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MVST 1B (Fach) / MoDA (Lektion)

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• Irbesartan HTN, Heart failure, diabetic nephropathy MoA: Angiotensin-II-receptor (AT-1) antagonist SE:Hyperkalaemia   → candesartan, losartan
• Chlortalidone Use: HTN ('D'), heart failure, oedema, nephrotic syndrome, diabetes insipidus MoA: Inhibits Na+ reabsorption in distal convoluted tubule SE: Electrolytes: ↓K+, ↓Na+, ↑Ca2+, ↑uric acid, ↓Mg2+ Oligospermia, impaired glycaemic control → bendroflumethiazide, → hydrochlorothiazide, → indapamide
• Indapamide Use: Essential hypertension MoA: Thiazide-like diuretic SE: electrolyte disturbances, GI upset, postural hypotension → chlortalidone, metonazole; benzoflumethiazide, hydrochlorothiazide
• Amlodipine* Use: HTN, angina MoA: DHP Ca2+ channel blocker; vessels > myocardium SE: ankle oedema, headache, dizziness, palpitations Dose: 5mg PO OD, max 10mg   → nifedipine, felodipine
• Bumetanide Use: Acute heart failure, oedema MoA: Loop diuretic: blocks Na+/K+/2Cl- channel in thALH, better absorbed with GI-oedema Dose: 40x as potent as →furosemide SE: Hypokalaemia, hyponatraemia, hypocalcaemia, hyperuricaemia
• Isosorbide mononitrate Nitrovasodilator used in angina MoA: GC → cGMP sublingual, acetylator status → isosorbide dinitrate
• GTN Use:  Angina, ACS MoA: Nitrate → GC →cGMP → SM relaxation → dilatation Dose: sublingual: 0.3 - 1mg PRN infusion: 10–200 mcg/min, adjusted according to response; max. 400 mcg/min SE: headache, reflex tachycardia, dizziness, flushing
• Prothrombin complex concentrate Use: Warfarin over-anticoagulation MoA: replenishes factors II, VII, IX, X SE:thrombotic events
• Alfuzosin Use: BPH MoA: α-adrenergic blocker SE: post hypotension, dizziness, headache   → doxazosin, prazosin, tamsolusin
• Tamsulosin Use: BPH MoA: α-adrenergic blocker SE: headache, dizziness, hypotension   → prazosin, doxazosin, alfuzosin
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• Metoprolol Use: ACS, stable heart failure, hypertension, arrythmias, hyperthyroidism, migraine prophylaxis MoA: cardioselective β1 -adrenoreceptor antagonist SE: typical → carvedilol, bisoprolol; atenolol, mesolol, sotalol, timolol
• Sotalol Use: Arrhythmias, HTN MoA: nonselective β-adrenoreceptor blocker, K+ channel blocker (→VW class III) SE: typical
• Tiotropium Use: COPD maintenance - "LAMA" MoA: mACh-receptor blocker SE: dry mouth, GI (constipation/diarrhoea, nausea), dizziness, taste disturbance, epistaxis, pruritus   → ipratropium bromide
• Chlorphenamine* Use: Allergy, Anaphylaxis MoA: H1-receptor blocker Dose: PO: 4mg every 4-6 hours; max 24mg/d IV / IM: 10mg over 1 min; repeated as needed; max 4x/d SE: Drowsiness, hypotension
• Betamethasone Use: Immune suppression, hormone replacement MoA: Inhaled glucocorticoid SE: Candidiasis, diabetes, osteoporosis, avascular necrosis, cataracts, psychiatric
• Budesonide Use: prophylaxis of asthma, croup, ileocaecal Crohn's MoA: inhaled corticosteroid (ICS) SE: infection (LRTI, oral), osteoporosis, growth retardation
• Oxygen* --
• Seretide Use: Asthma maintenance: stage 3 MoA: fluticasone (ICS, stage 2) + salmeterol (LABA, stage 3) SE: infection (cadidiasis etc), osteoporosis
• Terbutaline Use: Asthma MoA: Short-acting β2-adrenergic agonist = SABA →salbutamol
• Quetiapine Use: Schizophrenia, bipolar disorder, depression MoA: Atypical antipsychotic: dopamine, serotonin, adrenergic antagonist SE: Extrapyrimidal: parkinsonism, dystonia, akathisia, tardive dyskinesia weight gain, sleep disorder, hypotension → olanzapine; → risperidone, haloperidol
• Olanzapine Use: Schizophrenia MoA: atypical antispychotic SE: weight gain, diabetes mellitus, metabolic syndrome extrapyramidal hormonal: ↑prolactin → sexual dysfunction; hypotension neuroleptic malignant syndrome: hyperthermia, fluctuating level of consciousness, muscle rigidity, and autonomic dysfunction with pallor, tachycardia, labile blood pressure, sweating, and urinary incontinence → dantrolene → clozapine, quetiapine, risperidone; haloperidol, chlorpromazine, fluphenazine
• Chlordiazepoxide Use: Alcohol withrawal MoA: Benzodiazepine, ↑ GABA-ergic transmission SE: like diazepam: resp depression etc.
