ICC-1 — Pharmacology: Anticoagulants, Antidotes & Cardiovascular Drugs
Written by Betra Youhanna, a medical student and not a doctor — check every detail against your own teaching.
lecture-sourced finals-triage sheet · 206 drugs across 49 classes · Cardiology · Vascular · Pulmonology · Haematology · Radiology · Vertical
Indications
Side effects
★ High-yield (SBA-flagged)
#NNN = source card · gaps =
Indications
- ★ Hypertension [, , ]
- ★ Heart failure — decreases mortality; prevents unfavourable remodelling []; HFrEF pillar [, ]
- Proteinuria; diabetic nephropathy []
- Post-MI (reduces mortality) []
Side effects
- ★ Dry cough [, ]
- ★ Angioedema [, ]
Indications
- ★ Hypertension [, ]
- Heart failure; proteinuria; CKD/diabetic nephropathy []
- Preferred when ACEi-intolerant (cough/angioedema) []; valsartan = ARNI component for HFrEF []
Side effects
- ★ Hyperkalaemia []
- ★ Teratogen []
- ↓GFR; hypotension []
Indications
- ★ Heart failure with reduced EF (HFrEF) [, ]
Side effects
- Hypotension; hyperkalaemia; cough; dizziness []
- ★ Contraindicated with ACE inhibitors → angioedema []
Indications
- ★ Severe (acute) hypertension [, ]
- Heart failure (with an organic nitrate) [, ]; safe in pregnancy []
- Arterial vasodilator alternative if ACEi/ARB contraindicated (AHF / hypertensive APE) [, ]
Side effects
- Compensatory tachycardia; fluid retention; headache; angina []
- ★ Drug-induced lupus []
Indications
- ★ Hypertensive emergency []
- Aortic dissection BP control [, ]; AHF afterload reduction / severe hypertensive APE [, ]
Indications
- Hypertensive crisis/emergency (dopamine-1 agonist) [, ]
Indications
- Hypertensive emergency []
Indications
- Acute HF vasodilator (recombinant BNP) — not first-line, ARNI preferred [, ]
Indications
- ★ Hypertension [, , ]
- Angina incl. vasospastic; Raynaud phenomenon []
Side effects
- Gingival hyperplasia (all CCBs) []
- ★ Peripheral oedema; flushing; dizziness; postural hypotension [, ]
Indications
- Hypertension; angina (incl. vasospastic); Raynaud []
Side effects
- Peripheral oedema, flushing, dizziness []
- ★ Short-acting nifedipine aggravates ischaemia in MI []
Indications
- ★ Subarachnoid haemorrhage — prevents cerebral vasospasm []
Side effects
- Gingival hyperplasia; dihydropyridine class effects []
Indications
- Hypertensive urgency/emergency [, ]
Indications
- Hypertensive urgency/emergency [, ]; stable-CAD []
Indications
- Hypertension; angina []
- ★ AF/flutter rate control [, , , ]; SVT / nodal arrhythmia [, , ]
Side effects
- Constipation; flushing; oedema [, ]
- ★ Cardiac depression / AV block / sinus-node depression → contraindicated in HF, heart block, impaired EF [, , ]
Indications
- Hypertension; angina []; AF/flutter rate control [, ]
- ★ SVT / nodal arrhythmias [, , ]; re-entrant tachycardia []
- HCM symptom control (negative inotrope) [, ]
Side effects
- ★ Hyperprolactinaemia (verapamil-specific); constipation; AV block; cardiac depression []
- Gingival hyperplasia; displaces digoxin → toxicity [, ]; contraindicated in HF/bradycardia []
Indications
- ★ Immediate anticoagulation for PE, ACS, MI, DVT/VTE [, , ]
- Used in pregnancy (does not cross placenta) []; warfarin bridging [, ]
- AF/flutter cardioversion premedication (5000 IU IV) [, ]; DVT prophylaxis (5000 U SC BID) []
- Preferred in renal impairment / when rapid reversal needed [, ]; acute limb ischaemia []
Side effects
- ★ Bleeding [, ]
- ★ Heparin-induced thrombocytopenia (HIT) [, ]
- Osteoporosis (long-term); type-4 renal tubular acidosis; drug interactions []
- Reversal: protamine sulphate; monitor PTT [, ]
Indications
- Anticoagulation (mainly factor Xa); DVT/PE [, ]
- ★ Preferred for cancer-associated VTE (more effective than warfarin) [, ]
- ACS (enoxaparin 1 mg/kg q12h) []; DVT prophylaxis (30 mg SC BID) []
Side effects
- HIT very rare vs UFH; caution in renal impairment [, ]
Indications
