…inhibits the funny current (If) that drives spontaneous depolarisation of the sinus node and does nothing else. It therefore works only in sinus rhythm: in…

…gated calcium channels The same mechanism as pregabalin — binding to the α2δ subunit of voltage-gated calcium channels — but with a critical difference in kinetics:…

…cornerstone of cardiac arrest treatment. The most clinically dangerous property is not pharmacological but practical: two concentrations with a tenfold difference are used in the…

…Inhibits the Na⁺/Cl⁻ cotransporter in the distal tubule and is the most commonly used thiazide diuretic for hypertension. The key point is that the…

…80 % of absorbed drug is eliminated renally, so renal function governs treatment entirely. Dyspepsia affects one in ten patients and is the most common reason…

…The workhorse anticoagulant in hospital practice: subcutaneous dosing once daily, predictable effect, and no need for routine monitoring, allowing home administration. The difference between the…

…intravenous use The active metabolite of enalapril, given directly intravenously. Rarely used in hypertensive crisis: onset is slow, duration 8–24 hours, and the effect…

…With a half-life of 9 minutes and the effect gone 20–30 minutes after the infusion ends, it is useful in patients where beta…

…beta effects, with onset within minutes and duration under one hour — theoretically attractive in hypertensive crisis with renal involvement, but without documented hard-endpoint benefit.

…making the timing of administration a genuine treatment variable and not a formality. The most clinically important adverse effect is delayed: cholestatic liver injury can…

…Inhibits the Na⁺/K⁺/2Cl⁻ transporter in the loop of Henle. The dose–response relationship is a threshold curve, not a line: below the threshold…

…osteoporosis and the best-documented fracture-preventing treatment in primary care. Efficacy for vertebral and hip fractures is well established, but depends on the patient…

…Teva Highly selective β₁-blocker The most β₁-selective of the routinely used beta-blockers, with documented mortality benefit in heart failure from CIBIS-II…

…substitution in central diabetes insipidus, symptom relief in nocturia and nocturnal enuresis, and haemostatic release of von Willebrand factor and factor VIII. Selectivity for the…

…and intravenous diltiazem require a named-patient licence. Verapamil or a beta-blocker is therefore the practical first choice for rate control in this setting.

…doses — good in the cold, hypoperfused patient with an acceptable blood pressure, less so when blood pressure is already low. The dose threshold lies around…

…It is the standard choice in pneumonia in penicillin-allergic patients and in atypical pneumonia, but the age limit of 8 years and pregnancy significantly…

…at 20 mg for adults and 10 mg for patients over 65 years. In the elderly, hyponatraemia is the adverse effect most often causing discontinuation.

…The drug has two entirely different dosing worlds: a few milligrams in acute psychotic agitation in younger patients, and tenths of a milligram in delirium…

…A short half-life of around 2 hours means the effect arrives and resolves quickly, which is an advantage: the drug suits as-needed use…

…in diabetic ketoacidosis and hyperosmolar hyperglycaemic state. Subcutaneously it has an onset within 10–20 minutes and a duration of 3–5 hours; intravenously the…

…of nocturnal hypoglycaemia than NPH insulin. It is titrated against fasting glucose and nothing else — the morning fasting value drives the evening dose. Available in…

…and the bronchodilation makes it valuable in life-threatening asthma. Respiratory drive and laryngeal reflexes are largely preserved, which is an explanation but never a…

…beta-lactam antibiotic The first-choice oral penicillin for the most common respiratory and skin infections in outpatient care, and one of the reasons Sweden…

…gout, with the goal of titrating upward until serum urate is stably below 360 μmol/l — not setting a fixed dose and leaving it…

…steroid dose without an injection, and the long biological duration means a single dose suffices. Potency is approximately 25 times that of hydrocortisone and mineralocorticoid…

Forxiga Xigduo Qtern SGLT2 inhibitor An SGLT2 inhibitor whose clinical importance extends well beyond the diabetes indication. DAPA-HF demonstrated reduced cardiovascular death and worsening…

…a single dose in seizures it is fast and reliable — high lipid solubility gives onset within a couple of minutes intravenously, and the rectal solution…

…is the underlying aetiology: long-acting insulin and in particular sulphonylurea require follow-up infusion and hours of monitoring, whereas a missed meal in a…

