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OPIC Drugs > OPIC Drugs > Flashcards

OPIC Drugs Flashcards

1
Q

Haloperidol

A

D2 antagonist
Schizphrenia, delirium, anti-emetic
Dry mouth, nausea, constipation/diarrhoea, nervousness
increases risk of falls

Alcohol  = hypotension
Amiodarone = QT prolongation
Beclometasone  = hypokalaemia
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2
Q

Macrogol

A

Osmotic laxative (increases water retention in bowel)
Constipation
SFx Flatulence, GI discomfort, nausea, vomiting
Increases risk of falls
Contraindication = ileus/obstruction
Reduces absorption of soluble medicine (anti-epileptics) = avoid medicine 1hr before or after

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3
Q

Alendronate

A

Bisphosphonate
Osteoprosis/osteopenia
Headache, oesophagi’s, GI disturbance, renal impairment
Reduces risk of fracture if fall
Interactions = GI irritation with Naproxen + aspirin, calcium gluconate + antacids decreasesalendronate absorption

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4
Q

Adcal D3

A

Calcium + vitamin D
Prevention of osteoporosis + osteopenia
Abdominal pain, constipation, diarrhoea, headache, hypercalcaemia
Reduces risk of fracture with fall
Calcium carbonate-containing antacids may impair absorption
Antacids might damage enteric coatings
Bendroflumethiazide = increased risk of hypercalemia

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5
Q

Strontium ranelate

A

Dual action bone agent (DABA): Increases deposition of new bone + reduces resorption of bone, strengthens bone tissue
Severe Osteoporosis
Dizziness, headache, GI discomfort, diarrhoea, constipation, peripheral oedema
Reduces risk of fracture with fall
Antacids decrease absorption of it, fluorouracil + tamoxifen increases risk of DVT

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6
Q

Colchicine

A

Alkaloid, inhibits inflammation caused by tubular disruption
Acute gout
Abdo pain, diarrhoea, nausea, vomiting
Contraindication = eGFR <10
No effect on falls
CYP3A4 inhibitors = increase exposure to colchicine
Atorvastatin = rhabdomyolysis

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7
Q

Allopurinol

A

Xanthine oxidase inhibitor
Gout, calcium oxalate renal stones
Initiation/up-titration may cause acute attack
Rash, hypersensitivity, nausea, vomiting
Reduces BP?
ACEi = increased risk of hypersensitivity + haematological reactions
Amoxicillin = increased risk of skin rash
Pyrazinamide = increased risk of hyperuricaemia

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8
Q

Prednisolone

A

Glucocorticoid
Decrease leucocyte migration to inflammation, decrease vasodilation of capillaries, alter gene expression
Inflammatory conditions, adrenocortical insufficiency

Anxiety, GI discomfort, headache, fluid retention, cataracts, increased weight
Reduce bone density = increase fracture risk with fall
Amiodarone = hypokalaemia
Aspirin = increased risk of GI bleeding
Live vaccines

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9
Q

Pizotifen

A

Serotonin + tryptamine antagonist for migraine prophylaxis
Prevention of migraine/cluster headache
Increased appetite + weight
Dizziness, drowsiness
Dry mouth
Fatigue
Nausea
Causes dizziness = may increase risk of falls
Alcohol, amitrityline, codeine, lorazepam = increased risk of CNS depressant
Isocarboxazid = increased risk of antimuscarinic adverse effects

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10
Q

Zopiclone

A

Non-benzodiazepine hypnotic
Insomnia
Dry mouth, taste bitter, anxiety, dizziness, fatigue, headache, nausea, sleep disorders, vomiting
Increases risk of falls through cognitive + psychomotor impairment
Alcohol, fentanyl, ketamine = CNS Depressant

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11
Q

Entacapone

A

Selective reversible COMT inhibitor
Adjunct to co-beneldopa/careldopa in PD with ‘end-of-dose’ motor fluctuations
Abdominal pain, confusion dizziness, diarrhoea, movement disorder, red-brown urine
Increase risk of falls a make drowsy
Increased risk of CV events when give with adrenaline, dobutamine
Increases exposure to levo + methyldopa

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12
Q

Ropinirole

A

Non-ergoline dopamine agonist
Parkinson’s disease (alone/adjunct to levodopa), Restless Legs Syndrome
Confusion, dizziness, GI discomfort, hallucination, movement disorders, compulsive behaviour
?orthostatic hypotension, fall asleep suddenly
Bisoprolol, captopril, chlorpromazine = increased risk of hypotension

