Mnemonics of Pharmacology

Drugs causing gynaecomastia.

‎"DESI Gossypol R Most Common Cause oF Gynaecomastia in Kommon People"

D- Digitalis
E-Ethionamide,Estrogen
S-Spirinolactone

I- INH

Gossypol-Griseofulvin
R- Reserpine
Most-Methyl dopa
Common- Cyperoterone acetate,cimitidine,
Cause-clomiphine,Calcium antagonist
oF-Flutamide
Gynaecomastia- Goserelin
Kommon-Ketoconazole
People-Phenytoin.

Sodium valproate: side effects

VALPROATE:
Vomiting
Alopecia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Appetite increase
Tremor
Enzyme inhibitor

Anti-hypertensives used in emergencies...

Antihypertensives used in emergencies.... . Singh & Gambhir HELP S-sodium nitroprusside G-GTN  H-hydralazine E-esmolol  L-labetalol P-phentolamine

Chloroquine: uses

" My RED LIP "

• Malaria
• Rhematoiid arthritis
• Extraintestinal amoebiasis
• DLE
• Lepra reaction
• Infectious mononucleosis
• Photogenic reactions

Lead poisoning: presentation

ABCDEFG:
Anemia
Basophilic stripping
Colicky pain
Diarrhea
Encephalopathy
Foot drop
Gum (lead line)

Respiratory depression inducing drugs

"STOP breathing":
Sedatives and hypnotics
Trimethoprim
Opiates
Polymyxins

Methyldopa: side effects

METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism

The Cephalosporins

• First Generation Cephahlosporins - Remember this story:

Mr. Fazol (ceFAZOLin) is a Lorry Driver (cephaLORIdine). He works very hard and has become Thin (cephaloTHIN) He has a "Rad" Watch on his hand (cephRADine) and a "Lux" soap (cephaLEXin). He wears a bright green Drawer {i.e trousers} ( cefaDROxil)

Route of drug administration: He will put the Rad Lux soap in his Drawer - (Cephradin, Cefalexin & Cefradine are given orally. The latter can also be given i.v. /.i.m.. All others- i.v. /.i.m)

• Second Generation Cephalosporins: Remember FOX, FUR, FAC - ceFOXitin, ceFURoxime, ceFAClor

• Third Generation Cephalosporins - The story goes thus:

Mr. Aziz (ceftAZIdime) is taking an Ox (ceftizOXime, cefpodOXime) in a Taxi (cefoTAXIme) for slaughtering, i.e. an Operation (cefOPERAZONE). For this purpose he is taking Three Axon blades (cefTRIAXONe). He will Fix (ceFIXime) the ox for dinner (cefDINIR) in a short time!

Route of drug administration: Fix the price and eat (only Cefixime is given oral: all others im/iv).

ADRs: Operation will cause bleeding (Cefoperazone cause bleeding)

• Fourth Generation Cephalosporins:

My wierd dream:  QUEEN of ROME who FLEW to OZONE layer, fell down and was made IP (Inpatient) by ME. Helps you to remember fourth generation cephalosporins - Cefquinome, Cefpirome, Cefluprenam, Cefozopran, Cefipime.

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

drugs causing pul fibrosis

BBC MAN B-BLEOMYCIN  B-BUSULPHAN  C-CYCLOPHOSAMIDE  M-METHOTREXATE  A-AMIODARONE N-NITROFURANTOIN

BUPRIOPION or BUSPIRONE... ??

antianXiety=buXpirone

BuPROPERion = PROPER habits ( no smoking )

its used for smoking cessation.

Inhalation anesthetics SHINE:

Sevoflurane

Halothane

Isoflurane

Nitrous oxide

Enflurane

Cholinergics (eg organophosphates): effects

If you know these, you will be "LESS DUMB":

Lacrimation

Excitation of nicotinic synapses

Salivation

Sweating

Diarrhea

Urination

Micturition

Bronchoconstriction

SSRIs: side effects SSRI:

Serotonin syndrome

Stimulate CNS

Reproductive disfunctions in male

Insomnia

Adrenoceptors: vasomotor function of alpha vs. beta

ABCD:

Alpha = Constrict.

Beta = Dilate.

Ca++ channel blockers: uses CA++ MASH:

Cerebral vasospasm/ CHF

Angina

Migranes

Atrial flutter, fibrillation

Supraventricular tachycardia

Hypertension

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)

Ribavirin: indications

RIBAvirin:
RSV
Influenza B
Arenaviruses (Lassa, Bolivian, etc.)

