Uses Flashcards
Which class of drug is drug of choice for prophylaxis of Deep Vein Thrombosis
DOAC
Which drug is drug of choice for prophylaxis of thrombosis in non-valvular atrial fibrillation
DOAC
Which drug is drug of choice for Deep Vein Thrombosis
Low molecular weight Heparin
Which drug is drug of choice for prophylaxis in atrial fibrillation with mechanical valve
Warfarin
Antidote:Dabigatran
Idarucizumab
Antidote:Oral Xa inhibitor
Andexanet alfa
Alpha glucosidase inhibtors are used in
Type 2 DM
Hypertension
Cardiac disease
(Delay the onset)
Reduce post prandial hyperglycemia
(Delay digestion of carbohydrates)
Drugs which are GLP 1 agonists
Exendin-4
Exenatide
Lixisenatide
Drugs which are GLP 1 analogues
Liraglutide
Semaglutide
Albiglutide
Dulaglutide
Uses of GLP 1 analogues
Maintenance in DM 2
Drugs which are GLP 2 analogue
Tedaglutide
Use of teduglutide
Short Bowel Syndrome
(Decrease gastric emptying)
Gliptins can be used in combination with (4)
Sulfonylureas
Metmorfin
TZDs
Insulin
Amylin analogue
Type 1 and 2 DM
(Decrease post prandial hyperglycemia)
Use of short acting insulin? (3)
Mimic prandial relase of insulin and control post prandial hyperglycemia
Swift correction of elevated glucose
Conjuction with basal insulin to correct fasting glucose
Intermidiate acting (2)
Type 1 and 2 DM: Basal control
Conjuction with short acting for Meal time control
Long acting
Basal control
IV regular Insulin (2)
Diabetic Ketoacidosis
Hyperkalemia
Pramlintide
(2)
Supplement meal time insulin injection in Type 1 and 2 DM
Additional: reduce Body weight
Uses of Meglitinides
Post prandial hyperglycemia
Metformin (Biguanides)
(5)
Insulin Resistance in DM
PCOS
Obese patients
Metabolic Syndrome
NAFLD
Pioglitazone
(Thiazolidinediones)
2nd/3rd line for Type 2 DM
High-risk hypoglycemic patients
Monotherapy or combination when 1st line contraindicated
Which thiazolidinediones are banned and why?
Roziglitazone for myocardial infarctiob
Troglitazone for hepatotoxicity
SGLT2 inhibitors
Heart Kidney disease Weight
DM 2 treatment
(Combination)
Reduce CVS events
Decrease risk of ESRD
Diabetic nephropathy and albuminuria
Weight loss
Growth Hormone
Uses
- Length
Gestational Age baby: SMALL
Children: growth failure
Adults: Replacement
DWARFISM
NOONAN
PRADER WILLI
TURNER
- MASS->AIDS Wasting (Cachexia)
3.GIT MALABSORPTION →Short Bowel Syndrome
- RENAL → CHRONIC RENAL insufficiency
5.Anti-Ageing
(Off-label)
atheletes
old individuals
Growth hormone
GH
GIT
Tumors
Diagnosis Specfic
Adrenal Gland Specific
ACROMEGALY
SECRETORY DIARRHEA
FLUSHING episodes
OESOPHAGEAL Varices bleeding
(Acute)
CARCINOID
SOMATOSTATINOMA
GRFoma
VIPoma
Glucagonoma
Thyrotroph adenoma
(Octeroide)
Carcinoid tumor
Pituitary adenoma
(Paserotide)
CUSHING’S DISEASE
(Decrease ACTH)
Which drug is used for induction of ovulation in PCOS
Urofollitropin
Gonadotropins
1.Infertility: Ovulation
- Amenorrhea
Which drug is used intanasally for supression of endogenous FSH and LH so that external controlled Gonadotropins can be used
Nafarelin
Docusates
It is a mild laxative; especially indicated when straining at stools must be avoided.
Sodium picosulfate has been used Along
with which drug has been used
to evacuate the colon for colonoscopy and
colonic surgery.
mag. citrate solution
In combination products with a with which drug is Senna it is useful in treating opioid-induced constipation
docusate-containing stool softener,
Prucalopride
Colonic transit and stool frequency
is improved in constipation-predominant IBS.
the treatment of
chronic constipation in women, when other laxatives fail
to provide adequate relief
Lubiprostone when and diseases
recommended only in patients
who have not improved adequately by other measures,
including laxatives of at least two classes.
constipation-
predominant IBS and in idiopathic chronic constipation.
Saline Purgatives
However, they may be employed when constipation is to be relieved urgently and for preparation of bowel before surgery, colonoscopy; in food/drug poisoning and as after-purge in the treatment of tapeworm infestation.
Lactitol
Lactitol is indicated as an alternative to lactulose for the treatment of constipation and hepatic encephalopathy.
