ACE Inhibitor Side Effects CAPTOPRIL C ough A naphylaxis P alpitations T aste O rthostatic hypotension P otassium elevated R enal impairment I mpotence L eukocytosis
Anti-Epileptic Side Effect ABCDEFGH
A taxia
B lood dyscrasia C left lip
D upuytrens / Vit D deficiency
E xfoliation of skin & Stevens Johnson's F its
G I upset/gum hypertrophy H epatitis/hairy
Barbiturate Side Effects ABCD
A taxia
B ehavioral disturbance
C oncentration decreased/coma D epression/drowsy/diplopia Cholinergic OD Side Effects DUMB BELS D iarrhea U rination M iosis/muscle weakness B ronchorrea B radycardia E mesis L acrimation S alivation/sweating Cyclosporin Side Effects 4HRT
ACE Inhibitor Side Effects
4H yperkalemia, hypertension, gum hypertrophy, hair R enal toxicity
T remor
Gynacomastia Causing Drugs DISCO MTV D igoxin I soniazid S pironolactone C imetidine O estrogens M ethyldopa/metronidazole T CAD V erapamil
MAOI Side Effects The 3Hs H epatocellular jaundice H yperthermia H ypertension Propranolol, contra-indications ABCDE A sthman B lock (heart) C ardiac failure D M (hypoglycemic shock)
E xtremities (occlusive arterial disease) Pulmonary Edema, Non-Cardiac PONS
P hosgene/paraquat/phenothiazines O pioids/organophosphates
N itrous dioxide S alicylate
TCAD Side Effects CAN WOO C VS A nticholinergic N euro W ithdrawal O verdose
ACE Inhibitor Side Effects O thers Rat Poison RATS PANIC R ed squill A rsenic T hallium S trychnine P NU/phosphorus/ZN phosphide A lpha naphtha thiurea (ANTU) N orbormide
I ndanediones
C oumarin/cholecalciferol Steroid Side Effects HIGH COMPACT IMPS H ypertension
I mmunosuppresion G astric ulcer (bleeding) H eartburn C ataract O steoporosis M uscle weakness P ath #/psychosis A cne/altered glucose C ushingoid T hin skin I ncreased appetite M yopathy
P oor wound healing S tress response reduced or
AM CUSHINGOID A cne
M yopathy/proximal muscle weakness C ushingoid/cataract
U lcers
S triae, skin thinning/bruising H ypertension/hairy
ACE Inhibitor Side Effects I nfection G lycosuria O besity/osteoporosis/oedema I mmunosuppression/insomnia D epression Warfarin WEPT W arfarin E xtrinsic pathway Measure PT Class IC Antiarrhythmics FEP F lecainide E ncainide P ropafenone
Class III Antiarrhythmics SIBA
S otalol I butilide B retylium A miodarone
Beta 1 Selective Blockers A-BEAM A cebutalol B etaxolol E smolol A tenolol M etoprolol
Gynacomastia, Drugs That Cause "Some Drugs Create Awesome Knockers S pironolactone
D igistalis C isplatin A lcohol K etoconozole
Drugs Causing Pulmonary Fibrosis BABE
ACE Inhibitor Side Effects A miodarone
B usulfan E (empty)
Drugs that Cause Hepatic Necrosis HAVE
H alothane
A cetaminophen (liquefactive necrosis) V alproic acid
E (empty)
Drugs Causing Agranulocytosis The 3Cs
C lozapine C olchicine C arbamazepine
Drugs for All Types of Seizures (except petit mal) CAPHE
CA rbamazepine
PHE nytoin/phenobarbital Drugs for Petit Mal Seizures VALET
VAL proic acid ET hosuximide Vancomycin
"A Red Van Drove Into The Wall"
A ntihistamines (prevents redman syndrome) R ed man syndrome
V ancomycin D -ala D-ala I nhibitor
T hrombophlebitis W all (as in cell wall) Tuberculosis Drugs RESPI R ifampin E thambutol S treptomycin Pyrazinamide I soniazid
Short Acting Benzodiazepines
ACE Inhibitor Side Effects TOM thumb T riazolam O xazepam M idazolam Beta 2 Agonists SMART S almeterol M etaproterenol A lbuterol R itodrine T erbutaline Stevens-Johnson Syndrome LESS L amotrigine E thosuximide S ulfonamides S tevens-Johnson Fluconazole The 3Cs C andidiasis C occidiomycosis C ryptocococcal meningitis Class IB Antiarrhythmics "Medical Lab Technician" M exilietine L idocaine T ocainide Lithium LITHIUM L eukocytosis
I nhibits PIP2, cAMP and 5' deiodinase T eratogenic/thiazide contraindicated
H ypothyroidism/hyponatremia increases toxicity I nsipidus (nephrogenic diabetes)
visUal dysfunction
M ovement disorders: CATS (choreoathetosis, ataxia, tremors, seizures)
Drugs Contraindicated During Pregnancy SAFE CT
ACE Inhibitor Side Effects S ulfonamide A minoglycoside F louroquinolones E rythromycin C larithromycin T etracycline
Benzodiazepines Metabolized Outside the Liver "Outside The Liver
O xazepam T emazepam L orazepam
Drugs Cuasing Megaloblastic Anemia MAPLE
M ethotrexate A ZT = zidovudine
P henytoin (causes folate deficiency) L iver disease E thanol Amphotericin Toxicities AMPHOTERICIN B A nemia M uscle spasms
ACE Inhibitor Side Effects P hlebitis
H eadaches/hypotension/hypokalemia T hrombocytopenia
E mesis, encephalopathy R espiratory strida
I ncreased temperature (fever) C hills
I mmediate hypersensitivity (anaphylaxis) N ephrotoxicity--important! B ronchospasm CNS Effects of Morphine SCREAMNT S edation C ough suppression/convulsions R espiratory depression E uphoria A nalgesia
M yosis (but may cause mydriasis in doses causing asphyxia)
N ausea and vomiting
T runcal rigidity (especially with fentanyl)
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
Antiarrhythmics: class III members BIAS:
Bretylium Ibutilide Amiodarone Sotalol
Ca++ channel blockers: uses CA++ MASH:
Cerebral vasospasm/ CHF Angina
Migranes
Atrial flutter, fibrillation Supraventricular tachycardia CHASM
