top 100 drugs

Question 1

bendroflumethiazide
(thiazide like diuretic)

Answer 1

DCT- blocks Na/Cl transporter.
decreaces blood volume + pressure

I: 1st line Rx for HTN, or add on for HTN with CCB.
odema

Contraindications: Allergy, addisons, hypercalcaemia,hyponatremia, inc uric acid. severe renal impairment.

Route of admin: oral

Adverse effects: hypokalaemia, caardiac arrythmia, hypotension, hyponatraemia. inc glucose plasma concentrations.

Question 2

Atorvostatin

Answer 2

M: competative inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase- decrecing cholesterol synth in the liver.

I: high cholesterol, those at high CVS risk. 2nd prevention.

C: allergy, pregnancy/ lactation, liver faliure. (caution) renal impairment.

R: Orally

A: Myositis, myopathy, dizzy, constipation, GI upset, (muscle upsets).
Alopecia, hepatic disorders, pancreatitis, memory loss,

Question 3

clopidogrel

Answer 3

M:ADP irreversable inhibitor- prevents platelet aggregation

I: ACS, stent placement, PAD,prevention post MI(30/7) stroke (6/12)

C: allergy, bleeding, 1/52 before surgery, any hemoragic stroke, other clotting disorder, peptic ulcer

R: oral

A: blreding, GI symptoms, thombotic, thrombocytopaenic purpurma, leukpenia, dec platelets.

Question 3

adrenaline

Answer 3

M: Acts on both alpha and beta receptors, increacing heart rate and contactility. periferal and vasoconsdtiction.

I: anaphylaxis, CPR, Hypotension, bradycardia post MI,priaprism.

C: no absolute contras, some cautions: closed angle glaucoma, anesthsia, VF,cor pulmonale,

R: IM, IV (caution) droplets,

A: cardiommyopathy, muscle necrosis/ nec fash, hemiplegia musce rigidity.

Question 3

Metformin

Answer 3

a Biguanides medication

M: phosphorylates GLUT 4 in peripheral tissue
reduces gluconeogenesis in the liver
reduces intestinal absorption of glucose.

I: pts older than 10 with T2DM.

Contraindication/ caution: Very low BMI. severe liver or kidney disease. eGFR lower than 30.creatinine over 150.

R: Oral.

A: Lactic acidosis, GI upset, anorexia, bloating, flatulence, epigastric pain.

Question 3

Sulfonylureas (gliclazide, glimepride, glipizide)

Answer 3

M: Binds to SUR1, closes ATP-K channel. depolarises B cell, VGCC open–> release insulin. (need enough B cells to work)

I: T2DM with surviving B cells. Not for pregnancy.

C: pregnancy, liver failure, ketoacidosis

R: Oral

A: weight gain, interacts with warfrin, hypoglycaemia, SIADH, Anaemia.

Question 3

ceftriaxone (caphlasporin antibiotics)

Answer 3

M: Beta lactam binds to PBP in cytoplasmic membrane, inhibiting cell wall synthesis.

I: Broad spectrum antibiotic for use against suspected infections.

C: hypercalciuria, kidney stones. risk of nephrotoxicity. do not give concominant calcium infusions. hyperbilirubinaemia, neonates.

R: IV, IM.

A: Abdominal pain; diarrhoea; dizziness; eosinophilia; headache; leukopenia; nausea; neutropenia; pseudomembranous enterocolitis; skin reactions; thrombocytopenia; vomiting; vulvovaginal candidiasis

Question 3

methotrexate

Answer 3

M: dihydrofolate reductase inhibition- leading to prevention of nucleotide synthesis(purines and pyrimadines) . leading to an accumulation of adenosine triphosphate and adenosine in the extracellular space, stimulating adenosine receptors, leading to anti-inflammatory action

I: Chrons, Psoriasis, Rheumatoid arthritis, neoplastic diseases.

