ICC-3 — Pharmacology: Neurology, Endocrine, Haem/Onc & Nephrology
Written by Betra Youhanna, a medical student and not a doctor — check every detail against your own teaching.
lecture-sourced finals-triage sheet · 233 drugs across 50 classes · Neurology · Endocrine · Haematology & Oncology · Nephrology · Infections
Indications
Side effects
★ High-yield (SBA-flagged)
#NNN = source card · gaps =
Indications
- ★ Type 1 DM — lifelong basal-bolus, first-line
- ★ Type 2 DM — when catabolic/weight loss, A1C >10% or BG ≥300, markedly symptomatic; combination-injectable basal 0.1–0.2 U/kg
- Gestational DM when diet fails — early intervention
- Diabetic ketoacidosis — IV bolus 0.1 U/kg then 0.1 U/kg/hr; drop to 0.05 at RBS 250
- Inpatient / perioperative & post-MI — basal-bolus or premixed
- Hyperkalaemia — insulin + dextrose shifts K⁺ intracellularly
Side effects
- ★ Hypoglycaemia
- Weight gain
- Premixed → obligate eating
Indications
- ★ Type 2 DM — first-line, universal backbone, combinable with any class
Side effects
- GI symptoms — nausea/diarrhoea
- Vitamin B12 deficiency
- Lactic acidosis (rare)
- Caution/withhold: CKD stage 3B, before IV contrast (48 h), 6 months post-MI
Side effects
- ★ Hypoglycaemia; weight gain
- High secondary-failure rate; needs renal dose adjustment
- Higher hypoglycaemia risk while fasting/Ramadan; avoid in basal-bolus escalation
Indications
- Type 2 DM — reduce postprandial glucose; safe in advanced renal disease (esp. repaglinide)
Side effects
- Hypoglycaemia; weight gain
Indications
- Partial central diabetes insipidus — prolongs vasopressin action
Indications
- Type 2 DM — increase insulin sensitivity; pioglitazone lowers ASCVD events/triglycerides, raises HDL
Side effects
- ★ Oedema / heart failure — contraindicated in HF
- Weight gain; bone loss/fractures; macular oedema
- Bladder cancer (pioglitazone); ↑LDL (rosiglitazone)
Indications
- Type 2 DM — weight-neutral, no hypoglycaemia
Side effects
- Rare urticaria/angioedema; joint pain; bullous pemphigoid; pancreatitis
- ↑Heart-failure hospitalisation (saxagliptin)
- Do not combine vildagliptin with a GLP-1 RA
Indications
- ★ Type 2 DM — weight loss, lowers MACE/albuminuria; preferred injectable over insulin
Side effects
- GI (nausea/vomiting); modestly ↑heart rate; acute pancreatitis
- C-cell hyperplasia / medullary thyroid tumours (rare)
Indications
- Type 2 DM adjunct — reduces postprandial glucose & weight
Side effects
- Hypoglycaemia; frequent GI effects
Indications
- ★ Type 2 DM — esp. ASCVD / heart failure / CKD; cardio-renal protection
Side effects
- ★ Genital mycotic infections & UTI
- Polyuria / volume depletion / dehydration; ↑LDL; rare euglycaemic DKA
- Amputation & fracture risk (canagliflozin); Fournier's gangrene
Indications
- Type 2 DM — lower postprandial glucose
Side effects
- Frequent GI effects; needs renal dose adjustment
Indications
- Type 2 DM adjunct — lowers LDL
Side effects
- Constipation; ↑triglycerides; ↓absorption of other drugs
Indications
- Hypoglycaemia rescue — IM/SC when unable to swallow
- Glucagon stimulation test for GH deficiency
Indications
- ★ Hypothyroidism replacement — 50–100 mcg OD (25 mcg if elderly/IHD); shrinks goitre
- Subacute thyroiditis hypothyroid phase
- Myxoedema coma — IV
- Post-thyroidectomy TSH suppression for thyroid cancer
Side effects
- Over-replacement precipitates angina in IHD → start low
- Excess ingestion = thyrotoxicosis factitia; listed as an ADH-potentiating (SIADH) drug
Indications
- ★ Hyperthyroidism / Graves' — 12–18 months
- Thyroid storm — PTU first-line (load 1000 mg), methimazole alternative
- PTU preferred in pregnancy/1st trimester & breastfeeding
Side effects
- Rash (5% — most common)
- ★ Agranulocytosis (0.5% — fever + sore throat; most dangerous)
- Cholestatic jaundice; hepatocellular toxicity; angioneurotic oedema/arthralgia
Indications
- ★ Hyperthyroidism — Graves', toxic adenoma, toxic MNG
- Thyroid cancer ablation
Side effects
- Eventual hypothyroidism (100%)
- May worsen thyroid ophthalmopathy
- ★ Contraindicated in pregnancy & lactation
Indications
- Thyroid storm — inhibits hormone release; give AFTER PTU
Indications
- Named as an anti-arrhythmic (no cardiac indication detailed in ICC-3)
Side effects
- ★ Thyroid dysfunction — hyperthyroidism/Jod-Basedow and hypothyroidism
- Thyroiditis; precipitant of myxoedema coma
Indications
- Graves' ophthalmopathy
- Granulomatous hypercalcaemia (sarcoid/TB) — high dose ×10 days
- Thyroid storm; minimal change disease & FSGS (1° — dramatic response), MPGN, Goodpasture's
- Pulmonary eosinophilia; CLL autoimmune complications; multiple myeloma
- Bacterial meningitis / brain abscess with raised ICP; EBV airway/autoimmune; FUO empiric; allergic reactions; infantile spasms; MS relapse
Side effects
- Secondary osteoporosis; elevated blood pressure
- Neutrophilia via demargination; Cushingoid hypernatraemia/hypokalaemia; UTI predisposition
- Of NO benefit in dengue
Indications
- Adrenal insufficiency replacement — 15–20 mg/day
- Myxoedema coma — 100 mg IV q8h to prevent adrenal crisis
- Anaphylaxis — IV adjunct
Indications
- Adrenal insufficiency replacement
- Drug-induced acute interstitial nephritis — high dose 60 mg/day
- SJS/TEN
Indications
- Graves' ophthalmopathy post-RAI — 100 mg/day taper
- Subacute thyroiditis, severe — 20 mg TDS
Indications
- Thyroid storm — 2 mg IV q6h
- Vasogenic cerebral oedema / brain tumour
- Bacterial meningitis adjunct — 10 mg
- (Diagnostic: dexamethasone suppression test — , , )
Indications
- ★ Multiple-sclerosis relapse — IV 1 g/day ×3–5 days
Side effects
- Osteoporosis; rare avascular necrosis; sleep & mood disturbance
Indications
- Duchenne muscular dystrophy — disease-modifying glucocorticoid
Indications
- Mineralocorticoid replacement — primary adrenal insufficiency & classic salt-wasting CAH; NOT in secondary insufficiency
Indications
- ★ Primary hyperaldosteronism / bilateral hyperplasia — first-line MRA
Side effects
- ★ Gynaecomastia, impotence, ↓libido (male); breast tenderness, menstrual irregularity (female)
- Stop before aldosterone/renin testing
Indications
- Primary hyperaldosteronism — selective MRA, avoids anti-androgen effects
Side effects
- Less effective than spironolactone for hypertension; stop before testing
Indications
- ★ CKD associated with type 2 diabetes; secondary hyperaldosteronism
Side effects
- Hyperkalaemia, hypotension, hyponatraemia; CI eGFR <25 or K⁺ >5
Indications
- Primary hyperaldosteronism — 2nd-line if MRA-intolerant
- Lithium-induced nephrogenic diabetes insipidus
Indications
- Cushing's syndrome — medical therapy (mnemonic KEMMMO): osilodrostat = 11β-hydroxylase inhibitor; metyrapone/ketoconazole/etomidate = steroidogenesis inhibitors; mifepristone = glucocorticoid-receptor antagonist; mitotane = adrenolytic
Indications
- Acromegaly — when surgery not possible
- (Somatostatin/octreotide scan = pheochromocytoma functional imaging, )
Indications
- Cushing's disease — pituitary source, inhibits ACTH, when surgery not possible
Indications
- ★ Hyperprolactinaemia — drug of choice; shrinks tumour
- Type 2 DM — quick-release; Parkinson's disease (ergot D2 agonist)
Side effects
- Headache/dizziness/syncope, nausea, fatigue, rhinitis
Indications
- Hyperprolactinaemia — long-acting alternative; Parkinson's (ergot D2 agonist)
Indications
- Parkinson's disease — D2 agonists
Indications
- ★ Central diabetes insipidus — first-line, nasal spray/tablet
- Water-deprivation test
Indications
- Central diabetes insipidus in hypernatraemia — "give vasopressin"; hormone physiology
Indications
- ★ Tolvaptan — ADPKD, slows cyst progression (NICE: CKD 2–3, rapidly progressing)
- SIADH — fluid overload; vasopressin-receptor antagonists
Indications
- ★ Osteoporosis — alendronate first-line oral weekly, ibandronate monthly, zoledronate IV yearly
- Paget's disease
- Hypercalcaemia / parathyroid crisis — pamidronate 60–90 mg IV; multiple myeloma bone disease
Side effects
- ★ Osteonecrosis of the jaw (rare); atypical femoral fracture (rare)
- Oesophagitis; contraindicated oral in upper-GI problems
- Pamidronate → secondary FSGS (nephrotic)
Indications
- Osteoporosis — SC every 6 months; multiple myeloma bone disease
Side effects
- ★ Hypocalcaemia; weakness, muscle pain, constipation, rash
Indications
- Osteoporosis — SC, increases bone turnover
Side effects
- Nausea, limb pain, headache; ↑serum Ca²⁺; [MAIN] osteosarcoma risk
Indications
- Postmenopausal osteoporosis — reduces vertebral > hip fracture
Side effects
- ↑DVT risk; cardiovascular risk; no longer used
Side effects
- Nausea, diarrhoea; ↑DVT & cardiovascular risk; no longer used
Indications
- Hypercalcaemia (pharmacological); Paget's disease; parathyroid/hypercalcaemic crisis
Indications
- Osteomalacia/rickets — cholecalciferol 20,000 IU weekly ×6 then 800–1000 IU/day
- Hypocalcaemia — calcitriol 0.5–1 mcg/day (renal disease), calcifediol (liver disease), ergocalciferol long-term
- CKD-MBD — calcitriol / alfacalcidol to suppress PTH once ≥3× ULN
Side effects
- Over-treatment with active vitamin D → adynamic bone disease; vitamin D intoxication → hypercalcaemia
Indications
- Primary hyperparathyroidism — medical option
- Tertiary hyperparathyroidism in CKD
Side effects
- GI effects; does not mitigate end-organ effects; expensive
Indications
- Hyperphosphataemia in CKD — non-calcium binder, taken with meals
Indications
- ★ Pheochromocytoma — pre-op alpha blockade, given FIRST, 7–10 days
Indications
- Pheochromocytoma — pre-op selective alpha blockade
Indications
- Pheochromocytoma hypertensive crisis — IV
Indications
- Inoperable pheochromocytoma — catecholamine-synthesis inhibitor
Indications
- Pheochromocytoma hypertensive crisis — IV, releases NO
Indications
- ★ Anaphylaxis — first-line IM/SC 0.5 mg; EpiPen
Side effects
- Ineffective in ACE-inhibitor / bradykinin-mediated angioedema
Indications
- GH dynamic stimulation testing
Side effects
- Withdrawal interferes with metanephrine assay
Indications
- Pseudoephedrine — sickle-cell priapism prevention (vasoconstrictor); PD orthostatic hypotension
Side effects
- Elevate blood pressure; interfere with metanephrine assay
Indications
- ★ Essential tremor
- Graves' — symptomatic control + blocks T4→T3 conversion; thyroid storm
- Pheochromocytoma pre-op beta blockade (AFTER alpha); migraine prevention
Indications
- Bisoprolol — pheochromocytoma beta blockade
- Atenolol, metoprolol — migraine prevention
- Labetalol — combined α/β blocker: pheochromocytoma; acute-stroke BP control if >185/110
- Carvedilol — Duchenne MD cardiac prophylaxis with ACEi, from age ≥10
Indications
- Glaucoma — decreases aqueous production
Side effects
- Contraindicated in asthma, COPD, heart block
Indications
- Pheochromocytoma — IV hypertensive-crisis agent
Indications
- ★ Cluster-headache prevention — mainstay; migraine prevention
- CKD 2nd-line renoprotective CCB if targets unmet; safe antihypertensive during aldosterone testing
Side effects
- Drug-induced hyperprolactinaemia
Indications
- CKD 2nd-line renoprotective CCB if targets unmet
Indications
- Safe antihypertensive to continue during aldosterone testing
Indications
- Hypertension (ACE inhibitor); type 2 DM with hypertension
- Diagnostic captopril-challenge renogram for renovascular hypertension / renal-artery stenosis
Indications
- Enalapril — acute-stroke BP control; hypertension (ACEi)
- Lisinopril, candesartan — migraine prevention; antihypertensive (ACEi/ARB)
- ACEi/ARB class — first-line for proteinuria/HTN in CKD & nephrotic syndrome
Indications
- ★ Ischaemic/embolic stroke — helps embolic, KILLS haemorrhagic; stroke secondary prevention
- Essential thrombocythemia & polycythaemia vera antiplatelet; migraine/tension abortive
Side effects
- Haemorrhagic-stroke death; subdural-haematoma predisposition
- G6PD haemolysis (high dose); acute urticaria; analgesic nephropathy; contraindicated in yellow fever (bleeding)
Indications
- Stroke secondary-prevention antiplatelet
Indications
- Prophylactic anticoagulation for nephrotic hypercoagulability
Side effects
- Withhold for 24 h after thrombolysis
Indications
- Prophylactic anticoagulation for nephrotic hypercoagulability
Side effects
- Levels raised by phenytoin displacement / lowered by carbamazepine induction (DDI)
Indications
- ★ Acute ischaemic stroke — thrombolysis ≤4.5 h, small/medium vessels, 0.9 mg/kg
Side effects
- ★ Haemorrhage — "do not touch the patient"
Side effects
- Blocks Na-K pump → hyperkalaemia risk
Indications
- Hyperlipidaemia of nephrotic syndrome — inhibits intestinal cholesterol absorption (with a statin)
Indications
- Oedema / hypertension in nephrotic syndrome & CKD — ± thiazide
- SIADH — loop diuretics increase free-water excretion; idiopathic intracranial hypertension
Side effects
- Acute interstitial nephritis
Indications
- Hypertension / oedema in nephrotic syndrome — with a loop diuretic
- Nephrogenic diabetes insipidus — paradoxical antidiuresis via DCT Na-Cl block
Side effects
- Hypercalcaemia; hypokalaemia — renal K⁺ loss; acute interstitial nephritis
Indications
- Iron-overload chelation — injectable SC/IV, 8–12 h infusion
Indications
- Iron-overload chelation — oral OD; hold if ferritin <500
Indications
- Iron-overload chelation — oral
Side effects
- ★ Neutropenia & agranulocytosis — weekly CBC
Indications
- ★ Anaemia of chronic kidney disease — EPO deficiency
- Erythropoiesis-stimulating supportive care in MDS / myeloma / marrow failure
Side effects
- ★ Hypertension — 30% of ESA-naïve patients; monitor BP for first 6 months
Indications
- Hereditary spherocytosis & G6PD deficiency — prevent deficiency
- Anaemia of CKD haematinic replacement; pre-pregnancy epilepsy supplementation 0.4–5 mg/day; corrects phenytoin megaloblastic anaemia
Indications
- Cerebral toxoplasmosis — with pyrimethamine + sulphadiazine (marrow rescue)
Indications
- Haematinic replacement in anaemia of CKD / deficiency
- Subacute combined degeneration / B12-deficiency neuropathy
Indications
- ★ Sickle-cell disease — disease modifier
- CML (older therapy); essential thrombocythemia & polycythaemia vera cytoreduction
Side effects
- ★ Risk of transformation to AML
Indications
- Multiple myeloma — proteasome inhibitor (bortezomib) / immunomodulator (thalidomide)
Indications
- Hodgkin lymphoma — ABVD regimen
- Doxorubicin & vinblastine — Kaposi sarcoma (IV doxorubicin, intralesional vinblastine)
Indications
- Hodgkin lymphoma — anti-CD30 antibody-drug conjugate
Indications
- Follicular lymphoma (R-CVP + maintenance); DLBCL (R-CHOP) — anti-CD20
- Goodpasture's / anti-GBM disease
Indications
- CLL — ibrutinib (BTK), idelalisib (PI3K-δ), venetoclax (Bcl-2)
Indications
- ★ CML — imatinib first-line TKI (BCR-ABL); nilotinib for newly-diagnosed Ph+ or imatinib-resistant/intolerant
Indications
- Myelofibrosis — JAK inhibitor, shrinks spleen
Indications
- Acute myeloid leukaemia — anti-CD33
Indications
- Myelodysplastic syndrome — demethylation therapy
Indications
- Lupus nephritis; MPGN; Goodpasture's / anti-GBM
Indications
- (immunosuppressant/chemo — no specific indication card in ICC-3)
Indications
- (chemotherapy — no specific indication card in ICC-3)
Side effects
- Nephrogenic diabetes insipidus; SIADH
Indications
- Tumour-lysis-syndrome prophylaxis — >24 h pre-chemo; acute hyperuricaemic nephropathy
- CKD gout prevention — reduced dose
Side effects
- Acute interstitial nephritis
Indications
- Hyperuricaemic nephropathy — if allopurinol not tolerated & eGFR >30; CKD gout prevention
Indications
- Established/high-risk tumour lysis syndrome — recombinant urate oxidase; hyperuricaemic nephropathy
Indications
- Severe aplastic anaemia (with ATG)
- Minimal change disease & FSGS — alternative to steroids; SJS/TEN
Side effects
- Chronic tubulointerstitial nephritis; lowers seizure threshold
Indications
- Minimal change disease & FSGS — alternative to steroids
Indications
- Lupus proliferative nephritis
Indications
- ★ Group A strep / scarlet fever
- Confirmed meningococcal meningitis (penicillin G); actinomyces
- C. botulinum wound & C. tetani (benzylpenicillin); sickle-cell infection prophylaxis
Side effects
- Rash/hypersensitivity 1–10%; anaphylaxis 0.05%; antibiotic-associated diarrhoea; safe in pregnancy
- Lowers seizure threshold
Indications
- Group A strep; enterococci first-line
- Listeria — drug of choice; add for meningitis if >60/immunocompromised
Indications
- Listeria meningitis/bacteraemia; upper UTI in pregnancy (+ gentamicin)
Indications
- ★ Staph aureus — SSSS, impetigo, cellulitis, folliculitis, septic arthritis, osteomyelitis, pneumonia, IE; penicillinase-resistant
Indications
- Broad-spectrum — S. aureus / E. coli / H. influenzae; when GAS + S. aureus co-infection
Indications
- MSSA first-line — complex skin, bacteraemia, catheter, osteomyelitis, pneumonia
Indications
- ★ Empiric bacterial meningitis — 3rd-gen ceftriaxone/cefotaxime/cefepime
- Brain abscess (aerobic cover); enteric fever & pneumococcal/asplenic bacteraemia (ceftriaxone); cefepime = neutropenic-fever single agent; UTI
- Cephalexin — MSSA simple skin; Group A strep in penicillin allergy
Side effects
- ★ Antibiotic-associated diarrhoea / C. difficile colitis — highest risk of the β-lactams
- Avoid in immediate penicillin hypersensitivity (cross-reactivity); intrinsically inactive vs enterococci & Listeria; acute interstitial nephritis
Indications
- Resistant Gram-negatives; Enterobacteriaceae meningitis if resistant (meropenem 2 g tds); neutropenic-fever single agent
- Monobactams — named only in the antimicrobial-mechanism slide; no agent/indication given
Indications
- ★ MRSA — complex skin, bacteraemia, catheter, osteomyelitis, pneumonia (–); CoNS/prosthetic
- Penicillin-resistant pneumococcal meningitis add-on; neutropenic fever if MRSA/Corynebacterium suspected
- ★ Oral for C. difficile colitis
Side effects
- ★ Nephrotoxicity (> teicoplanin) & ototoxicity — monitor levels
- ★ Red-person syndrome if infused too fast — give at 1 mg/min
Indications
- Glycopeptide — enterococci 2nd-line; can be given IM
Side effects
- Nephro/ototoxicity, less than vancomycin
Indications
- Group A strep in penicillin allergy; atypical pneumonia / β-lactam alternative
- Azithromycin → chlamydia & enteric fever; clarithromycin → mycobacteria; erythromycin → C. diphtheriae (+ antitoxin)
Side effects
- ★ GI disturbance (nausea/vomiting/abdominal discomfort/diarrhoea) — worst with erythromycin
- Azithromycin contraindicated in hepatic impairment; erythromycin → acute interstitial nephritis
Indications
- ★ Gram-negative/Pseudomonas septicaemia (urinary/biliary/respiratory/GI) with a β-lactam
- Infective-endocarditis synergy; febrile-neutropenia add-on if septic; upper UTI in pregnancy; ear/eye drops as monotherapy; streptomycin → TB
Side effects
- ★ Ototoxicity & nephrotoxicity — monitor levels (Hartford nomogram, 6–14 h post-dose)
- Caution with diuretics; acute tubular necrosis; nephrogenic DI & hypomagnesaemia
Indications
- Gram-negative UTI/GI in penicillin allergy; upper UTI
- Meningococcal contact prophylaxis (single-dose ciprofloxacin); moxifloxacin → LRTI + mycobacteria (no Pseudomonas); neutropenic prophylaxis (oral)
Side effects
- ★ Lowers seizure threshold; tendon damage
- Not licensed in children (joint effects); G6PD haemolysis; acute interstitial nephritis (ciprofloxacin)
Indications
- TB first-line (RIPE); meningococcal contact prophylaxis 600 mg bd ×2 d; add for resistant pneumococcal meningitis; MSSA osteomyelitis combo
Side effects
- Acute interstitial nephritis
Indications
- MSSA/MRSA skin; Group A strep in penicillin allergy; osteomyelitis alternate; malaria adjunct (–, , )
Side effects
- ★ C. difficile colitis — classic trigger
Indications
- MRSA — skin, bacteraemia, osteomyelitis, pneumonia (favoured for MRSA pneumonia) (–)
Indications
- MRSA — skin, bacteraemia, catheter, osteomyelitis (–)
Side effects
- ★ Inactivated by lung surfactant → NOT for pneumonia
Indications
- ★ PCP treatment & prophylaxis; MRSA skin; Nocardia
- Listeria meningitis in penicillin anaphylaxis; prophylaxis in HIV CD4<200 / renal transplant / BMT
- Trimethoprim/nitrofurantoin — lower UTI (avoid trimethoprim 1st trimester)
Side effects
- Neutropenia; sulfonamides → G6PD haemolysis
Indications
- Cerebral toxoplasmosis — with pyrimethamine + folinic acid
Indications
- Bacterial meningitis when penicillin/cephalosporin anaphylaxis
Side effects
- G6PD haemolysis; leukaemogenic / aplastic anaemia
Indications
- ★ Metronidazole — C. difficile colitis (oral); brain-abscess anaerobic cover; amoebic liver abscess (+ diloxanide)
- Tinidazole — amoebic liver abscess alternative; diloxanide furoate — luminal cyst eradication
Indications
- Tick typhus / rickettsia (doxycycline); malaria adjunct (+ quinine)
- Tetracycline — 30S protein-synthesis inhibitor class
Indications
- Lower UTI — PO (non-pregnant & pregnant)
Indications
- Named only in the antimicrobial-mechanism slide (cell-wall / 30S inhibitors); no clinical indication in deck
Indications
- ★ Fungal CNS / cryptococcal meningitis (+ flucytosine); mucormycosis; invasive pulmonary aspergillosis
Indications
- Antifungal (inhibit ergosterol synthesis); itraconazole → neutropenic/BMT prophylaxis; fluconazole → Candida UTI; aspergillosis
Indications
- Systemic antifungal — resistant neutropenic fever / lung infiltrates; aspergillosis; parenteral echinocandin prophylaxis
Indications
- Cryptococcal meningitis — with amphotericin
Indications
- Oral candida prophylaxis — non-absorbable
Indications
- ★ HSV — mucocutaneous, genital, encephalitis, neonatal (high-dose IV)
- Viral encephalitis; VZV chickenpox & herpes zoster; prophylaxis in T-cell lymphopenia/BMT; reduces EBV shedding
Indications
- HSV/VZV — valaciclovir (prodrug of aciclovir) & famciclovir (prodrug of penciclovir): greater oral bioavailability
Indications
- ★ CMV — IV ganciclovir gold standard; oral valganciclovir; CMV retinitis (± intravitreal); viral-encephalitis alternative
Indications
- Ganciclovir-resistant CMV
Indications
- ★ P. falciparum malaria (+ doxycycline OR clindamycin OR pyrimethamine-sulfadoxine); severe malaria — IV quinine 10 mg/kg q8h
Side effects
- ★ Cinchonism, severe deafness, arrhythmias; hypoglycaemia
Indications
- Non-falciparum malaria — 600 mg then taper
Side effects
- G6PD haemolysis (caution)
Indications
- ★ P. vivax/ovale hypnozoite (liver) eradication — 15 mg ×14 days
Side effects
- ★ Haemolysis in G6PD deficiency — check G6PD status first
Indications
- Malarone — [MAIN] uncomplicated malaria first-line, 4 tabs/day ×3 days
- Mefloquine & artemisinin (artemether-lumefantrine) — falciparum alternatives
Indications
- Malaria (pyrimethamine-sulfadoxine); [MAIN] cerebral toxoplasmosis (+ sulphadiazine + folinic acid)
Indications
- Allergic reactions — leukotriene-receptor antagonist
Indications
- Allergic reactions — SC anti-IgE monoclonal
Indications
- ★ SJS/TEN — first-line; Guillain-Barré syndrome
- Immunoglobulin replacement / VZIG post-exposure prophylaxis
Indications
- SJS/TEN — biological agent
Indications
- ★ Epilepsy — focal & tonic-clonic (Na-channel blocker); trigeminal neuralgia first-line; TBI seizures; MS Lhermitte symptom
Side effects
- ★ SIADH / hyponatraemia; [MAIN] Stevens-Johnson syndrome (HLA-B*1502, Asian)
- Diplopia, vertigo, neutropenia, drowsiness, rash; strong enzyme inducer; worsens absence/myoclonic
- Acute interstitial nephritis
Indications
- Epilepsy — focal (carbamazepine prodrug); trigeminal neuralgia first-line
Side effects
- Hyponatraemia, drowsiness, osteoporosis
Indications
- Epilepsy — focal (carbamazepine-related); new AED
Side effects
- (carbamazepine class — none additional stated)
Indications
- ★ Epilepsy — focal, tonic-clonic, status epilepticus (Na-channel blocker); TBI seizure prophylaxis
- Convulsions from advanced hypocalcaemic tetany
Side effects
- ★ Gingival hyperplasia, hirsutism, ataxia, nystagmus; purple-glove syndrome (IV)
- Megaloblastic anaemia (folate corrects), osteoporosis, peripheral neuropathy; zero-order kinetics; teratogenic
- Acute interstitial nephritis; anticonvulsant osteomalacia
Indications
- Epilepsy — focal (Na-channel blocker, age 17+, clean PK); refractory status epilepticus
Side effects
- (minimal DDI — none additional stated)
Indications
- Epilepsy — focal adjunct (α2δ Ca-channel); post-herpetic neuralgia; trigeminal neuralgia; essential tremor; migraine prevention; MS Lhermitte
Side effects
- Somnolence, dizziness, ataxia; may aggravate absence/myoclonic
Indications
- Epilepsy — focal adjunct (GABA-uptake inhibitor)
Side effects
- Confusion, depression; can cause seizures in non-epileptics
Indications
- Epilepsy — focal 3rd-line (K-channel opener)
Side effects
- Retinal & skin pigment discoloration
Indications
- ★ Broad-spectrum epilepsy — focal (first-line, SANAD), generalized, absence, atonic; safest in pregnancy
Side effects
- ★ Stevens-Johnson syndrome — slow titration; valproate greatly raises risk; insomnia
Indications
- ★ Broad-spectrum epilepsy — focal, myoclonic, tonic-clonic (SV2A); status epilepticus 2nd-line; safest in pregnancy
Side effects
- Irritability, behavioural & mood changes
Indications
- Epilepsy — focal & tonic-clonic (AMPA antagonist)
Side effects
- Aggression, hostility, irritability, anger
Indications
- ★ Broad-spectrum epilepsy — first-line generalized/absence/myoclonic/tonic-clonic; migraine prevention
Side effects
- ★ Teratogenicity 9–10% (NTDs) — avoid in women of reproductive age; [MAIN] hepatotoxicity (fatal idiosyncratic)
- Tremor, weight gain, alopecia, GI, PCOS, pancreatitis; hyperammonaemic encephalopathy
- SIADH; acute interstitial nephritis
Indications
- Broad-spectrum epilepsy; migraine & cluster-headache prevention; idiopathic intracranial hypertension (carbonic-anhydrase inhibitor)
Side effects
- ★ Cognitive slowing, nephrolithiasis, angle-closure glaucoma/acute myopia; weight loss
- Metabolic acidosis, oligohydrosis/hyperthermia, paraesthesias, teratogenic; ↓OCP efficacy
Indications
- Broad-spectrum epilepsy — focal & tonic-clonic (sulfonamide derivative)
Side effects
- Kidney stones, oligohydrosis/hyperthermia; CI sulfonamide/CA hypersensitivity
Indications
- ★ Absence seizures — T-type Ca-channel, thalamocortical
Side effects
- Can precipitate tonic-clonic seizures
Indications
- Atonic seizures / Lennox-Gastaut (age 2+), focal — GABA-A PAM
Indications
- Lennox-Gastaut atonic seizures (age 4+), focal — Na-channel blocker
Side effects
- Shortened QT; contraindicated in familial short-QT syndrome
Indications
- ★ Status epilepticus — lorazepam first-line IV (prolonged action); diazepam IV/rectal gel; midazolam buccal/IM (out-of-hospital) & refractory IV
- Clonazepam — absence/atonic/myoclonic seizures; tremor control; diazepam — MS spasticity in labour, dystonia
Indications
- Drug-refractory status epilepticus (phenobarbital, GABA-A PAM); epilepsy; primidone → essential tremor
Side effects
- Sedation, physical dependence, DDI; worsens absence/infantile spasms; highest teratogenicity
Side effects
- Sedation, physical dependence
Indications
- Dravet syndrome — with clobazam/valproate (GABA-A PAM)
Indications
- ★ Infantile spasms (esp. tuberous sclerosis) & focal seizures — irreversible GABA-transaminase inhibitor
Side effects
- ★ Irreversible retinal / visual-field defect; depression & psychosis
Indications
- CDKL5-deficiency-disorder seizures (age 2+), neuroactive-steroid GABA-A PAM; refractory status epilepticus (IV)
Indications
- New AEDs — cannabidiol (epilepsy); brivaracetam (focal, SV2A); cenobamate (focal)
Indications
- Refractory status epilepticus — propofol/ketamine (RSI induction, "ketofol"), thiopental (refractory infusion); rocuronium/succinylcholine — RSI paralytics
Indications
- ★ Parkinson's disease — dopamine precursor, with carbidopa; dopa-responsive dystonia
Side effects
- ★ Dyskinesias & motor fluctuations (wearing-off / on-off)
- Nausea/vomiting, orthostatic hypotension, vivid dreams, hallucinations, delusions; L-dopa-induced chorea
Indications
- Parkinson's — peripheral DOPA-decarboxylase inhibitor, with levodopa
Side effects
- (as levodopa/carbidopa combination)
Indications
- Parkinson's add-on — extend levodopa duration
Side effects
- Potentiate levodopa side effects; entacapone → diarrhoea, orange urine
- ★ Tolcapone → hepatotoxicity
Indications
- Parkinson's — reduce dopamine degradation; safinamide for off episodes; rasagiline for PD fatigue
Side effects
- Hypertension, orthostatic hypotension, potentiate levodopa effects
- Contraindicated with SSRIs → serotonin syndrome
Indications
- Parkinson's add-on — motor fluctuations
Indications
- ★ Parkinson's disease — D2 agonists; rotigotine patch; apomorphine SC/sublingual sudden-off rescue
Side effects
- ★ Impulse-control disorders (gambling/hypersexuality); sleep attacks
- Nausea/vomiting, orthostatic hypotension, hallucinations/psychosis, peripheral oedema, dopamine-agonist withdrawal syndrome
Indications
- Parkinson's — NMDA antagonist for postural symptoms, bradykinesia, resting tremor, levodopa-induced dyskinesia
Side effects
- ★ Livedo reticularis; confusion, hallucinations, ankle oedema, constipation, dry mouth/eyes, urinary retention
Indications
- Parkinsonian tremor; acute drug-induced dystonia / oculogyric crisis (IV procyclidine/benztropine)
Side effects
- Dry mouth/eyes, confusion, hallucinations, constipation, urinary retention; cognitive decline/dementia — avoid in elderly
Indications
- ★ Huntington's chorea — VMAT2 inhibitor, depletes dopamine
Indications
- Huntington's chorea — dopamine-receptor blocker / neuroleptic
Indications
- ★ Focal dystonia / blepharospasm — blocks ACh release; chronic migraine prophylaxis (Botox)
Indications
- MS spasticity (both); baclofen — dystonia, trigeminal neuralgia 2nd-line
Indications
- Wilson's disease — copper chelation
Indications
- Friedreich's ataxia — Nrf2 activator (first FDA-approved)
Indications
- ★ RRMS first-line — shifts Th1→Th2
Side effects
- Injection-site reactions, lipoatrophy, hypersensitivity, harmless post-injection systemic reaction
Indications
- ★ Highly active / rapidly-evolving RRMS — anti-α4-integrin
Side effects
- ★ Progressive multifocal leukoencephalopathy (JC virus, 1:500); infections, infusion reactions, urticaria, headache
Indications
- RRMS — first oral, S1P modulator
Side effects
- VZV reactivation, PML, basal-cell carcinoma, transient bradycardia (first-dose monitoring), macular oedema, haemophagocytic syndrome
Indications
- RRMS — pyrimidine-synthesis inhibitor
Side effects
- Thrombocyte/leukocyte reduction, GI, hepatic impairment, hair thinning, peripheral neuropathy, acute uric-acid nephropathy; teratogenic
Indications
- RRMS and PPMS — anti-CD20
Indications
- Highly active RRMS rescue — anti-CD52
Side effects
- Autoimmune disease; requires irradiated blood products
Indications
- Highly active RRMS — purine analogue, B/T depletion
Side effects
- Lymphopenia, herpes infection, rash, hair loss
Indications
- RRMS — first subcutaneous anti-CD20
Side effects
- Injection reactions, nasopharyngitis, headache, URTI, UTI
Side effects
- GI upset (affects OCP absorption)
Indications
- ★ Migraine abortive (specific); cluster headache — SC sumatriptan 6 mg, intranasal sumatriptan/zolmitriptan
Indications
- Migraine abortive — ergot derivative
Indications
- Migraine — antiemetic / prokinetic adjunct
Side effects
- Metoclopramide → precipitates pheochromocytoma crisis; drug-induced hyperprolactinaemia
Indications
- Migraine prevention — when ≥2 conventional preventives fail
Side effects
- Constipation, injection-site reactions, nasopharyngitis
Indications
- Amitriptyline (TCA) — migraine & tension-headache prevention; post-herpetic neuralgia — with nortriptyline & desipramine, 25–75 mg nocte
- Duloxetine (SNRI) — migraine prevention
- Pizotifen, methysergide (serotonin antagonists) — migraine prevention; methysergide → cluster prevention
Indications
- Post-LP / intracranial-hypotension headache — stimulate CSF production
Side effects
- Theophylline lowers seizure threshold; caffeine — migraine trigger
Indications
- Idiopathic intracranial hypertension (carbonic-anhydrase inhibitor); angle-closure glaucoma — IV/PO 500 mg
Side effects
- Metabolic acidosis (CA inhibition) ( analogue mechanism)
Indications
- ★ Raised ICP / cytotoxic cerebral oedema — osmotic diuresis; angle-closure glaucoma
Indications
- ★ Myasthenia gravis — acetylcholinesterase inhibitor; PD orthostatic hypotension
Indications
- Parkinson's-disease psychosis / hallucinations
Side effects
- Clozapine lowers seizure threshold
Indications
- Parkinson's — apathy / dementia (cholinesterase inhibitor)
Indications
- Parkinson's — orthostatic hypotension
Indications
- Parkinson's / MS bladder dysfunction — antimuscarinic
Indications
- Parkinson's / prodromal constipation
Indications
- ★ Glaucoma — first-line, increase uveoscleral outflow
Side effects
- Iris pigmentation, increased eyelash length, stinging
Indications
- Glaucoma — decrease aqueous production
Indications
- Glaucoma — decrease aqueous production
Side effects
- Lethargy, dry mouth/eyes, allergy
Indications
- Angle-closure glaucoma — increase trabecular outflow, 2%
Indications
- Sickle-cell pain (first-line/adjunct); subacute thyroiditis & thyroid-storm antipyretic; migraine/tension abortive; chickenpox & yellow-fever symptomatic; malaria supportive
Side effects
- Analgesic nephropathy in combinations
Indications
- Migraine & tension-headache abortive (ibuprofen, naproxen, diclofenac); sickle-cell pain
- Indomethacin — nephrogenic diabetes insipidus (reduces urine output)
Side effects
- Ibuprofen — contraindicated in yellow fever (bleeding) & chickenpox (necrotizing infection); NSAID class → minimal change disease/FSGS, AIN, analgesic nephropathy, avoid in CKD gout
Indications
- Sickle-cell pain — oral/PCA; oxycodone — sustained-release for post-herpetic neuralgia
Side effects
- ★ AVOID in sickle-cell pain — norpethidine → seizures
Indications
- Post-herpetic neuralgia — topical patch
Indications
- Sickle-cell priapism — acute treatment (α-adrenergic)
Indications
- Cluster-headache prophylaxis; mood stabiliser (bipolar — context )
Side effects
- Nephrogenic diabetes insipidus; hypothyroidism / goitrogen; hypercalcaemia; precipitates Graves'; myxoedema-coma trigger; postural tremor; removed by RRT in toxicity
Side effects
- Drug-induced hyperprolactinaemia; phenothiazines lower seizure threshold
Indications
- (antihypertensive — no indication card in ICC-3)
Side effects
- Drug-induced hyperprolactinaemia
Indications
- (antihypertensive/dopamine depletor — no indication card in ICC-3)
Side effects
- Secondary Parkinsonism; drug-induced hyperprolactinaemia & catecholamine-assay interference
Indications
- (antidepressant / smoking cessation — no indication card in ICC-3)
Side effects
- Lowers seizure threshold — contraindicated in epilepsy
Indications
- (H2 antagonist — no indication card in ICC-3)
Side effects
- Acute interstitial nephritis
Indications
- Migraine antiemetic adjunct
Side effects
- Precipitates pheochromocytoma crisis; drug-induced hyperprolactinaemia
Indications
- (withdrawn analgesic — no current indication)
Side effects
- ★ Analgesic nephropathy / papillary necrosis — classic historical drug
Indications
- (NSAID — no indication card in ICC-3)
Side effects
- Aplastic anaemia / leukaemogenic; isolated neutropenia
Indications
- (urinary analgesic — no indication card in ICC-3)
Side effects
- High-dose → polyneuropathy
Side effects
- Drug cause of polyneuropathy