PADLET

Piperacillian + Tazobactam

Class explanation:

Piperacillin is a broad-spectrum penicillin antibiotic, while Tazobactam is a beta-lactamase inhibitor that prevents bacterial resistance. They enhance antibacterial efficacy against a wide range of infections.

Use:

• treatment of moderate to severe bacterial infection

• effective against gram+, gram- and anaerobic bacteria

Common side effects:

1. nausea

2. diarrhoea

3. rash

Adverse effects:

• hypersensitivity reactions

• clostridioides difficile-associated diarrhoea (a bacterial infection in the colon which causes diarrhoea)

• liver enzyme abnormalities

Mechanism of action:

Piperacillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to bacterial lysis. Tazobactam protects Piperacillin from degradation by bacterial beta-lactamases, expanding its spectrum of activity.

Drug interactions

• May increase the risk of bleeding when used with anticoagulants

• Reduces renal clearance of methotrexate, increasing toxicity risk.

• Can reduce the effectiveness of amino glycosides when mixed in the same IV solution.

System:

Immune system

Amoxicillin

Amoxicillin is a penicillin antibiotic. Broad spectrum antibiotic. Used to treat bacterial caused infections.

3 common side affects may include:

• fever

• diarrhoea

• headache

Adverse effects:

• super infection

• (rare) crystalluria, tooth discolouration in children

• black hairy tongue

• nausea/ vomiting

• anaemia

• (rare) hepatitis, cholestatic jaundice

Mechanism of action: Antibiotics aim to be 'harmful' to invading organisms without harming the host. This is known as selective 'toxicity'.

Drug interactions: Can interact with medications such as warfarin, allopurinol and probenecid. Could affect the stability of anticoagulant control. etc.

System: Immune system

Gentamicin

Class: Gentamicin is a Aminoglycosides drug which is a class of antibiotics that are used to treat serious bacterial infections.

Use:

-       infections of external eye

-       life threatening infections where other antibacterial agents are ineffective or contraindicated

-       soft tissue infection

Side effects:

-       Rash

-       diarrhoea

-       Nausea

Adverse effects:

-       Urticaria

-       Ototocicity

-       Increased or decreased urinary frequency

Drug interaction:

-       NSAIDs

-       Furosmide

System

• Gram negative

-       Anaesthetivs

Aciclovir

• Aciclovir is classified as a Anitviral drug because it stops the spread of herpes

• use: of Aciclovir is treatment for herpes, simplex infections including type 1 & 2 herpes, shingles and advanced HIV diseases

• Side effects: vertigo, headache, fatigue

• adverse effects: renal damage, reversible abnormal liver enzymes and bilirubin, Hypotension

• the action of Aciclovir is selectively taken up by herpes virus infected cell where it is converted to an active form that inhibits viral replication by interfering with DNA synthesis

• drug interactions: cautions if use with mycophenolate mofetil, ciclosporin or tracrolimus. Not recomended with nephrotoic agents

• System: the immune system

Nirmatrelvir + Ritonavir

Why it belongs in class

• work to inhibit viral replication which essential to control and treat viral infections

3 Common Side effects

• Altered Tase

• Diarrhea

• Muscle pain

Adverse effects

• Liver toxicity

• Kidney impairment

• Potential HIV Drug Resistance

Mechanisms of action

• Nirmatrelvir + Ritonavir work by blocking virus replication and help the body fight off the infection faster

Drug Interactions

• Avoid: Blood thinners (risk of heavy bleeding), heart meds (can affect heart rhythm) , cholesterol meds (Risk of muscle damage) , sedatives (Can cause extreme drowsiness) and transplant meds (reach extreme toxic levels).

• Use with altered dose changes: Blood pressure meds, steroid and birth control pills

Body System

• Digestive / Endocrine System

TRAMADOL

Tramadol is classified as an analgesic drug as it is primarily used to relieve pain. 

USE:Commonly used to treat moderate to serve pain. eg. post surgical pain , injury related pain, chronic pain conditions, etc

COMMON SIDE EFFECTS:

1- NAUSEA

2- DIZZINESS

3- FATIGUE

ADVERSE EFFECTS:

1- RESPIRATORY DEPRESSION

2-SEIZURES

3- ADDICTION

MECHANISM OF ACTION:

Tramadol alters the way the brain and nervous system process/respond to pain, by binding opioid receptors in the brain and spinal cord, which helps reduce the perception of pain.

DRUG INTERACTION:

Tramadol can interact with blood-thinning medications like warfarin, potentially increasing the risk of bleeding.

