High Yield - SketchyPharm Flashcards by Fiona Pudewa

Muscarinic Agonist

Treatment of Non-Obstructive GI dysmotility or Urinary Retention

Beth with Cola

Bethanechol

How well did you know this?

Not at all

Perfectly

Muscarinic Agonist

Treatment of Acute Angle Glaucoma (Pupillary Constriction and Aqueous Humor Outflow Increase)

Pile of Carp

Pilocarpine

How well did you know this?

Not at all

Perfectly

Muscarinic Agonist and Nicotinic Agonist

Treatment of Acute Angle Glaucoma (Pupillary Constriction and Aqueous Humor Outflow Increase)

Carbon Fumes

Carbachol

How well did you know this?

Not at all

Perfectly

Muscarinic Agonist

Instigates asthma for Pulmonary testing
(Contract Bronchial smooth muscle which may exacerbate asthma or COPD)

Marathon challenge

Methacholine

How well did you know this?

Not at all

Perfectly

Nicotinic Partial Agonist

Used for Smoking Cessation

1-800-Very-Clean

Varenicline

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase Inhibitor

Increase Ach at NMJ endplate to outcompete Myasthenia Gravis Antibodies (Peripheral Only)

Community PRIDE

Pyridostigmine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase Inhibitor

Increase Ach at NMJ endplate to outcompete Myasthenia Gravis Antibodies (Peripheral Only)

Neon sign STIGMA

Neostigmine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase Inhibitor

Increase Ach at NMJ endplate to Transiently Reverses Myasthenia Gravis Antibodies (Peripheral Only) - Tensilon test

Phone Booth

Edrophonium

How well did you know this?

Not at all

Perfectly

Inhibitors of Nicotinic Ach-R in NMJ endplate

Non-depolarizing Neuromuscular blockade

Crayons stuck in end plate

Tubocurarine, Pancuronium, Cisatracurium

How well did you know this?

Not at all

Perfectly

Nicotinic Ach receptor Agonist

Depolarizing Neuromuscular blockade. May cause HSN induced-Malignant Hyperthermia (RYR1 Defect are prone to) → Rhabdomyolysis .

SUCKS

Succinylcholine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase inhibitor

Increase Ach at synaptic Cleft + with CENTRAL effects
Treatment for Atropine Overdose

PHYS ED center

Physostigmine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Alzheimer’s GALA

Galantamine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Reverse the Stigma

Rivastigmine

How well did you know this?

Not at all

Perfectly

Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Done with the Puzzle

Donepezil

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Muscarinic Antagonist (M1)

Treatment for Seasick/ Motion sickness (Vestibular Nueasa). Atropinic Side effects.

Sailor outfit

Scopolamine

How well did you know this?

Not at all

Perfectly

Muscarinic Antagonist (M3)

Treatment for COPD (Bronchodilator). Atropinic Side effects.

Cat-Ipa-Tio-Tropillar

Ipratropium and Tiotropium

tiotropium dissociates more slowly

How well did you know this?

Not at all

Perfectly

Muscarinic Antagonist (M3)

Used to relieve Bladder spasm after Urologic surgery. Atropinic Side effects.

Ox butler

Oxybutynin

How well did you know this?

Not at all

Perfectly

Muscarinic Antagonist (M3)

Treatment for Adult urinary incontinence. Atropinic Side effects.

Turtle butler

Tolterodine

How well did you know this?

Not at all

Perfectly

Muscarinic Antagonist (M1 + Centrally Acting)

Treats Parkinsonism Tremor and Rigidity by restoring Dopaminergic/Muscarinic balance! Atropinic Side effects.

BENZ parked in M1

Benztropine

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

α-1 Agonist

Vasoconstriction - Treats Nasal Congestion, TPR ↑, Diastolic and Systolic BP↑

Flannel friends

Phenylephrine

How well did you know this?

Not at all

Perfectly

α-1 Agonist > β-1 Agonist

Vasoconstriction - Treats Septic Shock, TPR ↑, PULSE PRESSURE↑ > Heart Contractility↑

North Compass Scout Leader

Norepinephrine

How well did you know this?

Not at all

Perfectly

β-2 Agonists

Treats COPD, Asthma etc. (Bronchodilation)

ROLL (Suffix) call sheet held by tuba player

Albuterol (aka Ventolin in Israel)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

β-1 Agonist >β-2 Agonist

Treats Cardiogenic Shock
HR↑, Contractility↑, PULSE PRESSURE↑

Just DO Bugling

Dobutamine

How well did you know this?

Not at all

Perfectly

β-1 Agonist = β-2 Agonist

Treats Heart Block
HR↑, Contractility↑, TPR↓, PULSE PRESSURE↑

Iso-pro-tunnel

Isoproterenol

How well did you know this?

Not at all

Perfectly

β-2 Agonist

Prevents Premature Labor
Relax uterine smooth muscle tone

Do Not DisTURB

Terbutaline

How well did you know this?

