The top 100 drugs listed by indication

We analysed data from hundreds of millions of prescriptions in primary and secondary care to identify the drugs that were prescribed most often. To this list we added a handful of ‘emergency drugs’ which, although less commonly used, are important to know about. We tested the stability of the resulting ‘top 100’ list over the next two years to confirm it did not change significantly. We surveyed 149 foundation doctors who told us that, on average, they prescribed 41 of the top 100 drugs at least every week and another 24 at least every month. More than three-quarters said they rarely prescribed drugs that are not on the list.

We provide information that we hope will inform your understanding of drugs and their practical use, but this is not a prescribing formulary. This is particularly important in relation to cautions and contraindications (which we refer to collectively as ‘warnings’). To reproduce all the points that might need to be considered in practice would be overwhelming and destroy the point of the book. Likewise for drug doses, we will often provide a ‘typical starting dose’ because we think it’s useful for you to have an idea of the kind of doses you will see used in practice. However, it is not our intention that when writing real prescriptions you will look up doses in this book. The key point is this: this book is for learning. When you start making decisions for patients, you will need to consult a formulary (in the UK, the British National Formulary [BNF]). You can practise this now – the knowledge you will acquire from this book will make the BNF more useful and accessible.

Acne

-         Tetracyclines

Acute coronary syndrome

-         Angiotensin-converting enzyme (ACE) inhibitors

-         Aspirin

-         Beta-blockers

-         Clopidogrel

-         Fibrinolytic drugs  

-         Heparins and fondaparinux

-         Nitrates

-         Opioids, strong  

-         Statins

Addison’s disease

-         Corticosteroids (glucocorticoids), systemic

Adrenal insufficiency

-         Corticosteroids (glucocorticoids), systemic

Agitation, psychomotor

-         Antiemetics, phenothiazines

-         Antipsychotics, first-generation (typical)

-         Antipsychotics, second-generation (atypical)

Alcohol withdrawal

-         Benzodiazepines

Allergy

-         Antihistamines (H1-receptor antagonists)

-         Corticosteroids (glucocorticoids), systemic

Anaemia

-          Iron

-         Vitamins

Anaphylaxis

-         Adrenaline (epinephrine)

-         Antihistamines (H1-receptor antagonists)

-         Corticosteroids (glucocorticoids), systemic

Angina

-         Beta-blockers

-         Calcium channel blockers

-         Nicorandil

-         Nitrates

Anxiety

-         Antidepressants, selective serotonin reuptake inhibitors

-         Antidepressants, venlafaxine and mirtazepine

-         Benzodiazepines  

-         Gabapentin and pregabalin

Ascites

-         Aldosterone antagonists

-         Diuretics, loop

-         Colloids (plasma substitutes)

Asthma

-         Antimuscarinics,

-         - bronchodilators

-         Beta2-agonists

-         Compound (β2-agonist–corticosteroid) inhalers

-         Corticosteroids (glucocorticoids), inhaled

Atrial fibrillation and flutter

-         Amiodarone

-         Aspirin

-         Beta-blockers

-         Calcium channel blockers

-         Clopidogrel

-         Digoxin

-         Warfarin

Autoimmune disease

-         Aminosalicylates

-         Corticosteroids (glucocorticoids), systemic

-         Methotrexate

Benign prostatic hyperplasia

-         Alpha-blockers

-         5α-reductase inhibitors

Bipolar disorder

-         Antipsychotics, first-generation (typical)

-         Antipsychotics, second-generation (atypical)

-         Carbamazepine

-         Valproate

Bone metastases

-         Bisphosphonates

Bowel preparation

-         Laxatives, osmotic

Bradycardia

-         Antimuscarinics, cardiovascular and gastrointestinal uses

Breathlessness

-         Diuretics, loop

-         Opioids, strong

Carbon monoxide poisoning

-         Oxygen

Cardiac arrest

-         Adrenaline (epinephrine)

