Section Contents:
- Antiarrhythmic Drugs.
- Adrenoceptor agonists.
- Antiplatelets.
- Benzodiazepine antagonist.
- Anaesthetic Agents
- Angina Drugs
- Antithrombotic Drugs
- Fibrinolytics.
- Antihypertensive medication.
- Antidiabetic Drugs.
- Muscle Relaxants.
- Antidepressants.
- Antipsychotics
- Antiepileptics
- Antivirals
- …
Antiarrhythmic Drugs
Lignocaine (Lidocaine)
Classification: Class 1B antiarrhythmic (Shortens Repolarization).
Amiodarone
Classification: Class 3 antiarrhythmic.
Sotalol / Sotalol Hydrochloride
Classification: Class 3 antiarrhythmic (β-Blocker and K channel blocker).
Adenosine
Classification: miscellaneous antiarrhythmic.
Digoxin
Classification: Cardiac glycoside, miscellaneous antiarrhythmic.
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Magnesium Sulphate 50%
Classification: miscellaneous anti-arrhythmic.
Metoprolol tartrate
Classification: Class 2 anti arrhythmic agent (β1-Blocker)
Esmolol
Classification: Class 2 anti arrhythmic agent (cardio-selective β1-Blocker).
| Class | Mechanism | Example |
|---|---|---|
| Class 1 1A: Prolongs repolarization. 1B: Shortens repolarization. 1C: No effect on repolarization. | Na channel Blockers | 1-A: Procainamide, Quinidine. 1-B: Lignocaine. 1-C: Flecainide, Propafenone. |
| Class 4 | Ca Channel Blockers (Non-dihydropyridine) | Verapamil Diltiazem |
| Class 3 | K Channel Blockers | Amiodarone Sotalol |
| Class 2 | β Blockers | Metoprolol Esmolol Propranolol |
| Miscellaneous | Adenosine Digoxin Magnesium sulphate (MgSO4) |
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Adrenoceptor agonists
DoButamine
Classification: direct-acting adrenoceptor agonist/ synthetic catecholamine.
(β1 > β2 > α)
| DoButamine | Dopamine | |
|---|---|---|
| Naturality | Synthetic | Natural |
| Receptor affinity | β1 > β2 > α | D1 > β1 > α |
| Vasopressor | No | Yes |
| Noradrenaline secretion | No | Yes |
Dopamine
Classification: direct-acting adrenoceptor agonist/catecholamine.
(D1 > β1 > α).
Stimulation of NA secretion
| Dose | Receptor | Organ | Effects | Indications |
| 2-5 mcg/kg/min | D1 | – Renal vasculature. – Mesenteric vascular bed | – Renal vasodilation – ↑renal blood flow – ↑GFR – ↑Na excretion | – Congestive Cardiac failure. – Acute Renal Failure |
| 5-10 mcg/kg/min | β1 | – Heart | – ↑ Cardiac contractility(inotropy). – ↑ Heart Rate (chronotropy) | – Congestive Cardiac failure. – Cardiogenic shock. – Septic Shock. |
| 10-20 mcg/kg/min | α1 | – Vascular smooth mm | – Peripheral vasoconstriction. – ↑ BP. | – Acute symptomatic hypotension (Adjunct to fluid resuscitation) |
Adrenaline
Classification: direct-acting adrenoceptor agonist / catecholamine.
Receptor affinity β1 = β2; α1 = α2
Isoproterenol
Classification: Direct-acting adrenoceptor agonist/catecholamine.
(β1 = β2 >>α)
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Phenylephrine
Classification: Direct-acting adrenoceptor agonist / non-catecholamine.
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Antiplatelets
Aspirin / ASA (Acetylsalicylic acid)
Classification: platelet aggregation inhibitor.
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Clopidogrel
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Atropine
Classification: Anticholinergic / anti-muscarinic agent.
…
Bevacizumab (Avastin)
Classification: antiangiogenic drug.
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Charcoal, Activated (Activated Carbon)
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Calcium Chloride
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Diazepam
Classification: anticonvulsant benzodiazepine.
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Lorazepam
Classification: anticonvulsant, benzodiazepine.
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Benzodiazepine antagonist
Flumazenil
Classification: competitive benzodiazepine antagonist.
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Anaesthetic Agents
Etomidate
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Ketamine
Classification: dissociative anaesthetic.
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Propofol
Classification: non-barbiturate anaesthetic, diisopropyl phenol compound.
Thiopental Sodium
Classification: barbiturate.
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Furosemide
Classification: Loop diuretic
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Glucose 50%
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ANGINA
Verapamil / Verapamil hydrochloride
Classification: Non-Dihydropyridine CCB – phenylalkylamine derivative. Class 4 antiarrhythmic drug.
