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Top 100 Drugs > Indications > Flashcards

Indications Flashcards

1
Q

Fibrinolytic drugs

(alteplase, streptokinase)

A

1) Acute ischaemic stroke

2) Acute STEMI

3) Massive PE with haemodynamic instability

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2
Q

Vitamins

(folic acid, thiamine, hydroxocobalamin, phytomenadione)

A

1) Thiamine (vit B) used in treatment and prevention of Wernicke’s encephalopathy and Korsakoff’s psychosis (severe thiamine deficiency)

2) Folic acid (vit B3) used in megaloblastic anaemia and in first trimester to reduce risk of neural tube defects

3) Hydroxocobalamin (vit B12) used in treatment of megaloblastic anaemia and subacute combined generation of the cord as a result of B12 deficiency

4) Phytomenadione (vit K) recommended for newborn babies to prevent vit K deficiency bleeding, and is used to reduce anticoagulant effect of warfarin

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3
Q

Nitrates

(isosorbide mononitrate, glyceryl trinitrate)

A

1) Short-acting (GTN) used in treatment of acute angina and chest pain associated with ACS

2) Long-acing (isosorbide) used for prophylaxis of angina where β-blocker and/or CCB insufficient

3) IV used in treatment of pulmonary oedema

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4
Q

Methotrexate

A

1) As disease-modifying treatment for RA

2) As part of chemotherapy for leukaemia, lymphoma and some solid tumours

3) Severe psoriasis (and psoriatic arthritis) that is resistant to other therapies

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5
Q

Antiemetics - dopamine D2-receptor antagonists

(metoclopramide, domperidone)

A

1) Prophylaxis and treatment of nausea and vomiting

Particularly in reduced gut motility

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6
Q

Penicillins - penicillinase-resistant

(flucloxacillin)

A

Staphylococcal infection, usually as part of combination therapy:

1) Skin and soft tissue infections such as cellulitis

2) Osteomyelitis and septic arthritis

3) Other infections including endocarditis

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7
Q

Quinolones

(ciprofloxacin, moxifloxacin, levofloxacin)

A

Generally reserved as 2nd or 3rd line due to antibiotic resistance

1) UTI (mostly Gram-negative organisms)

2) Severe gastroenteritis (e.g. Shigella, Campylobacter)

3) lower respiratory tract infections (Gram-positive and negative)

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8
Q

5α reductase inhibitors

(finasteride)

A

Benign prostatic enlargement (2nd line)

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9
Q

Leukotriene receptor antagonists

(montelukast)

A

1) Adults: add-on therapy for asthma where symptoms not adequately controlled with other meds

2) Children aged 5-12: alternatives to LABAs as an add-on for asthma

3) Children under 5: 1st line prevention for children with asthma who cannot take inhaled corticosteroid

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10
Q

Tetracyclines

(doxycycline, lymecycline)

A

1) Acne vulgaris

2) Lower respiratory tract infections inc. infective exacerbations of COPD, pneumonia and atypical pneumonia

3) Chlamydia infection including PID

4) Other infections e.g. typhoid, anthrax, malaria and Lyme disease

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11
Q

Calcium and vitamin D

(calcium carbonate, calcium gluconate, colecalciferol, alfacalcidol)

A

1) Osteoporisis

2) CKD to treat/prevent secondary hyperparathyroidism and renal osteodystrophy

3) Severe hyperkalaemia to prevent life-threatening arrhythmias (calcium gluconate)

4) Symptomatic hypocalcaemia

5) Prevention/treatment of vitamin D deficiency

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12
Q

Vancomycin

A

1) treatment of Gram-positive infection e.g. endocarditis where infection is severe and penicillins cannot be used

2) Treatment of antibiotic-associated colitis (usually 2nd line where emtronidazole is poorly tolerated)

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13
Q

Antimuscarinics - cardiovascular and GI uses

(atropine, hyoscine butylbromide, glycopyrronium)

