Clinical Pharmacology

Therapeutics and
Prescribing

MBBS Student Formulary

2014-15 Edition

MBBS STUDENT FORMULARY 2014-15

This formulary has been produced to assist your learning of clinical pharmacology and
therapeutics to provide learning objectives that are realistic and attainable. It has
been developed in consultation with all course directors and lists the drugs of which
you should have acquired core knowledge by the end of your undergraduate training.
The formulary has the same structure as the British National Formulary, with drugs
appearing in the same section and in the same order. The order in which drugs appear
does not necessarily indicate the order of preference of use.
We emphasise that the formulary is a minimum knowledge base. You should not
restrict your reading and learning to these drugs alone, particularly if you encounter
other drug therapy in patients you see. It is acknowledged that different drugs within
the same class may be used in different hospitals.

Clinical Pharmacology, Therapeutics and Prescribing Learning

Outcomes
Phase I outcomes
Essential drugs (shown in CAPITALS in the formulary) and important drugs (shown in
LOWERCASE in the formulary)

Describe the mechanism of action and clinical use of [the drug/class of drug]

Describe any major pharmacokinetic characteristics which affect the clinical use
of [the drug/class of drug]

Describe the major side effects of [the drug]

Phase II outcomes
Essential drugs (shown in CAPITALS in the formulary)

Explain the appropriate route, frequency and duration of administration (drug

doses are not expected to be memorised) of [the drug]

Identify all clinically relevant contraindications, interactions and adverse drug

reactions of [the drug]

Explain how to monitor the effects of [the drug]

Explain the salient features of [the drug] to the patient

Important drugs (shown in LOWERCASE in the formulary)

Define the class of [the drug]

Explain the mechanism of action of [the drug]

Describe common indications for use of [the drug]

Identify the most important or serious contraindications, interactions and

adverse drug reactions of [the drug]

Some drugs are used under specialist supervision only and are highlighted in ITALICS.
They are included because they may demonstrate a novel mechanism of action or may
have important adverse reactions or interactions that you should be aware of and be
able to recognise.
A student who achieves these targets should be able to cope effectively and safely
with most of the prescribing challenges that they will face in their early postgraduate
years whether in hospital or in general practice.

BNF Section 1
1.1
1.2

1.3
1.4
1.5

1.6

Drugs Acting on the Gastro-Intestinal System

Antimuscarinic

MAIN DRUGS
Aluminium hydroxide
Hyoscine butylbromide

Smooth muscle relaxant

Mebeverine

Motility Stimulant
H2-receptor Antagonists

Metoclopramide
RANITIDINE

Proton Pump Inhibitors

Antimotility Drugs
Aminosalicylates

OMEPRAZOLE
Loperamide
Mesalazine

Cytokine modulators
Bulk-forming drugs
Stimulant Laxatives

Infliximab
ISPAGHULA HUSK
SENNA

Sodium docusate

Osmotic Laxatives

Lactulose

Macrogols

Antacids

Antispasmodics and other drugs

altering gut motility

Ulcer healing drugs

Anti-diarrhoeal Drugs
Treatment of Chronic Diarrhoea/
Inflammatory Bowel Disease
Laxatives

ALTERNATIVES

LANSOPRAZOLE

BNF Section 2
2.1
2.2

Drugs used in the Treatment of Disease of the Cardiovascular System

Positive Inotropic Drugs

Diuretics

2.3

Anti-arrhythmic Drugs

2.4

Beta-adrenoreceptor blocking drugs

2.5

Antihypertensive Therapy

2.6

Nitrates and other Vasodilators, and

Calcium Channel Blocking drugs

Cardiac glycosides
Thiazides
Loop diuretics
Potassium sparing diuretics
Aldosterone Antagonist
Drugs for arrhythmias

Alpha-adrenoceptor antagonists
ACE inhibitors
Angiotensin II antagonists
Centrally acting antihypertensives
Nitrates
Calcium Channel Blockers

