The drug atlas

Cardiovascular

Vascular-selective calcium-channel blockers. First-line for hypertension (esp. age ≥55 or Black African/Caribbean) and for stable angina.

Amlodipine · Nifedipine · Felodipine · Lercanidipine

Cardiovascular

Rate-limiting calcium-channel blockers — act on cardiac conduction as well as vessels. Used for rate control and angina, NOT routine first-line hypertension.

Verapamil · Diltiazem

Cardiovascular

First-line for hypertension (<55, non-Black), heart failure (prognostic), diabetic nephropathy and post-MI. The "-pril" drugs.

Ramipril · Lisinopril · Perindopril · Enalapril

Cardiovascular

Used where an ACE inhibitor is indicated but not tolerated (typically the cough). The "-sartan" drugs.

Losartan · Candesartan · Valsartan · Irbesartan

Cardiovascular

Negative chronotropes/inotropes for rate control, angina, prognostic heart failure and post-MI. Cardioselective (β₁) vs non-selective matters for safety.

Bisoprolol · Atenolol · Metoprolol · Propranolol · Carvedilol · Labetalol · Sotalol

Cardiovascular

Step-2/3 antihypertensives. Thiazide-LIKE (indapamide) now preferred over true thiazides in NICE hypertension.

Indapamide · Bendroflumethiazide

Cardiovascular

Powerful diuresis for fluid overload — heart failure, pulmonary/peripheral oedema. Not an antihypertensive of choice.

Furosemide · Bumetanide

Cardiovascular

Potassium-sparing diuretics. MRAs are prognostic in heart failure and key in resistant hypertension and primary hyperaldosteronism.

Spironolactone · Eplerenone · Amiloride

Cardiovascular

Venodilators for angina relief and acute heart failure / pulmonary oedema.

GTN · Isosorbide mononitrate

Cardiovascular

Cornerstone of CVD primary and secondary prevention. Atorvastatin 20 mg (primary, QRISK ≥10%) / 80 mg (secondary).

Atorvastatin · Rosuvastatin · Simvastatin · Pravastatin · Ezetimibe

Cardiovascular

Secondary prevention of arterial thrombosis (ACS, stroke/TIA, PAD, post-stent). Cross-references Haematology.

Aspirin · Clopidogrel · Ticagrelor · Prasugrel

Cardiovascular

First-line oral anticoagulation for non-valvular AF and VTE — no routine monitoring (cf. warfarin). Cross-references Haematology.

Apixaban · Rivaroxaban · Edoxaban · Dabigatran

Cardiovascular

Rate control in AF (esp. sedentary / coexisting HF) and a positive inotrope in heart failure. Narrow therapeutic index — a classic toxicity exam topic.

Cardiovascular

Broad-spectrum antiarrhythmic for AF, VT/VF and other tachyarrhythmias. Huge volume of distribution, very long half-life (~50+ days), and a long list of organ toxicities.

Cardiovascular

Vitamin K antagonist still required where DOACs are contraindicated — mechanical valves and significant mitral stenosis. INR-monitored.

Cardiovascular

Injectable anticoagulants for VTE prophylaxis/treatment, ACS and bridging. LMWH is the workhorse; unfractionated heparin (UFH) is used where rapid reversibility is needed.

Enoxaparin / dalteparin / tinzaparin · Unfractionated heparin

Cardiovascular

α₁-antagonists — step-4 add-on for resistant hypertension (if K⁺ >4.5) and first-line medical therapy for benign prostatic hyperplasia (BPH).

Doxazosin · Tamsulosin / alfuzosin

Cardiovascular

The antiarrhythmics not covered by the rate-control cards — adenosine for SVT, flecainide for paroxysmal AF, lidocaine for VT — organised by the Vaughan-Williams classification.

Adenosine · Flecainide · Lidocaine · Procainamide

Cardiovascular

The drugs of cardiac arrest, shock and symptomatic bradycardia — adrenaline, the vasopressors/inotropes, atropine, and glucagon for β-blocker/CCB overdose.

Adrenaline · Noradrenaline · Dobutamine · Atropine · Glucagon

Cardiovascular

Second-line agents added when first-line heart-failure or angina therapy is insufficient — each with a distinctive mechanism.

Sacubitril/valsartan (ARNI) · Ivabradine · Nicorandil · Hydralazine + nitrate

Obstetrics & Gynaecology

Oestrogen + progestogen contraception (pill, patch, vaginal ring). Highly effective with perfect use; eligibility governed by FSRH UKMEC.

Microgynon / Rigevidon · Marvelon / Yasmin · Evra patch · NuvaRing

Obstetrics & Gynaecology

Progestogen-only oral contraception — the safe choice when oestrogen is contraindicated (migraine with aura, VTE risk, breastfeeding, smokers ≥35).

Desogestrel (Cerazette/Cerelle) · Levonorgestrel / Norethisterone

Obstetrics & Gynaecology

Long-acting reversible contraception — the most effective methods (user-independent). Implant is the single most effective contraceptive.

Etonogestrel implant (Nexplanon) · LNG-IUS (Mirena/Levosert) · DMPA (Depo-Provera)

Obstetrics & Gynaecology

The only non-hormonal LARC, and the most effective emergency contraceptive.

Obstetrics & Gynaecology

Post-coital contraception. Copper IUD is most effective and the only method that works after ovulation; the oral options delay ovulation only.

Levonorgestrel 1.5 mg · Ulipristal acetate 30 mg · Copper IUD

Obstetrics & Gynaecology

Oestrogen to relieve menopausal symptoms; a progestogen is added if the uterus is present to protect the endometrium.

