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Phase II Flashcards

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1
Q

Antacids

A

Aluminium & magnesium hydroxide/calcium carbonate

MoA - Gastric acid neutralisation

Indication - Dyspepsia, heartburn

Adverse effects - Nausea

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2
Q

Aluminium & magnesium hydroxide/calcium carbonate

A

Antacids

MoA - Gastric acid neutralisation

Indication - Dyspepsia, heartburn

Adverse effects - Nausea

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3
Q

What would you prescribe for dyspepsia or heartburn?

A

Antacids

Aluminium & magnesium hydroxide/calcium carbonate

MoA - Gastric acid neutralisation

Adverse effects - Nausea

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4
Q

Antacids + alginates

A

Sodium alginate with sodium bicarbonate

MoA - Gastric acid neutralisation

Indication - Gastric reflux

Adverse effects - Abdominal distension

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5
Q

What would you prescribe for gastric reflux?

A

Antacids + Alginates (sodium alginate with sodium bicarbonate)

or

PPIs (omeprazole, lansoprazole)

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6
Q

H2-receptor antagonists

A

Ranitidine, Cimetidine

MoA - Blockade of gastric H2 histamine receptors

Indication - Stomach ulcers

Adverse effects - Dizziness

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7
Q

Ranitidine, cimetidine

A

H2-receptor antagonists

MoA - Blockade of gastric H2 histamine receptors

Indication - Stomach ulcers

Adverse effects - Dizziness

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8
Q

What would you prescribe for stomach ulcers?

A

H2-receptor antagonists (ranitidine, cimetidine)

or

PPIs (lansoprazole, omeprazole)

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9
Q

PPIs

A

Omeprazole, Lansoprazole

MoA - Blockade of stomach acid transporters

Indication - Stomach & duodenal ulcers, gastric reflux

Adverse effects - Headache, diarrhoea

Interactions - Warfarin

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10
Q

Pancreatic enzymes

A

Pancreatin

MoA - Restoration of pancreatic enzymes

Indication - Pancreatic insufficiency - Cystic fibrosis, pancreatitis

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11
Q

What would you prescribe for pancreatic insufficiency (ie. in cystic fibrosis or pancreatitis)?

A

Pancreatin

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12
Q

Bulk laxatives

A

Methylcellulose, isphagula husk

MoA - Water absorption in intestinal lumen to bulk stools

Indication - Constipation

Adverse effects/Interactions - Rare

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13
Q

Methylcellulose, isphagula husk

A

Bulk laxatives

MoA - Water absorption in intestinal lumen to bulk stools

Indication - Constipation

Adverse effects/Interactions - Rare

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14
Q

Faecal softener

A

Docusate, arachis oil

MoA - Stimulates water and electrolyte secretion into intestinal lumen

Indication - Constipation

Adverse effects/interactions - rare

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15
Q

Docusate, arachis oil

A

Faecal softener

MoA - Stimulates water and electrolyte secretion into intestinal lumen

Indication - Constipation

Adverse effects/interactions - rare

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16
Q

Osmotic laxatives

A

Macrogol (PEG), lactulose, magnesium sulphate, magnesium hydroxide

MoA - Water retention in intestinal lumen

Indication - Constipation

Adverse effects - Stomach cramps

Interactions - Antiepileptics

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17
Q

Macrogol (PEG), lactulose, magnesium sulphate, magnesium hydroxide

A

Osmotic laxatives

MoA - Water retention in intestinal lumen

Indication - Constipation

Adverse effects - Stomach cramps

Interactions - Antiepileptics

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18
Q

Stimulant laxatives

A

Bisacodyl, Senna

MoA - Increase intestinal motility

Indication - Constipation

Adverse effects - Nausea

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19
Q

Opioid anti-motility agents

A

Loperamide, codeine

MoA - Agonist for µ-opioid receptors in myenteric plexus. Blocks intestinal muscarinic receptors

Indication - Diarrhoea

Adverse effects/interactions - Rare

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20
Q

Loperamide, codeine

A

Opioid anti-motility agents

MoA - Agonist for µ-opioid receptors in myenteric plexus. Blocks intestinal muscarinic receptors