2.7

Sympathomimetics

2.8

Anticoagulants

Potassium channel activator

Vasoconstrictor Sympathomimetics
Cardiopulmonary resuscitation
Parenteral Anticoagulants
Oral anticoagulants

MAIN DRUGS
DIGOXIN
BENDROFLUMETHIAZIDE
FUROSEMIDE
Amiloride
SPIRONOLACTONE
ATROPINE
ADENOSINE
AMIODARONE
Flecainide
BISOPROLOL
Doxazosin
LISINOPRIL
Losartan
Methyldopa
GLYCERYL TRINITRATE
ISOSORBIDE MONONITRATE
AMLODIPINE
Diltiazem
Verapamil
Nicorandil
Norepinephrine
EPINEPHRINE
Heparin (unfractionated)
ENOXAPARIN
WARFARIN

ALTERNATIVES

Atenolol
Propranolol
RAMIPRIL

NIFEDIPINE

Tinzaparin

2.9

Antiplatelet Drugs

2.10
2.11

Fibrinolytic Drugs
Antifibrinolytic drugs and
Haemostatics

2.12

Lipid-regulating drugs

Blood-related products

Dabigatran
ASPIRIN
CLOPIDOGREL
ALTEPLASE (rt-PA)
Dried Prothrombin Complex

HMG-CoA Reductase Inhibitors

Absorption inhibitors
Fibrates

Factor VIII fraction

Fresh Frozen Plasma
SIMVASTATIN
Ezetimibe
Bezafibrate

ATORVASTATIN

BNF Section 3
3.1

Drugs Acting on the Respiratory System

Bronchodilators

3.3

Inhaled Corticosteroids

3.3
3.4

Cromoglicate and related therapy

Antihistamines, hyposensitisation
and allergic emergencies

Selective 2 Adrenoreceptor
Stimulants
Antimuscarinic Bronchodilators

Oxygen

3.7

Mucolytics

ALTERNATIVES

IPATROPIUM BROMIDE
Tiotropium

Xanthines

Theophylline

Aminophylline

Inhaler Devices and Nebulisers

Metered Dose Inhaler

Dry Powder Device
Breath Activated Device
Spacer Device
Nebuliser
BECLOMETASONE
Fluticasone
Montelukast
CETIRIZINE

CHLORPHENAMINE

Leukotriene receptor antagonist

Antihistamines
Allergic Emergencies

3.6

MAIN DRUGS
SALBUTAMOL
Salmeterol

EPINEPHRINE
Hydrocortisone
OXYGEN
Oxygen concentrator
Carbocisteine

BNF Section 4

Drugs Acting on the Central Nervous System

4.1

Hypnotics and Anxiolytics

4.2

Drugs used in Psychoses and

Antipsychotic drugs

Related Disorders

Antimanic drugs
4.3

Antidepressant Drugs

Tricyclic and related antidepressant

drugs
Monoamine oxidase inhibitors
Selective serotonin reuptake inhibitors

Other antidepressant drugs

4.6

4.7

Drugs used in Nausea and Vertigo

Analgesics

Antihistamines
Phenothiazines and related drugs
5-HT3 receptor antagonists
Non-opioid analgesics and compound
analgesic preparations

MAIN DRUGS
DIAZEPAM
Lorazepam
Zopcilone
HALOPERIDOL
(oral, im, depot)
OLANZAPINE
Risperidone
Quetiapine
Clozapine
LITHIUM
Valproic acid
AMITRIPTYLINE
Phenelzine
FLUOXETINE
Sertraline
Citalopram
Mirtazapine
Venlafaxine
CYCLIZINE
PROCHLORPERAZINE
METOCLOPRAMIDE
Ondansetron
ASPIRIN
PARACETAMOL
NAPROXEN

ALTERNATIVES
TEMAZEPAM
CHLORDIAZEPOXIDE
Aripiprazole
Amisulpiride

Lamotrigine
Trazodone

DOMPERIDONE

IBUPROFEN
Diclofenac

Opioid Analgesics

4.8

Antiepileptics (anticonvulsants)

