Morphine: side-effects MORPHINE:

Myosis
Out of it (sedation)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis

Tricyclic antidepressants: members worth knowing

"I have to hide, the CIA is after me":
Clomipramine Imipramine Amitrptyline
· If want the next 3 worth knowing, the DNDis also after me:
Desipramine Norrtriptyline Doxepin

Patent ductus arteriosus: treatment

"Come In and Close the door": INdomethacin is used to Close PDA

SIADH-inducing drugs ABCD:

Analgesics: opioids, NSAIDs
Barbiturates
Cyclophosphamide/ Chlorpromazine/ Carbamazepine
Diuretic (thiazide)

Vir-named drugs: use"-vir at start, middle or end means for virus": · Drugs:
Abacavir,
Acyclovir,
Amprenavir,
Cidofovir,
Denavir,
Efavirenz,
Indavir,
Invirase,
Famvir,
Ganciclovir,
Norvir,
Oseltamivir,
Penciclovir,
Ritonavir,
Saquinavir,
Valacyclovir,
Viracept,
Viramune,
Zanamivir,
Zovirax.

Phenobarbitone: side effects

Children are annoying (hyperkinesia, irritability, insomnia, aggression).
Adults are dosy (sedation, dizziness, drowsiness).

Thrombolytic agents USA:

Urokinase Streptokinase Alteplase (tPA)

Narcotic antagonists
The Narcotic Antagonists are NAloxone and NAltrexone. · Important clinically to
treat narcotic overdose.

Routes of entry: most rapid ways meds/toxins enter body

"Stick it, Sniff it, Suck it, Soak it":
Stick = Injection
Sniff = inhalation
Suck = ingestion
Soak = absorption

Anticholinergic side effects

"Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine

Atropine use: tachycardia or bradycardia

"A goes with B": Atropine used clinically to treat Bradycardia.

Aspirin: side effects ASPIRIN:

Asthma
Salicyalism
Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet
disaggregation/ Premature closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)

Morphine: effects at mu receptor PEAR:

Physical dependence
Euphoria
Analgesia
Respiratory depression

Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":

Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.

SSRIs: side effects SSRI:

Serotonin syndrome
Stimulate CNS
Reproductive disfunctions in male
Insomnia

Warfarin: action, monitoring WePT:

Warfarin works on the extrinsic pathway and is monitored by PT.

Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case
b's. Backward b's stand for "beta blocker". · Beta blockers include acebutolol,
betaxolol, bisoprolol, oxprenolol, propranolol.

Depression: 5 drugs causing it PROMS:

Propranolol
Reserpine
Oral contraceptives
Methyldopa
Steroids

Lead poisoning: presentation ABCDEFG:

Anemia
Basophilic stripping
Colicky pain
Diarrhea
Encephalopathy
Foot drop
Gum (lead line)

Cholinergics (eg organophosphates): effects

If you know these, you will be "LESS DUMB":
Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating
Diarrhea
Urination
Micturition
Bronchoconstriction

Benzodiazepines: actions
"Ben SCAMs Pam into seduction not by brain but by muscle":
Sedation
anti-Convulsant
anti-Anxiety
Muscle relaxant
Not by brain: No antipsychotic activity.

Teratogenic drugs "W/ TERATOgenic":

Warfarin
Thalidomide
Epileptic drugs: phenytoin, valproate, carbamazepine
Retinoid
ACE inhibitor
Third element: lithium
OCP and other hormones (eg danazol)

Gynaecomastia-causing drugs DISCOS:

Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens
Stilboestrol

Osmotic diuretics: members GUM:

Glycerol
Urea
Mannitol

Antibiotics contraindicated during pregnancy MCAT:

Metronidazole
Chloramphenicol
Aminoglycoside
Tetracycline

Lithium: side effects LITH:

Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria]
Tremor/ Teratogenesis
Hypothyroidism

caine -local anesthetics

-cillin; antibiotic
-dine ;anti-ulcer ( H2 blocker )
-done; opioid analgesic
-ide; oral hypoglycemics
-lam; antianxiety
-mide ;diuretic
-mycin ;antibiotic
-nium; neuromuscular blocking
-olol; beta blocker
-oxacin ;antibiotic
-pam ;antianxiety
-pril ;ACE inhibitor
-sone ;steroids
-statin ;cholesterol
-vir; antiviral
-zide; diuretic
• -ase = thrombolytic
-azepam = benzodiazepine
-azine = antiemetic; phenothiazide
-azole = proton pump inhibitor, antifungal
-barbital = barbiturate
-coxib (cox 2 enzyme blockers
-cep/-cef = anti-infectives
-caine = anesthetics
-cillin = penicillin
-cycline = antibiotic
-dipine = calcium channel blocker
-floxacin = antibiotic
-ipramine = Tricyclic antidepressant
-ine = reverse transcriptase inhibitors, antihistamines
-kinase = thrombolytics
-lone, pred- = corticosteroid
-mab = monoclonal antibiotics
-micin = antibiotic, aminoglycoside
-navir = protease inhibitor
nitr-, -nitr- = nitrate/vasodilator
-olol = beta antagonist
-oxin = cardiac glycoside
-parin = anticoagulant
-prazole = PPI’s
-phylline = bronchodilator
-pril = ACE inhibitor
-statin = cholesterol lowering agent
-sartan = angiotensin receptor blocker
-sone = glucocorticoid
-stigmine = cholinergics
-terol = Beta 2 Agonist
-thiazide = diuretic
-tidine = antiulcer
-trophin = Pituitary Hormone
-vir = anti-viral, protease inhibitors
-zosin = Alpha 1 Antagonist
-zolam = benzo/sedative
-zine = antihistamine
• ANTICOAGULANTS - ends in parin, rin
THROMBOLYTICS - ends in ase, kinase
ACE INHIBITORS - ends in pril
ANGIOTENSIN II RECEPTOR BLOCKER- ends in sartan
ALPHA ADRENERGIC - ends in zocin
BETA-BLOCKERS - ends in olol
CALCIUM CHANNEL BLOCKER - ends in dipine
DIRECT ACTING VASODILATORS - starts with nitro
CARDIAC GLYCOSIDES - starts with dig
BRONCHODILATORS - ends in terol, terenol, phrine, phylline
ANTIHISTAMINES - ends in tadine, amine, ramine
H2 BLOCKER - ends in tidine
ANTI-EMETICS - ends in setron
PANCREATIC ENZYME REPLACEMENT - starts with pancrea
ADH MEDS - ends in pressin
THYROID MEDS - starts with thyro, thy, thro
CALCIUM REGULATORS - ends in dronate (hypocalcemia), tonin hypercalcemia)
SULFONYLUREAS - ends in ide, amide, zide, ride
NON-SULFONYLUREAS - ends in glinide, glitazone
ANTIBIOTICS - ends in cillin
CEPHALOSPORINS - starts with ceph, cef
AMINOGLYCOSIDE - ends with mycin, micin
QUINOLONES - ends in floxacin, oxacin