- Anticoagulant (only factor Xa); VTE prevention in major orthopaedic / high-risk abdominal / high-risk medical patients; superficial vein thrombosis [, ]
- ★ Safe alternative in HIT [, , ]; initial MI anticoagulant []
Indications
- ★ HIT alternative anticoagulant [, ]; VTE, AF []
Indications
- VTE, AF []; MI early invasive strategy []
Indications
- VTE prevention (elective hip/knee); stroke/systemic-embolism prevention in non-valvular AF; DVT/PE treatment & prevention [, , ]
Side effects
- ★ Bleeding, esp. GI [, ]
- Reversal: idarucizumab []; contraindicated in mechanical valve / mod-severe MS []
Indications
- DVT/PE treatment & prophylaxis; stroke prophylaxis in non-valvular AF [, , , ]
- Rivaroxaban 2.5 mg BID + aspirin for stable atherosclerotic vascular disease []; rivaroxaban needs no heparin bridging []
Side effects
- ★ Bleeding, esp. GI [, ]
- Reversal: andexanet alfa []
Indications
- ★ Chronic anticoagulation / VTE treatment & secondary prophylaxis [, , ]
- ★ Stroke prevention in AF; AF + mechanical valve or mitral stenosis (regardless of CHADS-VA) [, , , ]
- Target INR 2.5 (2–3) first VTE; 3.5 (3–4) recurrent []
Side effects
- ★ Bleeding (intracranial; fatal ~0.2%/yr) [, ]
- ★ Teratogenic — crosses placenta [, ]
- ★ Skin/tissue necrosis (early hypercoagulable state, protein C depletion) [, ]
- Alopecia, rash, diarrhoea, 'purple toes' syndrome []; interacts with antibiotics/antifungals (fluconazole)/aspirin []
- Reversal: vitamin K (menadiol PO / phytomenadione IV), Beriplex/PCC, FFP [, ]
Indications
- Reversal agent for dabigatran []
Indications
- ★ Life-/limb-threatening warfarin-related bleeding — rapid reversal (contains factors II, VII, IX, X + protein C & S) [, ]
Indications
- Warfarin reversal (phytomenadione 1–2 mg slow IV; menadiol 2.5 mg PO for INR >8) [, ]
Side effects
- Large doses interfere with subsequent anticoagulation control []
Indications
- ★ Early MI; early ischaemic stroke; high-risk PE thrombolysis [, ]
Side effects
- ★ Bleeding []
- Contraindications: active bleeding, prior ICH, recent surgery, bleeding diatheses, severe hypertension []
Indications
- Systemic fibrinolysis for massive/high-risk PE []
Side effects
- Bleeding; contraindicated in stroke, CNS tumour, major trauma/surgery/head injury <3 wk, bleeding diathesis, active bleeding []
Indications
- Antifibrinolytic reversal of thrombolytics []
Indications
- Factor correction for thrombolytic-bleed reversal []
Indications
- ★ ACS / STEMI (300 mg loading), coronary stenting [, , ]
- ↓ recurrence of thrombotic stroke; stable CAD; post-MI [, , ]
- Antiplatelet low-dose (75–81 mg), irreversible COX-1,2 inhibitor []
Side effects
- ★ Gastric ulcers / GI bleeding [, , ]
- ★ Reye syndrome (children) []
- Tinnitus; allergic reactions; renal injury []; triggers aspirin-induced respiratory disease (Samter's) [, ]
Indications
- ★ ACS / PCI — dual antiplatelet therapy with aspirin [, , ]
- Clopidogrel monotherapy (lifelong) for TIA / ischaemic stroke / PAD []
Side effects
- ★ Bleeding []; ticagrelor reversible []
Indications
- ACS / antiplatelet (ADP blocker) []
Indications
- Unstable angina; PCI (IV/parenteral only) []
Side effects
- Bleeding; thrombocytopenia []
Indications
- Intermittent claudication / peripheral arterial disease (cilostazol); stroke prevention; cardiac stress testing; prevention of coronary-stent restenosis [, , ]; dipyridamole + aspirin for TIA/stroke []
Side effects
- Nausea, headache, facial flushing, hypotension, abdominal pain; bleeding [, ]
Indications
- Drug overdose; [MAIN] elevated intracranial/intraocular pressure []; retinal artery occlusion []; cerebral oedema in CO poisoning []
Side effects
- ★ Pulmonary oedema []; dehydration; hypo-/hypernatraemia []; contraindicated in anuria & HF []
Indications
- (named as diuretic acting at proximal convoluted tubule; no specific indication stated) []
Indications
