High Yield - SketchyPharm Flashcards by Fiona Pudewa

Muscarinic Agonist

Treatment of Non-Obstructive GI dysmotility or Urinary Retention

Beth with Cola

Bethanechol

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Muscarinic Agonist

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

Pile of Carp

Pilocarpine

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Muscarinic Agonist and Nicotinic Agonist

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

Carbon Fumes

Carbachol

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Muscarinic Agonist

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

Marathon challenge

Methacholine

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Nicotinic Partial Agonist

Used for Smoking Cessation

1-800-Very-Clean

Varenicline

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Acetylcholinesterase Inhibitor

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

Community PRIDE

Pyridostigmine

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Acetylcholinesterase Inhibitor

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

Neon sign STIGMA

Neostigmine

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Acetylcholinesterase Inhibitor

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

Phone Booth

Edrophonium

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Inhibitors of Nicotinic Ach-R in NMJ endplate

Non-depolarizing Neuromuscular blockade

Crayons stuck in end plate

Tubocurarine, Pancuronium, Cisatracurium

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Nicotinic Ach receptor Agonist

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

SUCKS

Succinylcholine

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Acetylcholinesterase inhibitor

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

PHYS ED center

Physostigmine

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Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Alzheimer’s GALA

Galantamine

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Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Reverse the Stigma

Rivastigmine

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Acetylcholinesterase inhibitor

Alzheimer’s disease (CENTRAL effects)

Done with the Puzzle

Donepezil

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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

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Muscarinic Antagonist (M1)

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

Sailor outfit

Scopolamine

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Muscarinic Antagonist (M3)

Treatment for COPD (Bronchodilator). Atropinic Side effects.

Cat-Ipa-Tio-Tropillar

Ipratropium and Tiotropium

tiotropium dissociates more slowly

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Muscarinic Antagonist (M3)

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

Ox butler

Oxybutynin

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Muscarinic Antagonist (M3)

Treatment for Adult urinary incontinence. Atropinic Side effects.

Turtle butler

Tolterodine

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Muscarinic Antagonist (M1 + Centrally Acting)

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

BENZ parked in M1

Benztropine

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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

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α-1 Agonist

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

Flannel friends

Phenylephrine

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α-1 Agonist > β-1 Agonist

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

North Compass Scout Leader

Norepinephrine

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β-2 Agonists

Treats COPD, Asthma etc. (Bronchodilation)

ROLL (Suffix) call sheet held by tuba player

Albuterol (aka Ventolin in Israel)

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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

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

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

Venlafaxine

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. #Rule 2: Silly Prank Prohibited

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

Phenelzine

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

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

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

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)

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

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