caine= local anesthetics ceph/cef - cephalosporin cillin= antibiotics cycline – tetracycline (s/e: stains teeth and stunted growth for children) dine= anti-ulcer agents done= opiod analgesics ide= oral hypoglycemics iam= antianxiety agents mab – monoclonal anti-bodies micin= antibiotics nium= neuromuscular blocking agents olol= beta blockers ole= anti-fungal oxacin= antibiotics pam= antianxiety agents pine: calcium channel blockers pril= ace inhibitors sone= steroids statin= antihyperlipidemics stigmine -cholinergic
vir= antivirals zide= diuretics phylline - bronchodilator cal- calcium done- opiods ase- enzyme line - bronchodilator vir- antiviral
zide - diuretics dine - anti-ulcer ide- oral hyoglycemics iam-anxiolytics
Pharmacology Mnemonics - Drugs Made Easy To Remember
Morphine: side-effects MORPHINE: Myosis Out of it (sedation) R espiratory depression Pneumonia (aspiration) Hypotension Infrequency (constipation, urinary retention) Nausea Emesis
Tricyclic antidepressants: members worth knowing "I have to hide, the CIA is after me": Clomipramine Imipramine Amitrptyline · If want the next 3 worth knowing, the DNDis also after me: Desipramine Norrtriptyline Doxepin Patent ductus arteriosus: treatment "Come In and Close the door": INdomethacin is used to Close PDA SIADH-inducing drugs ABCD: Analgesics: opioids, NSAIDs Barbiturates Cyclophosphamide/ Chlorpromazine/ Carbamazepine Diuretic (thiazide) Vir-named drugs: use"-vir at start, middle or end means for virus": · Drugs: Abacavir, Acyclovir, Amprenavir,
Cidofovir, Denavir, Efavirenz, Indavir, Invirase, Famvir, Ganciclovir, Norvir, Oseltamivir, Penciclovir, Ritonavir, Saquinavir, Valacyclovir, Viracept, Viramune, Zanamivir, Zovirax. Phenobarbitone: side effects Children are annoying (hyperkinesia, irritability, insomnia, aggression). Adults are dosy (sedation, dizziness, drowsiness). Thrombolytic agents USA: Urokinase Streptokinase Alteplase (tPA)
Narcotic antagonists The Narcotic Antagonists are NAloxone and NAltrexone. · Important clinically to treat narcotic overdose.
Routes of entry: most rapid ways meds/toxins enter body "Stick it, Sniff it, Suck it, Soak it": Stick = Injection Sniff = inhalation Suck = ingestion Soak = absorption Anticholinergic side effects "Know the ABCD'S of anticholinergic side effects": Anorexia Blurry vision Constipation/ Confusion
Dry Mouth Sedation/ Stasis of urine
Atropine use: tachycardia or bradycardia "A goes with B": Atropine used clinically to treat Bradycardia.
Aspirin: side effects ASPIRIN: Asthma Salicyalism Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDA Intestinal blood loss R eye's syndrome Idiosyncracy Noise (tinnitus)
Morphine: effects at mu receptor PEAR : Physical dependence Euphoria Analgesia R espiratory depression Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs": Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs. SSRIs: side effects SSRI: Serotonin syndrome Stimulate CNS R eproductive disfunctions in male Insomnia
Warfarin: action, monitoring WePT: Warfarin works on the extrinsic pathway and is monitored by PT.
Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's stand for "beta blocker". · Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol, propranolol.
Depression: 5 drugs causing it PROMS: Propranolol R eserpine Oral contraceptives Methyldopa Steroids Lead poisoning: presentation ABCDEFG: Anemia Basophilic stripping Colicky pain Diarrhea Encephalopathy Foot drop Gum (lead line)
Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction Benzodiazepines: actions "Ben SCAMs Pam into seduction not by brain but by muscle": Sedation anti-Convulsant anti-Anxiety Muscle relaxant Not by brain: No antipsychotic activity.