- ★ Oedematous states — HF, cirrhosis, nephrotic syndrome, pulmonary oedema []; acute HF/APE (IV furosemide 40 mg first-line) [, ]
- Hypertension; hypercalcaemia []
Side effects
- ★ Ototoxicity (permanent) []
- ★ Hypokalaemia []
- Hypomagnesaemia, dehydration, sulfa allergy, metabolic alkalosis, interstitial nephritis, gout (OHH DAANG) []
Indications
- Diuresis in patients allergic to sulfa drugs []
Side effects
- Like furosemide but more ototoxic []
Indications
- ★ Hypertension (first-line / diuretic of choice) [, , ]
- Heart failure; idiopathic hypercalciuria; nephrogenic DI; osteoporosis []
Side effects
- ★ HyperGLUC: hypokalaemic metabolic alkalosis, hyponatraemia, hyperglycaemia, hyperlipidaemia, hyperuricaemia, hypercalcaemia []
- Sulfa allergy []; drug cause of secondary hyperlipidaemia []
Indications
- ★ Heart failure (HFrEF pillar / MRA) [, , ]
- Hyperaldosteronism; K⁺ depletion; hepatic ascites (spironolactone); antiandrogen; resistant-HTN add-on [, ]
Side effects
- ★ Hyperkalaemia → arrhythmias []
- ★ Gynaecomastia / antiandrogen effects (spironolactone) []
Indications
- K-sparing diuretic; amiloride for nephrogenic DI []
Indications
- ★ Angina [, ]; ACS [, ]
- Pulmonary oedema / APE [, , ]; stable CAD; symptomatic HF (venodilator) [, ]; retinal artery occlusion []
Side effects
- ★ Hypotension; headache [, ]
- Reflex tachycardia; flushing; "Monday disease" (tolerance) []
- ★ Contraindicated: right-ventricular infarction [, ]; hypertrophic cardiomyopathy []; concurrent PDE-5 inhibitor / sildenafil [, ]
Indications
- (no independent indication stated — appears only as the nitrate contraindication/interaction) [, ]
Side effects
- ★ Dangerous hypotension with nitrates; cerebral-vasodilation headache [, ]
Indications
- Angina / stable CAD (K-channel activator); advantage — no nitrate tolerance [, ]
Side effects
- Headache; GI (nausea/vomiting); dizziness/malaise/fatigue []
Indications
- ★ Refractory angina (most effective oral coronary vasodilator; no BP/HR drop) [, ]
Side effects
- Constipation; dizziness; headache; nausea []
Indications
- Chronic stable angina (patients who cannot take beta-blockers) [, ]; chronic HFrEF [, ]
Side effects
- ★ Luminous phenomena / visual brightness []; hypertension; bradycardia []
Indications
- ★ Hyperlipidaemia (first-line, LDL↓↓↓) [, ]
- ↓ mortality in CAD; stable CAD; post-MI high-intensity (atorvastatin 40–80) [, , ]
Side effects
- ★ Myopathy (esp. with fibrates/niacin) [, ]
- Hepatotoxicity / ↑LFTs [, ]; stop if ALT >3× or CK >10× []
Indications
- Hyperlipidaemia (LDL↓↓) []; cholestyramine also lesser-used warfarin-overdose reversal []
Side effects
- GI upset; ↓ absorption of other drugs & fat-soluble vitamins []
Indications
- ★ Hyperlipidaemia — second-line, added to statin [, , ]
Indications
- ★ Hyperlipidaemia (TG↓↓↓) / hypertriglyceridaemia [, , ]
Side effects
- ★ Myopathy (↑ risk with statins); cholesterol gallstones []
Indications
- Hyperlipidaemia (HDL↑↑) [, ]
Side effects
- ★ Flushed face (prostaglandin-mediated; ↓ by NSAID/aspirin) []; hyperglycaemia; hyperuricaemia []
Indications
- Hyperlipidaemia (LDL↓↓↓, very-high-risk) [, , ]
Side effects
- Myalgias; delirium; dementia; other neurocognitive effects []
Indications
- Hyperlipidaemia — LDL reduction (siRNA, ↓PCSK9 synthesis) [, ]
Indications
- Hyperlipidaemia — LDL reduction []
Indications
- Hypertriglyceridaemia (TG 135–499 on statin; preferred) [, ]
Indications
- Severe hypertriglyceridaemia >750 mg/dL (familial chylomicronaemia; 300 mg/wk) [, ]
Indications
- TG ≥500 mg/dL management / LDL-TG reduction [, ]
Indications
- Triglyceride reduction []
Indications
- ★ Heart failure; atrial fibrillation [, ]; AF/flutter rate control esp. with HF [, ]
Side effects
- ★ Blurry yellow vision (xanthopsia) []
- ★ Arrhythmias & AV block; hyperkalaemia = poor prognosis [, ]