Indication - Diarrhoea

Adverse effects/interactions - Rare

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21
Q

Carbonic anhydrase inhibitor

A

Acetazolamide

MoA - Reduces aqueous humour volume

Indication: Intra-ocular pressure - open & acute closed angle glaucoma

Adverse effects - Paraesthesia

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22
Q

Acetazolamide

A

Carbonic anhydrase inhibitor

MoA - Reduces aqueous humour volume

Indication: Intra-ocular pressure - open & acute closed angle glaucoma

Adverse effects - Paraesthesia

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23
Q

Osmotic diuretics

A

Mannitol

MoA - Elevates plasma osmolarity

Indication - Cerebral oedema, intra-ocular pressure

Adverse effects - Hypotension

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24
Q

Mannitol

A

Osmotic diuretics

MoA - Elevates plasma osmolarity

Indication - Cerebral oedema, intra-ocular pressure

Adverse effects - Hypotension

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25
Loop diuretics
Furosemide MoA - Inhibits Na+/K+/2Cl- transporter in loop of Henle Indication - Left ventricular heart failure, oedema Adverse effects - Nausea, dizziness Interactions - NSAIDs, ACE inhibitors
26
Furosemide
Loop diuretic MoA - Inhibits Na+/K+/2Cl- transporter in loop of Henle Indication - Left ventricular heart failure, oedema Adverse effects - Nausea, dizziness Interactions - NSAIDs, ACE inhibitors
27
Thiazides
Indapamide, Bendroflumethiazide, Chlorthalidone Hydrochlorothiazide MoA - Decreases sodium and chloride reabsorption Indication - Hypertension Adverse effects - Electrolyte imbalance, exacerbation or precipitation of gout Interactions - NSAIDs, digoxin
28
Indapamide, Bendroflumethiazide, Chlorthalidone Hydrochlorothiazide
Thiazides MoA - Decreases sodium and chloride reabsorption Indication - Hypertension Adverse effects - Electrolyte imbalance, exacerbation or precipitation of gout Interactions - NSAIDs, digoxin
29
Potassium sparing diuretics
Spironolactone, eplerenone (mineralocorticoid receptor blockade) Amiloride (Blockade of sodium reabsorption via ENaC channel) Indication - Oedema, congestive heart failure Adverse effects - GI Interactions - NSAIDs, ACEi
30
Spironolactone, eplerenone
Potassium sparing diuretics (mineralocorticoid receptor blockade) Indication - Oedema, congestive heart failure Adverse effects - GI Interactions - NSAIDs, ACEi
31
Amiloride
Potassium sparing diuretics (Blockade of sodium reabsorption via ENaC channel) Indication - Oedema, congestive heart failure Adverse effects - GI Interactions - NSAIDs, ACEi
32
Mannitol
Osmotic diuretic MoA - Elevates plasma osmolarity Indication - Cerebral oedema, intra-ocular pressure Adverse effects - Hypotension
33
Acetazolamide
Carbonic anhydrase inhibitor MoA - Reduces aqueous humour volume Indication - Intra-ocular pressure - open & acute closed angle glaucoma Adverse effects - Paraesthesia
34
Ramipril, captopril, lisinopril
ACE inhibitors MoA - Inhibits conversion of angiotensin I to angiotensin II. Blocks vasoconstriction. Indication - hypertension, diabetic nephropathy, heart failure Adverse effects - cough, hyperkalaemia Interactions - Lithium, NSAIDs
35
Losartan, valsartan
ARBs MoA - Blocks angiotensin-renin system Indication - hypertension, diabetic nephropathy, heart failure Adverse effects - hypotension, fatigue Interactions - Diuretics
36
Sacubitril (in combination with the ARB valsartan)
Neprilysin inhibitors (used in combination with an ARB) MoA - Inhibition of natriuretic peptide breakdown Indication - Heart failure (with reduced ejection fraction) Adverse effects - hypokalaemia, hypoglycaemia (from BNF)
37
Bisoprolol, atenolol
Beta-blockers (Beta-1 selective) MoA - Negative inotropic/chronotropic agent Indication - Hypertension, stable angina Adverse effects - Bradycardia, bronchospasm Interactions - NSAIDs, digoxin
38
Propranolol
Beta-blockers (Beta-1 and beta-2 selective) MoA - Negative inotropic/chronotropic agent Indication - Hypertension, stable angina Adverse effects - Bradycardia, bronchospasm Interactions - NSAIDs, digoxin
39
Doxazosin
Alpha adrenergic blockers MoA - vasodilator, decreases total peripheral resistance Indication - Hypertension Adverse effects - dizziness, headache Interactions - hypotensive drugs
40
Amlodipine, nifedipine, diltiazem
Calcium channel blockers MoA - Blockade of vascular smooth muscle contraction Indication - Hypertension, stable angina Adverse effects - ankle swelling, oedema Interactions - beta blockers, digoxin
41
Glyceryl trinitrate (GTN), Isosorbide Mononitrate (ISMN)
