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** πŸ’Š Medications > Year 2 > Flashcards

Year 2 Flashcards

1
Q

Azathioprine

A
  • Disease: Used in autoimmune diseases like rheumatoid arthritis, inflammatory bowel disease, and in transplant medicine.
  • Mechanism: Suppresses the immune system by inhibiting purine synthesis, leading to decreased proliferation of lymphocytes.
  • Side Effects: Bone marrow suppression, increased risk of infections, gastrointestinal disturbances, hepatotoxicity.
  • Contraindications: Hypersensitivity, severe bone marrow suppression.
  • Pertinent Info: Requires monitoring of blood cell counts and liver function.
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2
Q

Sulfasalazine

A
  • Disease: Primarily used in inflammatory bowel disease (Crohn’s disease, ulcerative colitis), and also in rheumatoid arthritis.
  • Mechanism: Combination of 5-aminosalicylic acid (anti-inflammatory) and sulfapyridine (antibacterial). Exact mechanism in IBD is not fully understood.
  • Side Effects: Gastrointestinal upset, headache, rash, reversible oligospermia.
  • Contraindications: Hypersensitivity to sulfonamides, porphyria.
  • Pertinent Info: Requires monitoring for blood cell counts, liver function, and kidney function.
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3
Q

Docetaxel

A
  • Disease: Used in the treatment of various cancers, including breast cancer, non-small cell lung cancer, prostate cancer, gastric cancer, and head and neck cancer.
  • Mechanism: Taxane class chemotherapeutic agent that promotes and stabilizes microtubule assembly, inhibiting their disassembly, which disrupts mitotic cell division and leads to cell death.
  • Side Effects: Bone marrow suppression (neutropenia, anemia, thrombocytopenia), hypersensitivity reactions, fluid retention, peripheral neuropathy, alopecia, gastrointestinal disturbances (nausea, vomiting, diarrhea), mucositis, fatigue.
  • Contraindications: Severe hypersensitivity to docetaxel or polysorbate 80, severe liver impairment, baseline neutrophil count < 1500 cells/mmΒ³.
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4
Q

Cyclophosphamide

A
  • Disease: Used in the treatment of various cancers, including lymphomas, leukemias, breast cancer, ovarian cancer, and as an immunosuppressant in autoimmune diseases like lupus and vasculitis.
  • Mechanism: Alkylating agent that cross-links DNA, leading to DNA damage and cell death, particularly in rapidly dividing cells.
  • Side Effects: Bone marrow suppression (leading to anemia, leukopenia, thrombocytopenia), gastrointestinal disturbances (nausea, vomiting), hemorrhagic cystitis, alopecia, increased risk of infections, secondary malignancies.
  • Contraindications: Hypersensitivity to cyclophosphamide, severe bone marrow suppression, active infections.
  • Pertinent Info: Adequate hydration and mesna (a uroprotective agent) are used to prevent hemorrhagic cystitis. Regular monitoring of blood counts and renal function is necessary.
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5
Q

Vincristine

A
  • Disease: Used in the treatment of various cancers, including leukemia, lymphoma, and some solid tumors like neuroblastoma and Wilms’ tumor.
  • Mechanism: Vinca alkaloid that inhibits microtubule formation, disrupting mitosis and leading to cell death.
  • Side Effects: Neurotoxicity (peripheral neuropathy, constipation, neurogenic bladder), myelosuppression (less common compared to other chemotherapeutic agents), alopecia, gastrointestinal disturbances.
  • Contraindications: Hypersensitivity to vincristine, Charcot-Marie-Tooth disease, intrathecal administration (which is fatal).
  • Pertinent Info: Dosing is typically capped to minimize neurotoxic effects. Requires careful handling and administration.
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6
Q

Nivolumab

A
  • Disease: Used in the treatment of various cancers, including melanoma, non-small cell lung cancer, renal cell carcinoma, Hodgkin lymphoma, head and neck squamous cell carcinoma, and others.
  • Mechanism: Immune checkpoint inhibitor that blocks PD-1 (programmed death-1) receptor, enhancing T-cell responses against cancer cells.
  • Side Effects: Immune-related adverse events including colitis, hepatitis, pneumonitis, endocrinopathies (e.g., hypothyroidism, adrenal insufficiency), rash, and fatigue.
  • Contraindications: Severe hypersensitivity to nivolumab.
  • Pertinent Info: Requires close monitoring for signs of immune-related adverse events, which can often be severe and may require corticosteroids or other immunosuppressive therapies. Regular blood tests and assessments of liver, renal, and thyroid function are typically performed during treatment.
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7
Q

Rituximab

A
  • Disease: Used in the treatment of** non-Hodgkin’s lymphoma, chronic lymphocytic leukemia**, rheumatoid arthritis, and certain autoimmune diseases like granulomatosis with polyangiitis and microscopic polyangiitis.
  • Mechanism: Monoclonal antibody that targets CD20, a protein expressed on the surface of B cells, leading to B cell lysis through antibody-dependent cellular cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and direct apoptosis.
  • Side Effects: Infusion-related reactions (fever, chills, hypotension), infections, cytopenias, progressive multifocal leukoencephalopathy (PML), cardiovascular events.
  • Contraindications: Hypersensitivity to rituximab or any component of the formulation, active severe infections.
  • Pertinent Info: Requires premedication with antihistamines and antipyretics to reduce the risk of infusion reactions. Monitoring for infections and regular blood counts is essential.
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8
Q

Cytarabine

A
  • Disease: Used primarily in the treatment of acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), and non-Hodgkin’s lymphoma. It is also used intrathecally for the treatment and prophylaxis of meningeal leukemia and lymphoma.
  • Mechanism: Cytarabine is a pyrimidine nucleoside analogue that inhibits DNA synthesis. It is converted into its active form, cytarabine triphosphate (ara-CTP), which incorporates into DNA and inhibits DNA polymerase, leading to impaired DNA replication and repair, resulting in cell death, particularly in rapidly dividing cells.
  • Side Effects: Bone marrow suppression (leading to anemia, leukopenia, thrombocytopenia), gastrointestinal disturbances (nausea, vomiting, diarrhea, mucositis), hepatotoxicity, neurotoxicity (cerebellar toxicity, seizures), ocular toxicity (conjunctivitis, keratitis), and pulmonary toxicity. Other side effects include rash, fever, and flu-like symptoms.
  • Contraindications: Hypersensitivity to cytarabine, severe bone marrow suppression (except when used in controlled conditions for treatment of leukemia), active infections.
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9
Q

Methotrexate

A
  • Disease: Used in the treatment of various conditions, including rheumatoid arthritis, psoriasis, and certain cancers such as acute lymphoblastic leukemia, non-Hodgkin’s lymphoma, and osteosarcoma.
  • Mechanism: Antimetabolite and antifolate agent that inhibits dihydrofolate reductase, leading to inhibition of DNA, RNA, and protein synthesis. This results in reduced cell proliferation and induces apoptosis, particularly in rapidly dividing cells.
  • Side Effects: Bone marrow suppression (leading to anemia, leukopenia, thrombocytopenia), gastrointestinal disturbances (nausea, vomiting, mucositis), hepatotoxicity, nephrotoxicity, pulmonary toxicity, and risk of serious infections. Other side effects include alopecia, fatigue, and stomatitis.
  • Contraindications: Severe renal or hepatic impairment, bone marrow suppression, active infections, known hypersensitivity to methotrexate, and pregnancy (due to teratogenic effects).
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10
Q