• Temazepam Use: insomnia, premediaction before surgery / procedures MoA: Benzodiazepine ↑GABAA SE: like diazepam: drowsiness ± resp depression;  confusion, amnesia, aggression → diazepam, chlordiazepoxide, lorazepam, midazolam
• Co-codamol Use: analgesic: mild to moderate pain MoA: paracetamol+ codeine SE: opiates: respiratory depression, nausea, vomiting, constipation, dry mouth paracetamol: liver damage !! → co-dydramol
• Co-dydramol Use: Analgesic: mild to moderate pain MoA: paracetamol + dihydrocodeine SE: opiate: nausea, vomiting, constipation, resp depression dependence paracetamol: liver damage → cocodamol
• Cyclizine* Use: Nausea, vomiting (incl. morphine-induced), vertigo, motion sickness MoA: centrally acting H1-receptor antagonist SE: Drowsiness; antimuscarinic (dry mouth/eyes, urinary retention); hypertension, twitiching Dose: 50mg up to 3x/d, PO or IV/IM → metoclopramide, chlorpromazine; domperidone; ondansetron;
• Dantrolene Use: Neuroleptic malignant syndrome, malignant hyperthermia MoA: Ryanodine receptor blocker → muscle relaxant SE: hepatotixicity, pulm oedema, injection site reactions
• Co-careldopa Levodopa + carbidopa Use: Parkinson's disease MoA: Dopamine precursor + peripheral Dopa DeCarboxylase inhibitor SE: Nause & vomiting (→ domperidone), dyskinesias, pschosis → co-beneldopa
• Carbidopa Use: Parkinson's disease MoA: Peripheral DDC inhibitor → benserazide
• Co-beneldopa Use: Parkinson's disease MoA: →Levodopa + →benserazide SE: Nausea & vomiting (→ domperidone), dyskinesias, psychosis → co-carbeldopa
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• Naloxone Use: Opiod overdose MoA: centrally acting μ-opiod-receptor antagonist SE: nausea, vomiting, hypo-/hypertension, dizziness, headache short-acting, short half-life; aggression due to missed high in IVDU's
• Codeine Use: opiod analgesic: mild to moderate pain; diarrhoea MoA: Centrally acting μ-opiod receptor antagonist SE: ause & vomiting (→ metoclopramide), constipation (→ senna), resp depression → dihydrocodeine, morphine*, fentanyl, oxycodone, tramadol
• Dihydrocodeine Use: Analgesic: moderate to severe pain MoA: Centrally acting μ-opiod receptor antagonist SE: Nausea & vomiting (→ metoclopramide); constipation (→ senna); resp depression → codeine, oxycodone, tramadol, morphine*, fentanyl
• Oxycodone Use: Opiod analgesic; severe pain MoA: Centrally acting μ-opiod receptor antagonist SE: vomiting & nausea (→ metoclopramide); constipation (→ senna); resp depression; withdrawal → codeine, morphine*, dihydrocodeine, tramadol, fentanyl
• Tramadol Use: opiod analgesic: mioderate to severe pain MoA: Centrally acting μ-opiod receptor antagonist SE: Nausea & vomiting, constipation, resp depression → codeine, morphine*, dihydrocodeine, tramadol, oxycodone, fentanyl
• Morphine* Use: opiod analgesic: mild to moderate pain, incl chronic and acute; MI, acute HF MoA: centrally acting μ-opiod receptor antagonist SE: nausea & vomiting, constipation, resp depression Dose: Acute pain 5mg / 4h IV → codeine, dihydrocodeine, oxycodone, tramadol, fentanyl