Warfarin: interactions

ACADEMIC QACS:
Amiodarone
Cimetidine
Aspirin
Dapsone
Erythromycin
Metronidazole
Indomethacin
Clofibrates
Quinidine
Azapropazone
Ciprofloxacin
Statins

Osmotic diuretics: members

GUM:
Glycerol
Urea
Mannitol

Aminoglycosides: common characteristics

AMINO:
Active Against Aerobic gram negative
Mechanism of resistance are Modifying enzymes
Inhibit protein synthesis by binding to 30S subunit
Nephrotoxic
Ototoxic

Vigabatrin: mechanism

Vi-GABA-Tr-In:
Via GABA Transferase Inhibition

Uses of chloroquine

Rheumatoid arthritis
Extraintestinal amoebiasis
DLE
Lepra reaction
Infectious mononucleuosis
Photogenic reactions

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
Sedations

Antimuscarinics: members, action

"Inhibits Parasympathetic And Sweat":
Ipratropium
Pirenzepine
Atropine
Scopolamine
· Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic.

B2agonist......SMART

1)Salmeterol

2)Metaproterenol

3)Albuterol

4)Ritodrine

5)Terbutaline.

Nitrofurantoin: major side effects

NitroFurAntoin:
Neuropathy (peripheral neuropathy)
Fibrosis (pulmonary fibrosis)
Anemia (hemolytic anemia)

Drugs causing pancreatitis

PADS
pentamidine
azathioprim/ L- asparaginase
didanosine
sulfa drugs

Captopril (an ACE inhibitor): side effects

CAPTOPRIL:
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

Drugs causing lupus like symptoms

SHIP sulfonamide hydralazine isoniazid procanamide

Drugs causing gynaecomastia.

DISCO

Digitalis
INH
Spironolactone
Cimetidine
Oestrogen

drugs causing hypokalemia

B-beta2 agonists A-Amphotericin B D-Digoxin F-Furesemide,Foscarnet I-Insulin T-Thiazide

Torsades de Pointes: drugs causing

APACHE:
Amiodarone
Procainamide
Arsenium
Cisapride
Haloperidol
Eritromycin

Direct sympathomimetic catecholamines

DINED:
Dopamine
Isoproterenol
Norepinephrine
Epinephrine
Dobutamine

Dose related adr of tetracylines

KAPIL DEV
K-KIDNEY DAMAGE
A-ANTIANABOLIC EFFECT
P-PHOTOTOXICITY
I-INCREASED INTRACRANIAL PRESSURE
L-LIVER DAMAGE
D-DIABETES INSIPIDUS
E-TEETH AND BONES
V-VESTIBULAR TOXICITY

Serotonin syndrome: components

Causes HARM:
Hyperthermia
Autonomic instability (delirium)
Rigidity
Myoclonus

HMG-CoA reductase inhibitors (statins): side effects, contraindications, interactions

HMG-CoA:
· Side effects:
Hepatotoxicity
Myositis [aka rhabdomyolysis]
· Contraindications:
Girl during pregnancy/ Growing children
· Interactions:
Coumarin/ Cyclosporine

PHENYTOIN TOXICITY

5H's

Hyperplasia of gums
Hyperglycemia
Hirsutism
Hypersensitivity
Hydontoin Syndrome

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

ORGANOPHOSPHATE POISONING

DUMBLES D=diaphoresis U=urination M=meiosis B=bowl motility(incresed) L=Lacrimation E=emesis S=salivation

Teratogenic drugs: major non-antibiotics

TAP CAP:
Thalidomide
Androgens
Progestins
Corticosteroids
Aspirin & indomethacin
Phenytoin

NNRTI

END E- efavirenz N- nevirapine D- delavirdine

Thrombolytic agents

USA:
Urokinase
Streptokinase
Alteplase (tPA)

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).

METRONIDAZOLE-SPECTRUM OF ACTION

SPECTRUM OF ACTION
A-Amoebiasis
B-Bacteroides fragilis
C-Clostridium perfringens
D-Dracunculus medinensis
E-Pseudomembranus Enterocolitis
F-Fusobacterium
G-Giardiasis
H-Helicobacter Pylori
S-Anaerobic Streptococci
T-Trichomonas

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).

Tricyclic antidipressents (TCA): side effects

TCA'S:
Thrombocytopenia
Cardiac (arrhymia, MI, stroke)
Anticholinergic (tachycardia, urinary retention, etc)
Seizures

Inhibitors of p450:

IC(see) KEGS (going down)
INH, Cimetidine, Ketoconazole, Erythromycin,Grapefruit,Sulfonamides

Parasympathetic vs. sympathetic neurotransmitters

"No sympathy for a Pair of Aces":
Norepinephren is secreted in by the Sympathetic nervous system while Acetylcholine is secreted in the Parasympathetic nervous system.

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)

How To Crack DAMn PG Entrance

H Hypertension, HOCM
T Thyrotoxicosis
C Cardiac arrythmias, Congestive Heart
Failure
D Dissecting aortic aneurysm
A Angina, anxiety
M MI, Migraine
P Phaeochromocytoma
G Glaucoma
E essential tremors

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

Second line anti tubercular drugs

  Please TAKE Carbon Copy

Paraaminosalicylic acid
Thiacetazone
Amikacin
Kanamycin
Ethinamide
Cycloserine
Capreomycine

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)

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.

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.

