Pharmacology Review: Gastrointestinal, Respiratory, Infectious Diseases, and Miscellaneous Drugs (Lecture Notes)

A comprehensive set of Q&A flashcards covering GI medicines (diarrhoea, constipation, acid-related disorders), respiratory drugs (asthma/COPD), infectious disease therapies (TB and H. pylori), dermatological and analgesic medications, and other miscellaneous drugs listed in the notes.

What is the maximum daily dose and maximum duration for loperamide when treating diarrhoea?

Max 16 mg per day; should not be used for more than 48 hours.

What are the common adverse effects of loperamide and when should you stop taking it?

Common adverse effects: constipation, nausea, vomiting, bloating. Stop taking once diarrhoea stops.

What are key dosing and safety notes for Co-phenotrope (Dhamotil) in acute diarrhoea?

Max 20 mg total (PO 5 mg taken 4 times daily); not for children below 12; may cause drowsiness; take with/without food; drink more water; stop after diarrhoea stops.

What are the main cautions and administration notes for activated charcoal in diarrhoea or poisoning?

Dose: PO 3-4 capsules 3 times daily; SE: black stools; space 2 hours apart from any other medication; may stain stools black; drink plenty of water.

What probiotic preparation is listed for acute and chronic diarrhoea, and how should it be taken?

Lacteol Fort (probiotics); can be added to cereal/food/juices; can take with or without food; important to drink more water to prevent dehydration.

What is hyoscine butylbromide used for and what is its typical dosing and precautions?

Used for GI tract spasm; dosing: 60 mg daily, or 10–20 mg 3–5 times daily; SE: dry mouth; swallow tablets whole with fluids; should not be used continuously without investigating cause.

What is mebeverine indicated for and what are its dosing forms and key cautions?

IBS and GI spasm; IR: 135 mg three times daily; MR: 200 mg twice daily; SE: constipation; MR should be swallowed whole; take before meals.

How is ispaghula husk typically dosed and what are important safety notes?

PO 1 sachet twice daily; SE: abdominal cramps, diarrhoea; space 2 hours apart from digoxin, warfarin, nitrofurantoin, salicylates; full effect may take 12–72 h; don’t take before bed; drink enough water.

When is phospho-soda oral solution indicated and what is the dosing and precautions?

Indicated for severe constipation or bowel prep before endoscopy; PO 20 ml once to twice daily, diluted in water and followed by another glass of water; SE: abdominal pain, diarrhoea; Contra in heart failure and renal problems; onset 30 min–3 h; drink water to prevent dehydration.

What are the indications and key dosing for lactulose in constipation?

Constipation; onset 24–48 h; SE: distention, flatulence; drink plenty of water; take with meals to reduce GI discomfort; may mix with juice, water, or milk.

What is Fleet enema used for and what is its onset and contraindications?

Relief of occasional constipation and bowel cleaning; PR 1 bottle; onset 2–5 minutes; SE: local irritation, abdominal cramps; Contra in people with renal problems or heart failure.

Which laxative is contraindicated in bedridden patients and why?

Liquid paraffin; contraindicated in bedridden patients due to aspiration risk; onset 6–8 h; SE includes cramps, nausea, vomiting, diarrhoea; do not use for more than 1 week; avoid giving orally with meals.

What are the dosing and key cautions for bisacodyl (laxative) in this material?

Constipation; tablet onset 6–12 h; suppository onset 15–60 min; SE: mild abdominal cramps; not used for more than 1 week; swallow whole; don’t take within 1 h of antacids, milk or dairy; may cause abdominal cramps and diarrhoea.

What are sennosides used for and what is the typical regimen and precautions?

Constipation; 2 tablets at night; onset 6–12 h; SE: abdominal cramps and diarrhoea; not used for more than 1 week; can take with/without food; may discolor urine.

What is pyridoxine used for in pregnancy-related nausea, and what is the dose listed?

Supplement for pregnancy-induced nausea and vomiting; PO 50 mg once daily.

Diclectin is listed for pregnancy-related nausea and vomiting. What is its dosing instruction?

Diclectin: treatment for pregnancy-induced N&V; 2 tablets at night (ON) or 1 tablet in the morning and 2 at night (OM + ON); may cause drowsiness; take ½ to 1 hour before meals on an empty stomach; swallow whole, do not chew/crush/split.

What are the general uses and timing for omeprazole in GI conditions?

GERD, peptic ulcer disease, H. pylori eradication; typical regimen includes PO 20 mg OD for 4–8 weeks for GERD; HP: 20 mg PO BD; SE: headache; take 30–60 minutes before a meal; swallow whole with a full glass of water before breakfast.

What is the esomeprazole dosing for GERD and its administration note?