A

1) 1st line for bradycardia

2) 1st line for IBS (particularly hyoscine butylbromide)

3) Reducing copious respiratory secretions in dying patients

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14
Q

β-blockers

(bisoprolol, atenolol, propanolol, metoprolol, carvedilol)

A

1) Ischaemic heart disease to improve symptoms/prognosis associated with angina and ACS

2) Chronic heart failure to improve prognosis

3) AF to reduce ventricular rate

4) SVT to restore sinus rhythm

5) HTN (if other medications insufficient)

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15
Q

Naloxone

A

1) Acute treatment of opioid toxicity

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16
Q

Lidocaine

A

1) First choice local anaesthetic

2) Uncommonly as anti-arrhythmic in VT and VF refractory to electrical cardioversion

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17
Q

Antipsychotics - 2nd generation (atypical)

(quetiapine, olanzapine, risperidone, clozapine)

A

1) Urgent treatment of severe psychomotor agitation

2) Schizophrenia

3) Bipolar disorder

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18
Q

Chloramphenicol

A

1) Bacterial conjunctivitis (eye drops)

2) Otitis externa (ear drops)

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19
Q

Gabapentin and pregablin

A

1) Add-on treatment of focal epilepsies (not recommended in absence or myoclonic seizures)

2) 1st line for neuropathic pain (inc. painful diabetic neuropathy)

3) Generalised anxiety disorder (pregablin)

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20
Q

Angiotensin receptor blockers

(losartan, candesartan, irbesartan)

A

Generally used when ACE inhibitors not tolerated due to cough

1) HTN - 1st or 2nd line

2) Chronic heart failure 1st line

3) Ischaemic heart disease to reduce risk of further CV events

4) Diabetic nephropathy and CKD with proteinuria

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21
Q

Antiemetics - serotonin 5-HT3-receptor antagonists

(ondansetron, granisetron)

A

1) Prophylaxis and treatment of nausea and vomiting

Particularly in general anaesthesia and chemotherapy

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22
Q

Antiemetics - histamine H1-receptor antagonists

(cyclizine, cinanrizine, promethazine)

A

1) Prophylaxis and treatment of nausea and vomiting

Particularly in motion sickness and vertigo

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23
Q

Corticosteroids (glucocorticoids) - systemic

(prednisolone, hydrocortisone, dexamethasone)

A

1) Allergic or inflammatory disorders e.g. anaphylaxis, asthma

2) Suppression of autoimmune disease e.g. IBD, inflammatory arthritis

3) Some cancers - reduce tumour-associated swelling

4) Hormone replacement in adrenal insufficiency or hypopituitarism

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24
Q

Warfarin

A

1) VTE treatment and prevention of recurrence

2) To prevent arterial embolism in patients with AF or prosthetic heart valves

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25
Q

Thyroid hormones

(levothyroxine, liothyronine)

A

1) Primary hypothyroidism

2) Hypothyroidism secondary to hypopituitarism

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26
Q

α-blockers

(doxazosin, tamsulosin, alfuzosin)

A

1) Benign prostatic enlargement

2) Resistant HTN (as add-on)

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27
Q

Dopaminergic drugs for Parkinson’s disease

(levodopa as co-careldopa/co-beneldopa, ropinirole, premipexol)

A

1) Early Parkinson’s disease - ropinirole, pramipexol

2) Later Parkinson’s disease - levodopa

3) Levodopa and dopamine agonists may be options for secondary parkinsonism

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28
Q

Sex hormone antagonists for breast cancer

(tamoxifen, anastrozole, letrozole)

A

1) Early and locally advanced oestrogen-receptor positive (ER-positive) breast cancer as adjuvant treatment to reduce risk of recurrent disease

2) Advanced ER-positive breast cancer
to slow disease progression

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29
Q

Adenosine

A

1) 1st line diagnostic and therapeutic agent in SVT

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30
Q

Prostaglandin analogue of eye drops

(latanoprost, bimatoprost)

A

1) 1st line agents to lower intraocular pressure in open-angle glaucoma and ocular hypertension