Parkinsonism: drugs

SALAD:
Selegiline
Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine)
L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide)
Amantadine
Dopamine postsynaptic receptor agonists (bromocriptine, lisuride, pergolide)

Adverse effects of captopril

C-Cough
A-Angioedema
P-Potassium increase(hyperkalemia)
T-Taste alteration
O-Orthostatic hypotension
P-Pregnancy(fetopathic)
R-Renal failure
iL-Leucopenia(granulocytopenia)

TOM thumb for short acting Benzodiazepines.

Triazolam
Oxazepam
Midazolam

(Triazolam is the drug of choice for sleep on overnight flight.)

Thalidomide: effect on cancer cells

"Thalidomide makes the blood vessels hide":
Use thalidomide to stop cancer cells from growing new blood vessels.

Atropine use: tachycardia or bradycardia

"A goes with B":
 Atropine used clinically to treat Bradycardia.

Insulin: mixing regular insulin and NPH

"Not Ready, Ready Now":
Air into NPH
Air into Regular
Draw up Regular
Draw up NPH

Beta-blocker main contraindications / cautions

ABCDE:

• Asthma
• Block (heart block)
• COPD
• Diabetes mellitus
• Electrolyte (hyperkalemia

Anesthesia: 4 stages

"Anesthesiologists Enjoy S & M":
Analgesia
Excitement
Surgical anesthesia
Medullary paralysis

Inhibition of Choline uptake during ACh synthesis

HICUp ":

Hemicholinium Inhibits Acetyl Choline Uptake
(Choline Uptake is the rate limiting step in ACh synthesis)

Quinolones [and Fluoroquinolones]: mechanism

"Topple the Queen":
Quinolone interferes with Topoisomerase II.

Cholinergic effects (eg organophosphates):

"If you know these, you will be LESS DUMB Choline ":

• Lacrimation
• Excitation of nicotinic synapses
• Salivation
• Sweating
• Diarrhea
• Urination
• Micturition/Miosis
• Bronchoconstriction

Beta-blockers: nonselective beta-blockers

"Tim Pinches His Nasal Problem" (because he has a runny nose...):
Timolol
Pindolol
Hismolol
Naldolol
Propranolol

Cholinergic effects on Bowel and Bladder

"Call inergic/Cholinergic makes us attend natures call ! ":
ie.,Evacuation of Bowel and Bladder

Monoamine oxidase inhibitors: members

"PIT of despair":
Phenelzine
Isocarboxazid
Tranylcypromine
· A pit of despair, since MAOs treat depression.

Therapeutic index: formula

TILE:
TI = LD50 / ED50

Muscarinic effects

" SLUG BAM ":

• Salivation/ Secretions/ Sweating
• Lacrimation
• Urination
• Gastrointestinal upset
• Bradycardia/ Bronchoconstriction/ Bowel movement
• Abdominal cramps/ Anorexia
• Miosis

Reversible Anticholinesterases ( antiChEs )

" Car PPENDoRi ": Read as "carpentry"
Reversible Anticholiesterases belonging to Carbamates are

• Physostigmine
• Pyridostigmine
• Edrophonium
• Neostigmine
• Donepezil
• Rivastigmine

Mechanism of Action -Tacrine and Edrophonium

"  TEA ":
Tacrine and Edrophonium attach only to Anionic site of enzyme,Cholinesterase(ChE)
( Organophosphates attach only to the estatrtic site of Cholinesterase )

Morphine vs. Amphetamine :Pupils in overdose

"MorPHINE: Fine and  AmPHETamine: Fat"
Morphine overdose: pupils constricted (fine)
Amphetamine overdose: pupils dilated (fat)

Clopidogrel: use

CLOPIdogrel is a drug that prevents
CLots, an Oral Platelet Inhibitor (OPI).

Tetracyclines: Mechanism of action

'T e tr A '
Tetracyclines bind to Thirty S (30 S) ribosome & e(i)nhibits trna attachment to the  A site.

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.

Receptors of the heart

Think: "2 Beautiful hearts Marry 2 Be 1"

• B₂  receptor (adrenergic)
• M₂  receptor (cholinergic) and
• B₁  receptor (adrenergic)

The heart is innervated by both sympathetic (adrenergic) and parasympathetic (cholinergic) fibres.

Adrenergic nerves from cervical sympathetic chain exerts positive ionotropic (contractility) and chronotropic (heart rate) effects on heart through B1 receptors.

B2 receptors are more in smooth muscles of vessel walls and thus mediate vasodilatation.

Parasympathetic fibres which reach the heart through the vagus nerves have inhibitory effect on the heart through M2 receptors and is responsible for decreasing heart rate, conduction (dromotropic) and contractility.

