I.

Cold

Respiratory Drugs II. cough

II. Bronchospastic d/ 0
I.
Cough ,
✗
Foreign body
reflex
-

protective ✗ Excessive secretions

I. Cold

Acute V1 Chronic
A. Common cold / Acute Rhinitis 3 wks swks

-
viral infection
-

infection -

drug-induced ACEI
occupational TB

}
Rhinovirus infection
limiting
→

self
-
-

-
Adenovirus
-

coronavirus
-

foreign body postnasal drip

Rot : recall :

droplet vs airborne
◦ ◦
A. Mucoregulators
◦ °
Measles
Ambroxol
°
0

◦
◦ ◦ Tuberculosis
Varicella
{ 1m > 1m Bromhexine
Carbocisteine

↓ of
Phases : MOA : ↑ Hyo portion
=

viscosity mucus

Catarrhal
Dry ±

f
B.
nonspecific watery discharge Mucolytics
headache (t ) rhinorrhea i. N
e.
acetyl cysteine
- ( Fluimicil ,
Exflem )
of
Makris MOA : break disulfide bonds > ⑧
visocity mucus

C.
WTD :
Expectorant
the
supportive MOA : ① Stimulate bronchial glands
-

nasal decongestant ↓
91 agonists
vasoconstrictor
H2O portion ① viscosity of
Phelyphrine Neozep④
T
= =
mucus
↓ i.e .
-

Tissue shrink
↓ Oxymetazoline Drixin -

↓ ↑
drainage ② Irritate the
vagus nerve

i. e. Guiafenesin

✗ agonist
aka
Glyceryl quiacolate
-

Apra clonidine better

i. e. -
vs .

placebo
Brimonidine bronchitis ( COPD)
Uses : vs .
chronic

WOF :
NMT 3 days 7
( anti
d. agonist
→
rhinitis medicament" D. Antitussive cough)
-

I rebound congestion)
exacerbation of HTN
→
used is /
hemoptysis ( TB)
intranasal steroids /
nonproductive cough
-

Fluticasone
Beclomethasone / affects 13 days)
-

, QOL -5

MOA :
anti inflammatory
-

WOF of Narcotic narcotic

drying
:
mucosa
¥ Non
-

codeine Dextromethorphan
Noscapine same
potency w/ codeine
-

addiction
B. rhinitis
✗

Allergic chronic centrally acting

-

or recurrent IgE mediated -

✗
analgesic
inflammation of the nasal mucosa
WOF : addiction
-

not given if < Gylo

! Pollen
"

:-. >
nasal itchiness
↳ wot : hallucination

cold environment
CNS depression
>
sneezing
nasal discharge Crhinorrhea)
allergen
>
watery
centrally acting
-
-

WTD ! avoid the

trigger
intermittent exposure
peripherally -

acting
oral antihistamine -
if short term or
i. e. Butamirate citrate

steroids if long term persistent ↓ of peripheral receptor

nasal MOA :
sensitivity cough
-

nasal decongestants
III. Bronchospastic disorders a. Bz agonist

f
* " °°ʳʰ " " " "" "° "°" " " °"

episodal reversible airflow limitation salbutamol / Albuterol salmeterol

-

-
It) wheeze
, dyspnea , cough Albuterol Forme tent

risk factor Bambuterol

:
atopy hypersensitivity
-
=

exag . rxn

" "

hygeine hypothesis
exercise-induced * SABA -

1ˢᵗ line reliever us . BA

occupational salbutamol 1 neb

every 20 mins ✗ 3 doses

Dx
Spirometer WOF : tremors
-

( pulmonary Function test)

tachycardia
if f) but ↑ suspicious
hypokalemia
→

test
↳ Provocative
challenge
i. e. Meta choline * LABA 1- steroids -

controllers vs.BA

Histamine ↓ inflamm ,

bronchodilation 1st Phase : Broncho constriction

GINA 1 Global initiative for Bronchial Asthma )
Mgt :
2nd phase i. Inflammation
-

i. e. Symbicor
B. COPD ( Disease) Budesonide 1- Forme tent
Obstructive Pulmonary
=

Chronic

limitation that is not

Fully reversible
airway
-

" ⑧
Sere tide
"

chronic bronchitis ↑ secretions =

Blue puffer i. e.
large airways
=
→

Salmeteol + Fluticasone
lung parenchyma ⊕ =

gas exchange
>

"

pink Puffer
"

e¥9 also be used reliever

small
airways Note ! as
=

may

risk factor :
smoking b-
Methyl xanthine
-

pack years i. Theophylline e.

