High Yield - SketchyPharm Flashcards
Muscarinic Agonist
Treatment of Non-Obstructive GI dysmotility or Urinary Retention
Beth with Cola
Bethanechol
Muscarinic Agonist
Treatment of Acute Angle Glaucoma (Pupillary Constriction and Aqueous Humor Outflow Increase)
Pile of Carp
Pilocarpine
Muscarinic Agonist and Nicotinic Agonist
Treatment of Acute Angle Glaucoma (Pupillary Constriction and Aqueous Humor Outflow Increase)
Carbon Fumes
Carbachol
Muscarinic Agonist
Instigates asthma for Pulmonary testing
(Contract Bronchial smooth muscle which may exacerbate asthma or COPD)
Marathon challenge
Methacholine
Nicotinic Partial Agonist
Used for Smoking Cessation
1-800-Very-Clean
Varenicline
Acetylcholinesterase Inhibitor
Increase Ach at NMJ endplate to outcompete Myasthenia Gravis Antibodies (Peripheral Only)
Community PRIDE
Pyridostigmine
Acetylcholinesterase Inhibitor
Increase Ach at NMJ endplate to outcompete Myasthenia Gravis Antibodies (Peripheral Only)
Neon sign STIGMA
Neostigmine
Acetylcholinesterase Inhibitor
Increase Ach at NMJ endplate to Transiently Reverses Myasthenia Gravis Antibodies (Peripheral Only) - Tensilon test
Phone Booth
Edrophonium
Inhibitors of Nicotinic Ach-R in NMJ endplate
Non-depolarizing Neuromuscular blockade
Crayons stuck in end plate
Tubocurarine, Pancuronium, Cisatracurium
Nicotinic Ach receptor Agonist
Depolarizing Neuromuscular blockade. May cause HSN induced-Malignant Hyperthermia (RYR1 Defect are prone to) → Rhabdomyolysis .
SUCKS
Succinylcholine
Acetylcholinesterase inhibitor
Increase Ach at synaptic Cleft + with CENTRAL effects
Treatment for Atropine Overdose
PHYS ED center
Physostigmine
Acetylcholinesterase inhibitor
Alzheimer’s disease (CENTRAL effects)
Alzheimer’s GALA
Galantamine
Acetylcholinesterase inhibitor
Alzheimer’s disease (CENTRAL effects)
Reverse the Stigma
Rivastigmine
Acetylcholinesterase inhibitor
Alzheimer’s disease (CENTRAL effects)
Done with the Puzzle
Donepezil
Natural Antimuscarinic Agent
Prototype from Jimson Weed/Deadly nightshade/ Atropa Belladonna. Side effects: hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter
Alice
Atropine
Muscarinic Antagonist (M1)
Treatment for Seasick/ Motion sickness (Vestibular Nueasa). Atropinic Side effects.
Sailor outfit
Scopolamine
Muscarinic Antagonist (M3)
Treatment for COPD (Bronchodilator). Atropinic Side effects.
Cat-Ipa-Tio-Tropillar
Ipratropium and Tiotropium
tiotropium dissociates more slowly
Muscarinic Antagonist (M3)
Used to relieve Bladder spasm after Urologic surgery. Atropinic Side effects.
Ox butler
Oxybutynin
Muscarinic Antagonist (M3)
Treatment for Adult urinary incontinence. Atropinic Side effects.
Turtle butler
Tolterodine
Muscarinic Antagonist (M1 + Centrally Acting)
Treats Parkinsonism Tremor and Rigidity by restoring Dopaminergic/Muscarinic balance! Atropinic Side effects.
BENZ parked in M1
Benztropine
Muscarinic Antagonist (M1 + Centrally Acting)
Treats Parkinsonism Tremor and Rigidity by restoring Dopaminergic/Muscarinic balance! Atropinic Side effects.
Tri-Hex car parked in M1
Trihexyphenidyl
α-1 Agonist
Vasoconstriction - Treats Nasal Congestion, TPR ↑, Diastolic and Systolic BP↑
Flannel friends
Phenylephrine
α-1 Agonist > β-1 Agonist
Vasoconstriction - Treats Septic Shock, TPR ↑, PULSE PRESSURE↑ > Heart Contractility↑
North Compass Scout Leader
Norepinephrine
β-2 Agonists
Treats COPD, Asthma etc. (Bronchodilation)
ROLL (Suffix) call sheet held by tuba player
Albuterol (aka Ventolin in Israel)
β Agonist >α Agonist
Treats Anaphylactic Shock
Low Dose = β Agonist → Bronchodilation, TPR↓ and Heart Contractility↑
High Dose = α Agonist → Vasoconstriction, TPR↑ and PULSE PRESSURE↑
EPIC kiss between α and β camps
Epinephrine
β-1 Agonist >β-2 Agonist
Treats Cardiogenic Shock
HR↑, Contractility↑, PULSE PRESSURE↑
Just DO Bugling
Dobutamine
β-1 Agonist = β-2 Agonist
Treats Heart Block
HR↑, Contractility↑, TPR↓, PULSE PRESSURE↑
Iso-pro-tunnel
Isoproterenol
β-2 Agonist
Prevents Premature Labor
Relax uterine smooth muscle tone
Do Not DisTURB
Terbutaline
β-2 Agonist
Prevents Premature Labor
Relax uterine smooth muscle tone
I DREAM of band camp
Ritodrine
Tyrosine Hydroxylase Inhibitor
Prevents conversion of tyrosine to L-DOPA
Camp counselor Mitch yelling “My TIRE!”
Metyrosine
Illicit drug
Peripherally, NET Inhibitor - Hypertension, Tachycardia, Mydriasis (may also nasal septum perforation or MI)
Centrally, DAT Inhibitor - Arousal, Addiction, and Seizures.
Hot cocoa
Cocaine
NET Inhibitor
Treats ADHD
Atom on TV next to empty net
Atomoxetine
VMAT Inhibitor
Deplete catecholamines peripherally - HTN treatment
Serpent blocking V mat
Reserpine
Also tetrabenazine
Amphetamine Derivative
Treats ADHD - Displaces Catecholamines and Monoamines into Synapse
Friend Date on HDTV
Methylphenidate
Atypical, selective, and weak Dopamine Reuptake Inhibitor
Treats Narcolepsy - Unknown Mechanism
Sleep Mode fine
Modafinil
Catecholamine for Shock or HF
Low Dose = D1R = RBF↑
Medium Dose = β1-Agonist = Cardiac Activator
High Dose = α1-Agonist = Vasoconstrictor
Single Dope Rope swing
Dopamine
α-2 Agonist
Treatment for Hypertension - Sympathetic↓ = CO↓ and BP↓.
Also for ADHD and Tourette’s
Raul with the “law weapon Claw”
Clonidine
α-2 Agonist
for Gestational Hypertension - Sympathetic↓ = CO↓ and BP↓. May induce Lupus like syn.
Alpha-shaped dope rope
α-Methyldopa
α-2 Agonist
Centrally acting Muscle Relaxant
“To X-tine”
Tizanidine
Reversible α-1 and α-2 Antagonist (Non-Selective)
Indirect Vasodilator - treats Cocaine Toxicity, MAOi HTN crisis, Pheochromocytoma Symptoms
Phantom
Phentolamine
Irreversible α-1 and α-2 Antagonist (Non-Selective)
Indirect Vasodilator - treats Pheochromocytoma Symptoms preoperatively and Intraoperatively to control BP
Irreversible phoenix tattoo
Phenoxybenzamine
α-1 Antagonist (Selective)
treat BPH - Relax smooth muscle in the urethra and prostate
Opera singer compressing prostate
Terazosin
α-1 Antagonist (Selective)
treat PTSD as well as BPH Relax smooth muscle in the urethra and prostate
Opera singer compressing prostate
Prazosin
α-2 Antagonist (Selective)
Atypical antidepressant - Enhances Serotonin and Norepinephrine release, Blocks 5HT2R, 5HT3R and H1R. Causes Sedation and Weight Gain. Sexual Function is unharmed.
Mirth and Misery Theater
Mirtazapine
Selective β1 Blocker (cardioselective)
Useful in the acute treatment of MI and other acute coronary syndromes (ACS)+ Cardiac remodeling↓ and Mortality↓
The 2 As A-BEAM spotlight on β1 bugler
Atenolol (aka Normiten) and Acebutolol
Selective β1 Blocker (cardioselective)
Useful in the acute treatment of MI and other acute coronary syndromes (ACS)+ Cardiac remodeling↓ and ; Mortality↓
The B in A-BEAM spotlight on β1 bugler
Betaxolol
Selective β1 Blocker (cardioselective)
Useful in the acute treatment of MI and other acute coronary syndromes (ACS)+ Cardiac remodeling↓ and Mortality↓
The E in A-BEAM spotlight on β1 bugler
Esmolol
Selective β1 Blocker (cardioselective)
Useful in the acute treatment of MI and other acute coronary syndromes (ACS)+ Cardiac remodeling↓ and Mortality↓
The M in A-BEAM spotlight on β1 bugler
Metoprolol
Non-Selective β Blocker and α-1 Blocker
Useful in the treatment of CHF + Cardiac remodeling↓ and Mortality↓
CARVED candle holder next to failing heart:
Carvedilol
Non-Selective β Blocker and α-1 Blocker
With Peripheral Vasodilation - Treats Gestational Hypertension, Aortic Dissection, Hypertrophic obstructive cardiomyopathy and Migraine as Prophylaxis
α and β organ stops with extinguished alpha candle
Labetalol
Non-Selective β Blocker
Treatment of thyroid storm (blocks catecholamine surge) “treat with 3 p’s __________ , Prednisone, and Propylthiouracil”
Large Bow-Tie
Propranolol
Topical Non-Selective β Blocker
Treat Glaucoma - Blocks β2 Receptors on the Ciliary Epithelium → Aqueous humor production↓
TIM draining the muted β2 tuba
Timolol
PDE Inhibitor used for HF treatment
cAMP↑ → Contractility↑ and ; Arteriolar Dilation
One in a Million
Milrinone
BNP Analogue (Brain Natriuretic peptide)
cGMP↑ → Venous and Arteriolar Dilation → Preload↓ and Afterload↓.Along with Natriuresis effect.
Turn the tide
Nesiritide
CHF, HTN and DM Nephropathy Treatment Drugs (3 ex)
ATII↓ → Aldosterone↓, [NaHCO3] Reab↓ and GFR↓.
Cardiac Remodeling↓ and Mortality↓.
May lead to fetal Hypotension/ Renal Toxicity with NSAIDs
Ace on table of APRIL showers Casino
ACE Inhibitors: Captopril, Ramipril, Lisinopril
aka In Israel Enalapril
CHF, HTN and DM Nephropathy Treatment Drugs (3 ex)
ATII Binding↓ → Aldosterone↓, [NaHCO3] Reab↓ and GFR↓. Cardiac Remodeling↓ and Mortality↓
May Cause Hyperkalemia
SoRry Taken seat
ARBs : Losartan, Candesartan, Valsartan
Direct Renin Inhibitor
AT↓ → Aldosterone↓, [NaHCO3] Reab↓ and GFR↓. Cardiac Remodeling↓ and Mortality↓
May Cause Hyperkalemia
“High Risk” Slot Machine
Aliskiren
Natriuretic: PCT Lumin Carbonic Anhydrase Inhibitor
For Intraocular/ Intracranial / General HTN / Mountain Sickness: NaHCO3 Reabsorption↓
May Cause Hyperchloremic Metabolic Acidosis / Type 2 RTA / Hypokalemia / CaP Stones / Sulfa Drug effects
Battery acid Breaking Car Battery
Acetazolamide
Osmotic Diuretic at PCT and descending limb of loop
For Intraocular/ Intracranial / General HTN: ECF↑ + ICF↓
May Cause Pulmonary edema and Hyponatremia
Tall Man
Mannitol
Loop Diuretic (TAL) blocks Luminal NKCC Transporter
For Acute HF (Preload↓), Liver Failure (Ascites↓), HTN (Natriuresis). May Cause Sulfa Drug effects / Hypomagnesemia / Hypokalemia / Hyperuricemia / Contraction Alkalosis / Interstitial Nephritis
Furious kid
Furosemide
Loop Diuretic (TAL) blocks Luminal NKCC Transporter
For Acute HF (Preload↓), Liver Failure (Ascites↓), HTN (Natriuresis). May Cause Hypomagnesemia / Hypokalemia / Hyperuricemia / Contraction Alkalosis / Interstitial Nephritis
Code of Ethics Sign
Ethacrynic Acid
2 Diuretics - Blocks PT Luminal NaCl cotransporter + Enhances DCT Basolateral Na Ca exchanger (Ca↑)
For HTN, HF (2nd Line), DI, Prevention of Calcium Stones. Can Cause Hyperglycemia, Hyperlipidemia Hyperuricemia, Hypokalemia, Hyponatremia and sulfa Effects. Contraction Alkalosis / Metabolic Acidosis
Chloro-thighs, Theodore Roosevelt on high dive
Thiazides: Hydrochlorothiazide and Chlorthalidone
K+ Sparing Diuretics (2): Block Collecting Duct ENaC
For Lithium Induced DI, Liddle’s syndrome
May lead to Hyperkalemia, Type 4 RTA, Hyperchloremic Metabolic Acidosis.
Tangerines and Almonds
Triamterene and Amiloride
K+ Sparing Diuretics (2) : Block Mineralocorticoid Receptor (ENaC↓)
For Primary or Secondary Hyperaldosteronism, Reduce CHF Mortality by Remodeling↓, Lithium Induced DI and Hirsutism
May lead to Hyperkalemia, Type 4 RTA, Hyperchloremic Metabolic Acidosis, Gynecomastia and impotence
Spiral bound Notebook with Inspector and Apple with the teacher
Spironolactone and Eplerenone
Calcium Channel Blockers: L-Type Cardiac (2)
For Arrhythmias, Hypertension by Inotropy↓, Chronotropy↓, Dromotropy↓+ Minimal Vasodilation. May cause Constipation, Exacerbate HF or Heart Block.
Non-Dairy: Very Vanilla or Delicious Dark Chocolate
Non-Dihydropyridine: Verapamil and Diltiazem
Calcium Channel Blockers: L-Type Vascular (3)
For HTN Crisis, Prinzmetal and Stable Angina, Gestational HTN, Subarachnoid Hemorrhage and Raynaud’s Syn. by TPR↓ (Vasodilation). May cause Peripheral Edema (Short acting type may Exacerbate MI)
Dipping in Dairy: Large Knife, Clover, Nice card
Dihydropyridines: Nifedipine, Clevidipine, Nicardipine
aka in Israel Norvasc
Arteriolar Vasodilator
For HTN Crisis and Gestational HTN by TPR↓ (Vasodilation). May cause Reflex Tachycardia that Worsen Angina (can prevent with β Blockers)
Hydro-Boat with Dilated Red Hose
Hydralazine
Arteriolar and Venous Vasodilator
For HTN Crisis by NO Metabolite causing cGMP↑ and Myosin Activity↓ → TPR↓ and BP↓. May cause Cyanide Poisoning
Nitro Speedboat
Nitroprusside
Selective D1 Receptor Agonist and Natriuretic
For HTN Crisis by cAMP↑ → Vasodilation in Multiple Sites → TPR↓, Coronary Blood Flow↑ and Renal Blood Flow↑ + TBW↓
Old lady PAM with Camping tent
Fenoldopam
Class IA Antiarrhythmic, α-1 Blocker and Antimuscarinic Drug (May be used for P. Falciparum)
For Supraventricular and Ventricular Arrhythmias (WPW) by Blocking Na and K channels -Medium Binding Strength → AP Duration↑ and Refractory Period↑
can cause Cinchonism, TdP and PLT↓.
(The) Queen Dines
Quinidine
Class IA Antiarrhythmic
For Supraventricular and Ventricular Arrhythmias (WPW) by Blocking Na and K channels -Medium Binding Strength → AP Duration↑ and Refractory Period↑
can cause Lupus like sym, TdP and Hypotension
Prom King
Procainamide
Class IA Antiarrhythmic and Anticholinergic Drug
For Supraventricular and Ventricular Arrhythmias (WPW) by Blocking Na and K channels -Medium Binding Strength → AP Duration↑ and Refractory Period↑
can cause TdP and Excerabete HF (Negative Inotropy).
“Disappears!”
Disopyramide
Class IB Antiarrhythmic (Given as IV)and Local Anesthetic (Topical)
For Ischemia and Ventricular Arrhythmias by Blocking Na - Low Binding Strength → AP Duration↓ and Refractory Period↓
can cause Neurological Issues - paresthesias, tremor, convulsions
“Lied!”
Lidocaine
IB Antiarrhythmic and Narrow Spectrum Antiepileptic
For Ischemia and Ventricular Arrhythmias by Blocking Na - Low Binding Strength → AP Duration↓ and Refractory Period↓. Also for Acute Seizures.
May cause Ataxia, Diplopia, Megaloblastic Anemia (B9↓), Gingival Hyperplasia (PGF↑) and Lupus-Like Syn, DRESS Syndrome, SJS (Mostly in Asians), Teratogenic Cleft Palate, Osteoporosis and Induction of Hepatic CYP450.
Friendly towing (On Shirt)
Phenytoin
Class IB Antiarrhythmic (Oral Analogue of Lidocaine)
For Ischemia and Ventricular Arrhythmias by Blocking Na - Low Binding Strength → AP Duration↓ and Refractory Period↓
can cause Neurological Issues - paresthesias, tremor, convulsions.
Mexican flag
Mexiletine
Class IC Antiarrhythmic (Given as IV)
For Supraventricular (A.Fib) and Ventricular arrhythmias by Blocking Na - High Binding Strength → AP Duration Same, Refractory Period↑ and Upstroke Slowed down Contraindicated in patients with hepatic dysfunction, asthma, CHF, or bradycardia (proarrhythmic effects).
(Corn)Flakes
Flecainide
Class IC Antiarrhythmic (Given as IV) and β Blocker
For Supraventricular (A.Fib) and Ventricular arrhythmias by Blocking Na - High Binding Strength → AP Duration Same, Refractory Period↑ and Upstroke Slowed down Contraindicated in patients with hepatic dysfunction, asthma, CHF, or bradycardia (proarrhythmic effects).