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13
Q

Amitriptyline

A

TCA
Neuropathic pain, depression, migraine prophylaxis
Anticholinergic syndrome, drowsiness, QT interval prolongation
Increased risk of falls
Increases effect of adrenaline
Alcohol = increased risk hypotension
Alfentanil = CNS depressant

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14
Q

Co-beneldopa/carelodopa

A 
CC = levodopa + carbidopa (Sinemet)
CB = levodopa + benserazide (Madopar)
Levodopa = dopamine precursor
Carbidopa/benserazide =  dopa-decarboxylase inhibitor

Anxiety, arrhythmia, depression, diarrhoea, hallucination, dizziness, movement disorders, postural hypotension, compulsive behaviour
High risk of falls
Alcohol, BP medication = risk of hypotension

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15
Q

Trimethoprim

A

Antifolate antibiotic
UTI
(Co-trimoxazole = trimethoprime/sulfamethoxazole)
Diarrhoea, electrolyte imbalance, headache, skin reaction, vomiting
No impact on falls?
Nephrotoxicity with aciclovir
Hyponatraemia with amitriptyline

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16
Q

Tamsulosin

A

Alpha-1 adrenergic receptor antagonist
BPH
Dizziness, postural hypotension/micturition syncope, sexual dysfunction, asthenia, constipation, palpitations
Increases risk of falls
Basically all drugs increase risk of hypotension!

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17
Q

Oxybutynin

A

Antimuscarinic which reduces detrusor muscle activity = relaxes bladder = prevents urgency
Urinary frequency, urgency, incontinence
STOPP: delirium/dementia, narrow-angle glaucoma, chronic prostates, treating extrapyramidal side-effects of antipsychotics
Constipation, dizziness, dry mouth, flushing, headache, palpitations, skin reactions, vision disorders, vomiting
May cause dizziness/confusion = increased risk of falls
Cyclizine, haloperidol, hyoscine, nortryptiline, = antimuscarinic effect

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18
Q

Cinnarizine

A

Antihistamine + CCB
Vestibular disorders: vertigo, tinnitus, N+V in Meniere’s
Drowsiness, GI discomfort, nausea, increased weight
Risk of falls as sedating
Aripiprazole, bupivacaine, codeine, lorazepam = CNS depressant

19
Q

Baclofen

A

GABA-ergic agonist
Severe spasticity of cerebral/spinal origin, esp in palliative care
Conusion, constipation, dry mouth, hallucination, headache, hyperhidrosis, hypotension, paraesthesia, vision disorders, vomiting, bradycardia
Sedative + reduced muscle tone = increases risk of falls
Many many drugs= hypotension/CNS Depressant

20
Q

Digoxin

A

Cardiac glycoside, increases force of myocardial contraction + reduces AV node conductivity
Atrial flutter
HF
Risk of toxicity if eGFR<30
Arrythmia, cerebral impairment, diarrhoea, dizziness, skin reactions, vision disorders, vomiting
Increased risk of falls as causes bradycardia or other arrhythmia
Azithromycin, betamethasone, calcitriol, hydrocortisone = increases conc of digoxin + toxicity risk

21
Q

Doxazocin

A

Alpha-1 antagonist
HTN
BPH
Arrythmias, chest pain, cough, cystitis, dizziness, dry mouth, headache, oedema, increased risk of infection, palpitations, vertigo
Cause severe orthostatic hypotension = increased risk of falls
Many many drugs increase risk of hypotension

22
Q

Simvastatin

A

Competitively inhibit HMG CoA reductase, reducing cholesterol synthesis, especially in the liver
Primary/familial hypercholesterolaemia
Asthenia, constipation, diarrhoea, muscle toxicity (don’t start if CK>5x upper limit of normal), thrombocytopenia, sleep disorders
Increased risk of falls due to worsened muscle performance
Ciclosporin, grapefruit juice, verapamil = large increase in exposure to statin
Ciprofibrate, colchicine = increased risk of rhabdomyolysis
Paracetamol = increased risk of hepatic toxicity

23
Q

Clopidogrel

A

P2Y12 ADP receptor inhibitor antiplatelet
ACS
TIA if aspirin contraindicated
Diarrhoea, GI discomfort, Haemorrhage, Skin reactions
Increased risk of haemorrhage after fall
Increased risk of bleeding with other anti-thrombotic
Grapefruit juice decreases the exposure to clopidogrel

24
Q

Ibuprofen

A

NSAID and non-selective COX inhibitor
Pain
GI discomfort, skin reactions, asthma, hypersensitivity
Increased risk of falls as dizziness/vision impairment
Bendroflumethiazine = increased risk of hypoatrameia
Candesartan = increasesd risk of hyerkalaemia
Ceftriaxone = increased risk of nephrotoxicity
Dexamethasone = increased risk of GI bleeding

