Simvastatin

Drug Class Statin Mechanism Reversibly inhibits HMG CoA reductase - the rate limiting enzyme in cholesterol synt…

Doxycycline

Drug Class Tetracycline Mechanism Bacteriostatic - inhibit protein synthesis Typical Dose 500mg BD …

Dual antiplatelet therapy

Aspirin + ticagrelor for low bleeding risk Aspirn + clopdogrel for high bleeding risk  Prasugrel used when patients a…

Animal bite antibiotics

  Prophylactic antibiotic dose should be given in human, dog + cat bites 1st line - co-amoxiclav 2nd line - doxycycline & metroni…

Fluconazole

Can increase INR

Fluoxetine

Can cause hyponatremia with increased urinary sodium through SIADH

Gentamicin

Drug Class Aminoglycoside Mechanism Bactericidal  Typical Dose IV or drops only - 3-7mg/kg in 3 …

Antibiotic Classes

Cell wall synthesis inhibitors Beta lactams Penicillins - relatively narrow spectrum Cephalosporins Carbapenems Monobactams Glyco…

Antifungal classes

Cell membrane - ergesterol Azoles - clotrimazole, fluconazole Terbinafine Amphotericin B Cell wall Echinocandins - anidulafungin…

Antivirals

Aciclovir - HSV and VZV Ganciclovir - CMV Neuraminidase inhibitors - Influenza AZT (zidovudine), tenofovir, - HIV, protease inhibitors, NRTI…

Immunosuppression

Corticosteroids - \(\downarrow\) neutrophil margination, \(\downarrow\) inflammatory cytokines,\(\downarrow\) T cell proliferation,…

Anticoagulants

Heparin Increases the ability of antithrombin molecule to irreversibly inhibit thrombin, IXa, Xa, XIa. LMWH - mainly inhibits FXa only, less mo…

Anti-platelets

Aspirin Inactivates platelet cyclooxygenase reducing thromboxane A2. Irreversible effect 4-5 days P2Y\(_{12}\) antagonist Prevent pl…

OD codeine to OD morphine conversion

The conversion factor between oral codeine and oral morphine is to divide by 10. This is based on the general consensus that the potency of oral…

Sick Day Rules

Some medications require good kidney function. During sick days or periods of dehydration they should be stopped to preserve the kidneys. Stop for 3 …

Laxative Types

Laxative Type When to Use When to avoid Examples Bulk-forming laxatives Diverticulitis, dietary fibre i…

Nitrates in patients

Chest pain Patients with possible inferior MIs should not be given nitrates (or be given with cautious) due to the potential for right-sided he…

Drug induced PF

Amiodarone Methotrexate 

Fluid prescriptions

All should have daily U&Es, FBCs, creatinine 25 to 30 ml/kg/day of water Approximately 1 mmol/kg/day of potassium, sodium and chloride. …

Antibiotic Spectrum Coverage

Clindamycin

Clindamycin is an antibiotic belonging to the lincosamide class, and it is commonly used as a second-line treatment for cellulitis when patients ar…

Alpha and beta receptors

Alpha Receptors: Generally found on smooth muscle cells. Subtypes: α1 and α2. α1 receptors primarily mediate smooth muscl…

UTI in Pregnancy

UTI in pregnancy should always be treated even if asymptomatic First Trimester Trimethoprim should be avoided as it is teratogenic (fol…

Hospital Acquired Infections

C. diff Treatment of a patient with antibiotics, PPIs eg, allows the bacteria to grow unregulated → symptoms Spore are released in …

Warfarin

Vitamin K antagonist - vitamin K dependent clotting factors: II, VII, IX, X and protein C and S Indications: Mechanical heart valves Valvu…

Steroid side effects

Mood swings + emotional changes Weight gain - increased appetite High BP Increased risk of infection - suppressed immune system  Glau…

Sulphasalazine

Aminosalicylate - to reduce inflammation. Used in the treatment of ulcerative colitis and rheumatoid arthritis Can cause haemolytic anaemia wi…