• Fluoxetine Use: Major depression, bulimia nervosa, OCD MoA: Serotonin-Selective Reuptake Inhibitor SE: GI upset, anorexia, hypersensitivity rash → citalopram, sertraline
• Sertraline Use: Depressive illness, OCD, panic disorder MoA: SSRI SE: GI upset, anorexia, hypersensitivity rash; SSRI wihdrawal sydrome ! → citalopram, fluoxetine, [paroxetine, fluvoxamine, ]
• Dosulepin Use: Depressive illness + sedation MoA: TCA SE: Antimuscarinic, CNS; most dangerous in overdose ? → amitriptyline, nortriptyline, impramine, clomipramine
• Zopiclone Use: insomnia MoA: Z-drug - ↑GABAA SE: taste disturbance → benzodiazepines, antihistamines; zolpidem, [zaleplon]
• Cefotaxime Use: Meningitis, gonorrhoea, surgical prophylaxis, haemophilus epiglottitis Spectrum: sensitive bacteria, excl staph. aureus MoA: 3rd generation cephalosporin antibiotic; inhibition of  cell wall synthesis SE: GI upset, hypersensitivity reactions → cefalexin/cefaclor, cefuroxime, ceftazidime, ceftriaxone
• Cefalexin Use: Pyelonephritis Spectrum: Sensitive Gram-(+) and Gram-(-) bacteria. MoA: 1st generation β-lactam cephalosporin antiobiotic: inhibition of cell wall synthesis SE: GI upset, allergic reactions incl Stephen-Johnson syndrome ~cefaclor; → ceftazidime, cefuroxime, cetriaxone, cefotaxime
• Desferrioxamine Use: Iron overdose, chronic iron overload MoA: Iron chelator SE: GI upset, bone disorders, arthralgia, myalgia Dose: depending on serum iron concentration and expected TIBC, max 15mg/kg/h →ferrous sulfate, dimercaprol
• Magnesium sulphate Use: Supraventricular tachycardia, acute asthma MoA: Electrolyte; unknown
• Praziquantel Use: Schistosomiasis
• Ivermectin Use: strongyloides
• Phenoxybenzylpenicillin - Penicillin V Use: Oral infections: tonislitis, otitis media, epiglotitis; group A strep; rheumatic fever & pneumococcal prophylaxis Spectrum: Narrow: strep's MoA: β-lactam antibiotic SE: Hypersensitivity, no rash with EBV infection → benzylpenicillin (penicillin G)
• Ceftazidime Use: Pseudomonas Spectrum: Sensitive bacteria incl P. aeruginosa MoA: 3rd generation cephalosporin antibiotic; inhibition of cell wall synthesis SE: GI upset, hypersensitivity reaction, incl Stephen-Johnson syndrome →cefalexin/cefaclor, cefadroxil; cefuroxime, ceftriaxone, cefotaxime
• Cefaclor Use: PyelonephritisSpectrum: Sensitive Gram-(+) and Gram-(-) bacteria. MoA: 1st generation β-lactam cephalosporin antiobiotic: inhibition of cell wall synthesis SE: GI upset, allergic reactions incl Stephen-Johnson syndrome ~cefalexin, cefadroxil; → ceftazidime, cefuroxime, cetriaxone, cefotaxime
• Cefuroxime Use: Pyelonephritis, intraabdominal infection, surgical prophylaxis Spectrum: sensitive Gram-(+) and Gram-(-) bacteria, + H. influenzae MoA: 2nd generation β-lactam cephalosporin antibiotiuc: inhibition of cell wall synthesis SE: GI upset, hypersensitivity reactions incl Stephen-Johnson Syndrome → cefalexin/cefaclor, ceftazidime, ceftriaxone, cefotaxime, cefadroxil etc.

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