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| PHARM PNEUMONICS Pulmonary infiltrations inducing drugs "Go BAN Me!” Gold Bleomycin/ Busulphan/ BCNU Amiodarone/ Acyclovir/ Azathioprine Nitrofurantoin Melphalan/ Methotrexate/ Methysergide MPTP: mechanism, effect MPTP: Mitochondrial Parkinson's-Type Poison. • A mitochondrial poison that elicits a Parkinson's-type effect. Antimuscarinics: members, action "Inhibits Parasympathetic And Sweat": Ipratropium Pirenzepine Atropine Scopolamine • Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic. Teratogenic drugs: major non-antibiotics TAP CAP: Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin Steroid side effects CUSHINGOID: Cataracts Ulcers Skin: striae, thinning, bruising Hypertension/ Hirsutism/ Hyperglycemia Infections Necrosis, avascular necrosis of the femoral head Glycosuria Osteoporosis, obesity Immunosuppression Diabetes Beta blockers with CYP2D6 polymorphic metabolism "I Met Tim Carver, the metabolic polymorph": • The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism: Metoprolol Timolol Carvedilol (in patients with lower or higher than normal CYP2D6 activity) Beta blockers with intrinsic sympathomimetic activity Picture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels. Pindolol and Carteolol have high and moderate ISA respectively, making them acceptable for use in some diabetics or asthmatics despite the fact that they are non-seletive beta blockers. Muscarinic effects SLUG BAM: Salivation/ Secretions/ Sweating Lacrimation Urination Gastrointestinal upset Bradycardia/ Bronchoconstriction/ Bowel movement Abdominal cramps/ Anorexia Miosis Sulfonamide: major side effects • Sulfonamide side effects: Steven-Johnson syndrome Skin rash Solubility low (causes crystalluria) Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-binders like warfarin) Epilepsy types, drugs of choice: "Military General Attacked Weary Fighters Pronouncing 'Veni Vedi Veci' After Crushing Enemies": • Epilepsy types: Myoclonic Grand mal Atonic West syndrome Focal Petit mal (absence) • Respective drugs: Valproate Valproate Valproate ACTH Carbamazepine Ethosuximide Quinolones [and Fluoroquinolones]: mechanism "Topple the Queen": Quinolone interferes with Topoisomerase II. Beta blockers: B1 selective vs. B1-B2 non-selective A through N: B1 selective: Acebutalol, Atenolol, Esmolol, Metoprolol. O through Z: B1, B2 non-selective: Pindolol, Propanalol, Timolol. Ribavirin: indications RIBAvirin: RSV Influenza B Arenaviruses (Lassa, Bolivian, etc.) Hypertension: treatment ABCD: ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also) Beta blockers Calcium antagonists Diuretics Narcotics: side effects "SCRAM if you see a drug dealer": Synergistic CNS depression with other drugs Constipation Respiratory depression Addiction Miosis Sex hormone drugs: male "Feminine Males Need Testosterone": Fluoxymesterone Methyltestosterone Nandrolone Testosterone Ca++ channel blockers: uses CA++ MASH: Cerebral vasospasm/ CHF Angina Migranes Atrial flutter, fibrillation Supraventricular tachycardia Hypertension • Alternatively: "CHASM": Cererbral vasospasm / CHF Hypertension Angina Suprventricular tachyarrhythmia Migranes Disulfiram-like reaction inducing drugs "PM PMT" as in Pre Medical Test in the PM: Procarbazine Metronidazole Cefo (Perazone, Mandole, Tetan). Delerium-causing drugs ACUTE CHANGE IN MS: Antibiotics (biaxin, penicillin, ciprofloxacin) Cardiac drugs (digoxin, lidocaine) Urinary incontinence drugs (anticholinergics) Theophylline Ethanol Corticosteroids H2 blockers Antiparkinsonian drugs Narcotics (esp. mepridine) Geriatric psychiatric drugs ENT drugs Insomnia drugs NSAIDs (eg indomethacin, naproxin) Muscle relaxants Seizure medicines Morphine: side-effects MORPHINE: Myosis Out of it (sedation) Respiratory depression Pneumonia (aspiration) Hypotension