Teratogenic drugs "W/ TERATOgenic": Warfarin Thalidomide Epileptic drugs: phenytoin, valproate, carbamazepine R etinoid ACE inhibitor
Third element: lithium OCP and other hormones (eg danazol) Gynaecomastia-causing drugs DISCOS: Digoxin Isoniazid Spironolactone Cimetidine Oestrogens Stilboestrol Osmotic diuretics: members GUM: Glycerol Urea Mannitol
Antibiotics contraindicated during pregnancy MCAT: Metronidazole Chloramphenicol Aminoglycoside Tetracycline
Lithium: side effects LITH: Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism
Anti prokaryotic Agents A good diagram to review classifications with respect to mechanism of action for many of the prokaryotic antimicrobials is provided below as a starting point
Adapted from page 16 of Smart Charts, Pharmacology, Pelletier, Lange
Cell wall synthesis inhibitors • β-lactams (penicillins, cephalosporins, carbapenems, monobactam’s) • Non- -lactams (vancomycin, cycloserine, bacitracin, fosfomycin)
50s ribosomal inhibitors DNA Synthesis Inhibitors • Chloramphenicol • Fluoroquinolones Clindamycin • • Trimethoprim macrolides • • Sulfonamides
peptide
DNA
50s mRNA
30s
30s ribosomal inhibitors • Tetracyclines • aminoglycosides
1.
Cell wall synthesis inhibitors (See chapter 43 of the Katzung text, or table on web for details) a. Penicillin’s i. Penicillin’s • Penicillin G • Penicillin V ii. Beta-lactamase resistant penicillin’s • Methicillin • Nafcillin Link to beta-lactam • Oxacillin • Cloxacillin iii. Extended spectrum penicillin’s • Ampicillin • Amoxicillin • Carbenicillin
table
b.
c.
2.
3.
• Ticarcillin • Piperacillin iv. Drugs given in combination with penicillin (beta-lactamase inhibitors) • Clavulanic acid • Sulbactam • tazobactam Cephalosporins (generations differ in specificity and spectrum to G- and G+ organisms) i. First generation • Cephalothin More Effective • Cefazolin Less Effective • Cephalexin • Cephradine ii. Second-Generation Gram (+) • Cefamandole 1st-gen. • Cefaclor • Cefuroxime • Cefonicid 2nd-gen. • Cefoxitin • Cefotetan 3rd-generation iii. Third Generation • Cefotaxime Gram (-) • Ceftazidime • Cefoperazone -Spectrum• Ceftizoxime Less Effective More • Ceftriaxone Adapted from page 26 of Effective • Cefixime Smart Charts, iv. Fourth-Generation Pharmacology, Pelletier, • Cefepime Lange Other beta-lactams i. Carbapenems • Imipenem • Meropenem ii. Monobactam • Aztreonam iii. Vancomycin iv. Cycloserine v. Bacitracin vi. Fosfomycin
30S Antibacterial Agents (see chapters 44 and 45 of Katzung text or web tables for details) a. Aminoglycosides i. Streptomycin ii. Neomycin iii. Gentamicin iv. Tobramycin v. Amikacin vi. Netilmicin b. Tetracycline’s Link to protein synthesis inhibitor i. Tetracycline ii. Oxytetracycline iii. Demeclocycline iv. Minocycline v. Doxycycline 50S Antibacterial agents a. Macrolides i. Erythromycin ii. Clarithromycin
table
b. c. d. e. 4.
iii. Azithromycin Clindamycin Streptogramins i. Quinupristin-dalfopristin Linezolid Chloramphenicol
DNA synthesis inhibitors (see chapter 46 of Katzung’s text or web tables for details) a. Inhibitors of dihydropteroate synthase (prevents folic acid formation0 i. Sulfonamides • Sulfadiazine P-Aminobenzoic acid (PABA) • Sulfacetamide • Sulfamethoxazole • Sulfadoxine • Sulfasalazine Dihydrofolic acid b. Inhibitor of dihydrofolate reductase (2nd step in folic acid formation) i. Trimethoprim
Trimethoprim Dihydrofolate reductase
Tetrahydrofolic acid Adapted from page 44 of Smart Purines Charts, Pharmacology, DNA c.