20 sticks -_ 1
year Aminophylline
case : 12 sticks / day MOA : ⊖ adenosine
12 sticks tP 6 pack yrs
✗ loyrs
=
✗

⊖
10 Years zopackyrs
PDE
phosphodiesterase
lopackyrs = TCOPD
anti inflamm ? ?
* rural
-

urban area vs ↑ area

↳ & siga
gatong
Uses : alternative controller vs.BA

stimulant
Dx :
spirometry respiratory
( Global Initiative for Chronic Obstructive
Mgt GOLD Note :
therapeutic index
:
Narrow

Lung Disease ) 1- I =
TDI
F- Dso

C. therapeutic mcglml
Management
:S to is

④ WOF : confusion
-
reliever controller ✓ agitation ,

✓ seizures

1. Bronchodilators ✓ tachycardia
✓
constrict arrhythmia
^ ✓ diuretic effect
-0
anticholinergic +
Acetylcholine
⑤ Adenosine
methyl xanthine -0
bronchial tone c.
Anticholinergic →
"
LAMA
"

l Long-acting muscarinic antagonist)

methyl xanthine
( spirilla)
>
i.
Tiotropium
. . .
. .
_
.

e.
.
.
.
.

PDE
camp , inactive
Atrovent)
✓
-

% ATP Ipratropium (
"

Dilate Bz agonists
Oxytropium
"
" "

Gg
Umeclinidium ( Ellipra)
newer :

↳ lycopyrronium ( Breezchaler)
 2 .
Mast cell stabilizer * oral

⊕ opening short term ~

3-5 days →
> days
MOA
_ -

f. = HYPER polarization i. e. Prednisone

/ Chloride
Channels
;
;
Use !
Short term +✗ vs BA exacerbation

stabilize

i. e. Nedocromil His mast cell * IV

3- 4 wks
cromolyn sodium Hydrocortisone
uses :
allergic asthma methyl prednisone
rhinitis Severe asthma
allergic vs.
-

WOF : bronchoconstriction Review !

BA 1 Rapid Relief)
WTD ? w/ SABA > ✓ Salbutamol
pretreat
✓ 1- Salbutamol
Ipratropium
✓ Prednisone Po
3 Anti inflammatory ( severe BAJ
-
.

✓ IV
Hydrocortisone

a. Leukotriene modifiers > COPD ✓ Broncho dilator

Real / GOLD
Low
symptoms High symptoms
:
Phospholipid c ☐
≥ exacerbation LABA
LAMA +

A2 LAMA
Phospholipase ≥ hospital
LAMA
inhaled corticosteroids
LAB # +
ay ,
COPD >"
°

eosinophil
✓ -

Zilueton -

Arachidonic acid A B
{ 2 exacerbation
µgµ☐
"" "

??⇐.w +
LABA or
' > leukotrienes = Inflam ✗ hospital bronchodilators
prostaglandin
↳

LAMA
=
:*. Monte /ukast
Zafirlukast

-
broncho constriction
-
SRSA ( slow reacting substances
cancer Chemotherapy
of
Anaphylaxis)
Uses : ✓ alternative controller in BA I. Basic concepts
induced asthma
✓ NSAID II. Cytotoxic agents
-

↳ ⊖ COX

III. Hormones
of syndrome
unmask symptoms Churg Strauss
-

WOF :
II. Targeted therapy
↳ tx : steroids

"
" Aflatoxin → liver CA
steroid sparer
I. Basic concepts
↳④ use
-
lukast as

steroid sparer
Cancer disorder to mutation
genetic due DNA
-

a ↓
b. Glucocorticoids
spontaneous environmental
⊖ stimuli
MOA : ⊕ Lipocortin >
Putz
↓ AA -

Properties :

↓ inflammation
'

↓ PG ✓ Evasion of cell death

. .

↓ LT ✓ potential
limitless replicative
✓ ( form BV )
* inhalationat Angiogenesis
i. e. Budesonide ✓ metastasis -

spread to other areas

Fluticasone

controller lw / LABA) .BA

"
"
as vs
Neoplasia growth
-

=
new

µ
controller in COPD
malignant
-

>

"

( at
"
metastatic
WOF : less systemic side effects low doses
) to other areas
Benign _
spread
vocal nodule "
innocent
"

oral thrush / candidiasis } spit) localized

Nystatin (swish
-

↳ WTD :
Gargle after use CT

D. × :
Biopsy , Imaging MRI

PET scan
 after surgery
adjuvant -

inhibitors
WTD !
Chemotherapy neo adjuvant
- before surgery
2 .