Co-amoxiclav

Broad spectrum antibiotic - combination of amoxicillin and clavulanic acid (beta lactamase inhibitor) RTIs, UTIs, skin and soft tissue infection…

Thiazide diuretics

Commonly used in management of hypertension and heart failure Exacerbate gout by increasing serum uric acid levels

Gaviscon

Drug Class Antacids Mechanism Weak alkali to neutralise stomach acid Alginate component ↑ s…

Ranitidine

Drug Class H2 Antagonist Mechanism Competitively inhibits histamine actions at all H2 receptors, mainly inhibiting ga…

Omeprazole

Drug Class Proton pump inhibitor Mechanism Inhibits gastric acid secretion by dose-dependent inhibition of proton pum…

Loperamide

Drug Class Anti-diarrhoeal agent Mechanism Acts on opioid receptors in myenteric plexus to inhibit peristalsis (inhib…

Senna

Drug Class Stimulant laxative Mechanism Hydrolysed in colon to stimulate myenteric plexus, smooth muscle activity …

Mesalazine

Drug Class Aminosalicylates Mechanism Release 5-aminosalicyclate acid in the bowel Typical Dose 2.4-4…

Furosemide

Drug Class Loop diuretic Mechanism Inhibits Na/K/2Cl pump in ascending loop of Henle  Inhib…

Bendroflumethiazide

Drug Class Thiazide diuretic Mechanism Inhibits Na/Cl reabsorption in distal tubules Stimulate K excr…

Spironalactone

Drug Class Potassium sparing diuretic Mechanism Aldosterone antagonist Competes for receptors in DCT…

Atenolol

Drug Class Beta blocker Mechanism Acts on β1 receptors in the heart ↓ HR and force of …

Diltiazem

Drug Class Calcium channel blocker Mechanism Interfere with the inward movement of calcium ions into cells …

Ramipril

Drug Class ACE inhibitor Mechanism Inhibits angiotensin converting enzyme - ↓ angiotensin II synthesis…

Losartan

Drug Class Angiotensin 1 blocker Mechanism Displace angiotensin II from the angiotensin I receptor Typica…

Isosorbide Mononitrate

Drug Class Nitrate Mechanism Metabolised to NO in smooth muscle cells Causes vascular smooth muscle relaxa…

Digoxin

Drug Class Cardiac glycoside Mechanism Inhibits Na/K pump - ↑ intracellular Na conc inhibiting N…

Amiodarone

Drug Class Anti-dysrhythmic (Class III) Mechanism Prolongs refractory period in all parts of conduction system - …

Aspirin

Drug Class Anti-platelet agent Mechanism Irreversible COXI and COXII inhibitor Typical Dose 75g OD - …

Clopidogrel

Drug Class Anti-platelet agent Mechanism Irreversibly to the platelet P2Y12 receptor, inhibiting ADP-mediated pl…

Streptokinase

Drug Class Thrombolytic Mechanism Binds to circulating plasminogen forming activator complex Converts…

Enoxaparin

Drug Class Low molecular weight heparin Mechanism Activation of antithrombin causing inactivation of coagulation…

Salbutamol

Drug Class β2 agonist Mechanism Stimulates β2 receptors in the airways generating cAMP …

Ipratropium Bromide

Drug Class Anticholinergic Mechanism Blocks ACh - inhibit parasympathetic pathway which is responsible for smoot…

Prednisolone

Drug Class Corticosteroid Mechanism Inhibits phospholipase A2 activity - arachidonic acid production …

Oxygen

Drug Class Therapeutic gas Mechanism Specifically binds to Hb and dissolves in plasma Typical Dose Ox…

Levodopa

Drug Class Dopamine precursor Mechanism Crosses blood-brain barrier and converted by enzyme dopa decarboxylase …

Phenytoin

Drug Class Anti-convulsant Mechanism Alters transmembrane movement of Na+/K+ by blocking voltage-gated Na+ channels -…