Diltiazem
Classification: Non-Dihydropyridine CCB – benzothiazepine derivative. Class 4 antiarrhythmic drug.
| Dihydropyridine CCB | Non-Dihydropyridine CCB | |
| Examples | Amlodipine Felodipine Nifedipine | Verapamil Diltiazem |
| MOA | Blocking active (opened) voltage-gated L-Type Calcium channels. | Blocking closed voltage-gated L-Type Calcium channels. |
| Areas of effects | Vascular smooth muscles – Peripheral arteries | Cardiac conduction system – SA node – AV node |
| Maximum Effects | Vasodilatation – Reduced Blood pressure | – Slow down rate of cardiac contractility. – Slow down rate of cardiac conduction. |
| Effect on Inotropy (contraction strength) | Nil | Reduces |
| Effect on Chronotropy (heart rate / contraction rate) | Nil | Reduces |
| Effect on dromotropy (impulse conduction velocity) | Nil | Reduces |
| Indications | – Hypertension – Angina pectoris – Raynaud’s phenomenon (Nifedipine) – Cerebrovascular events (nimodipine) | – Angina – PSVT – Atrial Fibrillation. – Atrial flutter – Hypertension. |
ANTITHROMBOTICS
Heparin: Low molecular weight (ENOXAPARIN)
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Heparin: Unfractionated (UFH)
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Antithrombotic Drugs
Warfarin
Classification: Vitamin K antagonist.
Antihaemorrhagic
Antifibrinolytic
Tranexamic Acid
Classification: anti-fibrinolytic amino acid. See also aminocaproic acid.
Vitamin K
Vitamin K1 / Phytomenadione / Phylloquinone
Vitamin K1 / Phytomenadione/ Konakion
Protamine sulfate
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Hypertension
Hydrochlorothiazide (HCT)
Classification: low-ceiling diuretic / Thiazide diuretic.
Indapamide
Classification: low-ceiling diuretic / non-thiazide diuretic.
Amlodipine
Classification: Dihydropyridine Calcium Channel Blocker (CCB).
Felodipine
Classification: Dihydropyridine Calcium Channel Blocker (CCB).
Nifedipine
Classification: Dihydropyridine Calcium Channel Blocker (CCB).
Captopril
Classification: Class 1 ACEI.
Enalapril / Enalapril maleate
Classification: Class 2 ACEI.
Lisinopril
Classification: Class 3 ACEI.
Candesartan / Candesartan cilexetil
Classification: Angiotensin 2 receptor blocker (ARB).
Irbesartan
Classification: Angiotensin 2 receptor blocker (ARB).
Losartan / Losartan potassium.
Classification: Angiotensin 2 receptor blocker (ARB).
Valsartan
Telmisartan
Amiloride-Hydrochlorothiazide (Combo)
Classification: K-sparring diuretic.
[Adco-Retic]
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Diabetes
Metformin
Classification: Biguanides.
Glibenclamide
Classification: 2nd Generation Sulfonylureas.
Gliclazide
Classification: 2nd Generation Sulfonylureas.
Glipizide
Classification: 2nd Generation Sulfonylureas.
Glimepiride
Classification: 3rd Generation Sulfonylureas.
Dapagliflozin
Classification: Sodium-glucose cotransporter-2 (SGLT-2) inhibitor.
Dose
- HFreF and DM 2: 10 mg once daily.
Empagliflozin
Classification: Sodium-glucose cotransporter-2 (SGLT-2) inhibitor.
Dose:
HFrEF: 10 mg once daily. May be increased to a maximum of 25 mg per day.
- Type 2 DM: 10 mg once daily.
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Insulin: Short-Acting Human insulin
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Thyroid Hormones
Levothyroxine Sodium
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Naloxone
Classification: competitive opiate antagonist.
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Oxytocin
Classification: nonapeptide hormone receptor.
ANTIEPILEPTICS
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Phenobarbital Sodium
Classification: Barbiturate
Primidone
Classification: Barbiturate
Phenytoin
Classification: Hydantoin derivative
Clonazepam
Classification: Benzodiazepine.
Clobazam
Classification: Benzodiazepine.
Diazepam
Classification: Benzodiazepine.
Lorazepam
Classification: Benzodiazepine.
Midazolam
Classification: Benzodiazepine.
Carbamazepine
Carboxamide derivate
Valproic acid
Classification: Fatty acid.
Antipsychotic Drugs
Typical antipsychotics / 1st Gen
Chlorpromazine
Classification: Typical antipsychotic / D2 receptor antagonist
Flupentixol
Classification: Typical antipsychotic / D2 receptor antagonist
Zuclopenthixol
Classification: Typical antipsychotic / D2 receptor antagonist.
Haloperidol
Atypical antipsychotics / 2nd Gen
Aripiprazole
Classification: partial 5HT1A + D2 receptor agonist.
Clozapine
Classification: 5HT2A/2C + D2 receptor antagonist.
Clotiapine
Classification: 5HT2A/2C + D2 receptor antagonist
Risperidone
Classification: 5HT2A/2C + D2 receptor antagonist.
