Drugs of choice are categorized on the basis of diseases. The following are the most important classes of drugs used as a first choice in the treatment of different diseases.
DISEASES | DRUGS OF CHOICE |
Pregnancy | (1) Chloroquine is the drug of choice for malaria in pregnancy. |
Infections | (8) Penicillin G is the drug of choice in Septicemia, Meningitis, Pericarditis, Endocarditis and Severe pneumonia. |
Seizures | (19) Valproate is the drug of choice for Tonic seizures, Absence seizures, Grand mal (GTCS) |
Poisoning | (26) Physostigmine is the DOC of Atropine, Belladonna & Dhatura poisoning. (27) Atropine is the drug of chocie for Carbamate, Early mushroom poisoning, and Organophosphate poisoning. (28) Flumazenil is the first choice drug for Benzodiazepine poisoning. (29) Acetylcysteineis the antidote for Acetaminophen poisoning. (30) Naloxone is antidote for Opioid poisoning. (31) Deferiprone work great against Chronic iron poisoning. (32) Desferrioxamine is the DOC for Acute iron poisoning. (33) Glucagon is the DOC for Beta-blockers poisoning. (34) Amyl nitrate is first choice drug for Cyanide poisoning. |
Asthma | (35) Salbutamol is the drug of choice fo an acute attack of bronchial asthma in normal patients and pregnant women. It is also the first choice medicine for Exercise & Aspirin-induced acute attack of bronchial asthma. (36) Ipratropium is a great for an acute attack of bronchial asthma during labor. It is also a DOC for an acute attack of bronchial asthma on beta-blocker therapy. (37) Corticosteroids is the drug of choice for prophylaxis of bronchial asthma, Exercise-induced, and Aspirin-induced asthma. |
Antimicrobial Prophylaxis | (38) Ampicillin is the drug of choice for Group B streptococcus infection (39) Amoxicillin is first line drug for Endocarditis and Otitis media. (40) Azithromycin is the first choice drug for Mycobacterium avium complex (MAC) Pertussis (41) Benzathine penicillin is best for Rheumatic fever (42) Procaine Penicillin is the DOC for Gonorrhea and syphilis (43) Tetracycline is the first line drug for Rickettsial infection and plague. (44) Cefazoline is the first choice drug for Surgical Prophylaxis (45) Doxycycline is best for Anthrax (46) Trimethoprim and sulphamethoxazole is the drug of choice for Toxoplasmosis, and Pneumocystis service UTI. (47) Rifampicin is the DOC for Hemophilus influenza type B. (48) Oseltamivir is first line treatment for Influenza Type A & B. |
Anesthetic Drugs | (49) Propofol for Daycare |
Endocrine Disorders | (56) Insulin is the drug of choice for Type 1 DM, Diabetes Mellitus in pregnancy, Diabetic Ketoacidosis and Uncontrolled DM. |
Fungal Infections | (66) Amphotericin B is the drug of choice in Meningeal histoplasmosis, Endocarditis by candida, Sever or CNS blastomycosis |
Gastroinstestinal Disorders | (71) PPIs (Proton Pump Inhibitors) are the drugs of choice for Gastric ulcer, Duodenal ulcer, stress ulcer, NSAIDs-induced ulcer, GERD, & Zollinger Ellison syndrome. (72) Metoclopramide is the number one drug for a migraine-associated or drug or disease-associated vomiting (73) Domperidone is the best choice drug for Levodopa-induced vomiting (74) Ondansetron is the drug of choice for Postoperative or radiation-induced vomiting (75) 5HT3 antagonist is used in Cisplatin-induced early vomiting. (76) Lactulose is the first line therapy for Hepatic encephalopathy. (77) Methylnaltrexone is used for Opioid-induced constipation. (78) Octreotide is the DOC for Diarrhea in carcinoid syndrome. |
Hematological Disorders | (79) Warfarin is used for DVT prophylaxis, Chronic atrial fibrillation in mitral stenosis, Advanced kidney disease, and mechanical prosthetic heart valves (80) Heparin+Warfarin is used for Initiation of therapy in DVT. (81) Vitamin K is used for Warfarin overdose (82) Protamine is used as an antidote for Heparin overdose |
Hypertension | (83) Thiazide diuretics are the first line drugs for Hypertension |
Shock | (91) Adrenaline is the number one medicine for Anaphylactic shock. (92) Dopamine or noradrenaline is the DOC for Cardiogenic shock. (93) Phenylephrine is the first line therapy for Distributive shock. (94) Prazosin is used in the Secondary shock. (95) Dopamine is used as drug of choice for Shock with oliguria. (96) Corticosteroids is the DOC for Shock due to adrenal insufficiency. |
Viral Diseases | (97) Ribavirin is used for Viral hemorrhagic fever, Measles, Respiratory syncytial virus(in high-risk patient. (98) Zanamivir is most commonly used drug for Oseltamivir-resistant influenza, Seasonal influenza and avian influenza (bird flu). (99) Acyclovir is the drug of choice for Herpes simplex and varicella and Acute herpes zoster. (100) Gancyclovir is used for Cytomegalovirus retinitis. |
Drugs Of Choice List in pregnancy
(1)Chloroquine [1]
- Drug of choice for malaria in pregnancy
(2) Alpha-Methyldopa
- DoC for hypertension in pregnancy
(3) Heparin
- For anticoagulation in pregnancy
(4) Labetalol
- For the hypertensive crisis in pregnant women.