Ipilimumab

A
  • Disease: Used in the treatment of melanoma, renal cell carcinoma, and other cancers.
  • Mechanism: Monoclonal antibody that blocks cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). This inhibition enhances T-cell activation and proliferation, boosting the immune system’s response against cancer cells.
  • Side Effects: Immune-related adverse events including colitis, hepatitis, dermatitis, endocrinopathies (such as hypothyroidism or hypophysitis), and pneumonitis. Other common side effects include fatigue, diarrhea, rash, and pruritus.
  • Contraindications: Severe hypersensitivity to ipilimumab or any component of the formulation.
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11
Q

Trastuzumab and Pertuzumab:

A
  • Disease: Used in the treatment of HER2-positive breast cancer.
  • Mechanism: Monoclonal antibodies that** target the HER2 receptor**, inhibiting cancer cell growth and survival.
  • Side Effects: Infusion reactions, cardiotoxicity, diarrhea.
  • Contraindications: Hypersensitivity, pre-existing heart failure.
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12
Q

Timolol

A
  • Disease: Used in the treatment of glaucoma and ocular hypertension.
  • Mechanism: Non-selective beta-blocker that reduces intraocular pressure by decreasing aqueous humor production.
  • Side Effects: Eye irritation, bradycardia, hypotension, bronchospasm.
  • Contraindications: Asthma, severe COPD, bradycardia, heart block.
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13
Q

Name some drugs that act on the M-phase of the cell cycle.

A

Colchicine ( prevents microtubule polymerization, leading to the arrest of cells in mitosis.)

Vinca alkaloids (inhibit microtubule polymerization by binding to tubulin subunits, leading to the formation of abnormal microtubules.)

Paclitaxel (microtubule polymerization and prevents depolymerization.)

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14
Q

Colchicine

A
  • Disease: Used primarily in the treatment of gout and familial Mediterranean fever (FMF).
  • Mechanism: Inhibits microtubule polymerization, leading to disruption of cell division, migration of inflammatory cells, and phagocytosis.
  • Side Effects: Gastrointestinal upset (nausea, vomiting, diarrhea), myopathy, peripheral neuropathy.
  • Contraindications: Severe renal or hepatic impairment, gastrointestinal disorders.
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15
Q

Vinca Alkaloids

A
  • Disease: Used in various cancers, including leukemia, lymphoma, breast cancer, and lung cancer.
  • Mechanism: Inhibit microtubule assembly, leading to disruption of mitotic spindle formation and cell division.
  • Side Effects: Bone marrow suppression, peripheral neuropathy, gastrointestinal disturbances
  • Contraindications: Hypersensitivity, severe bone marrow suppression, neuropathy.
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16
Q

Paclitaxel

A
  • Disease: Used in various cancers, including breast cancer, ovarian cancer, and lung cancer.
  • Mechanism: Stabilizes microtubules, leading to inhibition of mitotic spindle function and cell division.
  • Side Effects: Bone marrow suppression, peripheral neuropathy, hypersensitivity reactions.
  • Contraindications: Hypersensitivity, severe bone marrow suppression.
  • Pertinent Info: Requires premedication to prevent hypersensitivity reactions.
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17
Q

Hydroxychloroquine

A
  • Disease: Used in autoimmune diseases like rheumatoid arthritis, lupus erythematosus, and malaria.
  • Mechanism: Exact mechanism in autoimmune diseases is not fully understood. May modulate immune response and interfere with lysosomal activity.
  • Side Effects: Retinopathy, gastrointestinal disturbances, skin reactions.
  • Contraindications: Pre-existing retinopathy, hypersensitivity to 4-aminoquinolines.
  • Pertinent Info: Requires regular eye examinations due to risk of retinopathy.
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18
Q

Certolizumab-pegol

A
  • Disease: Used in autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, Crohn’s disease.
  • Mechanism: Monoclonal antibody against tumor necrosis factor-alpha (TNF-Ξ±), inhibiting its inflammatory effects.
  • Side Effects: Increased risk of infections, injection site reactions, infusion reactions, increased risk of malignancies.
  • Contraindications: Active infections, hypersensitivity.
  • Pertinent Info: Increased risk of reactivation of latent tuberculosis (TB).
  • Pegylation increases the retention time, reduces the immunogenicity and increases the stability of the drug to be metabolized by enzymes.
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19
Q

MAOI (Monoamine Oxidase Inhibitors)

A
  • Diseases: Depression, particularly atypical depression and treatment-resistant depression.
  • Mechanism: Inhibit monoamine oxidase enzyme, increasing levels of neurotransmitters (serotonin, norepinephrine, dopamine)
  • Side Effects: Hypertensive crisis (with tyramine-rich foods), weight gain, insomnia, dizziness.
  • Contraindications: Concurrent use with SSRIs, TCAs, certain pain medications, and other serotonergic drugs.
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20
Q

SSRI (Selective Serotonin Reuptake Inhibitors)

A
  • Diseases: Depression, anxiety disorders, PTSD, OCD
    .
  • Mechanism: Inhibit reuptake of serotonin, increasing its availability in the synaptic cleft.
  • Side Effects: Nausea, sexual dysfunction, insomnia, weight gain, serotonin syndrome (rare but serious).
  • Contraindications: Concurrent use with MAOIs, certain other serotonergic drugs.
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21
Q

TCA (Tricyclic Antidepressants)

A
  • Diseases: Depression, neuropathic pain, migraine prophylaxis.
  • Mechanism: Inhibit reuptake of norepinephrine and serotonin, also block acetylcholine and histamine receptors.
  • Side Effects: Anticholinergic effects (dry mouth, constipation), sedation, weight gain, cardiotoxicity (in overdose).
  • Contraindications: Recent myocardial infarction, concurrent use with MAOIs.
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22
Q

Bupropion

A
  • Diseases: Depression, smoking cessation.
  • Mechanism: Inhibits reuptake of norepinephrine and dopamine.
  • Side Effects: Insomnia, dry mouth, seizure risk (dose-dependent).
  • Contraindications: Seizure disorders, eating disorders, concurrent use with MAOIs.
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23
Q

Mianserin

A
  • Diseases: Depression (primarily used in some countries).
  • Mechanism: Noradrenergic and specific serotonergic antidepressant (NaSSA); blocks alpha-2 adrenergic receptors and serotonin receptors.
  • Side Effects: Sedation, weight gain, agranulocytosis (rare but serious).
  • Contraindications: Severe liver impairment, mania.
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24
Q

Oestrogen

A
  • Diseases: Hormone replacement therapy (HRT), certain cancers, contraceptive.
  • Mechanism: Modulates gene expression by binding to estrogen receptors, influencing reproductive and other systems.
  • Side Effects: Thromboembolic events, breast tenderness, headache, nausea.
  • Contraindications: History of thromboembolic disorders, certain cancers, liver disease.
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25
Q

Glutamatergic Agents

A
  • Diseases: Alzheimer’s disease (memantine), treatment-resistant depression (ketamine).
  • Mechanism: Modulate glutamate receptors (e.g., NMDA receptor antagonists).
  • Side Effects: Dizziness, headache, confusion (memantine); dissociation, elevated blood pressure (ketamine).
  • Contraindications: Severe renal impairment (memantine).
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26
Q

Cannabidiol (CBD)

A
  • Diseases: Epilepsy (e.g., Dravet syndrome, Lennox-Gastaut syndrome), anxiety, certain pain conditions.
  • Mechanism: Modulates endocannabinoid system, serotonin receptors, and other pathways.
  • Side Effects: Diarrhea, fatigue, changes in appetite.
  • Contraindications: Known hypersensitivity, caution in liver impairmen
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27
Q