Topoisomerase

Radiotherapy ↓
unwind
Surgery DNA

④ supercoiling
Principles of chemotherapy
inside the cell
i.
target cells cycle a. Antibiotic
to active
> metabolize

#
>G1 i e D
actinomycin
'
-

OF :
Hemolytic
g. Uremic
's DNA synthesis Mitomycin
=

resting .am syndrome

,
plasmapheresis
☆ """ "^

]
mitosis WTD :

1.
L
↳ WOF :
pulmonary Fibrosis

2. Intermittent chemo administration ( cycle / weeks)

phase -

specific
why? Gz -
m

allow normal cells to recover

Allow cells in the Go to enter the cell

b. Anthracyoline
re
cycle
-

i e Doxorubicin F- pirubicin
real /
Gompertz ian
.

: ,
-

curve
↓
WOF : cardio toxicity

WTD : Dexrazoxane
• Go
rate

C.
Phodophyllotoxin
time i. e. F-
top side , teniposide
↓

II. phase specific -

Cytotoxic agents G1 -

A. Direct d. Camptothecin
DNA
acting
i. e. Irinotecan , Topotecan
1.
Alkylating agents WOF : diarrhea
eÑ¥?¥¥ WTD : anti -
diarrheal
MOA :
Form DNA addicts
-

Atropine , Diphenoxylate

hydration
Platinum
a.
compounds
i. e. cisplatin
B. Indirect DNA acting
carboplatin
WOF :
ototoxicity ,
nephrotoity

/
WTD : hydration ↓ Antimetabolite Antimitotic

Is phase) lmphase)
phase specific phase specific
-

I
-
- -

Crea

↓_ Crcl

1 Anti metabolite
± EGFR
.

b. Nitrogen mustard &

pyrimidine analogs
-

purine
i. e. Mechlorethamine .

i. e. methotrexate
vs.
lymphoma ⊖ Dihydro folate
-

reductase
-

-
WOF :
hepatotoxity
C. Busulfan WTD ? Folinic acid or Leucovorin

WOF : pulmona fibrosis

5- Fluorouracil

d-
Cyclophosphamide ,
Ifosfamiae
""
""
-
⊖
thymidylate synthase
≈
me
( toxic colon
activated in the arolein cystitis cornerstone in cancer
- -

Hemorrhagic
,

phosphamide / chemotherapy
-

← > No
mustard WTD : ME
active
 II. Seizure
I.
Psychosis
Neurologic / Psychiatric
mood disorder Parkinson 's
Hydroxy I. I.
urea
disorder VI. Anesthesia
II. Anxiety
-

⊖ ribonucleotide reductase

-
WOF : bone marrow
toxicity I. Psychosis

2 .

Antimitotic A. Basic concepts

Vincristine
i. e. Vinea -

neurotoxicity
impairment reality testing
Psychosis
in
Vinblastine bone toxicity gross
- =
marrow

7
( disassembly )
schizophrenia
=
disorder in ≥ 1- domain

paclitaxel
Taxanes
Docetaxel
(t ) symptoms 1- )
symptoms
it ( assembly ) hallucination
WOF :
hypersensitivity (t)
Alogia
-

WTD : antihistamine -

perception -
like
= × verbal output

experiences

III. Hormone &

Antagonists i. e. auditory Anhedonia

visual =
×
pleasure
SERM Tamoxifen
i.
olfactory
-

e.

Aromatase inhibitor -
Anasteride somatic Audition

reductase inhibitor Finasteride

voluntary work
-

g- d. =
✗

Dutasteride
(t) Delusion

fixed false belief

Androgen antagonist Flutamide A sociality
-
-

Bicalutamide
"

-
"
culture -
related =
✗ social interactions

i. e. Persecutory
)
linaapi
III. Targeted Therapy
Jealousy to )
( ↑ probability cause harm

monoclonal Ab kinase inhibitor

tyrosine Grandiose
-

mab -
inib Shared Psychosis
( by group )
extracellular intracellular
source ;

zu =
humanized i. e. Imatinib G) disorganized thinking
most toxic
i chimeric uses : CML (f) behavior
disorganized
= →
✗ us .