SYSTEM: NERVOUS SYSTEM

Tapentadol

Tapentadol is a pain-relieving medication that belongs to a class called analgesics. It works in two ways: like an opioid, it binds to receptors in the brain and spinal cord to reduce pain. Second, it inhibits the reuptake of norepinephrine, a chemical that helps control pain signals in the body. This dual action makes tapentadol effective for treating moderate to severe pain.

Use:

• Chronic pain

• Post surgical pain

3 Common side effects:

Dizziness, constipation, nausea.

Adverse effects:

Respiratory depression, low blood pressure, allergic reactions (rash, swelling)

Mechanism of Action:

It increases the levels of norepinephrine, a neurotransmitter, in the spinal cord, which helps to reduce pain by altering the way pain signals are transmitted. And it binds to a part of the brain called the mu-opioid receptor, which helps reduce pain.

Drug interactions:

• increased risk of serotonin syndrome if given with serotoninergic agents such as SSNIs, SNRIs, TCAs, MAOIs or triptans

• increased risk of respiratory depression if given with neuromuscular blocking agent or benzodiazepines

System:

Central Nervous System

Fentanyl

Class: Opioid Analgesic

Explanation: Fentanyl is a synthetic opioid analgesic, classified under narcotics due to its potency in pain relief by acting on the opioid receptors in the brain.

Use: Used for the management of severe pain, including cancer pain, and for anaesthesia purposes.

3 Side Effects:

Drowsiness, Nausea, Constipation

3 Adverse Effects:

Respiratory depression, Hypotension & Risk of addiction.

Mechanism of Action: Fentanyl binds to the μ-opioid receptors in the brain and spinal cord, leading to analgesia and sedation by inhibiting pain transmission and respiratory function.

Drug Interactions: Interacts with CNS depressants (e.g., benzodiazepines, alcohol) which increases the risk of respiratory depression & overdose.

System: Central Nervous System (CNS)

Ramipril

Ramipril is a medication that belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. It is commonly used to treat high blood pressure (hypertension) and heart failure. Additionally, it can help improve survival after a heart attack and reduce the risk of stroke and kidney problems in people with certain conditions.

3 common side effects are:

-Dizziness

-Cough

-Fatigue

-Headaches

Adverse Effects:

-Muscle spasms

-Cramps

-Myalgia

Mechanism of Action:

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking a substance in the body that causes blood vessels to tighten. As a result, ramipril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Drug Interactions:

contraindicated with angiotensin II receptor antagonists in patients with diabetic nephropathy and not recommended in other patients taking angiotensin II receptor antagonists

• serum potassium may increase if given with heparin

• see General Interactions of ACE inhibitors

System:

-Cardiovascular System

Amitriptyline

Amitriptyline is an antidepressant, that works by increasing brain chemicals like serotonin and norepinephrine. While it's effective for depression, it’s less commonly used now due to side effects, with newer medications being preferred for treating depression.

amitriptyline is used for to treat chronic pain, depression, migraines, anxiety ,insomnia and tension headache by balancing brain chemical.

3 common side effects for this medication are;

• Drowsiness;

• Dry mouth;

• Weight gain:

Adverse effects

• Suicidal Thoughts –

• Cardiovascular Issues –

Amitriptyline works by increasing the serotonin levels and norepinephrine brain levels by inhibiting their reuptake, which helps improves mood and reduce symptoms of depression and anxiety, it also has anticholinergic effects (causing dry mouth, blurred vision, etc.) and blocks histamine and alpha-1 receptors, leading to sedative effects and potential blood pressure drops. These actions contribute to both its therapeutic effects and side effects.

Amitriptyline can interact with several drugs, including MAOIs (risk of serotonin syndrome), other antidepressants(increased side effects), anticholinergic drugs (enhanced side effects like dry mouth or blurred vision), and blood pressure medications (may increase the risk of low blood pressure). Always inform a healthcare provider about all medications being taken to avoid harmful interactions.

Amitriptyline is included in central system

Sertraline

• classified as an antidepressant because it helps balance the levels of serotonin in the brain.

• Use to treat several mental health conditions such as Major Depression, Anxiety, OCD, PTSD, Social anxiety and more.

• Common side effects: Nausea, Insomnia, Headache.

• Adverse effects: Suicidal thoughts and behaviour. Serotonin Syndrome.

• Mechanism of actions: Selective serotonin and noradrenaline reuptake inhibitors that prolongs action of serotonin and noradrenaline at receptors sites.

• Drug interaction: Other antidepressants can increase the risk of serotonin syndrome. Increase the risk of bleeding if given with NSAIDs such as aspirin or warfarin.

• Its apart of the central nervous system as it helps adjust serotonin levels in the brain.

HEPARIN

use: Treatment of DVT, is a blood thinner to prevent blood clots.