Nitrates MoA - Nitric oxide release, leading to smooth muscle relaxation and vasodilation Indication - Acute angina pectoris (GTN), heart failure Adverse effects - Hypotension, headache Interactions - Antihypertensives
42
Adrenaline, dobutamine, noradrenaline
Sympathomimetics MoA - Adrenergic stimulation, increased inotropy Indication - Cardiac arrest, cariogenic shock Adverse effects - Arrhythmia
43
Aspirin, clopidogrel
Antiplatelet drugs MoA: Aspirin - Inhibition of thromboxane synthesis Clopidogrel - Inhibition of platelet activation by ADP Indication - Primary and secondary relief for CVD, anticoagulant prophylaxis Adverse effects - GI irritation and bleeding Interactions - Anticoagulants
44
Warfarin
Anticoagulants - coumarin MoA - Inhibition of vitamin K epoxide reductase complex 1 (VKORC1) enzyme. Indication - DVT, prophylaxis of stroke from AF Adverse effects - Abnormal bleeding Interactions - multiple drug interactions, notably NSAIDs, diuretics
45
Dabigatran
Anticoagulants - direct thrombin inhibitor MoA - Inhibition of thrombin (also called Factor IIa) Indication - Prophylaxis of venous thromboembolism post-surgery Adverse effects - Abnormal bleeding
46
Apixaban, Edoxaban, Rivaroxaban
Anticoagulants - direct Factor Xa inhibitor MoA - Inhibition of Factor Xa in coagulation cascade Indication - Prophylaxis of stroke from atrial fibrillation; DVT Adverse effects - Abnormal bleeding
47
Dalteparin, tinzaparin, enoxaparin (low molecular weight); unfractionated heparins
Anticoagulants - Heparins MoA - Inactivation of thrombin and Factor Xa via complexing antithrombin III Indication - Prophylaxis of venous thrombosis and pulmonary embolism Adverse effects - abnormal bleeding
48
Alteplase, streptokinase, urokinase
Thrombolytics/fibrinolytics MoA - Activation of plasminogen for proteolytic breakdown of thrombus fibrin Indication - Myocardial infarction, ischaemic stroke
49
Simvastatin, atorvastatin (statins)
HMG-CoA Reductase inhibitors MoA - Inhibition of mavelonate pathway required for cholesterol synthesis Indication - Hypercholesterolaemia, risk of CVD and stroke Adverse effects - Myalgia Interactions - Verpamil, macrolides
50
Disopyramide, Quinidine
Class Ia anti-arrhythmic drugs, Sodium channel blockers MoA - Voltage-sensitive sodium channel blockade Prolong QT interval, increase QRS duration. Indications - Ventricular and supra ventricular arrhythmias Adverse effects - oedema
51
Lidocaine
Class Ib anti-arrhythmic drug, Sodium channel blocker MoA - Voltage-sensitive sodium channel blockade Prolong QT interval, increase QRS duration Indication - CPR (used IV) Adverse effects - oedema
52
Flecainide, Propafenone
Class Ic anti-arrhythmic drug, Sodium channel blocker MoA - Voltage-sensitive sodium channel blockade Prolong QT interval, increase QRS duration Indication - Paroxysmal atrial fibrillation and ventricular ectopic beats "pill in pocket" Adverse effects - oedema
53
Class II anti-arrhythmic drugs
Beta-blockers: Atenolol, bisoprolol, metoprolol MoA - Beta-adrenergic receptor blockade – reduction in adrenergic effects on rate and inotropy Indication - Prophylaxis of paroxysmal atrial tachycardia or fibrillation Adverse effects - Hypotension
54
Amiodarone, dronedarone, sotalol
Class III Anti-Arrhythmic drugs – potassium channel blockers (Sotalol also has some beta blocker activity) MoA - Potassium channel blockade, also evidence of beta blocker and calcium channel blocker properties – prolong QT interval Indication - Supraventricular, nodal and ventricular tachyarrhythmias, atrial fibrillation, (CPR - used IV) Adverse effects - Nausea, vomiting
55
Verapamil, diltiazem
Class IV anti-arrhythmics – calcium channel blockers (phenylalkylamine & benzothiazepine subclasses) MoA - Cardiac calcium channel blockade – reduction of action potential & cardiac output Indication - Supraventricular tachycardia (especially paroxysmal SVT) Adverse effects - Hypotension (verapamil), Constipation (diltiazem)
56
Digoxin
Cardiac glycosides MoA - reduces conductivity of AV node Indication - arrhythmias, AF, congestive heart failure Adverse effects - fatigue, nausea
57
Adenosine
MoA - Activates adenosine receptors – causes hyperpolarization, Slows conduction through AV Node Indication - supraventricular tachycardia Adverse effects - Nausea; contraindicated in obstructive airway disease
58
Atropine
Antimuscarinic MoA - Blockade of vagal muscarinic acetylcholine receptors Indication - Emergency bradycardia Adverse effects - Urinary retention
59
Magnesium sulphate (IV)
MoA - Unclear – possible alteration of Na+, K+ and Ca2+ ion balance via ion channels and transporters Indication - Emergency arrhythmia (Also used IV for emergency asthma) Adverse effects - Electrolyte irregularities
60
Salbutamol, terbutaline
