolpidem/Zopiclone (non-bonzo hynotic)
sleep disorders insomnia benzo/z-drugs avoided in elderly
109
Sodium Oxybate Pitolisant
Narcolepsy
110
Acamprosate calcium
GABA analogues maintenance of abstinence in alcohol-dependent patients 333mg GR tablet
111
Bupropion HCl (zyban)
Nicotine dependence to aid smoking cessation in combination with motivational support in nicotine-dependent patients
112
Methadone
Opiod dependence
113
Amikacin (used in gentamicin-resistant gram positive) Gentamicin (broad spectrum, antibacterial of choice) Tobramycin Neomycin sulfate Streptomycin (mycobacterium tuberculosis)
Aminoglycosides against some Gram-positive and many Gram-negative organisms AGT: Pseudomonas aeruginosa
114
Etrapenem Imippenem with cilastatin Meropenem
carbapenems: beta-lactam antibacterials, broad spectrum, many gram-positive and gram-negative organisms, and anaerobes
115
Cefalexin
Cephalosporins (attach to penicillin binding proteins to interrupt cell biosyntheses leading to cell death) hospital-acquired pneumonia, lower UTI
116
Vancomycin
glyopeptide antibacterial C. difficile 125mg every 6 hrs for 10 days
117
Clindamycin
Lincosamides MRSA
118
Azithromycin Claritbromycin Erythromycin
Macrolides caution: QT prolongation
119
Metronidazole
nitromidazole derivatives anaerobic infections, H. pylori, Crohn's disease
120
Phenoxymethylpenicillin (Penicillin V) Amoxicillin (broad spectrum) Co-amoxiclav (broad with beta lactamase inhibitor) Pivmecillinam HCl (mecillinam-type) Flucloxacillin (penicillinase resistant)
Penicillins P: oral infection, otits media, acute sore throat 500mg QDS A: sinitus, oral infection, community-acquired pneumonia, COPD, dental abcess 500mg TDS Co-amoxiclav: 250/125, 500/125 Piv: uncomplicated cystitis, UTI Flu: 500mg QDS ***flu: cholestatic jaundice and hepatitis can occur after 2 months after treatment
121
Ciprofloxacin Levofloxacin Moxifloxacin Ofloxacin
Quinolones ***may induce convulsions, tendon damage, risk of aortic aneurysm Caution: QT prolongation
122
Co-trimoxazole Sulfadiazine (prevention of rheumatic fever occurrence)
Sulfonamides ***drug choice in prophylaxis and treatment of pneumonia
123
Doxycycline Lymecycline Minocycline Tigecycline
Tetracyclines chlamydia, UTI, bronchietasis, COPD, acne D: 200mg then 100mg OD L: 408mg BD
124
Chloramphenicol Fosfomycin Fucidic Acid Trimethoprim
antibacterial, other C: typhoid fever, lifethretening infections F: uti FA: skin infection
125
Dapsone Rifampicin Clofazimine Isoniazis
Antimycobacterials Leprosy rif: contra in jasduce caution: discolours soft lenses
126
Methenamine hippurate Nitrofurantoin
Antibacterials UTI Meth: 1g BD
127
Amphotericin
Antifungal, pollen anti fungal fungal infection **error dose in fungi zone administration
128
Fluconazole Itraconazole
triazole antifungal thrush F: 150mg OD I: 200mg BD
129
Atovaquone Ivermectin Mebendazole
Antoprotozoal Pneumonia 750mg BD
130
Ivermectin Mebendazole
Anthelmintics I: scabies M: threadworm
131
Atovaquone with proguanil HCl Chloroquine Mefloquine
Antimalarials A: 1 tablet OD started 1-2 days before travel and continued for 1 week after leaving C: 310mg once weekly started 1 week before travel and continued for 4 week after leaving M: 250mg once weekly started 2-3 weeks before travel and continued for 4 week after leaving
132
Entecavir Telbivudine Adefovir dipivoxil (nucleotide analogues) Ribavirin (nucleoside)
Nucleoside Analogues Hepatitis B Hep C
133
Peginterferon alfa Elbasvir with grazovir
Interferones, immunostimulants Hepatitis C HCV inhibitor, antiviral ***risk of interaction with vitamin K antagonist and changed in INR
134
Inosine pranobex Aciclovir/Famciclovir/Valaciclovir
