Class, action ,main uses upto 3 and dosage for the following drugs Digoxin digitalis Amiodarone Dopamine Phenytoin -blocker Nitrate furesemide Mannitol strepto / urokinase Heparin Adrenaline Atropine Salbutamol Hydrocortisone Dexamethasone Cortisone Diazepam midazolam lorazepam phenobarbitone Thiopentone Thiopental Penicillin streptomycin Erythromycin Acyclovir Insulin glucose Biguanides metformin Glibenclamide sulfonyl urea phenofibrate Na bicarbonate KCl calcium gluconate antacid Ivabradine Tranexamic acid NS Ringer lactate D5 D50 dextrose Erythropoietin zidovudine Cardiovascular drugs Inotropic Antiarrhythmic Diuretics Antithrombotic Autonomic drug Antimuscarinic Glucocorticoids Anticonvulsant Sedative Hypnotic Antibiotic Antiviral Intravenous fluids Antidote
Reading File
Given the very large number of drugs and categories, I'll answer this comprehensively from established pharmacology knowledge — covering class, action, main uses (up to 3), and dosage for each drug listed.
Drug Reference Table
CARDIOVASCULAR DRUGS
Inotropic Agents
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Digoxin | Cardiac glycoside | Inhibits Na⁺/K⁺-ATPase → ↑ intracellular Ca²⁺ → positive inotropy; also ↑ vagal tone → negative chronotropy | 1. Heart failure (HFrEF) 2. Atrial fibrillation (rate control) 3. Atrial flutter | Oral: 0.125–0.25 mg/day; Loading IV: 0.5–1 mg in divided doses; therapeutic level 0.5–2 ng/mL |
| Digitalis | Cardiac glycoside | Same as Digoxin (Digoxin is the main purified form of digitalis) | 1. Heart failure 2. AF rate control 3. SVT | Same as Digoxin |
| Dopamine | Catecholamine / Sympathomimetic | Dose-dependent: low dose (1–3 mcg/kg/min) → dopaminergic (renal vasodilation); moderate (3–10) → β₁ stimulation → ↑ CO; high (>10) → α₁ vasoconstriction | 1. Cardiogenic shock 2. Septic shock (vasopressor) 3. Acute heart failure with hypotension | IV infusion: 2–20 mcg/kg/min (titrated) |
| Adrenaline (Epinephrine) | Catecholamine | Stimulates α₁, α₂, β₁, β₂ → ↑ HR, ↑ contractility, vasoconstriction, bronchodilation | 1. Cardiac arrest (CPR) 2. Anaphylaxis 3. Severe asthma/bronchospasm | Cardiac arrest: 1 mg IV q3–5 min; Anaphylaxis: 0.3–0.5 mg IM (1:1000) |
Antiarrhythmic Agents
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Amiodarone | Class III antiarrhythmic (Vaughan-Williams) | Blocks K⁺ channels → prolonged action potential; also blocks Na⁺, Ca²⁺ channels and β-receptors | 1. Ventricular tachycardia/fibrillation 2. Atrial fibrillation (rhythm control) 3. SVT | IV: 150–300 mg over 10–20 min, then 1 mg/min × 6h, then 0.5 mg/min; Oral: 200 mg TDS loading → 200 mg/day maintenance |
| Phenytoin | Class IB antiarrhythmic / Anticonvulsant | Blocks fast Na⁺ channels → stabilises neuronal/myocardial membranes; shortens action potential | 1. Epilepsy (tonic-clonic, partial) 2. Digoxin-induced arrhythmias 3. Status epilepticus | IV: 15–20 mg/kg loading at ≤50 mg/min; Oral maintenance: 300–400 mg/day (4–7 mg/kg/day) |
| β-Blocker (e.g., Metoprolol, Propranolol) | Class II antiarrhythmic / Antihypertensive | Competitive antagonism of β₁ (and β₂) adrenergic receptors → ↓ HR, ↓ contractility, ↓ BP, slows AV conduction | 1. Hypertension 2. Angina pectoris 3. AF/SVT rate control; also post-MI, heart failure | Metoprolol: 25–200 mg/day oral; Propranolol: 40–320 mg/day; IV Metoprolol: 5 mg IV over 5 min |