Neuropathic pain
Antimigraine drugs
Control of the epilepsies

Drugs used in status epilepticus

4.9

Drugs used in Parkinsonism and

related disorders

4.10

Drugs used in Substance Dependence

4.11

Drugs for dementia

Dopaminergic drugs

Antimuscarinics
Nicotine dependence

Opioid dependence

CODEINE
MORPHINE
Tramadol
Gabapentin
Sumatriptan
CARBAMAZEPINE
PHENYTOIN
SODIUM VALPROATE
Lamotrigine
DIAZEPAM
PHENYTOIN
CO-CARELDOPA
Bromocriptine
Selegiline
Entacapone
Apomorphine
Procyclidine
NICOTINE

Methadone
Donepezil
Rivastigmine
Galantamine
Memantine

DIAMORPHINE
Amitriptyline

LORAZEPAM

BNF Section 5

Drugs used in the Treatment of Infections

MAIN DRUGS

5.1

Antibacterial drugs

Penicillins

Cephalosporins, cephamycins
and other
Carbapenems
Tetracyclines
Aminoglycosides
Macrolides
Sulfonamides and trimethoprim
Anti-tuberculosis drugs

Metronidazole and tinidazole

Quinolones
Other antibacterials

5.2

Antifungal Drugs

Triazole antifungals
Other antifungals

ALTERNATIVES

BENZYLPENICILLIN
AMOXICILLIN
FLUCLOXACILLIN
Co-amoxiclav
Piperacillin with tazobactam
Cefalexin
Cefotaxime
Meropenem
Doxycycline
Gentamicin
CLARITHROMYCIN
TRIMETHOPRIM
Co-trimoxazole
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
METRONIDAZOLE
Ciprofloxacin
Nitrofurantoin
Clindamycin
Vancomycin
Fluconazole
NYSTATIN

ERYTHROMYCIN

5.3

5.4

Antiviral drugs

Antiprotozoal Drugs

HIV infection

Efavirenz
Tenofovir
Darunavir

Herpes virus infections

Aciclovir

Antimalarials

Quinine
Chloroquine

5.5

Anthelmintics

Drugs for threadworms

Piperazine

BNF Section 6 Drugs Used in the Treatment of Disorders of the Endocrine System
6.1

Drugs used in Diabetes

Insulins

Sulphonylureas
Biguanides
Other antidiabetics
Treatment of Hypoglycaemia
6.2

Thyroid & Antithyroid Drugs

6.3

Corticosteroids

6.4

Sex Hormones

6.5

Hypothalamic and Pituitary

Hormones and Anti-oestrogens

MAIN DRUGS
INSULIN (soluble)
INSULIN (Isophane)
Insulin Aspart
Insulin Glargine
GLICLAZIDE
METFORMIN
Pioglitazone

Progestogens
Male Sex Hormones
Anti-oestrogens

GLUCOSE 20%
Glucagon
LEVOTHYROXINE
Carbimazole
Fludrocortisone
PREDNISOLONE
HYDROCORTISONE
CONJUGATED
OESTROGENS
NORETHISTERONE
Testosterone
Clomifene citrate

Anterior pituitary hormones

Tetracosactide

Thyroid Hormones
Antithyroid drugs
Replacement therapy
Glucocorticoid therapy
Oestrogens and HRT

Somatropin
(recombinant human

ALTERNATIVES

growth hormone)
6.6

Drugs Affecting Bone Metabolism

Posterior pituitary hormones

Desmopressin

Bisphosphonates

Alendronic acid

BNF Section 7 Drugs used in Obstetrics, Gynaecology and Urinary Tract Disorders
7.1