-         Amiodarone

Chemotherapy

-         Allopurinol

-         Corticosteroids (glucocorticoids), systemic

-         Methotrexate

-         Antiemetics, serotonin 5-HT3-receptor antagonists

Childhood immunisations

-         Vaccines

Chronic kidney disease

-         Angiotensin receptor blockers

-         Angiotensin-converting enzyme (ACE) inhibitors

-         Calcium and vitamin D

Chronic obstructive pulmonary disease

-         Antimuscarinics, bronchodilators

-         Beta2-agonists

-         Compound (β2-agonist–corticosteroid) inhalers

-         Corticosteroids (glucocorticoids), inhaled

Circulatory compromise

-         Colloids (plasma substitutes)

-         Compound sodium lactate (Hartmann’s solution)

-         Sodium chloride

Clostridium difficile colitis

-         Metronidazole

-         Vancomycin

Constipation

-         Laxatives, bulk-forming

-         Laxatives, osmotic

-         Laxatives, stimulant

Contrastnephropathy

-         Acetylcysteine (N-acetylcysteine)

Contraception, hormonal

-         Oestrogens and progestogens

Deep vein thrombosis

-         Heparins and fondaparinux

-         Warfarin

Dental infection

-         Metronidazole

Depression

-         Antidepressants, selective serotonin reuptake inhibitors

-         Antidepressants, tricyclics and related drugs

-         Antidepressants, venlafaxine and mirtazepine

Diabetes mellitus

-         Insulin

-         Metformin

-         Sulphonylureas

-         Thiazolidinediones

Diabetic ketoacidosis

-         Insulin

Diabetic nephropathy

-         Angiotensin receptor blockers

-         Angiotensin-converting enzyme (ACE) inhibitors

Diarrhoea

-         Antimotility drugs

-         Laxatives, bulk-forming

Dry eyes

-         Ocular lubricants (artificial tears)

Dry skin

-         Emollients

Dyspepsia

-         Alginates and antacids

-         H2-receptor antagonists

-         Proton pump inhibitors

Eczema

-         Corticosteroids (glucocorticoids), topical

-         Emollients

Endocarditis

-         Aminoglycosides

-         Penicillins

-         Penicillins, penicillinase-resistant

-         Vancomycin

-         Epilepsy, absence seizures

-         Valproate

Epilepsy, focal

-         Carbamazepine

-         Gabapentin and pregabalin

-         Phenytoin

-         Valproate

Epilepsy, generalised

-         Phenytoin

-         Valproate

Epilepsy, status epilepticus

-         Benzodiazepines

-         Phenytoin

Erectile dysfunction

-         Phosphodiesterase (type 5) inhibitors

Faecal impaction Laxatives, bulk-forming

-         Laxatives, osmotic

-         Laxatives, stimulant

Fever

-         Aspirin

-         Paracetamol

Fluid and electrolyte therapy

-         Colloids (plasma substitutes)

-         Compound sodium lactate (Hartmann’s solution)

-         Glucose (dextrose)

-         Potassium, intravenous

-         Potassium, oral

-         Sodium chloride

Gastro-oesophageal reflux disease

-         Alginates and antacids

-         H2-receptor antagonists

-         Proton pump inhibitors

Generalised anxiety disorder

-         Antidepressants, venlafaxine and mirtazepine

-         Gabapentin and pregabalin

Glaucoma, open-angle

-         Prostaglandin analogue eye drops

Gout

-         Allopurinol

-         Non-steroidal anti-inflammatory drugs 8

Hay fever (seasonal allergic rhinitis)

-         Antihistamines (H1-receptor antagonists)

Heart failure

-         Aldosterone antagonists

-         Angiotensin receptor blockers

-         Angiotensin-converting enzyme (ACE) inhibitors

-         Beta-blockers

-         Digoxin

-         Diuretics, loop

Heart valve replacement

-         Warfarin

Helicobacter pylori eradication

-         Macrolides

-         Penicillins, broad-spectrum

-         Proton pump inhibitors

Hepatic encephalopathy

-         Laxatives, osmotic

Hormonal contraception

-         Oestrogens and progestogens

Hormone replacement therapy

-         Oestrogens and progestogens

Hyperaldosteronism

-         Aldosterone antagonists

Hypercalcaemia of malignancy

-         Bisphosphonates

Hyperglycaemic hyperosmolar syndrome

-         Insulin

Hyperkalaemia

-         Beta2-agonists

-         Calcium and vitamin D

-         Glucose (dextrose)