Oestrogen-only · Combined (oestrogen + progestogen) · Transdermal oestrogen (patch/gel) · Tibolone

Obstetrics & Gynaecology

Drugs that contract the uterus — active management of the third stage and treatment of atonic postpartum haemorrhage. The escalation order and the agent-specific contraindications are heavily tested.

Oxytocin (Syntocinon) · Ergometrine · Carboprost (Hemabate) · Misoprostol

Obstetrics & Gynaecology

Antifibrinolytic that reduces bleeding — postpartum haemorrhage (WOMAN trial), heavy menstrual bleeding, and trauma/surgery.

Obstetrics & Gynaecology

First-line for eclamptic seizures and seizure prophylaxis in severe pre-eclampsia; also fetal neuroprotection in early preterm birth. Narrow safety margin — monitor for toxicity.

Obstetrics & Gynaecology

Centrally-acting antihypertensive used in pregnancy. Labetalol and nifedipine are the other pregnancy-safe options (ACEi/ARB are contraindicated).

Obstetrics & Gynaecology

Passive immunisation that prevents RhD-negative mothers becoming sensitised to RhD-positive fetal cells — preventing haemolytic disease of the newborn in future pregnancies.

Obstetrics & Gynaecology

Cervical ripening and induction of labour. Prostaglandins ripen the cervix; oxytocin augments established labour.

Dinoprostone (Propess/Prostin) · Misoprostol (Mysodelle) · Oxytocin (Syntocinon)

Obstetrics & Gynaecology

Suppress preterm uterine contractions — used to buy ~48 hours for antenatal corticosteroids and in-utero transfer, not to prolong pregnancy indefinitely.

Nifedipine · Atosiban

Obstetrics & Gynaecology

The medical regimen for termination of pregnancy, medical management of miscarriage, and induction for intrauterine fetal death.

Mifepristone · Misoprostol

Obstetrics & Gynaecology

NSAID used for heavy menstrual bleeding and primary dysmenorrhoea — particularly useful when both heavy AND painful periods (cross-references the general NSAID class).

Obstetrics & Gynaecology

Drugs to induce ovulation in anovulatory infertility (esp. PCOS). Letrozole is now the preferred first-line agent; gonadotrophins are used in assisted conception.

Letrozole · Clomifene · Metformin · Gonadotrophins (FSH/hCG)

Obstetrics & Gynaecology

Create a reversible "medical menopause". Agonists downregulate the pituitary after an initial flare; antagonists suppress immediately. Used in endometriosis, fibroids and assisted conception.

Goserelin (Zoladex) · Leuprorelin / Triptorelin · Buserelin · Cetrorelix / Ganirelix

Obstetrics & Gynaecology

Reduce androgen action for hirsutism and acne in PCOS. All are teratogenic (feminise a male fetus) — reliable contraception is essential.

Co-cyprindiol (cyproterone + EE) · Spironolactone · Finasteride

Obstetrics & Gynaecology

Given to the mother in anticipated preterm birth to mature the fetal lungs — one of the highest-impact obstetric interventions (cross-references the corticosteroid class).

Obstetrics & Gynaecology

Lower prolactin — used for lactation suppression and hyperprolactinaemia/prolactinoma (cross-references the endocrine prolactinoma card).

Cabergoline · Bromocriptine

Obstetrics & Gynaecology

Used for the itch of intrahepatic cholestasis of pregnancy — but RCOG 2022 no longer recommends it routinely to improve fetal outcomes (PITCHES trial was negative).

Obstetrics & Gynaecology

Natural progesterone for early-pregnancy support and luteal support — distinct from the synthetic progestogens used for contraception.

Obstetrics & Gynaecology

Drug treatment of urinary incontinence after conservative measures. The decision tree: Urge → Bladder training → antimuscarinic/mirabegron; Stress → Pelvic-floor → duloxetine.

Oxybutynin · Solifenacin / Tolterodine · Mirabegron · Duloxetine

Obstetrics & Gynaecology

Erectile dysfunction (and pulmonary hypertension). The nitrate interaction is one of the most heavily tested drug pairings.

Sildenafil · Tadalafil

Obstetrics & Gynaecology

Antibiotic use specific to pregnancy and labour — GBS intrapartum prophylaxis, the safe agents for UTI in pregnancy, and the agents to AVOID.

Benzylpenicillin (intrapartum) · Nitrofurantoin · Cefalexin / amoxicillin · Co-amoxiclav

Obstetrics & Gynaecology

The supplements every pregnancy needs — folic acid (neural tube defect prevention) is the highest-yield, with the high-dose criteria a common exam point.

Folic acid 400 mcg · Folic acid 5 mg · Vitamin D 10 mcg · Iron (ferrous salt)

Obstetrics & Gynaecology

Treatment of nausea & vomiting of pregnancy / hyperemesis gravidarum — the stepwise antiemetic choice and thiamine are the exam points.

Cyclizine / promethazine · Prochlorperazine · Ondansetron / metoclopramide · Thiamine + IV fluids + VTE prophylaxis

Dermatology

The mainstay of eczema and dry-skin management — restore the skin barrier and reduce the need for steroid.

Light (lotions/creams) · Greasy (ointments)

Dermatology

Anti-inflammatory cornerstone of eczema and many dermatoses. Potency is matched to site and severity — the ladder and the fingertip unit are heavily tested.