25
Q

Gabapentin

A

Anti-convulsant, inhibits release of excitatory neurotransmitters
Neuropathic pain
Seizure
Muscular sx in MND
Anxiety, altered appetite, confusion, constipation, drowsiness, GI discomfort, cognitive impairment, respiratory depression
Some potential impact on falls
Many drugs cause CNS depression

26
Q

Phenytoin

A

Sodium-channel blocker anti-epileptic
Tonic-clonic/focal seizures, status epilepticus
Nystagmus, decreased coordination, tremor, slowed cognition and movement, memory problems, slurred speech, poor concentration
Big risk of falls as drowsiness, dizziness
Amiodarone = peripheral neuropathy
CYP450 inducer = decreases exposure to many drugs (clozapine, edoxaban, fentanyl etc)

27
Q

Amiodarone

A

Class III antiarrythmic (K+ blocker)
Arrythmias, VF/pulseless VT
SFx = arrhythmia, hepatic disorders, hyperthyroidism, nausea, respiratory disorders, skin reactions
Big impact on fall risk = STOPP (higher risk than beta-blocker, digoxin, verapamil, diltiazem)
Avoid in Sino-atrial heart block/bradycardia, thyroid dysfunction, acute porphyrias, HF, hypokalaemia, severe bradycardia

28
Q

Levetiracetam

A

Anti-epileptic
Focal seizures, adjunct for myoclonic/tonic-clonic seizures
Dizziness, headache, irritability, loss of strength + energy, mood + behaviour change, sleepiness
Increase risk of falls
Many drugs, morphine etc = CNS depressants too
Decreases clearance of methotrexate

29
Q

Sodium valproate

A

Anti-epileptic which increases GABA transmission
Nausea, diarrhoea, swollen gums, tremors, nystagmus, sleepiness, headache, weight gain hair thinning, irregular periods
Increased risk of falls
Atorvastatin, isoniazid = increased risk of hepatotoxicity
CYP450 inhibitor = increases exposure to many drugs

30
Q

Isosorbide mononitrate

A

Prodrug for nitric oxide, which is a vasodilator gas released when IM is metabolised = relaxation of smooth muscle cells
GTN spray/tablet/patch is similar
Angina
STOPP: long-acting nitrate with persistent postural hypotension = risk of syncope and falls
Headaches, dizziness, weak/sleepy, nausea, flushing, oedema, acute angle closure glaucoma
May cause falls due to syncope
BP tablets and others = increased risk of hypotension

31
Q

Gliclazide

A

Sulphonylurea
T2DM
STOPP if long-acting in T2DM as risk of prolonged hypoglycaemia
Abdo pain, diarrhoea, hypoglycaemia, nausea
Can cause hypoglycaemia = falls
Other DM medication = hypoglycaemia
Chloramphemicol = increases exposure to gliclazide
Rifampicin = decreases exposure to gliclazide

32
Q

Codeine phosphate

A

Selective agonist at mu opined receptor (weaker affinity than morphine)
Pain
STOPP: if without laxative/no need/long-acting without breakthrough relief
Respiratory depression, arrhythmia, confusion, palpitations, urinary retention, vertigo, dependence = taper, biliary spasm, postural hypotension, sexual dysfunction
Big impact on falls
Most impact on CNS depression
Buprenorphine = increases risk of opiate withdrawal when given with morphine
Clozapine = constipation

33
Q

Ramipril

A

ACEi
HTN
Dry cough, dizziness, headaches, diarrhoea, vomiting, rash, blurred vision
Risk of falls, check for postural hypotension
Many drugs = risk of hypotension
Ramipril + aliskiren/amiloride = hyperkalaemia risk
Azathioprine = risk of anaemia/leucopenia

34
Q

Furosemide

A

Loop diuretic
Oedema, resistent hypertension
STOPP: use other antihypertensive, urinary incontinence (may make it worse), oedema without HF (compression stockings instead)
Increased urinary frequency
Thirst, dry mouth, headache, confusion, dizziness, nausea/vomting, electrolyte imbalance, muscle spasm, deafness
Increases risk of falls - orthostatic hypotension, weakness (hyponatraemia + hypokalaemia)
Cardiac glycosides (digoxin), Amiodarone, clarithromycin, flecainide = hypokalaemia
Indometacin = hyponatraemia
Many drugs = hypotension

35
Q

Bisoprolol

A

Beta-blocker
HTN
STOPP: bradycardia, type II heart block, DM with lots of hypos, asthma + non-selective one
Headaches, dizziness, cold hands/feet, n/v, constipation
Increases risk of falls (bradycardia, hypotension, carotid sinus hypersentivitiy, orthostatic HTN, vasovagal syncope)
Many drugs, esp anti-hypertensives = hypotension
Amiodarone = cardiovascular events
Diltiazem/digoxin = bradycardia