| Atropine | Antimuscarinic / Parasympatholytic | Competitive antagonism of muscarinic (M2) receptors → blocks vagal tone → ↑ HR, ↑ AV conduction | 1. Symptomatic bradycardia 2. AV block (1st/2nd degree) 3. Organophosphate poisoning | IV: 0.5–1 mg bolus (max 3 mg); may repeat q3–5 min; Paediatric: 0.02 mg/kg |
| Ivabradine | Funny current (If) inhibitor | Selectively blocks HCN channels in SA node → reduces heart rate without affecting contractility or BP | 1. Stable angina (HR reduction) 2. Chronic heart failure (HFrEF, HR ≥75) 3. Inappropriate sinus tachycardia | Oral: 5 mg BD, increase to 7.5 mg BD after 4 weeks if tolerated |
Diuretics
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Furosemide (Frusemide) | Loop diuretic | Inhibits Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) in ascending loop of Henle → ↑ urine output | 1. Acute pulmonary oedema 2. Chronic heart failure (fluid overload) 3. Hypertension; nephrotic syndrome | Oral/IV: 20–80 mg/day; Acute pulmonary oedema: 40–80 mg IV bolus; up to 600 mg/day in resistant cases |
| Mannitol | Osmotic diuretic | Increases plasma osmolality → draws fluid from cells into bloodstream → increases renal filtration and urine output | 1. Raised intracranial pressure (ICP) 2. Cerebral oedema 3. Acute oliguric renal failure (short-term) | IV: 0.25–2 g/kg of 20% solution over 30–60 min; max 200 g/day |
Antithrombotic / Thrombolytic Agents
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Streptokinase | Thrombolytic (fibrinolytic) | Binds plasminogen → activates plasmin → dissolves fibrin clots | 1. STEMI (where PCI unavailable) 2. Massive pulmonary embolism 3. Deep vein thrombosis (DVT) | 1.5 million IU IV over 60 min (STEMI); 250,000 IU loading then 100,000 IU/hr × 24–72h (PE/DVT) |
| Urokinase | Thrombolytic | Directly activates plasminogen → plasmin → thrombolysis | 1. Pulmonary embolism 2. Arterial/venous thrombosis 3. Catheter occlusion | PE: 4400 IU/kg loading over 10 min, then 4400 IU/kg/hr × 12–24h |
| Heparin | Anticoagulant (indirect thrombin inhibitor) | Activates antithrombin III → inhibits thrombin (IIa) and factor Xa | 1. DVT/PE treatment and prophylaxis 2. STEMI / acute coronary syndrome 3. Atrial fibrillation (prevent thromboembolism) | UFH IV: 5000 IU bolus, then 1000–1500 IU/hr (titrated to APTT 1.5–2.5× control); Prophylaxis SC: 5000 IU BD–TDS |
| Tranexamic Acid | Antifibrinolytic | Competitively inhibits plasminogen activation → prevents fibrin clot breakdown | 1. Major trauma haemorrhage 2. Post-partum haemorrhage 3. Surgical bleeding / menorrhagia | IV: 1 g over 10 min within 3h of injury, repeat in 8h; Oral: 1 g TDS |
Nitrates
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Nitrates (e.g., GTN, Isosorbide) | Vasodilator / Antianginal | Converted to NO → activates guanylate cyclase → ↑ cGMP → smooth muscle relaxation → venodilation (preload ↓) and coronary vasodilation | 1. Acute angina (GTN sublingual) 2. Acute pulmonary oedema 3. Hypertensive urgency; chronic angina prophylaxis | GTN sublingual: 0.3–0.6 mg PRN; IV GTN: 5–200 mcg/min; Isosorbide mononitrate: 20–60 mg BD oral |