- Cholinergic N/V/diarrhoea []; toxicity ↑ by renal failure, hypokalaemia, hypercalcaemia, hypomagnesaemia, displacing drugs (verapamil/amiodarone/quinidine) [, ]
- Antidote: Digibind (digoxin-specific antibodies); phenytoin/lidocaine for ventricular arrhythmias [, ]
Indications
- Heart failure (inotrope + vasodilator); inotrope for organ hypoperfusion/shock [, , ]
Indications
- ★ Heart failure (HFrEF pillar); type-2 diabetes [, ]
Side effects
- ★ Normoglycaemic DKA []; UTI; vaginal candida []
Indications
- ★ Acute heart failure; cardiogenic shock [, , ]; pharmacologic stress testing []
Side effects
- β2-mediated vasodilation (paired with a vasopressor) []
Indications
- Cardiogenic shock / HF inotrope [, ]
Side effects
- Large dose ↑ afterload → worsens HF []
Indications
- ★ First-line vasopressor in cardiogenic shock; acute RV failure in massive PE [, , ]
Side effects
- Aggravates HF (↑ SVR / afterload) [, ]
Indications
- Atrial + ventricular arrhythmias; re-entrant/ectopic SVT & VT []; disopyramide for HCM with LVOT obstruction []
Side effects
- ★ Cinchonism (quinidine); reversible SLE-like syndrome (procainamide); torsades (↑QT) []
- Heart failure (disopyramide) []; quinidine displaces digoxin []
Indications
- SVTs incl. AF (rhythm control if structurally normal heart); last-resort refractory VT [, ]
Side effects
- ★ Proarrhythmic — contraindicated post-MI, structural/ischaemic heart disease [, ]
Indications
- ★ SVT; ventricular rate control in AF/flutter [, ]
- Angina / stable CAD; HFrEF pillar; post-MI; hypertension (compelling indications) [, , , ]; ARVC & HCM first-line [, ]
Side effects
- ★ Bronchoconstriction (COPD/asthma exacerbation) [, ]
- ★ Masks hypoglycaemia; bradycardia / AV block / HF []
- Impotence, cold extremities, CNS sedation [, ]; metoprolol → dyslipidaemia; propranolol → worsens vasospastic angina []; contraindicated in cocaine toxicity (unopposed α1) []; abrupt withdrawal → arrhythmia/angina/MI []
Indications
- ★ AF, atrial flutter, VT (amiodarone/sotalol) []; AF rhythm control if structural heart disease (amiodarone) [, ]; VT/VF; ARVC symptomatic arrhythmias [, ]
Side effects
- ★ Sotalol/ibutilide → torsades []
- ★ Amiodarone → pulmonary fibrosis; hypo-/hyperthyroidism (40% iodine); corneal deposits; blue-grey skin [, ]
- Hepatotoxicity, neurologic, constipation, bradycardia/heart block/HF; t½ 60 days; CYP inhibitor; displaces digoxin [, ]
Indications
- ★ Diagnose / terminate SVT [, , ]
Side effects
- Flushing, hypotension, chest pain, sense of impending doom, bronchospasm []
- Very short-acting; blunted by theophylline/caffeine; contraindicated in AF + WPW [, ]
Indications
- ★ Symptomatic bradycardia / heart block (IV up to 3 mg) [, , ]; beta-blocker overdose []
- ★ Organophosphate/carbamate/nerve-gas poisoning (2–5 mg IV titrated to bronchospasm/secretions) [, ]
Side effects
- Overdose → anticholinergic toxidrome (warm/dry, dilated pupils, tachycardia, hyperthermia) []
Indications
- Beta-blocker / calcium-channel-blocker overdose [, ]
Indications
- Digoxin-toxicity ventricular arrhythmias []; local anaesthesia (thoracentesis, 1%) []
Indications
- Digoxin-toxicity ventricular arrhythmias []
Side effects
- Folate deficiency / megaloblastic anaemia (folate antagonist) [, ]; CYP inducer (paracetamol OD risk) []
Indications
- ACS/MI analgesia [, ]; aortic dissection IV analgesia []; acute HF/APE (5 mg IV) [, ]; PE []
Indications
- STEMI analgesia (alternative to morphine) []
Indications
- Hyperkalaemia — intracellular K⁺ shift (with glucose) []
Indications
- Empiric treatment of hypoglycaemia in poisoning (coma cocktail); K⁺-shift with insulin [, , ]
Indications
- ★ Acute pericarditis (with NSAIDs — reduces recurrence) [, , ]; Dressler's syndrome []
Indications
- Strep pneumoniae, enterococci; syphilis (penicillin G = neurosyphilis); Bacteroides []
Indications
- ★ MSSA — endocarditis, skin/soft-tissue infections []
Indications