36
Q

Mirtazapine

A

Tetracyclic antidepressant
Major depression, OCD, anxiety
Dry mouth, increased appetite + weight gain, headaches, sleepiness, n/v, diarrhoea, constipation
High risk of falls, due to drowsiness, blurred vision, dizziness, constipation, urinary retention
Consider alternative if possible, to SSRI
Many drugs = CNS depressants
Bupropion, Citalopram, fentanyl = risk of serotonin syndrome
Carbamazepine = decreases exposure to mirtazapine

37
Q

Sertraline

A

SSRI
Depression, panic disorder, PTSD
Nausea, headaches, unable to sleep, sleepiness, diarrhoea, dry mouth, dizziness, tiredness, weakness
May cause falls with orthostatic hypotension + bradycardia, but rare
Aspirin and many others = risk of bleeding
Bendroflumethiazide = hyponatraemia
Bupropion, tramadol = serotonin syndrome

38
Q

Aspirin

A

Acetylsalicylic acid, blocks prostaglandin synthesis, non-selective for COX-1 and 2
Secondary prevention of CVD
Unstable angina, NSTEMI
STEMI
TIA
AF if anticoagulation risk too high
Migraine, pre-eclampsia
Indigestion, bleeding, dyspnoea, SCARs, skin reactions, aplastic anaemia
Risk of bleeding after fall
NSAID, anti-platelets etc = increased risk of bleeding

39
Q

Dabigatran etexilate

A

direct thrombin inhibitor with rapid onset of action
Prophylaxis of VTE
Prophylaxis of AF if have risk factors for stroke
Not if anti-phospholipid syndrome as warfarin better
STOPP: bleeding risk/severe HTN, DVT/PE without continuing risk factors, dual therapy in CVD as no proven added benefit, eGFR <30
Anaemia, diarrhoea, GI discomfort, haemorrhage, abnormal LFTs, nausea
Risk of bleeding if fall?
Aspirin etc = risk of bleeding
Phenytoin, St John’s wort = decreases exposure to Dabigatran (CYP450 inducer)

40
Q

Warfarin

A

Vitamin K antagonist
Prophylaxis after VTE/PE
TIA
STOPP: bleeding risk/severe HTN, DVT/PE without continuing risk factors, dual therapy in CVD as no proven added benefit
Haemorrhage (mild or serious), rash, hair loss, nausea/vomiting
Increases bleeding risk if fall
Green vegetables, green tea, alcohol consumption = can alter anticoagulant control
Pomegranate juice = increases INR
Many medications inc anticoagulants + sertraline = increased bleeding risk
Prednisolone = increases effect of warfarin
Rifampicin = decreases effect of warfarin

41
Q

Senna

A

Stimulant laxative
Constipation
Contraindicated = intestinal obstruction, undiagnosed abdo pain
Stomach cramps, diarrhoea, red-brown urine, anaphylaxis
Senna may increase rushing to toilet = falls (?)
Furosemide/digoxin = Senna can decrease K+
Warfarin/COCP = diarrhoea from Senna stops absorption of drug

42
Q

Selegiline hydrochloride

A

Monoamine-oxidase-B inhibitor = enhances dopaminergic activity as less dopamine broken down
Parkinson’s disease
HTN if take with tyrosine-rich foods (mature cheese, salami, Bovril, Oxo, Marmite, beers/wines etc)
Arrythmias, confusion, constipation, depression, dry mouth, muscle cramps, nasal congestion, tremor, vertigo, hypotension, sudden daytime sleepiness
Increases risk of falls
Amantadine, anti-hypertensives etc = hypotension
Bisoprolol etc = bradycardia
COCP = increase selegiline exposure
Dopamine, dobutamine = hypertensive crisis
Duloxetine = serotonin syndrome

43
Q

Lorazapam

A

Short-acting benzodiazepine
Anxiety, difficulty sleeping, panic attacks, status epilepticus
STOPP: 4 weeks or longer (no need, withdraw over 2 weeks)
Acute/chronic T1/2 resp failure
If prone to falls (as sedative = reduce sensorium + impair balance)
Sleepy/tired, muscle weakness, coordination problems, respiratory depression, hallucinations, mood changes, amnesia
Increases risk of falls (as can cause drowsiness which can last into next day, confusion, lightheadedness, amnesia)
Many drugs inc opioids, lamotrigine, amitriptyline, zopiclone = CNS depressant

OPIC Drugs (1 decks)

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