most
Mu
=
human → least toxic { stable us . C- kit It)

Gastro Dopamine
Biologic theory
:
vs . > TT

i. e. Intestinal ↑ ↑ Serotonin
Bevacizumab =
anti vascular

Endothelial Stromal

Growth Tumor / 1ˢᵗ Generation

Factor
B. Typical antipsychotics
MOA :
Dz Antagonist
-

↓ Positive symptoms
Cefuximab anti Epidermal
-

( EPs)
Growth -
WOF :
extrapyramidal syndrome
Factor

Receptor 1 . Phenothiazine

a.
Chlorpromazine
-
WOF : corneal deposits
Trastuzumab =
anti -
CA b .
Thioridazine -
WOF : retinal deposits
if (f) Her 2- neu C. Flu phenazine
lgenepdti breast
(A
)
2.
Butyrophenone US .
MANIC

Huntington's dse
Haloperidol
us
a.
-
.

V5 .
syndrome
Tourette 's
 * Endocrine ↑ Prolactin
WOF : Neuroleptic malignant syndrome
:

4) amenorrhea
Fever >
Dopamine
( t) infertility
=
prolactin inhibiting
Encephalopathy
>

hormone
Vital unstable
signs =
IDA
Psychosis
→

Elevated creative kinase

↓_ DA
Antipsychotic →

Rigidity .
-

.↓DA=_↑ Prolactin

DOC : Dantrolene

Diazepam III. Mood Disorder

b.
Proper idol A. Basic Concept

C.
Atypical antipsychotic r mood Is .
Affect
-

pervasive feeling - external expression

-

MOA :
51ft >> DA
antagonist
-

experienced internally of mood

↓
-

Negative symptoms
wot : metabolic ADE -
Spectrum
-

elevated / irritable expansile mood

^
mania →
persistently 11 week)
1.
Clozapine Hypomania → 14 days)
that
antipsychotic
↓ suicide risk
only neuthymia
-

Dystonia 12 yrs)
WOF
agranulocytosis
-
:
Disorder)
MDD ( major Depressive
Depression
=

2.
Olanzapine
-

WOF :
overweight B. MDD

Symptoms
:
3. Quetiapine Sleep changes
"
for
"
sedation time
quiet ≥ g. weeks Interest ↓
-

Guilt

4. Risperidone Energy loss

intractable difficulty
-

vs.
hiccups Concentration

=
WOF : ↑
prolongation Appetite changes
Psychomotor disturbances
5. Ziprasidone Suicidal ideation
= WOF : QT Prolongation if ECG

Theory
:#
:
;
NE
SHT
6. Aripiprazole u
DA
-

partial Dz Agonist
( selective serotonin Inhibitor)
-
least sedating atypical antipsychotic 1 .
SSRI Reuptake
-
1st line vs .
MDD

D. WOF : ✓ Fluoxetine
-
Kabataan

di blockade ✓ sertraline
orthostatic
hypotension
>

"
Wonderland ✓ citalopram
"

* ANS
anti muscarinic
Alice in

✓ Escitalopram
* withdrawal syndrome
CNS estra
pyramidal symptom Serotonin
'
WOF :
]
-
-

> Akathesia -
restlessness note: slow onset > switch drugs
muscle contraction
> Acute dystonia persistent Serotonin
-

syndrome mitoinh
-

Ephedrine
> Tardive dyskinesia
-

repetitive involuntary movement SSRI +

Drugs that TSHT
inh
Reuptake
.

(t ) Fever (t) Diaphoresis

 (f) Agitation G)
Hyperreflexia a. Lithium -

1st line

(t ) tremors -0
MOA :
recycling of IP
-

Pharmacokinetic Food ↓
cyproheptadine SHT absorption
-

WTD :
= :

↑Vd = intracellular
"
Traditional
"
2. antidepressants 1st Gen Guanelhidine WOF :
-

Guanadrel

Amphetamine at usual dose : N&V ,

diarrhea
Ephedrine
inhibitors
reuptake
Tyramine
a. NE
Angiotensin
# at toxic dose : neuromuscular
↳
Tricyclic antidepressant NERI ↑
excitability
'

cocaine
TCA
=
siezure → coma

Recall : WTD :
NEO N ⊖ release GG Hemodialysis
release #

Etan
↑"
" -

idiosyncratic effects :

① reuptake NCT

✓ thyroid enlargement
✓ Ebstein
anomaly
÷ low location of
→

Abnormally
-

post valve
tricuspid
i. e.
Imipramine =
vs. enuresis ( bet wetting )
¥ ↑ Li -

_ ↓ Na

Amitriptyline Thiazide & NSAIDs

'

↑↑ Li
body
. .