-         Insulin

Hyperlipidaemia

-         Statins

Hypertension

-         Alpha-blockers

-         Angiotensin receptor blockers

-         Angiotensin-converting enzyme (ACE) inhibitors

-         Beta-blockers

-         Calcium channel blockers

-         Diuretics, thiazide and thiazide-like

Hyperuricaemia

-         Allopurinol

Hypocalcaemia

-         Calcium and vitamin D

Hypoglycaemia

-         Glucose (dextrose)

Hypokalaemia

-         Diuretics, potassium-sparing

-         Potassium, intravenous

-         Potassium, oral

Hypopituitarism

-         Corticosteroids (glucocorticoids), systemic

-         Thyroid hormones

Hypothyroidism

-         Thyroid hormones

Hypoxaemia

-         Oxygen

Incontinence, urinary

-         Antimuscarinics, genitourinary uses

Infection, complicated

-         Cephalosporins and carbapenems

-         Penicillins, antipseudomonal

Infection, fungal

-         Antifungal drugs

Infection, protozoal

-         Metronidazole

Inflammation

-         Corticosteroids (glucocorticoids), systemic

-         Corticosteroids (glucocorticoids), inhaled

-         Corticosteroids (glucocorticoids), topical

-         Non-steroidal anti-inflammatory drugs

Insomnia

-         Benzodiazepines

-         Z-drugs

Irritable bowel syndrome

-         Antimuscarinics, cardiovascular and

-         gastrointestinal uses

Ischaemic heart disease

-         Angiotensin receptor blockers

-         Angiotensin-converting enzyme (ACE) inhibitors

-         Aspirin

-         Beta-blockers

-         Clopidogrel

-         Fibrinolytic drugs

-         Statins

Keratoconjunctivitis sicca

-         Ocular lubricants (artificial tears)

Korsakoff’s psychosis

-         Vitamins

Leg cramps

-         Quinine

Local anaesthesia

-         Adrenaline (epinephrine)

-         Lidocaine

Lyme disease

-         Tetracyclines

Malaria

-         Quinine

Meningitis

-         Cephalosporins and carbapenems

-         Penicillins

Migraine

-         Gabapentin and pregabalin

Mucosal bleeding

-         Adrenaline (epinephrine)

Myocardial erfusion scan

-         Dipyridamole

Nausea and vomiting

-         Antiemetics, dopamine D2-receptor antagonists

-         Antiemetics, histamine H1-receptor antagonists

-         Antiemetics, phenothiazines

-         Antiemetics, serotonin 5-HT3-receptor antagonists

-         Antipsychotics, first-generation (typical)

Neural tube defects, prevention of

-         Vitamins

Obsessive compulsive disorder

-         Antidepressants, selective serotonin reuptake nhibitors

Ocular hypertension

-         Prostaglandin analogue eye drops

Oedema

-         Diuretics, loop

Opioid toxicity

-         Naloxone

Osteomyelitis

-         Penicillins, penicillinase-resistant

-         Vancomycin

Osteoporosis

-         Bisphosphonates

-         Calcium and vitamin D

Overdose

-         Acetylcysteine (N-acetylcysteine)

-         Activated charcoal

Paget’s disease

-         Bisphosphonates

Pain

-         Aspirin

-         Non-steroidal anti-inflammatory drugs

-         Opioids, compound preparations

-         Opioids, strong

-         Opioids, weak

-         Paracetamol

Pain, neuropathic

-         Antidepressants, tricyclics and related drugs

-         Gabapentin and pregabalin

Panic disorders

-         Antidepressants, selective serotonin reuptake inhibitors

Paracentesis

-         Colloids (plasma substitutes)

Parkinsonism, secondary

-         Dopaminergic drugs for Parkinson’s disease

Parkinson’s disease

-         Dopaminergic drugs for Parkinson’s disease

Peptic ulcer disease

-         H2-receptor antagonists

-         Proton pump inhibitors

Peripheral arterial disease

-         Aspirin

-         Clopidogrel

Pneumonia

-         Cephalosporins and carbapenems

-         Macrolides

-         Metronidazole

-         Penicillins

-         Penicillins, antipseudomonal

-         Penicillins, broad-spectrum

-         Quinolones

-         Tetracyclines

Pneumonia, pneumocystis

-         Trimethoprim (as co-trimoxazole) 206

Pneumothorax

-         Oxygen

Poisoning

-         Acetylcysteine (N-acetylcysteine)