Inosine Complex, antiviral nucleoside analogues, antiviral HPV
135
Cidofovir Ganciclovir
Cytomegalovirus Infections nucleoside analogues
136
Enfuvirtide Dolutegravir Elvitegravir, Raltegravir
HIV infection HIV-fusion inhibitor HIV-integrase inhibitor **increase risk of neural tube defects, not prescribed in pregnant seeking woman
137
Oseltammivir Zanamivir
Antiviral, Influenza, Neuraminidase inhibitor
138
Desmopressin (Desmomelt)
Vasopressin and Analogues, Pituitary and hypothalamic hormones and analogues Diabetes insipidus, treament Primary nocturnal enuresis 120 micrograms once daily, increased if necessary to 240 micrograms once daily, dose to be taken at bedtime, limit fluid intake from 1 hour before to 8 hours after administration, dose to be increased only if lower dose not effective, reassess after 3 months by withdrawing treatment for at least 1 week. Contra: hyponatraemia (elderly at risk, renal impairment)
139
Betamethasone Deflazacort Dexamethasone* Hydrocortisone* Methylprednisolone* Prednisolone* Triamcinolone acetonide*
Corticosteroid Suppression of inflammatory and allergic disorders, congenital adrenal hyperplasia ***M: do not use in patients with cow milk allergy, Solu-Medrone contains lactose Prednisolone: COPD, croup, asthma, myasthenia gravis *local inflammation of joints and soft tissue
140
Ketoconazole
Enzyme Inhibitor Cushing's syndrome ****oral ketoconaole suspended for fungal treatments, risk of hepatotoxicity
141
Metformin HCl (Glucophage SR, Sukkarto SR)
Biguanides, Blood glucose lowering drugs T2DM, PCOS IR: Initially 500 mg once daily for at least 1 week, dose to be taken with breakfast, then 500 mg twice daily for at least 1 week, dose to be taken with breakfast and evening meal, then 500 mg 3 times a day, dose to be taken with breakfast, lunch and evening meal; maximum 2 g per day. MR: Initially 500 mg once daily, then increased if necessary up to 2 g once daily, dose increased gradually, every 10–15 days, dose to be taken with evening meal, alternatively increased to 1 g twice daily, dose to be taken with meals, alternative dose only to be used if control not achieved with once daily dose regimen. If control still not achieved then change to standard release tablets. SE: nausea, vomitting, diarrhoea, lack of appetite, abdominal pain, unusual taste Lactic acidosis Diabetic ketoacidosos ***reduces B12 levels
142
Linagliptin (Trajenta) Sitagliptin (Januvia) Vildagliptin with metformin (Eucreas, 50/850, 50/1)
Dipeptidylpeptidase-4 inhibitors (Gliptins) T2DM L: 5mgOD S: 100mg OD V: 1 tab BD SE: cough, nose/throat symptoms, rash if persistent, severe tummy ache (can indicate inflamed pancreatitis), speak with GP
143
Dulalgutide (Trulicity) Liraglutide (Victoza, Saxenda) Semaglutide (Ozempic)
Glucagon-like peptide-1 receptor agonists T2DM (if metformin inappropriate) 0.75mg OW s/c in combination 1.5mg OW s/c Lira: Initially 0.6 mg once daily for at least 1 week, then increased to 1.2 mg once daily for at least 1 week, then increased if necessary to 1.8 mg once daily. Sema: Initially 0.25 mg once weekly for 4 weeks, then increased to 0.5 mg once weekly for at least 4 weeks, then increased if necessary to 1 mg once weekly. ***reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced/discontinued **insulin/sulfonylurea needs to be reduced when used concomitantly
144
Canagliflozin (Invokana 100mg, 300mg) Dapagliflozin (Forxiga) Dapafliflozin with metformin (Xigduo 5/850, 5/1) Empagliflozin (Jardiance 10, 25) Empagliflozin with metformin (Synjardy 12.5/850, 5/850, 5/1)