Barbiturates

A
  • Diseases: Seizure disorders, anesthesia, anxiety (historical).
  • Mechanism: Enhance GABA-A receptor activity, increasing inhibitory neurotransmission.
  • Side Effects: Sedation, respiratory depression, tolerance, dependence.
  • Contraindications: Porphyria, severe respiratory or hepatic impairment.
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28
Q

Benzodiazepines

A
  • Diseases: Anxiety, insomnia, seizure disorders, muscle spasms.
  • Mechanism: Enhance GABA-A receptor activity, increasing inhibitory neurotransmission.
  • Side Effects: Sedation, dependence, respiratory depression (in overdose).
  • Contraindications: Severe respiratory insufficiency, sleep apnea, myasthenia gravis.
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29
Q

Z Drugs (Non-Benzodiazepine Hypnotics)

A
  • Diseases: Insomnia.
  • Mechanism: Enhance GABA-A receptor activity, similar to benzodiazepines but more selective for the alpha-1 subunit.
  • Side Effects: Sedation, dizziness, dependence (less than benzodiazepines).
  • Contraindications: Severe respiratory insufficiency, sleep apnea.
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30
Q

5HT1A Antagonists

A
  • Diseases: Depression, anxiety disorders (e.g., buspirone).
  • Mechanism: Partial agonists or antagonists at 5HT1A receptors, modulating serotonin activity.
  • Side Effects: Dizziness, headache, nausea.
  • Contraindications: Severe hepatic or renal impairment.
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31
Q

Beta Noradrenergic Receptor Antagonists (Beta Blockers)

A
  • Diseases: Hypertension, anxiety (situational), arrhythmias, heart failure.
  • Mechanism: Block beta-adrenergic receptors, reducing heart rate and contractility, and decreasing anxiety symptoms.
  • Side Effects: Bradycardia, fatigue, bronchospasm.
  • Contraindications: Asthma, severe bradycardia, certain heart block conditions.
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32
Q

GABA Binding Agents

A
  • Diseases: Epilepsy, anxiety, insomnia.
  • Mechanism: Enhance GABAergic activity by binding to GABA receptors, increasing inhibitory neurotransmission.
  • Side Effects: Sedation, dizziness, dependence (varies by specific agent).
  • Contraindications: Varies by specific agent; typically includes severe respiratory insufficiency and hypersensitivity.
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33
Q

Hydrocortisone

A

Disease: Used in various conditions, including adrenal insufficiency, allergic reactions, asthma, and inflammatory disorders.

Mechanism: Synthetic glucocorticoid that suppresses inflammation and immune responses by inhibiting cytokine production and leukocyte migration.

Side Effects: Adrenal suppression, osteoporosis, hypertension, hyperglycemia, fluid retention.

Contraindications: Systemic fungal infections, hypersensitivity.

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34
Q

Prednisolone, Dexamethasone, Betamethasone

A
  • Disease: Used in the treatment of various inflammatory and autoimmune conditions, including rheumatoid arthritis, asthma, and dermatitis.
  • Mechanism: Synthetic corticosteroid that suppresses inflammation and immune responses by inhibiting cytokine production and leukocyte migration.
  • Side Effects: Adrenal suppression, osteoporosis, hypertension, hyperglycemia, mood changes.
  • Contraindications: Systemic fungal infections, hypersensitivity.
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35
Q

Nucleoside and Nucleotide Analog Polymerase Inhibitors:

A

Disease: Used primarily in the treatment of viral infections, including herpesviruses (e.g., herpes simplex virus, varicella-zoster virus) and HIV.

Mechanism: These drugs interfere with viral RNA or DNA synthesis by acting as analogs of nucleosides or nucleotides. They are incorporated into the viral DNA or RNA chain during replication, leading to premature termination of the chain and inhibition of further synthesis.

Side Effects:
nausea, vomiting, diarrhea, headache, and fatigue.
Long-term use may lead to renal toxicity (especially with tenofovir), bone marrow suppression, and peripheral neuropathy (particularly with older agents like stavudine).

Contraindications:
Hypersensitivity to the drug or its components.
Renal impairment (dose adjustments may be necessary for certain agents).

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36
Q

Protease Inhibitors:

A

Disease: Primarily used in the treatment of HIV infection, where they are part of combination antiretroviral therapy (cART) regimens.

Mechanism: Protease inhibitors block the activity of viral proteases, enzymes essential for the cleavage of viral polyproteins into functional proteins required for viral replication. By inhibiting protease activity, these drugs prevent the production of infectious viral particles.

Side Effects: gastrointestinal symptoms (nausea, diarrhea), metabolic disturbances (lipid abnormalities, insulin resistance), and drug interactions (due to inhibition of cytochrome P450 enzymes).

Contraindications Hypersensitivity to the drug or its components.
Concurrent use with medications metabolized by the cytochrome P450 system

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37
Q

Neuraminidase Inhibitors:

A

Disease: Used primarily for the treatment and prevention of influenza virus infections, including seasonal flu and influenza outbreaks.

Mechanism: Neuraminidase inhibitors target the neuraminidase enzyme, which is essential for the release of newly formed viral particles from infected cells. By inhibiting neuraminidase activity, these drugs prevent the spread of the virus to uninfected cells and reduce the severity and duration of symptoms.

Side Effects: nausea, vomiting, headache, and dizziness.

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38
Q

Fusion Inhibitors:

A

Disease: Primarily used in the treatment of HIV infection, particularly in patients who have developed resistance to other antiretroviral drugs.

Mechanism: Fusion inhibitors prevent viral entry into host cells by blocking the fusion between the viral and cellular membranes. They specifically target viral proteins involved in membrane fusion, such as the gp41 protein of HIV. By inhibiting fusion, these drugs prevent viral entry and subsequent infection of host cells.

Side Effects: injection site reactions (for enfuvirtide), hypersensitivity reactions, and gastrointestinal symptoms.
Rare but serious side effects may include immune reconstitution syndrome and pneumonia.

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39
Q

Amphotericin B:

A

Disease: Used in the treatment of severe fungal infections, including invasive candidiasis, aspergillosis, cryptococcosis, and mucormycosis.

Mechanism: Binds to ergosterol in fungal cell membranes, disrupting membrane integrity and leading to leakage of cellular contents and fungal cell death.

Side Effects: Infusion-related reactions (fever, chills, rigors), Nephrotoxicity (renal impairment, electrolyte disturbances), Hepatotoxicity, Hypokalemia, hypomagnesemia.. Anemia.

Contraindications:
Hypersensitivity to amphotericin B or any component of the formulation.
Pre-existing renal impairment.
Concomitant use with nephrotoxic drugs.

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40
Q

Zidovudine (AZT):

A

Disease: Used in the treatment of HIV infection, both as monotherapy and in combination with other antiretroviral drugs.

Mechanism: Nucleoside reverse transcriptase inhibitor (NRTI) that interferes with the reverse transcription process of HIV, leading to chain termination and inhibition of viral DNA synthesis.

Side Effects:
Bone marrow suppression (anemia, neutropenia).
Gastrointestinal disturbances (nausea, vomiting, diarrhea).
Lactic acidosis/hepatomegaly with steatosis (rare but serious).
Peripheral neuropathy.
Lipodystrophy.

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41
Q

Dabigatran

A

Disease: Used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation, and for the treatment and prevention of venous thromboembolism (VTE).

Mechanism: Direct thrombin inhibitor that specifically targets thrombin, a key enzyme in the coagulation cascade, thereby preventing the formation of fibrin clots.

Side Effects:
Bleeding (major and minor).
Gastrointestinal symptoms (dyspepsia, gastritis).
Increased risk of myocardial infarction (MI) and other cardiovascular events in certain patient populations.