Generic Name (Trade Name) Major Concerns

Analgesic

Acetaminophen (Tylenol) Watch for LIVER and KIDNEY problems

Hydrocodone with Acetaminophen ADDICTIVE
(Lortab)
Ibuprofen (Motrin) can lead to HPN and KIDNEY disease
Naproxen (Aleve) can lead to HPN and KIDNEY disease
Antianxiety

Alprazolam (Xanax) This drug can be ADDICTIVE

Diazepam (Valium) Watch for Allergies, *also anticonvulsant*
Lorazepam (Antivan) SEDATION
Promethazine HCI (Phenergan) *also antiemetic*
Antibiotic

Amoxicilline (Augmentin) Watch for allergic reactions

Azithromycin (Zithromax Z-Pak) Watch for allergies
Cephalexin (Keflex) If you are allergic to Cephalosporins, you might
also be allergic to Penicillin
Doxycycline hyclate (Vibramycin) Avoid for pregnant clients
Penicillin V Potassium (Penicillin) Watch for allergies
Sulfamethoxazole (Septra, Bactrim) Can cause GI diturbance
Anticoagulant

Warfarin Sodium (Coumadin) Teach the client to limit the intake of

GREEN LEAFY VEGETABLES
Watch for signs of BLEEDING
Anticonvulsant

Clonazepam (Klonopin) Should not be stopped abruptly

Diazepam (Valium) Watch for Allergies, also antianxiety
Lorazepam (Antivan) SEDATION
Antidepressant

Sertraline (Zoloft) SEDATION

Amitriptyline HCI (Elavil)
Trazodone HCI (Desyrel)
Antidiabetic

Glipizide (Glucotrol) Watch for HYPOGLYCEMIA

Metformin (Glucophage) This drug should be stopped prior to a dye
study such as cardiac catheterization
Antihistamine

Cetirizine (Zyrtec)
Fexofenadine (Allegra) DRY MOUTH
Antihypertensive

Amiodipine (Norvasc) HYPERTENSION

Atenolol (Tenormin) cause DROP in PULSE Rate, check PR daily
Doxazosin Mesylate (Cardura)
Lisinopril (Zestril) cause Postural HPN, remain supine for at least
30mins
Metoprolol Succinate (Toprol XL) Teach the client to check his PULSE
RATE
Metoprolol Tartrate (Lopressor,Toprol) Teach the client to check his
PULSE RATE
Antihypertensive/Antianginal

Verapamil HCI (Calan)

Anti-inflammatory

Ibuprofen (Motrin) can lead to HYPERTENSION and KIDNEY disease

Prednisone (Deltasone) can cause Cushing’s Syndrome and GI
problems
Antigout

Allopurinol (Zyloprim) Drink at least 8 glasses of WATER per day

Antilipidemic – usually ends in statin

Simbastatin (Zocor) Can cause LIVER problems & muscle soreness

Do not take this drug with GRAPE-FRUIT JUICE
Antiulcer/Histamine Blocker

Ranitidine HCI Best to take this drug with meals

Antiulcer/Proton Pump Inhibitor

Lansoprazole (Prevacid) Take this drug prior to meals

Omeprazole (Prilosec)
Bronchodilator

Albuterol (Proventil) Tachycardia, MD check blood levels for toxicity

Diuretic

Furosemide (Lasix) HYPOKALEMIA

Hydrochlorothiazide (HCTZ) HYPOKALEMIA
Hormone Replacement

Estrogen (Premarin) can ↑ blood clots

Levothyroxine (Levoxyl) can ↑ blood clots
Levothyroxin (Synthyroid) Teach the clients to check his PULSE RATE
Muscle Relaxant

Cyclobenzaprine HCI (Flexeril) SEDATION

Oral Contraceptive

Necon (Ortho-Novum 7/7/7) can ↑ blood clots

Trinessa (Ortho TriClen) can ↑ blood clots
Osteoporosis

Alendronate (Fosamax) Remain UPRIGHT for at least 30mins after

taking to prevent GERD.
Take with WATER
Potassium Supplement

Potassium Chloride (K-lyte) Check for renal function before giving this
drug
Sleep Aid

Zolpidem (Ambien) Allow at least 8hrs of sleep time to prevent daytime

drowsiness

ANTI PARKINSON'S

C- cogentin
A- artane
P- parlodel
A- akineton
B- benadryl
L- larodopa
E- Eldepryl
S- symmetril
Increase protein and give B6
Akathisia
Dystonia
Tardive Dysinesia
Neuroleptic Malignant Syndrome

ANTI-ANXIETY

V-valium
L-librium
A-ativan
S-serax
T-tranxene

M-miltown
E- equanil
V-vistaril
A-taxene
I-Inderal
B-buspar
Tolerance develop until seven days

A- void abrupt discontinuation after prolonged use

N- Not give if BP is up, hepatic/renal dysfunction or history of drug abuse
X-xanax, ativan, serax is also an anti-anxiety meds
I-increase in 3D's- drowsiness, dizziness, decreased BP
Enhances action of GABA
T-teach client to rise slowly from supine position
Y-es alcohol should also be avoided.

MAOI Drugs

M-marplan
N-nardil
P-parnate
Hypertensive crisis within several hours of ingestion of tyramine containing foods
Tyramine foods:
aged cheese, beer, ale, red wine, pickled foods, smoked or pickled fish, beef or
chopped liver, avocado of figs.

ANTI-DEPRSSION

A- asendin
N-norpramin
T- tofranil

S-sinequan
A-anafranil
- aventyl
V-vivactil
E-Elavil
P-paxil
Z-zoloft
D-riving is contraindicated
E-ffect has a delayed onset of 7-21 days
P-regnancy consult with your physician
R-elieves symptoms but never cure
E- valuate vital sign
S-toppind drug abruptly is Out!
S-afety measures
I-nstruct to report undesirable side effect
O-bserve for suicidal tendencies
N-o alcohol or CNS depressants

ANTI-MANIC DRUGS
Lithium- Eskalith

Increase risk of toxicity when given with: thiazide diuretics, methyldopa, and NSAIDs
Decrease lithium levels with excess sodium and antacids.
Increase CNS toxicity with Haloperidol

0.6-1.2 -meq/l Therapeutic Effect

> 1.5 meq/l Toxic
2.0 meq/l lethal

L- evel - therapeutic 0.6-1.2 meq/l

I-ncreased Urination
T-hirst Increased
H-eadaches and Tremors
I-ncreased fluids
U-nsteady
M-orton's Salt -adequate intake

HMG-CoA reductase inhibitors (statins): side effects, contraindications, interactions

HMG-CoA:
· Side effects:
Hepatotoxicity
Myositis [aka rhabdomyolysis]
· Contraindications:
Girl during pregnancy/ Growing children
· Interactions:
Coumarin/ Cyclosporine
Beta-blockers: main contraindications, cautions
ABCDE:
Asthma
Block (heart block)
COPD
Diabetes mellitus
Electrolyte (hyperkalemia)

Amiodarone: action, side effects

6 P's:
Prolongs action potential duration
Photosensitivity
Pigmentation of skin
Peripheral neuropathy
Pulmonary alveolitis and fibrosis
Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism

Ca++ channel blockers: uses

CA++ MASH:
Cerebral vasospasm/ CHF
Angina
Migranes
Atrial flutter, fibrillation
Supraventricular tachycardia
Hypertension
· Alternatively: "CHASM":
Cererbral vasospasm / CHF
Hypertension
Angina
Suprventricular tachyarrhythmia
Migranes

Anticholinergic side effects

Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine
Aspirin: side effects
ASPIRIN:

Asthma
Salicyalism
Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet
disaggregation/ Premature closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)

Benzodiazepines: actions
"Ben SCAMs Pam into seduction not by brain but by muscle":
Sedation
anti-Convulsant
anti-Anxiety
Muscle relaxant
Not by brain: No antipsychotic activity
Cholinergics (eg organophosphates): effects

If you know these, you will be "LESS DUMB": or SLUDGE

Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating
Diarrhea
Urination
Micturition
Bronchoconstriction
Methyldopa: side effects
METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism
Anaemia (haemolytic)
Physostigmine vs. neostigmine
LMNOP
Lipid soluble
Miotic
Natural
Orally absorbed well
Physostigmine
_ Neostigmine, on the contrary, is:
Water soluble
Used in myesthenia gravis
Synthetic
Poor oral absorption
Antibiotics contraindicated during pregnancy
MCAT:
Metronidazole
Chloramphenicol
Aminoglycoside
Tetracycline
Morphine: side-effects
MORPHINE:
Myosis
Out of it (sedation)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis
Beta-blockers: main contraindications, cautions
ABCDE:
Asthma
Block (heart block)
COPD
Diabetes mellitus
Electrolyte (hyperkalemia)
ADRS OF CHLORAMPHENICOL

smart boys in girls hostel

B.... bone marrow depression
H...hypersensitivity
I....irritative effects
S.....superinfections
G.....Gray baby syndrome
Steroids: side effects
BECLOMETHASONE
Buffalo hump
Easy bruising
Cataracts
Larger appetite
Obesity
Moonface
Euphoria
Thin arms & legs
Hypertension/ Hyperglycaemia
Avascular necrosis of femoral head
Skin thinning
Osteoporosis
Negative nitrogen balance
Emotional liability
Methyldopa: side effects
METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism
Anaemia (haemolytic)
Captopril (an ACE inhibitor): side effects
CAPTOPRIL:
Cough
Angioedema/ Agranulocystosis
Proteinuria/ Potassium excess
Taste changes
Orthostatic hypotension
Pregnancy contraindication/ Pancreatitis/ Pressure drop (first dose hypertension)
Renal failure (and renal artery stenosis contraindication)/ Rash
Indomethacin inhibition
Leukopenia/ Liver toxicity
.Ca++ channel blockers: uses
CA++ MASH
Cerebral vasospasm/ CHF
Angina
Migranes
Atrial flutter, fibrillation
Supraventricular tachycardia
Hypertension
Pulmonary infiltrations inducing drugs "Go BAN Me!":
Gold
Bleomycin/ Busulphan/ BCNU
Amiodarone/ Acyclovir/ Azathioprine
Nitrofurantoin
Melphalan/ Methotrexate/ Methysergide

MPTP: mechanism, effect MPTP:

Mitochondrial Parkinson's-Type Poison.
· A mitochondrial poison that elicits a Parkinson's-type effect.

Antimuscarinics: members, action

"Inhibits Parasympathetic And Sweat":
Ipratropium Pirenzepine Atropine Scopolamine
· Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic.

Teratogenic drugs: major non-antibiotics TAP CAP:

Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin

Steroid side effects CUSHINGOID:

Cataracts
Ulcers
Skin: striae, thinning, bruising
Hypertension/ Hirsutism/ Hyperglycemia
Infections
Necrosis, avascular necrosis of the femoral head
Glycosuria
Osteoporosis, obesity
Immunosuppression
Diabetes

Beta blockers with CYP2D6 polymorphic metabolism

"I Met Tim Carver, the metabolic polymorph":
· The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism:
Metoprolol Timolol Carvedilol (in patients with lower or higher than normal CYP2D6 activity)

Beta blockers with intrinsic sympathomimetic activity

Picture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels. Pindolol and Carteolol
have high and moderate ISA respectively, making them acceptable for use in some diabetics or
asthmatics despite the fact that they are non-seletive beta blockers.

Muscarinic effects SLUG BAM:

Salivation/ Secretions/ Sweating
Lacrimation
Urination
Gastrointestinal upset
Bradycardia/ Bronchoconstriction/ Bowel movement
Abdominal cramps/ Anorexia
Miosis

Sulfonamide: major side effects

· Sulfonamide side effects:
Steven-Johnson syndrome
Skin rash
Solubility low (causes crystalluria)
Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-
binders like warfarin)

Epilepsy types, drugs of choice:

"Military General Attacked Weary Fighters Pronouncing 'Veni Vedi Veci' After Crushing Enemies":
· Epilepsy types: Myoclonic Grand mal Atonic West syndrome Focal Petit mal (absence)
· Respective drugs: Valproate Valproate Valproate ACTH Carbamazepine Ethosuximide

Quinolones [and Fluoroquinolones]: mechanism

"Topple the Queen": Quinolone interferes with Topoisomerase II.

Beta blockers:
B1 selective vs. B1-B2 non-selective
A through N: B1 selective: Acebutalol, Atenolol, Esmolol, Metoprolol.
O through Z: B1, B2 non-selective: Pindolol, Propanalol, Timolol.

Ribavirin: indications RIBAvirin:

RSV
Influenza B
Arenaviruses (Lassa, Bolivian, etc.)
Hypertension: treatment ABCD:
ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also) Beta blockers
Calcium antagonists
Diuretics

Narcotics: side effects "SCRAM if you see a drug dealer": Synergistic CNS depression with other
drugs
Constipation
Respiratory depression
Addiction
Miosis
Sex hormone drugs: male "Feminine Males Need Testosterone":
Fluoxymesterone
Methyltestosterone
Nandrolone
Testosterone

Ca++ channel blockers: uses CA++ MASH:

Cerebral vasospasm/ CHF
Angina
Migranes
Atrial flutter, fibrillation
Supraventricular tachycardia
Hypertension
· Alternatively: "CHASM":
Cererbral vasospasm / CHF
Hypertension
Angina
Suprventricular tachyarrhythmia
Migranes

Disulfiram-like reaction inducing drugs "PM PMT" as in Pre Medical Test in the PM:
Procarbazine
Metronidazole
Cefo (Perazone, Mandole, Tetan).

Delerium-causing drugs ACUTE CHANGE IN MS:

Antibiotics (biaxin, penicillin, ciprofloxacin)
Cardiac drugs (digoxin, lidocaine)
Urinary incontinence drugs (anticholinergics)
Theophylline
Ethanol
Corticosteroids
H2 blockers
Antiparkinsonian drugs
Narcotics (esp. mepridine)
Geriatric psychiatric drugs
ENT drugs
Insomnia drugs
NSAIDs (eg indomethacin, naproxin)
Muscle relaxants
Seizure medicines

Morphine: side-effects MORPHINE:

Myosis
Out of it (sedation)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis

Therapeutic dosage: toxicity values for most commonly monitored medications

"The magic 2s":
Digitalis (.5-1.5) Toxicity = 2.
Lithium (.6-1.2) Toxicity = 2.
Theophylline (10-20) Toxicity = 20.
Dilantin (10-20) Toxicity = 20.
APAP (1-30) Toxicity = 200.