sodium glucose co-transportor 2 inhibitors T2DM 100 mg once daily; increased if tolerated to 300 mg once daily if required, dose to be taken preferably before breakfast. Dapag: T2DM 10mg OD, T1DM 5mg OD Empag: T2DM 10mg OD, increased to 25mg OD Empag w/met: 5/850–5/1000 mg twice daily, based on patient's current metformin dose, increased if necessary to 12.5/850–12.5/1000 mg twice daily not recommended in adults 85+ ***risk of ketoacidosis, lower-limb mutations (preventative foot care), Fournier's gangrene (necrotising fasciitis of the genitalia/perineum)
145
Glicazide Glimepiride
Sulfonylureas T2DM IR: Initially 40–80 mg daily, adjusted according to response, increased if necessary up to 160 mg once daily, dose to be taken with breakfast, doses higher than 160 mg to be given in divided doses; maximum 320 mg per day. MR: Initially 30 mg daily, dose to be taken with breakfast, adjust dose according to response every 4 weeks (after 2 weeks if no decrease in blood glucose); maximum 120 mg per day. Glimi: Initially 1 mg daily, adjusted according to response, then increased in steps of 1 mg every 1–2 weeks, increased to 4 mg daily, dose to be taken shortly before or with first main meal, the daily dose may be increased further, in exceptional circumstances; maximum 6 mg per day. caution: can cause weight gain, elderly, G6PD
146
Pioglitazone
Thiazolidinediones T2DM Initially 15–30 mg once daily, adjusted according to response to 45 mg once daily, review treatment after 3–6 months and regularly thereafter. In elderly patients, initiate with lowest possible dose and increase gradually. ***CVD safety, heart failure incidence, risk of bladder cancer
147
Insulin Insulin aspart (Fiasco, Novorapid) Insulin lispro (Humalog, Humalog Kwikpen)
Insulin **unit/international units should NOT be abbreviated, insulin NOT be withdrawn from pen/pen refill, can lead to fatal overdose SE: oedema overdose: hypoglycaemia
148
Biphasic isophane insulin (Humulin M3, Humulin M3 Kwikpen) Isophane insulin (Humulin I, Humulin I Kwikpen, Insulatard)
Intermediate acting insulin
149
Biphasic insulin aspart (Novomix 30 flexpen/penfill) Biphasic insulin lispro (Humalog Mix25/Mix 50)
Intermediate acting combined with rapid-acting insulin
150
Insulin deluded (Tresiba) Insulin determir (Levemir) Insulin glargine (Tuojeo, Abasaglar, Lantus, Semglee)
Long-Acting
151
15-20g of fast-acting carbohydrate (40% gel: glucogel, dextrogel) 3-4 teaspoons of sugar in water 4-7 glucose tablets 150-200mL fruit juice
Hypoglycaemia treatment low blood sugar able to swallow
152
Alendronic Acid Ibandronic Acid
Bisphosphates Osteoporosis A: 10mg OD, 70mg OW SE: GI disorder, joint swelling, vertigo ***atypical femoral fractures, osteonecrosis of the jaw/external auditory canal 1st line in postmenopausal women, in men: alendrotnic acid or risedronate treatment duration: benefit from biphosphnate period, review after 5 yrs in alendrotnic/risdronate/ibandronic, 3 yrs in zoledronic
153
Denusumab (Prolia, Xgeva)
Monoclonal Antibody, drugs affecting bone structure and mineralisation Osteoporosis in postmenopausal women and in men at increased risk of fractions (Prolia) Prevention of skeletal related events in patients with bone metastases (Xgeva)
154
Goserelin (Zoladex 3.6, Zoladex LA 10.8)) Leuprorelin acetate (Prostap 3 DCS)
Gonadotrophin-releasing hormones, pituitary and hypothalamic hormones/analogues Endometriosis Advanced prostate cancer
155
Estradiol (Elleste, Estraderm, Estradot, Evorel, Oestrogel, Sandrena) Ethinylestradio;
Female sex hormone responsive conditions Oestrogens (HRT) Menopausal women osteoporosis prophylaxis ***increased risk of breast cancer SE: headache, nausea, skin reaction
156