- Pseudomonas, E. coli, klebsiella; strep/enterococci []; pip-tazo covers pseudomonas []
Indications
- Strep pharyngitis, otitis media, URTIs, enteric GNR []; amoxicillin = IE prophylaxis (2 g) & native-valve IE empiric [, ]; CAP []
Side effects
- Ampicillin → QTc prolongation []
Indications
- Extend cover to MSSA, anaerobes, enteric GNR; pip-tazo & ticar-clav cover pseudomonas; AECOPD (amox/clav), CAP [, , ]
Indications
- Cefazolin/Cephalexin (1st-gen) — GPC/MSSA, IE prophylaxis [, ]
- Cefuroxime (2nd-gen) — extended gram-negative []
- Ceftriaxone / Ceftazidime (3rd-gen) — cross BBB (meningitis); ceftazidime covers pseudomonas; ceftriaxone = IE prophylaxis, CAP, IE empiric [, , , ]
- Cefepime (4th-gen) — pseudomonas, crosses BBB; prosthetic-valve IE empiric [, ]
- Ceftaroline (5th-gen) — [MAIN] only beta-lactam covering MRSA []
Indications
- Broad-spectrum: GPC, anaerobes, GNR, ESBL, pseudomonas (bronchiectasis, COPD exacerbation, septic shock); lung-abscess adjunct (meropenem) [, ]
Side effects
- ★ Seizures []; [MAIN] nephrotoxicity (imipenem) []; vomiting, abdominal pain, nausea, injection-site soreness []; no MRSA cover
Indications
- Gram-negative aerobes incl. pseudomonas & acinetobacter; inhaled for cystic bronchiectasis; safe in penicillin allergy []
Indications
- Gram-negative & pseudomonas; MDR-TB (streptomycin/amikacin/kanamycin) []; gentamicin = IE empiric []; tobramycin/garamycin inhaled (bronchiectasis) []
Side effects
- ★ Ototoxicity (amikacin/neomycin → ears) []
- ★ Nephrotoxicity (tobramycin/gentamicin → kidneys) []
- Neuromuscular blockade []
Indications
- Atypical organisms, NTM/MAC, URTIs, pneumonia/CAP [, ]; COPD/asthma/bronchiectasis anti-inflammatory (azithromycin 250 mg/d) [, ]; IE prophylaxis []
Side effects
- ★ Arrhythmia / QT prolongation [, ]; GI upset; resistant bacteria [, ]
Indications
- Chest infections/pneumonia, eye, UTI, GI, genital, bone & joint infections []; cipro = pseudomonas eradication in bronchiectasis (750 mg/12h) []; moxifloxacin adds anaerobe/TB cover []; CAP []
Side effects
- ★ Cartilage/tendon damage → contraindicated <18 yr & pregnancy []
- QT prolongation/arrhythmia; GI upset; CNS (dizziness/confusion/anxiety) [, ]
Indications
- ★ MRSA & MSSA infections; IE empiric; anti-MRSA CAP [, , ]
Side effects
- ★ Red-man syndrome (histamine; first dose/too-fast infusion → flushing, pruritus, hypotension; prevent with slow infusion ≥1 h) []
- Thrombophlebitis, ototoxicity, nephrotoxicity (A TON) []; no gram-negative/pseudomonas/anaerobe cover
Indications
- Anaerobic cover — lung abscess, aspiration pneumonia; IE prophylaxis (historical) [, , ]
Indications
- Anaerobes (aspiration pneumonia) []
Indications
- Anti-MRSA (CAP); 50S protein-synthesis inhibitor [, ]
Indications
- CAP outpatient []; IE prophylaxis (100 mg) []; elective AAA medical therapy (MMP inhibitor) []; lymphatic filariasis / onchocerciasis adjunct (targets Wolbachia) [, ]
Indications
- AECOPD antibiotic option []; IE prophylaxis class []
Indications
- Inhaled anti-pseudomonal (bronchiectasis, last-resort; ≥3 mo) []; cell-membrane inhibitor []
Indications
- 50S protein-synthesis inhibitor (class mechanism) []
Indications
- Non-beta-lactam cell-wall inhibitor (class mechanism) []
Indications
- 50S protein-synthesis inhibitor (class mechanism) []
Indications
- Folate-synthesis inhibitor antibacterial (class) []
Side effects
- QTc prolongation (via co-trimoxazole) []
Indications
- Folate-synthesis inhibitor antibacterial []
Side effects
- Folate deficiency (folate antagonist) []
Side effects
- Drug-induced interstitial lung disease / alveolar haemorrhage [, ]
Indications
- Influenza — added to CAP regimen if molecular test positive []
Indications
- (antiretroviral for AIDS — implied; not detailed) []
Side effects
- Anaemia / marrow suppression (exacerbates AIDS anaemia) [, ]
Indications
- (antifungal — named only as warfarin interaction) []
Indications