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31
Q

Dipeptidylpeptidase-4 inhibitors

(sitagliptin, linagliptin, saxagliptin)

A

T2DM

1) In combination with metformin where blood glucose not adequately controlled on single agent

2) As single agent to control blood glucose where metformin is contraindicated/not tolerated

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32
Q

Lamotrigine

A

1) Seizure prophylaxis in epilepsy - 1st line in focal, generalised tonic-clonic and absence

2) Bipolar depression (not mania/hypomania)

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33
Q

Penicillins

(benzylpenicilin, phenoxymethylpenicillin)

A

1) Streptococcal infection inc. tonsillitis, pneumonia, endocarditis, and skin and soft tissue infections

2) Meningococcal infection e.g. meningitis, septicaemia

3) Clostridial infection e.g. gas gangrene (clostridial myonecrosis)

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34
Q

Bisphosphonates

(alendronic acid, disodium pamidronate, zoledronic acid)

A

1) 1st line for patients at risk of osteoporotic fragility fractures

2) Treatment of severe hypercalcaemia of malignancy (pamidronate and zoledronic acid)

3) Myeloma and bone metastases (pamidronate and zoledronic acid)

4) 1st line treatment for metabolically active Paget’s disease

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35
Q

Aminoglycosides

(gentamicin, amikacin, neomycin)

A

Systemic (gentamicin, amikacin): treatment of severe infections

1) severe sepsis

2) Pyelonephritis and complicated UTI

3) Biliary and other intra-abdominal sepsis

4) Endocarditis

Topical (neomycin):

5) Bacterial skin, eye or external ear infections

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36
Q

Macrolides

(clarithromycin, erythromycin, azithromycin)

A

1) Treatment of respiratory, skin and soft tissue infections as alternative to penicillin when contraindicated

2) Severe pneumonia added to penicillin to cover atypical organisms

3) Eradication of H. pylori in combination with PPI and amoxicillin/metronidazole

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37
Q

Calcium channel blockers

(amlodipine, nifedipine, dilitiazem, verapamil)

A

1) 1st or 2nd line treatment for HTN (amlodipine)

2) Symptom control instable angina

3) Rate control in SVT (dilitiazem and verapimil)

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38
Q

Acetylcholinesterase inhibitors

(donepezil, rivastigmine)

A

1) Mild to moderate Alzheimer’s

2) Mild to moderate dementia in Parkinson’s (rivastigmine)

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39
Q

Amiodarone

A

1) Used in a wide range of tachyarrhythmias

AF, SVT, RVF

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40
Q

Metronidazole

A

1) Antibiotic-associated colitis caused by Gram-positive anaerobe C. dif

2) Oral infections or aspiration pneumonia caused by Gram-negative anaerobes form mouth

3) Surgical and gynaecological infections caused by Gram-negative anaerobes from colon

4) Protozoal infections

41
Q

Z-drugs

(zopiclone, zolpidem)

A

1) Short-term treatment of insomnia which is debilitating/distressing

42
Q

Valproate (valproic acid)

(sodium valproate, valproic acid)

A

1) Seizure prophylaxis in epilepsy, effective in most seizure types

2) Selected cases of established convulsive status epilepticus

3) Bipolar disorder for acute treatment of manic episodes

43
Q

Corticosteroids (glucocorticoids) - topical

(hydrocortisone, betamethasone)

A

1) Inflammatory skin conditions e.g. eczema

To treat disease flares or control chronic disease where emollients alone are ineffective

44
Q

Direct oral anticoagulants (DOACs)

(apixaban, dabigatran, edoxaban, rivaroxaban)

A

1) VTE

2) AF - to prevent stroke and systemic embolism in patients with at least one risk factor e.e. previous stroke

45
Q

Antiviral drugs

(aciclovir)

A

1) Treatment of acute episodes of herpesvirus infection

2) Suppression of recurrent herpes simplex attacks

46
Q

Antiplatelet drugs

(aspirin)