Carbamazepine

Drug Class Anti-convulsant Mechanism GABA-mediated inhibitory transmission in the CNS  Typical Dose …

Diabetes Sick Day Rules

Type 1 diabetes if a patient is on insulin, they must not stop it due to the risk of diabetic ketoacidosis check blood glucose more frequentl…

Sodium Valproate

Drug Class Anti-convulsant Mechanism ↑ GABA content of the brain - inhibits GABA re-uptake …

Metoclopramide

Drug Class Antiemetic (dopamine antagonist) Mechanism Blocks dopamine receptors in chemoreceptor trigger z…

Lamotrigine

Drug Class Anti-convulsant Mechanism Binds and inhibits voltage-gated sodium channels, stabilizing presynaptic neuron…

Insulin

Drug Class Peptide hormone Mechanism Lowers plasma glucose concentration: Glucose transport into fat…

Glicazide

Drug Class Sulphonylurea Mechanism Stimulates insulin production in pancreatic β cells - th…

Metformin

Drug Class Biguanide Mechanism “Increases insulin sensitivity” ↓ gluconeogenesis&nb…

Levothyroxine

Drug Class Thyroid hormone Mechanism Mimics endogenous thyroxine Typical Dose Initiall…

Carbimazole

Drug Class Anti-thyroid Mechanism Inhibits thyroid peroxidise which is necessary for thyroid synthesis …

Alendronate

Drug Class Bisphosphonate Mechanism Inhibits osteoclast bone reabsorption For optimal activity, enoug…

Cytochrome P450 dependant drugs

Dependant Phenytoin Theophylline Carbamazepine Tacrolimus and cyclosporine Digoxin Flecainide Sildenafil Simvastatin SSRIs SNRI…

Colecalciferol

Drug Class Vitamin D Mechanism   Typical Dose 400-2000 units daily 400 units = 10 micrograms …

Diclofenac

Drug Class NSAID Mechanism Reversible inhibition of COX-1 and COX-2 enzymes → prostaglandin synthesis …

Codeine

Drug Class Opiate  Mechanism Partial metabolic conversion to morphine - 1/6 potency Typical Dos…

Morphine

Drug Class Opiate Mechanism Mimics endogenous opioids, acting on opioid receptors  Typical Dose …

Paracetamol

Drug Class Non-opioid analgesic and antipyretic Mechanism Weak inhibitor of COX  Don't really kno…

Amoxicillin

Drug Class Broad spectrum bactericidal penicillin Mechanism Inhibits bacterial cell wall synthesis by preventing cros…

Cephradine

Drug Class Cephalosporin Mechanism Attach to penicillin binding proteins to interrupt cell wall synthesis …

Trimethoprim

Drug Class Antifolate abx Mechanism Decreases bacterial folate production so bacteria cannot synthesise DNA …

Erythromycin

Drug Class Macrolide Mechanism Broad spec bacteriostatic abx - inhibits bacterial protein synthesis Typic…

Ciprofloxacin

Drug Class Quinolone Mechanism Broad spec bactericidal abx - inhibits DNA gyrase (needed to coil and replicate bacter…

Metronidazole

Drug Class Anaerobic antimicrobial Mechanism Broken down to toxic compounds within microbes with anaerobic…

Lithium

Can exacerbate psoriasis Loads of other interactions Non-steroidal anti-inflammatory drugs (NSAIDs) decrease renal excretion of lithium, thus …

Paracetamol Overdose

Paracetamol is absorbed from the gut and rapidly metabolised by the liver. A toxic metabolite is produced and glutathione is required to continue the…

Amlodipine

  Drug Class Calcium channel blocker Mechanism Interfere with the inward movement of calcium ions into c…

Ototoxic Medications

FAV Q&A  Furosemide Aminoglycosides (gent) Vancomycin Quinine Aspirin  

Causes of hyponatremia

PPI TACO: PPIs Thiazides ACEi/ARBs Carbamazepine Opioids