Purple Phone
Propafenone
Class II Antiarrhythmics (Given IV)
For Acute Supraventricular (AFib “Rate control” but does not fix ) by cAMP↓ and Ca↓ - phase 4 of the nodal AP↑, Pacemaker activity↓, Conduction time↑ and Refractory period↑. May Cause heart block, Prolong PR.
β Bugle
β Blockers: Propranolol, Esmolol, Carvedilol, Metoprolol Atenolol…
A Drug with properties of class I, II, III, and IV antiarrhythmics. (Used mainly as Class III)
For Supraventricular and Ventricular Arrhythmias by Blocks K Channel - AP Duration ↑,Refractory period↑. May Cause neurologic Issues, grey corneal, Thyroid Malfunction, Pulmonary fibrosis, HF, HSN Hepatitis, Photodermatitis, cytochrome P450 inhibition, TdP.
Amigo Singing “uno, dos, tres, quattro”
Amiodarone
Class III Antiarrhythmics (2)
For Supraventricular and Ventricular Arrhythmias by Blocks K Channel - AP Duration ↑,Refractory period↑. May Cause TdP, Sick Sinus Syndrome.
“till I die”
Dofetilide and Ibutilide
Class III Antiarrhythmic and β Blocker
For Supraventricular and Ventricular Arrhythmias by Blocks K Channel - AP Duration ↑,Refractory period↑. May Cause TdP, Sick Sinus Syndrome,Fatigue, dizziness, lightheadedness, headache, weakness, nausea, shortness of breath, bradycardia.
Soda
Sotalol
Class IV Antiarrhythmics ( Rate Control)
For Supraventricular Arrhythmias by Ca↓ -Pacemaker Activity↓, Conduction Time ↑,Refractory period↑. May Cause May Cause heart block, Prolong PR.
Non Dairy Very Vanilla and Delicious Dark Chocolate
Cardiac CCBs (L type); Non-Dihydropyridine: Verapamil and Diltiazem
Class V (Irregular) Antiarrhythmic (Rate Control) and Parasympathomimetic (Vagal Tone↑)
For Supraventricular Arrhythmias and CHF Symptoms Relief Like A.fib and Flutter by AV nodal inhibition and Indirect Ca↑ -Contractility↑, Conduction Time↑. May cause scooped concave ST seg., Hyperkalemia, AV Block. (Not First line, Contraindicated in Hypokalemia)
DJ Foxglove
Digoxin
Class V (Irregular) Antiarrhythmic (Rate Control)
for TdP or Digoxin Toxicity - Decreases Ca influx by Competitive influx (Mg)
May lead to Hypotension Asystole
Magnets
Magnesium Sulfate
Class V (Irregular) Antiarrhythmic (Rate Control)
for AVNRT, Orthodromic AVRT and A.fib -A1 receptor Gi Activation→ cAMP↓ → L- Type Ca Channels↓ and K Channels↑
May lead to Hypotension Asystole, Angina, Flushing, bronchospasm Sense of impending doom, AV block.
A1 Swing Dancing
Adenosine
Heart Rate Control Drug (Oral) for HF and Angina
HCN4 receptors Blocking → If↓ → Depolarization Time↑ → HR↓
May lead to Luminous phenomena, AV block, Ventricular extrasystoles
Ivy on Brad (Not on Sketchy)
Ivabradine
Anticoagulant (Given as IV) - FIIa and Xa Antagonist
For DVT, PE, MI, Complexed with Antithrombin III irreversible inactivates thrombin and Factor Xa - Blocks Intrinsic Pathway (aPTT). May Cause HIT, Hyperaldosteronism, Type RTA 4, Hyperkalemia, Osteoporosis (Reversed by Protamine Sulfate).
Heppy Hunting Father
Heparin
Anticoagulant (Given as IV) - FIIa and Xa Antagonist
For DVT, PE, MI, Complexed with Antithrombin III irreversible inactivates thrombin and Factor Xa - Blocks Intrinsic Pathway (Not checked by aPTT). May Cause HIT, Contraindicated in Renal Failure - High Half Life (Less Reversed by Protamine Sulfate).
Heppy Hunting Daughter
LMWH: Low Molecular Weight Heparin
Anticoagulant (Given as IV) - FIIa and Xa Antagonist
For DVT, PE, MI, Complexed with Antithrombin III irreversible (Most Specific) inactivates Factor Xa Mostly (slight Thrombin)- Blocks Intrinsic Pathway (Not checked by aPTT). May Cause HIT (Less Reversed by Protamine Sulfate).
Fido with a Pair of FoXes
Fondaparinux
Anticoagulant - Direct Thrombin Inhibitor
Used in PCI or ACS, Heparin Induced Thrombocytopenia (HIT) is NOT a Side effect
No Intruding
Bivalirudin
Anticoagulant - Direct Thrombin Inhibitors (2)
Used in PCI or ACS, Heparin Induced Thrombocytopenia (HIT) is NOT a Side effect
Big Gator
Argatroban
and Dabigatran
Anticoagulant - Direct FXa Inhibitors (2) (Given Orally)
Used in Long term Afib , Heparin Induced Thrombocytopenia (HIT) is NOT a Side effect.
Banned foXes
Rivaroxaban
and
Apixaban
Anticoagulant - VKOR Inhibitor (Given Orally)
For Chronic Anticoagulation (3 days, Initially ProCoug from S and C) by Prevention of Gamma Carboxylation of Factors II, VII, IX, XII and X. May Cause Skin Necrosis, CYP450 Dependent Effect. Reversed by FFP or VitK.
Warhead destroying V-KOR supply ship
Warfarin
High Dose = Anti-Inflammatory Agent vs. Low Dose = Antiplatelet Agent - Non Selective COX Inhibitor (Oral)
For Migraine Prophylaxis and ACS - Platelet Activation↓ and Aggregation↓ by Irreversibly Acetylating COX1 and COX2. May cause Pseudo-Allergy (Asthma) due to LPO↑→LT↑, GI Bleeding, Reye’s syn. , Anion Gap Metabolic Acidosis, Respiratory Alkalosis and Gestational DA Closure.(Reversed by NaHCO3 or Activated Charcoal)
ASA umpire ejecting the Coaches
Aspirin (Acetylsalicylic acid, aka Cartia in Israel)
Antiplatelet Agent - ADP P2Y12 Receptor Inhibitors (2, Oral)
For Migraine Prophylaxis and ACS - Platelet Activation↓ and Aggregation↓ by Blocking ADP Irreversibly. One of Them may Cause GI Bleeding, Neutropenia / Granulocytopenia (WBC count before).
Greasy Grill Pipe and Ty Cobb
Thienopyridines - Clopidogrel (and Ticlopidine)
Antiplatelet Agent - GP IIb/IIIa Receptor Blocker (PLT-Fibrinogen Interaction Inhibition)
For Migraine Prophylaxis and ACS - Platelet Aggregation↓, It is Monoclonal IgG antibody. May cause GI Bleeding and Thrombocytopenia.
ABC sportscaster grabbing fries
Abciximab
Antiplatelet Agent - GP IIb/IIIa Receptor Blockers(PLT-Fibrinogen Interaction Inhibition, 2)
For Migraine Prophylaxis and ACS - Platelet Aggregation↓, given as IV continuously. May cause GI Bleeding and Thrombocytopenia.
Tie (Fi) game
Eptifibatide and Tirofiban
Antiplatelet Agent - PDE Inhibitor
For Migraine Prophylaxis and ACS - Platelet Aggregation↓,by cAMP↑. May cause Nausea and Rash.
Don’t Phoster disinterest and Two Pyramids
Dipyridamole
Antiplatelet Agent - PDE Inhibitor
Treats Claudication due to Peripheral artery disease - Platelet Aggregation↓ and Arterial Vasodilation by cAMP↑. May cause Coronary Steal (Dilate all of the other coronary arteries) - Exacerbating Ischemia. CYP450 Metabolism Dependent.
Don’t Phoster disinterest and Player that Lost the Ball
Cilostazol
Fibrinolytic Agent - Plasmin Activator (From Streptococci)
Treats Acute Thrombosis PE, DVT, Ischemic Stroke and MI. PTT↑, PT↑ and D-Dimers↑. IV must be given 3-4.5 hrs after event. May cause Hemorrhagic Stroke and Allergic reaction. ContraIndicated in Head Trauma or HTN. Reversed by FFP and Cryoprecipitate.
Strepto-kinectors
Streptokinase
Fibrinolytic Agent - Plasmin Activators
Treats Acute Thrombosis PE, DVT, Ischemic Stroke and MI. PTT↑, PT↑ and D-Dimers↑. IV must be given 3-4.5 hrs after event. May cause Hemorrhagic Stroke and Bleeding. ContraIndicated in Head Trauma or HTN. Reversed by FFP and Cryoprecipitate.
Toy PlAyset
tPA Analogues: Alteplase, Reteplase, Tenecteplase
Antifibrinolytic Agent - Plasmin Activation Competitive Inhibitor
Reverses the tPA and tPA analogues effect in adverse effect settings.
Teacher with Cap on Paint Tube and Exam
Aminocaproic Acid
also less commonly used Trans-Examic Acid
HMG-CoA Reductase Inhibitor (2)
Prevention of Cardiovascular Events - Reduces Mortality! Most effective drugs for lowering LDL (30-60%) by also causing LDLR Expression↑. CYP450 Metabolism Dependent. May Cause Statin-associated Autoimmune Myopathy, LFT elevations: AST↑, ALT↑.
Steampunk Pirate
Statins: Atorvastatin, Pravastatin
Pravastatin is the only one not metabolized by CYP450
Bile Acid Binding Resin (2)
For primary Hypercholesterolemia: Prevents Bile from Returning to Liver → Bile Production↑→ Cholesterol Stores↓. Side Effect HMG-CoA reductase overactivity → VLDL↑ → Hypertriglycemia. May also cause Cholesterol Gallstones Risk, Constipation, Bloating, Vit DEAK Malabsorption, Statins Absorption↓ (4 apart).
Cho”lobster”amine and Cho-Staples
Colestipol and Cholestyramine
Cholesterol Intestinal Absorption Blocker
For primary Hypercholesterolemia: Prevents Exogenous Cholesterol from going to Liver by Reducing Chylomicrons. Also causing LDLR Expression↑ (Not as effective as Statins). Side Effect HMG-CoA reductase overactivity → VLDL↑ → Hypertriglycemia. May also cause LFT elevations: AST↑, ALT↑.
Z Shaped Eel Blocking Gold Delivery
Ezetimibe
PCSK9 Inhibitor
Antibody Binds PCSK9 → PCSK9 Degrading LDLR↓ → Uptake of LDL↑.
Octopus antibody-shaped claws removing Pesky “9” crabs inhibiting LoaD L receptor workers
Evolocamab
PPAR-α Activators
PPAR-α↑ → LPL↑ → Hydrolysis of VLDL and Chylomicron → VLDL↓ (30-50%) and TGA↓ (also reduce Hepatic VLDL Secretion). May Increase Risk of Myopathy (if Used with Statins) and Risk of Cholesterol Gallstones.
Jellyfish
Fibrates - Gemfibrozil and Fenofibrate
Vitamin acting as a Lipid Drug
Most Effective Agent for increasing serum HDL (~30%) also reduces hepatic VLDL secretion → TGA↓. May cause Flushing and Warmth by PG induced Vasodilation, LFT elevations: AST↑, ALT↑ leading to Severe Hepatotoxicity (Close Monitoring required) , Hyperglycemia and Hyperuricemia.
Loch Niacin monster
Niacin (Vitamin B3)
Lipid Supplement
Found in Fish Oil, as Diat Twice a week it was found to Lower Serum Triglycerides by VLDL and apoB production↓.
Fish leaking oil (Tail shape)
Omega-3 Fatty Acids
NSAIDs (2) - Reversible Non Selective COX Inhibitor
For Inflammatory Diseases (e.g Gout). Side Effect: GI Bleeding and Ulceration (PLT Function↓), Cardiovascular Events (PLT Function↓) , ARF (PG↓), Acute Interstitial Nephritis, Aplastic Anemia, Type 4 RTA, (+ Hyperaldosteronism and Hyperkalemia), Gestational DA Closure.
BLAC sox Fan
Diclofenac and Ketorolac
NSAID - Reversible Non Selective COX Inhibitor
For Inflammatory Diseases (e.g Gout) and Closure of PDA. Side Effect: GI Bleeding and Ulceration (PLT Function↓), Cardiovascular Events (PLT Function↓) , ARF (PG↓), Acute Interstitial Nephritis, Aplastic Anemia, Type 4 RTA, (+ Hyperaldosteronism and Hyperkalemia),
Gestational DA Closure.
INDIGO sox Fan
Indomethacin
NSAIDs (2) - Reversible Non Selective COX Inhibitor
For Inflammatory Diseases (e.g Gout) and Closure of PDA. Side Effect: GI Bleeding and Ulceration (PLT Function↓), Cardiovascular Events (PLT Function↓) , ARF (PG↓), Acute Interstitial Nephritis, Aplastic Anemia, Type 4 RTA, (+ Hyperaldosteronism and Hyperkalemia),
Gestational DA Closure.
SOX CAM
Meloxicam and Piroxicam
NSAID - Reversible Non Selective COX Inhibitor
For Inflammatory Diseases (e.g Gout) and Closure of PDA. Side Effect: GI Bleeding and Ulceration (PLT Function↓), Cardiovascular Events (PLT Function↓) , ARF (PG↓), Acute Interstitial Nephritis, Aplastic Anemia, Type 4 RTA, (+ Hyperaldosteronism and Hyperkalemia),
Gestational DA Closure.
ApPROXimately 110 Mph
Naproxen
NSAID - Selective Inhibitor of COX-2
For Inflammatory Diseases (e.g Gout) - Increases Risk of ischemic cardiovascular disease, avoid in acute MI and stable angina. Sulfa Drug Side effects.
Celebrating catcher in the dugout drenching the assistant coach.
Celecoxib (Like Arcoxia)
Antipyretic and Anti-Analgesic - CNS COX Inhibitor
Used for Moderate Pain Relief: Osteoarthritis and some Rheumatoid arthritis. Side effects: High Doses→ Depletion of Glutathion → NAPQI Not Inhibited→Hepatotoxicity! (Reversed by N-acetylcysteine or Activated Charcoal).
Icy-Medicine Spray on Assistant Coach
Acetaminophen (Paracetamol)
Neutrophil Migration Inhibitor
For Acute Gout. Binds intracellular tubulin preventing polymerization of microtubules thereby inhibiting neutrophil migration,
phagocytosis, and degranulation. May Cause Diarrhea.
Choir Sing, First responders blocked by choir
Colchicine
Xanthine Oxidase Inhibitor
For Chronic Gout, Tumerolysis Syn, Lesch-Nyhan syn, . Prevents the Formation of Urate.
Contraindication: 6 Mercaptopurine and Azathioprine. Can Cause Steven-Johnson Syn, DRESS Syn and Eosinophilia.
Pure Nun
Allopurinol
Also is Febuxostat is more effective in low doses
Uricosuric agent
For Chronic Gout. Urate Reabsorption↓.
Side Effects: Halts Penicillin Excretion, Urate stones Risk, Sulfa Drug Effects. (also prevents Cidofovir Nephrotoxicity)
Probation officer Cid
Probenecid
High Dose Aspirin as well
Recombinant Uricase (Given IV)
For Chronic Gout. Converts Urate into Allantoin (Hydrophilic). Can cause hemolysis in G6PD
(bite cells) and Anaphylaxis.
(Holy Water) Just in case
Pegloticase
Acute Antianginal Drug (Given Sublingually )
NO Metabolite Formed → cGMP↑ → MLC Dephos → SMC Relaxes → Venodilation → Preload↓ . May cause Reflex Tachycardia, Hypotension, Methemoglobinemia, Tachyphylaxis (Prevented by Break Intervals). Contraindicated with PDEi or Hypertrophic Obstructive Cardiomyopathy.
Dynamite
Nitrates: Nitroglycerine
Chronic Antianginal Drug (Given Orally)
NO Metabolite↑ → cGMP↑ → MLC Dephos → SMC Relaxes → Venodilation → Preload↓ . May cause Reflex Tachycardia, Hypotension, Methemoglobinemia, Tachyphylaxis (Prevented by Break Intervals). Contraindicated with PDEi or Hypertrophic Obstructive Cardiomyopathy.
Single and Double Dynamite stick in cave
Nitrates: Isosorbide Mononitrate and Dinitrate
Migraine Therapy: 5-HT1bR / 5-HT1dR Agonist
5-HT1bR / 5-HT1dR→ Vasoconstriction, Prevention of CGRP, Substance P, Neurokinin A release from Trigeminal nerve (Vasodilate) and CNS Pain Pathway attenuation. May Cause Coronary Vasospasm and lead to Prinzmetal Angina.
Sumo Wrestler and Three gems on hat
Sumatriptan
PGE1 Vasodilator - Erectile Dysfunction Therapy
Also maintains PDA in Babies with Congenital Cardiac Defects. Side Effects: Priapism, Fever and Hypotension.
Dill Pickle Theme Board
Alprostadil
PGE1 Vasodilator - NSAIDs Peptic Ulcer Prevention
Gastric Blood Flow↑ → Protective Mucus Secretion↑ . Also Uterine Contraction↑ → Facilitates labor or Terminate Pregnancy. May cause GI Symptoms.
Missed the Ball
Misoprostol
Gestational Uterine Contraction PGE2 Simulator
Uterine Contraction↑ → Facilitates labor or Terminate Pregnancy. Uniquely for it - Also used for Ripening of the Cervix to Promote Same Goals. May cause GI Symptoms. Contraindicated for Glaucoma, Asthma and C-Section Patients.
Dino Helmet
Dinoprostone
Gestational Uterine Contraction PGF2a Simulator
Controls Postpartum Hemorrhage or for Termination of Pregnancy. May cause GI Symptoms. Contraindicated for Glaucoma, Asthma and C-Section, CV, Hepatic and Renal Patients.
Cardboard box (F in Foot wear)
Carboprost
PGF2a Glaucoma Treatment (2)
By Aqueous Humor Outflow↑. can produce
Brown pigmentation in the Iris.
