Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSRA > Drugs > Flashcards

Drugs Flashcards

1
Q

Bisoprolol

A 
Beta blocker, caution in asthmatics, 
step 1 NICE algorithm stable angina
step 4 NICE algorithm HTN K+>4.5
Prognostic benefit in HF
Don't use with verapamil (low CO)
OD treated with glucagon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amlodipine

A

Dihidropyridine CCB
Step 2 NICE algorithm stable angina (step 1 in prinzmetal angina)
Step 1 NICE algorithm HTN (afro/caribbean or >55)
Interacts with simvastatin (increase levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diltiazem

A

Dihidropyridine CCB
Step 2 NICE algorithm stable angina (step 1 in prinzmetal angina)
Rate control in AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Isosorbide Mononitrate

A

Vasodilator, give 0800, 1400 to give nitrate free period + avoid tolerance
SE flushing headaches hypotension
Step 3 NICE algorithm stable angina (MR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ivabradine

A

Slows HR down, patient must be NSR w resting HR >70
Step 3 NICE algorithm stable angina
Stop after 3 m if not working
Used in HF if LVEF <35% and NSR + HR >75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ranolazine

A

Step 3 NICE algorithm stable angina
Helps w HR, good if bradycardia
SE: long QT, avoid in cardiac, renal, liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nicorandil

A

Vasodilator
Step 3 NICE algorithm stable angina
C/I: low BP, LV dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Statins

A

Give if Qrisk2>10% or lifestyle changes ineffective
Atorvastatin for >85/CKD with no risk stratification
High dose in proven CVD
C/I : pregnancy
Amlodipine interacts w simvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ezetimibe

A

Monotherapy of primary hypercholesterolaemia if statins C/I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fibrates

A

Lipid modification in 2 care
Better to reduce triglycerides
Increased risk of gallstones
Combo w statins-> increase risk of rhabdo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aliro/evoloCUmab

A

specialist drug for primary heterozygous familial hypercholesterolaemia to lower LDL-C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clopidogrel

A 
Antiplatelet 
Omeprazole interacts (reduces effectiveness) use ticagrelor instead (or lansoprazole)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ticagrelor

A

Antiplatelet, use instead of clopi in DAPT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tirofiban

A

Used in ACS for high risk patients, causes anaemia and thrombocytopaenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ramipril

A 
ACE inhibitor
Step 1 `NICE algorithm HTN (<55 or T2DM)
Control BP in systemic sclerosis 
Prognostic benefit in `HF (helps remodel heart by reducing after load) 
SE: hyperkalaemia, dry cough, angioedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Losartan

A

ARB
Step 1 NICE algorithm HTN (<55/ T2DM)
Use if dry cough not tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indapamide

A

Thiazide like diuretic
Step 2 or 3 NICE algorithm HTN
S/E: Impotence, hypo N/K hyper Ca, precipitates gout (hyperuricaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spironolactone

A

Mineralocorticoid antagonist
Step 4 NICE algorithm HTN (K<=4.5)
Treat HTN in Conns syndrome
K sparing
Prognostic benefit in HF
S/E - painful gynaecomastia, impotence, hyperK
Use selective aldosterone receptor antagonist (eplerenone) if SE not tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Furosemide

A

Loop diuretic, offloads fluids
No prognostic benefit in HF
SE: hypoK/Na, exactas hyperglycaemia + gout
0800 1400 (avoid night diuresis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Entresto

A 
To treat HF, indication LVEF <35% 
Combo valsartan (prognostic benefit) and sacubitril
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Digoxin

A

Need loading as long half life
Used in CHF as some positive isotropy
Used for AF in sedentary patients, only reduces ventricular rate at rest
OD: N/V/D, blurred vision w xanthopsia/halos + pals/syncope + confusion. Rx = Fab fragment to digoxin (digibind)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Amiodarone

A

Chemical cardio version in AF, preferred for patients with LV failure. V long half life so needs loading.
SE: photosensitivity, slate grey pigmentation. hepatotoxicity, thyroid (hypo/hyper, contains IODine), pulmonary fibrosis
Interactions: warfarin, digoxin
300mg IV (20-60 mins) then 900mg (24 hrs) in unstable tachycardia, regular broad complex tachycardia, pre-excited AF w adverse features)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Flecanide

A

paroxysmal AF chemical cardioversion - “pill in pocket”

Cant use in patients with structural heart conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Atropine

A

500mcg for profound bradycardia, repeat up to 3mg max if risk of asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Adenosine