Oestrogen combined with medroxyprogesterone (Premique) Estradiol with dydrogesterone (Femoston, Femoston Conti) Estradiol with levonorgestrel (Femseven conti/sequi patch) Estradiol with norethisterone (Elleste duet, Evorel conti/sequi, kliofem, kliovance)
Oestrogen combined with medroxyprogesterone Menopausal symptoms in women with a uterus: 1 tablet OD
157
Norethisterone Progesterone (Utrogestan)
Progestogens N: endometriosis, dysfunctional uterine bleeding, dysmenorrhoea, contraception progestognenic opposition of oestrogen HRT 200mg OD on days 15-26 of each 28-day oestrogen HRT cycle, alternatively 100mg OD on days 1-25 of each 28-day oestrogen HRT cycle
158
Testosterone (Testim, Testogel, Tostran)
Androgens (male sex hormones) SE: hypertrigluceridaemia, hot flush, hypertension, increase weight, prostate abnormalities Testim/Testogel 50mg/5g: Apply 50 mg once daily, subsequent application adjusted according to response; maximum 100 mg per day. Testim (Testogel): one tube (satchet) of 5 g contains 50 mg testosterone. Testogel 16.2mg/g: Apply 40.5 mg once daily; increased in steps of 20.25 mg, adjusted according to response; maximum 81 mg per day. **monitor prostate in men over 45 one pump actuation delivers 1.25 g of gel containing 20.25 mg of testosterone.
159
Carbimazole Propylthiouracil (thiouracil)
Sulfur-containing imidazole, antithyroid drugs Hyperthyroidism15–40 mg daily continue until the patient becomes euthyroid, usually after 4 to 8 weeks, higher doses should be prescribed under specialist supervision only, then reduced to 5–15 mg daily, reduce dose gradually, therapy usually given for 12 to 18 months. ***neutropenia, agranulocytosis, risk of congenital malformations, risk of acute pancreatitis contra: blood disorders, pregnancy
160
Levothyroxine sodium Liothyronine sodium
Thyroid hormones Hypothyroidism contra: thyrotoxicosis
161
Darifenacin Fesoterodine fumarate Flavoxate HCl Oxybutynin HCl Propiverine HCl Solifenacin succinate Tolterodine tartrate Trospium HCl Mirabegron (beta3 adrenoreceptor, 25, 50)
antimuscarinics, Urinary urinary frequency, urgency, incontinenence D: 7.5mg OD increased to 15mg after 2 weeks Fe: 4mg OD, increased to 8mg OD (4mg MAX with concurrent CYP3A4 inhibitors) Fl: 200mg TDS O: (IR)5mg 2-3 times, upto 4 times (MR): 5mg OD, 20mg max avoid in hepatic/renal impairment caution: QT prolongation
162
Alfuzosin HCl Doxazosin Tamsulosin (400mcg MR)
alpha adrenoreceptor urinary retention benign prostatic hyperplasia D: hypertension
163
Dutaseride Finsasteride
5alpha-reductase inhibitor F: androgenic alopecia in men, 1mg
164
Cirtic acid with potassium citrate Sodium citrate
Alkalising drug, urinary Lidocaine HCl gel for urethral pain/catherter discomfort Alkalisation of urine with potassium citrate, cystitis discomfort
165
Pentosan polysulfate sodium
Heparinoids bladder pain syndrome 100mg TDS
166
Dienogest with estradiol valerate (Qlaira) Estradiol with nomegestrol Ethinylestradiol with desogestrel (Gedarel, Mercilon) Ethinylestradiol with drospirenone (Lucette, Yasmin) Ethinylestradiol with etanogestrel (Nuvaring) Ethinylestradiol with gestodene (Millinette) Ethinylestradiol with levonorgestrel (Microgynon 30, Rigevidon) Ethinylestradiol with norgestimate (Cilique)
Combined hormonal contraceptive
167
Ulipristal acetate
Progesterone receptor modulator, emergency U: 30mg within 5 days ***risk of liver injury
168
Desogestrel (desogestrel, Cerazette) Levonorgestrel (Levonelle, Mirena (IUD)
progestogen-only contraception L: emergency, 1.5 mg within 3 days ***uterine perforation
169
Etonogestral (implant) Medroxyprogesterone acetate (Depo)
progestogen-only parenteral contraception ****neurovascular injury and implant migration
170
Nonoxinol (gel)
spermicidal contraception
171