Cererbral vasospasm / CHF Hypertension Angina Suprventricular tachyarrhythmia Migranes 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 Anticholinergic side effects
"Know the ABCD'S of anticholinergic side effects": Anorexia
Blurry vision
Constipation/ Confusion Dry Mouth
Sedation/ Stasis of urine
Antimuscarinics: members, action "Inhibits Parasympathetic And Sweat": Ipratropium
Pirenzepine Atropine Scopolamine
_Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic. 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)
Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT:
Lorazepam Oxazepam Temazepam
Benzodiazepenes: antidote "Ben is off with the flu":
Benzodiazepine effects off with Flumazenil.
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. 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. Beta selective blockers
"BEAM ONE up, Scotty": Beta blockers:
Esmolol Atenolol Metropolol
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).
Cholinergics (eg organophosphates): effects
If you know these, you will be "LESS DUMB": or SLUDGE Lacrimation
Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction Delerium-causing drugs ACUTE CHANGE IN MS:
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: Dopamine Isoproterenol Norepinephrine Epinephrine Dobutamine Inhalation anesthetics SHINE: 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:
Anemia Basophilic stripping Colicky pain Diarrhea Encephalopathy Foot drop Gum (lead line) Lithium: side effects LITH:
Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis
Hypothyroidism 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. Methyldopa: side effects
METHYLDOPA: 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":
Phenelzine Isocarboxazid Tranylcypromine
_ A pit of despair, since MAOs treat depression. Morphine: effects MORPHINES: Miosis Orthostatic hypotension Respiratory depression Pain supression
Histamine release/ Hormonal alterations Increased ICT
Nausea Euphoria Sedation
Morphine: effects at mu receptor PEAR: Physical dependence Euphoria Analgesia Respiratory depression Narcotic antagonists
The Narcotic Antagonists are NAloxone and NAltrexone. _ Important clinically to treat narcotic overdose.
SALAD: Selegiline
Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine)
L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide) Amantadine
Dopamine postsynaptic receptor agonists (bromocriptine, lisuride, pergolide) Phenytoin: adverse effects
PHENYTOIN: 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:
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":
Morphine overdose: pupils constricted (fine). Amphetamine overdose: pupils dilated (fat). Serotonin syndrome: components Causes HARM:
Hyperthermia
Autonomic instability (delirium) Rigidity
Myoclonus
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)
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.
Tricyclic antidepressants: members worth knowing "I have to hide, the CIA is after me":
Clomipramine Imipramine Amitrptyline
_ If want the next worth knowing, the DNDis also after me: Desipramine
Doxepin
Tricyclic antidipressents (TCA): side effects TCA'S: ThrombocytopeniaCardiac (arrhymia, MI, stroke) Anticholinergic (tachycardia, urinary retention, etc) Seizures
Vigabatrin: mechanism Vi-GABA-Tr-In:
Via GABA Transferase Inhibition
Antibiotics contraindicated during pregnancy MCAT: Metronidazole Chloramphenicol Aminoglycoside Tetracycline 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
Metabolism enzyme inducers
"Randy's Black Car Goes Putt Putt and Smokes": Rifampin Barbiturates Carbamazepine Grisoefulvin Phenytoin Phenobarb Smoking cigarettes Morphine: side-effects MORPHINE: 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": Phenytoin
Ethanol Aspirin Zero order
_ Someone that pees out a constant amount describes zero order kinetics (always the same amount out) Asthma drugs: leukotriene inhibitor action
zAfirlukast: Antagonist of lipoxygenase zIlueton: Inhibitor of LT receptor Beta- vs Beta- receptor location "You have heart and lungs":
Beta- are therefore primarily on heart. Beta- primarily on lungs.
"Very Angry Hepatocytes": Valproic acid
Acetaminophen Halothane
Adrenoceptors: vasomotor function of alpha vs. beta ABCD:
Alpha = Constrict. Beta = Dilate.
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.
Beta-blockers: main contraindications, cautions ABCDE:
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...): Timolol
Pindolol Hismolol Naldolol Propranolol
1.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
2.Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": Lacrimation
Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction 3.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
4.Methyldopa: side effects METHYLDOPA:
Mental retardation Electrolyte imbalance Tolerance
psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic)
5.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) 6.
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 7.Lithium: side effects LITH:
Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis
Hypothyroidism 8.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
9.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