Contraindications:
Hypersensitivity to dabigatran or any component of the formulation.
Active pathological bleeding.
Severe renal impairment (CrCl < 30 mL/min).

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42
Q

Immune Checkpoint Inhibitor:

A

Disease: Used in the treatment of various cancers, including melanoma, non-small cell lung cancer, renal cell carcinoma, and others.

Mechanism: Blocks inhibitory checkpoint proteins such as PD-1 (programmed cell death protein 1) or CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), thereby enhancing the activity of T cells against cancer cells.

Side Effects:
Immune-related adverse events (irAEs) including dermatitis, colitis, hepatitis, pneumonitis, and endocrinopathies (e.g., hypothyroidism, hypophysitis).
Fatigue.
Rash.
Infusion reactions.

Contraindications:
Hypersensitivity to the immune checkpoint inhibitor or any component of the formulation.
Active autoimmune disease requiring systemic immunosuppressive therapy.
Severe or uncontrolled concurrent infections.

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43
Q

Disease Modifying Antirheumatic Drugs (DMARDs):

Entanercept

A

Disease: Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis.

Mechanism: Tumor necrosis factor (TNF) inhibitor, reducing inflammation and joint damage.

Side Effects: Injection site reactions, increased risk of infections, headache, gastrointestinal symptoms.

Contraindications: Active infections, heart failure.
Pertinent Information: Requires regular monitoring for infections and signs of heart failure.

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44
Q

Disease Modifying Antirheumatic Drugs (DMARDs):

Cyclosporin

A

Disease: Rheumatoid arthritis, psoriatic arthritis.

Mechanism: Calcineurin inhibitor, suppresses T-cell activation and inflammatory response.

Side Effects: Nephrotoxicity, hypertension, tremor, gingival hyperplasia.

Contraindications: Hypersensitivity to cyclosporin, uncontrolled hypertension, renal impairment.
Pertinent Information: Requires regular monitoring of renal function and blood pressure.

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45
Q

Dopamine Agonists:

Bromocriptine
Ropinirole
Pramipexole

A

Disease: Parkinson’s disease, restless legs syndrome, hyperprolactinemia.

Mechanism: Stimulate dopamine receptors, restoring dopaminergic function in the brain.

Side Effects: Nausea, dizziness, hallucinations, hypotension.

Contraindications: Hypersensitivity to the drug, uncontrolled psychiatric disorders.
Pertinent Information: Start with low doses and titrate gradually to minimize side effects.

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46
Q

Antiestrogens:

Tamoxifen

A

Disease: Breast cancer (estrogen receptor-positive).

Mechanism: Selective estrogen receptor modulator (SERM), blocks estrogen binding to breast cancer cells.

Side Effects: Hot flashes, vaginal discharge, increased risk of endometrial cancer, thromboembolic events.

Contraindications: History of thromboembolic events, pregnancy, concurrent use with strong CYP2D6 inhibitors.
Pertinent Information: Long-term use may increase the risk of uterine cancer; regular monitoring is required.

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47
Q

Cholinesterase Inhibitors:

Donepezil, Rivastigmine

A

Disease: Alzheimer’s disease, dementia.

Mechanism: Inhibit acetylcholinesterase, increasing acetylcholine levels in the brain, improving cognitive function.

Side Effects: Nausea, vomiting, diarrhea, bradycardia (rivastigmine).

Contraindications: Hypersensitivity to the drug, severe bradycardia, concurrent use with anticholinergic drugs.

Pertinent Information: Start with low doses and titrate gradually to minimize gastrointestinal side effects.

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48
Q

NMDA Receptor Antagonists:

Memantine

A

Disease: Alzheimer’s disease.

Mechanism: NMDA receptor antagonist, regulates glutamate activity, reducing excitotoxicity.

Side Effects: Dizziness, headache, confusion.

Contraindications: Hypersensitivity to the drug, severe renal impairment.

Pertinent Information: May be used in combination with cholinesterase inhibitors for moderate to severe Alzheimer’s disease.

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49
Q

Monoclonal Antibodies:

Rosuzumab

Lecanemab

A

Disease: Osteoporosis.

Mechanism: Monoclonal antibody targeting sclerostin, increasing bone formation.

Side Effects: Injection site reactions, hypercalcemia, hypophosphatemia.

Contraindications: Hypersensitivity to the drug, hypercalcemia.

Pertinent Information: Administered subcutaneously once monthly; requires monitoring of serum calcium and phosphorus levels.

50
Q

Antidiabetic Drugs:

Metformin

A

Disease: Type 2 diabetes mellitus.

Mechanism: Biguanide, decreases hepatic glucose production, improves insulin sensitivity.

Side Effects: Gastrointestinal upset, lactic acidosis (rare).

Contraindications: Renal impairment (eGFR < 30 mL/min/1.73 mΒ²), acute or chronic metabolic acidosis.

Pertinent Information: Considered first-line therapy for type 2 diabetes; monitor renal function regularly.

51
Q

Anticonvulsants

Gabapentin

A

Disease: Epilepsy, neuropathic pain, restless legs syndrome.

Mechanism: Binds to voltage-gated calcium channels, reducing excitatory neurotransmitter release.

Side Effects: Dizziness, somnolence, peripheral edema.

Contraindications: Hypersensitivity to the drug.

Pertinent Information: Titrate dose gradually to minimize side effects; avoid abrupt discontinuation.

52
Q

Antidiabetic Drugs:

Gliclazide

A

Disease: Type 2 diabetes mellitus.

Mechanism: Sulfonylurea, stimulates insulin release from pancreatic beta cells.

Side Effects: Hypoglycemia, weight gain, gastrointestinal upset.

Contraindications: Hypersensitivity to the drug, type 1 diabetes mellitus, diabetic ketoacidosis.

Pertinent Information: May require dose adjustment in renal impairment; monitor blood glucose regularly.

53
Q

Antihyperlipidemics:

Atorvastatin

A

Disease: Hypercholesterolemia, prevention of cardiovascular events.

Mechanism: HMG-CoA reductase inhibitor, reduces cholesterol synthesis, increases LDL receptor expression.

Side Effects: Myopathy, elevated liver enzymes, gastrointestinal upset.

Contraindications: Active liver disease, pregnancy, breastfeeding.

Pertinent Information: Monitor liver function tests periodically; may interact with other medications metabolized by CYP3A4.

54
Q

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

A
  • Disease: Pain, inflammation, fever, arthritis.
  • Mechanism: Inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis.
  • Side Effects: Gastrointestinal ulcers, bleeding, renal impairment, cardiovascular risks.
  • Contraindications: Peptic ulcer disease, renal impairment, cardiovascular disease, hypersensitivity to NSAIDs.
55
Q

Capsaicin

A
  • Disease: Neuropathic pain, osteoarthritis.
  • Mechanism: Activates TRPV1 receptors, leading to the depletion of substance P and reduced pain sensation.
  • Side Effects: Local burning, stinging, erythema.
  • Contraindications: Hypersensitivity to capsaicin.
56
Q

COX-2 Inhibitors

A
  • Disease: Pain, inflammation, arthritis.
  • Mechanism: Selectively inhibits COX-2 enzyme, reducing prostaglandin synthesis with less gastrointestinal side effects.
  • Side Effects: Cardiovascular risks, renal impairment, gastrointestinal issues (less than non-selective NSAIDs).
  • Contraindications: Cardiovascular disease, renal impairment, hypersensitivity to COX-2 inhibitors.
    *
57
Q

Corticosteroids

A
  • Disease: Inflammatory and autoimmune conditions, allergies, asthma.
  • Mechanism: Inhibits multiple inflammatory cytokines, suppressing immune response.
  • Side Effects: Weight gain, osteoporosis, hyperglycemia, hypertension, adrenal suppression.
  • Contraindications: Systemic infections, hypersensitivity to corticosteroids.
58
Q

Calcineurin Inhibitors (Tacrolimus)

A
  • Disease: Organ transplantation, atopic dermatitis.
  • Mechanism: Inhibits calcineurin, reducing T-cell activation and cytokine production.
  • Side Effects: Nephrotoxicity, hypertension, hyperglycemia, neurotoxicity.
  • Contraindications: Hypersensitivity to tacrolimus.
59
Q

Antihistamines

A

Disease: Allergies, allergic rhinitis, urticaria.
Mechanism: Blocks H1 histamine receptors, reducing allergic symptoms.
Side Effects: Sedation, dry mouth, dizziness (more in first-generation antihistamines).
Contraindications: Hypersensitivity to antihistamines.