Short-acting Beta-2 adrenergic agonists MoA - Dilates bronchial smooth muscle Indications - Asthma, reversible airways obstruction Adverse effects - Tachycardia, tremor Interactions - Diuretics
61
Ipratropium
Short-acting anti-muscarinic MoA - Blocks muscarinic receptors to promote bronchial dilation Indication - Acute asthma, bronchiospasm in COPD Adverse effects - Dry mouth, constipation
62
Tiotropium
Long-acting anti-muscarinic MoA - Blocks muscarinic receptors to promote bronchial dilation Indication - Acute asthma, bronchiospasm in COPD Adverse effects - Dry mouth, constipation
63
Theophylline, aminophylline
Methylxanthines MoA - Bronchodilator, increases cAMP in smooth muscle Indications - Acute asthma, reversible airways obstruction Adverse effects - Headache, nausea Interactions - Antidepressants, salbutamol
64
Beclomethasone, Prednisolone, Hydrocortisone, Fluticasone
Glucocorticoids MoA - Reduction of inflammation and mucus production Indications - Asthma, allergic rhinitis Adverse effects - Cough Interactions - Aspirin
65
Montelukast, zafirlukast
Leukotriene antagonists MoA - Blockade of leukotriene receptors Indications - Asthma, allergic rhinitis Adverse effects - Abdominal pain Interactions - Phenobarbital
66
Dornase alfa
Mucolytic MoA - Synthetic DNAse 1 – breakdown of extracellular DNA to reduce sputum viscosity Indication - Cystic fibrosis
67
Dopaminergics
Levodopa (precursor); Pramipexole, Ropinirole, Rotigotine (synthetic agonists) MoA - Increased dopamine synthesis and dopaminergic function Indication - Parkinson's Disease Adverse effects - Confusion, agitation Interactions - MAOI
68
Dopa-decarboxylase inhibitor
Carbidopa, Benserazide MoA - Stops breakdown of Levadopa in the periphery by inhibiting dopa-decarboxylase Indication - Parkinson's Disease Adverse effects - Confusion, agitation
69
Inhibitors of Monoamine Oxidase B (MAOI)
Selegiline, Rasagiline MoA - Inhibition of dopamine breakdown Indication - Parkinson's Disease
70
COMT (catechol-O-methyl transferase) Inhibitors
Entacapone, Tolcapone MoA - Blockade of dopamine precursor breakdown by inhibition of COMT Indication - Parkinson's Disease Adverse effects - N+V
71
Anticholinergics
Orphenadrine, Procyclidine, Trihexphenidyl MoA - Muscarinic cholinergic receptor antagonist Adverse effects - Dry mouth, constipation
72
Dopamine-depleting drugs
Tetrabenazine MoA - Blocks VMAT, preventing uptake of DA into vesicles Indications - Huntingdon's chorea
73
Class/Group | Selective serotonin reuptake inhibitors (SSRIs)
Sertraline, Citalopram, Fluoxetine MoA - Inhibition of serotonin (5HT) reuptake pump in synaptic cleft Indications - depression, generalised anxiety disorder Adverse effects - Insomnia, nausea Interactions - NSAIDs, lithium
74
Reversible Inhibitor of Monoamine Oxidase type A (RIMA)
Moclobeminde MoA - Inhibits monoamine oxidase A, preferentially decreases breakdown of serotonin and noradrenaline Indications - Depression Adverse effects - Tachycardia
75
Tricyclic antidepressants (TCAs)
Amitriptyline, Nortriptyline, Dosulepin MoA - Inhibition of noradrenaline and serotonin reuptake in synaptic cleft, H1 antagonist, M1 antagonist, Adrenergic antagonist Indications - Depression Adverse effects - Anticholinergic syndrome
76
Atypical antidepressants
Reboxetine, Venlafaxine, Buproprion, Agomelatine, Mirtazepine MoA - Noradrenaline reuptake inhibitor (Reboxetine); Noradrenaline/serotonin reuptake inhibitor (Venlafaxine); Noradrenaline /Dopamine reuptake inhibitor (Buproprion); Melatonin agonist (Agomelatine); Alpha-2 antagonist (Mirtazepine) Indications - Depression
77
Antipsychotics – Classical (also known as First Generation)
Chlorpromazine, Haloperidol MoA - Selective D2 dopamine receptor blockade Indication - Schizophrenia Adverse effects - Blurred vision, tremor, Extrapyramidal symptoms, hypotension
78
Antipsychotics – Atypical (also known as Second Generation)
Olanzapine, Risperidone, Quetiapine, Clozapine, Amisulpride MoA - Selective D2 dopamine receptor blockade Indication - Schizophrenia Adverse effects - Extrapyramidal symptoms (less than classical antipsychotics), hypotension
79
Mood stabiliser
Lithium carbonate MoA - Unclear – possible neuronal calcium channel blockade Indication - Bipolar Disorder Adverse effects - Tremor, hypothyroidism Interactions - NSAIDs, ACE inhibitors
80
Cholinesterase inhibitors
Donepezil, Galantamine, Rivastigmine MoA - Inhibition of acetylcholinesterase (reversible) Indications - Alzheimer’s Disease, mild to moderate dementia Adverse effects - N+V
81
NMDA receptor antagonist
Memantine MoA - VD blocker of NDMA receptors Indications - Alzheimer’s Disease, moderate to severe dementia Adverse effects - constipation, hypertension
82
