Top 100 Drugs Flashcards
1
Q
5a reductase inhibitor
1. Examples
2. Indications
3. Mechansim of action
4. Side effects
5. Warnings
6. Interactions
7. Communications
8. Monitoring
A
- Examples
- finasteide
- dutestride - Indications
- benign prostatic hyperplasia - Mechansim of action
Inhibiting the enzyme 5a reductase. Converts testosterone to dihydrotestosterone - stimulates prostatic growth.
Takes a while. Therefore alpha blockers are usually preferred as they work quicker. - Side effects
Due to its anti-androgenic action -
- impotence
- decreased libido
- gynaecomestia and breast tenderness
- hair growth
- breast cancer has also been reported. - Warnings
Pregnant women should not handle these.
Exposure of the drug to male fetus can cause abnormal development to the male genitalia. - Interactions
None - Communications
- may take up-to 6 months for the symptoms to improve
- symptoms don’t last. They improve. - Monitoring
None
2
Q
Acetylcholinestrase inhibitor
1. Examples
2. Indications
3. Mechansim of action
4. Side effects
5. Warnings
6. Interactions
7. Communications
A
- Examples
- donepazil
- Rivastigmine
- galantanine - Indications
- Mild to moderate Alzheimer’s
- Mild to moderate dementia in Parkinson’s disease (rivastigmine) - Mechansim of action
Acetylcholine is needed for brain function like learning and memory. The drugs work by inhibiting the enzyme that breaks the acetylcholine. Which makes the neurotransmitter more available to improve cognitive function and decrease cognitive decline. - Side effects
- pts with asthma or COPD may experience exacerbation of symptoms.
- peptic ulcers and bleeding
- bradycardia and heart block
- hallucinations
- altered/aggressive behaviour
- EPS/ neuroleptic malignant syndrome (small risk) - Warnings
Caution - asthma/COPD/ peptic ulcers
Avoid - sick sinus syndrome/ heart block
Rivastigmine can worsen the tremors in Parkinson’s disease. - Interactions
-NSAIDS
- corticosteroids
- antipsychotic (increased risk of malignant syndrome)
- b-blockers (bradycardia and heart block) - Communications
- donepazil should be taken right before bedtime - vivid dreams have been reported with donepazil. In this case take in the morning instead of nighttime.
- side-effects are reversible by reducing dose or stopping treatment.
3
Q
Acetylcysteine
1. Examples
2. Indications
3. Mechansim of action
4. Side effects
5. Warnings
6. Interactions
7. Communications
A
- Example
None - Indications
- paracetamol poisoning
- help prevent renal injury due to contrast nephropathy.
- reduce the viscosity of respiratory secretions - Mechansim of action
- works by replenishing the body’s glutathione. In paracetamol poisoning the glutathione supply is depleted.
- also breaks the disulphide bonds in the mucus making it less viscous - Side effects
- IV can cause anaphylactic reactions
- bronchospasm so in COPD a salbutamol should be given immediately before - Warnings
Specialist advise should be used if the patient has a history of anaphylactoid reaction to acetylcystine. - Interactions
None - Communications
For paracetamol poisoning weight adjusted doses are given over 21 hours as 3 components.
Can cause a reaction - rash, nausea and wheeziness. To interrupt the treatment if this occurs.
4
Q
Alpha blockers
- Examples
- Indications
- Mechansim of action
- Side effects
- Warnings
- Interactions
- Communications
A
- Examples
Alfuzosin, doxazosin, tamsulosin - Indications
- benign prostatic hyperplasia
- resistant hypertension - Mechansim of action
a1 adrenoreceptors are found in the smooth blood vessels and the urinary tract. Alpha blockers therefore cause relaxation of blood vessels - vasodilation and reduced resistance to bladder outflow. - Side effects
- postural hypotension
- dizziness and syncope - Warnings
Should not be used in patients with postural hypotension - Interactions
Drugs that cause hypotension. - Communications
To take the first dose at bedtime. And if they need to get up at night then to rise from the bed slowly.
5
Q
Adenosine
- Examples
- Indications
- Mechansim of action
- Side effects
- Warnings
- Interactions
- Communications
A
- Examples
None - Indications
- Rapid reversal to sinus rhythm in SVT - Mechansim of action
- increases the refractory period in the AV node so slows down the tachycardia and also breaks the re-entry circuit.
- short duration 10 seconds - Side effects
- bradycardia
- asystole (pts say it feels like a sinking feeling in the chest)
- breathlessness (sense of impending doom) - Warnings
- contra-indicated in hypotension, coronary ischaemia, decompensated heart failure.
- avoid in asthma and COPD
- patients with heart transplant and sensitive to adenosine. - Interactions
- lower doses with dipyridamole (halved)
- higher dose with theophylline and aminophylline (competitive antagonists) - Communications
- works by resetting the heart.
- briefly makes the patient feel bad. Around 30 seconds
6
Q
Adrenaline
1. Examples
2. Indications
3. Mechansim of action
4. Side effects
5. Warnings
6. Interactions
7. Communications
A
- Examples
- none - Indications
- cardiac arrest
- anaphylaxis - Mechansim of action
- potent agonist of alpha1, alpha2, beta1 and beta2 adrenoreceptors.
Beta1 in heart - increases heart rate and force of contraction
Beta2 in blood vessels - vasodilation of vessels supplying the heart and muscle
Beta2 in lungs - bronchodilation and suppression of inflammatory mediator release from mast cells. Helps in anaphylaxis.
Alpha1 - vasoconstriction - ^ blood flow to the heart and hypertension - Side effects
- adrenaline induced hypertension in cardiac arrest
- anxiety, tremor, headache, palpitations
- angina, MI and arrhythmias - Warnings
Not many contra-indications in cardiac arrest or anaphylaxis. Cautioned in pts with heart disease. - Interactions
- beta-blockers - may induce widespread vasoconstriction - Communications/practice
Roses for anaphylaxis
7
Q
Aldosterone antagonists
A
8
Q
Alginates and antacids
A
9
Q
Allopurinol
A
10
Q
Aminoglycosides
A
11
Q
Aminosalicylates
A
12
Q
Amiodarone
A
13
Q
ACEi
A
14
Q
ARBS
A
15
Q
Antidepressant - SSRI
A