LA tan sandals and World traveler boots (F in Foot wear)
Travoprost and Latanoprost
Prostacyclin Analogs: Anti-Thrombotic, Vasodilator and Anti-Fibroblastic Drug (2, Given IV)
First line Treatment for Pulmonary Hypertension, prolong survival and delays lung transplants. Adverse effects: Flushing headache, and Hypotension
Dilated Pro-cycler with iLow –ePRO Switch
Epoprostenol and Iloprost
PDE5 Inhibitor Treats Pulmonary Hypertension and Erectile Dysfunction
PDE5↓ → cGMP↑ → MLC Dephos → SMC Relaxes → Vasodilation. Adverse effects: Flushing headache, and Hypotension → Contraindicated with Nitrates and α1 Blockers.
Don’t Phoster disinterest and Erect Bat Slides
Sildenafil
Endothelin Receptor Antagonist (Gq Block)
For Pulmonary Hypertension by Blocking the receptor on Vascular SMCs - Vasoconstriction (IP3 Pathway) is Inhibited → Vasodilation. May cause fatal Hepatotoxicity, HSN, GERD and Hypotension.
Boss Man Stan
Bosentan
1st Generation H1 Receptor Antagonists (2)
Has Antihistamine, Antimuscarinic and Antiserotonergic effects For Hives, Allergic Rhinitis, Motion Sickness (Lipophilic go through BBB) and Acute Dystonia(re-establish dopaminergic-cholinergic
balance) . May cause Drowsiness, Hunger, Hypotension, Delirium, constipation and Exacerbation of Glaucoma.
Dragonfly fairy with Bee swatter
Diphenhydramine and Dimenhydrinate
1st Generation H1 Receptor Antagonists (3)
Has Antihistamine, Antimuscarinic and Antiserotonergic effects For Hives, Allergic Rhinitis, Motion Sickness (Lipophilic go through BBB) and Acute Dystonia(re-establish dopaminergic-cholinergic
balance) . May cause Drowsiness, Hunger, Hypotension, Delirium, constipation and Exacerbation of Glaucoma.
Fairy cuiSINE (with Bee swatter)
Meclizine, Hydroxyzine, Promethazine
2nd Generation H1 Receptor Antagonist
Has Mostly Antihistamine effects For Allergic Rhinitis, (LESS Lipophilic goes LESS through BBB LESS Side Effects) and Chronic Urticaria . May cause Miosis or pinpoint pupils, nausea, drowsiness, and menstrual cramps.
Fox (with Bee swatter)
Fexofenadine
2nd Generation H1 Receptor Antagonist
Has Mostly Antihistamine effects For Allergic Rhinitis, (LESS Lipophilic goes LESS through BBB LESS Side Effects) and Chronic Urticaria . May cause GI Symptoms or Urinary Retention.
Rat (with Bee swatter)
Loratadine
Direct Lipoxygenase Inhibitor - Alternative Asthma Therapy
Halting LT production → Airway Vascular Permeability↓, Mucus production↓, and Bronchoconstriction↓. Risk of Hepatotoxicity. (Corticosteroids and β2 Agonist are First line)
Godzilla falling on coach LOX
Zileuton
LTD4-Receptor (CysLT1) Antagonists(2) - Alternative Asthma Therapy ( Given Orally)
Airway Vascular Permeability↓, Mucus production↓, and Bronchoconstriction↓. May cause diarrhea, nausea, vomiting, mild rashes, asymptomatic elevations in liver enzymes, and fever. (Corticosteroids and β2 Agonist are First line)
Monte the broadcaster
Montelukast and Zafirlukast
PDE Inhibitor - Alternative Asthma Therapy ( Given Orally)
cAMP↑ → PKA Activated , inhibited TNF-alpha. also it is a Nonselective Adenosine Receptor Antagonist.
May cause CNS excitation, Tachycardia and it is metabolized by the CYP450 system
“flyin” Xanthine energy drink
Theophylline (A Methylxanthine)
Alternative Asthma Therapy (Monoclonal antibody)
Monoclonal antibody against the Fc portion of IgE → Preventing mast cell Sensitization and Degranulation. May Cause Anaphylaxis.
Limousine and Grabbing end of IgE gun
Omalizumabe
Alternative Asthma Therapy
Preventing Mast cell Sensitization and Degranulation. May Cause Anaphylaxis.
Lynn’s Bee control ( Bee sedating smoke)
Cromolyn Sodium
Chemo-induced or Post-op Vomiting Treatment
5-HT3 Receptor Antagonist on Vagal Afferents → No Signal to NTS. May Cause Constipation, QT Prolongation Inducing TdP and Serotonin Syndrome.
Ribbon Dancer blocking the hammer throw
Ondansetron
Chemo-induced or Post-op Vomiting Treatment
D2R Antagonist on Area Postrema. has also a Upper GI prokinetic effect. Contraindicated in Small-Bowel Obstruction. May cause Diarrhea, Drowsiness, Depression, extrapyramidal effects due to central D2 blockade (dystonia, akathisia, parkinsonian features), Neuroleptic Malignant Syndrome (Autonomic instability, Rhabdomyolysis) , Hyperprolactinemia and QT Prolongation Inducing TdP.
Tickler Blocking the METal D-rings
Metoclopramide
Chemo-induced Vomiting Treatment
NK1R (Activated by Substance P) Blocker on Area Postrema (Partial Block of Vomiting signal since Histamine, Dopamin and Serotonin Pathways are unaffected). May Cause GI Symptoms.
a Preppy Ant for Substance Pee Check
Aprepitant
ZE Syn, GERD and GI Ulcer Treatment (Not First Line)
H2 Histamine Receptor Antagonist on Parietal cells → Acid Secretion↓. May cause Anti-androgenic side effects by CYP450 Inhibition - Gynecomastia, Impotence.
Tie Dye t shirt guy on Cement with 2 bee swatters
Cimetidine
ZE Syn, GERD and GI Ulcer Treatment (2, Not First Line)
H2 Histamine Receptor Antagonist on Parietal cells → Acid Secretion↓. May cause Bradycardia, Pneumonia, Masking stomach cancer, Clostridium Difficile Colitis, GI Symptoms and QT Prolongation Inducing TdP.
Tie Dye t shirt guy with 2 bee swatters
Ranitidine and Famotidine
First Line Treatment for ZE Syn, GERD, GI Ulcer and Part of H.Pylori infection triple Therapy
Irreversibly inhibit the H+/K+ ATPase → Acid Secretion↓. , Pneumonia, Clostridium Difficile Colitis, Minerals Malabsorption (Ca2+, Mg2+, and Fe2+ require acid) and Risk of Osteoporotic Hip Fractures (Also different HSN for each of 3 drugs).
Girl scout blocking puree pump with PRIZE
(Omer lan with rav)
Proton Pump Inhibitors (PPIs): Omeprazole, Lansoprazole, Rabeprazole
(Aka in Israel Omepradex)
Osmotic Laxatives (2)
Non-absorbable substance → Draws
water volume into the intestinal lumen → Distension → Peristalsis. Can cause Diarrhea and Dehydration
PEG drain cover and Magnets
PEG: Polyethylene Glycol and Magnesium Compounds
with Citrate or Hydroxide
Osmotic Laxatives and Hepatic Encephalopathy Treatments (2)
Non-absorbable substance → Draws
water volume into the intestinal lumen → Distension → Peristalsis. intestinal bacteria metabolize drug
into acidic metabolites to trap Ammonia of HE in GI forming Excretable Ammonium Ion. Can cause Diarrhea and Dehydration
Relaxulose into the liver and brain coral tank and Fisherman removing fish
Lactulose and Rifaximin
Bulk Forming Laxative
Indigestible Hydrophilic Colloid → Draws
water volume into the intestinal lumen → Distension → Peristalsis. Can cause Diarrhea and Dehydration
Bulky seaweed outside of the shop
Psyllium
Stool Softener
surfactant agent that facilitates penetration of stool by
water and lipids. Can cause Diarrhea and Dehydration.
Water penetrating a canoe at the DOCK
Docusate
Neural Stimulant Laxative
Stimulation of Enteric Nervous System and Colonic
Secretion. chronic use of it causes Melanosis Coli (brown pigmentation of the colon).
Stimulating Suntan Lotion
Senna
Antidiarrheal Agent - μ Receptor Opiate Agonist
Does not cross the BBB → no analgesia or potential
for addiction. colonic phasic segmenting activity↑ → colonic transit time↑. contraindicated in patients with bloody diarrhea or fever (treat the underlying cause). May Cause Constipation.
MUssage by Lop-eared rabbit
Loperamide
Antidiarrheal Agent - μ Receptor Opiate Agonist
Does cross the BBB → Combine with Atropine to
prevent abuse. colonic phasic segmenting activity↑ → colonic transit time↑. contraindicated in patients with bloody diarrhea or fever (treat the underlying cause). May Cause Constipation.
MUssage with Dolphins
Diphenoxylate
Hyperthyroidism Treatment
Including Graves disease, toxic multinodular goiter, and Thyrotoxic crisis. Inhibits Thyroid-Peroxidase → Iodination of MIT and DIT↓ → T3 and T4↓. 10x More Potent than PTU. Contraindicated with Anticoagulants, Anti-Diabetics and Digoxin. May cause Agranulocytosis, Thrombocytopenia, Aplastic Anemia, Hepatitis and HSN. It is Teratogenic.
Evil math equation board being kicked by the antithyroid agent
Methimazole
Hyperthyroidism Treatment
Including Graves disease, toxic multinodular goiter, and Thyrotoxic crisis. Inhibits Thyroid-Peroxidase → Iodination of MIT and DIT↓ → T3 and T4↓. Also It Inhibits 5’-deiodinase preventing T4 → T3 Conversion at Tissue Periphery. Contraindicated with Anticoagulants, Anti-Diabetics and Digoxin. May cause Agranulocytosis, Thrombocytopenia, Aplastic Anemia, Hepatitis and HSN. Safe in Pregnancy.
Shooting the gun – PTU! PTU! – at the TransPOrter
Propylthiouracil (PTU)
Sodium-dependent Iodide Transporter Competitive Inhibitors(2).
Diagnostic Tool for Thyroid Disorders and Functions. Prevents Iodine from reaching the TG and TPO for T3 and T4 synthesis. May be used for Treatment of Hyperthyroidism (Not First Line).
Agent sneaking into the lair in the anion crate
Perchlorate and Thiocyanate
Hypothyroidism Treatment (Prevention of Myxedema Coma by IV)
A T4 Analogue. May also be used to treat and prevent certain types of thyroid tumors. May cause Tachycardia, Tremor, Exacerbation of Osteoporosis, Hypoglycemia. In High doses administered with β Blockers. Contraindicated for MI, Adrenal Insufficiency or HF patients.
Agent Preventing Myxing Fat Bartender
Levothyroxine (L-Thyroxine)
Insulin Analogues: Rapid acting, Short duration
Do not polymerize into Hexamers. Mimicking postprandial response - Control the Glucose Spike. May cause Hypoglycemia.
“Girls And Lads”
Insulin Analogues: Glusine, Aspart, Lispro
“Girls And Lads”
Insulin Analogues: Intermediate acting
Delayed onset since they polymerize into Dimers and Hexamers. Mimicking postprandial response - Control the Glucose Spike. The Only Anti-Diabetic to be administered IV for Diabetic Ketoacidosis and/or Hyperkalemia (With Glucose). May cause Hypoglycemia.
“Rest Now”
Insulin (Regular)
an Insulin Analogue: Intermediate acting
Delayed onset since they polymerize into Dimers and Hexamers. Mimicking postprandial response - Control the Glucose Spike. Not used much clinically. Never given IV. May cause Hypoglycemia.
“Rest Now”
NPH (Neutral Protamine Hagedorn)
Insulin Analogues: Long acting
Provide a steady background level of insulin effects (“g” drug has no peak). May cause Hypoglycemia.
“Don’t Go”
Detemir, Glargine
1st Gen. Endogenous Insulin Release Stimulator
for T2DM: Close ATP-dependent K+ channels on β cells→ Depolarization → Ca Channels Open → Release of Insulin Vesicles. Long Duration of action, Rarely used. Likely to cause Hypoglycemia and Disulfiram-like Reaction with ingestion of alcohol and Sulfa Drugs effects. . (C-Peptide elevating).
Sulfa egg laying swan with MAID outfit
Sulfonylureas: Tolbutamide and Chlorpropamide
2nd Gen. Endogenous Insulin Release Stimulator
for T2DM: Close ATP-dependent K+ channels on β cells→ Depolarization → Ca Channels Open → Release of Insulin Vesicles. Smaller dosing, Shorter (yet still long) duration of action. Less likely to cause Hypoglycemia and Sulfa Drugs effects. (C-Peptide elevating).
Sulfa egg laying swan with Goslings RIDing on the mother swan’s back
Sulfonylureas: Glyburide and Glipizide
Endogenous Insulin Release Stimulator (Non Sulfa)
for T2DM: Close ATP-dependent K+ channels on β cells→ Depolarization → Ca Channels Open → Release of Insulin Vesicles. Smaller dosing, Shorter (yet still long) duration of action. May cause Hypoglycemia. (C-Peptide elevating). NO Sulfa Drugs effects.
Father goose gliding into the scene (Not laying Sulfa Eggs)
Meglitinides: Repaglinide and Nateglinide
β cell Receptor agonists - Endogenous Insulin Release (Given Orally)
for T2DM. Also cause satiety, decreasing glucagon release and gastric emptying → Serum Glucose ↓.
May cause Pancreatitis. NO risk of Hypoglycemia. (C-Peptide elevating).
ExenaTIDE detergent - Langerhansel “Gulp” activated when looking at Hag
GLP-1R Agonists: Exenatide and Liraglutide
GLP-1 Hydrolysis Inhibitors - Endogenous Insulin Release (Given Orally)
for T2DM. Also cause satiety, decreasing glucagon release and gastric emptying → Serum Glucose ↓.
Risk for Upper Respiratory Infections (Acidic Environment?). NO risk of Hypoglycemia. (C-Peptide elevating).
4 DRIPPING laundry items hanging, Clipped in clothespins
Dipeptidyl Peptidase-4 Inhibitors (DPP-4i) : Sitagliptin, Saxagliptin, Linagliptin
Anti-Diabetic: mGDP Inhibitor and AMPK Activator
FIRST LINE Oral agent for T2DM. Hepatic Gluconeogenesis↓ → Serum Glucose ↓ as well as AMPK dependent Insulin Sensitivity↑.
May cause Lactic Acidosis (Lactate GNG↓, Especially in Renal Failure), GI Symptoms and Slight Weight Loss
Skinny Kid on his knee saying a METAPHOR
Metformin
(Mitochondrial glycerophosphate
dehydrogenase Inhibitor and AMP-activated Protein Kinase Activator)
Anti-Diabetics: PPARγ (a TF) Ligands
for T2DM. Glucose Utilization↑ and Glucose Production↓ By Insulin sensitivity↑ (Muscle, Adipose, Liver) with Adiponectin↑ and GLUT4↑ (+ FA oxidation). Also Serum TGA↓. May cause Weight Gain, Fluid Retention and Edema leading to Decompensated CHF. There is an elevated risk of atypical extremity fractures in women.
PPARγ in circle and Girl with GLITTERS
Rosiglitazone and Pioglitazone
Thiazolidinediones
Anti-Diabetic: Amylin Analogues (Given IV)
for T2DM and T1DM. Glucagon↓, Gastric Emptying↓, and Appetite↓. Control the Postprandial Glucose Spike. May cause Hypoglycemia and GI Symptoms (even Anorexia)
Amy and Lynn
Pramlintide
Anti-Diabetics: α-Glucosidase Inhibitors
for T2DM. Conversion of Disaccharides into absorbable Monosaccharides↓ (Intestinal Brush Border)→ Delayed Carbohydrates → Postprandial Glucose Spike↓. May cause GI symptoms (Bacterial Carbohydrate Fermentation↑)
A-Carb wigglers
Acarbose (and Miglitol)
Anti-Diabetics: SGLT2 inhibitors
SECOND or THIRD line for T2DM. Na-Glu Cotransporter Reabsorbs Glucose in PCT↓ → Serum Glucose↓. Risk of UTI, Vaginal Candidiasis, May cause Hypotension due to Osmotic Diuresis. Contraindicated in Renal Insufficiency.
FLOSSINg Teacher with Salty Peanuts
Canagliflozin and Dapagliflozin
First-line Treatment for Osteoporosis (Pyrophosphate Containing)
Allows for attachment to Hydroxyapatite Surface of Bones: Osteoclasts Adherence to Bony surface↓, Osteoclasts Development and Recruitment↓, Osteoclast Apoptosis↑. Also for Acute Hypercalcemia (Malignancy) and Paget Disease. May Cause GI Symptoms - Acid reflux and Ulcers (if Oral), Osteonecrosis of Mandible (If IV) and Hypocalcemia.
“D(r)onate” charity chest with two P coins
Bisphosphonates: Alendronate, Pamidronate and Zoledronate
Selective Estrogen Receptor Modulator (SERM)
Prevention and Treatment of Postmenopausal Osteoporosis. Inhibits Differentiation of Osteoclasts Precursors. Bone Tissue ER Agonist and Uterus and Breast Antagonist → Risk of Breast Carcinoma↓. Teratogenic and gynecological Issues could accompany.
Female Guard holding Relax Sign
Reloxifene
Monoclonal Antibody Against RANKL
For Osteoporosis. Inhibits Differentiation of Osteoclasts (Stopping the Indirect activation by PTH through Osteoblasts).
DINO-SUit man grabbing Crank-drill
Denosumab
Supplemental Hormone for Osteoporosis Treatment
Inhibits Osteoclasts Bone Resorption (Stopping the Indirect activation by PTH through Osteoblasts). Reduces Ca Reabsorption by Renal PCT. Useful also in Acute Hypercalcemia and Paget Disease. Not as effective as Bisphosphonates. May cause Hypocalcemia.
Curator toning it down
Calcitonin
Recombinant PTH Analogue
for Osteoporosis, Since Low Dose and Exogenous it has a Net Osteoblastic effect! (Unlike Endogenous one) → Mineral Bone Density↑. By Also (Like PTH) Renal Ca Absorption↑, P Absorption↓ and Calcitriol Production↑. May cause Hypercalcemia.