Propythiouracil (PTU): mechanism

It inhibits PTU:
Peroxidase/ Peripheral deiodination
Tyrosine iodination
Union (coupling)

Antibiotics contraindicated in pregnancy

MCAT '

• Metronidazole
• Chloramphenicol
• Aminoglycosides
• Tetracyclines

SSRIs: side effects

SSRI:
Serotonin syndrome
Stimulate CNS
Reproductive disfunctions in male
Insomnia

Drugs causing Lupus like syndrome

"SHIP"

• Sulfonamides
• Hydralazine
• Isoniazid
• Procainamide

Corticosteroids: Side effects

 A, B, C, D, E...I "

• Alkalosis, Appetite increases 
• Bone resorption (osteoprosis) 
• Cushing's habitus, Catract, Ca absorption decreases 
• Diabetes mellitus precipitation
• Emotional lability, Edema
• Femoral head necrosis, Fetal abnormalities
• Gastic ulcers, Glaucoma, Growth retardation
• Hypertension, Hirsutism, Hypokalemia, HPA axis suppression
• Immunosuppression & Infections.

Diuretics classification in order of site of action

"COLT Pee:"
· In their sequential site of action along the nephron:
Carbonic anhydrase inhibitors (at the proximal tubule)
Osmotic diuretics (at the Loop of Henle)
Loop diuretics (at the ascending loop)
Thiazides (at the distal tubule)
Potassium-sparing diuretics (at the collecting tubules)
· Diuretics make patient pee like a horse, hence "Colt Pee".

Drugs causing pancreatitis

 ' 12345'

• 1 -ACE inhibitors
• 2 -Didanosine
• 3 -Trimethoprim
• 4 -Tetracycline
• 5 -Pentamidine

Depression: 5 drugs causing it

PROMS:
Propranolol
Reserpine
Oral contraceptives
Methyldopa
Steroids

MPTP: mechanism, effect

MPTP:
Mitochondrial Parkinson's-Type Poison.
· A mitochondrial poison that elicits a Parkinson's-type effect.

Drugs metabolized by acetylation

SHIP'

• Sulfonamides including dapsone
• Hydralazine
• Isoniazid (INH)
• Procainamide

Acetylator polymorphism:Some individuals are slow acetylators and some are fast acetylators.The drugs metabolized by acetylation may become ineffective in fast acetylators and cause toxicity in slow acetylators.

Antiarrythmic drugs:Classes

i' M BAC in rhythm ":
I.Membrane stabilizing agents (Na channel blockers)
II.Beta blockers (Antiadrenergic agents)
III.Agents widening AP
IV.Calcium channel blockers

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

Warfarin metabolism

' SLOW':

• Small lipid-soluble molecule
• Liver is the site of action
• Oral route of administration.
• Warfarin

Antiarrhythmics: class III members

BIAS:
Bretylium
Ibutilide
Amiodarone
Sotalol

Antihypertensives contraindicated in pregnancy

DARSAN '

• Diuretics
• Angiotensin I antagonists
• Reserpine
• Sodium nitroprusside
• ACE inhibitors
• Non selective β blockers

TB: antibiotics used

STRIPE:
STreptomycin
Rifampicin
Isoniazid
Pyrizinamide
Ethambutol

Lithium: Uses

LIBRA '

• Leukopenia
• Inappropriate ADH secretion syndrome (SIADH)
• Bipolar disorder
• Recurrent neuropsychiatric syndrome
• Agranulocytosis

Enzyme inhibitors

COMIC CASE '

• Cimetidine
• Omeprazole
• Metronidazole
• Isoniazid
• Chloramphenicol
• Ciprofloxacin
• Allopurinol
• Sulphonamides
• Erythromycin

Anticholinergic side effects

"Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine

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.

Enzyme inducers

P RAGA ' 

• Phenylbutazone
• Anticonvulsants
• Rifampicin
• Griseofulvin
• Alcohol

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

Glucocorticoids: Adverse effects

 ' GLUCOCORTICOIDS '

• Glaucoma
• Lunacy (Psychotic episodes)
• Peptic Ulceration
• Cushing's syndrome
• Osteoporosis
• Cataracts (posterior subcapcular in children)
• Opportunistic infections
• Retention of Sodium and water (mineralocorticoid effects)
• Telengectasia
• Insulin resistance (hyperglycemia)
• Cause muscle weakness on withdrawal
• grOwth retardation
• by Growth hormone Inhibition
• Delayed wound healing
• Suppresses hypothalamo-pituitary-adrenal axis (HPA axis)

Patent ductus arteriosus: treatment

"Come In and Close the door":
INdomethacin is used to Close PDA.

Amiodarone: Adverse effects

" Plz Check PFT, LFT, TFT "

• Plz- Photosensitivity, Pigmentation
• Check for Corneal deposits
• PFT- Pulmonary fibrosis
• LFT- Liver damage (pseudoalcoholic liver injury)
• TFT- Thyroid dysfunction

Opiates: overdose findings

"Cool to the touch, unresponsive to pain,
Hunger diminished, and scars over vein.
Pupils pinpointed, and blood pressure low,
Urine diminished, and breathing is slow."

Phenytoin: Side effects

" PHENYTOIN "


P: Foetal hydantoin syndrome  (As 'Phenytoin' is pronounced as 'Fenytoin')
H: Hirsutism, Hypersensitivity
ENY: Anemia
T: Thick gums
0: Osteomalacia
I: Inhibits insulin

Phenytoin is not used during pregnancy as it can cause 'Foetal hydantoin syndrome' which is characterised by the development of hypoplastic distal phalanges, cleft lip, cleft palate, microcephaly, impaired growth and congenital heart defects in the foetus.