C: Active infection; ascites; immunodeficiency syndromes; significant pleural effusion, pregnancy, breast feeding. atypical antipsychotics. (absolute
Relative: dehydration, peptic ulceration, ulcerative processes. chirrosis,

R: Intra-arterial; Intramuscular; Intrathecal; Intravenous, oral, subcut,

A:Seizure.
anaemia; appetite decreased; diarrhoea; drowsiness; fatigue; gastrointestinal discomfort; headache; increased risk of infection; leucopenia; nausea; oral disorders; respiratory disorders; skin reactions; throat ulcer; thrombocytopenia; vomiting

Withdraw treatment if ulcerative stomatitis develops—may be first sign of gastro-intestinal toxicity.

Question 4

systemic corticosteroids (pred, dex etc)

Answer 4

m: bind to glucocorticoid receptor bring about changes in gene expression. (inhibit phospholipase A2–> prevent arachidonic acid, inhibit NfKb transcription factors). decreaces lymphs, monocites. some mineralocorticoid actions (not dex)

I: acute otitis media and acute otitis externa. High dose is immunosuppressant. low dose is anti inflammatory.
adrenal insufficiency

C: Systemic infection, live vaccines. Active ocular herpes simplex (in adults); active or suspected ocular infection (in adults); active or suspected periocular infection (in adults); rupture of the posterior lens capsule in patients with aphakia, iris or transscleral fixated intra-ocular lens or anterior chamber intra-ocular lens (in adults); uncontrolled advanced glaucoma (in adults)

R: All routes really.

A: adrenal suppression, inc susceptibility to infections, worsening chickenpox, psychiatric reactions, discomfort, altered tase, necrotising retinitis, htn, hypokalaemia, hypernatraemia

Question 5

Aminoglycoside (Gent, amikacin, neomycin)

Answer 5

M: bind to 30s subunit on ribisome preventing protein creation. it is bacteriocidal. enter through o2 dependant transport system. primeraly gram -ve. aerobics.

I: infection (uti, resp, meningitis, ottitis externa)

C: myasthenia gravis, muscular disorders. pregnancy. renal impairment, nsaids
Caution in neonatals

R: IV, IM, topical. intrathecal

A: ototoxicity, dec appetite, nephrrotoxicitty. neurotoxicity,

Question 6

Penicillins, antipseudomonal
(piperacillin & tazobactam)

Answer 6

M: binds to PBP in cell wall synth. anaerobic

I: severe inf, hospital aquired infections.

C: C-diff risk patients.
penicillin allergy.
renal impairment.
reduce methotrexate excretion, enhance warfarins effects.

R: IV.

A: GI, CDiff, cholitis, colonic perforation.

they are extended scope against gram negative.
give both, to allow PIP to work (tazo - is a betalactimase inhibitor)

Question 7

Antihistamines (H1-receptor antagonists)
cetirizine, fexofenadine, loratadine, chlorphenamine

Answer 7

M: H-1 receptor antagonist. smooth muscles, on vascular endothelium, heart, CNS. The H1 receptor is linked to an intracellular G-protein (Gq) that activates phospholipase C and the inositol triphosphate (IP3). stops Nf-Kb being released.

I: Rhinitis, urticaria

C: breast feeding. eGFR >10.

R: oral

A: headache, dry mouth, drowsiness, and fatigue. agitation/ restlessness. rare: tacycardia + edema

chlorphenamine- can be given IM, IV> for use in anaphylaxis. can cause epilepsy, coordination issues. drowsyness.

Question 8

oxygn (emergency drug list)

Answer 8

M: binds to haemaglobin in red blood cells and gets distributed around the body
I: reduced sp02 or Pa02

C: neonates- can cause retinal angeogenesis
Fi02 of more than for 48 hs can cause pulmonary fibrosis
paraquat ( a herbiside) poisoning is worsened by o2 therapy.

R: inhailed

A: care in COPD- hypercarbia pts resp drive suppression may occur. systemic vasoconstriction due to hyperoxia

Question 9

salbutamol

Answer 9

M: beta-2 receptor agonists. bronchodilation,

I: asthma, uncomplicated premature labour, bronchospasm (allergen or other)

C: Abruptio placenta , antepartum haemorrhage, cord compression eclampsia, history of cardiac disease, intra-uterine fetal death, intra-uterine infection, placenta praevia, pulmonary hypertension, severe pre-eclampsia, significant risk factors for myocardial ischaemia, threatened miscarriage.

