Top 200 Drugs

Everything to know about the top 200 drugs in pharmacology.

Escitalopram

Medicine: Lexapro

Drug Class: SSRI

Indications:

• Anxiety

• Major depressive disorder

• Panic Disorder

Notable Side Effects:

• Increased risk of bone fractures

• Increased risk of bleeding

• Appetite / weight disturbances

• Gastrointestinal upset

Clinical Pharmacology:

• Bleeding risk increased when taken with NSAIDs / aspirin

• Avoid taking with MAO inhibitors, as it increases the risk of serotonin syndrome

Food-Drug Interactions:

• Avoid with alcohol as it can worsen sedative / CNS effects

APAP / Hydrocodone

Medicine: Vicodin

Drug Class: Analgesic

Indications:

• Moderate-to-severe pain

Notable Side Effects:

• Constipation

• Dry mouth

• Blurred vision

• Gastrointestinal upset

Clinical Pharmacology:

• Opioids should ideally not be taken with other sedating drugs (e.g. antipsychotics, benzodiazepines, etc.), as the combination can worsen CNS adverse effects

Food-Drug Interactions:

• Avoid with alcohol as it can worsen sedative / CNS effects

Lisinopril

Medicine: Prinivil, Qbrelis

Drug Class: ACE Inhibitor

Indications:

• Hypertension

• Chronic heart failure (CHF)

• Ischemic heart disease

Notable Side Effects:

• Persistent, dry cough

• Hyperkalemia (high potassium)

• Hypotension

• Worsen renal damage

Clinical Pharmacology:

• ACE inhibitors should be avoided with other potassium-elevating drugs — including potassium supplements and potassium sparing diuretics (amiloride and spironolactone)

Food-Drug Interactions:

• Foods high in potassium (such as bananas and avocados) can increase the risk of hyperkalemia

Simvastatin

Medicine: Zocor

Drug Class: HMG-CoA Reductase Inhibitors / ‘statins’

Indications:

• Hyperlipidemia (high cholesterol)

• Prevention of cardiovascular disease

Notable Side Effects:

• Muscle pain / myopathies

• Elevated liver enzymes

• Increased risk of diabetes type 2

• Headache

Clinical Pharmacology:

• Risk of adverse effects increased if statins are taken with macrolide antibacterial drugs and amiodarone

• Statins are typically taken in the evening as they have greater effect when dietary intake is at its lowest

Food-Drug Interactions:

• Grapefruit juice increased the risk of myopathies / rhabdomyolysis

Levothyroxine

Medicine: Synthroid, Levoxyl

Drug Class: Thyroid hormone

Indications:

• Hypothyroidism

• Hypothyroidism secondary to hypopituitarism

Notable Side Effects:

• Diarrhea

• Weight loss

• Palpitations

• Tremors

Clinical Pharmacology:

• Antacids reduce the gastrointestinal absorption of levothyroxine. Administration should ideally be separated by 4-hours to avoid this drug interaction

Food-Drug Interactions:

• Food high in multivalent ions (calcium, iron, magnesium, aluminum, zinc) reduce the efficacy of levothyroxine

Amoxicillin

Medicine: Amoxil, Trimox

Drug Class: Antibacterial penicillin

Indications:

• Tonsillitis, bronchitis, pneumonia

• Infections of the ear, eye, and skin

• H. pylori infections (with PPI and macrolide)

Notable Side Effects:

• Nausea

• Diarrhea

• Allergic reactions

• Skin rash

Clinical Pharmacology:

• Penicillins reduce renal excretion of methotrexate, increasing the risk of toxicity

Food-Drug Interactions:

• No significant food-drug interactions

Azithromycin

Medicine: Zithromax

Drug Class: Macrolide antibacterial

Indications:

• Respiratory infections

• Infections of the ear, eye, and skin

• Sexually transmitted infections

Notable Side Effects:

• Nausea and vomiting

• Ototoxicity (at high doses)

• QT prolongation

• C. difficile infection

Clinical Pharmacology:

• Antacids can make azithromycin less effective

Food-Drug Interactions:

• Azithromycin is better tolerated when taken with food

Hydrochlorothiazide

Medicine: Microzide, Aquazide

Drug Class: Thiazide diuretic

Indications:

• Hypertension

• Edema (fluid retention)

• Congestive heart failure

Notable Side Effects:

• Hyponatremia (low sodium)

• Hypokalemia (low potassium)

• Impotence in men

• Increased risk of gout

Clinical Pharmacology:

• NSAIDs can reduce the efficacy of thiazide diuretics

• Hydrochlorothiazide should be avoided in patients with hypokalemia or hyponatremia

Food-Drug Interactions:

• Diuretics can cause potassium loss. Patients may be advised to eat potassium-rich foods, such as bananas, to help prevent this

Amlodipine

Medicine: Norvasc, Katerzia

Drug Class: Calcium channel blocker

Indications:

• Hypertension

• Control symptoms in stable angina

Notable Side Effects:

• Ankle swelling

• Flushing

• Headache

• Palpitations

Clinical Pharmacology:

• Modified-release and long-acting preparations should be swallowed whole, and not crushed or chewed as this can interfere with the slow release of the drug

Food-Drug Interactions:

• Grapefruit juice can increase the risk of side effects with amlodipine

Alprazolam

Medicine: Xanax

Drug Class: Benzodiazepine

Indications:

• Anxiety disorders

• Panic disorder

• Depression

Notable Side Effects:

• Drowsiness

• Light headedness

• Sedation

• Dependence (long-term use)