TERI the PtHD PARA-Assistant
Teriparatide
Vitamin Osteoblastic Agent - for Osteoporosis
Renal and Intestinal Calcium and Phosphate Absorption↑. Also Stimulates Osteoblasts Growth and their release RANKL and activate Osteoclasts. Inhibits PTH release. Also Useful in CRF (prevention of Hypocalcemia), Psoriasis and Post-op Hypoparathyroidism. May cause Hypercalcemia.
D3 Robot
Calcitriol: 1,25-Dihydroxycholecalciferol
Ergocalciferol and cholecalciferol are yet inactivated - Not for CRF
Calcimimetic Drug - Parathyroid Gland Activator
for Hyperparathyroidism-Induced Hypercalcemia (Primary or Secondary Hyperparathyroidism).
Calculator at the Calcified bone receptor
Cinacalcet
Phosphate binding Polymer
For CRF-induced Hyperphosphatemia- Intestinal Absorption of Phosphate↓
Worker shoveling P Shells to side of Truck
Sevelamer
Glucocorticoid - Given IV in Adrenal Insufficiency
Anti-Inflammatory effect for Immune Diseases: Upregulates Lipocortin-1 → PLA2 Inhibited → AA Substrate for COX and LOX ↓→ PG and LT↓. Also GC inhibit NFκB → TNF and IL2↓.
May Cause Neutrophilia (Migration↓), Lymphocytopenia, Eosinophilopenia, Insulin Resistance and Hyperglycemia. In Chronic Administration: Secondary Adrenal Insufficiency, Cushing Syndrome, Skin Striae, Moon Face, Osteoporosis, Hypokalemia, TB Reactivation. In High Dose: Aseptic Necrosis, Psychosis.
SONE-henge Scene
Hydrocortisone (Exogenous Cortisol)
Synthetic Glucocorticoid - Given IV in Adrenal Insufficiency
Anti-Inflammatory effect for Immune Diseases (Organ Transplants or Rejections, and Topically in Dermatological Cases). Has 80% of GCR and MCR Potency that Cortisol has, same Half-Life. Given IV/oral/Subcutaneous/Intra-Articularly. If Given Orally or IV the Corticosteroid Side effects are a risk.
SONE-henge Scene (No WATER)
Cortisone
Synthetic Glucocorticoid - Given IV in Adrenal Insufficiency
Anti-Inflammatory effect for Immune Diseases (Rheumatic Diseases, COPD AND Asthma). 3x times of GCR Potency that Cortisol has, 4x times Half-Life. Given IV/oral/Subcutaneous/Intra-Articularly. If Given Orally or IV the Corticosteroid Side effects are a risk.
SONE-henge Scene (Pre-Dino)
Prednisone
Synthetic Glucocorticoid - Given IV in Adrenal Insufficiency
Anti-Inflammatory effect for Immune Diseases (Rheumatic Diseases, COPD AND Asthma). 80x times of GCR Potency that Cortisol has, 50x times Half-Life. Given IV/oral/Subcutaneous/Intra-Articularly. If Given Orally or IV the Corticosteroid Side effects are a risk.
SONE-henge Scene (Decks of Math)
Dexamethasone
Synthetic Corticosteroid
Used Mostly for Adrenal Insufficiency BP effect, Conn’s Syn. Testing 15x times of GCR Potency that Cortisol has and 200x of MCR Potency that Aldosterone has. IV/oral/Subcutaneous/Intra-Articularly. If Given Orally or IV the Corticosteroid Side effects are a risk with Hypertension more seriously considered.
SONE-henge Scene (Flood or Cortisone)
Fludrocortisone
Anterior Pituitary Originating Anabolic Hormone
Treats Symptoms of Prader-Will Syndrome, Turner Syn., and Deficiency cases. Activates JAK-STAT Molecular pathway on Muscle Tissue as well as Hepatic Production of IGF-1, aso has catabolic effects on Adipose tissue.
Padre-Willi and X girl looking at Tall growing Bean
Growth Hormone (GH)
Recombinant Anabolic Hormone (Non-Steroid)
Treats Severe Deficiency cases of IGF-1 or Laron Syndrome (Dwarfism). May cause Hypoglycemia,
SERMon Sign with a Inside mat tossed by growing plant
Mecasermin
Somatostatin Analogue (Multiple Hormone Antagonist)
Used for Acromegaly (Adult) or Gigantism (Child) caused by Pituitary Adenoma, Gastrinoma (ZE), VIPoma, Carcinoid Tumors (with Serotonin release), Insulinoma, Glucagonoma and Control Esophageal Varices from Bleeding. Can Cause GI side effects, Steatorrhea (Reduced Pancreatic Secretion).
Octagon Stop Sign
Octreotide
Growth Hormone Release Inhibitors
D2 Receptor Agonists that cause GH not to be released from Anterior Pituitary. Used for Acromegaly (Adult) or Gigantism (Child). also used in T2DM, PD and Prolactinoma. In high Doses may cause Pulmonary Fibrosis.
Burglar with Broomstick on Double dope rope
Bromocriptine (and Cabergoline)
Growth Hormone Receptor (TyRK) Antagonist
Used for Acromegaly (Adult) or Gigantism (Child). also used in T2DM, PD and Prolactinoma. May Cause Hypoglycemia and Hepatitis.
ANTs on Tyrosine tire
Pegvisomant
Posterior Pituitary Hormone (Given IV)
Used for Central Diabetes Insipidus and Control of Esophageal Varices Bleeding. Through V1R(Gq) Intracellular Ca↑ → Vasoconstriction of Mesenteric Arterioles! Through V2(Gs) Intracellular cAMP↑ → Aquaporin 2 Translocation to Apical membrane on Nephrons Collecting Duct → Water Reabsorption↑. V2R also located on vascular endothelium→vWF and FVIII release↑.May cause Hyponatremia, Hypertension and in rare cases HSN or MI.
Water Boy Helping Golfer stuck next to Kid pissing Statute.
Antidiuretic Hormone (ADH aka Vasopressin)
Selective V2R Antagonist ADH Analogue
Used for Central Diabetes Insipidus, vWFD, Hemophilia A, Nocturnal Enuresis . V2R also located on vascular endothelium→vWF and FVIII release↑.
May cause Hyponatremia, Hypertension and in rare cases HSN or MI.
Deseret-mobile with V2 helping Golfer stuck in dehydrated brain next to Kid pissing Statue.
Desmopressin (DDAVP)
V2R Antagonists - First Line SIADH Treatment
Allow for release of free water and correction of Hyponatremia. Mat cause Hypernatremia or Central Pontine Myelinolysis (Osmotic Demyelination caused by Na rapid overcorrection)
VAPorizer sprinkling on TAN hyperactive waterboy
Tolvaptan and Conivaptan
Second Line SIADH Treatment
Tetracycline Antimicrobial Drug, Interferes with ADH Activity not completely understood. Tetracycline Side effects.
guy sprinkling on hyperactive waterboy is on biCYCLES
Demeclocycline
GABA-AR Allosteric Agonist - Benzodiazepines
Frequency of Cl Channel Opening↑ → CNS↓ → Treats Acute Seizures, Insomnia, Parasomnia (Sleep Walk in Children), GAD and Panic Disorders attacks (NOT 1st Line) and Works as Sedation for Minor Operations. Also Used as CNS Muscle Relaxant used for Tetanus, MS, Stroke etc. Hepatic Inactivation - Contraindicated in Liver Failure or with other CNS Depressants. Side effects: Anterograde Amnesia, Central Ataxia in Elderly, Tolerance (Downregulation) and Addiction → Psychosis.
Ben’s Diners has Best PAMcakes: Fast OX
Alprazolam, Lorazepam, Oxazepam and Triazolam (Shortest) (Aka Bondermin in Israel)
GABA-AR Allosteric Agonist - Benzodiazepines (IV)
Frequency of Cl Channel Opening↑ → CNS↓ → Treats Acute Alcohol Withdrawal Symptoms, Seizures, Anxiety, Insomnia and Works as Sedation For Minor Operations. Hepatic ACTIVATION - Contraindicated in Liver Failure or with other CNS Depressants. Side effects: Anterograde Amnesia, Central Ataxia in Elderly, Tolerance (Downregulation) and Addiction → Psychosis.
Ben’s Diners has Best PAMcakes with Long Flag
Diazepam (and Chlordiazepoxide)
GABA-A Competitive Antagonist: Anti-Hypnotics
Reverses Sedation or Side Effects caused by Benzodiazepines or Non-Benzodiazepines . May Precipitate Seizures (Contreversioal in use for Overdose).
Antagonizing Fluffy Muzzled Dog Preventing reaching Cab-A
Flumazenil
GABA-AR Allosteric Agonist: Non-Benzodiazepines
For Short term treatment for Insomnia,
CYP450 Metabolism→ 2hrs Half Life and Less likely to cause Tolerance and Addiction (also Bind same site as BZDs).
May Cause Delirium, Confusion and Central Ataxia in Elderly. Contraindicated with CNS Depressants.
ZZZ Mattresses
Zolpidem, Zaleplon
GABA-AR Allosteric Agonist: Non-Benzodiazepines
For Long term treatment for Insomnia and Sleep Maintenance Insomnia.
CYP450 Metabolism→ 6hrs Half Life and Less likely to cause Tolerance and Addiction (also Bind same site as BZDs).
May Cause Delirium, Confusion and Central Ataxia in Elderly. Contraindicated with CNS Depressants.
ZZZ Mattresses
Eszopiclone
Melatonin Analogue - MTR1 and MTR2 Agonist
For Short term treatment for Insomnia, and Maintenance of Circadian Cycle.
Non Withdrawal Symptoms, Safe in Elderly.
May cause dizziness, nausea, fatigue, headache.
Melt away (mattress)
Ramelteon
GABA-AR Allosteric Agonist: Barbiturates (Given IV)
Duration of Cl Channel Opening↑ → CNS↓.
Short Half Life - Induction of Anesthesia
Effect in 30 seconds: Lipid Soluble and Rapid Redistribution to Adipose and Muscle tissue prevents long term effect on CNS. Induces CYP450 Hepatic Production → Contraindicated with CYP450 dependent drugs. Side Effects: Profound Respiratory and Cardiac Depression, Hypotension, Coma, Addiction and Tolerance.
Barb Shop - “The Ol Quick Shave”
Thiopental
GABA-AR Allosteric Agonist: Barbiturates (Given IV)
Duration of Cl Channel Opening↑ → CNS↓.
100 hrs > Half-life. Narrow Spectrum Antiepileptic (3rd Line) and For Insomnia. Side Effects: Profound Respiratory and Cardiac Depression, Hypotension, Coma, Addiction and Tolerance. Induces CYP450 Hepatic Production → Contraindicated with CYP450 dependent drugs.
Barb Shop: Shaking Jackhammer
Phenobarbital
GABA-AR Allosteric Agonist: Barbiturates (Given IV)
Duration of Cl Channel Opening↑ → CNS↓.
100 hrs > Half-life - Anti-Seizures (3rd Line) and For Essential Tremor (Low dose with Propranolol) and Insomnia. Induces CYP450 Hepatic Production → Contraindicated with CYP450 dependent drugs.
Side Effects: Profound Respiratory and Cardiac Depression, Hypotension, Coma, Addiction and Tolerance.
Barb Shop: “Perm is Done”
Primidone
IV Anesthetic for Induction and Maintenance
Lipophilic and Potentiates Chloride influx by GABA-AR binding. Has the most pronounced decrease in Systemic BP by Strong Vasodilation (Arteriolar and Venous) → May cause Hypotension!
“Prospero…. Fall Asleeps!”
Propofol
IV Anesthetic for Induction
Lipophilic and Potentiates Chloride influx by GABA-AR binding. Causes Cardiovascular Stability - Useful of CV Patients.
“Intimidator Stabilizing the Patient”
Etomidate
IV Anesthetic for Induction
Lipophilic and Inhibits NMDA-R. Causes Cardiovascular Stability - Useful of CV Patients. Causes “Dissociative Anesthesia” (Eyes Remain Open with Slow Nygmastic Gaze) and Hallucinations: Unpleasant Emergence (Vivid Colorful Dreams and Out of Body Experiences). It is a Cardiovascular Stimulator as well.
“SnaKE TAMINg Nomad”
Ketamine
Inhaled Gaseous Anesthetic for Induction
Low (Hydrophilic) Blood Solubility → Fast Onset and Faster Recovery! (Low Partition Coeffi.)
Minimal Alveolar Concentration (where half of Patient doesn’t respond to stimuli), 1/MAC = Potency of Inhaled Anesthetics. Cause Myocardial Depression - potential Hypotension. May cause and HSN induced-Malignant Hyperthermia (RYR1 Defect are prone to) → Rhabdomyolysis .
“Laughing Gas and Fat Kid not moving fast in pool”
Nitrous Oxide (N2O)
Halogenated Ether Anesthetic
Liquid at room temperature and Fluorinated. High (Hydrophilic) Blood Solubility → Slower Onset and Longer Duration of Action! (High Partition Coeffi.)
MAC = 0.75, (1/MAC = Potency of Inhaled Anesthetics). Cause Myocardial Depression - potential Hypotension and Cause Respiratory Depression - potential Hypercapnia. also Cerebral Blood Flow ↑.
May cause Hepatic Necrosis (High Toxicity) and HSN induced-Malignant Hyperthermia (RYR1 Defect are prone to) → Rhabdomyolysis .
“Skinny Kid moving fast in pool”
Halothane
Halogenated Ether Anesthetics (2 Isomers)
Liquid at room temperature and Fluorinated. High (Hydrophilic) Blood Solubility → Slower Onset and Longer Duration of Action! (High Partition Coeffi.)
MAC = 1.5 (1/MAC = Potency of Inhaled Anesthetics). Cause Myocardial Depression - potential Hypotension and Cause Respiratory Depression - potential Hypercapnia. also Cerebral Blood Flow ↑.
May cause Nephrotoxic effects, Neurotoxic effects and HSN induced-Malignant Hyperthermia (RYR1 Defect are prone to) → Rhabdomyolysis .
“Skinny Kid moving fast in pool”
Enflurane and Isoflurane
Muscle Relaxants - RYR Blocker
Treatment for Malignant Hyperthermia. Side effect -encompass speech and visual disturbances, mental depression and confusion, hallucinations, headache, insomnia and exacerbation or precipitation of seizures, and increased nervousness.
Trampoline
Dantrolene
μ-Opioid Receptor Agonist - Prototype Analgesic
Gi-Coupled→ Post-Synaptic K Channel Open → Hyperpolarization, also Presynaptic Neurons VGCC Close → Excitatory NT Release↓ →→ Pain Signal↓.
For Severe Pain and Chronic Pain.
May cause Constipation (μR in GI), Miosis, CNS and Respiratory Depression, Biliary Colic (SMC Contracts). In Chronic Use - Tolerance (but not for Constipation or Miosis), Opioid-Induced Hyperalgesia and Addiction.
Utopia Resorts, μssage, “More Fun Less Pain”
Morphin (and Derivative Hydromorphone)
μ-Opioid Receptor Agonist
Analgesic for Chronic Pain and Post-Op Pain.
May cause Constipation (μR in GI), Miosis, CNS and Respiratory Depression, Biliary Colic (SMC Contracts). In Chronic Use - Tolerance (but not for Constipation or Miosis), Opioid-Induced Hyperalgesia and Addiction.
Utopia Resorts, μssage, “Make Pain a Fantasy”
Fentanyl
μ-Opioid Receptor Agonist
Analgesic for Chronic Pain and Neuropathic Pain. Also Inhibits Reuptake of Serotonin and Norepinephrine.
May cause Constipation (μR in GI), Miosis, CNS and Respiratory Depression, Biliary Colic (SMC Contracts). In Chronic Use - Tolerance (but not for Constipation or Miosis), Opioid-Induced Hyperalgesia and Addiction.
Utopia Resorts, μssage, TRAM with a North heading Compass
Tramadol
Antitussive, μ-Opioid Receptor Agonist
For Pathologic Cough.
May cause Constipation (μR in GI), Miosis, CNS and Respiratory Depression, Biliary Colic (SMC Contracts). In Chronic Use - Tolerance (but not for Constipation or Miosis), Opioid-Induced Hyperalgesia and Addiction.
Utopia Resorts, μssage, Coughing dude with Magazine that has an Orphan and a Nomad camel
Dextromethorphan
Antitussive, μ-Opioid Receptor Agonist
For Pathologic Cough. Also NMDA Antagonist
May cause Constipation (μR in GI), Miosis, CNS and Respiratory Depression, Biliary Colic (SMC Contracts). In Chronic Use - Tolerance (but not for Constipation or Miosis), Opioid-Induced Hyperalgesia and Addiction.
Utopia Resorts, μssage, Coughing dude with Magazine that has a barCode
Codeine
Long Term Use, μ-Opioid Receptor Agonist
For Attenuating General Opioid Withdrawal Symptoms (Lacrimation, Hyperventilation, Hyperthermia, Vomiting, Diarrhea, Anxiety and Muscle Aches) aka Opioid Detoxification. Long Half life. (Also used for Neonatal Abstinence Syndrome)
Utopia Resorts, μssage, Done Timer and Long Flags
Methadone
Long Term, μ-Opioid Receptor Partial Agonist
For Attenuating General Opioid Withdrawal Symptoms (Lacrimation, Hyperventilation, Hyperthermia, Vomiting, Diarrhea, Anxiety and Muscle Aches) aka Opioid Detoxification. Long Half life. (Also may be used for Neonatal Abstinence Syndrome)
Utopia Resorts, μssage, Blueprint for Stop buttons and Long Flags (Bluefin Restaurant)
Buprenorphine
μ-Opioid Receptor Partial Agonists (2)
Can Induce Withdrawal Symptoms when given after full agonists.
Utopia Resorts, μssage, Bluefin Restaurant
Nalbuphine (and Butorphanol)
μ-Opioid Receptor Antagonist (Given IV)
Reverses Opioid Overdose/Toxicity. Can Precipitate Withdrawal Symptoms. May cause Diarrhea.
Utopia Resorts, μssage, No Lax Zone
Naloxone
μ-Opioid Receptor Antagonist (Given Intramuscular)
Helps maintain Abstinence in Heroin Addicts (Rehab). also useful for halting Alcohol and Nicotine Abuse (Reduces Craving). when given with Bupropion the combination supports Weight loss and Treats Obesity.
May cause Diarrhea.
