Indications and line in therapy Flashcards
Which are the FOUR medication classes most commonly prescribed in heart failure?
-ACEI OR ARB
-BETA BLOCKER
-ALDOSTERONE ANTAGONIST
-SGLT2 INHIBITOR
What is first line therapy to reduce the frequency of angina?
Beta blockers…
Then calcium channel blockers, mainly diltiazem and verapamil can be used as alternatives. Long acting nitrates are third line.
What medication classes are used to treat acute angina?
Short acting nitrates
Which of the beta blockers are used in heart failure?
Metoprolol
Bisoprolol
Nebivolol
Carvedilol
Which of the beta blockers are used in migraine prevention?
Propranolol
Atenolol
Metoprolol
(these are more lipophilic and are able to cross the BBB)
What is the beta blocker of choice in pregnancy?
Labetalol
What are the preferred beta blockers in BF?
Metoprolol, labetalol and propranolol
(this is because they are more extensively protein bound)
What are the TWO indications for prazosin?
Hypertension
Symptom relief in BPH
What are the indications of clonidine?
Hypertension
Menopausal flushing
Accepted also in:
ADHD
What are the indications of minoxidil
Hypertension
Alopecia
What is ANASTRAZOLE indicated for?
-Breast cancer
What is the indication of a fibrate?
Hypertriglyceridaemia
To prevent pancreatitis
Which classes are prescribed to decrease triglycerides?
Fibrates
Fish oil
Nicotinic acid
What are the two medications and indications for phosphodiesterase 5 inhibitors?
SILDENAFIL & TADALAFIL
Indicated for both erectile dysfunction AND pulmonary arterial hypertension.
what is the brand name and class of enoxaparin?
Clexane
Low weight molecular heparin
What is the brand name and class of dabigatran?
Pradaxa
direct thrombin inhibitor
What is the class of rivaroxaban and apixiban?
Factor Xa inhibitors
which oral anticoagulant has the slowest onset of action
Warfarin
Which emergency contraception has the highest efficacy?
Copper IUD
What is the ‘yuzpe regimen’
Emergency contraception method levonorgestrel or urlipristal isn’t available;
2 doses (12 hours apart) of 4 tablets of 30mcg ethinylesteradiol and 150mcg of levonorgestrel
What is first line for pregnant women with VTE?
LMWH
Low molecular weight heparin (clexane, pradaxa)
All oral anticoagulants are contraindicated.
Which opioids are the preferred choice in renal impairment?
Oxycodone and fentanyl
What are the TWO indications for oxycodone + naloxone combination?
- Severe CHRONIC pain with constipation refractory to laxatives
- Severe idiopathic restless leg syndrome.
What is first line treatment for c.diff infections?
Metronidazole
What is first line for Chlamydial infections?
Doxycycline or azithromycin
What is first line for traveller’s diarrhoea?
Norfloxacin
Is croup viral or bacterial and what are the treatment options?
Generally caused by parainfluenza virus
1. dexamethasone or prednisolone
2. inhaled budesonide
What is first and second line antibiotic treatment for pertussis (Whooping cough)?
1.azithromycin or clarithromycin
2.trimethoprim with sulfamethoxazole
What is first and second line to treat pneumonia?
- Amoxicillin
- Doxycycline
Treat for 5 to 7 days
What antibiotic spectrum is flucloxacillin?
Narrow spectrum penicillin active mainly against gram positive bacteria.
What spectrum is amoxicillin?
Moderate spectrum penicillin
They are inactivated by beta-lactamases
What spectrum is amoxicillin with clavulonic acid?
Broad spectrum against gram positive and gram negative, including beta-lactamases
Which antibiotic is interchangeable with flucloxacillin?
Dicloxacillin
Which antibiotic is first line for most Staphylococcus infections?
Flucloxacillin
second line is almost always cefalexin or clindamycin.
What is first and second line treatment for impetigo?
- Topical mupirocin for 5 days
- Flucloxacillin for 7 days
What is the indication of MOCLOBEMIDE
Major depression
What is the indication for silver sulfadiazine (flamazine)?
Silver is bactericidal and is used in:
Prevention and treatment of infection in severe burns.
Treatment of infection in leg ulcers and pressure sores.