Fluoroquinolones (DNA gyrase inhibitors) i. Ciprofloxacin ii. Ofloxacin iii. Lomefloxacin iv. Norfloxacin v. Enoxacin
Link to DNA synthesis inhibitor table
S D u i l h f y o d n r a o m p i t d e e r s o a ( t c e o s m y p n e t t h e a s w e i t h P A B A )
5.
Antimycobacterial Agents (see chapter 47 of Katzung’s text or web tables for details) a. first line agents to treat tuberculosis (used in 3-4 drug combinations) i. R ifampin ii. Ethambutol iii. Streptomycin Mnemonic:RESPIra iv. Pyrazinamide v. Isoniazid b. Second-line agents for tuberculosis i. Amikacin ii. Capreomycin Mnemonic: All these iii. Ciprofloxacin/Levofloxacin Can Clear Lungs And iv. p-Aminosalicylic acid Can Ease R e s iration v. Cycloserine vi. Ethionamide vii. R ifabutin c. Agents for treating leprosy i. Dapsone Mnemonic: Drugs Can ii. Clofazimine R emove Lesions iii. R ifampin • Leprosy d. Atypical antimycobacterial drugs i. Macrolide Antibiotics ii. Rifabutin iii. Tetracyclines
Antiviral Agents (see chapter 49 of Katzung’s text)
1.
2. 3.
4.
5.
6.
7. 8.
Adapted from page 48 of Smart Charts, Pharmacology,
Influenza A treatment Rimantadine and amantadine
Tricyclic Amines a. Amantidine b. Rimantadine Guanosine analogs a. Ribavirin Glycoproteins Viral absorption UncoatingCMV: a. Interferon-alfa Penetration b. Interferon –beta Interferons Nucleoside analogs a. Acyclovir b. Valacyclovir Early protein synthesis c. Ganciclovir d. Trifluridine HSV, CMV, e. Vidarabine HIV: purine, Nucleoside (RTIs, reverse transcriptase inhibitors) Nucleic acid synthesis a. Zidovudine pyrimidine b. Didanosine Viral release analogs, reverse Packaging c. Zalcitabine transcriptase and assembly d. Lamivudine Late protein e. Stavudine inhibitors synthesis and HIV: f. Abacavir NNRTIs non-nucleoside reverse transcriptase inhibitors processing protease a. Nevirapine inhibitors b. Delavirdine c. Efavirenz Pyrophosphanate derivative a. Foscarnet Protease Inhibitor a. Indinavir Link to antiviral table b. Saquinavir c. Ritonavir d. Amprenavir
Antifungal Agents (see chapter 48 of Katzung’s text for details) 1. Alter cell membrane integrity a. Azoles i. Ketoconazole ii. Miconazole iii. Clotrimazole iv. Fluconazole v. Itraconazole b. Allylamines i. Terbinafine ii. Naftifine c. Polyene macrolide antibiotics i. Amphotericin B ii. Nystatin 2. Block nucleic acid synthesis a. Flucytosine 3. Disrupt microtubule function a. Griseofulvin Antiprotozoal Agents (see chapter 53 of Katzung’s text for details) 1. Antimalarial agents a. Chloroquine b. Quinine c. Mefloquine d. Primaquine 2. Amebiasis a. Diloxanide furoate b. Metronidazole 3. Pneumocystis and toxoplasmosis agents a. Pentamidine b. Antifolates i. TMP-SMZ (Trimethoprim-sulfamethoxazole) ii. Pyrimethamine iii. Sulfadoxine 4. Trypanosomiasis a. Pentamidine
Anthelminthic Agents (see chapter 54 of Katzung’s text for details) 1. Mebendazole 2. Pyrantel pamoate 3. Praziquantel 4. Niclosamide
Link to antifungal table