①
s Li clearance

WOF :

[affinity convulsion
b. Valproic acid
, carbamazepine

b. Tetracycline antidepressant IV Anxiety disorders

i. e.
Mirtazapine
Bupropion
→ -
NE / DA
reuptake A. Basic Concept
cessation
smoking
-

Fear Anxiety
-

Is

C. Nonselective MAO Inhibitors known unknown

recall : Moclobemide external internal

Phenazine definite
vague
}
"

Isocarboxazid "
Pit of despair
+ Generalized (GAD) ≥ 6 months
ranylcypramine *
anxiety disorder

Selegiiine * disorder ( OCD)

obsessive-Compulsive
↓
"
recurrent
"
" repetitive
3 .

2nd Generation antidepressants thought impulses behavior

i. e. Trazodone : acts on multiple SHT

receptors * Panic attack

* specific phobia
4. Others

SNRI (serotonin / NE reuptake inhibitor) WTD : sedative hypnotics

-

a.

↓ ↓
i. e. Duloxetine " "
"
"

Katrina tulog
venlafaxine

b. RIMA ( Reversible Inhibitor of MAOA)

B-
i. e. moclobemide Benzodiazepines
MOA : ↑
Frequency of a- channel activity
C. Disorder A- :
Flumazenil
Bipolar Mania 1-
depression
= ×

WTD : mood stabilizer

 1. Short -

acting III. Seizures

i. e. midazolam Triazolam
,

( Dormicumr) A. Basic concepts

-

For initiation & maintenance of sleep

abnormal FINITE episode
WOE :
anterograde amnesia
frothy
-

electrical >
of brain = seizure
discharge dysfunction

2- Intermediate acting
-

i. e. *
Lorazepam -

1990s epilepsy
≥ 2 unprovoked seizure

Alprazolam
SEIZURE
clonazepam
For insomnia
'
-

For Seizures
-

Partial Generalized
WOF : anterograde amnesia
part of
the brain
-

entire brain
-
-

( both hemisphere )
1 ↳ complex
* Generalized tonic clonic
simple
-

A) loss of consciousness
3-
Long acting
" "
Grandma ,
-

f) loss of consciousness
i. e. ( Valium
Diazepam * Absence
"
Petit ma
"

N des
methyl diazepam
→
oxazepam blank stares
-
-
.

date
Flunitrazepam / Rohypnol opisthotones
=

rape drug * Tonic

-

seizure

12
'

Chlordiazepoxide -

longest 0TH ,

# Problems :
↓ GABA
*
Myoclonic -
isolated jerky
C. Barbiturates ↑NaᵗtCA " ↑ Glutamate movement

B
↑ duration of
opening of chloride channel
Drugs
-

1- 1 Classical / Traditional anticonvulsants

Ultra -
short acting .

i. e. thiopental
TI "
-

very lipophilic summary

: Nat cast GABA Glutamate
sulfur
"
,

Fast 0A , short DOA

Phenytoin ✓
-

For induction of Anesthesia ✓ ✓

carbamazepine
-

i i
Phenobarbital ✓

Valproic acid ✓ ✓
2. short acting
-

i. e. Pentobarbital
Hexobarbital a.
Phenytoin
Seco barbital - slow 0A but 100% BA

pre op
-
sedative for pheochromocytoma
-

crystallize in the muscle

↓ : ✗ wl Dextrose
give
.

tumor in the adrenal medulla

✗ IM
↑ EPI

TBP sweating used

partial seizure
-

us
THR ,
,
.

Amo barbital / need for adjustment

3. Intermediate i. e. WOF Nystagmus dose
-

: no

Phenobarbital
4. Long acting i. e.
diplopia ( adjust dose)
-

↳ vs . Gilbert syndrome gingival herplasia

Insomnia inducer
Enzyme
-

status epilepticus
overdose b- Carbamazepine
Amphetamine
D. Other t
lipophilic
agents
-

-
auto induction
i. e. Insomnia
Zolpidem
-

us .

