Amiodarone: action, side effects 6 P's: Prolongs action potential duration Photosensitivity Pigmentation of skin Peripheral neuropathy Pulmonary alveolitis and fibrosis Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism hypothyroidism
Beta blockers: members "The NEPAL Prime Minister": Timolol Nadolol Esmolol Pindolol Atenolol Labetalol Propranolol Metoprolol
Ca++ channel blockers: uses CA++ MASH: Cerebral vasospasm/ CHF Angina Migranes Atrial flutter, fibrillation Supraventricular Supraventricular tachycardia Hypertension · Alternatively: "CHASM":
Cererbral vasospasm / CHF Hypertension Angina Suprventricular tachyarrhythmia Migranes
Beta-blockers: nonselective beta-blockers "Tim Pinches His Nasal Problem" (because he has a runny nose...): Timolol Pindolol Hismolol Naldolol Propranolol
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
Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on factor Xa. Monitor Xa concentration, rather than APTT anti hyprtensive safe for pregnancy are--My N.H.L ---
Quote:
M-methyl dopa.. N-nifedipine... H-hydralazine.. L-labetalol. methyldopa Quote:
M = mental retardation E = electrolyte imbalance T = tolerance H = headache/ hepatotoxicity, rebound HTN Y = psYchological upset D = dry mouth, drowsiness O = oedema, orthostatic hypotension P = Parkinsonism A = Anemia [+ve coomb's test] sodium nitroprusside clinical uses: MR. CHIEF SURGERY IN EMERGENCY Quote:
Mr. = Acute MI chief = Acute CHF Surgery = maintain hemostasis during surgeries emergency = hypertensive emergencies antihypertensives used in emergencies............. Saurav Ganguly HELP Quote:
S-sodium nitroprusside G-GTN H-hydralazine E-esmolol L-labetalol P-phentolamine Anticholinergic side effects "Know the ABCD'S of anticholinergic side effects":
Quote:
Anorexia Blurry vision Constipation/ Confusion Dry Mouth Sedation/ Stasis of urine Antimuscarinics: members, action "Inhibits Parasympathetic And Sweat": Quote:
Ipratropium Pirenzepine Atropine Scopolamine _Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic. Aspirin: side effects ASPIRIN: Quote:
Asthma Salicyalism Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDA Intestinal blood loss Reye's syndrome Idiosyncracy Noise (tinnitus) Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Quote:
Lorazepam Oxazepam Temazepam Benzodiazepenes: antidote
Quote:
"Ben is off with the flu": Benzodiazepine effects off with Flumazenil. Benzodiazepenes: drugs which decrease their metabolism "I'm Overly Calm": Quote:
Isoniazid Oral contraceptive pills Cimetidine _ These drugs increase calming effect of BZDs by retarding metabolism. Benzodiazepines: actions "Ben SCAMs Pam into seduction not by brain but by muscle": Quote:
Sedation anti-Convulsant anti-Anxiety Muscle relaxant Not by brain: No antipsychotic activity. Beta selective blockers "BEAM ONE up, Scotty": Quote:
Beta blockers: Esmolol Atenolol Metropolol
Botulism toxin: action, related bungarotoxin Quote:
Action: "Botulism Bottles up the Ach so it can't be the released": Related bungarotoxin: "Botulism is related to Beta Bungarotoxin (beta-, not alphabungarotoxin--alpha has different mechanism).
Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": or SLUDGE
Quote:
Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction
Delerium-causing drugs ACUTE CHANGE IN MS: Quote:
Antibiotics (biaxin, penicillin, ciprofloxacin) Cardiac drugs (digoxin, lidocaine) Urinary incontinence drugs (anticholinergics) Theophylline Ethanol Corticosteroids H blockers Antiparkinsonian drugs Narcotics (esp. mepridine) Geriatric psychiatric drugs ENT drugs Insomnia drugs NSAIDs (eg indomethacin, naproxin) Muscle relaxants Seizure medicines Direct sympathomimetic catecholamines DINED: Quote:
Dopamine Isoproterenol Norepinephrine Epinephrine Dobutamine Inhalation anesthetics SHINE:
Quote:
Sevoflurane Halothane Isoflurane Nitrous oxide Enflurane _ If want the defunct Methoxyflurane too, make it MoonSHINE. Ipratropium: action Atropine is buried in the middle: iprAtropium, so it behaves like Atropine.