Hydrocortisone 1% · Clobetasone butyrate (Eumovate) · Betamethasone valerate 0.1% (Betnovate) / Mometasone · Clobetasol propionate (Dermovate)

Dermatology

Steroid-sparing topical immunomodulators — no skin atrophy, so ideal for the face, eyelids and flexures.

Tacrolimus ointment · Pimecrolimus cream

Dermatology

Topical treatment of plaque psoriasis. First-line is a potent corticosteroid PLUS a vitamin D analogue.

Calcipotriol / calcitriol · Coal tar · Dithranol

Dermatology

First-line acne treatment is a topical fixed-combination for 12 weeks. Always pair a topical antibiotic with benzoyl peroxide to limit resistance.

Benzoyl peroxide · Adapalene / tretinoin · Topical clindamycin · Azelaic acid

Dermatology

Powerful systemic vitamin-A derivatives for severe acne (isotretinoin) and psoriasis (acitretin) — highly teratogenic, specialist-initiated, under a Pregnancy Prevention Programme.

Isotretinoin · Acitretin · Alitretinoin

Dermatology

Systemic therapy for severe psoriasis and atopic eczema when topicals/phototherapy fail. Biologics target specific cytokines; screen for infection/TB first.

Methotrexate · Ciclosporin · TNF inhibitors (adalimumab/etanercept/infliximab) · IL-17/IL-23 inhibitors (secukinumab/guselkumab/ustekinumab) · Dupilumab

Dermatology

Treatment of dermatophyte (tinea), yeast (candida, pityriasis versicolor) and seborrhoeic skin infection (cross-references the antimicrobial section).

Terbinafine · Imidazoles (clotrimazole/ketoconazole/miconazole) · Griseofulvin · Nystatin

Dermatology

H1-antagonists for urticaria, allergic rhinitis and pruritus. Non-sedating agents are first-line; sedating agents are reserved for nocturnal itch (cross-references ENT/allergy).

Cetirizine / loratadine / fexofenadine · Chlorphenamine (Piriton) · Hydroxyzine / promethazine

Dermatology

Antimicrobials for skin/soft-tissue infection, in context — cellulitis, impetigo, the oral acne antibiotics, and the cutaneous antivirals.

Flucloxacillin · Fusidic acid (topical) · Lymecycline / doxycycline (oral) · Aciclovir · Co-amoxiclav

Dermatology

Topical antiparasitics for scabies and head lice — the "treat the whole household" and application rules are the exam points.

Permethrin 5% cream · Dimeticone 4% / wet combing · Malathion · Oral ivermectin

Child Health

Exogenous surfactant instilled into the lungs of preterm neonates with (or at risk of) respiratory distress syndrome from surfactant deficiency.

Poractant alfa (Curosurf) · Beractant (Survanta)

Child Health

The two OPPOSITE manoeuvres on the ductus arteriosus — one of the highest-yield neonatal pharmacology gates. Prostaglandin KEEPS the duct open; NSAID CLOSES it.

Alprostadil (PGE₁) · Ibuprofen / indometacin

Child Health

First-line respiratory stimulant for apnoea of prematurity — improves apnoea and reduces bronchopulmonary dysplasia and cerebral palsy (CAP trial).

Child Health

Asthma and croup drugs as used in children — broadly the same agents as adults but with age-specific delivery (spacer ± mask) and the specific croup/bronchiolitis rules.

Salbutamol · Inhaled corticosteroid (e.g. beclometasone) · Montelukast · Dexamethasone (oral) / nebulised adrenaline

Child Health

The cross-cutting safety rules of prescribing for children — weight-based dosing, age contraindications, and routine newborn vitamin K.

Vitamin K (phytomenadione) · Paracetamol / ibuprofen

Child Health

Antipyretics/analgesics in children, and the aspirin paradox: contraindicated for Reye syndrome — EXCEPT in Kawasaki disease, the one place children do get aspirin.

Paracetamol · Ibuprofen · Aspirin

Child Health

The treatment of Kawasaki disease — IV immunoglobulin plus aspirin — aimed at preventing the coronary artery aneurysms that define its danger.

Child Health

Drug treatment of bedwetting — after an enuresis alarm and lifestyle measures (the non-drug first-line).

Desmopressin · Oxybutynin

Child Health

Pharmacological treatment of ADHD (after environmental modifications). Stimulants are first-line; cardiac screening and growth monitoring are the key safety points.

Methylphenidate · Lisdexamfetamine · Atomoxetine · Guanfacine

Child Health

High-frequency primary-care paediatric prescriptions — childhood constipation, threadworm, and infant reflux.

Macrogol (Movicol Paediatric) · Mebendazole · Alginate / PPI

Child Health

The antibiotics/antivirals for common childhood infections, in context — same agents as adults but with the crucial paediatric/neonatal age rules (full class mechanisms live in the Antimicrobials section).

Phenoxymethylpenicillin / benzylpenicillin · Amoxicillin · Cefotaxime vs ceftriaxone · Gentamicin · Macrolide (clarithromycin/azithromycin) · Aciclovir · Nitrofurantoin / trimethoprim

Child Health

The status-epilepticus escalation ladder plus the maintenance antiepileptics by seizure type. The valproate teratogenicity restriction and the absence-seizure choice are heavily tested.

Buccal midazolam / PR diazepam · IV lorazepam · IV phenytoin / levetiracetam · Sodium valproate · Ethosuximide · Carbamazepine / lamotrigine

Child Health

Childhood nephrotic syndrome is usually minimal change disease and is highly steroid-responsive — high-dose oral prednisolone is first-line without needing a biopsy.