Sulfonamides: common characteristics

SULFA:
Steven-Johnson syndrome/ Skin rash / Solubility low
Urine precipitation/ Useful for UTI
Large spectrum (gram positives and negatives)
Folic acids synthesis blocker (as well as synthesis of nucleic acids)
Analog of PABA

Xylocaine: Where not to use with Adrenaline?

"Digital PEN"

• Digits (Fingers and toes)
• Penis
• Ear
• Nose tip

Adrenaline causes vasoconstriction which helps to trap Xylocaine (anaesthetic) locally prolonging its duration of action. The two are not used together at sites supplied by end arteries as the vasoconstriction produced by adrenaline can cause ischemic necrosis of the tissues.

Adrenaline is also referred to as Epinephrine.

Etoposide: action, indications, side effect

"eTOPoside":
· Action:
Inhibits TOPoisomerase II
· Indications:
Testicular carcinoma
Oat cell carcinoma of lung
Prostate carcinoma
· Side effect:
Affects TOP of your head, causing alopecia

Lithium: Adverse effects

"LITHIUM"

• Lethargy / Leucocytosis
• Intentional Tremor
• Teratogenicity
• Hypothyroidism
• Insipidus [Diabetes insipidus]
• Urine excess
• Metallic taste

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.

Aspirin: Adverse effects

"ASPIRIN"

• Asthma 
• Salicylism 
• Peptic ulcer / Premature closure of PDA
• Intestinal blood loss 
• Reye's syndrome 
• Idiosyncracy 
• Noise (tinnitus)

Morphine: side-effects

MORPHINE:
Myosis
Out of it (sedation)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis

Valproate: Adverse effects

VALPROATE"

• Vomiting 
• Alopecia 
• Liver toxicity (Hepatotoxicity)
• Pancreatitis/ Pancytopenia 
• Retention of fat (weight gain) / Reduced sleep
• Oedema (peripheral oedema) 
• Allergic reactions / Abdominal cramps/ Appetite increase 
• Tremor / Thrombocytopenia
• Enzyme inducer (liver)

Enoxaprin (prototype low molecular weight heparin): action, monitoring

EnoXaprin only acts on factor Xa.
Monitor Xa concentration, rather than APTT.

K+ increasing agents

K-BANK:
K-sparing diuretic
Beta blocker
ACEI
NSAID
K supplement

Benzodiazepenes: antidote

"Ben is off with the flu":
Benzodiazepine effects off with Flumazenil.

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 DND is also after me:
Desipramine
Norrtriptyline
Doxepin

Anti Tuberculous Drugs (ATT)

iREPS stands for
i - INH - 5mg/kg
R - Rifampicin - 10mg/kg
E - Ethambutol - 15mg/kg
P - Pyrazinamide - 20-35mg/kg
S - Streptomycin - 20-35mg/kg
Their dosages per kg are 5, 10, 15, 20-35, 20 - 35 respectively.
Which of these are Bacterocidal?
Of these, the ones that RIPS bacteria are the R, I, P, S.

To remember certain striking side effects see below:
INH - I Have Neuritis
Rifampicin - Red man syndrome
Ethambutol - Eye affected ( Retrobulbar neuritis )
Streptomycin - Song is difficult to hear ( Oto toxicity)

Inhalation anesthetics SHINE:

SHINE:
Sevoflurane
Halothane
Isoflurane
Nitrous oxide
Enflurane
· If want the defunct Methoxyflurane too, make it MoonSHINE

Opiods: mu receptor effects

"MD CARES":
Miosis
Dependency
Constipation
Analgesics
Respiratory depression
Euphoria
Sedation

Time period to stop certain drugs before surgery

Aspirin: stop 1 week before surgery (Remember 'A' is the 1st alpahabet)
Lithium: stop 2 weeks before surgery (Remember the alphabet 'L' is formed by 2 straight lines)
MAO-A irreversible inhibitors: 3 weeks (Remember, turn 'M'clockwise, you get something like '3'; Alternatively MAO has 3 letters)
Estrogen pills: 4 weeks ( 'E' is formed by 4 straight lines)

Teratogenic drugs

Warfarin
Thalidomide
Epileptic drugs: phenytoin, valproate, carbamazepine
Retinoid
ACE inhibitor
Third element: lithium
OCP and other hormones (eg danazol)

Vitamin D metabolism

UV rays from sun act on skin, convert Cholecalciferol (CC) --> 25 Hydroxy CC in liver --> 1,25 Di Hydroxy CC in kidney.
So there are two hydroxylation reactions, first in Liver, second in Kidney. Remember this: You have 1 liver, 2 kidneys; So hydroxylation 1st reaction in your 1 liver and 2nd hydroxylation in 2 kidneys.