GERD: 20 mg PO once daily for 14 days; SE: headache; swallow whole; take at least 1 hour before eating; do not crush or chew; in the morning before breakfast.

How is famotidine used for GERD and what is its dosing guideline here?

GERD; PO 20 mg twice when needed; max 40 mg/day; SE: headache; may be taken 10–60 min before meals or beverages that cause heartburn.

What are the magnesium carbonate precautions and dosing for dyspepsia/GERD?

Magnesium carbonate; 10 ml three times daily between meals or as required; SE: diarrhoea; Contra: renal failure; taken after meals and at bedtime; may impair absorption of other meds if taken together.

What is magnesium trisilicate used for and its cautions?

Dyspepsia/GERD; 5–15 ml three times daily between meals or when required; SE: diarrhoea; Contra: renal impairment; take at bedtime and not with other drugs that may impair absorption.

What is simethicone used for and its dosing schedule?

Gas retention and bloating; PO 40–125 mg four times daily as needed; max 500 mg/day; take with or after meals.

What is bismuth subcitrate used for and how should it be taken for H. pylori eradication?

Eradication of H. pylori infection; 120 mg four times daily for 2 weeks; SE: may darken teeth, tongue, and stools; chew tablets before swallowing with ½ glass of water; take on an empty stomach (30 min before meals); avoid taking antacids or fruit juice ½ hour before/after; do not drink milk by itself.

What are the key dosing and cautions for tetracycline in H. pylori therapy?

Antibiotic for H. pylori; 500 mg four times daily for 10–14 days with bismuth, metronidazole, and a PPI; GI irritation (nausea, oesophageal irritation); take while standing to minimise oesophageal contact; 1 h before or 2 h after food; avoid antacids or supplements with iron, calcium, zinc 2 h before/after; may cause diarrhoea; probiotics can help; complete course unless told to stop.

What is clarithromycin used for in this context and how is it typically combined?

Antibiotic for H. pylori eradication in triple therapy; used with other agents (bismuth, metronidazole, and a PPI).

What is levofloxacin used for and what are key safety considerations?

Antibiotics for UTI, respiratory, bone/joint infections; PO 250–750 mg once daily; SE: rash, photosensitivity; cannot use in G6PD deficiency; not recommended in pregnancy; caution in breastfeeding; take with plenty of water; avoid milk and meds with iron, zinc, calcium at least 2 hours after.

What is metronidazole used for in H. pylori therapy and what important precaution should be observed regarding alcohol?

Antibiotic for H. pylori infection; 200–400 mg every 8–12 hours; SE: nausea, headache, metallic taste; safe in pregnancy and breastfeeding; take with food; avoid alcohol completely until 24 hours after completion of antibiotics to prevent adverse reactions; may cause diarrhoea; probiotics can help.

Which antihistamines are listed for upper respiratory allergies and urticaria, and what are typical dosing ranges?

Chlorpheniramine: PO 4 mg every 4–8 h, max 24 mg; Cetirizine: PO 10 mg once daily; Loratadine: PO 10 mg once daily; Fexofenadine: PO 120 mg or 180 mg once daily (60 mg daily also listed); SEs include drowsiness (less for some).

What is the cautioned nasal decongestant with rebound congestion potential and its duration limit?

Oxymetazoline nasal decongestant; SE: nasal decongestion and rebound congestion with chronic use; nasal mucosa irritation; caution in hypertension, heart disease, diabetes; limit use to avoid rebound congestion (not more than 5 days stated).

What is pseudoephedrine dosing for nasal congestion and its major contraindication?

PO 60 mg every 4–6 hours; max 240 mg/day; SE: nervousness, insomnia, tremor; contraindicated in hypertension; avoid crushing sustained-release tablets; caution with sedating antihistamines near bedtime.

What advice is given for preparing and using Fluticasone nasal spray?

Management of allergic rhinitis; SE: headache, local irritation; rinse mouth after use to avoid throat SE; prime by shaking the spray vigorously for about 10 seconds with cap on, then press the nozzle firmly several times until a fine mist appears; re-prime as directed; shake before each use after priming.

What is salbutamol used for and how is it categorized?

SABA (short-acting beta-agonist) for anti-asthmatic and COPD; immediate relief in asthma attack; SE: tremors, palpitations, headache.

What is salmeterol (a LABA) used for and how is it different from a reliever inhaler?

Maintenance treatment of asthma in patients on inhaled/oral corticosteroids; controller inhaler; not for immediate relief during an attack; SE: tremors, palpitations, headache.

What is formoterol (Symbicort turbuhaler) used for and how is a turbuhaler primed?