7.2

Drugs used in Obstetrics

Treatment of Vaginal and Vulval

Conditions

Prostaglandins and oxytocics

Anti-progestogen
Topical Oestrogens
Fungal infections

7.3

Contraceptives

Combined Oral Contraceptives

Progesterone-Only Contraceptives

Intra-Uterine Devices

7.4

Drugs for Genito-urinary Disorders

Drugs for Urine retention - alphablockers

Drugs used for Urinary Frequency,
Enuresis and Incontinence
Drugs for erectile dysfunction

MAIN GENERIC DRUGS

Dinoprostone
Ergometrine
Oxytocin
Mifepristone
Conjugated oestrogens
Clotrimazole (cream,
pessaries)
ETHINYLOESTRADIOL/
LEVONORGESTREL
DESOGESTREL
Medroxyprogesterone
Acetate (depot)
Intrauterine progestogenonly system
Copper device
Tamsulosin

BRANDED DRUG*
e.g Prostin E2
e.g Syntometrine
e.g Syntocinon

e.g Microgynon
e.g Cerazette
e.g Depo-Provera

e.g Mirena

Oxybutynin
Sildenafil

*An example of a commonly used brand is provided in this section only as you may encounter these drugs being
prescribed by brand in your clinical attachment.

BNF Section 8 Drugs used in the treatment of Malignant Disease and Immunosuppression
8.1

8.2

8.3

Cytotoxic drugs

Drugs Affecting the Immune

Response

Sex hormones and hormone

antagonists in malignant disease

Alkylating Agents
Anthracyclines
Antimetabolites
Vinca Alkaloids and Etoposide

MAIN DRUGS
Cyclophosphamide
Doxorubicin
METHOTREXATE
Vincristine

Platinum compounds
Protein kinase inhibitors
Anti-proliferative
immunosupressants
Corticosteroids and other
immunosuppressants
Hormone Antagonists

Cisplatin
Imatinib
Azathioprine

Gonadorelin analogues
Anti-androgens

Leuroprelin
Flutamide

PREDNISOLONE
Ciclosporin
Tamoxifen

BNF Section 9 Drugs Affecting Nutrition and Blood

9.1

9.2

Anaemias and some other blood

disorders

Fluids and Electrolytes

Iron deficiency anaemia

Drugs used in Megaloblastic
Anaemias
Drugs used in Hypoplastic,
haemolytic and Renal Anaemias
Oral Potassium
Intravenous administration
Plasma and plasma substitutes

9.5

Minerals

9.6

Vitamins

Calcium supplements
Magnesium
Vitamin B group
Vitamin D
Vitamin K

MAIN DRUGS
FERROUS SULPHATE
FOLIC ACID
HYDROXOCOBALAMIN
Epoietins
POTASSIUM CHLORIDE
SODIUM CHLORIDE
GLUCOSE
Albumin
Calcium salts
Magnesium sulfate
THIAMINE
Alfacalcidol
Colecalciferol
PHYTOMENADIONE

BNF Section 10 Drugs used in the Treatment of Musculoskeletal and Joint Disease
10.1

Drugs used in Rheumatic Diseases

and Gout

Non-steroidal anti-inflammatory
drugs (NSAIDs)
Corticosteroids

Drugs affecting the immune

response
Cytokine modulators

10.2

Drugs used in Neuromuscular

Disorders

Gout and cytotoxic-induced

hyperuricaemia
Drugs that enhance neuromuscular
transmission
Skeletal Muscle Relaxants

MAIN DRUGS
NAPROXEN
Celecoxib
PREDNISOLONE
Methylprednisolone
(intra-articular injection)
METHOTREXATE
Azathioprine
ETANERCEPT
ALLOPURINOL
Pyridostigmine
DIAZEPAM
Baclofen

ALTERNATIVES
IBUPROFEN
Diclofenac

BNF Section 11
11.3
11.4

Drugs Acting on the Eye

11.5

Topical Anti-Infective Preparations Antibacterials

Corticosteroids and other antiCorticosteroids
inflammatory preparations
Mydriatics and cycloplegics
Antimuscarinics