avanafil sildenafil (Viagra) tadalafil (longer-acting) vardenafil alprostadil (prostaglandin and analogue, caverjet) dapoxetine (SSRI, premature ejaculation)
phosphodiesterase type-5 inhibitor erectile dysfunction
172
Mifepristone misoprostol
termination of pregnancy progesterone receptor modulators misoprostol dose to be given after mifepristone
173
Clindamycin (Dalacin 2%)
Lincosamide, antibacterial bacterial vaginosis
174
Clotrimazole (Canesten1%, 2%, 10%)
Imidazole anti fungal superficial sites (1%/2%) cream 2-3 times a day thrush (10%) cream, inserted, 5g in 1 dose pessary 200mg for three nights recurrent thrush 500mg every week for 6 months
175
Azathioprine
antimetabolites, immunosuppressant Crohn's disease, rheumatoid arthritis, autoimmune conditions, myasthenia gravis
176
Ciclosporin Tacrolimus (Adoport, Prograf)
calcineurin inhibitors and related drugs, immunosuppressants ulcerative colitis, rheumatoid arthritis, organ transplantation T: prophylaxis or transplant rejection **Cic/Tac: must be prescribed by brand
177
Mycophenolate mofetil
purine synthesis inhibitor, immunosuppressant prophylaxis of rejection in transplantation *does not indicate increased risk of malformations/miscarriage where father was taking medicine
178
Fampridine interferon beta, peginterferon beta-1a (interferon)
cholinergic receptor stimulating drugs F: improvement of walking disability in multiple sclerosis I: relapsing, remitting MS
179
Alemtuzumab Natalizumab Ocrelizumab
anti-lymphocyte monoclonal antibodies treatment of adults with relapsing-remitting MS with active disease by clinical or imaging features ***monitoring requirements due to CVD and immune-mediated reactions
180
Atezolizumab (Lung) Avelumab (me static merkel cell carcinoma) Bevacizumab (mestatic breast cancer) Daratumumab (multiple myeloma) Durvalumab (lung) Rituximab (non-hodgkins) Mitoxantrone (breast cancer) Fluorouracil (GI/breast) Mercaptopurine (leukaemia) methotrexate (crohns) Bleomycin (non Hodgkins, mestatic germ cell, squamous cell) cisplatin (platinums) (testicular, cervical, bladder, head and neck, ovarian) Paclitaxel (taxanes) (ovarian) vinblastine, vincristine (vinca alkaloid) Thalidomide
monoclonal antibodies, malignant disease ***Beva: risk of osteonecrosis of jaw ***Dara: risk of hep B virus reactivation
181
Darbepoetin Alfa Epoetin alfa Epoetin beta Epoetin zeta
Epoetins Symptomatic anaemia associated with renal failure in patients on dialysis ****Stevens-Johnson syndrome, toxic epidermal necrolysis, severe skin reactions ****erythropoietins-haemoglobin concentration overcorrection in patients with CKD increase CVD event and cancer patients increased thrombosis ***tumor progression and survival in patients with cancer
182
Ferric carboxymatlose Iron dextran Iron isomaltoside 1000 Iron sucrose Ferric maltolate Ferrous fumarate Ferrous sulfate Sodium feredetate (Sytron)
Iron, injectable iron-deficiency anaemia ****hypersensitivity reactions with IV iron Iron, oral FM: 30mg BD FF: 210mg 1-2 times a day (prophylactic), 2-3times a day (therapeutic) FS: 200mg OD (pro), 200mg 2-3 times (thera)
183
Folic acid
Folate 5mg OD (in pregnant women), OW prevention of methotrexate side effects in rheumatic disease taken on different day to met
184
Cyanocobalamin Hydroxocobalamin (IM, 1mg/ml)
Vitamin B Group vitamin B12 deficiency of dietary origin 50-150mcg OD to be taken between meals
185
Filgrastim Lenograstim Lipegfilgrastim
Granulocyte-colony stimulating factors, immunostimulant reduction in duration of neutropenia and incidence of febrile neutropenia in cytotoxic chemotherapy
186
Sodium bicarbonate
Bicarbonate Alkinisation of urine, severe metabolic acidosis
187
Potassium chloride with....