A

1) Treatment of ACS and acute ischaemic stroke

2) Long-term secondary prevention of thrombotic events in patients with CV, cerebrovascular and peripheral arterial disease

47
Q

Allopurinol

A

1) Prevent recurrent attacks of gout

2) Prevent uric acid and calcium oxalate renal stones

3) Prevent hyperuricaemia and tumour lysis syndrome associated with chemo

48
Q

Protein pump inhibitors

(lansoprazole, omeprazole, pantoprazole)

A

1) Prevention and treatment of peptic ulcer disease including NSAID-associated ulcers

2) Symptomatic relief of dyspepsia and GORD

3) Eradication of H. pylori infection (in combination with antibiotics)

49
Q

Heparins and fondaparinux

(enoxaparin, dalteparin, fondaparinux, unfractioned heparin)

A

1) DVT and PE (usually LMWH)

2) ACS to reduce clot progression or maintain revascularisation

50
Q

Laxatives - stimulant

(senna, bisacodyl, glycerol suppositories, docusate sodium)

A

1) Constipation

2) Suppositories for faecal impaction

51
Q

ACE inhibitors

(ramipril, lisinopril, perindopril)

A

1) HTN - 1st or 2nd line

2) Chronic heart failure 1st line

3) Ischaemic heart disease to reduce risk of further CV events

4) Diabetic nephropathy and CKD with proteinuria

52
Q

Penicillins - antipseudomonal

(piperacilllin with tazobactam - tazocin)

A

Reserved for severe infections, particularly where broad spectrum of potential pathogens; antibiotic resistance likely, or immunocompromised patient

1) Lower respiratory tract infections

2) Urinary tract infections

3) Intra-abdominal sepsis

4) Skin and soft tissue infections

53
Q

Penicillins - broad-spectrum

(amoxicillin, co-amoxiclav)

A

1) Susceptible infections including CAP, otitis media, sinusitis and UTIs (amoxicillin)

2) Treatment of H. pylori infection - amoxicillin may be given in combination with clarithromycin or metronidazole and PPI

3) Severe, resistant and hospital-acquired infections including respiratory tract infections, GU and abdominal infections, cellulitis and bone and joint infections (co-amoxiclav)

54
Q

Antiplatelet drugs - ADP-receptor antagonists

(clopidogrel, ticagrelor, prasugrel)

A

1) Treatment of ACS

2) Prevent occlusion of coronary artery stents

3) Long-term secondary prevention of thrombotic events in patients with CV, cerebrovascular and peripheral arterial disease

55
Q

Activated charcoal

A

1) Reduce absorption of certain poisons in the gut

2) Increase elimination of certain poisons

56
Q

Cephalosporins and carbapenems

(cefalexin, cefotazime, meropenem, ertapenem)

A

1) 2nd and 3rd line for urinary and respiratory tract infections (oral cephalosporins)

2) Very severe/complicated infections, or those caused by antibiotic-resistant microorganisms (parenteral cephalosporins/carbapenems)

57
Q

Phosphodiesterase (type 5) inhibitors

(sildenafil)

A

1) Erectile dysfunction

2) Primary pulmonary hypertension

58
Q

Loop diuretics

(furosemide, bumetanide)

A

1) Relief of breathlessness in acute pulmonary oedema

2) Symptomatic relief of fluid overload in chronic heart failure

3) Symptomatic relief of fluid overload in other oedematous states e.g. renal disease, liver failure

59
Q

Ocular lubricants - artificial tears

(hypromellose, carbomers, liquid and white soft paraffin)

A

1) 1st line symptomatic treatment of dry eye conditions e.g. keratoconjunctivitis sicca and Sjogren’s syndrome

60
Q

Antihistamines - H1-receptor antagonists)

(cetirizine, loratadine, fexofenadine, chlorpgenamine)

A

1) 1st line for allergies, particularly hayfever

2) Aid relief of pruritis and urticaria

3) Adjunctive for anaphylaxis

61
Q

Trimethoprim

(trimethoprim, co-trimoxazole)