Utopia Resorts, μssage, No Trix Zone
Naltrexone
SSRI: Selective Serotonin Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OCD. Useful in management of Bulimia and SAD. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause SIADH (Hyponatremia), Sexual Dysfunction, Weight Gain, Drowsiness, Serotonin Syndrome- Therefore should not combine with MAOis or TCAs. Sudden Withdrawal causes Flu-like symptoms.
expreSS tRIps - Fly Out Airlines
Fluoxetine
SSRI: Selective Serotonin Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OC. Useful in management of Bulimia and SAD. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause SIADH (Hyponatremia), Sexual Dysfunction, Weight Gain, Drowsiness, Serotonin Syndrome- Therefore should not combine with MAOis or TCAs. Sudden Withdrawal causes Flu-like symptoms.
expreSS tRIps - Parrot Air
Paroxetine
SSRI: Selective Serotonin Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OCD. Useful in management of Bulimia and SAD. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause SIADH (Hyponatremia), Sexual Dysfunction, Weight Gain, Drowsiness, Serotonin Syndrome- Therefore should not combine with MAOis or TCAs. Sudden Withdrawal causes Flu-like symptoms.
expreSS tRIps - Dessert Airline
Sertraline
SSRI: Selective Serotonin Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OCD. Useful in management of Bulimia and SAD. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause SIADH (Hyponatremia), Sexual Dysfunction, Weight Gain, Drowsiness, Serotonin Syndrome - Therefore should not combine with MAOis or TCAs. Sudden Withdrawal causes Flu-like symptoms.
expreSS tRIps - The City
Citalopram
SNRI: Serotonin Norepi Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT and Norepi Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OCD. Treats Diabetic Neuropathy and Chronic Pain: Neuropathic, Osteoarthritis or Fibromyalgia. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause Serotonin Syndrome (HTN, Hyperthermia, Hyperreflexia and Clonus) - Therefore should not combine with MAOis or TCAs. May also cause of Hypertension. Sudden Withdrawal causes Flu-like symptoms.
Duol Copy/Scanner Machine with N/S Compass Map
Duloxetine
SNRI: Serotonin Norepi Reuptake Inhibitor
1st Line Antidepressant by Inhibits Presynaptic 5HT and Norepi Reuptake. Also 1st line for GAD, PTSD, Panic Disorder and OCD. Treats Diabetic Neuropathy and Chronic Pain: Neuropathic, Osteoarthritis or Fibromyalgia. Takes 2 Months to achieve Maximal Effect (not for useful for Acute). May Cause Serotonin Syndrome (HTN, Hyperthermia, Hyperreflexia and Clonus) - Therefore should not combine with MAOis or TCAs. May also cause of Hypertension. Sudden Withdrawal causes Flu-like symptoms.
Fax Machine with N/S Compass Map
Venlafaxine
Rule 2: Silly Prank Prohibited
5HT-2R Blocker (1st Generation Antihistamine)
Treats Serotonin Syndrome (HTN, Hyperthermia, Hyperreflexia and Clonus) - can happen from SSRIs/SNRIs alone or combined with MAOis or TCAs.
Cyproheptadine
Tricyclic Antidepressant
Norepi and 5HT Presynaptic Reuptake↓ → Excitation↑
Used for MDD. Treats Diabetic Neuropathy and Chronic Pain: Neuropathic, Osteoarthritis or Fibromyalgia. May cause Sexual Dysfunction, Antimuscarinic Effects → Dry Mouth, Constipation, Mydriasis, Urinary Retention. H1R Block→ Sedation and Weight Gain. α-AdR Block→ Orthostatic Hypotension. Contraindicated in Elderly. Overdose: Cardiotoxicity Arrhythmia - Na Block → AP Conduction↓ → TdP! (NaHCO3 reverses), Coma, Seizures. Risk Serotonin Syndrome.
IMPRINt hit
Imipramine
Tricyclic Antidepressant
Norepi and 5HT Presynaptic Reuptake↓ → Excitation↑
Used for MDD. Treats Diabetic Neuropathy and Chronic Pain: Neuropathic, Osteoarthritis or Fibromyalgia. May cause Sexual Dysfunction, Antimuscarinic Effects → Dry Mouth, Constipation, Mydriasis, Urinary Retention. H1R Block→ Sedation and Weight Gain. α-AdR Block→ Orthostatic Hypotension. Contraindicated in Elderly.Overdose: Cardiotoxicity Arrhythmia - Na Block → AP Conduction↓ → TdP! (NaHCO3 reverses), Coma, Seizures. Risk Serotonin Syndrome.
Amy is Tripping
Amitriptyline
Imipramine Derivative (TCA)
Norepi and 5HT Presynaptic Reuptake↓ → Excitation↑
For OCD. May cause Sexual Dysfunction, Antimuscarinic Effects → Dry Mouth, Constipation, Mydriasis, Urinary Retention. H1R Block→ Sedation and Weight Gain. α-AdR Block→ Orthostatic Hypotension. Contraindicated in Elderly.Overdose: Cardiotoxicity Arrhythmia - Na Block → AP Conduction↓ → TdP! (NaHCO3 reverses), Coma, Seizures. Risk Serotonin Syndrome.
Obsessively CLOsed Neat Kid
Clomipramine
Secondary Amine TCAs (2)
Norepi and 5HT Presynaptic Reuptake↓ → Excitation↑. For MDD, Neuropathic Pain and ADHD but with LESS Antimuscarinic Effects! H1R Block→ Sedation and Weight Gain. α-AdR Block→ Orthostatic Hypotension. Contraindicated in Elderly. Overdose: Cardiotoxicity Arrhythmia - Na Block → AP Conduction↓ → TdP! (NaHCO3 reverses), Coma, Seizures. Risk Serotonin Syndrome.
Northside Prep School Protests kid
Nortriptyline and Desipramine
MAO Inhibitor (Irreversible, Non-Selective)
Norepi, Dopamine and 5HT Breakdown↓
NOT USED 1st line, mostly for Atypical Depression and Resistant Depression. With Aged Meat Cheese and Wine (Tyramine↑) → No MAO, Norepinephrine Release↑ → Hypertensive Crisis! (Reversed by Phentolamine). Also Risk for Serotonin Syndrome (even more with TCA/SSRI/SNRI)
Try a Sip of Wine
Tranylcypromine
MAO Inhibitor (Irreversible, Non-Selective)
Norepi, Dopamine and 5HT Breakdown↓
NOT USED 1st line, mostly for Atypical Depression and Resistant Depression. With Aged Meat Cheese and Wine (Tyramine↑) → No MAO, Norepinephrine Release↑ → Hypertensive Crisis! (Reversed by Phentolamine). Also Risk for Serotonin Syndrome (even more with TCA/SSRI/SNRI)
Wine Funnel
Phenelzine
MAO Inhibitor (Irreversible, Non-Selective)
Norepi, Dopamine and 5HT Breakdown↓
NOT USED 1st line, mostly for Atypical Depression and Resistant Depression. With Aged Meat Cheese and Wine (Tyramine↑) → No MAO, Norepinephrine Release↑ → Hypertensive Crisis! (Reversed by Phentolamine). Also Risk for Serotonin Syndrome (even more with TCA/SSRI/SNRI)
Wine Cardboard Box
Isocarboxazid
Parkinsonism Therapy - Selective MAO-B Inhibitor
CNS Dopamine Content↑ (Relative Minor Effect).
With Aged Meat Cheese and Wine (Tyramine↑) → No MAO, Norepinephrine Release↑ → Hypertensive Crisis! (Reversed by Phentolamine). Also Risk for Serotonin Syndrome (even more with TCA/SSRI/SNRI)
Sledge Hammer
Slegeline
Atypical Antidepressant - NET and DAT Inhibitor
For Resistant MDD and Tobacco Addiction. CNS Activating Effects. Sexual Function is unharmed . May cause Seizures (Contraindicated in Bulimia and Anorexia Nervosa ). Less likely to cause Weight gain.
NET DAT BALL PRO
Bupropion
Atypical Antidepressant - Serotonin Modulator
5HT2R, αR Blocker and Weak 5HT Presynaptic Reuptake Inhibitor. May Cause Priapism, Orthostatic Hypertension, Sedation, Sexual Dysfunction and Serotonin Syndrome.
Erect Trombone
Trazodone
Mood Stabilizer - Bipolar Disorder Treatment
Narrow Therapeutic Index.
Acute Toxicity → GI symptoms. Chronic Toxicity → Neuro symptoms: Tremor and Ataxia. May Cause Hypothyroidism, Nephrogenic Diabetes Insipidus and Teratogenic Effects (Ebstein’s Anomaly).
With Thiazide Diuretics or NSAIDs → Clearance↓
Chair LIFT
Lithium
Antiepileptic (Broad Spectrum) and Bipolar Disorder
For Focal Seizures, Grand Mal (Generalized), Absence Seizures and Juvenile Myoclonic Epilepsy by Binding VGNaC → Inactivation Phase↑ as well as CNS GABA↑.
May cause GI symptoms, Appetite↑, Weight↑, Tremor , Fatal Hepatotoxicity (LFTs should be done), Pancreatitis and Teratogenic effect (Neural Tube Defects - Spina Bifida). CYP450 Metabolised.
Welcome FestiVAL PARade
Valproate
Antiepileptic (Broad Spectrum)
For Focal Seizures, Grand Mal (Generalized) and Juvenile Myoclonic Epilepsy by Binding VGNaC → Inactivation Phase↑ also Binds GABA-AR allosterically. May cause Somnolence and Fatigue, Cognitive Dysfunction, Appetite↓, Acute Angle Glaucoma. CYP450 Metabolised.
Toupee on Mate
Topiramate
Antiepileptic (Broad Spectrum) and Bipolar Disorder
For Focal Seizures, Grand Mal (Generalized), Absence Seizures and Juvenile Myoclonic Epilepsy by Binding VGNaC → Inactivation Phase↑. 10% of Adults get Skin Rash and 1% of Children gets Toxic Epidermal Necrolysis (Stevens-Johnson Syndrome). May cause Diplopia. CYP450 Metabolised.
Llama with Rider Red Mask
Lamotrigine
Antiepileptic (Broad Spectrum)
For Focal Seizures, Grand Mal (Generalized) and Juvenile Myoclonic Epilepsy by Binding VGNaC → Inactivation Phase↑. Side effects: Somnolence and 13% get Neuropsychiatric Symptoms. CYP450 Metabolised.
Ancient Elevator Terrace
Levetiracetam
Antiepileptic (Narrow Spectrum - Focal Seizures) and Bipolar Disorder
1st Line Agent for Trigeminal Neuralgia by Binding VGNaC → Inactivation Phase↑. Adverse Effect: Diplopia, Ataxia, SIADH, Aplastic anemia and Agranulocytosis (in 13%), DRESS Syndrome, Teratogenic effect (Neural Tube Defects - Spina Bifida) , Stevens-Johnson Syndrome (Mostly in Asians), and Lupus-Like Syn. Inducer of Hepatic CYP450 .
Classic Car with 3 Gems Above
Carbamazepine
Antiepileptic (Narrow Spectrum - Focal Seizures)
For Diabetic Neuropathy, Neuropathic Pain (Fibromyalgia), Postherpetic Neuralgia (VZV) by blocking VGCC. May cause Ataxia.
Grab a Pint (On Truck)
Gabapentin
Antiepileptic (Narrow Spectrum - Focal Seizures)
Irreversible Inhibitor of GABA Transaminase (Structural Analogue of GABA). For Succinic Semialdehyde Dehydrogenase Deficiency and Panic Disorders as well. May cause Hyperactivity in kids and Somnolence and Risk of Psychosis.
Raised GABA Cab with V on it
Vigabatrin
Antiepileptic (Narrow Spectrum - Focal Seizures)
GABA Presynaptic Reuptake Inhibitor. For GAD, Panic Disorder and Fibromyalgia. May cause Aphasia and Somnolence and Risk of Psychosis.
Raised GABA Cab with Dude’s TIE stuck
Tiagabine
1st Line Antiepileptic for Absence Seizures
Blocks T-Type Calcium Channels in the Thalamus.
Can cause GI Distress (pain, nausea and Vomiting) and Lethargy.
ETHOS on board
Ethosuximide
High Potency 1st Generation Antipsychotic (FGA)
For Positive Symptoms Schizophrenia, Acute Psychosis or Aggression, Bipolar, Tourette’s syn by Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially. 20 - 40 Hrs Half Life (Very Lipophilic). Extrapyramidal Side effects (on Nigrostriatal tract): Acute Dystonia, Parkinsonism, Akathisia, Tardive Dyskinesia (Reversed with Benztropine) and also Hyperprolactinemia (From Tuberoinfundibular inhibition). Neuroleptic Malignant Syndrome (with Rhabdomyolysis) Risk. All FGAs can cause TdP and Seizures
Van-Gogh painting with High HALO
Haloperidol
High Potency 1st Generation Antipsychotic (FGA)
For Positive Symptoms Schizophrenia, Acute Psychosis or Aggression, Bipolar, Tourette’s syn by Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially. 20 - 40 Hrs Half Life (Very Lipophilic). Extrapyramidal Side effects (on Nigrostriatal tract): Acute Dystonia, Parkinsonism, Akathisia, Tardive Dyskinesia (Reversed with Benztropine) and also Hyperprolactinemia (From Tuberoinfundibular inhibition). Neuroleptic Malignant Syndrome (with Rhabdomyolysis) Risk. All FGAs can cause TdP and Seizures
Starry gAZINg painting with Patient Trying to Fly High
Fluphenazine and Trifluoperazine
Low Potency 1st Generation Antipsychotic (FGA)
For Positive Symptoms Schizophrenia, Acute Psychosis or Aggression, Bipolar, Tourette’s syn by Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially. 20 - 40 Hrs Half Life (Very Lipophilic). Side effects: Antimuscarinic (Atropine-Like), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Sedation (Anti-H1R). All FGAs can cause TdP and Seizures. This specific one may cause also Retinal Deposits (“Black Paint”).
Starry gAZINg painting with Color THEORY paints
Thioridazine
Low Potency 1st Generation Antipsychotic (FGA)
For Positive Symptoms Schizophrenia, Acute Psychosis or Aggression, Bipolar, Tourette’s syn by Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially. 20 - 40 Hrs Half Life (Very Lipophilic). Side effects: Antimuscarinic (Atropine-Like), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Sedation (Anti-H1R). All FGAs can cause TdP and Seizures. This specific one may cause also Corneal Deposits (“Corn yellow Paint”)
Starry gAZINg painting with Color-Pro paints
Chlorpromazine
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia, Resistant Depression, OCD and Tourette’s Syn. Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Mild Risk for Hyperglycemia or Dyslipidemia. Lower Incidence Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects (Highest among SGAs). All SGAs may cause TdP.
Quiet Please Only WhiSPERINg is Appropriate
Risperidone
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia, Resistant Depression, OCD, Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Mild Risk for Hyperglycemia or Dyslipidemia. Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects. All SGAs may cause TdP.
QUIET Please Only Whispering is Appropriate
Quetiapine
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia,
Resistant Depression, OCD, Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Weight Gain, Dyslipidemia and Hyperglycemia. Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects. All SGAs may cause TdP.
Quiet Please ONLY Whispering is Appropriate
Olanzapine
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia, Resistant Depression, OCD, Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Mild Risk for Hyperglycemia or Dyslipidemia. Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects. All SGAs may cause TdP.
Quiet Please Only Whispering is APPROPRiate
Aripiprazole
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia, Resistant Depression, OCD, Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Low Risk for Hyperglycemia or Dyslipidemia. Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects. All SGAs may cause TdP.
Zipper dress woman
Ziprasidone
(Atypical) 2nd Generation Antipsychotic (SGA)
For Positive and Negative Symptoms of Schizophrenia, Resistant Depression, OCD, Blocking Postsynaptic D2R in CNS: Mesolimbic and Striatal Especially as well as 5HT-2AR Block. Side Effects: Sedation (Anti-H1R), Orthostatic Hypotension and Tachycardia (Alpha1 Block), Antimuscarinic (Atropine-Like), Weight Gain, Dyslipidemia and Hyperglycemia, Agranulocytosis, Myocarditis or Cardiomyopathy, Seizures. Lower Incidence Extrapyramidal, NMS and Hyperprolactinemia Side effects. All SGAs may cause TdP.
large Closet
Clozapine
Parkinsonism Therapy (Narrow Window)
Cross BBB, In CNS Decarboxylated to become Dopamine. If Decarboxylated in PNS: Nausea and Vomiting occurs (Tolerance), Arrhythmias and Orthostatic Hypotension. In High Doses Neuropsychiatric Side effects emerge. In Chronic Use Parkinsonism Symptoms Re-Emerge Eventually and On-Off Phenomena (Motor Problems). Contraindicated in Psychosis.
L Shaped Crank inside vault with Dope Rope
Levodopa (L-DOPA)
Parkinsonism Therapy
DOPA Decarboxylase Inhibitor (PNS) → L-DOPA (CNS)↑ (Downside - only 3% since COMT still active).
In High Doses Neuropsychiatric Side effects emerge. In Chronic Use Parkinsonism Symptoms Re-Emerge Eventually and On-Off Phenomena (Motor Problems). Contraindicated in Psychosis.
Robber with L Shaped Crank outside vault
Carbidopa
Parkinsonism Therapy - CNS and PNS COMT Inhibitor
Conversion of DOPA to 3-OMD↓ → L-DOPA (CNS)↑
also Conversion of DOPA to 3-MT↓ → Dopamin (CNS)↑
May Cause Liver Failure. In High Doses Neuropsychiatric Side effects emerge. In Chronic Use Parkinsonism Symptoms Re-Emerge Eventually and On-Off Phenomena (Motor Problems). Contraindicated in Psychosis.
TOLL Al-Capone Gangster
Tolcapone
Parkinsonism Therapy - PNS COMT Inhibitor
Conversion of DOPA to 3-OMD↓ → L-DOPA (CNS)↑
In High Doses Neuropsychiatric Side effects emerge. In Chronic Use Parkinsonism Symptoms Re-Emerge Eventually and On-Off Phenomena (Motor Problems). Contraindicated in Psychosis.
“Guard the ENTrance” Al-Capone Gangster
Entacapone
Parkinsonism Therapy - D2R Agonist (Initial)
Dopamine Effect CNS↑ (Also for RLS).