Potassium electrolyte imbalance
188
sodium chloride
sodium chloride prophylaxis of sodium deficiency, renal salt wasting, management of diabetic ketoacidosis
189
Disodium hydrogen citrate with glucose, potassium chloride and sodium chloride (Dioralyte) Potassium chloride with rice powder, sodium chloride and sodium citrate (Dioralyte Relief)
oral rehydration salts fluid and electrolyte loss in diarrhoea
190
calcium carbonate (Adcal, Calciche, Rennie) calcium carbonate with calcium lactate gluconate (Sandocal) calcium chloride calcium glutinate
calcium calcium deficiency hypocalcaemia
191
Sevelamer
Phosphate binder hyperphosphataemia in patients on harm-dialysis, CKD
192
Mercaptamine
Cystinosis nephropathic cystinosis
193
Ascorbic Acid
Vitamin C prevention/treatment of scurvy
194
Thiamine (B1) Pyridoxine HCl (B6) Vitamin B complex
Vitamin B group
195
Alfacalcidol Cholecalciferol (D3, Sterol, Fultium, SunVit) Ergocalciferol (D2) Colecalciferol with calcium carbonate (Adcal, Accrete, Calcichew)
Vitamin D and analogues rickets, vitamin D prevention ***contra: hypercalcaemia
196
Glucosamine
chondroprotective drugs symptomatic relief of mild to moderate osteoarthritis of the knew
197
hydroxychloroquine sulfate leflunomide penicillamine sodium aurothiomalate
disease modifying antirheumatic drugs active rheumatic arthritis
198
Anakinra Sarilumab Secukinumab Tocilizumab Ustekinumab Baricitinib Tofacitinib Upadacitinb Abatacept Etanercept Infliximab
interleukin inhibitor, immunosuppressant RA JAK inhibitors T-Cell Activation Tumour necrosis factor alpha inhibitors
199
Colchicine Allopurinol Febuxostat
Plant alkaloids acute gout 500mcg 2-4 times Xanthane Oxidase inhibitors prophylaxis of gout treatment of chronic hyperuricaemia in gout
200
Neostigmine Pyridostigmine bromide
antocholinesterase Myasthenia gravis
201
Amifampridine
cholinergic receptor stimulating drugs Lambert-Eaton myasthenic syndrome
202
Baclofen Methocarbamol Tizanidine
centrally acting muscle relaxant B: pain of muscle spasm in palliative care, hiccup due to gastric distension, chronic severe spasticity M: short-term symptomatic relief of muscle spasm T: spasticity associated with MS or spinal cord injury
203
Aceclofenac/Celecoxib Ibuprofen (not for acute gout) Naproxen (1st choice) Flurbiprofen (more effective than ibuprofen) Ketoprofen Diclofenac sodium (voltarol emugel) Etodolac Indometacin (high incidence of side effects) Mefenamic acid Meloxicam Piroxicam (long furation of action, associated with skin reactions) Nabumetone Tolfenamic acid (migraine treatment) Aspirin
NSAIDs low back pain/sciatica =>nsaid, weake opiod with paracetamol, but not paracetamol alone for back pain, benzodiazepines =>consider GI, cardio-renal, hepatic c risks (paracetamol preferrred for elderly) A/C: pain and inflammation in osteoarthritis, RA, ankylosing spondylitis E: symptomatic relief osteoarthritis, RA Men: pain and inflammation in osteoarthritis, menorrhagia/dysmenorrhoea Mel: short-term relief of pain in osteoarthritis, long-term for RA and ankylosing A: high doses to treat RA
204
Xylometazoline and antazoline (Otrivine Antistin) Azelastine HCl (Optilast) Olopatadine
Antihistamines, eye allergic conjunctivitis
205
Sodium cromoglicate
mast-cell stabiliser allergic conjunctivitis
206
Nepafenac (Nevanac)
NSAID, eye drop prophylaxis and treatment of postoperative pain and inflammation associated with cataract surgery
207
Betamethasone (Betnesol) Dexamethasone (Dexafree, Eythalm) Prednisolone (Minims)
corticosteroid, eye drops local treatment of inflammation (short-term)
208