(5) Acetaminophen
- Analgesic DOC
(6) Phenobarbitone
- For epilepsy in pregnant women.
(7) Doxylamine & Pyridoxine
- For nausea in pregnancy
Drugs Of Choice List in infections
(8) Penicillin G
Drug of choice in
- Septicemia,
- Meningitis,
- Pericarditis,
- Endocarditis and
- Severe pneumonia.
(9) Ampicillin
Drug of choice in
- Listeria,
- Enterococcus faecalis.
(10) Vancomycin
Drug of choice for
- MRSA,
- Coagulase-negative Staphylococcus,
- Enterococcus faecium.
(11) Erythromycin
Drug of choice for
- Corynebacterium
(12) Doxycycline
- Bacillus anthracis,
- Borrelia burgdorferi, B.Recurrentis.
- Chalmydia & Rickettsiae.
(13) Cotrimoxazole
Drug of choice in
- Nocardia
(14) Azithromycin
Drug of choice in
- Hemophilus ducreyi &
- Mycoplasma.
(15) Ceftriaxone
Drug of choice for
- Proteus,
- E.coli,
- Salmonella
Drug of choice for
- Urinary Tract Infection.
- You can also use nitrofurantoin or oral cephalosporins, or fosfomycin. [2]
(17) Metronidazole:
It is an imidazole that is used for the treatment of antibacterial and antiprotozoal infections, including bacterial vaginosis and antibiotic-associated colitis.
Drug of choice for
- Trichomonas vaginalis. [3]
- Bacteriocides.
(18) Ceftazidime
DOC for
- Burkholderia pseudomallei
Related Article
Drugs Of Choice List for various types of seizures
(19) Valproate
Drug of choice for
- Tonic seizures
- Absence seizures
- Grand mal (GTCS)
- Clonic seizures
- Atonic seizures
- Myoclonic seizures [4]
(20) Carbamazepine
- Partial seizures
(21) Vigabatrin
- Infantile spasm with tuberous sclerosis
(22) ACTH
- Infantile spasm
(23) Lorazepam (IV)
- Status epilepticus
(24) Diazepam
- Febrile seizures
(25) Magnesium Sulphate
- Seizure in eclampsia
Drugs Of Choice List in poisoning
(26) Physostigmine
- Atropine,
- Belladonna &
- Dhatura poisoning
(27) Atropine
- Carbamate,
- Early mushroom poisoning,
- Organophosphate poisoning.
(28) Flumazenil
- Benzodiazepine poisoning
(29) Acetylcysteine
- Acetaminophen poisoning
(30) Naloxone
- Opioid poisoning
(31) Deferiprone
- Chronic iron poisoning
(32) Desferrioxamine
- Acute iron poisoning
(33) Glucagon
- Beta-blockers poisoning
(34) Amyl nitrate
- Cyanide poisoning
Drugs Of Choice List in bronchial asthma
(35) Salbutamol
Salbutamol is the drug of choice for
- An acute attack of bronchial asthma in normal patients and pregnant women.
- Exercise & Aspirin-induced acute attack of bronchial asthma.
(36) Ipratropium
- An acute attack of bronchial asthma during labor.
- An acute attack of bronchial asthma on beta-blocker therapy.
(37) Corticosteroids
- Prophylaxis of bronchial asthma,
- Exercise-induced, and
- Aspirin-induced asthma.
Drugs Of Choice List In Antimicrobials Prophylaxis
(38) Ampicillin
- Group B streptococcus infection
(39) Amoxicillin
- Endocarditis and Otitis media
(40) Azithromycin
- Mycobacterium avium complex (MAC) Pertussis
(41) Benzathine penicillin
- Rheumatic fever
(42) Procaine Penicillin
- Gonorrhea and syphilis
(43) Tetracycline
- Rickettsial infection and plague.
(44) Cefazoline
- Surgical Prophylaxis
(45) Doxycycline
- Anthrax
(46) Trimethoprim and sulphamethoxazole
- Toxoplasmosis,
- Pneumocystis service UTI
(47) Rifampicin
- Hemophilus influenza type B.
(48) Oseltamivir
- Influenza Type A & B.
Anesthetic Drugs Of Choice List
(49) Propofol
- Daycare
(50) Sevoflurane
- Congenital heart disease,
- ASD,VSD,PDA
(51) Etomidate
- Ischemic heart disease
(52) Ketamine
- Asthma and COPD
- Shock
- CHF, and
- congenital heart disease (Right to left shunt)
(53) Thiopentone
- Epilepsy
- Thyrotoxicosis
(54) Methohexitone
- Electroconvulsive therapy
(55) Isoflurane
- Cardiac surgery
- Neurosurgery
- For producing deliberate hypotension
Drugs Of Choice List in Endocrinological Disorders
(56) Insulin
- Type 1 DM
- Diabetes Mellitus in pregnancy.