3 common side affects:

thrombocytopenia,thrombocytopenia, thrombocytopenia

mechanism of action:

combines with antithrombin III (heparin co-factor) inactivating factor X and inhibiting the conversion of prothrombin to thrombin

drug interaction

drug interaction:

• decreased anticoagulant effect when given with antihistamines, digoxin, ascorbic acid (vitamin C), nicotine or tetracyclines

• decreased prothrombin time may occur if given simultaneously with IV glyceryl trinitrate, therefore should be given with caution, especially when starting or stopping therapy

• increased risk of hypoprothrombinaemia if given with large doses of aspirin

system: circulatory system

Sodium Valproate

Sodium Valproate is an anticonvulsant used for epilepsy and bipolar disorder.

Use:

Simple partial epilepsy

Tonic-clonic epilepsy

Mono or adjuvant therapy in partial epilepsy

Mania

Common side Effects:

Drowsiness

Vertigo

Nausea/Vomiting

Adverse effects:

Anorexia, diarrhoea, abdominal cramps, increased appetite and/or weight gain.

Transient hair loss nail/nail-bed disorder

Elevated liver enzymes

It is believed to increase GABA levels, while also blocking voltage-dependent sodium channels.

Its half life is 8-12 hrs.

Not advised to take with Carbapenem antibiotic

Increased risk of liver failure with salicylates such as asprin

Clozapine may result in increased serum levels

Neurological, can cause CNS depression.

Lignocaine

• Lignocaine is classified as a antiarrhythmic/ anaesthesia because it blocks sodium channels in the heart, stabilizing electrical activity and preventing abnormal rhythms.

• use : Treats ventricular arrhythmias, especially post-heart attack, and is used in cardiac resuscitation (ALS protocols).

• Common Side Effects: Dizziness, lightheadedness, numbness.

• Adverse Effects: Hypotension, bradycardia, seizures (CNS toxicity).

• Mechanism of Action: Blocks fast sodium channels in the heart, stabilizing electrical activity and suppressing abnormal rhythms.

• Drug Interactions:- Beta-blockers, amiodarone, cimetidine can increase toxicity risk. lignocaine

  - may be decreased by propranolol and metoprolol, increasing the risk of toxicity

• System: Cardiovascular

AMIODARONE

Class: Antiarrhythmic agents

Use : ventricullar fibrillation, atrial flutter and fibrillation, severe tachyarrhythmias

3 common side effects : nausea, vomiting, constipation

Adverse effects : severe bradycardia, sleep disorders, facial flushing

Mechanism of actions : increases coronary blood flow by vasodilation

Drug Interactions : not recommended with calcium channel blockers due to increased bradycardia and risk of conduction disorders

System : Central Nervous System (CNS)

Celecoxib

Celecoxib is a COX-2 inhibitor (anti-inflammatory) it prevents prostaglandin synthesis* with actions similar to other NSAIDs with analgesic (pain), antipyretic (fever) and anti-inflammatory activity

Uses:

• osteoarthritis,

• rheumatoid arthritis,

• ankylosing spondylitis

• primary dysmenorrhoea (menstrual cramps)

• (short-term) pain management post-surgery or musculoskeletal/soft tissue injury

Adverse affects:

• Abdo pain and GI upset

• N,V&D

• Dizziness and fatigue

Interactions :

• Increased plasma levels with fluconazole

• Renal impairment with ACE inhibitors

• May decrease effects of ACE inhibitor, angiotensin receptor antagonist, thiazide diuretics and beta-adrenoceptor blocking agents

System: Musculoskeletal

OMEPRAZOL

Proton Pump Inhibitor - Reduces gastric acid secretion produced by your stomach.

-Use: Benign gastric and duodenal ulcers, Gastro-oesophageal reflux disease (GORD), to prevent and treat ulcers and bleeding ulcers, Gastrinoma, Helicobacter Pylori.

-Common Side Effects: Nausea, vomiting, diarrhoea, constipation, flatulence, abdominal pain, fundic gland polyps.

-Adverse Effect: Vitamin B12 deficiency, Interstitial nephritis, hypomagnesaemia, increased risk of osteoporosis and bone fracture

-MOA: Inhibits the enzyme H+ - K+ATPase in the parietal cells

-Drug interaction: Contraindicated when treating H. Pylori with Clarithromycin in those with liver impairment.

-System: GIS

Quetiapine

Class: Antipsychotic

Use: Schizophrenia

Action:blocks dopamine receptoes, reducing ysmptoms like hallucinations and delusions. At the same time it blocks serotonin receptors which helps improve mood and reduces movement related side effects.