AUTONOMIC DRUGS
Antimuscarinic
(Atropine listed above under antiarrhythmics)
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Salbutamol | β₂-adrenergic agonist (sympathomimetic) | Selective β₂ stimulation → bronchial smooth muscle relaxation → bronchodilation; also slightly ↑ HR at high doses | 1. Acute bronchospasm / asthma 2. COPD exacerbation 3. Hyperkalaemia (IV/nebulised) | Inhaler: 100–200 mcg PRN; Nebulised: 2.5–5 mg; IV infusion: 3–20 mcg/min (severe asthma) |
GLUCOCORTICOIDS
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Hydrocortisone | Short-acting glucocorticoid (also mineralocorticoid activity) | Binds glucocorticoid receptors → ↓ phospholipase A2 → ↓ prostaglandins/leukotrienes; anti-inflammatory, immunosuppressive, vasopressor-sensitising | 1. Adrenal crisis / Addison's disease 2. Severe asthma / anaphylaxis 3. Inflammatory conditions; septic shock | Adrenal crisis: 100 mg IV stat, then 100 mg q6–8h; Asthma: 100–200 mg IV q6h |
| Dexamethasone | Long-acting glucocorticoid (no mineralocorticoid activity) | Same mechanism; ~25–30× more potent than hydrocortisone; minimal Na⁺ retention | 1. Cerebral oedema 2. Meningitis (reduce neuroinflammation) 3. Severe COVID-19; anti-emesis (oncology); croup | Cerebral oedema: 10 mg IV loading, then 4 mg q6h; Meningitis: 0.15 mg/kg q6h × 4 days; Oral: 0.5–10 mg/day |
| Cortisone | Short-acting glucocorticoid (prodrug → cortisol) | Converted to cortisol in liver; same anti-inflammatory mechanism | 1. Adrenal insufficiency (replacement) 2. Inflammatory/allergic conditions 3. Rheumatic diseases | Oral: 25–300 mg/day in divided doses (replacement ~25 mg/day) |
ANTICONVULSANTS / SEDATIVES / HYPNOTICS
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Phenytoin | Anticonvulsant / Class IB antiarrhythmic | Blocks voltage-gated Na⁺ channels → stabilises neuronal membranes | 1. Tonic-clonic seizures 2. Status epilepticus 3. Partial (focal) seizures | IV loading: 15–20 mg/kg at ≤50 mg/min; Oral maintenance: 300–400 mg/day |
| Phenobarbitone (Phenobarbital) | Barbiturate anticonvulsant | Enhances GABA-A receptor activity → prolongs Cl⁻ channel opening → CNS depression | 1. Epilepsy (tonic-clonic, partial) 2. Status epilepticus 3. Neonatal seizures | IV status: 15–20 mg/kg at ≤100 mg/min; Oral: 60–200 mg/day (adults); Neonatal: 20 mg/kg IV |
| Diazepam | Benzodiazepine (sedative/anticonvulsant) | Binds BZD site on GABA-A receptor → ↑ frequency of Cl⁻ channel opening → CNS depression | 1. Status epilepticus 2. Anxiety / acute agitation 3. Alcohol withdrawal; muscle spasm | Status epilepticus: 5–10 mg IV (2 mg/min) or 10 mg PR; Anxiety: 2–10 mg oral TDS–QDS |
| Midazolam | Benzodiazepine (short-acting) | Same GABA-A potentiation; rapid onset, short duration | 1. Procedural sedation / anaesthesia premedication 2. Status epilepticus (buccal/IM) 3. ICU sedation | IV sedation: 0.05–0.1 mg/kg; Buccal (status): 10 mg; ICU infusion: 0.02–0.1 mg/kg/h |