- Diabetic Ketoacidosis.
- Uncontrolled DM.
(57) Metformin
- Type 2 DM
- Diabetes mellitus in obesity
(58) Sildenafil
- Erectile Dysfunction
(59) Hydrocortisone
- Acute and chronic adrenal insufficiency.
(60) Nateglinide
- Postprandial hyperglycemia.
(61) Methotrexate
- Ectopic pregnancy
(62) Oxytocin
- Postpartum hemorrhage
- Induction of labor
(63) Cabergoline
- Acromegaly
- Hyperprolactinemia.
(64) Finasteride
- Anogenital alopecia.
(65) Alendronate
- Osteoporosis
Drugs of choice in fungal infections
(66) Amphotericin B
Amphotericin B is the drug of choice in
- Meningeal histoplasmosis
- Endocarditis by candida
- Sever or CNS blastomycosis
- Induction cryptococcal meningitis(For 2 weeks)
- Exserohium
(67) Fluconazole
- Candida albicans
- Maintainance in cryptococcal meningitis
(68) Itraconazole
- Nonmeningeal histoplasmosis
- Sporotrichosis
- Para Coccidioidomycosis
- Mild or non-CNS blastomycosis
- Chromoblastomycosis
- Penicillium mameffei
(69) Prednisolone+itraconazole/Voriconazole
- Allergic bronchopulmonary aspergillosis.
(70) Caspofungin
- Candida glabrate, and
- Candida krusei.
Drugs of choice in gastrointestinal disorders
(71) PPIs (Proton Pump Inhibitors)
- Gastric ulcer,
- Duodenal ulcer,
- stress ulcer,
- NSAIDs-induced ulcer.
- GERD,& Zollinger Ellison syndrome.
(72) Metoclopramide
- A migraine-associated or drug or disease-associated vomiting
(73) Domperidone
- Levodopa-induced vomiting
(74) Ondansetron
- Postoperative or radiation-induced vomiting
(75) 5HT3 antagonist
- Cisplatin-induced early vomiting
(76) Lactulose
- Hepatic encephalopathy
(77) Methylnaltrexone
- Opioid-induced constipation
(78) Octreotide
- Diarrhea in carcinoid syndrome
Drugs of choice in Hematological Disorders
(79) Warfarin
- DVT prophylaxis
- Chronic atrial fibrillation in mitral stenosis,
- Advanced kidney disease, and
- mechanical prosthetic heart valves
(80) Heparin+Warfarin
- Initiation of therapy in DVT.
(81) Vitamin K
- Warfarin overdose
(82) Protamine
- Heparin overdose
Drugs of Choice in Hypertension
(83) Thiazide diuretics
- Hypertension
(84) Prazosin
- Hypertension With BPH
(85) Beta-Blockers
- Hypertension with ischemic heart disease. (Angina)
(86) ACE inhibitors
- Hypertension with chronic kidney diseases.
(87) Alpha methylDopa
- Hypertension in pregnancy
(88) Phentolamine
- Hypertensive emergencies with cheese reaction
(89) Nitroprusside + Esmolol
- Hypertensive emergencies in aortic dissection.
(90) Labetalol
- Hypertensive emergencies in pregnancy.
Drugs of choice in shock
(91) Adrenaline
- Anaphylactic shock
(92) Dopamine or noradrenaline
- Cardiogenic shock
(93) Phenylephrine
- Distributive shock
(94) Prazosin
- Secondary shock
(95) Dopamine
- Shock with oliguria
(96) Corticosteroids
- Shock due to adrenal insufficiency
Drugs of choice For viral diseases
(97) Ribavirin
- Viral hemorrhagic fever
- Measles
- Respiratory syncytial virus(in high-risk patient
(98) Zanamivir
- Oseltamivir-resistant influenza
- Oseltamivir
- Seasonal influenza and avian influenza (bird flu)
(99) Acyclovir
- Herpes simplex and varicella.
- Valacyclovir
- Acute herpes zoster.
(100) Gancyclovir
- Cytomegalovirus retinitis.
References
- Pregnancy outcome following first trimester exposure to chloroquine [Cited 11/29/2020] [Available: https://pubmed.ncbi.nlm.nih.gov/2029276/#:~:text=Although%20the%20use%20of%20chloroquine,during%20pregnancy%20has%20been%20controversial.]
- THE CHOICE OF ANTIBACTERIAL DRUGS. [Cited 11/29/2020] [Available https://journals.lww.com/infectdis/fulltext/2001/12000/the_choice_of_antibacterial_drugs.21.aspx
- Metronidazole. [Cited 11/29/2020] [Available https://www.sciencedirect.com/topics/neuroscience/metronidazole]
- Valproate Efficacy in Absence Seizures Is Hard to Beat: Lamotrigine Comes Close [Cited 11/29/2020] [Available https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176308/]
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Great topic
Excellent thank you so much for this Informations
Thanks so much
Thanks for your efforts but a lot of therapeutic areas you mentioned have now more preferable drugs than what you mentioned.
Phenobarbitol is Antiepileptic DOC in pregnancy?
Isn’t the DOC is lamotrignine or laveteracetam?