Top 200 drugs: learn them by class, with flashcards

ACE inhibitors (Angiotensin-Converting Enzyme inhibitors). Examples include lisinopril, enalapril, and ramipril. Common side effects include dry cough and angioedema. They are contraindicated in pregnancy.

Heart failure with reduced ejection fraction. It is an ARB combined with a neprilysin inhibitor and should not be given within 36 hours of an ACE inhibitor due to angioedema risk.

Place 1 tablet under the tongue at the onset of chest pain. If the pain is not better or is worse 5 minutes after the first dose, call 911. Up to 3 doses can be taken 5 minutes apart. Keep tablets in the original glass bottle, and never combine with PDE-5 inhibitors such as sildenafil.

Clopidogrel is a prodrug activated by CYP2C19. It has a boxed warning for reduced effect in CYP2C19 poor metabolizers. Avoid omeprazole and esomeprazole, which reduce its activation.

Monitor the INR regularly (goal usually 2-3). Keep vitamin K intake (leafy green vegetables) consistent, and check every new drug or supplement for interactions. Vitamin K reverses warfarin.

Thiazide and loop diuretics (e.g., furosemide, HCTZ) lower potassium. Potassium-sparing diuretics (e.g., spironolactone, triamterene) raise potassium.

First-line drug for type 2 diabetes. Take with meals to reduce GI upset. It does not cause hypoglycemia when used alone. Boxed warning for lactic acidosis; contraindicated if eGFR is below 30 mL/min/1.73 m². Long-term use can lower vitamin B12.

A boxed warning for thyroid C-cell tumors. These drugs are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN 2).

Always draw up clear insulin (e.g., regular, lispro, aspart) before cloudy insulin (NPH).

Take on an empty stomach with water, 30-60 minutes before breakfast, and at least 4 hours apart from calcium, iron and antacids. It has a narrow therapeutic index.

Increased suicidal thoughts and behavior in children, adolescents, and young adults (under 25).

Maximum dose is 40 mg/day, or 20 mg/day for patients over age 60, due to risk of dose-related QT prolongation.

Bupropion lowers the seizure threshold, so it is contraindicated in patients with a seizure disorder or a current or past eating disorder (bulimia, anorexia). It rarely causes sexual side effects and is also used for smoking cessation (Zyban).

Has a narrow therapeutic index. Monitor blood levels regularly. Toxicity is increased by dehydration, NSAIDs, ACE inhibitors, and thiazides.

All are Schedule IV controlled substances. They carry boxed warnings regarding profound sedation and respiratory depression when combined with opioids, and risks of abuse, addiction, and withdrawal.

Liver toxicity. The maximum daily dose for healthy adults is 4 grams, and less for individuals with liver disease or alcohol use. Check combination products for hidden acetaminophen.

This combination carries a boxed warning for potentially fatal respiratory depression and profound sedation.

Only for opioid-tolerant patients. Change the patch every 72 hours. Heat (heating pads, hot tubs, fever) increases absorption and overdose risk. Fold used patches sticky sides together before disposal to prevent accidental exposure.

C-II substances have no refills allowed. An emergency oral prescription requires a written or electronic follow-up within 7 days.

Maximum of 5 refills are allowed within 6 months of the prescription date.

This is a rescue inhaler for asthma and COPD symptoms. Side effects can include tremor and fast heartbeat. Shake and prime the HFA inhaler before use.

Take 30-60 minutes before breakfast. Omeprazole and esomeprazole reduce the activation of clopidogrel. Long-term PPI use is associated with C. difficile infection, bone fractures, low magnesium and low vitamin B12.

Risk of tendinitis and tendon rupture, peripheral neuropathy, CNS effects, and worsening of myasthenia gravis.

Avoid alcohol during treatment and for 3 days after due to a disulfiram-like reaction. A metallic taste is also common.

Contraindicated with nitrates due to the risk of severe hypotension. Seek medical attention for an erection lasting more than 4 hours.