Anxiolytics
Benzodiazepines, buspirone MoA - GABA PAM (γ-subunit); 5-HT1A partial agonist (Buspirone) Indication - Anxiety and related disorders
83
Non-benzodiazepine hypnotic
Zopiclone MoA - GABA PAM (γ-subunit) Enhanced effects of GABA Adverse effects - Insomnia
84
Anti-epilepsy drugs (AEDs)
Sodium Valproate, Lamotrigine, Carbemazepine, Ethosuximide MoA - Na+ channel blockers; (Ethosuximide – Ca2+ channel blocker) Indication - Epilepsy Adverse effects - Nausea, blurred vision Interactions - Macrolide antibiotics
85
Benzodiazepines
Lorazepam, Midazolam, Diazepam, Zolpidem (BDZ-like) MoA - GABA PAM (γ-subunit) Enhanced effects of GABA Indications - Epilepsy, Acute seizures Adverse effects - Drowsiness, dependence Interactions - Sedatives
86
BDZ antagonist
Flumazenil MoA - Antagonises GABA signalling Indications - Reversal of BDZ sedation
87
Barbiturates
Phenobarbitone, Pentobarbitone, Primidone MoA - GABA PAM (β-subunit) Enhanced effects of GABA Indications - Epilepsy, Acute seizures Adverse effects - Drowsiness, fainting Interactions - Sedatives, anti-coagulants
88
Weak analgesic/antipyretic
Paracetamol MoA - Unclear – possible COX inhibitor in CNS Indications - Mild-moderate pain, pyrexia Adverse effects - constipation Interactions - Warfarin
89
Non-steroidal anti-inflammatory drugs (NSAIDs)
Ibuprofen, Diclofenac, Naproxen MoA - Non-selective COX inhibitors, blockade of prostaglandin synthesis Indications - Mild-moderate pain, inflammation Adverse effects - GI disturbance, hypertension, Aspirin not suitable for under 16s Interactions - Diuretics, ACE inhibitors,
90
COX2-selective NSAIDs
Etoricoxib, Celecoxib MoA - COX-2 inhibition, localised prostaglandin blockade Indications - Pain, inflammation Adverse effects - Indigestion Interactions - ACE inhibitors, SSRIs
91
Weak opioid analgesics
Codeine, Dihydrocodeine MoA - Stimulation of analgesic opioid receptors Indication - Mild-moderate pain Adverse effects - Constipations, nausea Interactions - sedatives
92
Strong opioid analgesics
Morphine, Diamorphine, Pethidine, Fentanyl MoA - Stimulation of analgesic opioid receptors Indications - Severe pain Adverse effects - constipation, nausea Interactions - sedatives
93
Partial/mixed agonist opioid analgesics
Buprenorphine, pentazocine MoA - Modulation of analgesic opioid receptors (µ and kappa) Indications - moderate to severe pain Adverse effects - constipation, nausea Interactions - sedatives
94
Opioid antagonist
Naloxone, naltrexone Indications - Opiate overdose, respiratory depression Adverse effects - nausea, tachycardia
95
Opioid addiction management
Methadone, Buprenorphine MoA - Narcotic opioid replacement; opioid receptor agonist/modulator Indication - Opiate addiction Adverse effects - Constipation Interactions - Sedatives
96
Drugs for neuropathic pain
Gabapentin, Pregabalin, Amitriptyline MoA - VDCC antagonist (gabapentin, pregabalin)/ TCA (amitriptyline) Indication - neuropathic pain Adverse effects - dizziness, fatigue Interactions - Antidepressants
97
Inhaled analgesics
Nitrous oxide + oxygen mixture (“Gas & Air”) Entonox MoA - unclear Indications - analgesia during childbirth Adverse effects - Decreased vitamin B12 synthesis
98
Propofol, isoflurane, sevoflurane
General anaesthetic MoA - Unclear - possiblel enhancement of GABA function Indication - Induction of anaesthesia throughout major surgery Adverse effect - hypotension
99
Ketamine
General anaesthetic MoA - NMDA receptor blockade Indication - Induction of anaesthesia throughout major surgery Adverse effect - hypotension
100
Local anaesthetic
Lidocaine, Bupivacaine, Levobupivacaine MoA - Voltage-gated sodium channel blockade Adverse effects - Rash
101
Non-depolarising neuromuscular blockers
Atracurium besilate, Vecuronium MoA - Competitive antagonist at AChR Indication - Tracheal intubation and mechanical ventilation during surgery Adverse effects - hypotension, skin flushing
102
Depolarising neuromuscular blocker
Suxamethonium MoA - Initially depolarisation and desensitisation of AChR Indication - Tracheal intubation and mechanical ventilation during surgery Adverse effects - hypotension, skin flushing
103
Sugammadex
Drugs for reversing neuromuscular block MoA - Oligosaccharide that forms a complex with NMBs removing them from NMJ Indication - Immediate reversal of NMB to reduce post-operative pulmonary complications
104
Neostigmine
Drugs for reversing neuromuscular blocker MoA - Peripheral acetylcholinesterase inhibitor Indication - Immediate reversal of NMB to reduce post-operative pulmonary complications (sugammadex) (Neostigmine also used for myasthenia gravis)
105
Muscle relaxants and sedatives