Diuretics:
thiazides: indications "CHIC to use thiazides":
CHF
Hypertension
Insipidous
Calcium calculi

Migraine: prophylaxis drugs

"Very Volatile Pharmacotherapeutic Agents For Migraine Prophylaxis":
Verpamil
Valproic acid
Pizotifen
Amitriptyline
Flunarizine
Methysergide
Propranolol

Adrenoceptors: vasomotor function of alpha vs. beta

ABCD:
Alpha = Constrict.
Beta = Dilate.

Antiarrhythmics: classification
I to IV MBA College
· In order of class I to IV:
Membrane stabilizers (class I)
Beta blockers
Action potential widening agents
Calcium channel blockers

Opiods: mu receptor effects "MD CARES":

Miosis
Dependency
Constipation
Analgesics
Respiratory depression
Euphoria
Sedation

Cancer drugs: time of action between DNA->mRNA ABCDEF: Alkylating agents

Bleomycin
Cisplastin
Dactinomycin/ Doxorubicin
Etoposide
Flutamide and other steroids or their antagonists (eg tamoxifen, leuprolide)

Busulfan: features ABCDEF:

Alkylating agent
Bone marrow suppression s/e
CML indication
Dark skin (hyperpigmentation) s/e
Endrocrine insufficiency (adrenal) s/e
Fibrosis (pulmonary) s/e
Tricyclic antidepressants: members worth knowing
"I have to hide, the CIA is after me":
Clomipramine Imipramine Amitrptyline
· If want the next 3 worth knowing, the DNDis also after me:
Desipramine Norrtriptyline Doxepin

Torsades de Pointes: drugs causing APACHE:

Amiodarone Procainamide Arsenium Cisapride Haloperidol Eritromycin

Serotonin syndrome: components Causes HARM:

Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus

Tetracycline: teratogenicity
TEtracycline is a TEratogen that causes staining of TEeth in the newborn.

Patent ductus arteriosus: treatment

"Come In and Close the door": INdomethacin is used to Close PDA.

Physostigmine vs. neostigmine LMNOP:

Lipid soluble
Miotic
Natural
Orally absorbed well
Physostigmine
· Neostigmine, on the contrary, is:
Water soluble
Used in myesthenia gravis
Synthetic
Poor oral absorption

Beta 1 selective blockers

"BEAM ONE up, Scotty":
Beta 1 blockers:
Esmolol
Atenolol
Metropolol

Antirheumatic agents (disease modifying): members

CHAMP:
Cyclophosphamide
Hydroxycloroquine and choloroquinine
Auranofin and other gold compounds
Methotrexate
Penicillamine

Auranofin, aurothioglucose: category and indication

Aurum is latin for "gold" (gold's chemical symbol is Au).
Generic Aur- drugs (Auranofin, Aurothioglucose) are gold compounds.
· If didn't learn yet that gold's indication is rheumatoid arthritis, AUR- Acts Upon Rheumatoid.

Antiarrhythmics: class III members BIAS:

Bretylium
Ibutilide
Amiodarone
Sotalol

MAOIs: indications MAOI'S:

Melancholic [classic name for atypical depression]
Anxiety
Obesity disorders [anorexia, bulemia]
Imagined illnesses [hypochondria]
Social phobias
· Listed in decreasing order of importance.
· Note MAOI is inside MelAnchOlIc.

SIADH-inducing drugs ABCD:

Analgesics: opioids, NSAIDs
Barbiturates
Cyclophosphamide/ Chlorpromazine/ Carbamazepine
Diuretic (thiazide)

K+ increasing agents K-BANK:

K-sparing diuretic
Beta blocker
ACEI
NSAID
K supplement

Reserpine action:
Reserpine depletes the Reserves of catecholamines [and serotonin].

Succinylcholine:
action, use Succinylcholine gets Stuck to Ach receptor, then Sucks ions in through open pore. You
Suck stuff in through a mouth-tube, and drug is used for intubation.
Beta-blockers: side effects "BBC Loses Viewers In Rochedale": Bradycardia
Bronchoconstriction
Claudication
Lipids
Vivid dreams & nightmares
-ve Inotropic action
Reduced sensitivity to hypoglycaemia
Cisplatin: major side effect, action "Ci-Splat-In":
Major side effect: Splat (vomiting sound)--vomiting so severe that anti-nausea drug needed. Action:
Goes Into the DNA strand.

Vir-named drugs: use"-vir at start, middle or end means for virus": · Drugs:
Abacavir,
Acyclovir,
Amprenavir,
Cidofovir,
Denavir,
Efavirenz,
Indavir,
Invirase,
Famvir,
Ganciclovir,
Norvir,
Oseltamivir,
Penciclovir,
Ritonavir,
Saquinavir,
Valacyclovir,
Viracept,
Viramune,
Zanamivir,
Zovirax.

Phenobarbitone: side effects

Children are annoying (hyperkinesia, irritability, insomnia, aggression).
Adults are dosy (sedation, dizziness, drowsiness).

Prazocin: usage
Prazocin sounds like an acronym of "praszz zour urine".
Therefore Prazocin used for urinary retention in BPH.

Opioids: effects BAD AMERICANS:

Bradycardia & hypotension
Anorexia
Diminished pupilary size
Analgesics
Miosis
Euphoria
Respiratory depression
Increased smooth muscle activity (biliary tract constriction) Constipation
Ameliorate cough reflex
Nausea and vomiting
Sedation

TB: antibiotics used

STRIPE:
STreptomycin Rifampicin Isoniazid Pyrizinamide Ethambutol

Phenytoin: adverse effects PHENYTOIN:

P-450 interactions
Hirsutism
Enlarged gums
Nystagmus
Yellow-browning of skin
Teratogenicity
Osteomalacia
Interference with B12 metabolism (hence anemia)
Neuropathies: vertigo, ataxia, and headache

Narcotic antagonists
The Narcotic Antagonists are NAloxone and NAltrexone. · Important clinically to treat narcotic
overdose.

Thrombolytic agents USA:

Urokinase Streptokinase Alteplase (tPA)

Routes of entry: most rapid ways meds/toxins enter body

"Stick it, Sniff it, Suck it, Soak it":
Stick = Injection
Sniff = inhalation
Suck = ingestion
Soak = absorption

Asthma drugs: leukotriene inhibitor action

zAfirlukast: Antagonist of lipoxygenase
zIlueton: Inhibitor of LT receptor

Direct sympathomimetic catecholamines DINED:

Dopamine
Isoproterenol
Norepinephrine
Epinephrine
Dobutamine

Anticholinergic side effects

"Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine

Atropine use: tachycardia or bradycardia

"A goes with B": Atropine used clinically to treat Bradycardia.