Buspirone 5HTia partial agonist DOC

trigeminal neuralgia
-

us
-

anxiolytic
 WOF :
diplopia C. Clinical Uses

SJS

✓ monotherapy
agranulocytosis
✓ start low slow
aplastic anemia ,
go
✓ Partial seizure
ENZYME inducer Phenytoin
-

Valproic
c. Phenobarbital
carbamazepine
Kunti ✓ Generalized seizure Valproic
tfwede 's
-
sa

☒
wede sa kata carbamazepine
protein
-

bound Ethosuximide

d. Valproic acid ✓ status Epilepticus ≥ 30 mins

-

100% BA WTD :
Diazepam / Lorazepam
-

-
1ˢᵗ line vs generalized seizure others :
phenobarbital
WOF :
hepatotoxicity Phenytoin
-

acid
teratogenic neural defect Valproic
→
tube
" "
spina bifida

ENZYME Inhibitor III. Parkinson 's disease

Ethosuximide A. Basic
e.
concept
"
MOA : ↓ Ca current in thalamus

:
absence PD of dopaminergic
DOC vs seizures
degeneration the
. =

neuron in the substantia nigra ÉBz

↓
2. Newer
Agents Dopamine
Gabapentin Tremors
a.
,
prebagalin
-
GABA analogue Rigidity
A kinesics
neuropathic pain
-
us .

↳ postural instability
postherpetic pain
varicella zoster virus
shuffling gait

( inhibitory)
b. Lamotrigine Recall :
GABAergic neurons

¥
-
for pregnant
-

MOA : vs Nat , Cast Glutamate

, CPD)
.

☐A
-
WOF : SJS
Acetylcholine

c. Levetiracetam lkeppra ) # Goals :

± Dopamine
-

MOA : binds synaptic vesicular protein 2A

± Acetylcholine
-

Not metabolized by CYP 450

to w/ comorbid / medication
given px multiple B.
Drugs
-

had seizure
who suddenly
-
WOF
'

Psychosis 1 .

Levodopa
-

Carbidopa ( sinemet
IT
w/o vomiting

(
d. Topiramate Levodopa >
Levodopa
Nat Cast Glutamate GABA ↓ decarboxylase
{
Dopa
'
- MOA : us .
,
,
,
carbidopa
Dopamine
-

us . Childhood epilepsy
WOF Peripheral
- :
kidney stones
decarboxylase BBB
 WOF off 1 Inhalation at
wearing
:
-

phenomenon .

MOA : ↑
Firing threshold = ↓ neuronal
activity
Agonists activate K' current
-

2. Dopamine hyperpolarization
→

a. Ergot derivative

concentration)
-

Bromocriptine I
Pergolide MAC ( minimum Alveolar

Cross BBB ✓ measure of Potency

to
DOA that ⊕ pain
longer ✓ Conc response
-
.

- WOF : ± prolactin in 50% of population

erythromelalgia
↑ MAC , ↓
Potency
b. Non ↓ MAC , ↑ Potency
ergot
-

Ropinirole ,
Pramipexole
-

smooth out fluctuations in

levodopa -
G. Nitrous oxide

Carbi
-

Fast 0A
response
Least toxic
hyper sexuality
WOF :
-

compulsive gambling
-
Least potent
=

Highest MAC

"
WOF
Laughing
"
:
-

gas
3- that ↓
Drugs enzymes megaloblastic anemia

a. MA Ops inhibitors

i. e. selegiline b. Desflurane

Note : no diet restrictions -

no 00 , ≈ toxicity
( ok to eat tyramine ) WOF : bronchospasm
-

c. Sevoflurane
"
b. inhibitors
"
COMT -
sweet smell

i. e.
Entacapone -

metabolized to compound A

Tokapone
WOF : urine d. Isoflurane
orange
preferred in 77
surgery
-

4. Amantadine WOF : steal phenomenon

-

coronary
-

can also ↑
Dopamine recall : ↳ also seen in

Dipyridamole

↑Ñgp§
-
anti -

influenza ; ;
- WOF :
lived ◦ reticular:S
! !
; :
Psychosis C
!
abnormal BV
normal BV

↑ dilation :

s .

Anticholinergic s ↑ blood

Biperiden us EPs
-
.