Prednisolone · Steroid-sparing (ciclosporin/tacrolimus/cyclophosphamide)

Child Health

Lifelong prophylaxis to prevent infection and crises, plus acute crisis management. The penicillin prophylaxis and hydroxycarbamide points are high-yield.

Penicillin V prophylaxis · Hydroxycarbamide · Folic acid · Crisis: analgesia + fluids + O₂

Child Health

Paediatric DKA differs from adult — the danger is CEREBRAL OEDEMA, so fluids are given cautiously and insulin is started AFTER fluids, with no bolus.

IV fluids (cautious) · Fixed-rate insulin infusion · Potassium

Child Health

Surgical division of the hypertrophied pylorus — the treatment of pyloric stenosis. The key teaching is to correct the metabolic disturbance FIRST.

Laparoscopic / open pyloromyotomy

Child Health

Radiological air-enema reduction is first-line for intussusception; surgery is reserved for failure or complications.

Air enema · Surgical reduction ± resection

Sexual Health / HIV

Combination therapy for HIV — typically two NRTIs plus a third agent (now usually an integrase inhibitor). Goal: undetectable viral load (U=U: untransmittable). Lifelong.

Tenofovir + emtricitabine · Dolutegravir / bictegravir · Efavirenz · Abacavir · Atazanavir / darunavir

Sexual Health / HIV

Antiretroviral taken by HIV-negative people at risk, BEFORE exposure, to prevent acquisition. Highly effective when adherent.

Sexual Health / HIV

A 28-day antiretroviral course started AFTER a possible HIV exposure (sexual or occupational/needlestick) to prevent seroconversion. Time-critical.

Sexual Health / HIV

First-line for gonorrhoea — ceftriaxone 1 g IM single-dose monotherapy (BASHH). The dose rise to 1 g and dropping azithromycin dual therapy are recent examinable changes.

Sexual Health / HIV

First-line for chlamydia (restored over azithromycin for better rectal efficacy) and a backbone of PID, LGV and penicillin-allergic syphilis.

Sexual Health / HIV

First-line for syphilis at every stage. The Jarisch–Herxheimer reaction and penicillin-allergy-in-pregnancy are the exam points.

Sexual Health / HIV

Antiviral for genital herpes — controls episodes and (as suppression) reduces recurrences/transmission, but does NOT eradicate the latent virus.

Sexual Health / HIV

Treatment of bacterial vaginosis and trichomoniasis. The alcohol (disulfiram-like) reaction is the classic counselling point.

ENT

The single most effective treatment for moderate–severe and persistent allergic rhinitis — more effective than antihistamines for nasal blockage.

Mometasone / fluticasone · Beclometasone

ENT

Adjuncts in rhinitis — intranasal antihistamine for rapid relief; topical decongestants only very short-term (rebound).

Azelastine · Xylometazoline / oxymetazoline

ENT

Topical treatment of otitis externa and softening of ear wax. The perforated-eardrum aminoglycoside caution is the key exam point.

Antibiotic + steroid drops (e.g. neomycin/dexamethasone) · Ciprofloxacin drops · Acetic acid 2% spray · Olive oil / sodium bicarbonate

ENT

Drugs for oral candidiasis, mouth ulcers and oral hygiene.

Nystatin suspension · Miconazole oral gel · Chlorhexidine mouthwash · Fluconazole

ENT

Symptomatic relief of acute vertigo, and prophylaxis in Ménière disease. Vestibular sedatives are for the ACUTE phase only — they delay central compensation if continued.

Prochlorperazine · Cinnarizine / cyclizine · Betahistine

ENT

Antibiotics for ENT infections, in context — the sore-throat penicillin (and the avoid-amoxicillin/check-FBC pitfalls), otitis media, bacterial sinusitis and the malignant-OE emergency.

Phenoxymethylpenicillin (penV) · Amoxicillin · Ciprofloxacin · Doxycycline

ENT

Two time-critical steroid indications in ENT — Bell's palsy and idiopathic sudden sensorineural hearing loss — where early oral steroids change the outcome.

Prednisolone (Bell's palsy) · High-dose prednisolone (sudden SNHL)

Endocrine & Metabolic

First-line drug for type 2 diabetes — weight-neutral, no hypoglycaemia as monotherapy, cardiovascular benefit. Also used in PCOS.

Endocrine & Metabolic

"-flozin" drugs — now key add-ons in T2DM, and independently prognostic in heart failure and CKD (regardless of diabetes).

Dapagliflozin · Empagliflozin

Endocrine & Metabolic

Injectable incretin mimetics for T2DM that also drive weight loss — increasingly used for obesity. Glucose-dependent action → minimal hypoglycaemia.

Semaglutide · Liraglutide · Dulaglutide

Endocrine & Metabolic

Oral, weight-neutral incretin enhancers for T2DM — well tolerated and usable in renal impairment (linagliptin).

Sitagliptin · Linagliptin

Endocrine & Metabolic

Insulin secretagogues — effective and cheap, but cause hypoglycaemia and weight gain. Useful when rapid glucose control or symptoms.

Endocrine & Metabolic

Replacement therapy — essential in type 1 diabetes and used in type 2. The action-profile (onset/peak/duration) of each type is the high-yield exam content.

Rapid-acting (lispro/aspart/glulisine) · Short-acting soluble (Actrapid) · Intermediate (isophane/NPH) · Long-acting (glargine/detemir/degludec)

Endocrine & Metabolic

Replacement for hypothyroidism (levothyroxine) and suppression for hyperthyroidism (carbimazole/PTU). The pregnancy choice and agranulocytosis warning are the exam points.