LABA; reliever and controller inhaler for COPD/asthma; priming involves loading and hearing a click; inhalation technique includes exhaling away, sealing lips, inhaling forcefully, and holding breath for about 10 seconds.

What is the proper technique to use a turbuhaler after priming according to the notes?

Open, exhale away from device, seal lips around mouthpiece, inhale forcefully and deeply, hold breath 10 seconds, then exhale slowly; close after use.

What is ipratropium bromide and tiotropium used for, and their basic adverse effects?

Antiasthmatic & COPD; Ipratropium (SAMA): maintenance of bronchospasm; SE: dry mouth, throat irritation, dizziness; Tiotropium (LAMA): maintenance for COPD; SE: dry mouth, throat irritation; avoid contact with eyes.

How is Spiriva (tiotropium) primed and used?

Priming: remove cap, shake, point away from face, press dose button twice until mist appears; use upright; inhale slowly through mouth; hold breath 10 seconds; replace cap.

What is theophylline used for and what are important cautions?

Maintenance treatment of asthma; SE: nausea, palpitations, esophageal reflux; Contra: peptic ulcers; swallow whole; may interact with many meds; inform doctor if starting or stopping smoking (dose may change).

Which corticosteroid inhalers are listed for maintenance in asthma and COPD, and what common counseling point is shared?

Beclomethasone, Fluticasone propionate, Budesonide; SE: oral candidiasis/throat irritation; rinse mouth after use; will not give immediate relief; use a reliever inhaler as prescribed.

What is Montelukast used for, and what are the dosing and monitoring notes?

Antiasthmatic, leukotriene receptor antagonist; maintenance (alternative controller if ICS cannot be taken); 10 mg at night; SE: headache, mood/behavior changes; administer in evening with or without food; granules can be given with cold foods like applesauce; monitor mood changes.

What is nystatin used for and how is the suspension administered?

Antifungal for oral candidiasis (oral thrush); swish and retain as long as possible before swallowing; duration 7–14 days; SE: diarrhoea, GI discomfort, N/V; shake before use.

What is beclomethasone used for and what are the key counseling points?

Antiasthmatic & COPD; ICS + LABA; treat asthma long-term; SE: throat irritation and oral candidiasis; rinse mouth after use; not for immediate relief; may need a reliever inhaler.

What is rifampicin used for, its basic dosing, and a key safety note regarding pregnancy and breastfeeding?

Antibiotic for tuberculosis; PO 10 mg/kg once daily; SE: joint/muscle pain initially; may be used in pregnancy (provide vitamin K near delivery in late pregnancy) and may discolor breast milk; take on an empty stomach (1 hour before or 2 hours after meals); ensure regular use.

What are the classic anti-tubercular drugs listed and their general purpose?

Isoniazid, Ethambutol, Pyrazinamide, Rifampicin; used for TB treatment; each has specific dosing, safety/monitoring requirements (e.g., optic changes with Ethambutol; pyridoxine with Isoniazid).

What is isoniazid used for and what are key safety notes?

Antibiotic for tuberculosis; max 300 mg/day; SE: nerve inflammation; safe in pregnancy and breastfeeding when given with pyridoxine (vitamin B6) 25 mg; take on empty stomach (1 hour before meals or 2 hours after); stop if persistent nausea, vomiting, fever, or rash; avoid fermented foods and alcohol; increase magnesium intake.

What are the major adverse effects and monitoring for ethambutol in TB therapy?

SE: red-green color blindness, blurred vision; monitor eyesight; take with or without food (with food if GI upset); stop and report changes in eyesight promptly.

What are the main cautions with pyrazinamide in TB therapy?

SE: nausea, vomiting, yellowing of skin; safe in pregnancy and breastfeeding; take with or without food; stop if persistent nausea or vomiting.

What is miconazole used for in this set, and how should it be used?

2% oral gel for oral thrush; retain in mouth before swallowing; avoid contact with mucous membranes (nose, throat, eyes); ensure adherence to course.

What is fluconazole used for and what are common GI effects?

Antifungal; can take with or without food; SE: nausea, vomiting, stomach upset; if severe headache occurs, stop and consult doctor.

What parasitic treatment is malathion used for and what are key application guidelines?

Antiparasitic for scabies and lice; Scabies: apply 24 h, then repeat 7 days after initial treatment if needed; Lice: apply to dry hair once and leave for at least 12 h; may have an unpleasant smell and skin irritation.

What is minoxidil used for and what are common adverse effects?

Topical treatment for alopecia; SE: temporary hair loss at start (1–2 months), scalp irritation, itching, redness; contraindicated in people with heart disease or high BP.

What should be considered when applying acyclovir 5% topical for cold sores?