In High Doses Neuropsychiatric Side effects emerge. Can reverse On-Off Phenomena (Motor Problems). Contraindicated in Psychosis. May Induce Uncontrollable Impulses (Gambling / Sexuality).
Double ROPE Ladder in a ROLL in the Vault
Ropinirole
Parkinsonism Therapy - D3R Agonist (Initial)
Dopamine Effect CNS↑ (Also for RLS).
In High Doses Neuropsychiatric Side effects emerge. In Chronic Use Parkinsonism Symptoms Re-Emerge Can reverse On-Off Phenomena (Motor Problems). Contraindicated in Psychosis. May Induce Uncontrollable Impulses (Gambling / Sexuality).
Large PECS Robber Holding Dope Rope Ladder
Pramipexole
Parkinsonism and Influenza Virus A Therapy
Short and Partial Relief of PD Motor Symptoms by Dopamine Synthesis↑ and Reuptake↓. Contraindicated in CRF. In High Doses Neuropsychiatric Side effects emerge and Rarely cause SJS.
green marble MANATee Sculpture
Amantadine
Antimetabolite-Cytotoxic Folate Analog, Dihydrofolate Reductase Inhibitor (S phase)
THF↓ → [THF↓ + dUMP → DHP + dTMP↓] → DNA↓
Therapeutic agent in Many Cancerous Diseases, with Misoprostol as Abortifacient. Treats Ectopic Pregnancy, Choriocarcinoma, Molar Pregnancy, Psoriasis. 1st line treatment in RA. Immunosuppressive for SLE, IBD, Vasculitis and Dermatomyositis. Side effects: Megaloblastic Anemia, Pancytopenia, Infection Risk↑, Pulmonary Fibrosis (Restrictive), Hepatotoxicity, Alopecia, Mucositis, GI Symptoms. Use Leucovorin Rescue to reduce side effects.
Meat Sticks instead of 4 leaves with dUMPlings
Methotrexate
Reverses Toxic effects of Methotrexate (IV or Muscular)
Especially GI, Bone Marrow and Mucosal Toxicity are reversed. Doesn’t Require Dihydrofolate Reductase for DNA Synthesis, Also Displaces Methotrexate from Dihydrofolate Reductase. May be Lethal if Injected Intrathecally.
Lucky Feline
Leucovorin (Folinic Acid = 5-Methyl-THF)
Antimetabolite-Cytotoxic Pyrimidine Analog, Thymidylate Synthase Inhibitor (S phase)
Binds THF → [THF↓ + dUMP↑ → DHP + dTMP↓] → DNA↓
Therapeutic agent in Many Cancerous Diseases; Colorectal, Lung, Breast, BCC etc.. . Side effects: Megaloblastic Anemia, Pancytopenia, Infection Risk↑, Pulmonary Fibrosis (Restrictive), Hepatotoxicity, Alopecia, Mucositis, Cutaneous Photosensitivity and Hyperpigmentation and also GI Symptoms. No Leucovorin Rescue for this one.
Full (from dUMPlings) and Waving Five Fingers
5-Fluorouracil (5FU)
Antimetabolite-Cytotoxic Pyrimidine Analog, Ribonucleotide Reductase Inhibitor (S phase)
[UDP → dUDP↓] → dUMP↓ → dTMP↓ → DNA↓
Therapeutic agent in Many Hematologic Cancers and Head and Neck Cancers etc.. Also for Sickle Cells Anemia (HbF↑) . Side effects: Megaloblastic Anemia, Pancytopenia, Infection Risk↑, Pulmonary Fibrosis (Restrictive), Hepatotoxicity, Alopecia, Mucositis, GI Symptoms. No Leucovorin Rescue.
Hydro-rock area and (U Dine Please) signed of OXY
Hydroxyurea (aka Hydroxycarbamide)
Antimetabolite-Cytotoxic Purine Analog, IMP Synthase (S phase)
In Tissues Converted to 6MP (Pro-Drug) and HGPRT Activation → IMP Synthesis↓ → Purine Cycle↓ → DNA↓ .
Treats Hematologic Malignancies, SLE, Autoimmune Hemolytic Anemia, RA, IBD. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Pancreatitis, Hepatotoxicity, with Allopurinol (XOi) adverse effects↑.
HiGh PRiesT captures AZA-meralda toppling IMP
Azathioprine
Antimetabolite-Cytotoxic Purine Analog, IMP Synthase (S phase)
HGPRT Activation → IMP Synthesis↓ → Purine Cycle↓ → DNA↓ .
Treats Hematologic Malignancies, SLE, Autoimmune Hemolytic Anemia, RA, IBD. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Pancreatitis, Hepatotoxicity, with Allopurinol (XOi) adverse effects↑.
HiGh PRiesT CAPTures Aza-Meralda toppling IMP
6-Mercaptopurine
Antimetabolite-Inosine Monophosphate Dehydrogenase Inhibitor (S phase)
[IMP → GMP]↓ → DNA↓
Treats Hematologic Malignancies, SLE, Autoimmune Hemolytic Anemia, RA, IBD, MG, GVHD. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, GI Distress.
Quasi-Mofet Topples GruMPy Statue
Mycophenolate-Mofetil
Antimetabolite-Cytotoxic Purine Analog, DNA Polymerase α /β Inhibitor (S phase)
Converted to Triphosphate Metabolite Active Inhibitor or Incorporated into DNA Destructively.
1st line agent for Hairy cell Leukemia.
Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑.
CLAD in BeaRskINs
Cladribine
Antimetabolite-Cytotoxic Pyrimidine Analog, DNA Polymerase α /β Inhibitor (S phase)
Converted to Triphosphate Metabolite Active Inhibitor.
Treats Hematologic Malignancies: AML, nHL.
Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑.
SAbER-Tooth Tiger
Cytarabine
Antimetabolite-Cytotoxic Pyrimidine Analog, DNA Polymerase α /β Inhibitor (S phase)
Converted to Triphosphate Metabolite Active Inhibitor.
Treats Hematologic Malignancies and Solid Tumors.
Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑.
GEMs SITs in rock BIN
Gemcitabine
Cytotoxic Alkylating Agent (Non Phase Specific)
Must be metabolized by CYP450 to Active Form. Alkylating N7 of Guanine to cause Intrastrand Crosslinks and Induce Apoptosis. Treats Hematologic and Solid Malignancies, Nephrotic and Nephritic Syndromes, Vasculitis and Autoimmune Hemolytic Anemia. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Hemorrhagic Cystitis (Acrolein Metabolite Toxicity), Bladder Cancer Risk↑, SIADH (Hyponatremia) and Infertility from Gonadal Toxicity.
Leg Chained Cyclops Polyphemus and Red Urine Pool
Cyclophosphamide
Prevents Cyclophosphamide Hemorrhagic Cystitis
Should be Co-Administered with Cyclophosphamide (IV/Oral).
Protective MAZE around Red Urine Pool
MESNA (2-Mercaptoethanesulfonate)
Cytotoxic Alkylating Agent (Non Phase Specific)
Causes Intrastrand Crosslinks and Induce Apoptosis. Conditioning Agent given before Bone Marrow Transplantation . Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Lung Toxicity: Fibrosis, Alveolar Hemorrhage, Injury, Hyperpigmentation Reaction.
Beautiful Sirens with Empty Bones and Classic Tan
Busulfan
Cytotoxic Alkylating Agent (Non Phase Specific)
Activated by Hepatic Non-Enzymatic Hydroxylation Causes Intrastrand Crosslinks and Induce Apoptosis. Highly Lipophilic → Cross BBB → for CNS Tumors i.e: GBM. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Neurotoxicity: Convulsions, Dizziness and Ataxia.
MUSTANg ceNTAURS
Nitrosoureas: Carmustine and Lomustine
Cytotoxic Alkylating Agent (Non Phase Specific)
Activated by Hepatic Non-Enzymatic Hydroxylation Causes Intrastrand Crosslinks and Induce Apoptosis. Highly Lipophilic → Cross BBB → for CNS Tumors i.e: GBM. Side effects: Leukopenia, Thrombocytopenia, Infection Risk↑, Neurotoxicity: Convulsions, Dizziness and Ataxia.
STRIPed Zebra ceNTAUR
Nitrosourea: Streptozotocin
Cytotoxic Platinum Agent
Binds N7 segment on Guanine Causes Intrastrand and Interstrand Crosslinks and Induce Apoptosis.
For Solid Malignancies. Side effects: Highly Ototoxicity (Hair cells targeted), Peripheral Neuropathy, Nephrotoxicity and ATN. Must be given with IV Saline Diuresis to prevent Nephrotoxicity.
PLATInum Store watched by lady with big SIlver earrings
Cisplatin
Free Radical Scavenger
Prevents Cisplatin-Induced Nephrotoxicity
Free Rare Amethyst with Purchase on platinum store
Amifostine
Cytotoxic Platinum Agent
Binds N7 segment on Guanine Causes Intrastrand and Interstrand Crosslinks and Induce Apoptosis.
For Solid Malignancies. Side effects: Slight Ototoxicity (Hair cells targeted), Peripheral Neuropathy, Severe Immunosuppression (Myelotoxic) - Leukopenia, Thrombocytopenia, Infection Risk↑.
PLATInum Store with CARDBOard Bone-Shaped box open
Carboplatin
Antitumor Antibiotic
a Peptide that binds Fe and DNA - Upon Binding DNA Produces ROS → Single and Double Stranded Breaks.
Stops G2 Cell Cycle Phase. For Solid and Hematologic Malignancies. Side effects: Pulmotoxicity
(Pneumonitis), Skin toxicity (Hyperpigmentation), Stomatitis and Mucositis and Alopecia.
Striped BELUga Whale with Galleon ship
Bleomycin
Antitumor Antibiotics
a Peptide that binds Fe and DNA - Upon Binding DNA Produces ROS → Single and Double Stranded Breaks. Also able (Smaller than Bleomycin) to Intercalate into DNA and Block Synthesis.
Stops G2 Cell Cycle Phase. For Solid and Hematologic Malignancies. Side effects: Cardiotoxicity (induce DCM), Skin toxicity (Hyperpigmentation), Stomatitis and Mucositis and Alopecia, Myelosuppression - Leukopenia, Thrombocytopenia, Infection Risk↑.
Santa Anthracyclines ship with RUBIEs Chest
Doxorubicin (and Daunorubicin)
Fe Chelator
Prevents Doxorubicin-Induced Cardiotoxicity
Santa Anthracyclines ship with pirate JACK’S heart sac and RAZOR
Dexrazoxane
Antitumor Antibiotics
Intercalate into DNA and Block Synthesis.
Stops G2 Cell Cycle Phase. For Pediatric Malignancies: Wilms Tumor, Ewing Sarcoma and Rhabdomyosarcoma. Side effects: Stomatitis and Mucositis and Alopecia, Myelosuppression - Leukopenia, Thrombocytopenia, Infection Risk↑.
ArTIfACT Childhood Doll
Actinomycin D
Topoisomerase 2 inhibitor
DNA Supercoiling↑ and Re-ligation↓ → Double Strand Breaks! Stops G2 and S Cell Cycle Phases. For Hematologic Malignancies and Solid Tumors. Side effects: Alopecia, Myelosuppression - Leukopenia, Thrombocytopenia, Infection Risk↑.
princess on TOP Tower SIDE going down with 2 Hair locks.
Etoposide (and Teniposide)
Topoisomerase 1 inhibitor
DNA Supercoiling↑ and Re-ligation↓ → Single Strand Breaks! Stops G2 and S Cell Cycle Phases. For Ovarian Cancer, Colorectal and Small cell Carcinoma. Side effects: Diarrhea, Myelosuppression - Leukopenia, Thrombocytopenia, Infection Risk↑.
TOUCAN with message going to TOP tower princess from 1 ponytail prince
Topotecan (and Irinotecan)
Topoisomerase 1 inhibitor
DNA Supercoiling↑ and Re-ligation↓ → Single Strand Breaks! Stops G2 and S Cell Cycle Phases. For Ovarian Cancer, Colorectal and Small cell Carcinoma. Side effects: Diarrhea, Myelosuppression - Leukopenia, Thrombocytopenia, Infection Risk↑.
TOUCAN with message going to TOP tower princess from 1 ponytail prince
Topotecan (and Irinotecan)
Vinca Alkaloid - Microtubule Polymerization Inhibitor
Mitotic Spindle Assembly↓ → Cell Division Halted!
Stops M Cell Cycle Phase. For Hematologic and Pediatric Malignancies, Breast Cancer and Germ cell Tumors. Side effects: Peripheral Neuropathy, Orthostatic Hypotension, Paralytic Ileus, Alopecia and Myelosuppression
CHRISTINE in VINEs and hunter BLASTing VINEs
Vincristine and Vinblastine
Microtubule Polymerization Enhancer
Mitotic Spindle Function↓ → Cell Division Halted!
Stops M Cell Cycle Phase. For Hematologic and Pediatric Malignancies, Breast Cancer and Germ cell Tumors. Side effects: Peripheral Neuropathy, Orthostatic Hypotension, Paralytic Ileus, Alopecia and Myelosuppression .
TARZAN
Paclitaxel (and Docetaxel)
Tyrosine Kinase Inhibitor (Anti-Growth Signals)
Halting the ABL/BCR (t9;22, Philadelphia Chromosome) formed TyKR and also c-Kit. For CML (t9;22 in 95%), ALL and GIST (c-Kit). Side effect: Periorbital and Lower Limb Edema.
broken pen NIB and IMITAting Speaker
Imatinib
Tyrosine Kinase Inhibitor (Anti-Growth Signals)
Blocks EGFR TyKR. For Non-Small Cell Carcinoma of Lung. Side effect: Papulopustular Acneiform Rash, Diarrhea.
broken pen NIB and British EARL “geoffrey”
Erlotinib
Tyrosine Kinase Inhibitor (Anti-Growth Signals)
Blocks VEGFR TyKR. For RCC, HCC and GIST. Side effect: Hyperkeratosis and Rashes, Hemorrhage Risk↑
broken pen NIB and Rising Sun with SOARing eagle above vegetable field
Sunitinib and Sorafenib
Tyrosine Kinase Inhibitor (Anti-Growth Signals)
Blocks B-Raf TyKR. For V600E BRAF Positive Melanoma (50% of Melanomas). Side effect: Hyperkeratosis and Rashes, Hemorrhage Risk↑
broken pen NIB and VENOMous snake sketch by B. FRA
Vemurafenib
Chimeric Monoclonal IgG for CD20+ B cells (IV)
Activates Complement and NK cell dependent Cytotoxicity. For CLL, RA, Vasculitis. Side effect: Immunosuppression - Infection Risk↑: Especially JC virus causing Progressive Multifocal Encephalopathy!, also causes Infusion reaction: Headache, Fever, Rash, Pruritus, Dyspnea and Hypotension (reversed with NSAIDs), and Serum Sickness (HSN Type 3, Reversed with Steroids).
RITUal for Prince and swollen red cherub with ivy.
Rituximab
Chimeric Monoclonal IgG for EGFR+ Tumor cells (IV)
Halts TykR dependent growth. For Solid Tumors (SCC, CRC). Side effect: Papulopustular Acneiform Rash (like in Erlotinib) also causes Infusion Reaction: Headache, Fever, Rash, Pruritus, Dyspnea and Hypotension (reversed with NSAIDs), and Serum Sickness (HSN Type 3, Reversed with Steroids, Less Frequent).
TUSKed elephant with giraffes and tyre
Cetuximab
Humanized Monoclonal IgG for VEGFR+ Tumor cells (IV)
Halts TykR dependent Angiogenesis. For Metastatic Tumors (CRC, Epithelial Ovarian Cancer) and Wet Macular Degeneration. Side effect: Fatal Hemorrhage Risk↑, Thrombotic events↑, GI Perforation also causes Infusion Reaction: Headache, Fever, Rash, Pruritus, Dyspnea and Hypotension (reversed with NSAIDs), and Serum Sickness (HSN Type 3, Reversed with Steroids, Less Frequent).
BEVRAge lady covered with red liquid
Bevacizumab
Humanized Monoclonal IgG for CD52+ Lymphocyte (IV)
Activates Complement and NK cell dependent Cytotoxicity. For CLL, RA, Vasculitis. Side effect: Immunosuppression - Infection Risk↑: Especially JC virus causing Progressive Multifocal Encephalopathy!, also causes Infusion reaction: Headache, Fever, Rash, Pruritus, Dyspnea and Hypotension (reversed with NSAIDs), and Serum Sickness (HSN Type 3, Reversed with Steroids).
ALMSgiving requesting poor Man
Alemtuzumab
Humanized Monoclonal IgG for Her2+ Breast Carci. (IV)
Halts TykR (Epidermal Growth Factor Receptor 2) dependent growth. Also for Ovarian and Salivary Gland Tumors Side effect: Cardiotoxicity (LVEF↓), also causes Infusion Reaction: Headache, Fever, Rash, Pruritus, Dyspnea and Hypotension (reversed with NSAIDs), and Serum Sickness (HSN Type 3, Reversed with Steroids, Less Frequent).
TApeSTRY weaving and a tyre with 2 babies
Trastuzumab
Selective Estrogen Receptor Modulator (SERM)
Treatment of Estrogen Receptor Positive Breast Cancer. Uterine and Ovarian ER Agonist and Breast ER Antagonist → Breast Carcinoma Risk ↓ BUT Uterine Carcinoma Risk↑ or Induction of Fertility↑. Also Teratogenic.
TAMI with FAn (Not on Sketchy)
Tamoxifen
Analgesic, Antipyretic, Anti Inflammatory Drug
For Perioperative Pain, Acute injury, Colic, Cancer Pain and High fever Unresponsive to other agents. Side effects: Agranulocytosis, Aplastic anaemia, HSN, SJS. Reversed by Activated Charcoal. It is banned in several countries, mechanism is still investigated - PGE2 Block Associated.
META cause it is ZOLE (Not on Sketchy)
Metamizole (aka Optalgin)
NSAID - Reversible Non Selective COX Inhibitor
For Acute Minor Aches and Pains and PDA. Side Effect (Less Probable from Indomethacin): GI Bleeding and Ulceration (PLT Function↓), Cardiovascular Events (PLT Function↓) , ARF (PG↓), Acute Interstitial Nephritis, Aplastic Anemia, Type 4 RTA, (+ Hyperaldosteronism and Hyperkalemia), Gestational DA Closure.
