100 important drugs to know - part 1

Question 1

Digoxin indication

Answer 1

• AF or flutter

- heart failure

Question 2

Digoxin contra-indications

Answer 2

• constrictive pericarditis
• hypertrophic cardiomyopathy
• intermittent complete heart block
• myocarditis
• second degree AV block
• SVT arrhythmias eg WPW syndrome
  = VF

Question 3

Digoxin common or very common SE

Answer 3

• arrhythmia
• blurred/yellow vision
• d+v
• eosinophilia/ rash

Question 4

Digoxin monitoring

Answer 4

Us/Es

Question 5

Digoxin drug class

Answer 5

cardiac glycoside

Question 6

Bendroflumethiazide indications

Answer 6

Oedema

Hypertension

Question 7

Dose of Bendroflumethiazide for HTN

Answer 7

2.5 mg OD

Question 8

Dose of Bendroflumethiazide for oedema

Answer 8

5-10 mg OD or alternate days

1-3/7 for maintenance

Question 9

Contra-indications of Bendroflumethiazide

Answer 9

• addisons
• high Ca, urea
• low K, Na

Question 10

Cautions with Bendroflumethiazide

Answer 10

• DM
• gout
• SLE

Question 11

Monitoring for Bendroflumethiazide

Answer 11

Us/Es

Question 12

Drug class of Bendroflumethiazide

Answer 12

thiazide diuretics

Question 13

Furosemide mech of action

Answer 13

Loop diuretic; inhibits reabsorption

Question 14

Furosemide indications

Answer 14

oedema

resistant oedema/ HTN

Question 15

Dose of furosemide for oedema (non resistant)

Answer 15

start with 40 mg OD, maintain 20-40 mg OD

Question 16

Dose of furosemide for resistant HTN

Answer 16

40-80 mg OD PO

Question 17

Contra-indications of furosemide

Answer 17

renal failure

low Na or K

Question 18

Main SE of furosemide

Answer 18

• hepatic impairment due to low K- could lead to encephalopathy and coma
• renal impairment
• tinnitus and deafness if rapidly administrated

Question 19

Monitoring of furosemide

Answer 19

Us and Es

Question 20

Spironolactone indications

Answer 20

• Oedema due to heart failure
• Ascites due to cirrhosis of liver
• nephrotic syndrome
• resistant HTN

Question 21

Dose of spironolactone for oedema

Answer 21

100-400 mg OD

Question 22

Dose of spironolactone for HTN

Answer 22

25 mg OD

Question 23

Contra indications to spironolactone

Answer 23

Addisons
Anuria
High K

Question 24

Monitoring of spironolactone

Answer 24

Plasma K levels- high risk of hyperkalaemia

Question 25

Drug class of spironolactone

Answer 25

aldosterone antagonist

Question 26

Indications of Co-amilofruse

Answer 26

oedema

Question 27

What is co amilofruse made of

Answer 27

amiloride + furosemide

Question 28

Amiloride indications

Answer 28

- oedema | - K conservation when used with other diuretics

Question 29

Dose of amiloride for oedema

Answer 29

10 mg OD or 5mg BD max daily =20mg

Question 30

Monitoring of amiloride

Answer 30

monitor electrolytes (high risk of hyper K)

Question 31

Adenosine indication

Answer 31

- rapid reversion to sinus rhythm from SVTs | - used in myocardial perfusion imaging in patients who cannot exercise adequately

Question 32

Dose of adenosine for rapid reversion to sinus rhythm

Answer 32

- 6mg IV over 2secs, | - followed by a possible 2 more 12mg doses 1-2 min apart if required

Question 33

Contra-indications of adenosine

Answer 33

- asthma, copd - decompensated heart failure - Long QT - 2/3rd degree HB - severe hypotension

Question 34

Common SEs of adenosine

Answer 34

- angina (discontinue if) - apprehension - arrhythmia, AV block - SOB - nausea - headache, dizziness

Question 35

Monitoring for adenosine

Answer 35

ECG monitoring resus facilities should be available

Question 36

Amiadarone indication

Answer 36

- arrhythmias | - If Refractory to defib: ventricular fibrillation or pulseless ventricular tachycardia

Question 37

Amiadarone dose

Answer 37

PO: 200 mg TDS 3days 1st wk, then 200mg BD for 2nd wk, then 20mg OD IV: 5mg/Kg over 20-120 mins, max 1.2 g daily

Question 38

Interactions of amiodarone

Answer 38

very long half life | interactions may occur several wks/months after taking

Question 39

Common SEs of amiodarone

Answer 39

- Low HR - high/low thyroid - pulmonary toxicity - jaundice, nausea/ vomiting - grey skin discolouration, phototoxicity - reversible corneal microdeposits

Question 40

Monitoring of amiadarone

Answer 40

``` Every 6 mo: - TFT - LFTs Before start : - K, LFTs, TFT - CXR ```

Question 41

Monitoring of iv amiadarone

Answer 41

ECG monitoring and resuscitation facilities must be available. - plus liver transaminases

Question 42

Concomitant use of which drugs and amiadarone should be avoided

Answer 42

Hep C anitretroviral rx: | sofosbuvir and daclatasvir, simeprevir and sofosbuvir, or sofosbuvir and ledipasvir

Question 43

Why should avoid treating hep c and amiadarone at the same time

Answer 43

risk of severe bradycardia and HB