Betamethasone with neomycin (Betnesol-N) Dexamethasone with framycetin sulfate and gramicidin (Sofradex) Dexamethasone with hypromellose, neomycin and polymyxin B sulfate (Maxitrol) Dexamethasone with Tobramycin (Tobradex)
corticosteroid combination with anti-infectives local treatment of inflammation and bacterial infection (short-term)
209
Atropine sulfate Cyclopentolate HCl
antimuscarinic, eye cyclopegia, anterior uveitis
210
Acetylcysteine (Ilube) Carbomer (Viscotears, Pailin) Carmellose sodium (Carmize, Celluvisc) Hypromellose (Hydromoor) Sodium hyaluronate (Blink) Sodiukm hyaluronate with trehalose (Thealoz duo)
ocular lubricants, dry eye conditions A: tear deficiency C: dry eyes CS: dry eye condition H: tear deficiency S: dry eye condition
211
latanoprost tafluprost (saflutan) travoprost bimatoprost betaxolol levobunolol hcl timolol maleate brinzolamide dorzolamide apraclonidine pilocarpine
ocular hypertension/glaucoma 1st line (topical prostaglandin analogue) switch to alternative TPA before topical beta blocker switch (2nd line) carbonic anhydrase inhibitor (3rd line) sympathomimetic topical miotic
212
Framycetin sulfate Gentamicin Neomycin sulfate Acetic Acid 2% (EarCalm)
Ear Aminoglycosides Bacterial infection in otitis externa
213
Ciprofloxacin
Ear Quinolones acute otitis externa
214
Chloramphenicol
Other antibacterial, ear Bacterial infection in otitis externa
215
clotrimazole
Imidazole antifungals, ear fungal infection in otitis externa
216
Betamethasone Flumetasone pivalate with clioquinol Prednisolone Betamethasone with neomycin Dexamethasone with framycetin sulfate and gramicidin Ciprofloxacin with dexamethasone Ciprofloxacin with fluocinolone
corticosteroids, ear eczematous inflammation in otitis externa acute otitis media in patients with tympanostomy tubes, acute otitis externa
217
sodium bicarbonate almond oil docusate sodium olive oil urea hydrogen peroxide
Bicarbonate softening drugs removal of earwax
218
Ephedrine HCl Pseudoephedrine HCl Xylometazoline HCl
Nasal congestion
219
Chlorhexidine with neomycin (Naseptin) Mupirocin (Bactroban)
Nasal infection, sinitus 'common cold' aminoglycosides
220
Azelastine HCl (Rhinolast) Ipratropium bromide (Rinatec)
nasal inflammation, allergic/nonallergic rhinitis antihistamine antimuscarinic
221
Beclometasone dipropionate (Beconase) Budesonide (Rhinocort) Fluticasone (Avamys) Fluticasone with azelastine (Dymista) Mometasone furoate (Nasonex) Triamcinolone acetonide (Nasocort)
corticosteroids, nose
222
1. Biotene Oralbalance gel, Xerotin 2. BioXtra, Glandosane, Saliva Orthana, Saliveze 3. Saliveze pastilles
Artificial saliva products 1. any condition to dry mouth 2. dry mouth associated only with radiotherapy or sicca syndrome 3. salivary stimulant
223
Chlorhexidine (Corsodyl) Hexetidine (Oraldene) Hydrogen peroxide (Peroxyl) Sodium Chloride
oral hygiene gingivitis, oral candidiasis
224
sodium fluoride
prophylaxis of dental caries
225
Lidocaine HCl (Anbesol)
mouth ulcer
226
benzydamine HCl (Difflam)
sore throat
227
Choline salicylate (bonjela)
mild oral lesions
228
miconazole (Daktarin oral gel) Nystatin
oropharyngeal fungal infections oral thrush
229
barrier creams and oitnments (Sudocrem) emollient bath and shower products, antimicrobial-containing (Dermol 200 shower emollient, Dermol 600 bath emoillient, Dermal wash emulsion, oilatum plus) emollient bath and shower products, paraffin-containing (Dermalo, doublebase, E45, hydromol, QV bath oil/gentle wash, Zerolatum) emollient bath and shower products, soya-bean oil-containing (Balneum) emollient creams and ointments, antimicrobial-containing (Dermol 500) emollient creams and ointments, colloidal oatmeal-containing (Aveeno) emollient creams and ointments, paraffin-containing (AproDerm, Epimax, Cetraben, Diprobase, E45, ZeroAQS, Zerobase, Epaderm, 50:50 emollients, urea-containing (Eucerin, Flexitol)