R:inhilation (powder, aerosol), nebuliser, iv infusion, iv injection, subcut/ IM injection.

A:arrythmia, hyperglycaemia, QT prolongation, HTN, pre-ecclampsia

Question 10

Penicillins, broad-spectrum (co-amoxiclav, amoxicillin)

Answer 10

M: amoxicillin is a B-lactam antibiotic. Clavulanic acid (co-amox) is a b-lactamase inhibitor. bactericidal

I: otitis media, streptococcal pharyngitis, pneumonia, cellulitis, urinary tract infections, and animal bites, part of H pylori infection

C: history of co-amoxiclav associated hepatitis or jaundice. cephlasporins. caution in ALL, CML, EBV.

R: Oral, IV.

A: diarrhea, vomiting, and allergic reactions. yeast infections, headaches, and blood clotting problems.

Question 11

Macrolides (clarithromycin, azithromycin, erythromycin)

Answer 11

M: bind to the 50S subunit of ribosomes and cause cessation of bacteiral protein synth. bacteriostatic

I: acute otitis, pharyngitis, tonsillitis, respiratory tract infections, uncomplicated skin infections, and helicobacter pylori infection.

C: QT elongation, aggravate myasthenia gravis, avoid 1st tri preg / breastfeeding

R: Oral, IV

A: Appetite decreased; diarrhoea; dizziness; gastrointestinal discomfort; gastrointestinal disorders; headache; hearing impairment (ototoxicity); insomnia; nausea; pancreatitis; paraesthesia; skin reactions; taste altered; vasodilation; vision disorders; vomiting

Question 12

paracetamol

Answer 12

M: mild Cox 1+2 inhibitor. also acts on receptors via its metabolite (cannabinoid receptors)

I: mild to moderate pain and fever

C: (cautions) hepatotoxicity, BW under 50KGs, co administratin of enzyme inducing antiepileptic meds. chronic alcohol/ acute alcohol consumption.

R: mouth, rectum, iv,

A: thrombocytopaenia, overdose, naphortoxicity, haem, some metabolic/ electrolite dysfunction.

Question 13

Non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors

Answer 13

M: inhibiting COX therefore reducing the prostaglanding and cytokine mediated inflammation

I: mild to mod pain, swelling, pyrexia

C: history of GI bleed/ ulcers. kidney disease, pregnancy/ breastfeeding, heart faliure, liver faliure.

R: oral, topical, injectable

A: GI, N+V, abdo pain, headache, dizzyness

Gi bleed, kidney dysfunction, CVS events, HTN, allergies.

Question 14

IRON

Answer 14

M: increaces the amount of iron in the body for absorbtion and utilisation

I: iron deficiency anaemia/ prophylaxis

C: no high doses in elderly

R: tablets of capsules

A: constipation, GI,

Question 15

folic acid

Answer 15

M: metabolised and used in the building of purine and thymadine nucleaic acids

I: Folate-deficient megaloblastic anaemia, prevention of neural tube defects, prevention of methotrexate side effects, prophylaxis in dialysis, + parenteral infusion

C: never given alone for pernicious anaemia or megaloblastic anaemias (may precipitate subacute combined degeneration of the spinal cord)

R: oral, IV

A: abdo distension, dec appetite, flatulance, vit b12 deficiency exacerbation.

Question 16

trimethoprim

Answer 16

M: blocks production of tetrahydrofolic acid- bacteriostatic.

I: UTI (uncomplicated), RTI, acne, prostatitis, pyelonephritis, PCP.

C: 1st trimester pregnancy.
folate, deficiency. Caution in HIV.

R: Oral, Iv

A: GI, hyperK, megaloblastic anaemea, blood disorders, errythema multiforme

Question 17

Benzodiazepienes (Midazolam, loraz)

Answer 17

M: binds to GABA receptor causing a change and increace in activity. This lets Cl into the nerve and makes it harder to depolarise. bind to A/Y interface.