I BOW PRO-FAN (Not on Sketchy)
Ibuprofen (aka Advil or Nurofen)
Antifungal Agent (IV with Saline/Intrathecally)
For Systemic or CNS Infections. Liposomal Formulation can lower Toxicity. Binds Ergosterol Fungal cell WALL creating a Polar hole for Ions and Water to enter (e.g for Cryptococcus). Side effects (from Binding Cholesterol): Hypotension, Headache, Fever and Chills, Seizures, Thrombophlebitis, RTA type 1, Prerenal Azotemia, Hypomagnesemia, Hypokalemia, Normocytic Anemia (EPO↓).
Amphibian
Amphotericin B
Antifungal Agent
Cytosine Deaminase Converts to 5-Flurouracil, Further Active Metabolites halt synthesis of Fungal DNA and RNA (e.g for Cryptococcus). Side Effects: Bone Marrow Suppression, Loss of Appetite, Diarrhea, Vomiting, and Psychosis and Anaphylaxis.
Flute
Flucytosine
Antifungal Agent
For Candida Infections (Vaginal or Oropharyngeal). Liposomal Formulation can lower Toxicity. Binds Ergosterol Fungal cell WALL creating a Polar hole for Ions and Water to enter (e.g for Cryptococcus). Side effects (from Binding Cholesterol): Mouth irritation, diarrhea, nausea, vomiting, or stomach upset.
“Be Nyce”
Nystatin
Antifungal Agent (IV/Topical)
Inhibits Conversion of Lanosterol to Ergosterol for Fungal Membrane. (by Inhibition CYP450, Mammalian and Fungal) - For Aspergillosis, Candidiasis.
Side effects: Blurry Vision with Flashes,
Pine Cones and Car Crushing VORtex
Voriconazole
Antifungal Agent (IV/Topical)
Inhibits Conversion of Lanosterol to Ergosterol for Fungal Membrane. (by Inhibition CYP450, Mammalian and Fungal) - For Esophageal/Vaginal/Oral Candidiasis as well as Cryptococcal Meningitis (BBB Penetration).
Side effects: Blurry Vision with Flashes,
Pine Cones and FLYing monkeys
Fluconazole
Antifungal Agent (IV/Topical)
Inhibits Conversion of Lanosterol to Ergosterol for Fungal Membrane. (by Inhibition CYP450, Mammalian and Fungal) - For Dimorphic Fungal Infections and Onychomycosis and Dermatophytosis.
Side effects: Blurry Vision with Flashes,
Pine Cones and Butterfly with two ITERAtions (Dimorph)
Itraconazole
Antifungal Agent (IV/Topical)
Inhibits Conversion of Lanosterol to Ergosterol for Fungal Membrane. (by Inhibition CYP450, Mammalian and Fungal) - For Tinea Infections and Vaginal Candidiasis .
Side effects: Blurry Vision with Flashes,
Pine Cones and CLOSe TRIM lion saying MY cone.
Clotrimazole and Miconazole
Antifungal Agent (ONLY Topical)
Inhibits Conversion of Lanosterol to Ergosterol for Fungal Membrane. (by Inhibition CYP450, Mammalian and Fungal) - For Dermatophytosis and Cushing’s.
Side effects: 17,20- Desmolase Inhibition → Corticosteroids↓ →Androgens and Estrogens↓ (Gynecomastia)
Pine Cones and Tin men with KEY
Ketoconazole
Antifungal Agent (Oral)
Binds Fungal cell Microtubules → Halts Mitosis. For Tinea Infections, Dermatophytosis and Vaginal Candidiasis. 1st Line Agent for Tinea Capitis in Children. CYP450 Activator related side effects.
GRIESE to mouth of tinman
Griseofulvin
Antifungal Agent (Topical/Oral)
Inhibits Fungal Squalene Epoxidase → Squalene↑ and Ergosterol Synthesis ↓ . For Tinea Infections, Dermatophytosis and Onchyociadidis. 1st Line Agent for Tinea Capitis in Children. Side Effects: Hepatotoxicity and Diarrhea
Turban Dude
Terbinafine
Antifungal Agent (IV)
Inhibits Synthesis of β-1-3-Glucan → Fungal cell Wall Damage .For Systemic Candidiasis and Aspergillosis. Side Effects: GI Symptoms.
Canadian with Fur Cap
Echinocandins: Caspofungin, Micafungin
Antiretroviral - NRTI for HBV or HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, Peripheral Neuropathy. (RT is POL gene dependent and mutation and resistance may occur.)
sir LAncelot DINEs (inSIDE)
Lamivudine
Antiretroviral - NRTI for HBV or HIV
Competitive Inhibition of Reverse Transcriptase NOT Activated by PHOsphorylation. NucleoTide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, Peripheral Neuropathy. (RT is POL gene dependent and mutation and resistance may occur.)
sir Tristan (ouT)
Tenofovir
Antiretroviral - NRTI for HBV or HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
First Line for Pregnant Patient and Postpartum - Reduces Vertical Transmission.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis and Myelosuppression - Anemia Granulocytopenia as well as Lipodystrophy. (RT is POL gene dependent and mutation and resistance may occur.)
princess IZlUDE with DOVE DINEs (inSIDE)
Zidovudine
Antiretroviral - NRTI for HBV or HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, and Peripheral Neuropathy as well as Lipodystrophy.
(RT is POL gene dependent and mutation and resistance may occur.)
sir STEVE DINEs (inSIDE)
Stavudine
Antiretroviral - NRTI for HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, and Peripheral Neuropathy with Dose Dependent Pancreatitis. (RT is POL gene dependent and mutation and resistance may occur.)
sir DAN DINEs (inSIDE)
Didanosine
Antiretroviral - NRTI for HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, and HSN Type 4 Delayed onset Rash(HLA B 57:01 related).
(RT is POL gene dependent and mutation and resistance may occur.)
merline saying ABraCAdabra
Abacavir
Antiretroviral - NRTI for HIV
Competitive Inhibition of Reverse Transcriptase Activated by Phosphorylation. NucleoSide Analogue incorporated into of Viral DNA WITHOUT 3’ OH→No Phosphodiester Bond→ Premature Chain Termination.
Side Effects: Mitochondrial Toxicity, Lactic Acidosis, and Hyperpigmentation of Palms and Soles.
(RT is POL gene dependent and mutation and resistance may occur.)
king arthur ExCAliBur
Emtricitabine
Antiretroviral - NNRTI for HIV
Allosteric Inhibition of Reverse Transcriptase (NOT Activated by Phosphorylation) → Premature Chain Termination. RT is POL gene dependent and mutation and resistance may occur.
Side Effects: Hepatotoxicity (in 6wks), Moderate CYP450 Activation, Steven Johnson Syndrome.
ElVEN PINE Forest (outSide fleeing P messenger)
Nevirapine
Antiretroviral - NNRTI for HIV
Allosteric Inhibition of Reverse Transcriptase (NOT Activated by Phosphorylation) → Premature Chain Termination. RT is POL gene dependent and mutation and resistance may occur.
Side Effects: Hepatotoxicity (in 6wks), Insomnia, Nightmares, Headaches, Psychosis, Teratogenic Effects, CYP450 Activation/Inhibition Varying and Metabolised by it, Steven Johnson Syndrome.
queen ELFAVIR (outSide fleeing P messenger)
Efavirenz
Antiretroviral - NNRTI for HIV
Allosteric Inhibition of Reverse Transcriptase (NOT Activated by Phosphorylation) → Premature Chain Termination. RT is POL gene dependent and mutation and resistance may occur.
Side Effects: Hepatotoxicity (in 6wks), Teratogenic Effects, CYP450 Activation/Inhibition Varying and Metabolised by it, Steven Johnson Syndrome.
Princess DELAVIR (outSide fleeing P messenger)
Delavirdine
Antiretroviral - Protease Inhibitor for HIV
Prevents the partial proteolytic activation of transcribed HIV proteins (POL gene produces the Proteases and may form Resistance). NOT Activated by Phosphorylation. Side Effects: Hyperglycemia and Potential DM, Dyslipidemia (LDL), Lipodystrophy. (Rifampin → CYP450 Activation→ Protease Inhibitors↓)
Lady NAVERE with paul smithy (outSide fleeing P messenger)
Guinevere
Antiretroviral - Protease Inhibitor for HIV
Prevents the partial proteolytic activation of transcribed HIV proteins (POL gene produces the Proteases and may form Resistance). NOT Activated by Phosphorylation. Side Effects: Hyperglycemia and Potential DM, Dyslipidemia (LDL), Lipodystrophy, and Nephrolithiasis. (Rifampin → CYP450 Activation→ Protease Inhibitors↓)
INDIgo Princess with Lady NAVERE and paul smithy (outSide fleeing P messenger)
Indinavir
Antiretroviral - Protease Inhibitor for HIV
Prevents the partial proteolytic activation of transcribed HIV proteins (POL gene produces the Proteases and may form Resistance). NOT Activated by Phosphorylation. Side Effects: Hyperglycemia and Potential DM, Dyslipidemia (LDL), Lipodystrophy, and CYP450 inhibition → other Protease Inhibitors↑.
(Rifampin → CYP450 Activation→ Protease Inhibitors↓)
“Right on!” children dismantle wheel of CYP carriage with Lady NAVERE and paul smithy (outSide fleeing P messenger)
Ritonavir
Antiretroviral - Entry Inhibitor for HIV
Prevents viral gp120 protein from attaching CCR5 on CD4+ T cells by attaching itself CCR5 (NOT for CXCR4 Strain dependent Therapy). gp120 is ENV gene dependent and mutation and resistance may occur.
MARE with CCR5 Banner stops 120 battering ram
Maraviroc
Antiretroviral - Fusion Inhibitor for HIV
Prevents viral gp41 protein from facilitating fusion in CD4+ T cells. gp41 is ENV gene dependent and mutation and resistance may occur.
DEFlector of FUsion Hook
Enfuvirtide
Antiretroviral - Integrase Inhibitor for HIV
Halts viral Integrase protein unlocking dsDNA in CD4+ T cells by binding it → mRNA / dsDNA is not integrated. Integrase is POL gene dependent and mutation and resistance may occur. Side effect: Rhabdomyolysis (CK↑)
key deflecToR
Ratelgravir
Antiviral - for HBV and HCV (Intramuscular)
Also for Hairy cell Leukemia, Malignant Melanoma, Kaposi Sarcoma caused by HHV 8, Condyloma Acuminata caused by HPV and RCC. Mechanism: Activation of B cells and NK cells and MHC-I↑. Side Effect in Chronic use: Flu-Like Syndrome, Tinnitus, Retinopathy and Confusion, Neurotoxicity, Myelosuppression, Lupus-Like Syndrome.
(PEGylated = for Long term)
pαc mαn with Hippo
Interferon-α (aka Multiferon)
Multiple Sclerosis treatment (Intramuscular)
Clinical trials for COVID-19. Mechanism: Activation of B cells and NK cells and MHC-I↑. Side Effect in Chronic use: Flu-Like Syndrome.
β Invaders in time and space
Interferon-β
For Chronic Granulomatous Disease (Intramuscular)
Mechanism: Activation of Macrophages for ROS formation - Bursting Granulomas over time (Cycles of TH1 Differentiation↑ and MHC-II Expression↑). Side Effect in Chronic use: Flu-Like Syndrome.
Gammaga
Interferon-γ
Antiviral - Guanosine Nucleoside Analog (Oral)
Against HCV and RSV. Given once weekly with PEGylated IFNα. No HCV RNA PCR positivity for 6 month after treatment is the goal (SVR). phosphorylated 3 times intracellularly eventually causes harmful viral mutation when incorporated. Side effect: Dose Dependent Hemolytic Anemia (20% of), Teratogenic and Embryocidal.
RIB steak with 3 peppers
Ribavirin
Anti-HCV, NS5B (RNA polymerase) Inhibitor
1st Line Treatment For Genotypes 1 2 3 4. No HCV RNA PCR positivity for 6 month after treatment is the goal (SVR). It is a Nucleoside Analog, phosphorylated 3 times to be activated. Side effect: Nausea and Fatigue.
SOFA
Sofosbuvir
Anti-HCV, NS3/4A (protease) Inhibitor
1st Line Treatment For Genotype 1 ONLY. No HCV RNA PCR positivity for 6 month after treatment is the goal (SVR). Side effect: Photosensitivity and Rash, Substrate and Inhibition of CYP450.
SEMMEring (over fire)
Simeprevir
Anti-HCV, NS5A (protease) Inhibitor
1st Line Treatment For Genotype 1 ONLY. No HCV RNA PCR positivity for 12 month after treatment is the goal (SVR). Side effect: Nausea and Fatigue.
LAdy doing DIPS
Ledipasvir
Anti-HSV and VZV, Guanosine Nucleoside Analog (IV)
Converted to monophosphate viral thymidine kinase which is rate determining and later to triphosphate by cellular kinases for Final activation. Absence of viral thymidine kinase causes Resistance. Against related Encephalitis or Shingles, Prophylaxis in Immunocompromised and Pregnancy with Genital HSV. Side effects: Interstitial Nephritis Crystalline Nephropathy (Hydration Prevents), delirium, confusion, vertigo, hallucinations.
hermes Airlines reCYCLing bin
Acyclovir
Anti-HSV, CMV and VZV, DNA polymerase Inhibitor (IV)
Doesn’t Depend of viral thymidine kinase therefore used for Acyclovir or Ganciclovir resistant cases. Against related retinitis and Prophylaxis in Immunocompromised and Pregnancy with Genital HSV. Side effects: Nephrotoxicity, leading to Proteinuria, Azotemia, and Metabolic acidosis (Probenecid reverse by reduced excretion)
CID the OFFicer
Cidofovir
Anti-HSV and VZV, Acyclovir Prodrug (Oral)
Converted to monophosphate viral thymidine kinase which is rate determining and later to triphosphate by cellular kinases for Final activation. Absence of viral thymidine kinase causes Resistance. Against related retinitis and Prophylaxis in Immunocompromised and Pregnancy with Genital HSV. Side effects: Interstitial Nephritis Crystalline Nephropathy (Hydration Prevents), delirium, confusion, vertigo, hallucinations.
VALet parking
Valacyclovir
Anti-HSV, CMV and VZV, DNA polymerase Inhibitor (IV)
Doesn’t Depend of viral thymidine kinase therefore used for Acyclovir or Ganciclovir resistant cases. Against related retinitis and Prophylaxis in Immunocompromised and Pregnancy with Genital HSV. Side effects: ARF, leading to Hypokalemia, Hypocalcemia, and Hypomagnesemia and May cause Seizures.
Car Net
Foscarnet (aka Foscavir)
Anti-CMV + GVHD, Guanosine Nucleoside Analog (IV)
converted to monophosphate by a virus encoded kinase (UL97) 1st phos step. converted to triphosphate by cellular kinase. UL97 absence = Resistance. Against related retinitis and Prophylaxis Organ transplant and CD4+ 50>HIV Patients. Side effects: Myelosuppression (additive in patients receiving zidovudine)
Can reCYCLing bin
Ganciclovir
Anti-CMV and GVHD, Ganciclovir Prodrug (oral)
converted to monophosphate by a virus encoded kinase (UL97) 1st phos step. converted to triphosphate by cellular kinase. UL97 absence = Resistance. Against related retinitis and Prophylaxis Organ transplant and CD4+ 50>HIV Patients. Side effects: Myelosuppression (additive in patients receiving zidovudine)
VALue meal
Valganciclovir
Antibiotic - β Lactam
For Gram+ Bacteria, halting Peptidoglycan Synthesis by binding PBP. Acid Stable. Indicated in Strep Throat, RA, cervicofacial actinomycosis, C.Perfringens/Pasteurella Infected Wound. Side Effect: Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis.
Purple Pencil with V-Ship
Penicillin V (Oral)
Antibiotic - β Lactam
For Gram+ Bacteria, halting Peptidoglycan Synthesis by binding PBP. Indicated in RA, S.Viridans/Bovis Endocarditis, Intrapartum for GBS Prophylaxis, cervicofacial actinomycosis, C.Perfringens/Pasteurella Infected Wound, Syphilis, Some Strains in Meningococcemia. Side Effect: Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis.
Purple Pencil of G-shaped hair
Penicillin G (IV)
Antibiotic - Narrow Spectrum β Lactam
Halting Peptidoglycan Synthesis by binding PBP of S. Aureus. Indicated in Abscesses, Folliculitis, Staph. Endocarditis, Staph. Osteomyelitis .Side Effect: Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis. MRSA will have altered PBP = Resistance.
Staff Pencil
Nafcillin
Antibiotic -Narrow Spectrum β Lactam
Halting Peptidoglycan Synthesis by binding PBP of S. Aureus. Indicated in Abscesses, Folliculitis, Staph. Endocarditis, Staph. Osteomyelitis .Side Effect: Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis. MRSA will have altered PBP = Resistance.
OX Horn
Oxacillin
Antibiotic - Broad Spectrum β Lactam (Oral)
For Gram+ and Gram-. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Strep. Throat, Otitis Media, Sinusitis, Strep. Pneumonia, H. Influenzae, H.pylori (Triple therapy), Listeria Monocytogenes Meningitis Lyme Disease (B. Burgdorferi), Asplenic Prophylaxis .Side Effect: SJS, Liver Injury, EBV-Settings Rash, Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis. β Lactamases = Resistance. β Lactamase Inhibitor (Clavulanate) could be added.
Ammo box
Amoxicillin (an Aminopenicillin)
Antibiotic - Broad Spectrum β Lactam (IV)
For Gram+ and Gram-. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Anaerobic Infections - Aspiration Pneumonia, Enterococcus Endocarditis and UTI, Listeria Monocytogenes Meningitis, Lyme Disease (B. Burgdorferi), Asplenic Prophylaxis . Side Effect: SJS, Liver Injury, EBV-Settings Rash, Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis. β Lactamases = Resistance. β Lactamase Inhibitor (Sulbactam) could be added.