Antirheumatic agents (disease modifying): members

CHAMP:
Cyclophosphamide
Hydroxycloroquine and choloroquinine
Auranofin and other gold compounds
Methotrexate
Penicillamine

Anticoagulant in Pregnancy

Which anticoagulant can be used in pregnancy? Heparin or Warfarin?
Answer is Heparin. WARfarin SHOULD NOT BE used. Remember: There SHOULD NOT BE WAR IN pregnancy.

Diuretics: thiazides: indications

"CHIC to use thiazides":
CHF
Hypertension
Insipidous
Calcium calculi

Drugs acting on 30s & 50s ribosomes

Remember this picture: 30 year old robber named ATkins is in CELL no. 50

Drugs acting on 30s ribosome subunits :

• Aminoglycosides ( Including Streptomycin, Gentamicin, Amikacin, Tobramycin)
• Tetracyclines 

Drugs acting on 50s ribosome subunits :

• Chloramphenicol
• Erythromycin
• Lincomycin
• cLindamycin

Extrapyramidal side effects

The extrapyramidal side effects (EPS) associated with certain antipsychotic drugs (like Haloperidol, Chlorpromazine etc) with the time frame when they will occur can be remembered by "I came 4 DISCO IN THIS INN):

Note: Start from '4' - The time these EPS appears are 4 hours, 4 days, 4 weeks, 4 months in that order.

• 4 hrs       - acute DYStOnia (DISCO) {EPS occurs like disco!}
• 4 days    - akINesia (IN)
• 4 weeks  - akaTHISia
• 4 months - tardive dyskINesia (INn - extra 'N' is for the delayed complication :-)  )

 Alternatively remember DAAD -  Dystonia, Akinesia, Akathisia, Dyskinesia in that order.

Sex hormone drugs: male

"Feminine Males Need Testosterone":
Fluoxymesterone
Methyltestosterone
Nandrolone
Testosterone

Microtubules: drugs that act on microtubules.

"The MicroTubule Growth Voiding Chemicals":
Thiabendazole
Mebendazole
Taxol
Griseofulvin
Vincristine/ Vinblastine
Colchicine

MAO-A and MAO-B Isoenzyme locations

Monoamine oxidase (MAO) isoenzyme locations are as follows:
MAO-A is located in Alimentary tract (intestine) and Adrenergic peripheral structures.
MAO-B is located in Brain and Blood platelets.

Drugs causing hepatic necrosis

Remember "Very Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane

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

Myasthenia gravis:Use of Edrophonium and Pyridostigmine

• eDrophonium is used to Diagnose Myastenia gravis
• pyRIDostigmine is used to get RID of symptoms

Cocaine: cardiovascular effect

COcaine causes blood vessels to
COnstrict (unlike other local anesthetics which cause vasodilation).

Narcotics: side effects

"SCRAM if you see a drug dealer":
Synergistic CNS depression with other drugs
Constipation
Respiratory depression
Addiction
Miosis

Side effects of Lithium

Remember "LITH":
Leukocytosis
Insipidus, Diabetes
Tremors; also Teratogenic
Hypothyroidism

Morphine: effects at mu receptor

PEAR:
Physical dependence
Euphoria
Analgesia
Respiratory depression

4-Aminopyradine (4-AP) use

"4-AP is For AP":
For AP (action potential) propagation in Multiple Sclerosis.

drugs that cause gynocomastia:

Some Drugs Create Awesome Knockers
Spironolactone, Digitalis, Cisplatin, Alcohol Ketoconazole

Beta 1 selective blockers

"A -BEAM "

acebutalol
betaxolol
esmolo
atenolol
metoprolol

Drugs following Zero order kinetics-
< Put An End To The War >
Phenytoin
Aspirin
Ethanol
Tolbutamide
Theophylline
Warfarin

Respiratory fluoroqinolones-

LG Ghatiya Mobile
levofloxacin,

Gemifloxacin,

Gatifloxacine,

Moxifloxacin

Typhoid fever-Drug of choice & Alternative drugs
Drug of choice:
< CiTy >
Ciprofloxacin

altrnative drugs:
< Plan Of Love- Cef And Chlorina Cot Committed >
(read it as- saif n kareena caught committed)
Pefloxacin
Ofloxacin
Levofloxacin
Ceftriaxone
Ampicillin/Amoxicillin
Chloramphenicol
Cotrimoxazole
Combination therapy

Drugs of choice for Alzheimer's disease--->

< DonT Respect Gals >

Donepezil
Tacrine
Rivastigmine
Galantamine

"Metoclopramide"
(a prokinetic antiemetic drug)-
1, 2, 3, 4
>Takes 1/2-1 hr. for oral action
>D2 antagonism
>5HT3 antagonism
>5HT4 agonism

Problems arising with the use of Antimicrobial Agents(AMAs) :

'Ma'sking of an infection
'N'utritional deficiencies(vit.B, K)
'S'uperinfection

'Hy'persensitivity reactions
'To'xicity
'Dr'ug Resistance

migraine prophylaxis drugs

very volatile pharmacotherapeutic agents for migraine prophylaxis

V-VERAPAMIL
V-VALPROIC ACID
P-PIZOTIFEN
A-AMITRYPTILINE
F-FLUNARAZINE
M-METHYL SERGIDE
P-PROPRANOLOL

Hemolytic uremic syndrome !
RATH. . . .