Lead poisoning: presentation ABCDEFG: Quote:
Anemia Basophilic stripping Colicky pain Diarrhea Encephalopathy Foot drop Gum (lead line) Lithium: side effects LITH: Quote:
Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism MAOIs: indications MAOI'S: Quote:
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.
Methyldopa: side effects METHYLDOPA: Quote:
Mental retardation Electrolyte imbalance Tolerance Headache/ Hepatotoxicity psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic) Monoamine oxidase inhibitors: members "PIT of despair": Quote:
Phenelzine Isocarboxazid Tranylcypromine _ A pit of despair, since MAOs treat depression. Morphine: effects MORPHINES: Quote:
Miosis Orthostatic hypotension Respiratory depression Pain supression Histamine release/ Hormonal alterations Increased ICT Nausea Euphoria Sedation Morphine: effects at mu receptor PEAR: Quote:
Physical dependence Euphoria
Analgesia Respiratory depression Narcotic antagonists Quote:
The Narcotic Antagonists are NAloxone and NAltrexone. _ Important clinically to treat narcotic overdose. Parkinsonism: drugs SALAD: Quote:
Selegiline Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine) L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide) Amantadine Dopamine postsynaptic receptor agonists (bromocriptine, lisuride, pergolide)
Phenytoin: adverse effects PHENYTOIN: Quote:
P- interactions Hirsutism Enlarged gums Nystagmus Yellow-browning of skin Teratogenicity Osteomalacia Interference with B metabolism (hence anemia) Neuropathies: vertigo, ataxia, headache Physostigmine vs. neostigmine LMNOP: Quote:
Lipid soluble Miotic Natural Orally absorbed well Physostigmine _ Neostigmine, on the contrary, is: Water soluble
Used in myesthenia gravis Synthetic Poor oral absorption Pupils in overdose: morphine vs. amphetamine "MorPHINE: Fine. AmPHETamine: Fat": Quote:
Morphine overdose: pupils constricted (fine). Amphetamine overdose: pupils dilated (fat). Serotonin syndrome: components Causes HARM: Quote:
Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus Sodium valproate: side effects VALPROATE: Quote:
Vomiting Alopecia Liver toxicity Pancreatitis/ Pancytopenia Retention of fats (weight gain) Oedema (peripheral oedema) Appetite increase Tremor Enzyme inducer (liver) Succinylcholine: action, use Quote:
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. Tricyclic antidepressants: members worth knowing "I have to hide, the CIA is after me": Quote:
Clomipramine Imipramine
Amitrptyline _ If want the next worth knowing, the DNDis also after me: Desipramine Norrtriptyline Doxepin Tricyclic antidipressents (TCA): side effects TCA'S: Quote:
ThrombocytopeniaCardiac (arrhymia, MI, stroke) Anticholinergic (tachycardia, urinary retention, etc) Seizures Vigabatrin: mechanism Vi-GABA-Tr-In: Quote:
Via GABA Transferase Inhibition Antibiotics contraindicated during pregnancy MCAT: Quote:
Metronidazole Chloramphenicol Aminoglycoside Tetracycline Busulfan: features ABCDEF: Quote:
Alkylating agent Bone marrow suppression s/e CML indication Dark skin (hyperpigmentation) s/e Endrocrine insufficiency (adrenal) s/e Fibrosis (pulmonary) s/e Metabolism enzyme inducers "Randy's Black Car Goes Putt Putt and Smokes": Quote:
Rifampin Barbiturates Carbamazepine
Grisoefulvin Phenytoin Phenobarb Smoking cigarettes Morphine: side-effects MORPHINE: Quote:
Myosis Out of it (sedation) Respiratory depression Pneumonia (aspiration) Hypotension Infrequency (constipation, urinary retention) Nausea Emesis Therapeutic index: formula TILE: Code: TI = LD / ED
Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount": Quote:
Phenytoin Ethanol Aspirin Zero order _ Someone that pees out a constant amount describes zero order kin etics (always the same amount out) Asthma drugs: leukotriene inhibitor action Quote:
zAfirlukast: Antagonist of lipoxygenase zIlueton: Inhibitor of LT receptor Beta- vs Beta- receptor location "You have heart and lungs": Quote:
Beta- are therefore primarily on heart.