A

6/12/12 mg IV boluses for regular narrow complex tachycardia after vagal manouvres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Salbutamol

A 
SABA, works acutely 
S/E tachycardia, tremor/anxiety, cramps, paradoxical bronchospasm
Increases lactate (false +ve on blood test), hypokalaemia, hyperglycaemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Salmeterol

A 
LABA, DELAYED onset, reduces nocturnal sx
S/E tachycardia, tremor/anxiety, cramps, paradoxical bronchospasm
Increases lactate (false +ve on blood test), hypokalaemia, hyperglycaemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Steroids (asthma)

A

Can be inhaled (ICS) or oral/IV (acute 5-7 days, chronic if still uncontrolled by ICS
Aim for lowest dose
Need bone + GI protection, may cause thrush (rinse mouth after inhaled)
Long term use can cause adrenal suppression -> steroid card
High acute dose can cause psychosis
May cause reactive leukocytosis but pt still “immunosuppressed”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Montelukast

A

Leukotriene receptor antagonist
Additive effect w ICS
S/E abdo pain, thirst, headache
V rare association with drug induced Churg-Strauss syndrome -> eosinophilia, vasculitic rash, pulmonary renal syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Theophylline

A

Aminophylline. Give note to prevent morning dipping. Not used in GP because variable metabolism in liver (smokers/liver/heart failure), affected by inducers, narrow therapeutic index
Toxicity - Nausea, tachycardia, seizures, hypokalaemia, hyperglycaemia

31
Q

Sodium Cromoglicate

A

INH mast cell stabilisers

Good for mild and exercise induced asthma esp kids

32
Q

Omalizumab

A

Anti-IgE May used in persistent ALLERGIC asthma in SECONDARY care

33
Q

Mepolizumab

A

Anti-IL5 May used in REFRACTORY EOSINOPHILIC asthma in SECONDARY CARE

34
Q

Ipratropium Bromide

A

SAMA, used in asthma exac
Common S/E - dry mouth (anti M)
Less common S/E - Nausea/headache
RARE S/E - constipation, tachycardia, retention, confusion, blurred vision as dilated pupils, angle closure glaucoma, hypersensitivity
CAUTION -> BPH and glaucoma prone patients

35
Q

Tiotropium

A

LAMA, used in COPD
Common S/E - dry mouth (anti M)
Less common S/E - Nausea/headache
RARE S/E - constipation, tachycardia, retention, confusion, blurred vision as dilated pupils, angle closure glaucoma, hypersensitivity
CAUTION -> BPH and glaucoma prone patients

36
Q

Metformin

A

Insulin sensitisation (needs residual islet cells to work)
No hypos, stop weight gain
Improve HbA1c 1-2%
S/E - GI upset (can try MR)
- lactic acidosis (stopped 2-3 days pre op or pre contrast, dehydration is risk factor) -> stopped if eGFR <30 or Cr >150

37
Q

Gliclazide

A

KATP channel inhibitor => increase insulin secretion
Improve HbA1c 1-2%
Causes weight gain, hypos
2nd line for T2DM
Rarer S/E: hepatic cholestasis, blood dycrasias, skin allergic rxn
Omit morning of surgery

38
Q

Gliptins

A

DPP-4 inhibitor (increase GLP-1 endogenously)=> insulin secretion
Slight HbA1c reduction (<1%)
Weight neutral
No hypo risk on its own
Good 2nd line if eGFR >50
S/E - headaches, N+V, HF, pancreatitis/pancreatic cancer risk, infection risk, arthralgia

39
Q

Glitazones

A

PPAR-gamma activator => insulin secretion + increase sensitivity
Slight HbA1c improvement (<1.5%)
Weight gain
Use if insulin RESISTANT, better lipid profile and MI risk reduction, also used if NAFLD
S/E - fluid retention (so HF =CI), hepatoxicity, osteoporosis, bladder Ca,
Need LFTs every 2mon for a yr
Monitor + stop in 3-6 mon if not working

40
Q

Gliflozins

A

Selective SGLT2 inhibitor = blocks glucose reabsorption by kidney => excess glycosuria so only effective if eGFR >60
Reduced mort in pt with cardiovascular disease/HF
Weight LOSS
S/E - NORMOGLYCAEMIC DKA, UTIs, thrush diuresis, hyperkalaemia