Renal failure
Anemia(coombs _ve),abdomnal symptms
Thrombocytopenia,
Hypofibrinogenimia,hyperkalemia

Methyldopa's side effects:-

"METHYLDOPA"

M-Mental retardation
E-Electrolyte imbalance
T-Tolerence
H-Headache/Hepatotoxicity
Y-psYchological upset
L-Lactation in female
D-Dry mouth
O-Oedema
P-Parkinsonism
A-Anaemia(heamolytic)

Clinical uses of propranolol
THAPPAD (means Slap)

T THYROTOXICOSIS AND TREMOR
H HYPERTENSION
A ANGINA AND ACUTE MI
P PROPHYLAXIS OF MIGRAINE
P PHEOCHROMOCYTOMA
A ANXIETY AND ARRYTHMIAS
D DISSECTING AORTIC ANEURYSM AND DIGITALIS TOXICITY

Uses of cephalosporin

A MESS Gives Parantha N Meat

Alternate to penicillin
Meningitis
Enteric fever
Septicemia
Surgical prophylaxis
Gonorrhea Pneumonia
Nosocomial infection

GLUCOCORTICOID adverse effects

GLUCOCORTICOID

G glucose level increases
...L LONG TIME TO HEAL
U ULCER-PEPTIC
C CUSHING SYND
O OSTEOPOROSIS
C CNS DISORDERS-INSOMNIA, PSYCHOSIS
O OCULAR DISEASE LIKE CATARACT,GLAUCOMA
R RETARDATION OF GROWTH
T THIN FRAGILE SKIN
I IMMUNOSUPPRESION
C CHF
O OEDEMA
I INCREASE IN BP
D DEPRESSION IN HPA AXIS

Name of drug increasing potassium levels
K+ bank

K= k+ sparing diuretics. eg. Spironolectone
B= beta blocker eg. Propranolol
A= ACE inhibitor eg= captopril
N=NSAID eg= asprin
K= k+ supplement eg. Pot. chloride

Pharmacological management of MI=
..Prevention OF Already Present Thrombi n Remove Plugs....

1.P=releive pain so morphine,pethidine wid antiemetics
2.O=oxygen therapy
3.F=iv fluids
4.A=correct acidosis by iv bicarbonate
5.P=prevent arrythmia by beta blockers nd correct pump failure by diuretics,vasodialators nd dopamine
T=thrombolytics lyk alteplase,nd heperin to prevent further extension
R=prevent remodlling by ACE inhibitors
P=prevent further attack by aspirin and hypolipidemic drug therapy

Aspirin: Adverse effects
"ASPIRIN"

Asthma
Salicylism
Peptic ulcer / Premature closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)

Corticosteroids: adverse side effects

CUSHINGS BAD MD:

Cataracts
...Up all night (sleep disturbances)
Suppression of HPA axis
Hypertension
Infections
Necrosis (avascular)
Gain weight
Striae
Bone loss (osteoporosis)
Acne
Diabetes
Myopathy, moon faces
Depression and emotional changes

Antibiotics contraindicated in pregnancy

'MCAT'

Metronidazole

Chloramphenicol
Aminoglycosides
Tetracyclines

Antihypertensives contraindicated in pregnancy

'DARSAN'

Diuretics
...Angiotensin I antagonists
Reserpine
Sodium nitroprusside
ACE inhibitors
Non selective β blockers

Xylocaine: Where not to use with Adrenaline?
"Digital PEN"

* Digits (Fingers and toes)
* Penis
* Ear
* Nose tip
Adrenaline causes vasoconstriction which helps to trap Xylocaine (anaesthetic) locally prolonging its duration of action. The two are not used together at sites supplied by end arteries as the vasoconstriction produced by adrenaline can cause ischemic necrosis of the tissues

Drugs causing SLE/Drug induced SLE :
HIP

H - Hydralazine
I - Isoniazid
P - Penicillamine

Pulmonary edema: treatments

MAD DOG:

Morphine
Aminophylline
Digitalis
Diuretics
Oxygen
GGases in blood (ABG's)

Uses of ceftriaxone

UMTS 3G

u-urinary tract infection

m-meningitis

t-typhoid fever

s-sepsis and septicaemia

3G means it z 3rd generation antibiotic

Adverse effects of CHLORAMPHENICOL

H.GIBS (the famous CRICKETER)

Hypersensitivity reactions
Gray baby syndrome
Irritative effects
Bone marrow depression
Superinfections

DRUGS CAUSING FOLATE DEFICIENCY:

"NO (Personal Secretary)2 P.M." No - Nitrofurantoin
(P.S.)X2
i.e.