- ★ TB first-line (whole course; 5 mg/kg, max 300) [, ]; NTM (M. kansasii) []
Side effects
- ★ Hepatitis / jaundice []
- ★ Peripheral neuropathy (competes with vitamin B6 → give pyridoxine) []
- Skin rash; GI upset; drowsiness [, ]
Indications
- ★ TB first-line (whole course; detects dormant bacilli; 10 mg/kg, max 600) [, ]
- Leprosy MDT (monthly 600 mg) + post-exposure prophylaxis (single dose) [, ]; NTM []
Side effects
- ★ Orange-red urine/secretions []
- Hepatitis / jaundice []; flu-like syndrome (intermittent dosing); CYP450 inducer (↓ ART/OCP) [, ]; warm autoimmune haemolytic anaemia []
Indications
- ★ TB first-line (first 2 months; 25 mg/kg) [, ]
Side effects
- ★ Hepatitis []; joint pain / gouty arthritis (hyperuricaemia → aspirin/NSAID/paracetamol) []; GI upset; skin rash []
Indications
- ★ TB first-line (first 2 months; 15 mg/kg) [, ]; NTM []
Side effects
- ★ Optic neuritis / red-green colour-vision disturbance → avoid in kids/psychiatric []; skin rash; avoid/adjust in renal disease []
Indications
- TB first-line (only injectable; MDR-TB); replaces ethambutol in TB meningitis (crosses BBB) [, , ]
Side effects
- ★ Deafness / ototoxicity; vertigo/nystagmus; nephrotoxicity []; contraindicated in pregnancy (fetal ototoxicity) []
Indications
- MDR-TB / second-line regimens []; thiacetazone for developing-world TB []
Side effects
- Thiacetazone → [MAIN] severe cutaneous reactions esp. in HIV []; capreomycin/aminoglycosides — reduce dose if CrCl <50; cycloserine/PAS avoided in renal disease []
Indications
- Prevention/treatment of isoniazid peripheral neuropathy (50–75 mg/d) []; NTM (M. kansasii regimen) []
Indications
- ★ Asthma controller (mainstay) + reliever []; COPD add-on (eos ≥300, frequent exacerbations, triple therapy) [, ]
Side effects
- ★ Oral candidiasis; hoarseness of voice []
- ★ Risk of pneumonia (high dose/prolonged) [, ]; limited systemic effects []
Indications
- Asthma & COPD exacerbations (40 mg/d, 5–7 d) [, ]; ILD; sarcoidosis (0.5 mg/kg, first-line) []
- Autoimmune (vasculitis); TB serositis (prevents fibrosis) []; severe CAP + shock/resp failure (dexamethasone 8 mg) [, ]; ARDS high-dose early []; cerebral oedema in CO poisoning []
Side effects
- ★ Mineralocorticoid: hypertension, hyperglycaemia, oedema [, ]
- Immunosuppression (infection/pneumonia); muscle weakness; gastritis/peptic ulcer; osteoporosis; Addisonian crisis (loss of endogenous cortisol) [, ]
Indications
- Injectable corticosteroid — COPD/ILD exacerbation; severe CAP adjunct (8 mg/d) [, ]
Side effects
- Systemic corticosteroid effects (as above) []
Indications
- Injectable corticosteroid — COPD/ILD exacerbation []; premedication before scorpion antivenom if hypersensitivity test positive []
Side effects
- Hypertension (drug cause of secondary HTN) []; systemic corticosteroid effects []
Indications
- Bronchial asthma (controller alternative); aspirin-induced asthma; exercise/antigen-induced asthma; allergic rhinitis [, ]
Side effects
- ★ Neuropsychiatric problems []; headache, GI disturbance, dizziness, hypersensitivity, reversible ↑liver enzymes []
Indications
- ★ Asthma/COPD reliever/rescue (4–6 h); reversibility testing; nebulised acute exacerbation; smoke-inhalation wheeze [, , , ]
Side effects
- ★ Tachycardia / arrhythmia [, ]; hypokalaemia; tremors; anxiety []
Indications
- Asthma controller (ICS-formoterol preferred reliever/MART); COPD maintenance; formoterol = rapid-onset LABA rescue [, , ]
Side effects
- Beta-2 class: tachycardia, hypokalaemia, tremor, anxiety []
Indications
- Asthma/COPD maintenance bronchodilation (24 h) [, ]
Indications
- Asthma/COPD bronchodilation (controller + reliever, inhalation only) [, , ]
Side effects
- Dry mouth; bitter/metallic taste (poor systemic absorption — safe) []
Indications
- COPD/asthma maintenance (LAMA reduces exacerbations more than LABA); safest bronchodilator in arrhythmia [, , ]