Levothyroxine · Carbimazole · Propylthiouracil (PTU)

Endocrine & Metabolic

Cross-cutting anti-inflammatory/immunosuppressant used across nearly every specialty. The adverse-effect profile, the never-stop-abruptly rule and sick-day rules are core exam content.

Prednisolone · Hydrocortisone · Dexamethasone

Endocrine & Metabolic

Osteoporosis and bone-protection therapy. Bisphosphonates are first-line; the dosing instructions and jaw osteonecrosis are the tested points.

Alendronate / risedronate · Zoledronate · Denosumab · Calcium + vitamin D

Endocrine & Metabolic

An oral T2DM agent — insulin sensitiser with no hypoglycaemia, but weight gain and fluid retention limit it (avoid in heart failure).

Endocrine & Metabolic

Physiological replacement in adrenal insufficiency — glucocorticoid (hydrocortisone) plus, in PRIMARY insufficiency, mineralocorticoid (fludrocortisone). The sick-day rules and the adrenal-crisis response are core exam content.

Hydrocortisone · Fludrocortisone

Endocrine & Metabolic

The drug treatments for the dangerous electrolyte disturbances — hyperkalaemia (the classic ECG emergency), calcium, magnesium and sodium correction.

Hyperkalaemia: calcium gluconate → insulin/dextrose + salbutamol · Hypocalcaemia: IV calcium gluconate (acute) / alfacalcidol + calcium · Hypomagnesaemia: IV magnesium sulfate · Hyponatraemia/SIADH: fluid restriction ± hypertonic saline / tolvaptan

Endocrine & Metabolic

Somatostatin analogues suppress growth hormone (acromegaly) and have several other high-yield uses (variceal bleeding, carcinoid). Dopamine agonists/GH antagonists complete the acromegaly toolkit.

Octreotide / lanreotide · Pegvisomant · Cabergoline

Surgery & Perioperative

The stop / continue / switch decisions for chronic medications around surgery — a high-yield, rule-dense topic.

Warfarin · DOACs · Metformin / SGLT2i · Insulin · Long-term steroids · COCP / HRT · ACE inhibitors / ARBs

Surgery & Perioperative

Agents producing reversible unconsciousness. The anaesthetic triad = hypnosis + analgesia + muscle relaxation. Malignant hyperthermia is the key emergency.

Propofol · Thiopental · Ketamine · Sevoflurane / isoflurane

Surgery & Perioperative

Reversible nerve conduction block for local/regional anaesthesia. The maximum doses and LA systemic toxicity are the safety essentials.

Lidocaine · Bupivacaine

Surgery & Perioperative

Paralysis for intubation and surgery, and the agents that reverse it. Suxamethonium's adverse effects are a heavy exam favourite.

Suxamethonium · Rocuronium / atracurium · Neostigmine · Sugammadex

Surgery & Perioperative

Anti-sickness drugs grouped by receptor target — choosing by cause (the receptor) is the schema that gets tested.

Ondansetron · Cyclizine · Metoclopramide · Prochlorperazine

Surgery & Perioperative

Acute, post-operative and palliative pain management — the WHO ladder, the opioids, and the safety points (naloxone, renal impairment, codeine pharmacogenetics).

Morphine · Oxycodone · Fentanyl · Codeine / dihydrocodeine / tramadol · Naloxone

Surgery & Perioperative

The two routine prophylaxis decisions around an operation — preventing surgical-site infection and preventing venous thromboembolism.

Antibiotic at induction · LMWH (e.g. enoxaparin) · Mechanical (anti-embolism stockings / IPC)

Surgery & Perioperative

Removal of the appendix — the definitive treatment of acute appendicitis.

Laparoscopic · Open (Lanz/gridiron)

Surgery & Perioperative

Removal of the gallbladder — for symptomatic gallstone disease.

Laparoscopic · Hot vs interval

Surgery & Perioperative

Surgical repair of an abdominal-wall hernia — urgent if strangulated or obstructed.

Open mesh (Lichtenstein) · Laparoscopic

Surgery & Perioperative

Open abdominal surgery to resect bowel — for obstruction, perforation, ischaemia, or cancer.

Hartmann procedure · Resection + primary anastomosis

Surgery & Perioperative

Repair of an abdominal aortic aneurysm — elective above the size/growth threshold, or emergency if ruptured.

EVAR · Open repair

Surgery & Perioperative

Removal of carotid plaque to prevent stroke in symptomatic significant carotid stenosis.

Endarterectomy · Carotid stenting

Surgery & Perioperative

Restoring coronary blood flow — by stent (PCI) or bypass graft (CABG). The choice between them is a classic decision.

PCI · CABG

Surgery & Perioperative

Surgical decompression of a muscle compartment — the emergency treatment of compartment syndrome.

Surgery & Perioperative

Draining a collection of pus — the principle that "antibiotics alone do not treat a walled-off abscess".

Surgery & Perioperative

Removal of the spleen — for trauma, haematological disease or hypersplenism. The lifelong infection prophylaxis afterwards is the high-yield point.

Vaccination (pre-op if elective) · Lifelong penicillin V prophylaxis

Neurology

The most effective Parkinson's drug — but motor complications (wearing-off, dyskinesia) develop over years, and it must never be stopped abruptly.

Co-careldopa · Co-beneldopa

Neurology

Directly stimulate dopamine receptors — used to delay levodopa in younger patients, but impulse-control disorders are the defining adverse effect.