P - Phenobarbitone
P - Phenytoin
S - Sulfonamide
S - sulfosalizine
P - Primidone
M - Methotrexate

METRONIDAZOLE - SPECTRUM OF ACTION

A-Amoebiasis
B-Bacteroides fragilis
C-Clostridium perfringens
D-Dracunculus medinensis
E-Pseudomembranus Enterocolitis
F-Fusobacterium G-Giardiasis
H-Helicobacter Pylori
S-Anaerobic Streptococci
T-Trichomonas

Systemic aminoglycosides

Saurav Ganguly- streptomycin,
gentamycin!
Anil Kumble- Amikacin, Kanamycin!
Sachin Tendulkar- Sisomycin, tobramycin

Uses of Fluoroquinolone

{3G SPECTRUM CT}
3G: Gonorrhoea, Gastroenteritis & Gram-ve Infections
S: Septicemia
P: Prophylaxis
E: Enterocolitis
C: Chancroid T: Typhoid
R: RTI
U: UTI
M: Meningitis
C: Conjunctivitis
T: Tuberculosis

Antiarrythmic drugs:Classes

 

" i' M BAC in rhythm ":

I.Membrane stabilizing agents (Na channel blockers)
II.Beta blockers (Antiadrenergic agents)
III.Agents widening AP
IV.Calcium channel blockers

Antihypertensives contraindicated in pregnancy

 

 ' DARSAN '

Diuretics

Angiotensin I antagonists

Reserpine

Sodium nitroprusside

ACE inhibitors

Non selective β blockers

Amiodarone: Adverse effects

 

" Plz Check PFT, LFT, TFT "

Plz- Photosensitivity, Pigmentation

Check for Corneal deposits

PFT- Pulmonary fibrosis

LFT- Liver damage (pseudoalcoholic liver injury)

TFT- Thyroid dysfunction

Hypertension: Management

 "ABCD"

ACE inhibitors/Angiotensin receptor blockers

Beta blockers

Calcium channel blockers

Diuretics

Phenytoin: Side effects

 

" PHENYTOIN "

P: Foetal hydantoin syndrome  (As 'Phenytoin' is pronounced as 'Fenytoin')

H: Hirsutism, Hypersensitivity

ENY: Anemia

T: Thick gums

0: Osteomalacia

I: Inhibits insulin

Phenytoin is not used during pregnancy as it can cause 'Foetal hydantoin syndrome' which is characterised by the development of hypoplastic distal phalanges, cleft lip, cleft palate, microcephaly, impaired growth and congenital heart defects in the foetus.

Adverse effects of Morphine

 

" MORPHINE "

Miosis

Oliguria

Respiratory depression

Pruritus

Hypotension

Infrequency (constipation)

Nausea

Emesis (Vomiting) 

Physostigmine vs. neostigmine

 

"LMNOP":

Lipid soluble

Miotic

Natural

Orally absorbed well

Physostigmine

Beta-blocker main contraindications / cautions

 

ABCDE:

Asthma

Block (heart block)

COPD

Diabetes mellitus

Electrolyte (hyperkalemia

Muscarinic effects

 

" SLUG BAM ":

Salivation/ Secretions/ Sweating

Lacrimation

Urination

Gastrointestinal upset

Bradycardia/ Bronchoconstriction/ Bowel movement

Abdominal cramps/ Anorexia

Miosis

Anticholinergic side effects

 

ABCD'S 

Anorexia

Blurry vision

Constipation/ Confusion

Dry Mouth

Sedation/ Stasis of urine

Teratogenic drugs :Major non-antibiotics

 

TAP CAP:

Thalidomide

Androgens

Progestins

Corticosteroids

Aspirin & indomethacin

Phenytoin

Drugs metabolized by acetylation

 

' SHIP'

Sulfonamides including dapsone

Hydralazine

Isoniazid (INH)

Procainamide

Enzyme inhibitors

 

 ' COMIC CASE '

Cimetidine

Omeprazole

Metronidazole

Isoniazid

Chloramphenicol

Ciprofloxacin

Allopurinol

Sulphonamides

Erythromycin

Enzyme inducers

 

 ' P RAGA ' 

Phenylbutazone

Anticonvulsants

Rifampicin

Griseofulvin

Alcohol

Drugs undergoing complete first pass metabolism when taken orally

'F I L T Hy'

First pass metabolism

Isoprenaline

Lignocaine

Testosterone

Hydrocortisone

H. Pylori treatment regimen (rough guidelines

"Please Make Tummy Better":

Proton pump inhibitor
Metronidazole
Tetracycline
Bismuth

Alternatively: TOMB:
Tetracycline
Omeprazole
Metronidazole
Bismuth

Miosis: causes of pin-point pupils

CPR ON SLIME:


Clonidine
Phenothiazines
Resting (deep sleep)
Opiates
Narcotics
Stroke (pontine hemorrhage)
Lomotil (diphenoxylate)
Insecticides
Mushrooms/ Muscarinic (inocybe, clitocybe)
Eye drops

Spinal anesthesia agents

"Little Boys Prefer Toys":
Lidocaine
Bupivicaine
Procaine
Tetracaine