| Lorazepam | Benzodiazepine (intermediate-acting) | GABA-A potentiation; preferred for status epilepticus (longer CNS action) | 1. Status epilepticus (first-line IV) 2. Acute anxiety / panic 3. Preoperative sedation | Status epilepticus: 0.1 mg/kg IV (max 4 mg); repeat once in 10 min; Anxiety: 0.5–2 mg oral BD–TDS |
| Thiopentone / Thiopental | Barbiturate (ultra-short acting) — same drug, two names | Potentiates GABA-A → ↓ neuronal excitability; at high doses directly opens Cl⁻ channels | 1. Induction of general anaesthesia 2. Status epilepticus (refractory) 3. Raised ICP (cerebral protection) | Induction: 3–5 mg/kg IV; Status epilepticus: 100–150 mg IV bolus, then infusion 1–5 mg/kg/h |
ANTIBIOTICS
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Penicillin (e.g., Benzylpenicillin) | Beta-lactam antibiotic | Inhibits transpeptidase (PBP) → prevents peptidoglycan cross-linking → bacterial cell wall lysis (bactericidal) | 1. Streptococcal infections (pharyngitis, rheumatic fever) 2. Pneumococcal pneumonia 3. Syphilis; meningitis | Benzylpenicillin: 1.2–2.4 g IV q4–6h; Phenoxymethylpenicillin oral: 250–500 mg QDS |
| Streptomycin | Aminoglycoside antibiotic | Binds 30S ribosomal subunit → misreading of mRNA → inhibits protein synthesis (bactericidal) | 1. Tuberculosis (2nd-line, in combination) 2. Brucellosis 3. Plague; infective endocarditis (with penicillin) | IM: 15 mg/kg/day (max 1 g/day); TB: 0.75–1 g/day IM |
| Erythromycin | Macrolide antibiotic | Binds 50S ribosomal subunit (23S rRNA) → inhibits translocation → bacteriostatic (bactericidal at high conc.) | 1. Atypical pneumonia (Mycoplasma, Legionella, Chlamydia) 2. Penicillin-allergic patients (streptococcal, staphylococcal) 3. Pertussis (whooping cough); Campylobacter | Oral: 250–500 mg QDS; IV: 500 mg–1 g q6h |
ANTIVIRAL
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Acyclovir | Nucleoside analogue (antiviral) | Converted to acyclovir triphosphate by viral thymidine kinase → inhibits viral DNA polymerase → chain termination | 1. Herpes simplex (HSV 1 & 2) 2. Herpes zoster (shingles) / varicella 3. HSV encephalitis | HSV encephalitis: 10 mg/kg IV q8h × 14–21 days; Herpes zoster: 800 mg oral 5×/day × 7 days; Genital HSV: 200 mg 5×/day × 5 days |
| Zidovudine (AZT) | Nucleoside reverse transcriptase inhibitor (NRTI) / Antiretroviral | Converted to triphosphate → inhibits HIV reverse transcriptase → prevents viral DNA synthesis; also causes chain termination | 1. HIV/AIDS (part of ART regimen) 2. Prevention of mother-to-child transmission (PMTCT) 3. Post-exposure prophylaxis (PEP) | Oral: 300 mg BD (as part of combination ART); PMTCT: 300 mg BD from 28 weeks + 300 mg q3h during labour |
ENDOCRINE / METABOLIC DRUGS
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Insulin | Peptide hormone / Antidiabetic | Binds insulin receptor → ↑ GLUT-4 translocation → glucose uptake in muscle/fat; inhibits gluconeogenesis and lipolysis | 1. Type 1 diabetes mellitus 2. Diabetic ketoacidosis (DKA) 3. Hyperkalaemia (with dextrose) | DKA: 0.1 unit/kg/h IV infusion; Type 1 maintenance: 0.5–1 unit/kg/day (basal-bolus); Hyperkalaemia: 10 units soluble insulin + 50 mL D50 IV |