Benztropin e. Enflurane

Trihexiphenidyl -

contraindicated in labor
-
WOF : uterine contraction

VI. Anesthesia Malignant Hyperthermia

WTD : Dantrolene

A- General -

reversible loss of consciousness

f.
I
Analgesia Methoxyflurane
I
Stages / Excitement Most
potent Lowestm
=

Euphoria
-

II
surgical anesthesia -

Nephrotic
#
medullary paralysis
→ coma
 2. Intravenous ESTER / Ii ) Is AMIDE I > ti )

a. Barbiturates & Benzodiazepine * Benzocaine * Lidocaine

↓ ↓ -
oral = # 1-
Diazepam spray
Thiopental
WOF :-O reflex -

antiarrhythmic
-

sulfur gag
a- s ↑
aspiration ( class 1- B)

tox
us Digoxin
-

b. Ketamine * cocaine -
WOF : seizures

MOA : block vasoconstriction

glutamate at NMDA
receptor
:

WOF : Dissociative Anesthesia * Bupivacaine

( t) analgesia * Tetracaine -
most cardiotoxic

It) amnesia WTD : Fat emulsion

most
allergenic
-
=

( t) catatonia

WTD ? pre-treatment Benzodiazepine *

Ropivacaine
'
12
longest
-

c.
Propofol -

1% emulsion
" "

milk emulsion
" "

Gastrointestinal
milk of Amnesia
Drugs
-

prolonged sedation

WOF : triglycerides I. Acid -

related disorders

d. Dexmedetomidine ( Preceded * GERD / Gastroesophageal reflux disease

✗
agonist ✓ heartburn
-

✓ acid regurgitation
e.
Opioids =
mainly adjuncts
✓ Neurolept * ulcer
Peptic disease =

Endoscopy
Anesthesia # 1 Helicobacter Pylori
Analgesia
#
Dro peridot Droperidol 2 NSAIDs

Fentanyl Fentanyl
Nitrous oxide recall : Éi

B. Local
÷ : >

1%-0
proton pump
Ht K' ATPase
_

= intro consciousness

MOA : Nat Channel Blocker A. PPI 1- prazole)

CNS stimulation i.
WOF depression Omeprazole
>
: e.

f) ino
Esomeprazole
f) dromo

µ, cnn.no
} Vasodilation Except Cocaine
GOA : N -
MOA !
Pantropazole
irreversible ⊖ Ht K+ ATPase
cocaine -
↓ basal & stimulated Ht secretion

ESTER / Ii ) Is AMIDE l > ti ) T -

30 mins pre
-
breakfast
liver ① reuptake also if
hydrolyzed plasma Ellison
syndrome
=

Zollinger
-

used -

shorter 12 ↓
'

vasoconstriction
'
12
longer i. -

Enzyme inhibitors
Gasnoma_
↑ Gastrin ↑ At
* Procaine

1st
-

synthetic
12
'
-

shortest
 Hz Osmotic H2O
Receptor antagonist
B. ↑
=
portion
i. e. Lactulose

↳ also used
1+201+20 us

cimetidine
Ranitidine Famotidine
.
-

, , HO

1- Hepathic encephalopathy
→
Hao

↑ SIE H2O
↓ DII

↓ basal secretion of Ht

at bedtime stimulant Senna

given
-
=

( Dulcolax
Bisacodyl
C. Mt blockers Castor oil
i. e.
Pirenzepine
recall :
telenzepine Stool softener =
Ducosate sodium

III. Diarrheal

D. Antacids - ↓
consistency
↑
Frequency
MOA : neutralization -

usually viral -

Rotavirus ,
Norovirus

i. e. ✓ bacteria
Systemic Nonsystemic E. coli
-

Naltcoz At 1011-13

Mg( OH)z Problem :

Dehydration
WTD : Hydration ORS I :|
-

E. Mucosal Protestants Zinc

supplement
probiotic -
Bacillus clausii ( Erceflora
i. e. antidiarrheal #

Rebamipide ( mucosta) Loperamide

↳
*
+ T MUCUS
MOA : > COX >
↑ PG =
+ Heo, lcytoprotectio) Diphenoxylate
Atropine
* Bismuth sub
salicylate Racecadotril ( Hidrasec)
WOF : black tongue
black stools

* sacral fate = Sucrose ⊕ Aluminum

* Alginate
= mucus
layer

III. Constipation

↓ stool Frequency < 3✗ /week

↑ hardness

straining
incomplete evacuation

Bulk -

forming =
↑ H2O portion → ↑ bulk

=
Fiber

i. e.
Psyllium