Clinical Pharmacology:

• Elderly are more susceptible to side effects so should be given lower dose

• Opioids can worsen the sedative / CNS effects of alprazolam

• Avoid in liver failure where it can cause hepatic encephalopathy

Food-Drug Interactions:

• Alcohol can worsen the sedative / CNS side effects of alprazolam

Metformin

Medicine: Glucophage, Fortamet

Drug Class: Biguanide antidiabetic

Indications:

• Type 2 diabetes

• Polycystic ovary syndrome (PCOS)

Notable Side Effects:

• Metallic taste

• Weight loss

• GI disturbances

• Vit. B12 deficiency (long-term)

Clinical Pharmacology:

• Drugs that elevate blood glucose levels (prednisolone, thiazide and loop diuretics) oppose the actions and reduce the efficacy of metformin

• Metformin should be taken with or after food to minimize GI side effects

Food-Drug Interactions:

• Alcohol increases the risk of developing lactic acidosis

Atorvastatin

Medicine: Lipitor

Drug Class: HMG-CoA Reductase Inhibitors / ‘statins’

Indications:

• Hyperlipidemia (high cholesterol)

• Prevention of cardiovascular disease

Notable Side Effects:

• Muscle pain / myopathies

• Elevated liver enzymes

• Increased risk of diabetes type 2

• Headache

Clinical Pharmacology:

• Risk of adverse effects increased if statins are taken with macrolide antibacterial drugs and amiodarone

• Statins are typically taken in the evening as they have greater effect when dietary intake is at its lowest

Food-Drug Interactions:

• Grapefruit juice increases the risk of myopathies / rhabdomyolysis

Omeprazole

Medicine: Prilosec

Drug Class: Proton-Pump Inhibitor (PPI)

Indications:

• Peptic ulcer disease

• Dyspepsia

• GERD

• H. pylori infection

Notable Side Effects:

• Nausea

• Diarrhea

• Headache

• Hypomagnesemia (long-term)

Clinical Pharmacology:

• PPIs such as omeprazole can disguise the symptoms of gastric cancer

• Prolonged courses in the elderly increases the risk of fractures

• Omeprazole reduces the anti-platelet effects of clopidogrel

Food-Drug Interactions:

• There are no significant food-drug interactions with omeprazole

Ciprofloxacin

Medicine: Cipro, Proquin

Drug Class: Fluoroquinolone Antibacterial

Indications:

• Skin, bone, or joint infections

• Urinary tract infections

• Respiratory infections

• Gonorrhea

Notable Side Effects:

• Tendon damage / rupture

• QT prolongation

• Increased risk of seizures

• Nausea and vomiting

Clinical Pharmacology:

• Antacids reduce the effectiveness of fluoroquinolones

• NSAIDs increase the risk of seizures with fluoroquinolones

• Prednisolone increases the risk of tendon rupture

Food-Drug Interactions:

• Foods that contain multivalent ions (calcium, magnesium, aluminum, zinc, etc.) decrease the effectiveness of ciprofloxacin

Ondansetron

Medicine: Zofran

Drug Class: 5-HT3 Antagonist / Antiemetic

Indications:

• Prevent nausea / vomiting due to cancer chemotherapy, radiation, or surgery

Notable Side Effects:

• Headache

• Diarrhea

• Sleepiness

• QT prolongation

Clinical Pharmacology:

• Drugs that also prolong the QT interval should be avoided (antipsychotics, SSRIs, quinine, etc.), as this increases the risk of cardiac arrhythmias

Food-Drug Interactions:

• Grapefruit juice increases the risk of side effects with ondansetron

Clozapine

Medicine: Clozaril

Drug Class: Antipsychotic Drug

Indications:

• Schizophrenia

• Schizoaffective disorder

Notable Side Effects:

• Agranulocytosis

• Weight gain / type 2 diabetes

• Heart inflammation

• Extrapyramidal effects

Clinical Pharmacology:

• Only certified pharmacies may dispense clozapine. It is a REMS medicine

• Clozapine carries 5 black box warnings — severe neutropenia, orthostatic hypotension, seizures, myocarditis, risk of death in the elderly who have been diagnosed with dementia-related psychosis

Food-Drug Interactions:

• Caffeine can worsen side effects and so should be limited / avoided whilst taking clozapine

Furosemide

Medicine: Lasix

Drug Class: Loop Diuretic

Indications:

• Acute pulmonary edema

• Chronic heart failure (CHF)

• Other edematous states (fluid build-up)

Notable Side Effects:

• Dehydration

• Hypotension

• Low electrolyte state

• Tinnitus (at high doses)

Clinical Pharmacology:

• Taken long-term, loop diuretics inhibit uric acid excretion and so increase the risk of gout

• Loop diuretics increase the risk of lithium and digoxin toxicity

• Loop diuretics increase the risk of ototoxicity and nephrotoxicity of aminoglycoside antibacterials

Food-Drug Interactions:

• Avoid consuming too much salt with furosemide because this opposes the effects of the drug

Vardenafil

Medicine: Levitra

Drug Class: PDE5 Inhibitor

Indications:

• Erectile dysfunction

• Pulmonary hypertension

Notable Side Effects:

• Flushing

• Hypotension, dizziness

• Nasal congestion

• Headache

Clinical Pharmacology:

• Taking nitrates with PDE5 inhibitors increases the risk of cardiovascular collapse

• PDE5 inhibitors should be avoided in patients who have recently suffered a stroke or acute coronary syndrome

Food-Drug Interactions:

• There are no significant food-drug interactions with vardenafil