Article: Pharmacology Mnemonics For The USMLE And Other Medical Examinations

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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. betaABCD: 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): membersCHAMP: Cyclophosphamide Hydroxycloroquine and choloroquinine Auranofin and other gold compounds Methotrexate Penicillamine Auranofin, aurothioglucose: category and indicationAurum 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 Cisplatin: major side effect, action "Ci-Splat-In": Major side effect: Splat (vomiting sound)--vomiting so severe that anti-nausea drug needed. Action: Goes Into the DNA strand. Vir-named drugs: use"-vir at start, middle or end means for virus": ∑ Drugs: Abacavir, Acyclovir, Amprenavir, Cidofovir, Denavir, Efavirenz, Indavir, Invirase, Famvir, Ganciclovir, Norvir, Oseltamivir, Penciclovir, Ritonavir, Saquinavir, Valacyclovir, Viracept, Viramune, Zanamivir, Zovirax. Phenobarbitone: side effectsChildren are annoying (hyperkinesia, irritability, insomnia, aggression). Adults are dosy (sedation, dizziness, drowsiness). Prazocin: usage Prazocin sounds like an acronym of "praszz zour urine". Therefore Prazocin used for urinary retention in BPH. Opioids: effects BAD AMERICANS: 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 Sedation TB: antibiotics usedSTRIPE: STreptomycin Rifampicin Isoniazid Pyrizinamide Ethambutol Phenytoin: adverse effects PHENYTOIN:P-450 interactions Hirsutism Enlarged gums Nystagmus Yellow-browning of skin Teratogenicity Osteomalacia Interference with B12 metabolism (hence anemia) Neuropathies: vertigo, ataxia, and headache  Narcotic antagonistsThe Narcotic Antagonists are NAloxone and NAltrexone. ∑ Important clinically to treat narcotic overdose. Thrombolytic agents USA: Urokinase Streptokinase Alteplase (tPA) Routes of entry: most rapid ways meds/toxins enter body "Stick it, Sniff it, Suck it, Soak it": Stick = Injection Sniff = inhalation Suck = ingestion Soak = absorption Asthma drugs: leukotriene inhibitor action zAfirlukast: Antagonist of lipoxygenase zIlueton: Inhibitor of LT receptor Direct sympathomimetic catecholamines DINED: Dopamine Isoproterenol Norepinephrine Epinephrine Dobutamine Anticholinergic side effects"Know the ABCD'S of anticholinergic side effects": Anorexia Blurry vision Constipation/ Confusion Dry Mouth Sedation/ Stasis of urine Atropine use: tachycardia or bradycardia"A goes with B": Atropine used clinically to treat Bradycardia. Bleomycin: action "Bleo-Mycin Blows My DNA to bits": Bleomycin works by fragmenting DNA (blowing it to bits). My DNA signals that its used for cancer (targeting self cells). Aspirin: side effects ASPIRIN: Asthma Salicyalism Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDA Intestinal blood loss Reye's syndrome Idiosyncracy Noise (tinnitus) Lupus: drugs inducing it HIP: Hydralazine INH Procanimide Vigabatrin: mechanism Vi-GABA-Tr-In: Via GABA Transferase Inhibition Morphine: effects at mu receptor PEAR: Physical dependence Euphoria Analgesia Respiratory depression Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on factor Xa. Monitor Xa concentration, rather than APTT. Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":  Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs. SSRIs: side effects SSRI: Serotonin syndrome Stimulate CNS Reproductive disfunctions in male Insomnia Ipratropium: action Atropine is buried in the middle: iprAtropium, so it behaves like Atropine. Warfarin: action, monitoring WePT: Warfarin works on the extrinsic pathway and is monitored by PT. Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's stand for "beta blocker". ∑ Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol, propranolol. Depression: 5 drugs causing it PROMS: Propranolol Reserpine Oral contraceptives Methyldopa Steroids Lead poisoning: presentation ABCDEFG: Anemia Basophilic stripping Colicky pain Diarrhea Encephalopathy Foot drop Gum (lead line)  Myasthenia gravis: edrophonium vs. pyridostigmine eDrophonium is for Diagnosis. pyRIDostigmine is to get RID of symptoms. Morphine: effects MORPHINES: Miosis Orthostatic hypotension Respiratory depression Pain supression Histamine release/ Hormonal alterations Increased ICT Nausea Euphoria Sedation Inhalation anesthetics SHINE: Sevoflurane Halothane Isoflurane Nitrous oxide Enflurane ∑ If want the defunct Methoxyflurane too, make it MoonSHINE.Cholinergics (eg organophosphates): effectsIf you know these, you will be "LESS DUMB": Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam Oxazepam Temazepam Benzodiazepines: actions "Ben SCAMs Pam into seduction not by brain but by muscle": Sedation anti-Convulsant anti-Anxiety Muscle relaxant Not by brain: No antipsychotic activity. Botulism toxin: action, related bungarotoxin Action: "Botulism Bottles up the Ach so it can't be the released": Related bungarotoxin: "Botulism is related to Beta Bungarotoxin (beta-, not alpha-bungarotoxin--alpha has different mechanism). Teratogenic drugs "W/ TERATOgenic": Warfarin Thalidomide Epileptic drugs: phenytoin, valproate, carbamazepine Retinoid ACE inhibitor Third element: lithium OCP and other hormones (eg danazol) Gynaecomastia-causing drugs DISCOS: Digoxin Isoniazid Spironolactone Cimetidine Oestrogens Stilboestrol Benzodiazepenes: drugs which decrease their metabolism "I'm Overly Calm": Isoniazid Oral contraceptive pills Cimetidine ∑ These drugs increase calming effect of BZDs by retarding metabolism. Anesthesia: 4 stages "Anesthesiologists Enjoy S & M": Analgesia Excitement Surgical anesthesia Medullary paralysis 4-Aminopyradine (4-AP) use"4-AP is For AP": For AP (action potential) propagation in Multiple Sclerosis. Osmotic diuretics: members GUM: Glycerol Urea Mannitol Sodium valproate: side effects VALPROATE: Vomiting Alopecia Liver toxicity Pancreatitis/ Pancytopenia Retention of fats (weight gain) Oedema (peripheral oedema) Appetite increase Tremor Enzyme inducer (liver) Nitrofurantoin: major side effects NitroFurAntoin: Neuropathy (peripheral neuropathy) Fibrosis (pulmonary fibrosis) Anemia (hemolytic anemia) Zafirlukast, Montelukast, Cinalukast: mechanism, usage"Zafir-luk-ast, Monte-luk-ast, Cina-luk-ast": ∑ Anti-Lukotrienes for Asthma. ∑ Dazzle your oral examiner: Zafirlukast antagonizes leukotriene-4. Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount": Phenytoin Ethanol Aspirin Zero order ∑ Someone that pees out a constant amount describes zero order kinetics (always the same amount out) Hepatic necrosis: drugs causing focal to massive necrosis"Very Angry Hepatocytes": Valproic acid Acetaminophen Halothane Steroids: side effects BECLOMETHASONE: 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 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 Monoamine oxidase inhibitors:Members "PIT of despair": Phenelzine Isocarboxazid Tranylcypromine ∑ A pit of despair, since MAOs treat depressionWarfarin: metabolism SLOW: ∑ Has a slow onset of action. ∑ A quicK Vitamin K antagonist, though. Small lipid-soluble molecule Liver: site of action Oral route of administration. Warfarin Propythiouracil (PTU): Mechanism It inhibits PTU: Peroxidase/ Peripheral deiodination Tyrosine iodination Union (coupling) Antibiotics contraindicated during pregnancy  MCAT: Metronidazole Chloramphenicol Aminoglycoside Tetracycline Beta-blockers: nonselective beta-blockers"Tim Pinches His Nasal Problem" (because he has a runny nose...): Timolol Pindolol Hismolol Naldolol Propranolol Methyldopa: side effects METHYLDOPA: Mental retardation Electrolyte imbalance Tolerance Headache/ Hepatotoxicity psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic) Lithium: side effects  LITH: Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism Respiratory depression inducing drugs "STOP breathing": Sedatives and hypnotics Trimethoprim Opiates Polymyxins Benzodiazepenes: antidote "Ben is off with the flu": Benzodiazepine effects off with Flumazenil.  ...

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