Beta- primarily on lungs. Hepatic necrosis: drugs causing focal to massive necrosis "Very Angry Hepatocytes": Quote:
Valproic acid Acetaminophen Halothane Adrenoceptors: vasomotor function of alpha vs. beta ABCD: Quote:
Alpha = Constrict. Beta = Dilate.
Beta blockers with intrinsic sympathomimetic activity Quote:
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. Beta-blockers: main contraindications, cautions ABCDE: Quote:
Asthma Block (heart block) COPD Diabetes mellitus Electrolyte (hyperkalemia) Beta-blockers: nonselective beta-blockers "Tim Pinches His Nasal Problem" (because he has a runny nose...): Quote:
Timolol Pindolol Hismolol Naldolol Propranolol
PREANASTHETIC MEDICATION HOSANA this is a christian word. Quote:
H-H2blockers O-opeoids S-sedatives-antianxiety A-anticholenergic N-neuroleptics A-antiemetics simple and sobar anti epeleptic drugs Dr.BHAISAB's New PC. Quote:
D...deoxy barbiturates B...barbiturates H....hydantoin A.. aliphatic carb acids I....iminostilbenes S....succinimides B....BZD's N.... newer drugs P....Phenyltriazines C... cyclic gaba analogues adverse effects of tetracyclins-KAPIL DEV Quote:
K kidney toxicity A antianabolic effect P phototoxicity I inc ICP L liver toxicity D diabetes insipidus E enamel problems V vestibular toxicity
GENERAL TOXICITY OF ANTICANCER DRUGS SHaLi's BF Ghoghari Gautam is Chor. Quote:
S-skin H-hyperurecemia L-lymphoreticular tissue B-bone marrow F-Foetus G-gonads G-git C-carcinogenecity 6 H s and 8 H s of adverse effects of thaizide diuretics and loop diuretics respectively..... 'melbourne cricket authority has high funds though players get minor amount' .. for clinical uses of beta blockers... Drugs causing pulmonary fibrosis: Quote:
BAB like in baba (father) Bleomycin Amiodarone Busulfan ADRS OF CHLORAMPHENICOL smart boys in girls hostel B.... bone marrow depression H...hypersensitivity I....irritative effects S.....superinfections G.....Gray baby syndrome ampicillin uses UR GMCS BeST Quote:
UTI Respi
Gonorrhoea Maningitis cholecystitis septicemias bacillary dysentry sabe typhoid misch Acyclovir “I see clover” I see a three-leaf clover (this is a prodrug that gets converted into a triphosphate – it resembles dNTP and inhibits DNA Polymerase). Imagine putting clovers over herpes sores and genital warts (this is used to treat those). Amantadine “Homan to Dean” In case you haven’t heard, Dr. Homan is our new SOM dean. His new policy: he won’t let us come to school without our white coats (this drug blocks uncoating, stage 2, in viral infection). Other interesting facts about him: he can pee for 12 hours straight! (The half-life is 12h and it’s excreted unchanged in the kidney .) Dr. Homan can’t take the pressure of being a new dean so he becomes a nervous drunk with depression, feelings of detachment, insomnia, dizziness, ataxia, slurred speech, and inability to concentrate (these are some of the adverse effects) Cephachlor “Chlorine” – as in swimming pools You swim and get water up your nose and in your ears (this drug treats sinusitis and OTITIS media). Cephadroxil “Drop rocks” While you are peeing you drop rocks (This drug treats UTIs). Cephalothin “…Loathing” If your heart is infected, you can’t love, only loathe (this is used to treat severe infections such as endocarditis). Cephamandole “…Man doll” You have to inflate your man doll and you get an upper respiratory infection. If you “use” this anatomically correct man doll, he will give you pelvic inflammatory disease (This drug is indicated for URI and PID). He’s also so real that