Side effects
- Dry mouth; metallic taste []
Indications
- COPD bronchodilator (not recommended unless inhaled BD unavailable); NOT for asthma [, , ]
Side effects
- ★ Narrow therapeutic index: cardiac (tachycardia/arrhythmia); CNS (convulsions/insomnia); GI (nausea/gastritis) [, ]
Indications
- COPD: FEV1 <50% + frequent exacerbations + chronic bronchitis despite ICS/LABA/LAMA (oral once daily) [, , ]
Side effects
- GI upset; psychological problems []
Indications
- COPD — novel bronchodilator + anti-inflammatory (nebuliser q12h); last-resort add-on for persistent dyspnoea [, , ]
Indications
- Expectoration / mucolytic; NAC may ↓ COPD exacerbations [, , ]; acetylcysteine = paracetamol-overdose antidote (glutathione precursor; ~100% hepatoprotective if <8 h) [, ]
Indications
- Severe (Th2/eosinophilic) asthma [, ]
Indications
- Severe asthma []; COPD with chronic bronchitis + eos ≥300 (SC q2wk) [, ]
Indications
- Idiopathic pulmonary fibrosis (antifibrotic) [, ]
Indications
- Lymphangioleiomyomatosis (LAM) [, ]
Side effects
- Almost no effect on BP []
Indications
- Pulmonary Langerhans cell histiocytosis (PLCH) [, ]
Indications
- ILD / sarcoidosis immunosuppressant [, ]
Side effects
- Hypercoagulability / DVT (chemotherapy agent) []
Indications
- ILD / sarcoidosis immunosuppressant (steroid-sparing) [, ]
Side effects
- Predisposes to NTM infection []
Indications
- ILD / sarcoidosis / rheumatoid arthritis immunosuppressant [, , ]
Side effects
- ★ Drug-induced pneumonitis / pulmonary fibrosis [, ]
- Folate deficiency / megaloblastic anaemia; hypercoagulability/DVT [, ]
Indications
- Sarcoidosis immunosuppressant (steroid-sparing) []
Side effects
- Predisposes to NTM infection []
Side effects
- Hypertension []; QTc prolongation []
Side effects
- Hypertension (less than ciclosporin) []
Indications
- ★ Folate-deficiency megaloblastic anaemia (5 mg/d) [, ]
- Methotrexate-toxicity prevention; pregnancy prophylaxis (400 µg — prevents neural-tube defects); chronic haemolytic anaemia [, , ]
Side effects
- Essentially nontoxic (oral); rare hypersensitivity (parenteral) []; never give before B12 (precipitates neuro damage) [, ]
Indications
- ★ Pernicious anaemia & other B12 deficiencies []; prophylaxis post-gastrectomy/ileal resection []
- Cyanide poisoning antidote (hydroxocobalamin → non-toxic cyanocobalamin) []
Side effects
- Nontoxic even in large doses []
Indications
- ★ Anaemia of chronic renal failure []; AIDS (zidovudine-related); myelosuppressive chemotherapy; elective surgery; autologous blood donation; premature infants; chronic inflammatory conditions [, ]
Side effects
- ★ Hypertension [, ]; thrombosis if Hb overcorrected []; benzyl-alcohol preservative → fatal toxic syndrome in neonates []
Indications
- Anaemia of CKD in adults on dialysis ≥4 months (first oral agent) [, ]
Side effects
- ★ Thrombosis, MI, stroke, hypertension, death (esp. if Hb >11) []; abdominal pain; hypersensitivity []
Indications
- ★ Iron overload / acute iron poisoning — chelation [, , ]
Indications
- Type-2 diabetes (continue peri-MI for cardiovascular benefit) [, ]
Indications
- Resistant hypertension (add-on vasodilator) []
Indications
- Resistant hypertension (centrally acting) []
Indications
- (antihypertensive — no indication detailed in deck)
Side effects
- Warm autoimmune haemolytic anaemia (true AIHA) []
Indications
- OCD (second-line, after SSRI failure) [, ]
Indications
- Rapid tranquilisation (5–10 mg PO / 5 mg IM); delirium tremens first-line [, ]
Side effects
- ★ QTc prolongation → torsades []; acute dystonia []; neuroleptic malignant syndrome []
Indications
- Depression []; akathisia (5-HT2 antagonist) []
Indications
- Rapid tranquilisation (lorazepam 1–2 mg) []; alcohol detox (chlordiazepoxide reducing regimen) []; alcohol-withdrawal seizures (diazepam 10 mg PR) []; benzodiazepine/GBL withdrawal (diazepam) []; akathisia / epilepsy (clonazepam) [, ]