barrier preparations, skin emollients dry and pruritic skin conditions including eczema and dermatitis dry skin conditions dry skin conditions, eczema eczema, ichthyosis, xeroderma, hyperkeratosis dry skin of feet/heels
230
metronidazole (Rozex) clotrimazole (Canesten 1% solution, Canesten 1%/2%/10%)
bacterial skin infection inflammatory papules, pustules and erythema of rosacea fungal skin infection
231
Ketoconazole (Dandrozol, Nizoral)
treatment/prophylaxis of dermatitis and dandruff
232
Amorolfine
fungal nail infection
233
Terbinafine (Lamisil) Griseofulvin Undecenoic acid with zinc undecenoate (Mycota)
tinea pedis (athlete's foot)
234
1. benzoic acid with salicylic acid 2. benzyl benzoate/permethrin 3. dimeticone/malathion/permethrin 4. aciclovir (Zovirax) 5. coal tar (Alphosyl 2 in 1, Neutrogena T/gel) 6. coal tar with coconut oil and salicylic acid (Capasal) 7. tacrolimus (Protopic)
1. ringworm 2. scabies 3. head lice, crab lice 4. cold sore 5. psoriasis, scaly scalp disorder such as psoriasis, eczema, seborrhoeic dermatitis and dandruff 6. 5+cradle cap 7. atopic eczema
235
1. betamethasone (Audavate), fluocinolone acetonide (Synalar), mometasone (Elocon) 2. Calcipotriol with betamethasone (Dovobet, Enstilar) 3. Clobetasol propionate (Dermovate, Etrivex) 4. Clobetasol butyrate (Eumovate) 5. betamethasone with clotrimazole (Lotriderm) 6. betamethasone with salicylic acid (Diprosalic) 7. clobetasone butyrate with nystatin and oxytetracycline (Trimovate) 8. Hydrocortisone with benzalkonium chloride, dimeticone and nystatin (Timodine), hydrocortisone with clotrimazole (Canesten HC), hydrocortisone with fusidic acid (Fucidin H), hydrocortisone with miconazole (Daktacort)
1. severe inflammatory skin disorder, psoriasis 2. scalp psoriasis 3. short-term treatment only of severe resistant inflammatory skin disorder, moderate scalp psoriasis 4. eczemas and dermatitis of all types, maintenance between courses of more potent corticosteroids 5. short-term treatment of ringworm infections and candidiasis 6. severe inflammatory skin disorders such as eczema and unresponsive to less potent corticosteroids, psoriasis 7. steroid-responsive dermatoses where candidal or bacterial infection is present 8. Mild inflammatory skin disorder associated with infection
236
Isotretinoin
retinoid severe acne ***PPP ****neuropsychiatric reactions and sexual dysfunction: erectile dysfunction and decreased libido, depression Caution: Avoid blood donation during treatment and for at least 1 month after treatment
237
Glycopyrronium bromide aluminium chloride hexahydrate (Driller)
hyperhidrosis
238
Levomenthol 0Dermacool, Menthoderm) Crotamiton (Eurex)
pruritis (itchy skin)
239
Clindamycin (Dalacin T) Co-cyprindiol (Clairette, Dianette, Teragezza)* Erythromycin with zinc acetate (Zineryt) Benzoyl peroxide (Acnecide) Benzoyl peroxide with clindamycin (Duac) Azelaic acid (Skinoren) Adapalene (Differin) Adapalene with benzoyl peroxide (Epiduo)
Acne vulgaris acne in females*
240
Ivermectin
rosacea
241
minoxidil (Regaine)
androgenetic alopecia
242
Povidone-iodine Chlorhexidine (Hibiscrub, Hydrex) Chlorhexidine with cetrimide (Savlon)
antiseptic and disinfectant
243
Silver nitrate Imiquimod (Aldara, genital) salicylic acid with lactic acid (Salataxc)
warts, verrucas