41
Q

Exenatide Liraglutide

A

Glucagon-like peptide mimetic => augment insulin release and slow gastric emptying. S/c 5 mins pre meal
No hypos when used alone
Weight LOSS
HbA1c improved <1.5%, doesn’t improve CV outcomes.
Indications: BMI >35 + problem ass w obesity, BMI <35, insulin poses occupational implications or weight loss may benefit obesity comorbidities
S/E TDS inj, GI inc pancreatitis/panceatic Ca risk, worsens gastroparesis (CI).
CI if eGRF<30

42
Q

Repaglinide Nateglinide

A

Secretogogues = sulphonylurea receptor binders => increase insulin release
HbA1c <1.5% reduction
Rapid onset/short duration, give 30 min pre meal
S/E - rash, N+V, GI upset, hypos, hepatotoxic
disfavoured

43
Q

Acarbose

A

Instestinal alpha-glucosidase inhibitor = less starch breakdown = less absorption
v small HbA1c benefit
Weight neutral.
Rarely used in Type 1s to reduce post prandial hyperglycaemia and in DUMPING SYNDROME post fundoplication
S/E flatulence, abdo discomfort, diarrhoea

44
Q

Orlistat

A

Inhibit pancreatic and gastric lipase => less fatty acids => steatorrhea and weight loss
NICE guidelines BMI>28 + RF or BMI >30
Only continue >3 months if >5% weight loss

45
Q

Cyclizine

A

H1 antagonist anti emetic

emetogenic for GI (PONV) or vestibular causes

46
Q

Metoclopromide

A

D2 antagonist
(also haloperidol, domperidone, prochlorperazine)
Emetogenic for GI/Vestibular/Opiates
S/E: pro kinetic (NOT USED IN BO) can cause dystonias and oculogyric crises

47
Q

Ondansetron

A

5-HT3 antagonist antiemetic

Emetogenic for chemo / surgery

48
Q

Methotrexate

A 
DMARD 
Terratogenic
Req folate replacement 
S/E - PNEUMONITIS, GI upset, myelosuppression, hepatotoxicity. 
Monitor FBC, LFT, CXR, Cr at baseline.
49
Q

Sulfasalazine

A

DMARD
Similar to aspirin so don’t use if aspirin allergy
S/E - Myelosupression (FBC monitoring, Hepatotoxic (LFTs), rash, oligospermia/male infertility), Heinz body anaemia

50
Q

Hydroxychloroquine

A

DMARD
BULLSEYE maculopathy
/retinopathy/corneal deposits
Yearly screen if >40 or prev ocular problem

51
Q

Azathioprine

A

DMARD
S/E Fever, bruising, hepatotoxicity, myelosupression
Check LFTs, FBC at baseline
Check thiopurine methyltransferase before starting

52
Q

Penicillamine

A

DMARD
Can give drug induced SLE
S/E rash, ulcers, taste loss, proteinuria (check protein:Cr ratio), Myelosupression, check FBC, exacerbation of myasthenia graves

53
Q

Cyclophosphamide

A

DMARD

S/E - skin pigmentation, male infertility, HAEMORRHAGIC CYSTITIS

54
Q

Ciclosporin

A

DMARD

S/E myelosupression, renal failure (hyperK+, Cr, HTN, oedema), gingival hyperplasia

55
Q

Anti-TNFa

A

Mabs
DMARDs
Screen for TB first (cause disseminated TB from reactivation
Other S/E: CHF, sepsis, demyelination

56
Q

Unfractionated Heparin

A

Inhibits Xa, IXa, XIa, XIIa
Continuous IV a infusion
Needs monitoring of APTT (1.5-2.5) tricky
FULL reversal w protamine sulphate
S/E long term osteoporosis, pain on inj site, hyperkalaemia (inhibits aldosterone secretion)

57
Q

Fondaparinux

A

Binds ATIII Xa - lower HIT rate
NO reversal with protamine sulphate
S/E long term osteoporosis, pain on inj site, hyperkalaemia (inhibits aldosterone secretion)

58
Q

LMWH

A

Binds ATIII Xa
Sub cut, renal excretion, easy dosing, half life 10h (long) no monitoring
S/E long term osteoporosis, pain on inj site, hyperkalaemia (inhibits aldosterone secretion)

59
Q

Dabigatran

A 
DOAC, vs THROMBIN, for non valve AF, VTE
Not for metal valves, arterial clot, pregnant or breast feeding 
Interactions - AED, ART, anti fungal, rifampicin 
Coag test = thrombin time 
RENAL elimination
Needs 5d heparin (like Edox) 
Can cause GI bleeds
Antidote = Idarucizumab
60
Q