…in the bleeding-prone patient, and when surgery or thrombolysis may become necessary at short notice. The disadvantages are continuous infusion, an unpredictable dose–response…

…making the drug unsuitable as first-line treatment in hypertensive crisis — but useful in pre-eclampsia and as afterload relief in combination with a nitrate…

…activator that dissolves fresh thrombus and is the standard thrombolytic for ischaemic stroke and haemodynamically significant pulmonary embolism. The dosing regimens differ entirely between indications…

…and the easiest calcium channel blocker to use: once-daily dosing, a half-life of almost two days, and no dose adjustment in renal impairment…

…which is the entire explanation for why the drug is ineffective in infranodal block. The effect comes within one minute and fades over an hour…

…and the foundation of the narrow-spectrum antibiotic tradition. Pneumococci, streptococci, and most oral anaerobes remain sensitive, and the resistance situation is favourable compared to…

…Turbuhaler Bufomix Easyhaler DuoResp Spiromax Inhaled corticosteroid in fixed combination with long-acting β₂-agonist Formoterol is the only long-acting β₂-agonist with onset…

…The ARB that together with valsartan has documented mortality benefit in heart failure (CHARM), and the first choice when an ACE inhibitor must be switched…

…bacterial meningitis and severe sepsis of unknown origin. The price is ecological: cephalosporins are one of the strongest drivers of Clostridioides difficile and ESBL-producing…

…in blood and tissue — the half-life is 5 minutes and the effect can be steered minute by minute. Selective for smooth muscle in the…

…Reduces mortality in heart failure with reduced ejection fraction — the effect is dose-dependent, and underdosing is more often than adverse effects the reason for…

…atrial arrhythmias in structurally normal hearts. The CAST trial showed increased mortality after myocardial infarction — that boundary remains the most important fact in the drug…

…glycogenolysis. In beta-blocker intoxication, glucagon is instead an inotrope that bypasses the blocked beta receptor, and the doses are five to ten times higher…

…Alkindi Nature-identical glucocorticoid with mineralocorticoid effect Endogenous cortisol in pharmaceutical form and accordingly the first choice when the intention is substitution rather than immunosuppression…

…eliminating thromboxane synthesis in platelets for their entire lifespan. This is why a low once-daily dose is sufficient, and why the effect persists for…

…atrial tachycardia are unmasked when the ventricular response is slowed. The half-life of a few seconds means both the effect and side effects are…

…sodium-channel-mediated modulation, not on antidepressant action. What limits treatment is anticholinergic side effects, and what makes the drug dangerous is cardiotoxicity in overdose.

…dosing and no routine monitoring. Lower risk of intracranial haemorrhage than warfarin — but the short half-life means a missed dose has consequences within hours.

…beta-agonists, and dialysis must be started in parallel, otherwise the arrhythmia risk returns when the calcium effect wanes after half an hour. Calcium gluconate…

…entirely free of sedation: a distinct minority of patients become drowsy, and this should be asked about in professional drivers. Renal function governs the dose…

…but with the most unfavourable cardiovascular profile in the class — the increase in risk for myocardial infarction, stroke, and heart failure resembles that of selective…

…AV-node slowing. Rate control fails under adrenergic stress — making it a poor choice for the active patient and a reasonable one for the bedridden.

…events regardless of ejection fraction in EMPEROR-Reduced and EMPEROR-Preserved, and slowed renal function decline down to eGFR 20 in EMPA-KIDNEY. The glucose…

…fixed dose of 10 mg, no titration, essentially no interactions, and an adverse effect profile barely distinguishable from placebo. IMPROVE-IT showed that the additional…

…effects of verapamil and diltiazem — no bradycardia, no AV block, and no clinically significant negative inotropy, making it combinable with beta-blockers. The price of…

…in practice it never lets go. The effect is immediate and complete: unbound dabigatran in plasma falls by over 99 per cent directly after the…

…but not pressure. Used where rate itself is the problem: bradycardia while awaiting pacing, bradycardia-dependent torsades de pointes, and electrical storm in Brugada syndrome.

…indicates the starting point, not the magnitude of the deficit. Rate, not daily dose, is what determines safety: peripherally 10 mmol per hour, in a…