Antiviral for cold sores/herpes; apply 5 times daily for 5–10 days; SE: itching, burning, stinging; avoid contact with eyes and inside mouth.

What is hydroxyzine used for in this list and what are common SEs?

Antihistamine for itch; 10–25 mg 3–4 times daily as prescribed; may cause drowsiness; avoid driving if drowsy; dizziness.

What is ketoconazole 2% shampoo used for and what precautions should be taken?

Shampoo for seborrhoeic dermatitis and dandruff; use twice weekly for 2–4 weeks (treatment) and then 1–2 weeks (prevention); may cause discoloration, abnormal hair texture, skin dryness; irritation if used after prolonged topical corticosteroid treatment; wait ~2 weeks before using shampoo after steroids.

What is clotrimazole 1% topical used for and typical application guidance?

Antifungal for skin infections; apply BD/TDS; ear solution: 4–5 drops 3–4 times daily; ensure adherence to regimen; avoid eye contact.

What is benzoyl peroxide used for and what are common adverse effects and precautions?

Acne treatment; concentrations 2.5%, 5%, 10%; SE: mild stinging or burning; may cause dryness/peeling; moisturise; avoid contact with eyes and avoid staining hair/clothes.

What is adapalene and its general use in dermatology?

Retinoid for acne; ON (once nightly); SE: burning, itching, or redness; may worsen before improvement (6–8 weeks); continue until no new acne develops.

What non-prescription topical bases are listed for skin care and when should they be applied?

Aqueous cream, Aqurea cream, white soft paraffin, emulsifying ointment; apply ASAP after washing/bathing; prep in tubs should be removed with a clean spoon; apply in direction of hair growth to reduce irritation; Aqurea cream 2–3 times daily or as directed.

What is methyl salicylate used for and how should it be applied?

Pain reliever for muscle aches/pains; applied BD–QDS; SE: burning sensation and redness; do not use on open wounds; avoid contact with eyes; avoid tight bandaging.

What is the recommended administration for topical acyclovir tablets (systemic form) in herpes/shingles?

Acyclovir tablet for herpes/shingles; SE: headache, nausea/vomiting; rare SE: dark urine or mood changes; complete full course.

What is paracetamol with orphenadrine (Anerax) used for and what are common SEs?

Painful disorders; PO 2 tablets three times daily; SE: dizziness and drowsiness; may cause drowsiness so avoid driving.

What is naproxen used for and what are key GI precautions?

Pain and inflammation; SE: GI ulceration or bleeding; Contraindicated in asthma, PUD, active GI bleeding; take with food or milk or antacids to reduce GI discomfort; limit alcohol.

What NSAIDs are listed and what common safety notes apply?

Naproxen, Ketoprofen, Mefenamic acid, Celecoxib, Etoricoxib; cautions around GI bleeding, asthma, and peptic ulcers; take with food to reduce GI upset; limit alcohol.

What opioid analgesics are listed and what are their common adverse effects?

Codeine, Tramadol, Morphine; SE: N/V, drowsiness, constipation; take with/after food; may cause drowsiness; do not drive.

What local anesthetic is listed for topical use and what should be considered?

Lidocaine topical cream/ointment (TDS to QDS); SE: application site reactions such as itch or burning; wear gloves before applying.

What should be considered when using ergotamine for migraine?

Migraine drug; PO 2 tablets; SE: drowsiness, dizziness; most effective when headache is beginning to develop; avoid driving until alertness returns.

What is sumatriptan used for and what is a key warning?

Migraine; SE: dizziness, drowsiness; most effective when headache is beginning to develop; may cause drowsiness; avoid driving.

What is allopurinol used for and what warning is given about gout attacks?

Urate lowering in gout; may increase gout attacks when first starting; do not stop without doctor; can take with or after food; SE: diarrhoea; seek medical advice if dark urine, pale stools, yellowing skin/eyes.

What is colchicine used for and what is a common side effect and management tip?

Prevention of gout flare; take as soon as symptoms begin; SE: stomach pain/cramps, N/V; take with/after food to reduce nausea.

What is glucosamine used for and what precaution should be noted?

Dietary supplement for symptomatic relief of osteoarthritis; take with or after meals; inform if allergic to shellfish; SE: stomach discomfort; take with food.

What are pregabalin and gabapentin used for and their common SEs?

Nerve pain; Pregabalin: SE: dry mouth, drowsiness; Gabapentin: SE: drowsiness, dizziness; take with or without food; onset of drowsiness can be reduced by taking first dose at bedtime.

What is norethisterone and what is advised regarding dosing with meals?

Progesterone; should be taken after meals; if a dose is missed, take as soon as remembered; do not double up; SE: stomach discomfort, N/V, breast tenderness, headache.