Special Population Drugs

Front 1

aminophylline

Back 1

Class: methylxanthine
Action: bronchodilator
Tx:
Side Effects: CNS psychoses
Contrain.:
Notes: ↓dose in elderly due to changes in body tissue distribution.

Front 2

captopril

Back 2

Class: ACE Inhibitor
Action:
Tx: anti-HTN
Side Effects: oligohydrammnios-anuria, neonatal hypotension, renal dysplasia, hypocalvaria.
Contrain.: 2nd/3rd trimester pregnancy
Notes: assoc. ACEI/ARB foetopathy

Front 3

carbamazepine

Back 3

Class: Anticonvulsant, antiepileptic
Action:
Tx: seziures
Side Effects: teratogenic; foetal hydantoin syndrome. Risk less than 10%, lower than phenytoin.
Contrain.:
Notes:

Front 4

chloramphenicol

Back 4

Class: Broad-spec antibiotic
Action: inhibits 50S ribosome; bacteriostatic
Tx: gram+/- bacteria
Side Effects: Gray Baby Syndrome; due to aplastic anaemia characterised by metabolic acidosis followed by hypotension, hypothermia, abdominal distension, grey colour, shock, and collapse.
Contrain.: prengancy
Notes: Underdeveloped glucuronic acid conjugation system in neonatal liver causes Grey Baby Syndrome; reversible when serum conc. ↓

Front 5

Codeine

Back 5

Class: Narcotic Analgesic
Action:
Tx:
Contrain.:
Notes: Metabolised to morphine by a P450 enzyme (CYP2D6) that certain white people lack. No analgesia + GI side effects = bad.

Front 6

dexamethasone

Back 6

Class: Synthetic corticosteroid
Action:
Tx: (infant resp. distress syndrome) foetal lung maturation; stimulates Type II pneumocyte to make fibroblast-pneumonocyte-factor, net result ↑ surfactant.
Side Effects: high doses may cause somatic, brain, and lung growth effects.
Contrain.:
Notes:

Front 7

digoxin

Back 7

Class: Na-K ATPase inhibitor
Action:
Tx: CHF
Side effects: cardiac arrhythmias
Contrain.:
Notes: Reduce dose in elderly due to change in body composition.

Front 8

folic acid

Back 8

Class:
Action: anti-teratogen; essential nutrient.
Tx: prevent spina bifida
Contrain.:
Notes: all women of childbearing age recommended to take 400μg/day.

Front 9

gentamicin

Back 9

Class: aminoglycoside antibiotic
Action: binds irreversibly to 30S ribosomal subunit
Tx: aerobic infections
Side effects: foetal ototoxiticity due to irreversible loss of hair cells.
Contrain.: Pregnancy
Notes:

Front 10

ibuprofen

Back 10

Class: NSAID
Action: analgesic action at low doses, anti-inflammatory at high doses.
Tx: help ductus arteriosus to close.
Contrain.: normal-course pregnancy; will cause premature closure of ductus.
Notes:

Front 11

indomethacin

Back 11

Class: NSAID
Action:
Tx: help ductus arteriosus to close. Use I.V. administration.
Contrain.: normal-course pregnancy; will cause premature closure of ductus.
Notes:
Notes:

Front 12

isotretinoin

Back 12

Class: retinoid (Vit. A analog)
Action:
Tx: acne, chronic dermatoses.
Side Effects: Teratogenic impairment of NS. Interferes with GFs and steroid/thyroid/retinoic acid superfamily. Bone demineralisation in children.
Contrain.: 0-3weeks of pregnancy
Notes:

Front 13

losartan

Back 13

Class: ARB (angiotensin AT_1 R antagonist)
Action:
Side Effects: oligohydrammnios-anuria, neonatal hypotension, renal dysplasia, hypocalvaria.
Tx: anti-HTN
Contrain.:
Notes: ACEI/ARB foetopathy. Doesn't work for blacks.

Front 14

phenytoin

Back 14

Class: anticonvulsant
Action:
Tx: seizures
Side Effects: Foetal Hyandtoin Syndrome in babies with low levels of epoxide hydrolase. Risk ~10%
Contrain.: pregnancy
Notes:

Front 15

thalidomide

Back 15

Class: anti-leprosy
Action: synthetic glutamic acid derivative.
Tx: first marketed as sedative; now leprosy (erythema nodosum leprosum)
Side Effects: causes phocomelia
Contrain.: pregnancy
Notes:

Front 16

valproic acid

Back 16

Class: anticonvulsant; antiepileptic
Action:
Tx: seizures
Side Effects: 3x ↑ of neural tube defects
Contrain.: pregnancy
Notes: Assoc. Foetal Hydantoin Syndrome

Front 17

warfarin

Back 17

Class: anticoagulant
Action: Interferes with vit. K, inhibiting factors II, VII, IX, and X. Also ihibits bone proteins osteocalcin and γ-carboxyglutamate matrix protein.
Tx:
Side Effects: Foetal Warfarin Syndrome; embryopathies of CNS, haemorrhages. Also, chondrodysplasia punctata, microcephaly, asplenia, diaphgragmatic hernia.
Contrain.: 6th-12th week of pregnancy
Notes: assoc. foetal warfarin syndrome. Warfarin is a small, weak acid that crosses placenta easily.