he bleeds!!! (Adverse effect: It affects Vit-K dependent clotting function) Cephazolin “…Soul in” You want to keep your soul in and not die if you go to surgery (this drug is used prophylactically for surgery). Cephoperazone “…Opera zone” Going to the opera makes me want to get drunk to the point of illness. These drugs, when mixed with ethanol interfere with ALDH, affecting alcohol metabolism (you end up with increased acetaldehyde – a DISULFIRAM-LIKE REACTION). Also, if you see Phantom of the Opera, expect to see some blood! (This affects Vit-K dependent clotting function.) Cephotaxime “…Tax time” IRS is hard to kill off – they are MULTIPLE DRUG RESISTANT (Use this drug against MDR strains.). Clindamycin “Clean the mice” You’re cleaning the mice because they are covered with ticks (this drug is used to treat Lyme Disease). You have to use SOS kitchen cleaner to clean the mice (SOS = 50 S ribosomal unit – where this drug acts). Richard Gere likes to put mice in “where the sun don’t shine” and this is a very FRAGILE procedure (Clindamycin may cause Pseudomembranous enterocolitis and it’s also used to treat B. fragilis infections). Fluconazole “Flu cone” Imagine an emaciated AIDS patient eating an ice cream cone made of the flu and he gets an oral and esophageal fungal infection. (This is used to treat oral and esophageal candidiasis in AIDS patients). Foscarnet “Fox cARRR net” If you catch foxes in a net, they won’t reproduce (this drug is a stage 3 inhibitor). ARRR… it inhibits RNA polymerase and Reverse transcriptase to block Reproduction. You’re going to put the foxes into a car that’s made out of bones instead of metal (this drug binds to bones and decreases Ca2+ and Mg2+). Also, a foxy lady is HOT (this drug will cause a fever) and never wear fox urine to hunt (this is excreted in the kidney and causes renal insufficiency). inhalational corticosteroids
Bed Bug Flew To Florida Quote:
B-BECLOMETHASONE DIPROPIONATE B-BUDESONIDE F-FLUTICASONE PROPIONATE T-TRIAMCINALONE F-FLUNISOLIDE Succinylcholine: action, use Quote:
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 Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": Quote:
Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction Steroids: side effects BECLOMETHASONE: Quote:
Buffalo hump Easy bruising Cataracts Larger appetite Obesity Moonface Euphoria Thin arms & legs Hypertension/ Hyperglycaemia Avascular necrosis of femoral head Skin thinning Osteoporosis
Negative nitrogen balance Emotional liability Methyldopa: side effects METHYLDOPA: Quote:
Mental retardation Electrolyte imbalance Tolerance Headache/ Hepatotoxicity psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic) Sodium valproate: side effects VALPROATE: Quote:
Vomiting Alopecia Liver toxicity Pancreatitis/ Pancytopenia Retention of fats (weight gain) Oedema (peripheral oedema) Appetite increase Tremor Enzyme inducer (liver) Captopril (an ACE inhibitor): side effects CAPTOPRIL: Quote:
Cough Angioedema/ Agranulocystosis Proteinuria/ Potassium excess Taste changes Orthostatic hypotension Pregnancy contraindication/ Pancreatitis/ Pressure drop (first dose hypertension) Renal failure (and renal artery stenosis contraindication)/ Rash Indomethacin inhibition Leukopenia/ Liver toxicity
Lithium: side effects LITH: Quote:
Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism Opioids: effects BAD AMERICANS: Quote:
Bradycardia & hypotension Anorexia Diminished pupilary size Analgesics Miosis Euphoria Respiratory depression Increased smooth muscle activity (biliary tract constriction) Constipation Ameliorate cough reflex Nausea and vomiting Sedations
Ca++ channel blockers: uses CA++ MASH: Quote: Cerebral vasospasm/ CHF Angina Migranes Atrial flutter, fibrillation Supraventricular tachycardia Hypertension
· Alternatively: "CHASM": Quote: Cererbral vasospasm / CHF Hypertension Angina Suprventricular tachyarrhythmia Migranes