Ammo box
Ampicillin (an Aminopenicillin)
β Lactamase Inhibitor
Paired with Aminopenicillins
Distracting Clarinet
Clavulanate
β Lactamase Inhibitor
Paired with Aminopenicillins
Soul jam Players Back to Back
Sulbactam
β Lactamase Inhibitor
Paired with Aminopenicillins
Tambourine Players Back to Back
Tazobactam
Antibiotic - Broad Spectrum β Lactam (IV)
For Gram+ and Gram-. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Anaerobic Infections like Aspiration Pneumonia and Pseudomona. Side Effect: SJS, Liver Injury, EBV-Settings Rash, Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis.. β Lactamases = Resistance. β Lactamase Inhibitor (Clavulanate) could be added.
Tigger stripes player
Ticarcillin
Antibiotic - Broad Spectrum β Lactam (IV)
For Gram+ and Gram-. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Anaerobic Infections like Aspiration Pneumonia and Pseudomona. Side Effect: SJS, Liver Injury, EBV-Settings Rash, Type 1 HSN, Autoimmune Hemolytic Anemia (Coombs+), Interstitial Nephritis.. β Lactamases = Resistance. Tazobactam (β Lactamase Inhibitor) could be added.
Pipers playing
Piperacillin
Broad Spectrum Antibiotic complexed with β Lactamase Inhibitor - Sulbactam/Ampicillin
(Trade Name)
Unasyn or Ampictam
Broad Spectrum Antibiotic complexed with β Lactamase Inhibitor - Clavulanate/Amoxicillin
(Trade Name)
Augmentin
Broad Spectrum Antibiotic complexed with β Lactamase Inhibitor - Tazobactam/Piperacillin
(Trade Name)
Zosyn
Antibiotic - β Lactam, 1st Generation Cephalosporins
For Gram+ and Gram-. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Cellulitis, Abscesses, Strep. Throat, PEK UTI, 1st line for Surgical Prophylaxis. Side Effect: Type 1 HSN for Penicillin Sensitive
General LEX, FEZ wearing, FLEXing squid
Cephalexin and Cefazolin
Antibiotic - β Lactam, 2nd Generation Cephalosporins
For Gram+ and Gram- (Extended). Halting Peptidoglycan Synthesis by binding PBP. Indicated in Cellulitis, Abscesses, Strep. Throat, PEK UTI and HENZ, RTI. Side Effect: Type 1 HSN for Penicillin Sensitive
General FOX FURIOUs squid
Cefuroxime and Cefoxitin
Antibiotic - β Lactam, 3rd Generation Cephalosporins
For Gram+ and Gram- (Extended more). Halting Peptidoglycan Synthesis by binding PBP. Indicated in Meningitis (IV), Nosocomial Pneumonia, Pseudomona, S. Viridans Endocarditis (also HACEK), Sepsis and GI Infection, N. Gonorrhoeae (Intramuscular), Lyme Disease (B. Burgdorferi). Side Effect: Type 1 HSN for Penicillin Sensitive
General TAZ with 3 axes squid guy
Ceftazidime and Ceftriaxone
Antibiotic - β Lactam, 4th Generation Cephalosporins
Broad Spectrum. Halting Peptidoglycan Synthesis by binding PBP. Indicated in Meningitis (IV), Pseudomona, Sepsis and GI Infection. β Lactamase Resistant Drug. Side Effect: Type 1 HSN for Penicillin Sensitive
Prim General squid
Cefepime
Antibiotic - β Lactam, 5th Generation Cephalosporins
Broad Spectrum. Halting Peptidoglycan Synthesis by binding PBP. Indicated in MRSA. β Lactamase Resistant Drug. Side Effect: Type 1 HSN for Penicillin Sensitive
General TARA squid
Ceftaroline
Antibiotic - β Lactamase Resistant
For Aerobic Gram-. Indicated in Pseudomona, Meningitis, Sepsis, Pneumonia. β Lactamase Resistant Drug and safe for for Penicillin Sensitive. Side Effect: GI effects and Rash, Seizures with Renal Patients. High in price.
AZ3M robot with Ineffective β Guard
Aztreonam (a Monobactam)
Antibiotic - β Lactamase Resistant
For Anaerobic Gram- and MDRs. Indicated in Pseudomona, Meningitis, Sepsis, Aspiration Pneumonia, Abdominal Abscesses. β Lactamase Resistant Drug and safe for for Penicillin Sensitive. Given with Cilastatin to Prevent Renal Dehydropeptidase deactivation. Side Effect: GI effects and Rash, Seizures with Renal Patients. High in price.
Amy’s Car Repair (keep in lastin…)
Imipenem (a Carbapenem)
Antibiotic - Glycopeptide, β Lactamase Resistant (IV)
For MRSA and PRSP. Halting Peptidoglycan Synthesis by binding D-ALA-D-ALA (Directly, NOT TO PBP). Indicated in Meningitis, Sepsis, Osteomyelitis, MDR Nosocomial Pseudomona, Empiric treat for Endocarditis, Enterococcus GI infection, Metronidazole Resistant C.Diff (Oral). Side Effect: Red Man Syndrome (Histamine Dependent), Thrombophlebitis, Ototoxicity and Nephrotoxicity, DRESS Syndrome. 90% Renal Excretion - Should be monitored.
No Mercy Pharoahe, Golden staff, VAN to Metro
Vancomycin
Antibiotic - Cyclic Lipopeptide, β Lactamase Resistant
For VRSA and VRE. Depolarizes the Bacterial Cells. Indicated in Meningitis, MRSA-Sepsis/Endocarditis/Skin, Enterococcus GI infection. Side Effect: Inactivated by Pulmonary Surfactant (NOT for Pneumonia), Myopathy and Rhabdomyolysis (CK↑).
Police DEPT with Taser shooting resisting Van
Daptomycin
Antibiotic - 30s Ribosomal Translation Inhibitor (Bacteriostatic)
For Broad Spectrum: MRSA, Tick-Borne Diseases (Tularemia, Rickets, Lyme), Zoonotics (Brucellosis, Q-Fever, Yersinia), Chlamydiasis PID and Gonorrhea, Atypical Pneumonia, Acne.Side effect: Ca, Mg and Fe are Chelated by it (Milk better avoided) - Teeth Discolouration, Teratogenic, GI Effects, Skin Photosensitivity, Fanconi Syndrome (Type 2 RTA) for Expired drug. Resistance is achieved by Efflux pump or alteration of Ribosomes. Eliminated Fecal so safe in ARF.
Typewriter with Paper Stuck - Bicycles
Tetracyclines: Doxycycline and Oxytetracycline
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
Broad Spectrum: Bordetella Pertussis and its Prophylaxis, For Penicillin Sensitivity Pneumonia patients: Strep. Pneumo, Moraxella, H. Influenza, For Atypical Pneumo: Mycoplasma, Legionella, Chlamydia. Bartonella Henselae, Mycobacterium Avium (CD4<50).
Side Effects: GI Symptoms, Jaundice, Prolonged QT and TdP, CYP450 Inhibition.
Typewriter with Paper Stuck - Black Crow + A-Z sign
Azithromycin (a Macrolide)
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
Broad Spectrum: Bordetella Pertussis and its Prophylaxis, C.Trachomatis, N.Gonorrhoeae, C.Diphtheriae. Side Effects: GI Symptoms, Jaundice, Prolonged QT and TdP, CYP450 Inhibition.
Typewriter with Paper Stuck - Red Crow
Erythromycin (a Macrolide)
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
Broad Spectrum: Bordetella Pertussis and its Prophylaxis, For Penicillin Sensitivity Pneumonia patients: Strep. Pneumo, Moraxella, H. Influenza, Bartonella Henselae, H. Pylori (with Amoxicillin and Omeprazole). Anti-Parasitic for Babesia.
Side Effects: GI Symptoms, Jaundice, Prolonged QT and TdP, CYP450 Inhibition.
Typewriter with Paper Stuck - Keep Clear Crow
Clarithromycin (a Macrolide)
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
For Staph and Strep Infections; Cellulitis from Pyogenes, MRSA. As well as Anaerobic Bacteria Infections Aspiration (Usually above Diaphragm) - Bacteroides Fragilis, C. Perfringens. With Gentamicin for Polymicrobial Gynecological Complications. Also for Gardnerella Vaginalis. Side Effects: C. Diff Pseudomembranous Colitis, GI Symptoms, Jaundice, Prolonged QT and TdP, CYP450 Inhibition.
Typewriter with Paper Stuck - Keep Clean Sign
Clindamycin
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
For Developing countries Endemic Meningitis: Neisseria, S. Pneumo, H.Flu. As well as for Rocky-Mountain Spotted Fever (Rickettsia Rickettsiae). Side Effects: Myelosuppression and Aplastic Anemia, Grey Baby Syndrome (Ineffective Glucuronate Conjugation) leading to Hypothermia, Flaccidity and Shock.
Rarely used in Developed Countries for these Side effects.
Typewriter with Paper Stuck - Chlorinated Pool
Chloramphenicol
Antibiotic - 50s Ribosomal Translation Inhibitor (Bacteriostatic)
For Gram Positive: Staph, Strep and Enterococcus. as in Nosocomial Infections, VRE, MRSA, VRSA. Side Effects: Myelosuppression, Thrombocytopenia, (Sometimes Neutropenia), Optic and Peripheral Neuropathy, Also a weak MAOi - Serotonin Syndrome is a Risk (especially with MAOi, SSRIs, SNRIs and Bupropion)
Typewriter with Paper Stuck - Police Line
Linezolid
Antibiotic - 30s Ribosomal Translation Inhibitor (Bactericidal)
For Aerobic Gram Negatives (Oxygen Dependent Transport), Useful for combo with β Lactams to get into the Bacterial cell - Enterococcal Endocarditis tx. Given IV for better bioavailability. Active in GI - Bowel Prep before surgery, Against Parasites. Resistance formed by Acetylases. Side Effects: Ototoxicity and Nephrotoxicity (ATN, Creatinine↑), MG Absolute Contraindicates: Neuromuscular Blockade precipitation, Teratogenic Deafness.
Ninjitsu Master and Sai killing Translator
Neomycin (an Aminoglycoside)
Antibiotic - 30s Ribosomal Translation Inhibitor (Bactericidal)
For Aerobic Gram Negatives (Oxygen Dependent Transport), Useful for combo with β Lactams to get into the Bacterial cell - Enterococcal Endocarditis tx. Given IV for better bioavailability. For Zoonotics: Francisella Tularensis, Yersinia Pestis and Yersinia Enterocolitica. Resistance formed by Acetylases. Side Effects: Ototoxicity and Nephrotoxicity (ATN, Creatinine↑), MG Absolute Contraindicates: Neuromuscular Blockade precipitation, Teratogenic Deafness.
Sai Master and Sai killing Translator
Streptomycin (an Aminoglycoside)
Antibiotic - 30s Ribosomal Translation Inhibitor (Bactericidal)
For Aerobic Gram Negatives (Oxygen Dependent Transport), Useful for combo with β Lactams to get into the Bacterial cell - Enterococcal Endocarditis tx. Given IV for better bioavailability. For MDR KES Nosocomial Infections; Pseudomona, Sepsis, RTI and UTI. Resistance formed by Acetylases. Side Effects: Ototoxicity and Nephrotoxicity (ATN, Creatinine↑), MG Absolute Contraindicates: Neuromuscular Blockade precipitation, Teratogenic Deafness.
Judo Master with Cobra Master and Sai killing Translator
Gentamicin (an Aminoglycoside) as well as Tobramycin
Antibiotic - 30s Ribosomal Translation Inhibitor (Bactericidal)
For Aerobic Gram Negatives (Oxygen Dependent Transport), Useful for combo with β Lactams to get into the Bacterial cell - Enterococcal Endocarditis tx. Given IV for better bioavailability. Useful FOR RESISTANT Acetylating Strands, like Pseudomonas.Side Effects: Ototoxicity and Nephrotoxicity (ATN, Creatinine↑), MG Absolute Contraindicates: Neuromuscular Blockade precipitation, Teratogenic Deafness. High Price.
Katana Master and Sai killing Translator
Amikacin
Antimycobacterial - Mycolic Acid Synthesis Inhibitor
Used for Latent TB to prevent reactivation and Part of the TB RIPE therapy. Prodrug that Activated by KatG (Catalase-peroxidase) of TB. Resistance is Achieved by Down Regulation of KatG . Side Effects: Dose Related Peripheral Neuropathy (B6 Addition helps), Ataxia, Metabolic Acetylation LIVER-DEPENDENT, Seizures, Hepatitis and LFT↑ , Lupus-like syndrome, Anion Gap Metabolic Acidosis, Inhibitor of CYP450.
RIPE Tubers 1for2 now 2for4 - Isolated Ranger
Isoniazid (INH)
Antimycobacterial - RNA Polymerase Inhibitor
Prophylaxis for Meningococcal or H.Flu, Part of the TB RIPE therapy and For Leprosy Together with Dapsone and Clofazimine. Side Effects: Orange Bodily Fluids, Hepatitis and LFT↑ , Inducer of CYP450.
RIPE Tubers 1for2 now 2for4 - Rifle Shooter
Rifampin (aka Rifampicin)
Antimycobacterial - Arabinosyl Transferase Inhibitor
Inhibiting the Carbohydrate Cell Wall Synthesis - Bacteriostatic. Part of the TB RIPE therapy. Side Effects: Optic Neuropathies (Red-Green).
RIPE Tubers 1for2 now 2for4 - Ethel, Horse Whisperer
Ethambutol
Antimycobacterial - FAS Inhibitor
Part of the TB RIPE therapy. Prodrug that Activated by pyrazinamidase of TB. Side Effects: Hyperuricemia and Goat attacks, Hepatotoxicity.
RIPE Tubers 1for2 now 2for4 - Pyro Man
Pyrazinamide
Anti- Atypical Mycobacteria - RNA Polymerase Inhibitor
Against Mycobacterium Avium Complex or Inracellularae, added to Macrolide and Ethambutol. For CD4<50 (Immunocompromised/AIDS) Prophylaxis. Side Effects: Orange Bodily Fluids, Hepatitis and LFT↑ , Inducer of CYP450.
caged bird and RIFLE in arizona BUTTES
Rifabutin
Anti-Leprosy Drug - Nucleotide Synthesis Inhibitor
Together with Clofazimine and Rifampicin.
Inhibits Bacterial dihydropteroate synthase. Side Effects: Agranulocytosis, Hemolytic Anemia in G6PD patients- “Bite Cells and Heinz Bodies”.
DEPuty ZONE with leaping Armadillo
Dapsone
Anti- Lepromatous Leprosy - DNA Synthesis Inhibitor
Together with Dapsone and Rifampicin.
Also elevating PLA2. Side Effects: Brownish skin pigmentation and discoloration of most bodily fluids and secretions.
Leonine Face Outlaw with CLOTH
Clofazimine
Antibiotic-Antifolate Drug Synergistic Combination
[PABA]↓→[DHF]↓→THF→DNA Synthesis. a PABA Analog with a Dihydrofolate Reductase Inhibitor →Bactericidal Together! First Line Treatment for Gram Negative: UTI, Acute Prostatitis, and Gram Positive: MRSA, Nocardia.Also for Prophylaxis: Fungal PJP in CD4<200, Parasitic Toxo. in CD4<100. Side Effects: Pancytopenia, Megaloblastic Anemia, Teratogenic Neural Tube Defects + Sulfa Drug Effects
BACKHAND - Rotten eggs SMX and Toilet Paper TP
Bactrim: Trimethoprim/Sulfamethoxazole
Antibiotic-Antifolate Drug Synergistic Combination
[PABA]↓→[DHF]↓→THF→DNA Synthesis. a PABA Analog with a Dihydrofolate Reductase Inhibitor →Bactericidal Together! Parasitic Toxoplasmosis Gondii in CD4<100 (Alternative to SMX/TMP). Side Effects: Pancytopenia, Megaloblastic Anemia, Teratogenic Neural Tube Defects + Sulfa Drug Effects
Dyed eggs SMX and Pyramide Hat with Ghandi cat
Sulfadiazine/Pyrimethamine
The Common 8 Sulfa Drugs Side Effects - High Yield
Happens in Acetazolamide, Furosemide, Thiazides, Celecoxib, Probenecid, 1st and 2nd Gen. Sulfonylureas, Bactrim: Trimethoprim/Sulfamethoxazole, Sulfadiazine/Pyrimethamine!
Always Marked by Rotten Eggs in Sketchy
1) Type 1 HSN, + Hemolytic Anemia in G6PD
2) Steven Johnson Syndrome
3) Type 4 RTA - Hyperkalemia
4) Interstitial Nephritis with Monocytic Infiltrate
5) Photosensitivity
6) Neonatal Kernicterus (Last Trimester)
7) Displacement of RX from albumin; Bleeding(Warferin)
8) Inhibition of CYP450.
Anti-Bacterial DNA Gyrase (Oral)
For Gram Negatives Mostly: UTI (PEK or Pseudomonas), Pyelonephritis, Acute Prostatitis, Gastroenteritis (Shigella, E.coli, Salmonella, Campylobacter J), Osteomyelitis. Divalent and Trivalent Metals Decrease Absorption (Ca, Fe, Mg). Side Effects: Prolonged QT, GI Symptoms, Tendon and Cartilage Damage In GC Rx or Elderly, Teratogenic, Contraindicated in Children - Bone Growth Inhibition.
Flowers: Mona lisa (Hair untangling) Sipping and Elevating
Fluoroquinolones: Ciprofloxacin and Levofloxacin
Anti-Bacterial DNA Gyrase (Oral)
For RTIs: Bacillus Anthracis, H.Flu, S. Pneumo, Mycoplasma. Divalent and Trivalent Metals Decrease Absorption (Ca, Fe, Mg). Side Effects: Prolonged QT, GI Symptoms, Tendon and Cartilage Damage In GC Rx or Elderly, Teratogenic, Contraindicated in Children - Bone Growth Inhibition.
Flowers: MUCUSy viking and Elevating
Fluoroquinolones: Moxifloxacin and Levofloxacin
Bactericidal ROS Forming Anti-DNA Agent
For Anti-Polymicrobial: Bacteroides Fragilis, C.Diff Pseudomembranous Colitis, Entamoeba Histolytica, Giardia, Trichomonas Vaginalis, Gardnerella, Substitutes Amoxicillin in Sensitive Patients Triple Therapy for H. Pylori, Abdominal Trauma Anaerobe Polymicrobial Infections. Side Effect: Disulfiram Like Reaction with Alcohol - Flushing, Tachycardia, GI Symptoms.
METRO Scene
Metronidazole