60
Q

Azathioprine

A
  • Disease: Autoimmune diseases, organ transplantation.
  • Mechanism: Inhibits purine synthesis, reducing lymphocyte proliferation.
  • Side Effects: Bone marrow suppression, gastrointestinal disturbances, hepatotoxicity.
  • Contraindications: Hypersensitivity to azathioprine, pregnancy.
61
Q

Methotrexate

A
  • Disease: Rheumatoid arthritis, psoriasis, cancer.
  • Mechanism: Inhibits dihydrofolate reductase, reducing DNA synthesis.
  • Side Effects: Bone marrow suppression, hepatotoxicity, pulmonary toxicity.
  • Contraindications: Pregnancy, liver disease, renal impairment.
62
Q

Ciclosporin

A
  • Disease: Organ transplantation, autoimmune diseases.
  • Mechanism: Inhibits calcineurin, reducing T-cell activation.
  • Side Effects: Nephrotoxicity, hypertension, hyperlipidemia, gingival hyperplasia.
  • Contraindications: Hypersensitivity to ciclosporin.
63
Q

Dupilumab

A

Disease: Atopic dermatitis, asthma.
Mechanism: IL-4 receptor alpha antagonist, reducing IL-4 and IL-13 signaling.
Side Effects: Injection site reactions, conjunctivitis, eosinophilia.
Contraindications: Hypersensitivity to dupilumab.

64
Q

Alitretinoin

A
  • Disease: Chronic hand eczema.
  • Mechanism: Binds to retinoid receptors, modulating cell proliferation and differentiation.
  • Side Effects: Headache, dryness of skin and mucous membranes, teratogenicity.
  • Contraindications: Pregnancy, hypersensitivity to retinoids. MUST BE ON BIRTH CONTROL
65
Q

Dithranol

A

Disease: Psoriasis.
Mechanism: Inhibits DNA synthesis, reducing keratinocyte proliferation.
Side Effects: Skin irritation, staining of skin and clothing.
Contraindications: Acute or pustular psoriasis, hypersensitivity to dithranol.

66
Q

Doxycycline

A
  • Disease: Bacterial infections, acne, Lyme disease.
  • Mechanism: Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit.
  • Side Effects: Gastrointestinal upset, photosensitivity, esophagitis.
  • Contraindications: Pregnancy, children under 8 years, hypersensitivity to tetracyclines.
67
Q

Duloxetine

A
  • Disease: Depression, anxiety, neuropathic pain.
  • Mechanism: Serotonin and norepinephrine reuptake inhibitor.
  • Side Effects: Nausea, dry mouth, dizziness, insomnia.
  • Contraindications: MAOI use, uncontrolled glaucoma, hypersensitivity to duloxetine.
68
Q

Amitriptyline

A
  • Disease: Depression, neuropathic pain.
  • Mechanism: Tricyclic antidepressant, inhibits reuptake of serotonin and norepinephrine.
  • Side Effects: Sedation, dry mouth, weight gain, cardiac toxicity.
  • Contraindications: MAOI use, recent myocardial infarction, hypersensitivity to amitriptyline.
69
Q

Teriparatide

A

Disease: Osteoporosis.
Mechanism: Recombinant PTH, stimulates bone formation.
Side Effects: Hypercalcemia, dizziness, leg cramps.
Contraindications: Hypercalcemia, bone metastases, skeletal malignancies.

70
Q

Romosozumab

A
  • Disease: Osteoporosis.
  • Mechanism: Sclerostin inhibitor, increases bone formation and decreases bone resorption.
  • Side Effects: Arthralgia, headache, injection site reactions.
  • Contraindications: Hypersensitivity to romosozumab.
71
Q

Bisphosphonates

A
  • Disease: Osteoporosis, Paget’s disease.
  • Mechanism: Inhibits osteoclast-mediated bone resorption.
  • Side Effects: Gastrointestinal issues, osteonecrosis of the jaw, atypical femoral fractures.
  • Contraindications: Esophageal abnormalities, inability to stand or sit upright for 30 minutes, hypocalcemia.
72
Q

Non-Bisphosphonates (e.g., Raloxifene)

A
  • Disease: Osteoporosis.
  • Mechanism: Selective estrogen receptor modulator, reduces bone resorption.
  • Side Effects: Hot flashes, leg cramps, thromboembolism.
  • Contraindications: History of venous thromboembolism, pregnancy.
73
Q

Denosumab

A
  • Disease: Osteoporosis, bone metastases.
  • Mechanism: RANKL inhibitor, reduces osteoclast activity.
  • Side Effects: Hypocalcemia, infections, osteonecrosis of the jaw.
  • Contraindications: Hypocalcemia, hypersensitivity to denosumab.
74
Q

NGF mAb (Nerve Growth Factor monoclonal antibodies)

A

Disease: Chronic pain.
Mechanism: Inhibits nerve growth factor, reducing pain signaling.
Side Effects: Arthralgia, headache, potential for joint destruction.
Contraindications: History of significant orthopedic conditions.

75
Q

Furosemide

A
  • Disease: Oedema, hypertension.
  • Mechanism: Loop diuretic, inhibits Na-K-2Cl transporter in the loop of Henle.
  • Side Effects: Electrolyte imbalances, dehydration, hypotension.
  • Contraindications: Anuria, severe electrolyte depletion, hypersensitivity to furosemide.
76
Q

Pamidronate

A
  • Disease: Hypercalcemia of malignancy, Paget’s disease, bone metastases.
  • Mechanism: Bisphosphonate, inhibits osteoclast-mediated bone resorption.
  • Side Effects: Hypocalcemia, osteonecrosis of the jaw, flu-like symptoms.
  • Contraindications: Hypocalcemia, severe renal impairment.
77
Q

Calcitonin

A
  • Disease: Osteoporosis, hypercalcemia, Paget’s disease.
  • Mechanism: Inhibits osteoclast activity, lowers blood calcium levels.
  • Side Effects: Nausea, facial flushing, injection site reactions.
  • Contraindications: Hypersensitivity to calcitonin.
78
Q

Prednisolone

A
  • Disease: Inflammatory and autoimmune conditions.
  • Mechanism: Glucocorticoid, reduces inflammation and suppresses immune response.
  • Side Effects: Weight gain, osteoporosis, hyperglycemia, adrenal suppression.
  • Contraindications: Systemic infections, hypersensitivity to corticosteroids.
79
Q

Calcimimetics (e.g., Cinacalcet)

A
  • Disease: Secondary hyperparathyroidism, parathyroid carcinoma.
  • Mechanism: Activates calcium-sensing receptors, reducing PTH secretion.
  • Side Effects: Hypocalcemia, nausea, vomiting.
  • Contraindications: Hypocalcemia.
80
Q