Ropinirole / pramipexole · Rotigotine · Apomorphine

Neurology

Enzyme inhibitors and other adjuncts that extend levodopa's effect or target specific symptoms.

Selegiline / rasagiline · Entacapone · Amantadine · Procyclidine

Neurology

Symptomatic drugs for Alzheimer's — acetylcholinesterase inhibitors (mild–moderate) and memantine (moderate–severe). NOT for vascular dementia.

Donepezil / rivastigmine / galantamine · Memantine

Neurology

Maintenance antiepileptics by seizure type, with the drug-specific safety points (valproate teratogenicity, lamotrigine/carbamazepine SJS, enzyme induction). Cross-references the paediatric seizure card.

Sodium valproate · Lamotrigine · Carbamazepine · Levetiracetam · Phenytoin · Ethosuximide

Neurology

Acute and preventive migraine therapy, plus cluster headache and the medication-overuse trap.

Acute: sumatriptan + NSAID/paracetamol ± antiemetic · Propranolol · Topiramate · Amitriptyline · Cluster: high-flow O₂ + SC sumatriptan; verapamil prophylaxis

Neurology

First-line neuropathic-pain agents (choose one, switch if it fails) and the special cases — trigeminal neuralgia and diabetic neuropathy.

Amitriptyline / duloxetine / gabapentin / pregabalin · Carbamazepine · Capsaicin cream

Neurology

Symptomatic and immunosuppressive treatment of myasthenia gravis — plus the crucial list of drugs that WORSEN it.

Pyridostigmine · Prednisolone / azathioprine · IVIG / plasma exchange

Neurology

Treatment of MS across relapse, disease modification and symptom control.

Methylprednisolone · DMTs (beta-interferon, dimethyl fumarate, natalizumab, ocrelizumab, fingolimod) · Baclofen / gabapentin (spasticity); oxybutynin (bladder); amantadine (fatigue)

Neurology

The acute-neurology drug decisions — ischaemic stroke (thrombolysis/antiplatelets), Guillain-Barré, motor neurone disease, and raised intracranial pressure.

Aspirin 300 mg → clopidogrel · Alteplase · IVIG / plasma exchange · Riluzole · Dexamethasone / mannitol

Respiratory

The acute "reliever" bronchodilator. NOTE: under NG245 (2024), SABA-only treatment is NO LONGER recommended in asthma — but salbutamol remains central to acute attacks and COPD.

Salbutamol · Terbutaline

Respiratory

The anti-inflammatory "preventer" — the backbone of asthma control. As ICS/formoterol it is now also the reliever (AIR/MART).

Beclometasone / budesonide · Fluticasone

Respiratory

The centrepiece of the 2024 asthma overhaul — a combined ICS/formoterol inhaler used as the reliever (AIR) and, with regular dosing, as maintenance + reliever (MART). LABAs must never be used without an ICS.

Budesonide/formoterol (e.g. Symbicort, Fostair) · Salmeterol

Respiratory

Anticholinergic bronchodilators — central to COPD (LAMA) and used in acute severe asthma/COPD (ipratropium).

Ipratropium · Tiotropium / glycopyrronium / umeclidinium

Respiratory

Oral add-on in asthma — useful with an allergic/exercise component. The neuropsychiatric warning is a recent MHRA point.

Respiratory

An older oral/IV bronchodilator — narrow therapeutic index and many interactions, so a later-line/specialist option.

Respiratory

The bundle for an acute attack — oxygen, bronchodilators, steroids and (in severe asthma) magnesium, with the COPD-specific target sats and antibiotics.

Oxygen · Salbutamol ± ipratropium (nebulised) · Prednisolone (or IV hydrocortisone) · Magnesium sulfate IV · Antibiotic (COPD)

Respiratory

Drugs for chronic sputum/mucus problems — COPD/bronchiectasis mucolytics, cystic fibrosis therapies, and the antifibrotics for idiopathic pulmonary fibrosis.

Carbocisteine · Dornase alfa / nebulised hypertonic saline · CFTR modulators (ivacaftor/lumacaftor) · Pirfenidone / nintedanib

Gastrointestinal

The most effective acid suppressants — GORD, peptic ulcers, H. pylori eradication and ulcer prophylaxis. Long-term risks and the clopidogrel interaction are the exam points.

Omeprazole / esomeprazole · Lansoprazole / pantoprazole

Gastrointestinal

Step-down / lower-potency acid control — H2-receptor antagonists and OTC antacids/alginates for mild reflux and dyspepsia.

Famotidine · Antacids (calcium/magnesium/aluminium salts) · Alginates (Gaviscon)

Gastrointestinal

Topical anti-inflammatory for inflammatory bowel disease — first-line to induce + maintain remission in ulcerative colitis (less effective in Crohn's).

Mesalazine · Sulfasalazine

Gastrointestinal

Steroid-sparing immunosuppressants to MAINTAIN remission in IBD (and used in many autoimmune diseases + transplant). The TPMT check and the allopurinol interaction are heavily tested.

Azathioprine · Mercaptopurine (6-MP)

Gastrointestinal

Laxatives by class — choosing depends on the cause (opioid constipation, faecal impaction, hepatic encephalopathy).

Bulk-forming (ispaghula husk) · Osmotic (macrogol, lactulose) · Stimulant (senna, bisacodyl) · Stool softener (docusate) · Naloxegol / methylnaltrexone

Gastrointestinal

Symptomatic drugs for diarrhoea and bowel cramp/IBS — with the important caution about not slowing the gut in inflammatory/infective colitis.