3 side effects: drowsiness

Dizziness

Dry mouth

3 adverse effects:

Uncontrollable muscle movements

Metabolic changes(such as weight gain)

Unstable BP

System: CNS(Central Nervous System)

Drug interactions:

Alcohol: Effects and Risk

Effects: Increases drowsiness and can cause extreme dizziness, confusion, and difficulty concentrating. It may also increase the risk of falls and accidents.

Risperidone

Antipsychotic

Used to treat schizophrenia and mania in bipolar disorder (short term). Can be used for behavioural disorders related to autism

Common side effects:

• Difficulty moving

• Headaches

• Changes in appetite

Adverse effects:

• Drooling

• Rash, dry skin

• Rhinorrhea (runny nose)

Mechanism of action:

It works by balancing the levels of dopamine and serotonin in your brain, substances that help regulate mood, behaviors, and thoughts.

Drug interactions:

Not recommended by with psychostimulants (e.g. methylphenidate) due to increased risk of extrapyramidal symptoms

System:

Central nervous system

Midazolam

Midazolam is classified under neurological medications because it acts on the central nervous system (CNS) to produce sedation, reduce anxiety, and control seizures by enhancing the inhibitory effects of GABA

Uses:

• Makes people sleepy before surgery.

• Reduces anxiety.

• Stops seizures.

3 Common Side Effects:

1. Drowsiness

2. Dizziness

3. Slow thinking

Adverse Effect:

• Respiratory depression, which can lead to difficulty breathing and require medical intervention.

Mechanism of Action:

Midazolam binds to GABA-A receptors in the CNS, increasing the effects of GABA, the primary inhibitory neurotransmitter. This leads to sedation, muscle relaxation, anticonvulsant effects, and reduced anxiety.

Drug Interactions:

• Opioids & other CNS depressants (increased risk of respiratory depression).

• Alcohol (enhanced sedation and risk of overdose).

• Some antifungal & antibiotic medications (can increase midazolam levels).

System Affected:

• Neurological System

• Respiratory System

Levodopa/Carbidopa

Class- Antiparkinsons Agent

Levodopa is converted into dopamine in the brain, and carbidopa stops it from converting too early, letting more reach the brain.

Use- Parkinson's disease to release symptoms

3 common side effects- nausea, dizziness and orthostatic hypotension (standing)

Adverse effects- hallucinations or psychosis

Mechanism of action-

Levodopa is converted to dopamine in the brain, replenishing dopamine levels which are low in Parkinson's disease.

Carbidopa blocks the enzyme that converts levodopa to dopamine outside the brain, allowing more levodopa to reach the brain.

Drug interactions-

MAO inhibitors (with serotonergic drugs) can cause serotonin syndrome.

Antipsychotics can antagonize dopaminergic effects, reducing effectiveness.

System involved- central nervous system

Diazepam- Anxiolytic Agent

Class: Anxiolytic Drug

Use:

• Reduce symptoms of anxiety

3 common side effects:

• Drowsiness, fatigue, muscle weakness

Adverse effects:

• Confusion, depression and dizziness

Mechanism of action:

• Stimulates GABA (gamma amino butyric acid) in the central nervous system, suppressing brain activity and convulsions.

Drug interactions:

• Alcohol, narcotics, ketoconazole

System:

• CENTRAL NERVOUS SYSTEM

Hydroxychloroquine Sulphate

• Class: Antimalarial / Immunosuppressant
  Hydroxychloroquine sulphate belongs to the antimalarial class because it is used to treat and prevent malaria caused by Plasmodium parasites. It is also classified as an immunosuppressant due to its ability to modulate the immune system, making it helpful in managing autoimmune conditions.

• Use:

  • Malaria: Used to prevent and treat malaria.

  • Autoimmune Diseases: Treats conditions like rheumatoid arthritis and lupus, reducing inflammation and controlling symptoms by suppressing the immune system.

• 3 Common Side Effects:

  1. Nausea

  2. Headache

  3. Dizziness

• Adverse Effects:

  1. Retinal toxicity (damage to the retina, leading to vision problems with long-term use)

  2. Heart problems, such as arrhythmias

  3. Severe skin reactions (e.g., rashes or skin pigmentation changes)

• Mechanism of Action:
  Hydroxychloroquine works by interfering with the growth and reproduction of Plasmodium parasites in red blood cells, treating malaria. For autoimmune diseases, it reduces inflammation and prevents the immune system from attacking the body’s tissues by altering immune cell activity.

• Drug Interactions:

  • Antacids and Cimetidine can increase the levels of hydroxychloroquine in the bloodstream, increasing the risk of side effects.

  • May interact with digoxin, increasing the risk of heart issues.

• System:

  • Immune System: Modulates immune function to reduce inflammation and control autoimmune disease symptoms.

  • Infectious Diseases: Targets and eliminates malaria-causing parasites in the bloodstream.