NICE Guidelines for Pharmacological Treatment Flashcards
First line in schizophrenia.
Atypical antipsychotics
Second line in schizophrenia
Typical antipsychotics
For treatment resistant schizophrenia.
Clozapine
First line in bipolar mania.
Trial antipsychotic such as olanzapine
First line in bipolar depression.
Olanzapine with or without fluoxetine
First line in bipolar maintenance.
Lithium
Second line in bipolar maintenance.
Sodium valproate
Last line in bipolar depression.
Lamotrigine
First line in early Parkinson’s.
L-dopa and DDi
Second line in early Parkinson’s.
Dopamine agonist
Option in advanced Parkinson’s with optimal oral treatment.
SC apomorphine
First line in tremor with Parkinson’s.
Anticholinergics
Add in for Parkinson’s with dyskinesia or motor fluctuation.
COMT inhibitor
Preferred in mild Parkinson’s or late stage add in.
MAO-B inhibitor
Add in for dyskinesias in late stage Parkinson’s.
Amantadine
First line in cognitive symptoms of dementia.
AChE inhibitor
First line alternative in dementia.
Memantine
Licensed antipsychotic for BPSD.
Risperidone
First line in GAD.
SSRI
Second line in GAD.
Alternative SSRI or SNRI
Third line in GAD.
Pregabalin
First line in panic disorder.
SSRI
Second line in panic disorder.
Imipramine
First line in social anxiety disorder.
SSRI
Second line in social anxiety disorder.
Alternative SSRI or SNRI
Third line in social anxiety disorder.
MAOI
Licensed for short term use in GAD crisis.
Diazepam
Licensed for physical anxiety symptoms.
Propranolol
First line in sulphonylurea overdose.
IV dextrose
First line in beta-blocker overdose.
Fluid and atropine
Second line in beta-blocker overdose.
IV glucagon infusion over 5-10 minutes
First line in CCB overdose.
Fluid resus followed by calcium salts
Second line in CCB overdose.
High dose insulin-dextrose infusion
First line in toxic alcohol overdose.
Ethanol (preferred substrate)
Second line in toxic alcohol overdose.
Fomepizole
Adjunct in cyanide poisoning.
Sodium thiosulphate
Treatment in severe cyanide poisoning.
Dicobalt edetate
Unlicensed treatment for cyanide poisoning.
Hydroxycobalamin
First line in pre-hospital first aid of cyanide poisoning.
Amylnitrite
First line cyanide poisoning. IMMEDIATE
Oxygen to reverse metabolic acidosis
First line in BZD only overdose.
Flumazenil
First line in opioid overdose.
Naloxone
First line in paracetamol overdose.
N-acetylcysteine
Indication for charcoal haemoperfusion.
Theophylline or carbamazepine overdose
Indication for urinary alkalisation.
Overdose of aspirin
First line BZD in status epilepticus.
IV lorazepam
Buccal BZD alternative in status epilepticus.
Midazolam
Rectal BZD alternative in status epilepticus.
Diazepam
First line AED in status epilepticus.
Phenytoin
Last line in status epilepticus.
Induction of coma
First line in partial seizures.
Carbamazepine
Second line in partial seizures.
Sodium valproate
Lamotrigine
First line in generalised tonic-clonic seizures.
Sodium valproate
Lamotrigine
Second line in generalised tonic-clonic seizures.
Carbamazepine
Topiramate
First line in absence seizures.
Sodium valproate
Second line in absence seizures.
Lamotrigine
Ethosuximide
Contraindicated in MAT seizures.
Carbamazepine
First line in epilepsy in pregnancy.
Lamotrigine
First line in Dravets syndrome.
Sodium valproate
Second line in Dravets syndrome.
Sodium valproate
And clobozam
Third line in Dravets syndrome.
Sodium valproate
And clobozam
And stiripentol
First line in Lennox-Gastaut syndrome.
Sodium valproate
Second line in Lennox-Gastaut syndrome.
Lamotrigine
Clobozam
Topiramate
Phenytoin