Infrequency (constipation, urinary retention) Nausea Emesis Therapeutic dosage: toxicity values for most commonly monitored medications "The magic 2s": Digitalis (.5-1.5) Toxicity = 2. Lithium (.6-1.2) Toxicity = 2. Theophylline (10-20) Toxicity = 20. Dilantin (10-20) Toxicity = 20. APAP (1-30) Toxicity = 200. Diuretics: thiazides: indications "CHIC to use thiazides": CHF Hypertension Insipidous Calcium calculi Migraine: prophylaxis drugs "Very Volatile Pharmacotherapeutic Agents For Migraine Prophylaxis": Verpamil Valproic acid Pizotifen Amitriptyline Flunarizine Methysergide Propranolol Adrenoceptors: vasomotor function of alpha vs. beta ABCD: Alpha = Constrict. Beta = Dilate. Antiarrhythmics: classification I to IV MBA College • In order of class I to IV: Membrane stabilizers (class I) Beta blockers Action potential widening agents Calcium channel blockers Opiods: mu receptor effects "MD CARES": Miosis Dependency Constipation Analgesics Respiratory depression Euphoria Sedation Cancer drugs: time of action between DNA->mRNA ABCDEF: Alkylating agents Bleomycin Cisplastin Dactinomycin/ Doxorubicin Etoposide Flutamide and other steroids or their antagonists (eg tamoxifen, leuprolide) Busulfan: features ABCDEF: Alkylating agent Bone marrow suppression s/e CML indication Dark skin (hyperpigmentation) s/e Endrocrine insufficiency (adrenal) s/e Fibrosis (pulmonary) s/e Tricyclic antidepressants: members worth knowing "I have to hide, the CIA is after me": Clomipramine Imipramine Amitrptyline • If want the next 3 worth knowing, the DNDis also after me: Desipramine Norrtriptyline Doxepin Torsades de Pointes: drugs causing APACHE: Amiodarone Procainamide Arsenium Cisapride Haloperidol Eritromycin Serotonin syndrome: components Causes HARM: Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus Tetracycline: teratogenicity TEtracycline is a TEratogen that causes staining of TEeth in the newborn. Patent ductus arteriosus: treatment "Come In and Close the door": INdomethacin is used to Close PDA. Physostigmine vs. neostigmine LMNOP: Lipid soluble Miotic Natural Orally absorbed well Physostigmine • Neostigmine, on the contrary, is: Water soluble Used in myesthenia gravis Synthetic Poor oral absorption Beta 1 selective blockers "BEAM ONE up, Scotty": Beta 1 blockers: Esmolol Atenolol Metropolol Antirheumatic agents (disease modifying): members CHAMP: Cyclophosphamide Hydroxycloroquine and choloroquinine Auranofin and other gold compounds Methotrexate Penicillamine Auranofin, aurothioglucose: category and indication Aurum is latin for "gold" (gold's chemical symbol is Au). Generic Aur- drugs (Auranofin, Aurothioglucose) are gold compounds. • If didn't learn yet that gold's indication is rheumatoid arthritis, AUR- Acts Upon Rheumatoid. Antiarrhythmics: class III members BIAS: Bretylium Ibutilide Amiodarone Sotalol MAOIs: indications MAOI'S: Melancholic [classic name for atypical depression] Anxiety Obesity disorders [anorexia, bulemia] Imagined illnesses [hypochondria] Social phobias • Listed in decreasing order of importance. • Note MAOI is inside MelAnchOlIc. SIADH-inducing drugs ABCD: Analgesics: opioids, NSAIDs Barbiturates Cyclophosphamide/ Chlorpromazine/ Carbamazepine Diuretic (thiazide) K+ increasing agents K-BANK: K-sparing diuretic Beta blocker ACEI NSAID K supplement Reserpine action: Reserpine depletes the Reserves of catecholamines [and serotonin]. Succinylcholine: action, use Succinylcholine gets Stuck to Ach receptor, then Sucks ions in through open pore. You Suck stuff in through a mouth-tube, and drug is used for intubation. Beta-blockers: side effects "BBC Loses Viewers In Rochedale": Bradycardia Bronchoconstriction Claudication Lipids Vivid dreams & nightmares -ve Inotropic action Reduced sensitivity to hypoglycaemia |
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