Bleomycin: action
"Bleo-Mycin Blows My DNA to bits": Bleomycin works by fragmenting DNA (blowing it to bits). My DNA
signals that its used for cancer (targeting self cells).

Aspirin: side effects ASPIRIN:

Asthma
Salicyalism
Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature
closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)

Lupus: drugs inducing it HIP:

Hydralazine
INH
Procanimide

Vigabatrin: mechanism Vi-GABA-Tr-In:

Via GABA Transferase Inhibition

Morphine: effects at mu receptor PEAR:

Physical dependence
Euphoria
Analgesia
Respiratory depression

Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on factor
Xa. Monitor Xa concentration, rather than APTT.

Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":

Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.

SSRIs: side effects SSRI:

Serotonin syndrome
Stimulate CNS
Reproductive disfunctions in male
Insomnia

Ipratropium: action Atropine is buried in the middle:

iprAtropium, so it behaves like Atropine.
Warfarin: action, monitoring WePT:
Warfarin works on the extrinsic pathway and is monitored by PT.

Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's
stand for "beta blocker". · Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol,
propranolol.

Depression: 5 drugs causing it PROMS:

Propranolol
Reserpine
Oral contraceptives
Methyldopa
Steroids

Lead poisoning: presentation ABCDEFG:

Anemia
Basophilic stripping
Colicky pain
Diarrhea
Encephalopathy
Foot drop
Gum (lead line)

Myasthenia gravis: edrophonium vs. pyridostigmine

eDrophonium is for Diagnosis.
pyRIDostigmine is to get RID of symptoms.

Morphine: effects MORPHINES:

Miosis
Orthostatic hypotension
Respiratory depression
Pain supression
Histamine release/ Hormonal alterations
Increased ICT
Nausea
Euphoria
Sedation

Inhalation anesthetics SHINE:

Sevoflurane
Halothane
Isoflurane
Nitrous oxide
Enflurane
· If want the defunct Methoxyflurane too, make it MoonSHINE.

Cholinergics (eg organophosphates): effects

If you know these, you will be "LESS DUMB":
Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating
Diarrhea
Urination
Micturition
Bronchoconstriction

Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam
Oxazepam Temazepam

Benzodiazepines: actions
"Ben SCAMs Pam into seduction not by brain but by muscle":
Sedation
anti-Convulsant
anti-Anxiety
Muscle relaxant
Not by brain: No antipsychotic activity.

Botulism toxin: action, related bungarotoxin

Action: "Botulism Bottles up the Ach so it can't be the released":
Related bungarotoxin: "Botulism is related to Beta Bungarotoxin (beta-, not alpha-bungarotoxin--alpha
has different mechanism).

Teratogenic drugs "W/ TERATOgenic":

Warfarin
Thalidomide
Epileptic drugs: phenytoin, valproate, carbamazepine
Retinoid
ACE inhibitor
Third element: lithium
OCP and other hormones (eg danazol)

Gynaecomastia-causing drugs DISCOS:

Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens
Stilboestrol

Benzodiazepenes: drugs which decrease their metabolism

"I'm Overly Calm":
Isoniazid
Oral contraceptive pills
Cimetidine
· These drugs increase calming effect of BZDs by retarding metabolism.

Anesthesia: 4 stages "Anesthesiologists Enjoy S & M":

Analgesia
Excitement
Surgical anesthesia
Medullary paralysis

4-Aminopyradine (4-AP) use"4-AP is For AP":

For AP (action potential) propagation in Multiple Sclerosis.

Osmotic diuretics: members GUM:

Glycerol
Urea
Mannitol

Sodium valproate: side effects VALPROATE:

Vomiting
Alopecia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Appetite increase
Tremor
Enzyme inducer (liver)

Nitrofurantoin: major side effects NitroFurAntoin:

Neuropathy (peripheral neuropathy)
Fibrosis (pulmonary fibrosis)
Anemia (hemolytic anemia)
Zafirlukast, Montelukast, Cinalukast:
mechanism, usage"Zafir-luk-ast, Monte-luk-ast, Cina-luk-ast": · Anti-Lukotrienes for Asthma.
· Dazzle your oral examiner: Zafirlukast antagonizes leukotriene-4.
Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount":
Phenytoin
Ethanol
Aspirin
Zero order
· Someone that pees out a constant amount describes zero order kinetics (always the same amount
out)

Hepatic necrosis: drugs causing focal to massive necrosis

"Very Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane

Steroids: side effects BECLOMETHASONE:

Buffalo hump
Easy bruising
Cataracts
Larger appetite
Obesity
Moonface
Euphoria
Thin arms & legs
Hypertension/ Hyperglycaemia
Avascular necrosis of femoral head
Skin thinning
Osteoporosis
Negative nitrogen balance
Emotional liability

Amiodarone: action, side effects 6 P's:

Prolongs action potential duration
Photosensitivity
Pigmentation of skin
Peripheral neuropathy
Pulmonary alveolitis and fibrosis
Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism

Monoamine oxidase inhibitors:

Members "PIT of despair":
Phenelzine
Isocarboxazid
Tranylcypromine ·
A pit of despair, since MAOs treat depression

Warfarin: metabolism SLOW:

· Has a slow onset of action.
· A quicK Vitamin K antagonist, though.
Small lipid-soluble molecule
Liver: site of action
Oral route of administration.
Warfarin

Propythiouracil (PTU):
Mechanism It inhibits PTU:
Peroxidase/ Peripheral deiodination
Tyrosine iodination Union (coupling)

Antibiotics contraindicated during pregnancy MCAT:

Metronidazole
Chloramphenicol
Aminoglycoside
Tetracycline

Beta-blockers:
nonselective beta-blockers"Tim Pinches His Nasal Problem"
(because he has a runny nose...):
Timolol
Pindolol
Hismolol
Naldolol
Propranolol

Methyldopa:
side effects METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism
Anaemia (haemolytic)

Lithium: side effects LITH:

Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria]
Tremor/ Teratogenesis
Hypothyroidism

Respiratory depression inducing drugs "STOP breathing":

Sedatives and hypnotics
Trimethoprim
Opiates
Polymyxins

Benzodiazepenes: antidote "Ben is off with the flu":

Benzodiazepine effects off with Flumazenil.
e-facts to avoid during pregnancy

e - erythromicin
f - fluoroquinolones

a - aminoglycosides

c - clarithromycin

t - tetracyclin

s - sulfonamide
Ototoxic
* Aminoglycosides (gentamicin)
* Vancomycin

Nephrotoxic:
* Penicillin
* Gentamicin (aminoglycosides)
* Amphotericin B
* Acyclovir

Hepatotoxic:
* Tetracycline
* TMP-SMZ (esp. pregnant, breastfeeding or less that 2 months old)
* INH
* Rifampin
* Pyrazinamide
* Ketoconazole

Decrease effectiveness of Oral Contraceptives:

* Penicillin
* Tetracycline
* Rifampin

Caution or **Contraindicated w/ Impaired Renal Function

1) TMP-SMZ:
** Contra. if creatinine clearance < 15 ml/min (otherwise decrease dose 50%)
2) Gentamicin
3) Vancomycin
4) Penicillin
5) Cephalosporins
6) Imipenem
7) ** Tetracycline (except doxycycline & minocycline)
8) Nitrofurantoin
** Creatinine clearance <40 ml/min
9) Acyclovir (esp. if also dehydrated)
10) Metronidazole
11) **Amphotericin B

Caution or **Contraindicated w/ Impaired Hepatic Function

1) **Erythromycin, clindamycin, clarithromycin, azithromycin
2) **INH
3) Rifampin (avoid giving to alcoholics

Parkinsonism: drugs
SALAD

Selegiline
Anticholinenergics...trihexyphe nidyl, benzhexol, ophenadrine
L-Dopa + peripheral decarboxylase inhibitor ...carbidopa, benserazide
Amantadine
Dopamine postsynaptic receptor agonists ...bromocriptine, lisuride, pergolide

Benzodiazepines: ones not metabolized by the liver (safe to use in liver failure)
LOT:
Lorazepam
Oxazepam
Temazepam

Food & Drug Interactions

Take with food
Ceftin - Cardene - Biaxin - Keflex - Demadex - Augmentin - Ceclor - Ticlid

Take 15 minutes before food

Prilosec - Propulsid

Take on an empty stomach

(1 hour before or 2 hours after food)
Prevacid - Zithromax - Carafate - Ampicillin

May take with or without food

Effexor - Prozac(avoid alcohol) - Pamelor(limit caffeine)

Take with food - Avoid alcohol

Xanax - Zoloft - Paxil - Restoril - Desyrel - Buspar - Klonopin - Flagyl

Take with food - Avoid alcohol - Limit caffeine

Ativan - Valium - Elavil

Take on empty stomach - Avoid alcohol

Isordil - Monoket - Procanbid - Sorbitrate - Nitroglycerin - Pronestyl - Imdur -
Quinidine Sulfate - Ismo

Gastrointestinal Medications

Axid - take with food. Avoid alcohol, limit caffeine, may need a bland diet.

Tagamet - take with food. Avoid alcohol, limit caffeine, may need a bland diet. Take
iron supplement separately by 2 hours.

Zantac/Pepcid - may take with or without food. Avoid alcohol. limit caffeine, may
need a bland diet.

Antibiotics
Take the following on an empty stomach 1 hour before or 2 hours after food.

Floxin/Noroxin- take with 8 ounces of water. Drink plenty of fluids.

Tetracycline - do not take milk, dairy products, iron or calcium supplements,

antacids or mineral supplements within 1 hour before or 2 hours after taking this
medication. Take with 8 ounces of water.

Penicillin- avoid taking with citrus juices or carbonated beverages. For best results
take with 8 ounces of water.

Take the following with food especially if stomach is easily upset.

Erythromycin - limit caffeine.

Cipro- limit caffeine and drink plenty of fluids. Take antacids, magnesium, iron,
calcium or zinc supplements separate by 2 hours.
Septra/Bactrim- drink plenty of fluids. Avoid high doses of vitamin C.
Antihypertensives
(high blood pressure medication)
Take the following on an empty stomach.

Capoten - decrease sodium, decrease calorie diet may be recomended. Avoid salt
substitutes that contain potassium, caution with potassium supplements. Take
calcium or magnesium supplements separate by 2 hours. Maintain adequate fluid
intake.

Procardia - take with decreased fat meal to prevent flushing. Do not take with
orange, grapefruit or other citrus fruit juices. A low salt diet may be recommended.
Do not take calcium supplement within 3 hours of taking this medication. Avoid
alcohol.

Cardizem - a low sodium, low calorie diet may be recommended.

Hydrocholorothiazide - diuretic potassium depleting. May need to decrease

sodium, decrease calorie, increase potassium, increase magnesium. Avoid natural
licorice. Limit alcohol. Caution with calcium supplements.

Triamterene - diuretic, potassium sparing. Avoid high potassium foods, potassium

supplements, salts substitutes that contain potassium. A decreased sodium,
decreased calorie diet may be recommended. Avoid natural licorice.

Calan (Verapamil/Isoptin)- decrease sodium, decrease calorie diet may be

recommended. Limit caffeine. Caution with calcium and/or vitamin D supplements -
hypercalcemia decreases effectiveness.

Take the following with food or on empty stomach:

Vasotec/Zestril/Accupril - avoid salt and salty foods. Avoid salt substitutes that
contain potassium. Caution with potassium supplements. Avoid alcohol.

Atenolol/Metoprolol (Tenormin, Lopressor, Toprol XL) - a decreased sodium,

decreased calorie diet may be recommended. Avoid natural licorice.

Hytrin/Cardura - a decreased sodium, decreased calorie diet may be

recommended. Avoid natural licorice. Caution with alcohol.

Antihyperlipidemics
These medications are prescribed to lower blood lipid (cholesterol) levels. A low
cholesterol, low fat diet may be recommended. Avoid alcohol.

Pravachol - take on an empty stomach 1 hour before or 2 hours after foods.

Mevacor/Lopid - take with food.

Zocor/Lescol - may take with or without food.
Cardiovascular

Lanoxin - take this medication 1 hour before breakfast. Avoid high fiber foods such
as bran, bran cereals or bran muffins for breakfast, but it is acceptable to eat high-
fiber foods later in the day. Avoid natural licorice.
Miscellaneous Cardiac Medications

Quinidine (Quinaglute, Duraguin, Quinidex) - take this medication 1 hour

before or 2 hours after food. Take with 8 ounces of water. Do not drink more than 1
or 2 glasses of citrus juice while on this medication. Caution with potassium
supplements.

Take the following with food:

Lozol - a low sodium, low calorie, high potassium, high magnesium diet may be
recommended. Avoid natural licorice. Limit alcohol.

Edecrin - a high potassium, high magnesium diet may be recommended. Liberal

sodium diet for most patients. Limit alcohol.

Trental- a low cholesteral, low calorie diet may be recommended. Limit caffeine.

Bumex/Lasix/Hydrodiuril- a low salt, high potassium diet may be recommended.

Avoid natural licorice and alcohol.

Miscellaneous Medications

Theophylline - this medication will not work well if you eat more protein than
usual. Try to eat the same protein foods each day. Avoid charcoal-broiled foods.
Avoid caffeine. For Theo-24 only take with a high fat meal or snack.

Monoamine Oxidase Inhibitors (Parnate, Nardil, Marplan) - avoid foods high in

tyramine. If you eat foods high in tyramine while on this medication it can cause
nausea, vomiting, high blood pressure and headaches. Avoid alcohol and limit
caffeine.

Oral Hypoglycemics (Diabinese, Glucotrol, Diabeta, Micronase) - take with

food and avoid alcohol. Compliance with a diabetic diet is important.

Coumadin (anticoagulant) - avoid excessive amounts of foods that are high in

vitamin K. Do not drink herbal teas or green teas while taking this medication.
Because of the varied effects that food can have on this medication, maintain a well
balanced diet with a consistent intake of vitamin K. Avoid alcohol.