A

First choice antibiotic for the treatment of:

1) Acute lower UTI

2) Prophylaxis of recurrent UTI

62
Q

Iron

(ferrous fumarate, ferrous sulfate)

A

1) Treatment of iron-deficiency anaemia

2) Prophylaxis of iron-deficiency anaemia

63
Q

Serotonin 5HT1-receptor agonists

(sumatriptan)

A

1) Acute migraine with or without aura

64
Q

H2-receptor antagonists

(ranitidine)

A

1) Peptic ulcer disease - treatment and prevention

2) GORD and dyspepsia (PPIs preferred in severe cases)

65
Q

Antipsychotics - 1st generation (typical)

(haloperidol, chlorpromazine, prochlorperazine)

A

1) Urgent treatment of severe psychomotor agitation

2) Schizophrenia

3) Bipolar disorder

4) Nausea and vomiting

66
Q

Emollients

(aqueous cream, liquid paraffin)

A

1) Topical treatment for all dry or scaling skin disorders

67
Q

Metformin

A

1) T2DM as first choice for control of blood glucose

Used alone or in combination with sulphonylureas, DPP-4 inhibitors, insulin

68
Q

Carbamazepine

A

1) Seizure prophylaxis in epilepsy

2) Trigeminal neuralgia (pain control, reduce frequency/severity of attacks)

69
Q

Antimuscarinics - GU uses

(oxybutynin, tolterodine, solifenacin)

A

1) 1st line in overactive bladder to reduce frequency, urgency and urge incontinence

70
Q

Azathioprine

A

1) Maintenance of remission in Crohn’s and UC

2) Disease-modifying agent in RA and autoimmune conditions

3) Prevention of organ rejection

71
Q

Antidepressants

(tricyclics; amitriptyline, lofepramine)

A

1) 2nd line for moderate to severe depression when SSRIs ineffective

2) Neuropathic pain (unlicensed)

72
Q

Sulphonylureas

(glicazide)

A

in T2DM:

1) In combination with metformin where blood glucose is not adequately controlled on a single agent

2) As a single agent to control blood glucose when metformin is contraindicated/not tolerated

73
Q

β2-agonists

(salbutamol, terbutaline, salmeterol, formoterol, indacaterol)

A

1) Asthma - short acting to relieve breathlessness, long-acting as treatment for chronic asthma

2) COPD - short-acting to relieve breathlessness, long-acting as 2nd line therapy

3) Hyperkalaemia

74
Q

Oxygen

A

1) Increase tissue oxygen delivery in acute hypoxaemia

2) Accelerate reabsorption of pleural gas in pneumothorax

3) Reduce carboxyhaemoglobin half-life in carbon monoxide poisoning

75
Q

Benzodiazepines

(diazepam, temazepam, lorazepam, chlordiazepoxide, midazolam)

A

1) 1st line management for seizures and status epilepticus

2) 1st line management for alcohol withdrawal

3) Sedation for interventional procedures

4) Short-term treatment of severe, disabling anxiety or insomnia

76
Q

Paracetamol

A

1) 1st line analgesic for most forms of acute and chronic pain

2) Antipyretic that can reduce fever and its associated symptoms

77
Q

Antidepressants

(venfalaxine, mirtazapine)

A

1) Option for major depression when SSRIs ineffective

Generalised anxiety disorder (venfalaxine)

78
Q

Acetylcysteine (N-acetylcysteine)

A

1) Antidote to paracetamol poisoning

2) Prevention of contrast nephropathy

3) Reduce viscosity of respiratory secretions

79
Q

Nitrofurantoin

A

1) First choice treatment for acute, uncomplicated lower UTI

2) Prophylaxis of UTI in patient with recurrent infections

80
Q

Alginates and antacids

(gaviscon, peptac)

A

1) GORD

2) Dyspepsia

81
Q

Oestrogens and progestogens

(combined ethinylestradiol products, desogestrel)