Loperamide · Hyoscine butylbromide (Buscopan) · Mebeverine

Gastrointestinal

The drug decisions in decompensated liver disease and paracetamol overdose — encephalopathy, variceal bleeding, ascites, SBP and the NAC antidote.

Lactulose + rifaximin · Terlipressin + prophylactic antibiotics · Propranolol / carvedilol · Spironolactone (± furosemide) · N-acetylcysteine · IV cefotaxime

Gastrointestinal

Replacement of pancreatic enzymes in exocrine insufficiency — chronic pancreatitis, cystic fibrosis, pancreatic cancer/resection.

MSK & Rheumatology

Cross-cutting analgesic/anti-inflammatories — OA, gout, RA flares, dysmenorrhoea, acute pain. The GI/renal/cardiac/asthma cautions and the "triple whammy" are core.

Ibuprofen · Naproxen · Diclofenac · Celecoxib

MSK & Rheumatology

The anchor disease-modifying drug for rheumatoid arthritis (and used in psoriasis, IBD, ectopic, chemo). The WEEKLY dosing, folic acid, and monitoring are the safety essentials — and a classic fatal prescribing error.

MSK & Rheumatology

The non-methotrexate conventional synthetic DMARDs for rheumatoid arthritis — each with a signature monitoring/toxicity point.

Sulfasalazine · Hydroxychloroquine · Leflunomide

MSK & Rheumatology

Targeted therapies for DMARD-refractory rheumatoid arthritis (and other autoimmune disease) — cytokine/cell-targeted. TB reactivation screening is the key pre-treatment step (cross-references the dermatology biologics card).

Anti-TNF (etanercept/adalimumab/infliximab) · Rituximab · JAK inhibitors (tofacitinib, baricitinib)

MSK & Rheumatology

Acute gout vs urate-lowering — and the critical TIMING relationship between them (when to start allopurinol, and how to cover it).

Acute: NSAID / colchicine / steroid · Allopurinol · Febuxostat

Haematology

Treatment of iron-deficiency anaemia — oral first-line; IV when oral not tolerated/absorbed. The response check and the black-stools point are exam staples.

Ferrous sulfate / fumarate / gluconate · Ferric carboxymaltose (IV)

Haematology

Replacement for megaloblastic anaemia. The order rule — B12 BEFORE folate — prevents precipitating subacute combined degeneration of the cord.

Hydroxocobalamin (B12) · Folic acid

Haematology

Recombinant growth factors that stimulate red-cell or neutrophil production — renal anaemia and chemotherapy-related cytopenias.

Epoetin / darbepoetin (EPO) · Filgrastim (G-CSF)

Toxicology & Immunosuppression

The poison → antidote pairs — a high-yield, drillable set spanning every system. Includes the supportive principles (activated charcoal, urinary alkalinisation).

Paracetamol → N-acetylcysteine · Opioids → naloxone · Benzodiazepines → flumazenil · Warfarin → vitamin K (± PCC) · Digoxin → digoxin-specific antibody (DigiFab) · Iron → desferrioxamine; lead → dimercaprol/EDTA · Organophosphates → atropine + pralidoxime · Methanol/ethylene glycol → fomepizole (or ethanol) · Beta-blocker/CCB → glucagon / IV calcium / high-dose insulin · Local anaesthetic → IV lipid emulsion; cyanide → hydroxocobalamin · DOAC → andexanet (Xa) / idarucizumab (dabigatran)

Toxicology & Immunosuppression

The transplant/autoimmune immunosuppressants not covered elsewhere — calcineurin inhibitors and mycophenolate. (Azathioprine→GI, methotrexate→MSK, corticosteroids→Endo, biologics→Derm/MSK.)

Tacrolimus · Ciclosporin · Mycophenolate mofetil

Antimicrobials

The β-lactam workhorses — bactericidal cell-wall agents spanning narrow (benzylpenicillin) to very broad (piperacillin-tazobactam). Penicillin allergy and the EBV-amoxicillin rash are core.

Benzylpenicillin / phenoxymethylpenicillin · Amoxicillin · Flucloxacillin · Co-amoxiclav · Piperacillin-tazobactam (Tazocin)

Antimicrobials

Broader β-lactams — cephalosporins by generation (broadening Gram-negative cover) and the very-broad carbapenems (reserve agents). C. diff risk and the neonatal ceftriaxone caution are key.

Cefalexin · Cefuroxime · Ceftriaxone · Ceftazidime · Meropenem

Antimicrobials

The main penicillin-allergy alternative for Gram-positive/atypical cover. QT prolongation and CYP3A4 interactions are the exam points.

Clarithromycin · Azithromycin · Erythromycin

Antimicrobials

Broad-spectrum protein-synthesis inhibitors — chlamydia, atypical pneumonia, acne, and more. Photosensitivity and the pregnancy/child contraindication are core.

Doxycycline · Lymecycline

Antimicrobials

Potent Gram-negative bactericidals — severe sepsis, but nephro/ototoxic, so levels and renal function must be monitored.

Gentamicin · Amikacin

Antimicrobials

Broad oral Gram-negative/atypical cover — but MHRA-restricted because of disabling, sometimes irreversible adverse effects.

Ciprofloxacin · Levofloxacin

Antimicrobials

Gram-positive agents reserved largely for MRSA and severe Gram-positive infection (and oral vancomycin for C. difficile).

Vancomycin · Teicoplanin · Linezolid · Daptomycin

Antimicrobials

The high-yield "miscellaneous" antibacterials — each with a signature niche and warning.