Temazepam (BDZ), Zolpidem, Dexmedetomidine (alpha-2 agonist) Alfentanil, Fentanil, Remifentanil (opioids) MoA (alpha-2 agonist) - inhibits sympathetic activity Indication - Maintain sedation and relaxed muscle tone Adverse effect - Bradycardia (alpha-2 agonist)
106
Cyclizine
Anti-emetic (H1-receptor antagonist) MoA - Histamine H1 receptor blockade Indications - N+V Adverse effects - Dry mouth, sedation Interactions - Sedatives
107
Domperidone
Anti-emetic (D2-receptor antagonist) MoA - Dopamine D2 receptor blockade in the Chemoreceptor Trigger Zone Indications - N+V Adverse effects - cardiac disease
108
Amoxicillin, Co-amoxiclav, Piperacillin-Tazobactam (Tazocin), Flucloxacillin, Phenoxymethylpenicillin
Penicillins (Beta lactam) MoA - Beta-lactam: Inhibition of bacterial cell wall synthesis Indications - Respiratory infection, pneumonia, H pylori Adverse effects - Rash, hypersensitivity Interactions - Warfarin, methotrexate
109
Meropenem
Carbapenems (Beta lactam) MoA - Beta-lactam: Inhibition of bacterial cell wall synthesis Indications - Meningitis, hospital-acquired septicaemia Adverse effects - Abdominal pain, pruritus
110
Ceftriaxone
Cephalosporins (Beta lactam) MoA - Beta-lactam Inhibition of bacterial cell wall synthesis Indications - Gram-negative infections (third generation), meningitis Adverse effects - GI disturbances, colitis Interactions - Warfarin
111
Trimethoprim
Antifolate antibiotic MoA - Inhibition of dihydrofolate reductase Indications - UTI Adverse effects - Rash, GI disturbances Interactions - Methotrexate
112
Ciprofloxacin
Fluoroquinolones MoA - Inhibition of bacterial DNA gyrase Indications - Respiratory tract infection Adverse effects - Nausea, convulsions Interactions - Iron salts, NSAIDs
113
Erythromycin, Azithromycin
Macrolide antibiotics MoA - Inhibition of bacterial protein synthesis Indications - pneumonia Adverse effects. - GI disturbance, headache Interactions - Digoxin, theophylline, statins
114
Doxycycline
Tetracycline antibiotics MoA - Inhibition of bacterial protein synthesis Indications - Community-acquired pneumonia
115
Nitrofurantoin
Nitrofuran MoA - Bacterial DNA interference Indications - UTI Adverse effects - peripheral neuropathy
116
Gentamicin
Aminoglycoside antibiotic MoA - Inhibition of bacterial protein synthesis Indication - Opthalmic infection
117
Vancomycin
Glycopeptide antibiotic MoA - Inhibition of cell wall synthesis in gram-positive bacteria Indication - C. difficile infection Adverse effects - Neutropenia, renal impairment
118
Metronidazole
Nitroimidazole (anti-aerobe agent) - antibiotic MoA - Inhibition of bacterial DNA synthesis Indication - Anaerobic bacterial infection: leg ulcers, pressure sores
119
Isoniazid, Ethambutol, Rifampicin, Pyrazinamide
Antituberculosis drugs (Used in combination) MoA - Inhibition of mycobacterial cell wall synthesis (Isoniazid, Ethambutol); inhibition of mycobacterial RNA synthesis (Rifampicin) Indication - Tuberculosis Adverse effects - hepatotoxicity
120
Interferon alpha
Therapeutic cytokines MoA - Activation of antiviral intracellular and immune responses Indications - Hepatitis B and C Adverse effects - Flu-like symptoms, loss of appetite
121
Aciclovir, Ganciclovir
DNA polymerase inhibitors MoA - Virus replication blockade via inhibiting viral DNA polymerase Indications - Herpes simplex infection Cytomegalovirus infection Adverse effects - nausea, diarrhoea
122
Oseltamivir
Neuraminidase inhibitors MoA - Prevention of viral budding and infectivity Indications - Influenza virus infection Adverse effects - N+V
123
Ribavirin
Nucleoside analogues MoA - Disrupts viral RNA synthesis Indications - Hepatitis C, RSV
124
Tenofovir
Nucleoside reverse transcriptase inhibitors (NRTI) MoA - Blockade of viral reverse transcriptase function essential for viral genetic replication Indications - HIV infection Adverse effects - Rash, Stevens-Johnson syndrome
125
Efavirenz
Non-nucleoside reverse transcriptase inhibitors (NNRTI) MoA - Blockade of viral reverse transcriptase function essential for viral genetic replication Indications - HIV infection Adverse effects - Rash, Stevens-Johnson syndrome
126
Lopinavir
Viral protease inhibitors MoA - Blockade of viral protease required for virus particle assembly Indications - HIV infection Adverse effects - GI bleeding
127
Dolutegravir
Integrase inhibitors MoA - Disrupts integration of HIV genome into host chromosomes Indications - HIV infection
128
Enfuvirtide
Viral fusion inhibitors MoA - Blockade of virus fusion to target cell membrane Indications - HIV infection
129
Maraviroc
Chemokine receptor/CCR5 antagonist MoA - Blockade of HIV binding to co-factor for cell entry Indications - HIV infection Adverse effects - Nausea, diarrhoea
130
Fluconazole