Apixaban

A

DOAC, vs Xa, for non valve AF, VTE
Not for metal valves, arterial clot, pregnant or breast feeding
Interactions - AED, ART, anti fungal, rifampicin
1st line for VTE
Faecal elimination
Bleeding - no antidote, give PCC, oral charcoal

61
Q

Rivaroxaban

A

DOAC, vs Xa, for non valve AF, VTE
Not for metal valves, arterial clot, pregnant or breast feeding
Interactions - AED, ART, anti fungal, rifampicin
LIVER excretion
Increased menorrhagia
Bleeding - no antidote give PCC, oral charcoal (if taken <4 hrs ago)

62
Q

Warfarin

A

Reduces II, VII, IX & protein C
VTE - aim 2.5 if recurrent/PE 3.5, AF - aim 2.5, mech valves 2.5-3.5 in old, 2-3 in new
S/e haemorrhage, teratogenic (but can use if breastfeeding) skin necrosis, purple toes.
Causes of high INR: diet, liver disease, Omeprazole, Disulfiram, Erythromycin, Valproate, Isoniazid, Cipro/Cimetidine, acute Ethanol, Sulphonamide, Cranberry juice, NSAIDs
Avoid foods high in vitamin K (brocoli spinach, kale sprouts)
Reverse w VIT K
Use if CrCl <30

63
Q

Levodopa

A

PD, combined with decarboxylase inhibitor (carbidopa) to prevent peripheral metabolism to dopamine
Reduced effectiveness with time
S/E: dyskinesia, on off effect, dry mouth, anorexia, palps, postural hypotension, psychosis, drowsiness.
Don’t use in neuroleptic induced Parkinsonism
Don’t acutely stop it! (patches if can’t take orally)

64
Q

Bromocriptine, cabergoline

A

PD, Ergot derived dopamine agonists
Ass with pulmonary, retriperitoneal and cardiac fibrosis. Need echo, ESR, Cr and CXR before Rx and closely monitor
Can cause impulse control disorders and daytime somnolence
More likely to cause hallucinations in elderly than levodopa
S/E nasal congestion, postural hypotension.

65
Q

Ropinirole, Apomorphine

A

PD: Newer, non ergot derived dopamine agonists
Can cause impulse control disorders and daytime somnolence
More likely to cause hallucinations in elderly than levodopa
S/E nasal congestion, postural hypotension.

66
Q

Selegiline

A

MAO-B inhibitor, PD

Inhibits breakdown of dopamine secreted by dopaminergic neurons

67
Q

Amantadine

A

PD, mech not fully understood

S/E: ataxia, slurred speech, confusion, dizziness, livedo reticularis

68
Q

Entacapone, Tolcapone

A

COMT inhibitor, adjunct to levodopa in patients with established PD

69
Q

Procyclidine, Benzotropine

A

Antimuscarinics, used more for drug induced Parkinson’s disease, help tremor and rigidity

70
Q

Carbemazepine

A

Used for partial seizures (1st line), trigeminal neuralgia.
P450 enzyme INDUCER
S/E dizziness and ataxia, drowsiness, headache, Diplopia, Steven-Johnson syndrome, leucopenia, agranulocytosis, hyponatraemia 2 to SIADH

71
Q

Lamotrigine

A

Antiepileptic 2nd line for generalised and partial seizures

Adverse effect: Steven Johnson syndrome

72
Q

Phenytoin

A

Antiepileptic
P450 INDUCER
Lots of adverse effects.
Acute: dizziness, diplopia, nystagmus, slurred speech, ataxia, then confusion, seizures
Chronic: gingival hyperplasia, hirsuitism, coarsening of facial features, drowsiness, megaloblastic anaemia, peripheral neuropathy, osteomalacia, lymphadenopathy, dyskinesia
Idiosyncratic: fever, rashes, hepatitis, dupuytrens, aplastic anaemia, drug induced lupus.
Teratogenic - cleft palates, heart disease

73
Q

Sodium Valproate

A

1st line generalised seizures
P450 enzyme INHIBITOR
Adverse effects:
Terratogenic (not used in women of childbearing age), nausea, weight gain, alopecia, ataxia, tremor, hepatotoxicity, pancreatitis, thrombocytopenia, hyponatraemia, hyperammonemic encephalopathy

74
Q

Triptans

A

5-HT1B and 5-HT1D agonists for migraine
1st line combo with NSAID or paracetamol
Take asap after onset headache (not aura)
Adverse effects: tingling, heat, tightness, heaviness, pressure
CONTRAINDICATED in IHD or CVD

MSRA (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions