Newcastle Student Formulary

2012 Edition For students qualifying in 2015

NEWCASTLE STUDENT FORMULARY 2012

This formulary has been produced to assist your learning of clinical pharmacology and therapeutics to provide learning objectives that are realistic and attainable. It has been developed in consultation with all course directors and lists the drugs of which you should have acquired core knowledge by the end of your undergraduate training. We emphasise that the formulary is a minimum knowledge base. You should not restrict your reading and learning to these drugs alone, particularly if you encounter other drug therapy in patients you see. It is acknowledged that different drugs within the same class may be used in different hospitals. For major drugs (shown in capitals in the formulary), students are expected to know its class and mechanism of action in detail appropriate indications for use the appropriate route, frequency and duration of administration (drug doses are not expected to be memorised) all clinically relevant contraindications, interactions and adverse drug reaction how to monitor the drugs effects

For other drugs (shown in lower case in the formulary) its class and mechanism of action in outline common indications for use the most important or serious contraindications, interactions and adverse drug reactions

Students should be able to explain the salient features of all the above to the patient

A student who achieves these targets should be able to cope effectively and safely with most of the prescribing challenges that they will face in their early postgraduate years whether in hospital or in general practice.

The formulary has the same structure as the British National Formulary, with drugs appearing in the same section and in the same order. The order in which drugs appear does not necessarily indicate the order of preference of use.

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Indicates that the drug also appears elsewhere.

Prof. S.H.L. Thomas Strand Leader, Pharmacology and Therapeutics

Dr R. Thanacoody Module leader, CSIM3 (Clinical Pharmacology and Therapeutics)

CHANGES IN DRUG NAMES

Changes in European law have required a change in the name or spelling of some drugs since January 1999. The student formulary contains the new European names (rINN) and spelling, but where there is a possibility of confusion, the old British approved drug name (BAN) is also shown in square brackets. You are strongly encouraged to learn and use the new rINN names or spellings, which will be used in examination questions.

The most important drugs in the student formulary which have undergone name or spelling changes are listed below:

Name changes New name (rINN)

Epinephrine Bendroflumethiazide Trihexyphenidyl Furosemide Lidocaine Phenobarbital Thiopental Levothyroxine

Old name (BAN)

Adrenaline Bendrofluazide Benzhexol Frusemide Lignocaine Phenobarbitone Thiopentone Thyroxine

Spelling changes New name (rINN)

Amoxicillin Beclometasone Ciclosporin Ethinylestradiol Indometacin Sodium cromoglicate Sulfamethoxazole Sulfasalazine

Old name (BAN)

Amoxycillin Beclomethasone Cyclosporin Ethinyloestradiol Indomethacin Sodium chromoglycate Sulphamethoxazole Sulphasalazine

BNF Section 1
Drugs Acting on the Gastro-Intestinal System
1.1 Antacids Aluminium hydroxide

1.2

Antispasmodics and other drugs altering gut motility Antimuscarinic Motility Stimulant Mebeverine Metoclopramide

1.3

Ulcer healing drugs H2-receptor Antagonists Proton Pump Inhibitors RANITIDINE OMEPRAZOLE1

1.4

Anti-diarrhoeal Drugs Antimotility Drugs Loperamide

1.5

Treatment of Chronic Diarrhoea/ Inflammatory Bowel Disease

(Sulfasalazine) Mesalazine

1.6

Laxatives Bulk-forming drugs Stimulant Laxatives ISPAGHULA HUSK SENNA Sodium docusate Faecal softeners Lactulose Macrogols

1 Alternative choice - lansoprazole

BNF SECTION 2
Drugs used in the Treatment of Disease of the Cardiovascular System
2.1 Positive Inotropic Drugs Cardiac Glycosides DIGOXIN

2.2.

Diuretics Thiazides Loop Diuretics Potassium sparing diuretics BENDROFLUMETHIAZIDE FUROSEMIDE SPIRONOLACTONE Amiloride Osmotic Diuretic Mannitol

2.3

Anti-arrhythmic Drugs Drugs for arrhythmias ADENOSINE LIDOCAINE Amiodarone Flecainide

2.4

Beta-adrenoreceptor antagonists

ATENOLOL Propranolol Bisoprolol

1

2.5

Antihypertensive Therapy Alpha-adrenoceptor antagonists ACE inhibitors Angiotensin II antagonists Centrally acting antihypertensives Doxazosin LISINOPRIL2 Losartan Methyldopa

2.6

Nitrates and other Vasodilators, and Calcium Channel Blocking drugs Nitrates GLYCERYL TRINITRATE ISOSORBIDE MONONITRATE Calcium Channel Blockers AMLODIPINE3 DILTIAZEM

Alternative choices metoprolol, carvedilol 2 Alternative choices perindopril, ramipril 3 Alternative choice- nifedipine

Verapamil Potassium channel activator Nicorandil

2.7

Sympathomimetics Inotropic Sympathomimetics Dobutamine Dopamine Vasoconstrictor Sympathomimetics Cardiopulmonary resuscitation Norepinephrine EPINEPHRINE

2.8

Anticoagulants Parenteral Anticoagulants Unfractionated heparin LMW HEPARIN Oral Anticoagulants WARFARIN

2.9

Antiplatelet Drugs

ASPIRIN CLOPIDOGREL Dipyridamole

2.10

Fibrinolytic Drugs

ALTEPLASE (rt-PA)

2.11

Haemostatics

Factor VIII fraction Fresh Frozen Plasma

2.12

Lipid lowering drugs Fibric Acid Analogues HMG-CoA Reductase Inhibitors Absorption inhibitors Bezafibrate SIMVASTATIN Ezetimibe

BNF SECTION 3
Drugs Acting on the Respiratory System
3.1 Bronchodilators Selective 2Adrenoreceptor Stimulants Antimuscarinic Bronchodilators SALBUTAMOL Salmeterol Ipratopium bromide Tiotropium Xanthines Theophylline

Peak Flow Meters Inhaler Devices and Nebulisers

PEAK FLOW METER Metered Dose Inhaler Dry Powder Device Breath Activated Device Spacer Device Nebuliser

3.2

Inhaled Corticosteroids

BECLOMETASONE Fluticasone

3.3

Cromoglicate and related therapy Leukotriene receptor antagonist

Sodium cromoglicate Montelukast

3.4

Antihistamines, hyposensitisation and allergic emergencies Antihistamines Allergic Emergencies Chlorphenamine (EPINEPHRINE) Hydrocortisone

3.6

Oxygen

OXYGEN Oxygen Concentrator

BNF Section 4
Drugs Acting on the Central Nervous System
4.1 Hypnotics and Anxiolytics DIAZEPAM Temazepam

4.2

Drugs used in Psychoses and Related Disorders Antipsychotic Drugs HALOPERIDOL (oral, im, depot) RISPERIDONE Aripiprazole Clozapine

Antimanic Drugs

LITHIUM VALPROIC ACID

4.3

Antidepressant Drugs Tricyclic & Related Antidepressant Drugs Monoamine-oxidase inhibitors (MAOI)s SSRIs and related Others AMITRIPTYLINE Phenelzine FLUOXETINE Mirtazapine

4.5

Drugs used in the treatment of obesity Anti-obesity drugs acting on the GI tract Orlistat

4.6

Drugs used in Nausea and Vertigo

Prochlorperazine Metoclopramide4 Cyclizine Ondansetron Hyoscine hydrobromide Betahistine

4.7

Analgesics Non-opioid analgesics ASPIRIN PARACETAMOL IBUPROFEN Diclofenac Celecoxib

4 Alternative choice - domperidone

Opioid Analgesics

Codeine phosphate MORPHINE Diamorphine

Neuropathic pain

Gabapentin (Amitriptyline)

Treatment of Acute Migraine Attack

Sumatriptan

4.8

Antiepileptics (anticonvulsants) Control of epilepsy CARBAMAZEPINE PHENYTOIN SODIUM VALPROATE Lamotrigine

4.9

Drugs used in Parkinsonism and related disorders Dopaminergic Drugs CO-CARELDOPA Bromocriptine Selegiline Entacapone Antimuscarinics Trihexyphenidyl Procyclidine

4.10

Drugs used in Substance Dependence

Nicotine Amfebutamone (Bupropion) Methadone

4.11

Drugs for dementia

Donepezil

BNF Section 5
Drugs used in the Treatment of Infections
5.1 Antibacterial drugs Penicillins BENZYLPENICILLIN AMOXICILLIN FLUCLOXACILLIN Co-amoxiclav Cephalosporins, cephamycins and other Beta-Lactam Antibiotics Tetracyclines CEFUROXIME Meropenem Oxytetracycline Doxycycline Aminoglycosides Other antibiotics GENTAMICIN Fusidic Acid Vancomycin Macrolides Sulphonamides & Trimethoprim Antituberculous Drugs Clarithromycin5 Trimethoprim Sulfamethoxazole Rifampicin Isoniazid Pyrazinamide Ethambutol Metronidazole and tinidazole 4-amino Quinolones METRONIDAZOLE CIPROFLOXACIN

5.2

Antifungal Drugs

Nystatin Fluconazole Amphotericin

5.3

Antiviral Drugs

Aciclovir Oseltamivir Efavirenz Tenofovir Darunavir

5.4

Antiprotozoal Drugs Antimalarials Chloroquine Primaquine Quinine

5 Alternative choice - erythromycin

10

5.5

Anthelmintics Drugs for threadworms Piperazine

BNF Section 6
Drugs Used in the Treatment of Disorders of the Endocrine System
6.1 Drugs used in Diabetes Insulin - Short Acting Insulin - Intermediate Acting INSULIN (SOLUBLE) INSULIN (ISOPHANE)

Oral Antidiabetic Drugs/Oral Antidiabetic Agents Sulphonylureas Biguanides Other antidiabetics Treatment of Hypoglycaemia GLICLAZIDE METFORMIN Pioglitazone 20% Glucose Glucagon 6.2 Thyroid & Antithyroid Drugs Thyroid Hormones Antithyroid Drugs LEVOTHYROXINE CARBIMAZOLE

6.3

Corticosteroids Replacement therapy Clinical management Fludrocortisone PREDNISOLONE HYDROCORTISONE

6.4

Sex Hormones Oestrogens and HRT Progestogens Male Sex Hormones CONJUGATED OESTROGENS NORETHISTERONE Testosterone

6.5

Hypothalamic and Pituitary Hormones and Anti-oestrogens Anterior Pituitary Hormones Anti-oestrogens Anti-androgens Human growth hormone (Somatropin) Clomifene Finasteride

6.6

Drugs Affecting Bone Metabolism Bisphosphonates Alendronate

11

6.7

Other Endocrine Drugs Dopamine receptor stimulants Bromocriptine

BNF Section 7
Drugs used in Obstetrics, Gynaecology and Urinary Tract Disorders
7.1 Drugs used in Obstetrics Ergometrine Oxytocin Mifepristone Ritodrine Dinoprostone

7.2

Treatment of Vaginal and Vulval Conditions Topical Oestrogens Anti-infective Drugs (Conjugated Oestrogens) Clotrimazole (cream, tablets) Nystatin (cream, pessaries)

7.3

Contraceptives Combined Oral Contraceptives ETHINYLESTRADIOL/ NORETHISTERONE Progesterone-Only Contraceptives NORETHISTERONE (oral) Medroxyprogesterone

(parenteral depot prep)

Intra-Uterine Devices Copper device Progestogen device

7.4

Drugs for Genito-urinary Disorders Drugs for Urine retention - alpha-blockers Drugs used for Urinary Frequency, Enuresis and Incontinence Drugs for erectile dysfunction Oxybutynin Sildenafil Alfuzosin

12

BNF Section 8
Drugs used in the treatment of Malignant Disease and Immunosuppression
8.1 Cytotoxic drugs Alkylating Agents Cytotoxic Antibiotics Antimetabolites Vinca Alkaloids and Etoposide Other Antineoplastic Drugs Protein kinase inhibitors Cyclophosphamide Doxorubicin Methotrexate Vincristine Cisplatin Imatinib

8.2

Drugs Affecting the Immune Response Corticosteroids and other immunosuppressants (PREDNISOLONE) Ciclosporin [= cyclosporin] Azathioprine Sex Hormones Antagonists in Malignant Disease Tamoxifen Leuprorelin

Section 9
Drugs Affecting Nutrition and Blood
9.1 Anaemias and some other blood disorders Oral Iron Drugs used in Megaloblastic Anaemias FERROUS SULPHATE FOLIC ACID HYDROXOCOBALAMIN Drugs used in Hypoplastic, haemolytic and Renal Anaemias Epoetin

9.2

Fluids and Electrolytes Oral Potassium Intravenous administration POTASSIUM CHLORIDE GLUCOSE SODIUM CHLORIDE (POTASSIUM CHLORIDE) Plasma and plasma substitutes Albumin

13

Gelatin (Polygelatin/Haemaccel)

9.5

Minerals Calcium supplements Calcium salts

9.6

Vitamins

Vitamin B group Vitamin D

Thiamine Pyridoxine Colecalciferol Alfacalcidol

Vitamin K

Phytomenadione

Section 10
Drugs used in the Treatment of Musculoskeletal and Joint Disease
10.1 Drugs used in Rheumatic Diseases and Gout Non-steroid anti-inflammatory drugs (NSAIDs) (IBUPROFEN) (Diclofenac) (Celecoxib) Corticosteroids (PREDNISOLONE) iv, oral Triamcinolone (intra-articular injection) Drugs which suppress the Rheumatic Disease Methotrexate (Sulfasalazine) (Etanercept) Gout and cytotoxic-induced hyperuricaemia ALLOPURINOL

10.2

Drugs used in Neuromuscular Disorders Drugs which enhance neuromuscular transmission Skeletal Muscle Relaxants Pyridostigmine Baclofen (Quinine)

14

Section 11
Drugs Acting on the Eye
11.3 Topical Anti-Infective Preparations Chloramphenicol Fusidic Acid

11.4

Corticosteroids and other anti-inflammatory preparations Corticosteroids Betamethasone (Prednisolone) (drops/ointment)

Other anti-inflammatory preparations

Levocabastine (sodium cromoglicate) Lodoximide

11.5

Mydriatics and cyplegics

(Atropine) Tropicamide

11.6

Treatment of Glaucoma

Pilocarpine Timolol Latanoprost

11.8

Miscellaneous Ophthalmic Preparations Preparations for Tear Deficiency Hypromellose Carbomers Liquid paraffin

BNF Section 12
Drugs used in the treatment of the Ear Nose and Oropharynx
12.1 Drugs Acting in the Ear Otitis Externa Gentamicin drops Gentamicin with Hydrocortisone drops Betametasone drops 12.2 Drugs Acting on the Nose Drugs used in Nasal Allergy Beclometasone (nasal spray)

12.3

Drugs Acting on the Oropharynx Oropharyngeal anti-infective drugs Amphotericin (lozenges or suspension)

15

Section 13
Drugs Acting on the Skin
13.1 Vehicles Ointments/creams/lotions

13.2

Emollients and barrier preparations

Aqueous cream Epaderm

13.4

Topical Corticosteroids

BETAMETHASONE HYDROCORTISONE

13.5

Preparations for Eczema and Psoriasis Preparations for Psoriasis

Coal Tar DITHRANOL CALCIPOTRIOL

Systemic drugs

(Methotrexate) (Ciclosporin) (Etanercept) Acitretin

13.6

Drugs for Acne Topical preparations for acne Systemic drugs Benzoyl peroxide (TETRACYCLINE) (ERYTHROMYCIN) Isotretinoin

13.10

Anti-infective skin preparations Antibacterial Preparations (Topical) Mupirocin Fusidic acid Polymyxins

Antifungal preparations

Terbinafine

Antiviral preparations

(Aciclovir)

Parasiticidal preparations

Permethrin

16

Section 14
Immunological Products and Vaccines
14.4 Vaccine and antisera Diptheria Tetanus and Pertussis Haemophilus Influenza type b Vaccine (Hib) Hepatitis A Vaccine Hepatitis B Vaccine Influenza Vaccine Measles Mumps & Rubella Vaccine Poliomyelitis Vaccine Tetanus Toxoid Meningococcal A and C Vaccine Pneumococcal vaccine Human Papilloma Virus (HPV) vaccine 14.5 Immunoglobulins Anti-D Immunoglobulin

Section 15
Drugs used in Anaesthesia
15.1 General Anaesthesia Intravenous anaesthetics Thiopental Propofol Inhalation anaesthetics Isoflurane Nitrous oxide Antimuscarinic pre-medication Drugs Muscle Relaxants - depolarising - non-depolarising Antagonists for Central and Respiratory Depression Flumazenil (NALOXONE) Local Anaesthetics (LIDOCAINE) ATROPINE Suxamethonium Atracurium

17

Section 16
Drugs used in the Treatment of Poisoning
16.1 Removal and Elimination Prevention of Absorption Activated charcoal

16.2

Agents used in Poisoning due to Specific Drugs Paracetamol Opioid ACETYLCYSTEINE (NALOXONE)

Substances not listed in the BNF

X-Ray Contrast Media

Ionic - high osmolality

Ionic - low osmolality

Non-ionic - low osmolality

18