Calcium Gluconate

A
  • Disease: Hypocalcemia, hyperkalemia, hypermagnesemia, calcium channel blocker overdose.
  • Mechanism: Provides calcium ions necessary for physiological functions, including muscle contraction, nerve function, and blood clotting.
  • Side Effects: Nausea, vomiting, constipation, hypercalcemia (with excessive use), hypotension (if administered too quickly intravenously).
  • Contraindications: Hypercalcemia, renal calculi, ventricular fibrillation, hypersensitivity to calcium gluconate.
81
Q

Leflunomide

A
  • Disease: Rheumatoid arthritis.
  • Mechanism: Inhibits dihydroorotate dehydrogenase, leading to a reduction in pyrimidine synthesis and decreased lymphocyte proliferation.
  • Side Effects: Hepatotoxicity, gastrointestinal disturbances, hypertension, alopecia.
  • Contraindications: Pregnancy, severe hepatic impairment, hypersensitivity to leflunomide.
  • Pertinent Information: Teratogenic; requires effective contraception during and after treatment until drug levels are sufficiently low.
82
Q

Etanercept

A
  • Disease: Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis.
  • Mechanism: TNF-alpha inhibitor, reduces inflammation and immune response.
  • Side Effects: Increased risk of infections, injection site reactions, malignancies.
  • Contraindications: Active infections, hypersensitivity to etanercept.
  • Pertinent Information: Screen for latent tuberculosis before starting treatment.
83
Q

Bromocriptine

A
  • Disease: Parkinson’s disease, hyperprolactinemia.
  • Mechanism: Dopamine agonist, stimulates dopamine receptors.
  • Side Effects: Nausea, vomiting, orthostatic hypotension, hallucinations.
  • Contraindications: Uncontrolled hypertension, hypersensitivity to ergot derivatives.
  • Pertinent Information: May be used to treat symptoms of Parkinson’s disease and disorders related to high prolactin levels.
84
Q

Ropinirole

A
  • Disease: Parkinson’s disease, restless legs syndrome.
  • Mechanism: Dopamine agonist, stimulates dopamine receptors in the brain.
  • Side Effects: Nausea, dizziness, somnolence, orthostatic hypotension.
  • Contraindications: Hypersensitivity to ropinirole.
  • Pertinent Information: Gradually increase dosage to reduce the risk of side effects.
    *
85
Q

Pramipexole

A
  • Disease: Parkinson’s disease, restless legs syndrome.
  • Mechanism: Dopamine agonist, stimulates dopamine receptors in the brain.
  • Side Effects: Nausea, dizziness, somnolence, orthostatic hypotension.
  • Contraindications: Hypersensitivity to pramipexole.
  • Pertinent Information: Monitor for signs of compulsive behaviors and sudden onset of sleep.
    *
86
Q

Amantadine

A
  • Disease: Parkinson’s disease, drug-induced extrapyramidal symptoms.
  • Mechanism: Increases dopamine release, blocks NMDA receptors.
  • Side Effects: Dizziness, insomnia, livedo reticularis.
  • Contraindications: Renal impairment, history of seizures.
  • Pertinent Information: May also have antiviral activity against influenza A.

This sounds like cimetidine. The rule is Ti Dine not Ta Dine

87
Q

Selegiline

A
  • Disease: Parkinson’s disease.
  • Mechanism: MAO-B inhibitor, prevents breakdown of dopamine.
  • Side Effects: Nausea, dizziness, headache, insomnia.
  • Contraindications: Concurrent use of meperidine, hypersensitivity to selegiline.
  • Pertinent Information: Can be used as an adjunct to levodopa therapy.
    *
88
Q

Entacapone

A
  • Disease: Parkinson’s disease (as adjunct to levodopa/carbidopa).
  • Mechanism: COMT inhibitor, prolongs the action of levodopa by inhibiting its breakdown.
  • Side Effects: Diarrhea, dyskinesia, urine discoloration (brownish-orange).
  • Contraindications: Hypersensitivity to entacapone.
  • Pertinent Information: Only effective when used with levodopa/carbidopa.
89
Q

Benztropine

A
  • Disease: Parkinson’s disease, drug-induced extrapyramidal symptoms.
  • Mechanism: Anticholinergic, reduces acetylcholine activity to balance dopamine and acetylcholine levels.
  • Side Effects: Dry mouth, blurred vision, constipation, urinary retention.
  • Contraindications: Narrow-angle glaucoma, gastrointestinal obstruction, hypersensitivity to benztropine.
  • Pertinent Information: Use with caution in elderly patients due to increased risk of cognitive impairment.
90
Q

Procyclidine

A
  • Disease: Parkinson’s disease, drug-induced extrapyramidal symptoms.
  • Mechanism: Anticholinergic, blocks acetylcholine receptors to balance dopamine and acetylcholine levels.
  • Side Effects: Dry mouth, blurred vision, constipation, urinary retention, confusion.
  • Contraindications: Narrow-angle glaucoma, gastrointestinal obstruction, hypersensitivity to procyclidine.
  • Pertinent Information: Use cautiously in elderly patients due to potential cognitive side effects.
91
Q

Sumatriptan

A
  • Disease: Migraine headaches.
  • Mechanism: Selective 5-HT1 receptor agonist, causes vasoconstriction of cranial blood vessels.
  • Side Effects: Tingling, dizziness, chest discomfort, flushing.
  • Contraindications: History of ischemic heart disease, uncontrolled hypertension, hemiplegic or basilar migraine, hypersensitivity to sumatriptan.
  • Pertinent Information: Available in various forms (oral, nasal spray, injection); should be used at the onset of migraine symptoms.
92
Q

Prochlorperazine

A
  • Disease: Nausea, vomiting, schizophrenia.
  • Mechanism: Dopamine D2 receptor antagonist, antipsychotic, antiemetic.
  • Side Effects: Drowsiness, dizziness, extrapyramidal symptoms, hypotension.
  • Contraindications: Coma or severe CNS depression, bone marrow depression, hypersensitivity to prochlorperazine.
  • Pertinent Information: Used for acute nausea/vomiting and psychiatric disorders; monitor for signs of tardive dyskinesia with long-term use.a
93
Q

Oxycodone

A
  • Disease: Moderate to severe pain.
  • Mechanism: Opioid receptor agonist, alters perception of pain.
  • Side Effects: Constipation, nausea, drowsiness, respiratory depression.
  • Contraindications: Severe respiratory depression, acute or severe bronchial asthma, hypersensitivity to oxycodone.
  • Pertinent Information: Risk of addiction, abuse, and misuse; use with caution in patients with a history of substance abuse.
94
Q

Gabapentin

A
  • Disease: Neuropathic pain, epilepsy, restless legs syndrome.
  • Mechanism: Modulates calcium channels, reduces excitatory neurotransmitter release.
  • Side Effects: Dizziness, somnolence, peripheral edema, weight gain.
  • Contraindications: Hypersensitivity to gabapentin.
  • Pertinent Information: Dose adjustment required in renal impairment; monitor for signs of depression or suicidal thoughts.
95
Q

Fexofenadine

A
  • Disease: Allergic rhinitis, chronic idiopathic urticaria.
  • Mechanism: Second-generation antihistamine, blocks H1 histamine receptors.
  • Side Effects: Headache, drowsiness (less than first-generation antihistamines), dry mouth.
  • Contraindications: Hypersensitivity to fexofenadine.
  • Pertinent Information: Non-sedating antihistamine, suitable for use where alertness is required.
96
Q