A

1) Hormonal contraception

2) HRT to delay early menopause or to treat distressing menopausal symptoms

82
Q

Opioids - strong

(morphine, oxycodone)

A

1) Rapid relief of acute severe pain

2) Relief of chronic pain when paracetamol, NSAIDs and weak/moderate opioids insufficient (rung 3 of pain ladder)

3) Relief of breathlessness in context of end-of-life care

4) Relief of breathlessness/anxiety in acute pulmonary oedema (alongside oxygen furosemide and nitrates)

83
Q

Insulin

(insulin aspart, insulin glargine, biphasic insulin, soluble insulin)

A

1) Insulin replacement in T1DM and control of blood glucose in T2DM

2) Diabetic emergencies e.g. DKA and hyperglycaemic hyperosmolar syndrome

3) Alongside glucose to treat hyperkalaemia

84
Q

Statins

(simvastatin, atorvastatin, pravastatin, rosuvastatin)

A

1) Primary prevention of CV events (people over 40 with risk factors)

2) Secondary prevention of CV events

3) Primary hyperlipidaemia

85
Q

Antimotility drugs

(loperamide, codeine phosphate)

A

1) Symptomatic treatment for diarrhoea (IBS, gastroenteritis)

86
Q

Laxatives - osmotic

(lactulose, macrogol, phosphate enema)

A

1) Constipation and faecal impaction

2) Bowel preparation prior to surgery/endoscopy

3) Hepatic encephalopathy

87
Q

Antifungal drugs

(nystatin, clotrimazole, fluconazole)

A

1) Local fungal infections (oropharynx, vagina, skin)

2) Systemic treatment of invasive or disseminated fungal infections

88
Q

Thiazide and thiazide-like diuretics

(bendroflumethiazide, indapamide, chlortalidone)

A

1) Alternative 1st line for HTN where CCB would otherwise be used, but is either unsuitable (e.e.g oedema) or there are features of heart failure

2) Add-on treatment of HTN

89
Q

Adrenaline

(epinephrine)

A

1) Cardiac arrest

2) Anaphylaxis

3) Induce local vasoconstriction e.g. prolong local anaesthetic

90
Q

Antimuscarinics - bronchodilators

(ipratropium, tiotropoium, glycopyrronium, aclidinium)

A

1) COPD to relieve breathlessness

2) Asthma to relieve breathlessness

91
Q

NSAIDs

(naproxen, ibuprofen, etoricoxib)

A

1) Treatment of mild to moderate pain

2) Regular treatment for pain related to inflammation, particularly MSK e.g. RA, severe OA and gout

92
Q

Quinine

(quinine sulfate)

A

1) Treatment and prevention of night-time leg cramps

2) 1st line treatment for Plasmodium falciparum malaria

93
Q

Corticosteroids (glucocorticoids) - inhaled

(beclometasone, budesonide, fluticasone)

A

1) Asthma to treat inflammation and control symptoms

2) COPD to control symptoms and prevent exacerbations

94
Q

Digoxin

A

1) AF and atrial flutter to reduce ventricular rate (β-blocker or CCB usually more effective)

2) Severe heart failure

95
Q

Aldosterone antagonists

(spironolactone, eplerenone)

A

1) Ascites and oedema due to liver cirrhosis

2) Chronic heart failure

3) Primary hyperaldosteronism

96
Q

Aminosalicylates

(mesalazine, sulfasalazine)

A

1) Mesalazine is 1st line for mild to moderate UC

2) Sulfasalazine is used in RA

97
Q

Levetiracetam

A

1) Seizure prophylaxis in epilepsy - focal, myoclonic and generalised tonic-clonic

2) Established convulsive status epilepticus that has not responded to benzodiazepine

98
Q

Opioids - weak/moderate

(tramadol, codeine, dihydrocodeine)

A

1) Mild to moderate pain as 2nd line when simple analgesics insufficient - rung 2 on pain ladder

Top 100 Drugs (4 decks)

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