What is the indication of sodium fusidate (Fucidin)
Staph infections on specialist advice when other options are unsuitable.
What are the three indications for imiquimod (aldara)?
External genital warts
Carcinoma
Actinic keratosis
What is the indication of betahistine?
Meniere’s disease
What is the indication of mercaptopurine?
Leukaemia and IBD
Which glucocorticoid has the most efficacy and less systemic side effects in IBD treatment?
Budesonide
What are the two indications of imipramine (tofranil)?
Major depression
Nocturnal enuresis under specialist supervision
What are the indications of axetazolamide (diamox)?
Glaucoma
Adjunctive therapy in epilepsy.
What are the indications of topiramate?
Epilepsy
Migraines
Which medication is first line for focal seizures?
carbamazepine
Which medication is first line for generalised tonic-clonic seizures?
Valproate
Which medication is preferred in absence seizures?
Ethosuximide
Which medication is first line in infantile spasms?
Prednisolone
What are the two indications of lamotrigine?
Epilepsy and bipolar
What is the indication of phenytoin?
Epilepsy
What are the indications of anticholinergic drugs?
Parkinson’s disease
Nausea and vomiting
Urinary incontinence
COPD
What is the class and indication of benzotropine (benztrop)?
It is an anticholinergic used in Parkinson’s disease.
What is the class and indication of trihexyphenidyl (artane)?
It is an anticholinergic used in Parkinson’s disease.
What are the two indications of amantadine (symmetrel) ?
Parkinson’s disease and prevention of influenza A upon specialist advice (rarely)
What is the brand name, indication and side effect profile of pizotifen?
Sandomigran
Prevention of migraine
Sedation, increased appetite and weight gain
What is the drug class and indication of donepezil?
Anticholinesterase used in Alzheimers disease
What is the drug class and indication of rivastigmine?
Anticholinesterase used in Alzheimers disease
What is the drug class and indication of galantamine?
Anticholinesterase used in Alzheimers disease
What is the indication of memantine and its brand name?
Ebixa used in Alzheimers disease
What is the indication and mechanism of action of baclofen?
It is a muscle relaxant, and works by being a structural analogue of GABA which inhibits transmission at the spinal level and depresses the CNS.
It’s indicated in MULTIPLE SCLEROSIS.
What is the drug class, brand name and indication of pyridostigmine?
Anticholinesterase
Mestinon
Myasthenia gravis
When is estrogen only HRT recommended?
Post hysterectomy.
Why is progesterone recommended with estrogen for menopausal women?
Women with a uterus are at risk of endometrial hyperplasia with unopposed estrogen.
What are the indications of hydroxychloroquine (plaquenil)?
RA
Lupus
Malaria treatment
Juvenile idiopathic arthritis
which oral bendodiazepine has the longest period of action?
nitrazepam
which triptan has the slowest onset of action?
naratriptan
Which drug class is imipramine and what are it’s indications?
TCA
Major depression
Nocturnal enuresis (upon specialist advice)
Panic disorder
What is the brand name, MOA and therefore indications of desmopressin ?
Minirin
Increases tubular reabsorption of water; increases factor VIII and von Willebrand’s factor coagulation activity.
- nocturnal enuresis (on specialist advice)
- Central (cranial) diabetes insipidus
- Control of bleeding (also specialist advice)
What is the brand name and indication of mirabegron?
Betmiga for urinary urge incontinence
What is the drug class and brand name of clomipramine?
TCA
Anafranil
What is the drug class and brand name of dosulepin?
TCA
Dothep
What is the drug class and brand name of imipramine?
TCA
Tofranil
What is the drug class and brand name of doxepin?
TCA
Deptran
What are the two active ingredients of contrave and what is it’s indication?
Naltrexone & bupropion
Weight loss
What is the indication of amisulpride?
Schizophrenia
What is the more unusual indication of olanzapine?
Chemotherapy-induced nausea and vomiting
What is the drug class and indication of suvorexant?
Oroxine receptor antagonist
Chronic insomnia
What is the indication and brand name of atomoxetine?
ADHD
Strattera
What is the brand name and indication of guanfacine?
Intuniv
ADHD
What is the brand name and class of imipramine?
Tofranil
TCA
What is the indication of mannitol (Bronchitol)?
Cystic fibrosis