Laxatives indications
Functional constipation Constipation is infre quent production of hard stools requiring straining to pass, or a sense of incomplete evacuation.
Bedridden patients (myocardial infarction, stroke, fractures, postoperative): bowel movement may be sluggish and constipation can be anticipated.
To avoid straining at stools (hernia, cardio vascular disease, eye surgery) and in perianal afflictions (piles, fissure, anal surgery) it is essential to keep the faeces soft. One should not hesitate to use adequate dose of a bulk forming agent, lactulose or docusates.
Preparation of bowel for surgery, colono scopy, abdominal Xray The bowel needs to be emptied of the contents including gas. Saline purgative, bisacodyl or senna may be used.
- After certain anthelmintics (especially for tapeworm) Saline purgative or senna may be used to flush out the worm and the antihelmintic drug. Fixed dose combinations of an anthelmintic (other than piperazine) with a purgative is banned in India, as are laxatives with enzyme preparations. 6. Food/drug poisoning
The idea is to drive out the unabsorbed irritant/poisonous material from the intestines. Only saline purgatives are satisfactory.
Dicyclomine
prophylaxis of motion sickness and for
morning sickness
Combination
of these antihistaminics with other antiemetics
has been used in chemotherapy-induced nausea
and vomiting (CINV).
Promethazine, diphenhydramine, dimenhydri-
nate
By
their central anticholinergic action they block the
extrapyramidal side effects of metoclopramide
while supplementing its antiemetic action.
Which drugs supplement metoclorpramide?
Promethazine, diphenhydramine, dimenhydri-
nate
it is specifi-
cally promoted in India for ‘morning sickness’
(vomiting of early pregnancy),
doxylamine + pyridoxine
Which drug is used for vertigo by inhibiting Calcium influx from endolymph into the vestibular sensory cells
which mediates labyrinthine reflexes.
Cinnarizine
What protects
against sea sickness for nearly 24 hours.
Meclizine
NEUROLEPTICS
(a) Drug induced and postoperative nausea and
vomiting (PONV).
(b) Disease induced vomiting: gastroenteritis,
uraemia, liver disease, migraine, etc.
(c) Malignancy associated and cancer chemothe-
rapy (mildly emetogenic) induced vomiting.
(d) Radiation sickness vomiting (less effective).
(e) Morning sickness: should not be used except
in hyperemesis gravidarum
Metoclorpramide
Anti-emetic:postoperative, drug induced, disease associated
(especially migraine), radiation sickness,
prophylaxis and treatment
of vomiting induced by emetogenic anticancer
drugs (cisplatin, etc.).
Gastrokinetic: To accelerate gastric emptying:
(a) When emergency general anaesthesia has
to be given and the patient has taken food
less than 4 hours before.
(b) To relieve postvagotomy or diabetic gastro-
paresis associated gastric stasis.
Dyspepsia and other functional g.i. dis-
orders: symptomatic relief may obtained.
Metoclopramide may succeed in stopping
persistent hiccups.
4. Gastroesophageal reflux disease (GERD)
Metoclopramide may benefit milder cases
of GERD, but is much less effective than
PPIs/H2
blockers
Domperidone
antiemetic
for mild-to-moderate cases of postoperative, drug
and disease induced nausea and vomiting
Mosapride
Nonulcer dyspepsia,
diabetic gastroparesis, GERD (as adjuvant to
PPIs), and some cases of chronic constipation.
it is more
effective in suppressing delayed vomiting occur-
ring between 2nd to 5th days, probably because
of its longer duration of action (elimination
t½ is 40 hours). It is the only drug of this
class approved by US-FDA for delayed CINV.
Moreover, antiemetic efficacy is maintained
during repeat cycles of chemotherapy.
Palonosetron
Oral
aprepitant (125 mg + 80 mg + 80 mg over 3
days) combined with standard i.v. ondansetron
+ dexamethasone regimen significantly enhanced
the antiemetic efficacy to protect upto 90%
patients against
high emetogenic cisplatin based
chemotherapy.
Delayed onset CINV
Aprepitant
given before chemotherapy as adjuvant
to metoclopramide or ondansetron, help by relieving the psychogenic component, anticipatory vomiting and produce amnesia for the unpleasant procedure.
- They also suppress
the dystonic side effects of metoclopramide.
.Benzodiazepines
it can be used as an alterna-
tive antiemetic for moderately emetogenic chemotherapy
in patients who cannot tolerate other antiemetics or are
unresponsive to them.
- It has been
used in lower doses to improve feeding in cachectic/AIDS
patients.
Dronabinol
Ramosetron
diarrhoea-predominant irritable bowel syndrome.
Macrolides are used as prokinetics for
Diabetic Gastroparesis
Pseudo Obstruction
Flligrastim
Neutropenia due to myelodysplasia, aplastic anemia, HIV, chemotherapy
is still the preferred anticoagulant, cardiopulmonary bypass surgery ?
high
dose UFH