Cigarette smoking increases the risk of serious cardiovascular events (heart attack, stroke, blood clots) with combined oral contraceptives. The risk rises with age and the number of cigarettes smoked, so women over 35 who smoke should not use them.

Highly teratogenic; requires enrollment in the iPLEDGE REMS program. Patients capable of becoming pregnant must use two forms of contraception. Maximum 30-day supply with no refills.

For rheumatoid arthritis and psoriasis it is taken once weekly, never daily; accidental daily dosing has been fatal. It is given with folic acid to reduce side effects, and it is teratogenic.

HydrOXYzine is an antihistamine used for anxiety/itching, while hydrALAZINE is a vasodilator used for hypertension/HF.

It ends in -prazole but is an antipsychotic, not a PPI.

It has a narrow therapeutic index. Toxicity can cause nausea and visual disturbances (yellow-green halos). Low potassium levels increase the risk of toxicity.

They are not interchangeable due to different release mechanisms (immediate vs. extended release).

Common side effect is ankle edema. Unlike diltiazem and verapamil, they do not significantly lower heart rate.

Protamine sulfate.

It carries a boxed warning for causing or worsening heart failure (HF).

SGLT2 inhibitors used for T2D, HF, and CKD. Can cause genital yeast infections, UTIs, and dehydration.

NPH is a cloudy, intermediate-acting suspension: roll it gently to mix, do not shake. When mixing with regular insulin in one syringe, draw up the clear regular insulin first, then the cloudy NPH ("clear before cloudy").

Screen for HLA-B*1502 in patients of Asian ancestry before starting due to risk of serious skin reactions. It is a strong enzyme inducer.

All antipsychotics carry a boxed warning for increased mortality in this population.

Carries boxed warnings for liver toxicity, pancreatitis, and birth defects (neural tube defects). DR and ER forms are not interchangeable mg for mg.

It is a selective norepinephrine reuptake inhibitor for ADHD that is not a controlled substance. It carries a boxed warning for suicidal thoughts in children and adolescents.

Total use, across all routes of administration, is limited to 5 days due to risks of bleeding and kidney damage.

They were reclassified as C-II in 2014, not C-III.

3.6 grams per purchaser per day and 9 grams per purchaser per 30 days.

DEA Form 222 (or its electronic equivalent, CSOS) is used to order Schedule I and Schedule II controlled substances.

These are maintenance inhalers, not for rescue. Rinse mouth after use to prevent oral thrush.

Neuropsychiatric events, including behavioral changes, depression, and suicidal thoughts.

Risk of tardive dyskinesia, a potentially irreversible movement disorder. Use should be limited to a maximum of 12 weeks.

Ranitidine has been off the US market since 2020 due to NDMA contamination. Zantac 360 contains famotidine.

Take with a full glass of water and remain upright to prevent esophagitis. Photosensitivity is common. Avoid dairy, calcium, iron, and antacids within 2 hours of administration.

Oral vancomycin is not absorbed from the gut, so it treats only intestinal infections (mainly C. difficile infection). It cannot treat systemic infections.

Avoid in patients with a sulfa allergy. It can cause photosensitivity, hyperkalemia, and increase warfarin effect. Drink plenty of fluids.

500 mg on day 1, followed by 250 mg on days 2-5.

Take 30 minutes after the same meal each day. It can cause orthostatic dizziness and is associated with floppy iris syndrome during cataract surgery.

Both contain sildenafil but are indicated for different conditions: erectile dysfunction and pulmonary arterial hypertension, respectively.

Administered every 13 weeks. Carries a boxed warning for bone loss.

Can cause a permanent change in iris color (usually to brown) and eyelash growth.

Inject into the outer thigh, even through clothing if necessary. Call 911 immediately after use.

This is a three-way look-alike/sound-alike group: Celecoxib (NSAID), citalopram (SSRI), and fosphenytoin (IV anticonvulsant).

It ends in -statin but is an antifungal, not a cholesterol-lowering drug.