Triazole anti-fungal agent MoA - Disruption of fungal membrane function Indications - Candida infection Adverse effects - Nausea, abdominal pain
131
Insulin
Blood glucose-reducing hormones MoA - Stimulation of glucose uptake by cells Indications - Type 1 and type 2 diabetes mellitus Adverse effects - Hypoglycaemia Interactions - Digoxin, beta-blockers
132
Oral biguanide
Metformin MoA - Increases insulin sensitivity, inhibits hepatic gluconeogenesis Indications - Type 2 diabetes Adverse effects - N+V Interactions - Diuretics, digoxin
133
Gliclazide
Sulphonylureas MoA - Stimulates pancreatic insulin secretion Indications - Type 2 diabetes Adverse effects - hypoglycaemia Interactions - Warfarin, NSAIDs
134
Pioglitazone
Thiazolidinediones MoA - Increases insulin sensitivity in muscle and adipose tissue Indications - Type 2 diabetes Adverse effects - weight gain
135
Exenatide
Glucagon-like peptide-1 receptor (GLP-1) agonist MoA - Incretin analogue – improves glucose control Indications - Type 2 diabetes Adverse effects - asthenia
136
Sitagliptin
Dipeptidyl peptidase-4 (DPP-4) Inhibitor MoA - Reduces inactivation of incretins Indications - Type 2 diabetes Adverse effects - Headache
137
Empagliflozin, Dapagliflozin
SGLT-2 Inhibitor MoA - Blockade of renal Na-glucose transporter – increases urinary excretion of blood glucose Indications - Type 2 diabetes Adverse effects - urinary infection
138
Orlistat
Lipase inhibitor MoA - Inhibition of GI uptake of dietary fat Indications - Obesity, especially in presence of Type-2 diabetes Adverse effects - Oily stools, faecal urgency
139
``` Levothyroxine sodium (T4) Liothyronine sodium (T3) ```
Thyroid hormones MoA - Synthetic hormones Indications - Hypothyroidism Adverse effects - Diarrhoea, vomiting Interactions - oral anticoagulants
140
Methotrexate
Antifolate antiproliferative MoA - Inhibition of dihydrofolate reductase and DNA synthesis for lymphocyte proliferation Indications - Rheumatoid arthritis Adverse effects - nausea, hair loss Interactions - warfarin, corticosteroids
141
Azathioprine
Antimetabolite immunosuppressant MoA - Unclear – possible inhibition of DNA synthesis and lymphocyte proliferation Indications - Rheumatoid arthritis (also Crohn’s Disease) Adverse effects - alopecia
142
Adalimumab, Etanercept, Infliximab
Cytokine modulators MoA - TNF-alpha blockade Indications - Rheumatoid arthritis Adverse effects - alopecia
143
Sulfasalazine, Mesalazine
Aminosalicylates MoA - Unclear – possible COX inhibition. Possible free radical scavenging, T cell suppression Indications - Rheumatoid arthritis (also Crohn’s Disease) Adverse effects - Nausea Interactions - Digoxin, warfarin
144
Desogestrel and ethinyl-estradiol
Oral combination pill contraceptives MoA -Mimics ovulation, reduces LH and FSH Indication - Hormonal contraception, PCOS Adverse effects - weight gain, depression, DVT risk
145
Desogestrel, | Levonorgestrel (emergency)
Oral mini-pill contraceptives Progestogen-only MoA - Mimics ovulation, reduces LH and FSH, endometrial changes Indications - Hormonal contraception Adverse effects - depression
146
Etonogestrel
Implants/ injectable contraceptives MoA - Mimics ovulation, reduces LH and FSH Indications - Hormonal contraception Adverse effects - Weight gain, depression
147
Estradiol, Noresthisterone, Medroxyprogesterone
Hormone replacement therapy (HRT) MoA - Restores decreased hormone level and function Indication - menopause Adverse effects - weight gain, depression
148
Dinoprostone
Induction of labour MoA - Prostaglandin E2 – stimulates cervical ripening Indications - delay in labour
149
Oxytocin
Augmentation agents MoA - Stimulation of uterine contraction Indications - Delay in labour
150
Mifepristone with Misoprostol
Antiprogestogen/Prostaglandin for medical termination MoA - Steroidal antiprogestogen in combination with synthetic prostaglandin Indication - Termination of pregnancy Adverse effects - GI cramps, uterine contractions, vaginal bleeding
151
Tranexamic acid
Antifibrinolytic for menorrhagia MoA - Inhibits fibrin clot breakdown by plasmin Indications - Menorrhagia Adverse effects - Nausea
152
Mefenamic acid
NSAID (for dysmenorrhoea) MoA - Inhibition of prostaglandin synthesis Indications - dysmenorrhoea Adverse effects - GI bleeding
153
Tamsulosin
Alpha-1 blocker MoA - Smooth muscle relaxant acting on bladder neck Indications - BPH, urinary retention Adverse effects - dizziness Interactions - hypotensive drugs
154
Oxybutinin
Urinary antispasmodic (Antimuscarinic) MoA - Blockade of acetylcholine receptors leading to bladder smooth muscle relaxation Indications - Overactive bladder Adverse effects - dry mouth, tachycardia (preceded by transient bradycardia)
155