Enfuvirtide

A
  • Disease: HIV/AIDS.
  • Mechanism: Fusion inhibitor, prevents HIV from entering CD4+ cells.
  • Side Effects: Injection site reactions, pneumonia, hypersensitivity reactions.
  • Contraindications: Hypersensitivity to enfuvirtide.
  • Pertinent Information: Subcutaneous injection; used in combination with other antiretrovirals for treatment-experienced patients.
97
Q

Maraviroc

A
  • Disease: HIV/AIDS.
  • Mechanism: CCR5 antagonist, blocks HIV from entering cells via the CCR5 receptor.
  • Side Effects: Hepatotoxicity, cough, fever, upper respiratory tract infections.
  • Contraindications: Severe renal impairment, hypersensitivity to maraviroc.
  • Pertinent Information: Requires tropism testing to confirm CCR5-tropic HIV before use.
98
Q

Scopolamine

A
  • Disease: Motion sickness, postoperative nausea and vomiting.
  • Mechanism: Anticholinergic, blocks muscarinic receptors in the vestibular system.
  • Side Effects: Dry mouth, blurred vision, drowsiness, urinary retention.
  • Contraindications: Narrow-angle glaucoma, hypersensitivity to scopolamine.
  • Pertinent Information: Available as a transdermal patch; apply several hours before needed for motion sickness prevention.
99
Q

Ramipril

A
  • Disease: Hypertension, heart failure, post-myocardial infarction.
  • Mechanism: ACE inhibitor, reduces angiotensin II production, lowering blood pressure and decreasing cardiac workload.
  • Side Effects: Cough, hyperkalemia, hypotension, angioedema.
  • Contraindications: Pregnancy, history of angioedema related to previous ACE inhibitor therapy, hypersensitivity to ramipril.
  • Pertinent Information: Monitor blood pressure, renal function, and electrolytes regularly.
    *
100
Q

Trimbow

A
  • Disease: Asthma, COPD.
  • Mechanism: Short-acting beta-2 agonist, relaxes bronchial smooth muscle.
  • Side Effects: Tremor, palpitations, tachycardia, headache.
  • Contraindications: Hypersensitivity to salbutamol.
  • Pertinent Information: Used for acute relief of bronchospasm; overuse can lead to decreased effectiveness and increased side effects.
101
Q

Allopurinol

A
  • Disease: Gout, hyperuricemia.
  • Mechanism: Xanthine oxidase inhibitor, reduces uric acid production.
  • Side Effects: Rash, gastrointestinal disturbances, hepatotoxicity, Stevens-Johnson syndrome (rare).
  • Contraindications: Hypersensitivity to allopurinol.
  • Pertinent Information: Start at a low dose to minimize the risk of gout flares; monitor renal function and uric acid levels regularly.
102
Q

Beta-Blockers

A
  • Mechanism of Action: Block Ξ²-adrenergic receptors, inhibiting the effects of adrenaline (epinephrine) and noradrenaline (norepinephrine).
  • Subtypes:
  • Selective Ξ²1-blockers primarily affect the heart.
  • Non-selective Ξ²-blockers affect both the heart and other tissues like bronchial smooth muscle and blood vessels.
  • Indications:
  • Hypertension, Angina pectoris, Arrhythmias, Heart failure, Glaucoma (non-selective Ξ²-blockers), Essential tremor (primarily propranolol)
  • Side Effects: Bradycardia (slow heart rate), Hypotension (low blood pressure), Fatigue, Dizziness, Bronchoconstriction (non-selective Ξ²-blockers)
  • Contraindications:
  • Severe bradycardia, Heart block, Decompensated heart failure, Hypotension, Asthma (non-selective Ξ²-blockers)
  • Pertinent Information:
  • Non-selective Ξ²-blockers should be used with caution in patients with asthma or chronic obstructive pulmonary disease (COPD).
  • Abrupt withdrawal of Ξ²-blockers can lead to rebound hypertension or angina.
103
Q

PAEDS

Corticosteroids

A
  • Disease: Inflammatory conditions, asthma, autoimmune diseases.
  • Mechanism: Anti-inflammatory and immunosuppressive effects by inhibiting cytokine production and reducing immune cell activity.
  • Side Effects: Growth suppression, weight gain, increased infection risk, osteoporosis.
  • Contraindications: Untreated systemic infections, hypersensitivity to corticosteroids.
  • Pertinent Information: Monitor growth regularly in children; use the lowest effective dose for the shortest duration.
104
Q

PAEDS

Sulphonamide

Kernicterus

A
  • Disease: Bacterial infections.
  • Mechanism: Inhibit folic acid synthesis in bacteria by blocking dihydropteroate synthase.
  • Side Effects: Allergic reactions, rash, Stevens-Johnson syndrome, kernicterus in neonates.
  • Contraindications: Infants less than 2 months old, pregnant women at term, hypersensitivity to sulfonamides.
  • Pertinent Information: Avoid use in neonates and late pregnancy to prevent kernicterus.
105
Q

PAEDS

Ceftriaxone + Calcium Solutions

A
  • Calcium Precipitation in Lungs
  • Disease: Bacterial infections.
  • Mechanism: Third-generation cephalosporin antibiotic, inhibits cell wall synthesis.
  • Side Effects: Diarrhea, rash, calcium precipitation leading to lung and kidney damage.
  • Contraindications: Concurrent use with calcium-containing IV solutions in neonates.
  • Pertinent Information: Avoid co-administration with calcium-containing solutions in neonates; flush IV lines between medications.
106
Q

PAEDS

IV Chloraphenicol

A
  • Disease: Severe bacterial infections.
  • Mechanism: Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
  • Side Effects: Bone marrow suppression, aplastic anemia,Grey baby syndrome in neonates.
  • Contraindications: Neonates, hypersensitivity to chloramphenicol.
  • Pertinent Information: Use with caution in neonates due to risk of Grey baby syndrome; monitor blood levels and function.
107
Q

PAEDS

Gentamycin

A
  • Disease: Severe bacterial infections (e.g., sepsis, pneumonia, urinary tract infections)
  • Mechanism: Aminoglycoside antibiotic that binds to the 30S ribosomal subunit, inhibiting bacterial protein synthesis.
  • Side Effects: Nephrotoxicity (kidney damage) Ototoxicity (hearing loss) Neuromuscular blockade
  • Contraindications: Hypersensitivity to gentamycin or other aminoglycosides, Caution in patients with pre-existing renal or hearing impairment
  • Pertinent Information: Requires careful dosing and monitoring of blood levels, particularly in neonates and infants, to avoid toxicity. Regularly monitor renal function and hearing during treatment.Dosage adjustments needed in renal impairment.

Higher volume of distribution of water-soluble drugs

108
Q

PAEDS

Diazepam

A

Used in paediatrics for acute seizure management and anxiety; caution with long-term use due to potential for dependence and withdrawal.

Similar or lower for fat-soluble drugs

109
Q

Synometrine

A
  • Disease: Postpartum hemorrhage, uterine atony.
  • Mechanism: Combination of oxytocin and ergometrine, stimulates uterine contractions.
  • Side Effects: Hypertension, nausea, vomiting, headache.
  • Contraindications: Hypertension, pre-eclampsia, severe cardiac disease.
  • Pertinent Information: Used to prevent or control postpartum hemorrhage; monitor blood pressure and uterine tone.
110
Q

Anabolic Steroids

Stanozolol, Nandrolone

A
  • Disease: Anemia, muscle wasting diseases, delayed puberty.
  • Mechanism: Synthetic derivatives of testosterone, promote muscle and bone growth.
  • Side Effects: Liver damage, cardiovascular disease, hormonal imbalances, aggressive behavior.
  • Contraindications: Prostate cancer, breast cancer in males, hypersensitivity to anabolic steroids.
  • Pertinent Information: Potential for abuse and serious side effects; used under medical supervision for specific conditions.
111
Q

GnRH Agonist

A
  • Disease: Prostate cancer, endometriosis, precocious puberty.
  • Mechanism: Initially stimulate and then desensitize GnRH receptors, leading to a decrease in gonadotropin release and sex hormone production.
  • Side Effects: Hot flashes, decreased libido, osteoporosis, injection site reactions.
  • Contraindications: Pregnancy, breastfeeding, hypersensitivity to GnRH analogs.
  • Pertinent Information: Used to suppress hormone-dependent conditions; monitor bone density and hormone levels.
    *
112
Q

GnRH Antagonist

A
  • Disease: Prostate cancer, endometriosis, infertility treatments.
  • Mechanism: Directly inhibit GnRH receptors, leading to an immediate decrease in gonadotropin release and sex hormone production.
  • Side Effects: Hot flashes, decreased libido, osteoporosis, injection site reactions.
  • Contraindications: Pregnancy, breastfeeding, hypersensitivity to GnRH analogs.
  • Pertinent Information: Used to suppress hormone-dependent conditions and in assisted reproductive technology; monitor bone density and hormone levels.
113
Q

Androgen Antangonists

A
  • Disease: Prostate cancer, hirsutism.
  • Mechanism: Block androgen receptors, inhibiting the effects of male sex hormones.
  • Side Effects: Gynecomastia, hot flashes, gastrointestinal disturbances, liver toxicity.
  • Contraindications: Severe liver disease, hypersensitivity to androgen antagonists.
  • Pertinent Information: Used primarily in prostate cancer treatment; monitor liver function and hormone levels.
114
Q

Copper Coil/IUD

A
  • Disease: Contraception.
  • Mechanism: Copper ions released create a hostile environment for sperm, preventing fertilization.
  • Side Effects: Heavy menstrual bleeding, cramping, risk of pelvic inflammatory disease.
  • Contraindications: Active pelvic infection, uterine abnormalities, copper allergy.
  • Pertinent Information: Long-term contraceptive method; regular check-ups recommended to ensure proper placement.
115
Q

Levonorgestrel (Levonelle)

A
  • Disease: Emergency contraception.
  • Mechanism: Progestin, inhibits ovulation and fertilization.
  • Side Effects: Nausea, fatigue, headache, menstrual changes.
  • Contraindications: Hypersensitivity to levonorgestrel.
  • Pertinent Information: Most effective within 72 hours of unprotected intercourse; available over-the-counter.
116
Q

Ulipristal Acetate (EllaOne)

A
  • Disease: Emergency contraception.
  • Mechanism: Selective progesterone receptor modulator, delays ovulation.
  • Side Effects: Headache, abdominal pain, menstrual changes, nausea.
  • Contraindications: Hypersensitivity to ulipristal acetate, existing pregnancy.
  • Pertinent Information: Effective within 120 hours (5 days) of unprotected intercourse; requires prescription in some regions.
117
Q

Montelukast

A
  • Disease: Asthma, allergic rhinitis.
  • Mechanism: Leukotriene receptor antagonist that blocks leukotrienes, reducing bronchoconstriction, inflammation, and mucus production.
  • Side Effects: Headache, abdominal pain, cough, dizziness, mood changes (e.g., depression, anxiety, suicidal thoughts).
  • Contraindications: Hypersensitivity to montelukast or any of its components.
  • Pertinent Information:
  • Used as a maintenance treatment for asthma and to relieve symptoms of allergic rhinitis; not intended for the relief of acute asthma attacks.
  • Monitor for changes in mood or behavior.
  • Typically taken once daily in the evening for asthma; dosing may vary for allergic rhinitis.
118
Q

Prednisolone

A
  • Mechanism: Glucocorticoid that reduces inflammation by inhibiting multiple inflammatory cytokines and mediators.
  • Side Effects: Weight gain, increased infection risk, hypertension, osteoporosis, mood changes, hyperglycemia.
  • Contraindications: Systemic fungal infections, hypersensitivity to prednisolone.
  • Pertinent Information:
  • Long-term use requires monitoring for side effects such as osteoporosis and adrenal suppression.
  • Dosage should be tapered gradually to avoid adrenal insufficiency.
119
Q

Dexamethasone

A
  • Disease: Inflammatory conditions, autoimmune diseases, severe allergies, cerebral edema, croup, adjunct in cancer therapy, COVID-19
  • Mechanism: Potent glucocorticoid that reduces inflammation by inhibiting multiple inflammatory cytokines and mediators.
  • Side Effects: Weight gain, increased infection risk, hypertension, osteoporosis, mood changes, hyperglycemia, insomnia.
  • Contraindications: Systemic fungal infections, hypersensitivity to dexamethasone.
  • Pertinent Information:
  • More potent and longer-acting than prednisolone; used in conditions requiring strong anti-inflammatory effects.
  • Monitor for side effects, especially in long-term use or high doses.
    *
120
Q

Betamethasone

A
  • Disease: Inflammatory conditions, autoimmune diseases, severe allergies, preterm labor to enhance fetal lung maturity.
  • Mechanism: Glucocorticoid that reduces inflammation by inhibiting multiple inflammatory cytokines and mediators.
  • Side Effects: Weight gain, increased infection risk, hypertension, osteoporosis, mood changes, hyperglycemia.
  • Contraindications: Systemic fungal infections, hypersensitivity to betamethasone.
  • Pertinent Information:
  • Highly potent with strong anti-inflammatory effects.
  • Commonly used in obstetrics to promote fetal lung development in preterm labor.
  • Monitor for side effects, particularly with prolonged use.
121
Q

Aspirin

A
  • Disease: Pain, fever, inflammation, cardiovascular disease (prevention of heart attacks and strokes).
  • Mechanism: Non-selective irreversible inhibitor of cyclooxygenase (COX-1 and COX-2), reducing the production of prostaglandins and thromboxanes, which mediate inflammation, pain, fever, and platelet aggregation.
  • Side Effects: Gastrointestinal ulcers and bleeding, tinnitus (ringing in the ears), allergic reactions, Reye’s syndrome (in children with viral infections).
  • Contraindications: Active peptic ulcer disease, bleeding disorders, hypersensitivity to aspirin or other NSAIDs, children and teenagers with viral infections (due to the risk of Reye’s syndrome).
  • Pertinent Information:
  • Low doses (81-325 mg daily) are commonly used for cardiovascular protection.
  • Higher doses are used for anti-inflammatory and analgesic effects but increase the risk of side effects.
  • Should be taken with food or a full glass of water to minimize gastrointestinal irritation.
122
Q

Naproxen

A
  • Disease: Pain, inflammation, arthritis (osteoarthritis, rheumatoid arthritis), menstrual cramps, ankylosing spondylitis, gout.
  • Mechanism: Non-selective reversible inhibitor of cyclooxygenase (COX-1 and COX-2), reducing the production of prostaglandins which mediate inflammation, pain, and fever.
  • Side Effects: Gastrointestinal irritation, ulcers and bleeding, renal impairment, cardiovascular events (e.g., heart attack, stroke), dizziness.
  • Contraindications: Active peptic ulcer disease, recent gastrointestinal bleeding, severe renal impairment, hypersensitivity to naproxen or other NSAIDs, perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.

Pertinent: GI bleeding

** πŸ’Š Medications (3 decks)

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