Summary
Drug formulary SUMMARY for 3rd year MBChB
- Module
- 3rd year MBChB
- Institution
- University Of Leeds (UoL)
Drug formulary for 3rd year of medicine at University of Leeds
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MOA Indications Side effects Interactions/Contraindications Cautions ExamplesANTACIDS Buffer stomach acids, GORD Diarrhoea and Interactions Patients with fluid Gaviscon
contain carbonates/Mg or Al Dyspepsia constipation Can reduce serum concentrations of overload or hyperK Peptac
salts other drugs and ↑ excretion of aspirin e.g. renal failure
and lithium
Contraindications
With Na/K for overload/hyperkalaemia
e.g. Renal disease
sucrose for diabetes
ANTIEMETICS Dopamine D2-receptor Acute migraine Extrapyramidal Interactions Asthma Metoclopramide
(antivomiting) antagonist Delayed chemo effects Topical prilocaine - predicted to Bradycardia
Radiotherapy Galactorrhoea increase the risk of Cardiac
D2 receptor = main receptor Prevention of Gynaecomastia methaemoglobinaemia conduction
in chemoreceptor trigger postoperative N+V Hyperprolactinaemia Antipsychotics = risk of disturbances
zone (CTZ) = area Diarrhoea extrapyramidal side effects increased
responsible to sensing Fatigue Dopaminergic agents for PD - should
emetogenic substances in not be combined as it will antagonise
the blood effects
Contraindications
3-4 days after GI surgery
Can also stimulate GI
GI haemorrhage
activity
Obstruction
Perforation
Phaeochromocytoma
Children and young adults
ANTIDIARRHE Agonist of opioid u-receptors Acute and chronic Dizziness Contraindications Overdose can cause Loperamide
AL in GI tract = reduces diarrhoea and faecal Flatulence Active UC elevated QT Codeine
peristaltic contractions incontinence (in IBS or Headache Antibiotic-associated colitis (C. Diff) intervals phosphate
viral gastroenteritis) Nausea Conditions where abdominal distension
develops
Excreted by liver – hepatic
Conditions where inhibition of
impairment so risk of
peristalsis should be avoided
accumulation
Acute bloody diarrhoea (dysentery)
AMINOSALICY Release 5-aminosalicylic Mesalazine: UC Abdominal pain Interactions Pulmonary disease Mesalazine
LATES acid (5-ASA) = anti- Sulfasalazine: RA Diarrhoea PPIs ↑ gastric pH – cause pH Sulfasalazine
inflammatory and Exacerbation of colitis sensitive coating to be broken down
immunosuppressive on gut symptoms prematurely
Headache Lactose lowers stool pH, prevents 5-
Hypersensitivity ASA release in colon
Avoid in severe hepatic
reactions
impairment
Nausea
Contraindications
Rash
Blood clotting abnormalities
Urticaria
salicylate hypersensitivity - including
Vomiting
aspirin hypersensitivity as aspirin is a
Blood dyscrasia
salicylate
, LAXATIVES ↑ water and electrolyte Constipation Abdominal pain Contraindications Senna
secretion from colonic As suppositories for Diarrhoea Intestinal obstruction - could induce Bisacodyl
mucosa = ↑ volume of faecal impaction Prolonged use = perforation Glycerol
colonic content and melanosis coli Haemorrhoids (rectal preparation) suppositories
stimulating peristalsis Anal fissure (rectal preparation) Docusate sodium
PPIS Reduce gastric acid Prevention and GI disturbances Interactions Lansoprazole
secretion - irreversibly treatment of PUD Headache Omeprazole reduce antiplatelet effect of Omeprazole
inhibit H+/K+-atpase in Symptomatic relief of Increased risk of C. clopidogrel Pantoprazole
gastric parietal cells dyspepsia and GORD Diff
Eradication of H pylori Prolonged =
Contraindications
hypomagnesaemia
Osteoporosis – if prolonged ↑ risk of
(so tetany and
fracture
ventricular
arrhythmias if
severe)
H2-RECEPTOR Binds to the histamine Peptic ulcer disease Bowel disturbance Contraindications It is stimulated by Ranitidine
ANTAGNOSITI receptors to ↓activity of the GORD and dyspepsia Headache Reduce dose in patients with renal substances other
S protein pump and ↓ HCl Dizziness impairment than potassium so
production. Histamine normally binds to histamine will not completely
Not as effective as PPIs receptors on the parietal cells of the stop the production
Excreted by kidneys stomach and produces H+ ions in of acid but will
exchange for K+ reduce it
BETA 2 Bronchial dilation Asthma Hypokalaemia Interactions Arrythmias Salbutamol
AGONISTS Reversible airway obs Fine tremour Beta blockers – reduce effectiveness CV disease
COPD Arrhythmia Corticosteroids hypokalaemia Hyperglycaemia
Hyperkalaemia Tachycardia
Contraindications: severe pre-eclampsia
ANTICHOLINER Blocks Ach receptors, COPD Constipation Bladder Outflow Tiotropium (longer
GICS muscle contraction Asthma during Nausea Obs half life)
Used as adjuvant to B2 exacerbations Dry mouth Paradoxical Ipratropium
agonists Epistaxis Bronchospasm (main, inhaled)
Reduce mucous secretion Oropharyngeal Prostatic
candidiasis Hyperplasia
Headache
Urinary retention in
men
Angle-closure glucoma
CORTICOSTER Modify immune response – COPD exacerbations Adrenal supression Interactions Prednisolone
OIDS up Acute Asthma ↑ risk of infection ↑ risk of peptic ulcers and GI bleeding (Oral)
regulate anti-inflammatory autoimmune IBD Osteoporosis with NSAIDs Hydrocortisone
genes and down regulate Myasthenia gravis Mood/behavioural hypokalaemia in pt’s taking B2 (IV)
pro-inflammatory genes Chemo changes agonists, theophylline, loop/thiazide Beclomethasone
(cytokines, TNF-a) HTN, hypoK, Oedema diuretics (inhaled)
Adrenal atrophy efficacy reduced by CP450 inducers
(prolonged (phenytoin, carbamazepine,
rifampicin)
reduced immune response to vaccines
MUCOLYTICS Reduce sputum viscosity CF GI bleeding Contraindication: active peptic Carbocisteine
Erythema ulceration
Steven-Johnson
syndrome
XANTHINES Bronchodilatation Chronic asthma Hypokalaemia Interaction Arrhythmias Theophylline
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