Mirabegron
Beta-3-agonist MoA - Stimulation of Beta-3 adrenergic receptors, leading to detrusor smooth muscle relaxation MoA - Overactive bladder Adverse effects - Bladder pain
156
Finasteride
Anti-androgens MoA - Inhibition of synthesis of dihydrotestosterone Indication - Benign prostatic hyperplasia Adverse effects - impotence
157
Chlorphenamine, Cetirizine
Anti-histamines MoA - H1 histamine receptor blockade Indications - Hay fever, urticaria Adverse effects - Dry mouth, sedation Interactions - TCAs
158
Prednisolone, hydrocortisone, | Dexamethasone
Glucocorticoids MoA - Intracellular transcription factor interactions, gene expression Indications - Suppression of inflammatory diseases (e.g. Crohn’s, RA) Adverse effects - Weight gain, muscle atrophy Interactions - oral antidiabetics
159
Cyclosporin, tacrolimus
Calcineurin inhibitor MoA - Inhibition of T cell signalling Indications - Solid organ transplantation, Eczema (topical) Adverse effects - Hypertension Interactions - Aspirin
160
Cyclophosphamide
Classical alkylating agents MoA - DNA crosslinking Indication - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
161
Paclitaxel, Docetaxel
Taxanes MoA - Inhibition of microtubule assembly in mitotic spindle Indication - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
162
Vincristine, vinblastine
Vinca alkaloids MoA - Inhibition of microtubule assembly in mitotic spindle Indication - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
163
Methotrexate
Antifolates MoA - Inhibition of dihydrofolate reductase and DNA synthesis Indication - Broad spectrum of malignancies
164
Fluorouracil, Cytarabine
Antipyrimidines MoA - Inhibition of RNA and DNA synthesis Indication - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
165
Mercaptopurine, thioguanine
Antipurines MoA - Inhibition of RNA and DNA synthesis Indications - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
166
Doxorubicin
Anthracycline antibiotics MoA - DNA intercalation; Inhibition of RNA and DNA synthesis Indication - Broad spectrum of malignancies Adverse effects - Hair loss, bone marrow suppression, nausea
167
Trastuzumab
Antineoplastic monoclonal antibodies MoA - Targeting of cells overexpressing Human Epidermal Growth Factor Receptor-2 (HER2) for tumour reduction & destruction Indication - Early breast cancer Adverse effects - fever, chills
168
Rituximab
Antineoplastic monoclonal antibodies MoA - Targeted destruction of CD20+ B cells Indication - Follicular lymphoma, Non-Hodgkin’s lymphoma Adverse effects - fever, chills
169
Nivolumab
Antineoplastic monoclonal antibodies MoA - Stimulation of anti-tumour responses via blocking PD-1 Indication - melanoma Adverse effects - fever, chills
170
Lenolidamide
Immunomodulator MoA - Stimulation of T cell responses Indication - myeloma Adverse effects - foetal risk
171
Tamoxifen
Selective estrogen receptor modulator (SERM) MoA - Inhibition of oestrogen receptor function and cell proliferation in breast Indication - Breast cancer
172
Goserelin
Luteinising hormone releasing hormone (LHRH) receptor agonist MoA - Synthetic analogue of LHRH. Activates LHRH receptor function leading to sustained reduction in testosterone Indication - Prostate cancer
173
Calcitonin
Therapeutic Hormones MoA - Inhibits mobilisation of calcium from bones Indications - osteoporosis, hypercalcaemia Adverse effects - Abdominal pain Interactions - antacids
174
Alendronate, Pamidronate
Bisphosphonates MoA - Inhibits osteoclast function and bone resorption Indications - osteoporosis, hypercalcaemia
175
IV calcium gluconate, vitamine D, parathyroid hormone
Drugs for hypocalcaemia MoA - Restoration of calcium levels and metabolism Indications - Hypocalcaemia, bone loss
176
Vitamin D (colecalciferol, calcitriol (1,25-dihydroxyvitamin D)
Vitamin D deficiency MoA - Restoration of vitamin D levels Indications - Vitamin D deficiency
177
Raloxifene
Selective estrogen receptor modulator (SERM) (for osteoporosis) MoA - Stimulation of oestrogen function in bone Indications - prevention of bone fractures Adverse effects - hot flushes Interactions - warfarin
178
Denosumab
Monoclonal antibody MoA - Inhibition of osteoclast function and bone resorption Indication - osteoporosis Adverse effects - hypocalcaemia
179
Ferrous sulphate
Oral iron compound MoA - iron provision Indication - Iron-deficient anaemia Adverse effects - constipation Interactions - Antacids
180
Folic acid
Water soluble vitamin MoA - Supports nucleic acid synthesis Indications - Folate-deficient anaemia
181
Vitamin B12 (parenteral)
Water soluble vitamin MoA - Enzyme cofactor Indications - Pernicious anaemia

Drugs list (24 decks)

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