Pupils in overdose: morphine vs. amphetamine MorPHINE: Fine. AmPHETamine: Fat "Morphine overdose: pupils constricted (fine) Amphetamine overdose: pupils dilated (fat)
Phenobarbitone side effects Children are annoying (hyperkinesia, irritability, insomnia, aggression) Adults are dosy (sedation, dizziness, d rowsiness
Atropine: origin tells action or vice versa Atropine causes your pupils to dilate, and it came from nightshade [belladona]In the night or in shade, your pupils dilate so you can see
Atropine use: tachycardia or bradycardia "A goes with B": Atropine used clinically to treat Bradycardia
Reserpine action Reserpine depletes the Reserves of catecholamines [and serotonin] Sodium channel blockade: Procainamide, Quinidine, Disopyramide "Quaker Preachers Discussed Sobriety." Quaker-Quinidine Preachers-Procainamide Discussed-Disopyramide Sobriety-Sodium channel blockade
Class IB - Sodium channel blockade: Lidocaine, Phenytoin, Mexiletine, tocainide
"Philadelphians Like Salty Mexican Tacos." Philadelphians-Phenytoin Like-Lidocaine Salty-Sodium channel blockade Mexican-Mexiletine Tacos-Tocainide
Class IC - Sodium channel blockade: Flecainide, Encainide, Propafenone "Flea Encrusted Prophets." Flea-Flecainide Encrusted-Encainide Prophets-Propafenone
Class II - Beta-adrenergic blockade: Propranolol "Betting Professionals." Betting-Beta-adrenergic blockade Professionals-Propranolol
Class III - Prolong repolarization: Amiodarone, Bretylium, Solatol "Britain Repossessed American Soaps." Britain-Bretylium Repossessed-Repolarization is prolonged. American-Amiodarone Soaps-Solatol
Class IV - Calcium channel blockade: Verapamil, Diltiazem "Calligraphist's Verbal Dilemma." Calligraphist-Calcium channel blockade Verbal-Verapamil Dilemma-Diltiazem
Antiarrhythmic agents: "A Dubious Quality Product... Bought To Preserve Little Money... Can Fabricate Enough Problems." A-1a B-1b C-1c 1a-A: D-Disopyramide Q-Quinidine P-Procainamide
1b-B: T-Tocainamide P-Phenytoin L-Lidocaine M-Mexiletine
1c-C: F-Flecainamide E-Encainamide P-Propafenone
Mnemonics For Side Effects.
ACEI, Side Effects CAPTOPRIL
Cough, anaphylaxis, palpitations, taste, orthostatic ↓BP, Potassium (↑K+), Renal impairment, impotence, leucocytosis
Anti-epileptic side Effects ABCDEFGH Ataxia, blood dyscrasia, cleft lip, dupuytrens / vit D def, exfoliation of skin & Stevens Johnson’s. Fits, GI upset / gum hypertrophy, hepatitis / hairy
Barbiturate side Effects ABCD Ataxia, behavioural disturbance, ↓concentration / coma,
depression / drowsy / diplopia
Cholinergic OD side Effects DUMB BELS Diarrhoea, Urination, Miosis / muscle weakness,
bronchorrea Bradycardia, emesis, lacrimation, salivation / sweating
Cyclosporin Side Effects 4HRT 4H - Hyper K+, hypertension, gum hypertrophy, hairy R – Renal toxicity T - Tremor
Digoxin S/E GECCKO GIT – n&v, abdo pain, ulcers Eyes – blurring, halo, xanthopsia CNS – depression, confusion, delirium, hallucinations Cardiac – ANY arrhythmia K - low
MAOI side Effects 3Hs Hepatocellular jaundice, Hyperthermia, hypertension
TCAD side Effects CAN WOO Cvs, Anticholinergic, Neuro, Withdrawal,
Overdose, Others
Steroids Side Effects HIGH COMPACT IMPS Hypertension, Immunosuppression, Gastric Ulcer (bleeding), Heartburn Cataract, Osteoporosis, Muscle weakness, Path # / Psychosis, Acne / Altered Glucose, Cushingoid, Thin skin Increased appetite, Myopathy, poor wound healing, stress response reduced
AM CUSHINGOID Acne, Myopathy (prox) / muscle wasting (prox) Cushingoid / Cataract, Ulcers, Striae, skin thin (bruising), Hypertension / hairy, Infection, Glycosuria, Obesity / Osteoporosis / Oedema,
Immunosuppression / Insomnia, Depression
http://imedrx.blogspot.com/2010/02/physiology-and-pharmacology-video.html