-         Activated charcoal

-         Benzodiazepines

-         Naloxone

-         Oxygen

-         Vitamins

Pruritus

-         Antihistamines (H1-receptor antagonists)

Psoriasis

-         Emollients

-         Methotrexate

Psychomotor gitation

-         Antiemetics, phenothiazines

-         Antipsychotics, first-generation (typical)

-         Antipsychotics, second-generation (atypical)

Pulmonary ypertension

-         Phosphodiesterase (type 5) inhibitors

Pulmonary oedema

-         Diuretics, loop

-         Nitrates

-         Opioids, strong

Pyelonephritis

-         Aminoglycosides

Reconstitution and dilution of drugs

-         Glucose (dextrose)

-         Sodium chloride

Respiratory ecretions

-         Acetylcysteine (N-acetylcysteine)

-         Antimuscarinics, cardiovascular and

-         gastrointestinal uses

Rheumatoid arthritis

-         Aminosalicylates

-         Methotrexate

Schizophrenia

-         Antipsychotics, first-generation (typical)

-         Antipsychotics, second-generation (atypical)

Sedation

-         Benzodiazepines

Sepsis

-         Aminoglycosides

-         Cephalosporins and carbapenems

-         Penicillins

-         Penicillins, antipseudomonal

-         Vancomycin

Sepsis, intra-abdominal

-         Aminoglycosides

-         Metronidazole

-         Penicillins, antipseudomonal

-         Penicillins, broad-spectrum

Septic arthritis

-         Penicillins, penicillinase-resistant

Shock

-         Colloids (plasma substitutes)

-         Compound sodium lactate (Hartmann’s solution)

-         Sodium chloride

Pulmonary embolus

-         Fibrinolytic drugs

-         Heparins and fondaparinux

-         Warfarin

Skin and soft tissue infection

-         Macrolides

-         Penicillins

-         Penicillins, antipseudomonal

-         Penicillins, penicillinase-resistant

Sjögren’s syndrome

-         Ocular lubricants (artificial tears)

Smoking cessation

-         Nicotine replacement and related drugs

Stroke

-         Aspirin

-         Clopidogrel

-         Dipyridamole

-         Fibrinolytic drugs

Subacute combined degeneration of the cord

-         Vitamins

Supraventricular tachycardia

-         Adenosine

-         Amiodarone

-         Beta-blockers

-         Calcium-channel blockers

Tetanus

-         Penicillins

Thiamine deficiency

-         Vitamins

Tonsillitis

-         Penicillins

Trigeminal neuralgia

-         Carbamazepine

Tumour lysis syndrome

-         Allopurinol

Ulcerative colitis

-         Aminosalicylates

Urinary catheterisation

-         Lidocaine

Urinary tract infection

-         Cephalosporins and carbapenems

-         Nitrofurantoin

-         Penicillins, antipseudomonal

-         Penicillins, broad-spectrum

-         Quinolones

-         Trimethoprim

Urticaria

-         Antihistamines (H1-receptor antagonists)

Vaccination

-         Vaccines

Venousthromboembolism, prophylaxis

-         Heparins and fondaparinux

Venous thromboembolism, treatment

-         Fibrinolytic drugs

-         Heparins and fondaparinux

-         Warfarin

Ventricular fibrillation

-         Adrenaline (epinephrine)

-         Amiodarone

-         Lidocaine

Ventricular tachycardia

-         Adrenaline (epinephrine)

-         Amiodarone

-         Lidocaine

Vitamin D deficiency

-         Calcium and vitamin D

Vitamin K deficiency bleeding

-         Vitamins

Warfarin, reversal of

-         Vitamins

Wernicke’s encephalopathy

-         Vitamins

·       THE TOP 100 DRUGS

        Clinical pharmacology and

       practical prescribing

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