| Glucose (Dextrose 50%) | Carbohydrate / Antidote for hypoglycaemia | Rapidly raises blood glucose; in hyperkalemia: drives K⁺ into cells when given with insulin | 1. Severe hypoglycaemia 2. Hyperkalaemia (with insulin) 3. Hypoglycaemic coma | Hypoglycaemia: 50 mL of D50% (25 g glucose) IV stat; may repeat |
| Metformin / Biguanides | Biguanide / Oral antidiabetic | Activates AMPK → inhibits hepatic gluconeogenesis; improves peripheral insulin sensitivity; does NOT cause hypoglycaemia | 1. Type 2 diabetes mellitus (first-line) 2. Polycystic ovary syndrome (PCOS) 3. Metabolic syndrome / insulin resistance | Oral: Start 500 mg BD with meals, increase to max 2000–3000 mg/day in 2–3 divided doses |
| Glibenclamide / Sulphonylurea | Sulphonylurea / Oral antidiabetic | Blocks ATP-sensitive K⁺ channels on pancreatic β cells → membrane depolarisation → Ca²⁺ influx → insulin secretion | 1. Type 2 diabetes mellitus 2. MODY (maturity-onset diabetes of the young) 3. When metformin is contraindicated | Glibenclamide: 2.5–20 mg/day oral (once or twice daily with meals) |
| Phenofibrate | Fibric acid derivative (fibrate) / Lipid-lowering | Activates PPARα → ↑ lipoprotein lipase → ↓ TG; ↑ HDL-C; mild ↓ LDL-C | 1. Hypertriglyceridaemia 2. Mixed dyslipidaemia 3. Reduction of CV risk (combined with statin) | Oral: 145 mg/day (nanoparticle formulation) or 160–200 mg/day standard |
| Erythropoietin (EPO) | Recombinant human erythropoietin / Haematopoietic agent | Binds EPO receptor on erythroid progenitors → stimulates red blood cell production in bone marrow | 1. Anaemia of chronic kidney disease (CKD) 2. Anaemia in cancer / chemotherapy 3. Reduction of transfusion need (pre-surgery) | SC/IV: 50–300 units/kg 3×/week (CKD); adjust to target Hb 10–12 g/dL |
INTRAVENOUS FLUIDS
| Fluid | Class | Composition / Action | Main Uses | Rate / Volume |
|---|---|---|---|---|
| Normal Saline (NS / 0.9% NaCl) | Isotonic crystalloid | 154 mmol/L each of Na⁺ and Cl⁻; iso-osmolar → stays in ECF | 1. Volume resuscitation / hypovolaemia 2. Hyponatraemia correction 3. Drug dilution / IV medication vehicle | 250–1000 mL bolus (resuscitation); maintenance: 1–3 L/day |
| Ringer's Lactate (Hartmann's) | Balanced isotonic crystalloid | Na⁺ 130, K⁺ 4, Ca²⁺ 1.5, Cl⁻ 109, Lactate 28 mmol/L; lactate → bicarbonate in liver | 1. Surgical resuscitation / trauma 2. Burns fluid replacement 3. Hypovolaemia (preferred over NS for large volumes) | 1–2 L bolus, then titrated; Parkland formula for burns: 4 mL/kg/% BSA over 24h |
| Dextrose 5% (D5W) | Hypotonic crystalloid (after metabolism) | 50 g glucose/L; iso-osmolar initially → free water once glucose metabolised | 1. Fluid maintenance / free water replacement 2. Hypoglycaemia (mild) 3. Vehicle for drug infusion (e.g., amiodarone, potassium) | Maintenance: 1–2 L/day; not for resuscitation |
| Dextrose 50% (D50) | Hypertonic glucose solution | 500 g glucose/L; rapid rise in blood glucose | 1. Severe/symptomatic hypoglycaemia 2. Hyperkalaemia (with insulin) 3. Hypoglycaemic coma | 50 mL (25 g) IV bolus stat; repeat if needed |
| Dextrose (general) | Carbohydrate IV fluid | Provides caloric energy; various concentrations | Covers D5, D10, D50 uses above | Varies by concentration |
ELECTROLYTES / ACID-BASE AGENTS