11.6

Treatment of Glaucoma

11.8

Miscellaneous Ophthalmic
Preparations

Beta-blockers
Prostagladin analogues and
prostamides
Carbonic anhydrase inhibitors and
systemic drugs
Miotics
Tear Deficiency,ocular lubricants
and astringents
Ocular diagnostic preparations

MAIN DRUGS
CHLORAMPHENICOL
PREDNISOLONE
Tropicamide
Atropine
Timolol
Latanoprost
Dorzolamide
Pilocarpine
Hypromellose
Fluorescein sodium

ALTERNATIVES
BETAMETHASONE

BNF Section 12 Drugs used in the treatment of the Ear Nose and Oropharynx
12.1

Drugs Acting in the Ear

Otitis externa

12.2

Drugs Acting on the Nose

Drugs used in Nasal Allergy

12.3

Drugs Acting on the

Oropharynx

Drugs for oral ulceration and

inflammation

MAIN DRUGS
ALTERNATIVES
BETAMETASONE ear drops
Gentamicin ear drops
Gentamicin and
hydrocortisone ear drops
BECLOMETASONE nasal
spray
Benzydamine
hydrochloride

Oropharyngeal anti-infective drugs

NYSTATIN

BNF Section 13
13.2
13.4
13.5

Drugs Acting on the Skin

Emollients and barrier

preparations
Topical Corticosteroids

Emollient bath and shower

preparations

Preparations for Eczema and

Psoriasis

Topical preparations for Psoriasis

Drugs affecting immune response

13.6

Acne and Rosacea

Topical preparations for acne

Oral preparations for acne

13.10

Anti-infective skin preparations

Antibacterial preparations
Antifungal preparations
Antiviral preparations
Parasiticidal preparations

MAIN DRUGS
Aqueous cream
Epaderm
BETAMETHASONE
HYDROCORTISONE
Coal Tar
Dithranol
Calcipotriol
Methotrexate
Azathioprine
Ciclosporin
Etanercept
Benzoyl peroxide
Oxytetracycline
Isotretinoin
Mupirocin
Clotrimazole
Aciclovir
Permethrin

ALTERNATIVES

BNF Section 14
14.4

Vaccine and antisera

Immunological Products and Vaccines

Routine UK immunisation schedule

Vaccines in high-risk groups

14.5

Immunoglobulins

Diptheria, Tetanus,
Pertussis (Acellular
component), Poliomyelitis
(Inactivated) and
Haemophilus Influenza
type b Vaccine (Hib)
Measles Mumps &
Rubella, Live (MMR)
Vaccine
Meningococcal Group C
conjugate Vaccine
Pneumococcal
Polysaccharide conjugate
vaccine
Human Papilloma Virus
(HPV) vaccine
Rotavirus vaccine
BCG vaccine
Hepatitis A Vaccine
Hepatitis B Vaccine
Influenza Vaccine
Shingles vaccine
Anti-D(Rho)
Immunoglobulin

BNF Section 15
15.1

General Anaesthesia

Drugs used in Anaesthesia

Intravenous anaesthetics
Inhalation anaesthetics
Anti-muscarinic drugs
Neuromuscular blocking drugs
Antagonists for central and
respiratory depression

15.2

Local Anaesthesia

MAIN DRUGS
Propofol
Thiopental sodium
Isoflurane
Nitrous oxide
ATROPINE
Atracurium
Suxamethonium
Flumazenil
NALOXONE
LIDOCAINE

Emergency Treatment of Poisoning

Removal and Elimination
Agents used in Poisoning due to
Specific Drugs

Prevention of absorption
Paracetamol

MAIN DRUGS
ACTIVATED CHARCOAL
ACETYLCYSTEINE

Opioid
Iron

NALOXONE
Desferrioxamine

Organophosphates

ATROPINE
Pralidoxime

Acknowledgements:
Formulary originally devised by Prof Simon Thomas and Dr Ruben Thanacoody, Institute of Cellular Medicine, Newcastle University. Edited by
Dr Guilding and Dr Ball, School of Medical Education.