Side effects
- Respiratory depression (reversed by flumazenil) []
Indications
- GBL withdrawal (with benzodiazepines) []
Indications
- Acute dystonia (antipsychotic-induced) []
Indications
- Neuroleptic malignant syndrome — reduce rigidity [, ]
Indications
- ★ Opioid overdose / opioid-induced respiratory depression (opiate antagonist; short half-life) [, ]
Indications
- Opioid substitution for opiate dependence (5–10 mg STAT, max 40 mg/24 h; oral solution 1 mg/mL) [, ]
Side effects
- ★ Fatal respiratory depression if combined with alcohol/benzos/opioids []; QTc prolongation []
Indications
- Opioid substitution for opiate dependence [, ]
Indications
- Symptomatic opiate withdrawal (loperamide → diarrhoea; buscopan → abdominal cramps) []
Indications
- ★ Wernicke's encephalopathy (IV thiamine) [, ]; alcohol-detox prophylaxis (100 mg TDS PO or Pabrinex I+II IM/IV, 3–5 d) []; coma cocktail in poisoning []
Indications
- ★ Reversal of benzodiazepine-induced respiratory depression / benzodiazepine overdose antidote [, ]
Side effects
- May precipitate seizures (mixed overdose) []
Indications
- Organophosphate / nerve-gas poisoning — reactivates AChE (within 24–48 h) [, ]
Indications
- Arsenic / mercury / lead poisoning antidote []
Indications
- Methanol (& ethylene glycol) poisoning antidote []
Side effects
- (as a poison: sedative/hypnotic toxidrome) []
Indications
- Methanol / ethylene glycol poisoning antidote []
Indications
- Cyanide poisoning — provides sulfur → thiocyanate (renally excreted) [, ]
Indications
- Cyanide poisoning — chelates circulating cyanide (not intracellular) []
Indications
- Body packing without leak — bowel evacuation + observe []
Indications
- Aspirin-overdose peptic-ulcer treatment []
Indications
- Analgesic / antipyretic (acute bronchitis; pyrazinamide joint pain) [, ]
Side effects
- ★ Hepatotoxicity in overdose (NAPQI accumulation; antidote = N-acetylcysteine) [, , ]
Indications
- VEGF inhibitor — antiangiogenic cancer therapy []
Indications
- Tyrosine-kinase inhibitor (cancer) []
Indications
- Weight loss / diet pill []
Indications
- (antimalarial — indication not detailed; quinine also antiarrhythmic-class relative)
Side effects
- QTc prolongation / torsades []
Indications
- (antimicrobial — no indication detailed)
Indications
- ★ Lymphatic filariasis (treatment of choice, 6 mg/kg × 12 d); loiasis (8–10 mg/kg × 21 d) [, ]
Side effects
- ★ Severe encephalopathy in high-density Loa loa (obtain microfilarial count first) [, ]
Indications
- Onchocerciasis / river blindness (150 mcg/kg q3mo; mass treatment) [, ]
Indications
- Onchocerciasis (antiparasitic; ≥12 yr) []
Indications
- Loiasis pretreatment (200 mg bid × 3 wk before DEC) []
Indications
- (antiparasitic — indication not detailed)
Side effects
- Folate deficiency (folate antagonist) []
Indications
- ★ Leprosy MDT (daily 100 mg) [, ]
Side effects
- ★ Haemolysis (G6PD); allergy; hepatitis; red urine []
Indications
- Leprosy multibacillary MDT (daily 50 mg + monthly 300 mg) [, ]
Side effects
- Red/brown skin discolouration; ichthyosis []
Indications
- Chemotherapy (anthracycline chemotherapeutic agent) [, ]
Side effects
- ★ Cardiotoxicity → dilated cardiomyopathy [, , ]; endothelial damage → DVT []
Side effects
- Endothelial damage → DVT []
Side effects
- Endothelial damage → DVT []
Indications
- (migraine — indication not detailed in deck)
Side effects
- Nonocclusive mesenteric ischaemia (vasoconstriction) []
Indications
- Intermittent claudication / peripheral arterial disease []
Indications
- Varicose-vein sclerotherapy — telangiectasias, reticular & small varicose veins [, ]
Indications
- (indication not detailed in deck)
Side effects
- Folate deficiency (folate antagonist) []
Indications
- (COX-2 inhibitor NSAID — appears only as a concomitant medication) []
Side effects
- CYP inducer (↑ paracetamol-overdose risk) []