Not at all

Perfectly

β-2 Agonist

Prevents Premature Labor
Relax uterine smooth muscle tone

I DREAM of band camp

Ritodrine

How well did you know this?

Not at all

Perfectly

Tyrosine Hydroxylase Inhibitor

Prevents conversion of tyrosine to L-DOPA

Camp counselor Mitch yelling “My TIRE!”

Metyrosine

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

NET Inhibitor

Treats ADHD

Atom on TV next to empty net

Atomoxetine

How well did you know this?

Not at all

Perfectly

VMAT Inhibitor

Deplete catecholamines peripherally - HTN treatment

Serpent blocking V mat

Reserpine

Also tetrabenazine

How well did you know this?

Not at all

Perfectly

Amphetamine Derivative

Treats ADHD - Displaces Catecholamines and Monoamines into Synapse

Friend Date on HDTV

Methylphenidate

How well did you know this?

Not at all

Perfectly

Atypical, selective, and weak Dopamine Reuptake Inhibitor

Treats Narcolepsy - Unknown Mechanism

Sleep Mode fine

Modafinil

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

α-2 Agonist

Treatment for Hypertension - Sympathetic↓ = CO↓ and BP↓.
Also for ADHD and Tourette’s

Raul with the “law weapon Claw”

Clonidine

How well did you know this?

Not at all

Perfectly

α-2 Agonist

for Gestational Hypertension - Sympathetic↓ = CO↓ and BP↓. May induce Lupus like syn.

Alpha-shaped dope rope

α-Methyldopa

How well did you know this?

Not at all

Perfectly

α-2 Agonist

Centrally acting Muscle Relaxant

“To X-tine”

Tizanidine

How well did you know this?

Not at all

Perfectly

Reversible α-1 and α-2 Antagonist (Non-Selective)

Indirect Vasodilator - treats Cocaine Toxicity, MAOi HTN crisis, Pheochromocytoma Symptoms

Phantom

Phentolamine

How well did you know this?

Not at all

Perfectly

Irreversible α-1 and α-2 Antagonist (Non-Selective)

Indirect Vasodilator - treats Pheochromocytoma Symptoms preoperatively and Intraoperatively to control BP

Irreversible phoenix tattoo

Phenoxybenzamine

How well did you know this?

Not at all

Perfectly

α-1 Antagonist (Selective)

treat BPH - Relax smooth muscle in the urethra and prostate

Opera singer compressing prostate

Terazosin

How well did you know this?

Not at all

Perfectly

α-1 Antagonist (Selective)

treat PTSD as well as BPH Relax smooth muscle in the urethra and prostate

Opera singer compressing prostate

Prazosin

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Non-Selective β Blocker

Treatment of thyroid storm (blocks catecholamine surge) “treat with 3 p’s __________ , Prednisone, and Propylthiouracil”

Large Bow-Tie

Propranolol

How well did you know this?

Not at all

Perfectly

Topical Non-Selective β Blocker

Treat Glaucoma - Blocks β2 Receptors on the Ciliary Epithelium → Aqueous humor production↓

TIM draining the muted β2 tuba

Timolol

How well did you know this?

Not at all

Perfectly

PDE Inhibitor used for HF treatment

cAMP↑ → Contractility↑ and ; Arteriolar Dilation

One in a Million

Milrinone

How well did you know this?

Not at all

Perfectly

BNP Analogue (Brain Natriuretic peptide)

cGMP↑ → Venous and Arteriolar Dilation → Preload↓ and Afterload↓.Along with Natriuresis effect.

Turn the tide

Nesiritide

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Direct Renin Inhibitor

AT↓ → Aldosterone↓, [NaHCO3] Reab↓ and GFR↓. Cardiac Remodeling↓ and Mortality↓
May Cause Hyperkalemia

“High Risk” Slot Machine

Aliskiren

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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…

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Anticoagulant - Direct Thrombin Inhibitor

Used in PCI or ACS, Heparin Induced Thrombocytopenia (HIT) is NOT a Side effect

No Intruding

Bivalirudin

How well did you know this?

Not at all

Perfectly

Anticoagulant - Direct Thrombin Inhibitors (2)

Used in PCI or ACS, Heparin Induced Thrombocytopenia (HIT) is NOT a Side effect

Big Gator

Argatroban

and Dabigatran

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

NSAIDs (2) - Reversible Non Selective COX Inhibitor

SOX CAM

Meloxicam and Piroxicam

How well did you know this?

Not at all

Perfectly

NSAID - Reversible Non Selective COX Inhibitor

ApPROXimately 110 Mph

Naproxen

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

1st Generation H1 Receptor Antagonists (3)

Fairy cuiSINE (with Bee swatter)

Meclizine, Hydroxyzine, Promethazine

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Alternative Asthma Therapy

Preventing Mast cell Sensitization and Degranulation. May Cause Anaphylaxis.

Lynn’s Bee control ( Bee sedating smoke)

Cromolyn Sodium

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

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

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

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)

Wine Funnel

Phenelzine

MAO Inhibitor (Irreversible, Non-Selective)

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)

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