Foods High In Tyramine

Aged cheese - Caffeine - Pickled Herring - Aged Meat - Chicken Liver - Raisins -
Anchovies - Chocolate - Red Wine - Bananas - Cola Drinks - Salami - Beef Liver -
Eggplant - Sausage - Beer - Figs - Sour Cream - Bologna - Mushrooms - Yeast
Extract - Broad Beans - Pepperoni - Soy Sauce - Yogurt

Foods High In Potassium

Apricots - Cantelope - Honeydew - Prune Juice - Asparagus - Carrots - Milk -
Pumpkin - Artichokes - Celery - Mushrooms - Raisins - Avocado - Chocolate -
Oranges - Spinach - Bananas - Dates - Orange Juice - Squash - Bran Flakes - Dried
Beans - Parsnips - Tomatoes - Broccoli - Dried Fruit - Potatoes - Tomato Juice -
Brussel Sprouts - Figs - Prunes - V-8 Juice - Yams

Foods High In Vitamin K

Beef Liver - Green Tea - Brussel Sprouts - Cauliflower - Tomatoes -
Soybeans/Soybean Oil - Green Leafy Vegetables
especially Broccoli, Cabbage, Kale, Lettuce & Turnips

Foods that Contain Caffeine

Coffe - Tea - Chocolate - Dark Sodas - Mountain Dew

Tyramine exceptions: most vegetables and fruits, fresh meat and fish, milk, yogurt,
cottage cheese, cream cheese, major domestic brands of beer, most wines

MAOI's + tyramine-rich food= hypertensive crisis (s/s headache, tachycardia,

palpitations, n/v). If hypertensive crisis occurs, BP can be lowered by IV phentolamine
and sublingual nifedipine.
Here's some more tips too..
PHARMACOLOGY

Insulin, Coumadin, Heparin, antihypertensives, viagra, digitalis, ritalin, actonel, accutane, anti-ulcer medications, nitroglycern, to name a few. Try to look at the
suffixes:

ace inhibitors end with 'pril (eg: captopril) *note that this drug increases potassium in the blood,

angiotensinogen 2 inhibitors end in 'sartan (eg: losartan),

beta blockers end with 'olol (eg: metoprolol) *caution with patients who are diabetic or who are asthmatic,

cholesterol reducing drugs usually end with 'statin (eg: atorvastatin) * note that if the patient experiences muscular pain, they should stop immediately and report it
to the doctor, also not to consume grapefruit juice,

impotence drugs end with "defil (eg: sildenefil-hope I spelled it correctly...if not please excuse the typo) *note that you cannot take this drug if you are taking
nitrates such as nitroglycerin or isosorbide and go to the doctor if an erection last longer than 4 hours,

accutane is an acne drug, where a pregnancy test must be done on females before prescribing them

actonel (again, this may be a typo) cannot be taken unless a person is able to sit up for at least 1/2 hour to an hour after adminstration.

Know the acting times of insulin, which is fast acting, long acting or the lente. They may ask when will a person become hypoglycemic, and that would be during
peak hours.

penicillin: if a person has an allergy to penicillin, they may be at risk for an allergy to a cephalosporin, in that case suggest a macrolide such as clarithromycin.
Macrolides are known to cause severe stomach pain for some people. Also, if a nurse administers penicillin or cephalosporin, that the patient should remain with
the nurse for 1/2 hour afterwards to intervene with allergic reactions.

Most drugs that end with 'mycin may cause nephrotoxicity or ototoxicity

Parameters for digitalis administration, and also that if potassium is low and calcium and magnesium is high, there is a higher chance for digitalis toxicity.

corticosteriods usually end with 'sone (eg: predinsone), may cause medication related diabetes, increase chances of infection, cause Cushoid symptoms (buffalo
hump in back, thin skin, easy to bruise, etc...)

Aspirin should not be consumed with alcohol, increases bleeding, causes ulcers, should be taken with food to diminish gastric distress

Antidote for tylenol is Mucomyst.

dont forget your diuretics ... esp. those are imp. also I have some for now ...

meds that end in -sartan=decrease blood pressure, increase cardiac load (Used for those who side effect is cough with ACE)
ANGIOTENSIN II RECEPTOR BLOCKERS
side effects 2nd degree AV block, angina, muscle cramps monitor BUN,BP and pulse

-vastatin(Lovastatin)=decrease cholesterol, lower tricycerides (NOTE*Lipitor at night only do not take with grapefruit juice)
ANTIHYPERLIPIDEMICS
side effects muscle weakness, alopecia monitor liver/renal profile

cox=osteoarthritis, rheumatoid arthritis(relieve pain by reducing inflammation)

NSAID/CO2 ENZYME BLOCKER
side effects tinnitus, dizziness monitor bowel habits (could cause GI bleed, platlet count) Increase risk of strokes, heart attacks***

tidine=GERD
HISTAMINE 2 ANTAGONIST(inhibit gastric acids)
side effects agranulocytosis, brady/tachycardia monitor gastric PH/BUN ***If taking antacids take one hour after or before taking these drugs***

-prazole=ulcers, indigestion, GERD (Take before meals better absorption)

PROTON PUMP INHIBITORS
side effects gas, diarrhea, hyperglycemia monitor LFTs

-parin=thin blood, DVT, M.I.,post surgeries (Antidote Protamine sulfate--check PTT should be 1.5-2.0x) anticoag. decread vit. K levels
side effects hematuria, bleeding, fever monitor PTT, hematocrit and occult testing q 3mths

-pam
-pate
-aze/azo =Benzos/Antianxiety/anticonvulsants
side effects incontinence, respiratory depression/ monitor for LFT, respirations

-caine (anesthetic)
-mab (monoclonal antibodies)
-ceph or cef (cephalosporins)
-cycline (tetracyclines)
-cal (calciums)
-done (opioids)

ganciclovir sodium causes neutropenia and thrombocytopenia and nurse should monitor for s/s of bleeding just as equiv. to a pt. on anticoag. therapy.

SSRIs and MAOIs used together potentially fatal

caine= local anesthetics

cillin= antibiotics
dine= anti-ulcer agents
done= opiod analgesics
ide= oral hypoglycemics
iam= antianxiety agents
micin= antibiotics
nium= neuromuscular blocking agents
olol= beta blockers
ole= anti-fungal
oxacin= antibiotics
pam= antianxiety agents
pril= ace inhibitors
sone= steroids
statin= antihyperlipidemics
vir= antivirals
zide= diuretics

Generic Name (Trade Name) Major Concerns

Analgesic
Acetaminophen (Tylenol) Watch for LIVER and KIDNEY problems
Hydrocodone with Acetaminophen ADDICTIVE
(Lortab)
Ibuprofen (Motrin) can lead to HPN and KIDNEY disease
Naproxen (Aleve) can lead to HPN and KIDNEY disease

Antianxiety
Alprazolam (Xanax) This drug can be ADDICTIVE
Diazepam (Valium) Watch for Allergies, *also anticonvulsant*
Lorazepam (Antivan) SEDATION
Promethazine HCI (Phenergan) *also antiemetic*