| Drug | Class | Action | Main Uses | Dosage |
|---|---|---|---|---|
| Sodium Bicarbonate (NaHCO₃) | Alkalinising agent / Electrolyte | Provides HCO₃⁻ → buffers H⁺ → ↑ blood pH; also shifts K⁺ intracellularly | 1. Metabolic acidosis (severe, pH <7.1) 2. Hyperkalaemia 3. TCA overdose / salicylate poisoning; urinary alkalinisation | 1–2 mEq/kg IV bolus (cardiac arrest/severe acidosis); 50 mEq IV in hyperkalaemia emergency |
| Potassium Chloride (KCl) | Electrolyte supplement | Replenishes K⁺ → restores membrane potential, cardiac conduction, muscle function | 1. Hypokalaemia (with ECG changes or severe) 2. Hypokalaemia from diuretics 3. Prevention in patients on digoxin | IV: max 10–20 mEq/h (diluted, with monitoring); Oral: 20–80 mEq/day in divided doses |
| Calcium Gluconate | Calcium supplement / Antidote | Rapidly restores ionised Ca²⁺; in hyperkalaemia → stabilises cardiac membrane (does NOT lower K⁺) | 1. Hyperkalaemia (cardiac membrane stabilisation, emergency) 2. Hypocalcaemia (tetany, post-thyroidectomy) 3. Calcium channel blocker / magnesium toxicity antidote | 10 mL of 10% (1 g) IV over 2–3 min; repeat in 5 min if no ECG change |
| Antacid (e.g., Mg(OH)₂, Al(OH)₃, CaCO₃) | Antacid | Neutralises gastric HCl → ↑ gastric pH | 1. Dyspepsia / heartburn 2. Peptic ulcer disease (symptomatic relief) 3. GORD (gastro-oesophageal reflux) | 10–20 mL or 1–2 tablets 1h after meals and at bedtime |
QUICK CATEGORY SUMMARY
| Category | Key Drugs Listed |
|---|---|
| Inotropic | Digoxin, Digitalis, Dopamine, Adrenaline |
| Antiarrhythmic | Amiodarone, Phenytoin, β-blocker, Atropine, Ivabradine, Digoxin |
| Diuretics | Furosemide (loop), Mannitol (osmotic) |
| Antithrombotic | Heparin, Streptokinase, Urokinase, Tranexamic acid |
| Vasodilator/Antianginal | Nitrates |
| Autonomic (β₂ agonist) | Salbutamol |
| Antimuscarinic | Atropine |
| Glucocorticoids | Hydrocortisone, Dexamethasone, Cortisone |
| Anticonvulsant | Phenytoin, Phenobarbitone, Diazepam, Lorazepam |
| Sedative/Hypnotic | Diazepam, Midazolam, Lorazepam, Thiopentone |
| Antibiotic | Penicillin, Streptomycin, Erythromycin |
| Antiviral | Acyclovir, Zidovudine |
| Antidiabetic | Insulin, Metformin/Biguanides, Glibenclamide/Sulphonylurea |
| Lipid-lowering | Phenofibrate |
| IV Fluids | NS, Ringer's Lactate, D5, D50 |
| Electrolyte/Acid-base | NaHCO₃, KCl, Calcium gluconate |
| Antidote / Special | Glucose (hypoglycaemia), Calcium gluconate (hyperkalaemia/CCB OD), Atropine (organophosphate), NaHCO₃ (TCA OD), Tranexamic acid |
| Haematopoietic | Erythropoietin |
| Antiretroviral | Zidovudine |
Note on Thiopentone vs Thiopental: These are the same drug — thiopental sodium. "Thiopentone" is the British Approved Name (BAN); "Thiopental" is the International Nonproprietary Name (INN). Identical pharmacology and dosing.
Note on Digoxin vs Digitalis: Digitalis refers to the plant genus (Digitalis purpurea/lanata) and historically to the crude extract. Digoxin is the purified, standardised cardiac glycoside derived from it — clinically they are used interchangeably in meaning, but only digoxin is administered in modern practice.
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