Metronidazole · Nitrofurantoin · Trimethoprim / co-trimoxazole · Clindamycin

Antimicrobials

The four-drug TB regimen — 2 months RIPE then 4 months RI. Each drug has a signature toxicity, and rifampicin is a potent enzyme inducer.

Rifampicin · Isoniazid · Pyrazinamide · Ethambutol

Antimicrobials

Antifungals for candidiasis, dermatophytes and invasive fungal infection. The azole CYP interactions and amphotericin nephrotoxicity are key.

Fluconazole · Nystatin · Amphotericin B · Terbinafine

Antimicrobials

Antivirals for herpes/varicella, influenza and CMV (HIV antiretrovirals are in the Sexual Health section).

Aciclovir / valaciclovir · Oseltamivir · Ganciclovir

Ophthalmology

FIRST-LINE for primary open-angle glaucoma — most effective IOP-lowering eye drop, once daily, works by increasing outflow. The cosmetic side effects are distinctive and examinable.

Latanoprost · Travoprost / bimatoprost

Ophthalmology

Glaucoma eye drops that reduce aqueous production. The catch: they are systemically absorbed, so the systemic β-blocker contraindications (asthma, heart block) still apply.

Timolol · Betaxolol

Ophthalmology

Reduce aqueous production — topical (dorzolamide) for chronic glaucoma, systemic (acetazolamide) for acute angle-closure and other uses.

Dorzolamide / brinzolamide · Acetazolamide

Ophthalmology

Glaucoma drops that both reduce production and increase outflow. Note: brimonidine is an α₂-agonist (a common labelling error is "α₁").

Brimonidine · Apraclonidine

Ophthalmology

Pilocarpine constricts the pupil to open the drainage angle — central to acute angle-closure glaucoma, the ophthalmic emergency. The emergency combination + definitive laser iridotomy are high-yield.

Pilocarpine

Ophthalmology

Drops that dilate the pupil (and paralyse accommodation) — for fundoscopy/examination and to relieve pain/synechiae in anterior uveitis.

Tropicamide · Cyclopentolate · Atropine · Phenylephrine

Ophthalmology

Intravitreal injections that halt neovascularisation — wet (neovascular) age-related macular degeneration and diabetic macular oedema.

Ranibizumab / aflibercept · Bevacizumab

Ophthalmology

The everyday eye drops — conjunctivitis antibiotics, HSV keratitis antivirals, anti-inflammatory steroids (with their cautions), and dry-eye lubricants.

Chloramphenicol drops/ointment · Ganciclovir gel / aciclovir · Prednisolone / dexamethasone drops · Artificial tears (hypromellose, carbomer)

Psychiatry

First-line antidepressants for depression and anxiety. The drug-choice rules (sertraline post-MI, fluoxetine in young people, citalopram QT) and the early-suicidality monitoring are core.

Sertraline · Citalopram / escitalopram · Fluoxetine · Paroxetine

Psychiatry

Serotonin–noradrenaline reuptake inhibitors — second-line for depression and useful in neuropathic pain (duloxetine).

Venlafaxine · Duloxetine

Psychiatry

Older antidepressants — now rarely first-line for depression because of anticholinergic effects and danger in overdose, but used for neuropathic pain, migraine prophylaxis and OCD (clomipramine).

Amitriptyline · Clomipramine · Lofepramine

Psychiatry

A noradrenergic and specific serotonergic antidepressant — its sedation and appetite stimulation make it useful for depression with insomnia or poor appetite.

Psychiatry

Rarely-used antidepressants — the tyramine ("cheese") reaction and the serotonin-syndrome interactions are the exam points.

Phenelzine / tranylcypromine · Moclobemide

Psychiatry

The older "typical" antipsychotics — strong dopamine blockade, so prominent extrapyramidal side effects and hyperprolactinaemia.

Haloperidol · Chlorpromazine · Flupentixol / zuclopenthixol

Psychiatry

The "atypical" antipsychotics — first-line for schizophrenia. Fewer extrapyramidal effects than typicals, but metabolic syndrome is the dominant problem.

Olanzapine · Risperidone · Quetiapine

Psychiatry

The most effective antipsychotic, reserved for treatment-resistant schizophrenia because of agranulocytosis — it requires mandatory blood monitoring.

Psychiatry

The newest class — dopamine partial agonists, which "stabilise" dopamine and so cause the least weight gain, prolactin elevation and sedation.

Aripiprazole · Cariprazine

Psychiatry

First-line mood stabiliser for bipolar — narrow therapeutic index, so levels and organ monitoring are mandatory, and the interaction/toxicity list is heavily examined.

Psychiatry

Short-term anxiety/insomnia drugs — benzodiazepines and Z-drugs (dependence-prone, short-term only), plus the non-sedating options. (SSRIs are first-line for chronic anxiety — see Antidepressants.)

Benzodiazepines (diazepam, lorazepam) · Z-drugs (zopiclone, zolpidem) · Propranolol · Buspirone

Psychiatry

Managing alcohol withdrawal and preventing relapse. The thiamine-before-glucose rule (Wernicke) and the benzodiazepine detox regimen are core.

Chlordiazepoxide (reducing regimen) · Thiamine (Pabrinex) · Acamprosate · Naltrexone · Disulfiram

Psychiatry

Opioid substitution therapy plus the reversal agents. The full- vs partial-agonist distinction is the key point.

Methadone · Buprenorphine · Naloxone · Naltrexone

Psychiatry

Pharmacological smoking-cessation aids — NRT, varenicline and bupropion, alongside behavioural support.

Nicotine replacement (patch + short-acting) · Varenicline · Bupropion