Antibiotic
Amoxicilline (Augmentin) Watch for allergic reactions
Azithromycin (Zithromax Z-Pak) Watch for allergies
Cephalexin (Keflex) If you are allergic to Cephalosporins, you might also be allergic to Penicillin
Doxycycline hyclate (Vibramycin) Avoid for pregnant clients
Penicillin V Potassium (Penicillin) Watch for allergies
Sulfamethoxazole (Septra, Bactrim) Can cause GI diturbance

Anticoagulant
Warfarin Sodium (Coumadin) Teach the client to limit the intake of GREEN LEAFY VEGETABLES
Watch for signs of BLEEDING
Anticonvulsant
Clonazepam (Klonopin) Should not be stopped abruptly
Diazepam (Valium) Watch for Allergies, also antianxiety
Lorazepam (Antivan) SEDATION

Antidepressant
Sertraline (Zoloft) SEDATION
Amitriptyline HCI (Elavil)
Trazodone HCI (Desyrel)

Antidiabetic
Glipizide (Glucotrol) Watch for HYPOGLYCEMIA
Metformin (Glucophage) This drug should be stopped prior to a dye study such as cardiac catheterization
Antihistamine
Cetirizine (Zyrtec)
Fexofenadine (Allegra) DRY MOUTH

Antihypertensive
Amiodipine (Norvasc) HYPERTENSION
Atenolol (Tenormin) cause DROP in PULSE Rate, check PR daily
Doxazosin Mesylate (Cardura)
Lisinopril (Zestril) cause Postural HPN, remain supine for at least 30mins
Metoprolol Succinate (Toprol XL) Teach the client to check his PULSE RATE
Metoprolol Tartrate (Lopressor,Toprol) Teach the client to check his PULSE RATE

Antihypertensive/Antianginal
Verapamil HCI (Calan)

Anti-inflammatory
Ibuprofen (Motrin) can lead to HYPERTENSION and KIDNEY disease
Prednisone (Deltasone) can cause Cushing’s Syndrome and GI problems

Antigout
Allopurinol (Zyloprim) Drink at least 8 glasses of WATER per day

Antilipidemic – usually ends in statin

Simbastatin (Zocor) Can cause LIVER problems & muscle soreness
Do not take this drug with GRAPE-FRUIT JUICE
Antiulcer/Histamine Blocker
Ranitidine HCI Best to take this drug with meals

Antiulcer/Proton Pump Inhibitor

Lansoprazole (Prevacid) Take this drug prior to meals
Omeprazole (Prilosec)

Bronchodilator
Albuterol (Proventil) Tachycardia, MD check blood levels for toxicity

Diuretic
Furosemide (Lasix) HYPOKALEMIA
Hydrochlorothiazide (HCTZ) HYPOKALEMIA

Hormone Replacement
Estrogen (Premarin) can ↑ blood clots
Levothyroxine (Levoxyl) can ↑ blood clots
Levothyroxin (Synthyroid) Teach the clients to check his PULSE RATE

Muscle Relaxant
Cyclobenzaprine HCI (Flexeril) SEDATION

Oral Contraceptive
Necon (Ortho-Novum 7/7/7) can ↑ blood clots
Trinessa (Ortho TriClen) can ↑ blood clots

Osteoporosis
Alendronate (Fosamax) Remain UPRIGHT for at least 30mins after taking to prevent GERD.
Take with WATER

Potassium Supplement
Potassium Chloride (K-lyte) Check for renal function before giving this drug

Sleep Aid
Zolpidem (Ambien) Allow at least 8hrs of sleep time to prevent daytime drowsiness

Neutropenic Precautions
■ For individuals with compromised immune system
■ Use standard precautions, especially hand hygiene
■ Caregivers and visitors should be free of communicable illnesses
■ Private room if possible; keep room meticulously clean
■ Teach to avoid sources of potential infection (crowds, confined spaces
such as airplanes, raw fruits/vegetables, flowers/plants)

DELEGATION
As far as delegation, Kaplan stresses that the RN is ultimately responsible for all tasks delegated.
Now I know from experience, LPNs can be given a lot of tasks that require assessment/gathering, planning, & evaluating loads of information...
BUT in terms of the NCLEX-RN...they can't do ANY assessing, planning, evaluation, OR initial teaching. That is entirely the role of the RN on that exam!
Also, LPNs can only be given patients that are hemodynamically *STABLE*. They can't be given any patients that require constant monitoring for
evaluation purposes. LPNs are only allowed to implement written orders from MDs/APNs & follow instructions given to them by the RNs in charge to
cover their patients.
As far as the UAPs (unlicensed assistive personnel)...they can only be given the most basic of psychomotor nsg tasks like taking vital signs on stable
patients...assisting with ADLs & ambulating patients for therapy & again...no assessing, planning, & evaluation...etc.

Another thing....MDs/APNs/Nsg Mgt/other interdisciplinary dept/personnel such as MSW/Chaplins/Resp/Occup/Physical Therapists are *ALWAYS*
available to the NCLEX-RN staff nsg! These people are multiple & fruitful...but remember this.... *DO NOT PASS THE BUCK TO THEM* !!! You have to
assume that there are standing….if not written orders for your patients...remember...this is a *perfect world*.
If you see in your answer choice where "call the physician", "contact a supervisor from another dept", "refer grieving families to the Chaplin", for
example, before you've exhausted everything that YOU as the RN can do for the patient...don't pick those answers.
If though, you read that everything was done for the patient, i.e. O2 was started, the patient was repositioned, high vent alarms & you've disconnect the
patient & started bagging...then & only then do you contact the physician, supervisor, Resp Therapist...etc.
You may be asked questions on what to do for a patient based on their ABGs or common labs...you'll have to know the normals & what's expected
when they're abnormal & know where to go from there.
The only other time that you will "pass the buck" is when an UAP or a LPN observed something wrong with another RN's patient. You are not suppose
to assess that patient since you don't know that patient's base vitals & situation. Only then would you inform either that RN or contact your supervisor
(staying within your chain of command)...or both.
I've seen questions that suggest an UAP of 12 years or a LPN of 20 years observes a new grad RN do something that they know (or feel) isn't right.
What do you do? Confront said nurse, observed said nurse in their duties, or ask the reporting personnel to elaborate on how they come to feel this
way. Unless what the UAP/LPN seen is unsafe...then you as the RN would ask that reporting personnel to explain their concerns further.

Primary Roles for the Licensed Nurse**

General Education and Support to promote wellness, health maintenance and disease prevention as requested by client *Client initiates

Care Consultation related to health impairment, includes education and support to maintain client independence Client or nurse initiates

Care Coordination Nursing activities include: · consultation · needs assessment · teaching care provider to perform care activities · providing education, support
and other direct care · monitoring client status · ongoing review of care provision Client or nurse initiates/directs

Care Coordination Nursing activities include all previous activities plus: · directing nursing care, including assignment and delegation of activities Nurse directs

Total Care Management Includes direct care, assignment and delegation responsibilities within health care system; care provided by both licensed
nurses and AP (delegated activities) Nurse directs