I: epilepsy, sedation, combined anaesthesia, antipsychotic adjunct, convulsions in pal care.

C: acute pulmonary insifficiency, neuromusc resp weakness, not use alone in psychosis, depression

midazolam specifically- contraindicated in cns depression, compromised airway, resp depresison.

R: subcut, iv, im, buccal

A: dec alertness, anxiety, ataxia, confusion, depression, dizzy, drowsy, fatigue, dysarthira, hypotension, muscle weakness, mood altering, nausea, resp depression.

generally dont reverse them in a mixed overdose as can be protective against seziures.

Question 18

amlodipine

Answer 18

Mechanism of action
It is a drug to reduce BP and treat coronary artery disease
Amlodipine is an oral dihydropyridine calcium channel blocker
It works by blocking the voltage-dependent L-type calcium channels of heart and blood vessels, thereby inhibiting the initial influx of calcium

Indications
Hypertension
Chronic stable angina
Vasospastic angina
Angiographically documented coronary artery disease

Contraindications
cardiogenic shock, severe aortic stenosis, unstable angina, severe hypotension, heart failure, and hepatic impairment.

Route of administration
orally , suspensions created from oral tablets

Adverse reactions
Peripheral oedema, heart failure, pulmonary oedema, flushing, dizziness, headache, drowsiness, skin rash, nausea, abdominal pain, and constipation

Question 19

frusomide

Answer 19

loop diuretic
hypertension and oedema in congestive heart failure, liver cirrhosis, renal disease, and hypertension

diuresis by blocking tubular reabsorption of sodium and chloride in the proximal and distal tubules and in the thick ascending loop of Henle.

competitive inhibition of
sodium-potassium-chloride cotransporters (NKCC2)

As with other loop diuretics, furosemide decreases the excretion of uric acid

Indications
oedema, congestive heart failure, cirrhosis of the liver, and renal disease.
Oral furosemide is indicated alone for the management of mild to moderate hypertension or severe hypertension in combination with other antihypertensive medications
Intravenous furosemide is acute pulmonary oedema
CCF

Contraindications
allergies to furosemide
anuria.

Route of administration
Oral, I.V., or S/C.

Adverse reactions
Increased urination
Signs of dehydration
Confusions/dizziness
Headaches, nausea, vomiting
Inflammation if the kidneys
Pancreatitis
Ototoxicity
blood volume reduction, dehydration, electrolyte imbalance, hypotension, hypochloremic alkalosis, and hypokalaemia.

Question 20

alpha blockers (tamsulosin, doxazosin, alfuzosin)

Answer 20

M: block alpha receptors, post synaptinc reduction in blood pressure, additionally some can be used for benign prostatic hyperplasia.

I: HTN, benign prostatic hyperplasia

C: micturition syncope, postural htn, monotherapy in patients with overflow bladder issues.

R: oral

A: arrythmias, chest pain, cough, dizzy, drowsy, hypotension, dry mouth, gi discomfort, headache.

Question 21

typical psychotics (Haloperidol)

Answer 21

M: block D2 receptors for long periiods when compared to atypical. + other dopamine receptors in brian - less specific. - also serotonin + histamine.

I: schitzophrenia, other psychotic disorders. OCD, tourettes, huntingtons. reduce nausea + vom. (pal care)

C: parkinsons, long QT, cvs disease.

R: oral, + IM or other depending on drug. halo- short IM

A: long QT, extra pyramidal side effects- parkinsonian features, NMS. antimuscarinic effects.

Question 22

atypical psychotics (clozapine, apriprazole, alanzapine, respiridone)

Answer 22

M: block D2 receptors in the brain, can block serotoinin as an extra. (d2 reduced extra pryamidal symptoms) rapdidly dissociate from receptor.

I: psyosis, major depression, acute onset agitation.

C: QT prolongation
bone marrow disorders- espesh agranulocytosis. uncontrolled epilepsy

R: oral + others depending on drug (apriprazole IM)

A: weight gain, DM, hyperlipidaemia. QT prolongation.
sexual dysfunction.