Olanzapine
Classification: 5HT2A/2C + D2 receptor antagonist.
Quetiapine
Classification: 5HT2A/2C + D2 receptor antagonist.
Lithium carbonate
Classification: Mood stabiliser
| No | TEST | COMMENTS |
|---|---|---|
| 1 | Lithium | – Check levels 4 – 7 days post initiation – Once daily dose post 12 hours: 0.7 – 1.0 mmol/L – Monitor 3 monthly for the first 12 months and then 6 monthly |
| 2 | FBC + differential | – Baseline – 6 monthly |
| 3 | Urea and electrolytes | – Baseline – 6 monthly |
| 4 | eGFR | – Baseline – 6 monthly |
| 5 | Blood urea nitrogen (BUN) | . |
| 6 | Urinalysis | . |
| 7 | Calcium levels | – Baseline – 12 monthly |
| 8 | Thyroid function tests | . |
| 9 | Pregnancy test | – Refer to specialist if pregnant. |
Mineral Supplement
Calcium Chloride
Potassium chloride 15%
Sodium Bicarbonate 8.4%
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Corticosteroids
Hydrocortisone
Classification: Glucocorticoid.
Methylprednisolone
Classification: Glucocorticoid.
Prednisone
Classification: Glucocorticoid.
Betamethasone
Classification: Glucocorticoid.
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Rivaroxaban (Xarelto)
Classification: selective factor Xa inhibitor.
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Sodium Polystyrene Sulfonate (Kayexalate)
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Muscle Relaxation
Suxamethonium Chloride (Succinylcholine chloride)
Classification: depolarising muscle relaxant.
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Atracurium besylate
Classification: benzylisoquinoline non-depolarizing muscle relaxant.
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Rocuronium
Classification: steroid-based non-depolarising muscle relaxant.
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Fibrinolytics
Alteplase
Classification: fibrinolytic
Streptokinase
Classification: fibrinolytic.
Tenecteplase
Classification: fibrinolytic
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Antidepressants
Citalopram
Classification: SSRI antidepressant
Escitalopram
Classification: SSRI antidepressant.
Fluoxetine
Classification: SSRI antidepressant.
Fluvoxamine
Classification: SSRI antidepressant.
Paroxetine
Classification: SSRI antidepressant.
Sertraline
Classification: SSRI antidepressant.
Amitriptyline hydrochloride
Classification: TCA antidepressant.
Clomipramine hydrochloride
Classification: TCA antidepressant.
Imipramine hydrochloride
Classification: TCA antidepressant.
Trimipramine
Classification: TCA antidepressant.
Dosulepin
Classification: TCA antidepressant.
| . | Tricyclic Antidepressants (TCA) | Selective Serotonin Reuptake Inhibitors (SSRI) |
|---|---|---|
| MOA | Inhibit the re-uptake of both NA and 5-HT at presynaptic terminal membrane. This results in increased levels of NA and 5-HT in the synaptic cleft. | Only Inhibit the re-uptake of 5-HT at presynaptic terminal membrane |
| Example | – Amitriptyline hydrochloride – Clomipramine hydrochloride – Imipramine hydrochloride – Trimipramine – Dosulepin | – Citalopram – Imipramine hydrochloride – Escitalopram – Trimipramine – Dosulepin |
5-HT = 5-Hydroxytrptamine (Serotonin); NA = Noradrenaline
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Antimalarials
Mefloquine
Chemoprophylaxis.
Atovaquone/proguanil
Chemoprophylaxis.
Doxycycline
Chemoprophylaxis.
Artemether/Lumefantrine
Artesunate
Vaccines
Hepatitis A inactivated vaccine
Hepatitis B vaccine
ANTIVIRALS
Oseltamivir (Tamiflu)
Classification: neuraminidase (sialidase) inhibitor.
Zanamivir (Relenza)
Classification: neuraminidase (sialidase) inhibitor.
Acyclovir
Classification: Nucleoside analogue.
Famciclovir
Classification: Nucleoside analogue.
Ganciclovir
Classification: Nucleoside analogue.
Valaciclovir
Classification: Nucleoside analogue.
Intravenous fluids
Sodium chloride 0.9%
Hypertonic Saline
| Abbreviation | Latin | English |
|---|---|---|
| a.c. | ante cibum | Before Food. |
| b.d. | bis die | Twice daily. |
| o.d. | omni die | Every day. |
| o.m. | omni mane | Every morning. |
| o.n. | omni nocte | Every night. |
| p.c. | post cibum | After food |
| p.r.n. | pro re nata | When required. |
| q.d.s | quater die sumendus | To be taken 4 times daily. |
| q.i.d. | quater in die | 4 times daily. |
| stat | statim | Immediately. |
| t.d.s | ter die sumendus | To be taken 3 times daily. |
| t.i.d. | ter in die | 3 times daily. |
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