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Drug mnemonics; by RxVichuZ! ;)

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...and this is my 100th powerpoint.....!!
Sincerely thanking everyone who have supported me in my journey till now :) :)

This powerpoint deals with drug mnemonics, easy to remember mnemonics, that can be helpful for easy memory of some aspects of Pharmacology!!

Happy reading!!

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Drug mnemonics; by RxVichuZ! ;)

  1. 1. PRESENTED BY: (DR.) VISHNU.R.NAIR, PHARM.D INTERN(AMRI HOSPITAL ACADEMIC TRAINEE), NATIONAL COLLEGE OF PHARMACY, KOZHIKODE, KERALA.
  2. 2.  Pharmacology  one of the most difficult subjects in medical science!  Along with newer drugs that get approved each year  remembering the older ones  poses a significant impediment in the path of smooth memory!  Use of easy-to-remember mnemonics  helps in the following: - Easy interpretation - Easy memorizing - Contributes to smart work!  Hence this powerpoint  aims at presenting some clinically relevant drug mnemonics, that may be worthwhile for some! HAPPY READING!!
  3. 3. GENERAL PHARMACOLOGY
  4. 4. To remember the names of drugs that undergo first-pass metabolism Remember the code: “Nitrates Have Large Pre Systemic Metabolism” Nitrates Morphine Salbutamol Propranolol Lignocaine Hydrocortiso ne
  5. 5. To remember the relevance of protein binding of drug Remember the code “DDDD(4D)” PPB: Plasma protein binding. Duration of action: Drugs with high PPB  Long-acting! Dialysis: Drugs with high PPB  Can’t be removed by dialysis! Displacement: A high PPB drug  can displace another high PPB drug! Distribution: Drugs with high PPB  stay in plasma  low distribution!
  6. 6. To remember the names of drugs, which cannot be eliminated by dialysis Remember the code “AVOID Dialysis” Amphetamines Digitalis Imipramine Diazepam Organophosph ates, opioids Verapamil
  7. 7. To remember the names of prodrugs Remember the code: “All Prefer Doing MD In Clinical Subjects” *Except captopril & lisinopril ACE- inhibitors* Sulfasalazine Cyclophosphamide, carbimazole, clopidogrel Irinotecan, INH Dopamine precursor(L- dopa) Mercaptopurine , Methyldopa, Minoxidil Dipivefrine Prednisone, Proguanil, PPIs
  8. 8. To remember the names of drugs/substances that are enzyme inducers Remember the code: “GPRS Cell Phone” *Carbamazepine Griseofulvin CBZ* Phenobarbitone Smoking(Nic otine)Rifampicin Phenytoin
  9. 9. To remember the names of drugs that cause enzyme inhibition Remember the code: “Vitamin K Cannot Cause Enzyme Inhibition” *Isoniazid Valproate Ketoconazole INH* ErythromycinCiprofloxacin Cimetidine
  10. 10. To remember the names of drugs metabolized by CYP3A4 enzymes Remember the code: “CT-SCAN” Cyclosporine, CCBs Tacrolimus, terfenadine Statins Cisapride Astemizole, amiodarone Navirs(Protease Inhibitors)
  11. 11. To remember the names of drugs that require TDM(Therapeutic Drug Monitoring) Remember the code: “A Drug Possessing Low Therapeutic Index” *Tricyclic antidepressants Aminoglycosides Immunomodulators(Cyclo sporine) TCAs*LithiumPhenytoinDigoxin
  12. 12. To remember the drugs that cause SLE Remember the code: “SHIP” *Hydrochlorothiazide causes SLE(as published in American Journal of Case Reports, 2019) Sulfonamides Hydralazine, Hydrochlorothiazide* Isoniazid Procainamide
  13. 13. To remember the names of drugs that cause hemolysis in G,6-PD(Glucose-6-phosphate dehydrogenase deficiency) patients Remember the code : “PINS MCQ” *Nitrofurantoin Primaquine Quinine Chloroquine Menadione Sulfonamides NTU*, Nalidixic acidIsoniazid
  14. 14. AUTONOMIC NERVOUS SYSTEM
  15. 15. To remember the names of drugs used in overactive bladder Remember the name “SOFT BladDAR” Solefenacin Darifenacin Tolterodine, trospium Flavoxate, fesoterodine Oxybutynine
  16. 16. To remember the contraindications of non-selective beta-blockers Remember the code : “ABCD” *Congestive Heart Failure ** Diabetes Mellitus Asthma DM**CHF*Block(AV)
  17. 17. To remember the names of cardioselective beta-blockers Remember the code: “New Beta Blockers Acting Exclusively At Myo Cardium” *Nebivolol  most cardioselective beta-blocker Nebivolol* Betaxolol Bisoprolol Acebutolol Esmolol Atenolol Metoprolol Celiprolol
  18. 18. To remember the names of beta-blockers that can be safely used in patients prone to severe bradycardia Remember the code: “COntain Partial Agonistic Activity” Celiprolol Oxprenolol Pindolol, penbutolol Alprenolol Acebutolol
  19. 19. To remember the beta-blockers that possess anti-arrhythmic activity Remember the code “Possess Membrane stabilizing or Local Anesthetic Property” *Propranolol  shows maximum antiarrhythmic activity. Propranolol* Metoprolol Labetalol Acebutolol Pindolol
  20. 20. To remember the names of lipid-insoluble beta-blockers Remember the code: “Not Soluble ABC” *Nadolol  longest-acting beta-blocker(Esmolol is shortest acting) Nadolol* Celiprolol Betaxolol, bisoprolol Atenolol, acebutolol Sotalol
  21. 21. AUTACOIDS
  22. 22. To remember the anti-cholinergic uses of H1-antihistaminics Remember the code: “Possess Anti Cholinergic Properties” Parkinsonism Prophylaxis of motion sickness Common cold Acute muscular dystonia
  23. 23. To remember the uses of Colchicine Remember the code: “SLUM” *Colchicine  indicated for prophylaxis of recurrent attacks of gouty arthritis. Sarcoid arthritis Mediterranean fever Uric acid elevation* Liver cirrhosis
  24. 24. CARDIOVASCULAR SYSTEM
  25. 25. To remember the contraindications of digoxin Remember the code: “Contraindicated IN Weak HEART” * Wolff-Parkinson-White Syndrome ** Both hypothyroidism and hyperthyroidism. Carditis Thyroid dysfunction** Hypokalemia, hypomagnesemia Renal failure AV block(partial) Elderly WPW syndrome* Increased calcium
  26. 26. To remember the properties of ACE-Inhibitors Remember the code: “CAPTOPRIL” * Except captopril & lisinopril ** Especially when combined with diuretics C: Cough P: Pregnancy(contraindicated!) A: Angioedema R: Renal artery stenosis(contraindicated!) P: Prodrugs* Increased K+ (contraindicated!) T: Taste disturbances Lower the formation of Angiotensin-II (Mechanism of action) O: Orthostatic hypotension**
  27. 27. To remember the names of Class-III antiarrhythmics Remember the code: “BInDAS” Bretylium SotalolAmiodarone Dofetilide, dronedarone Ibutilide
  28. 28. To remember the adverse effects of amiodarone Remember the code: “The Periphery of My Lung Liver and Cornea is Photosensitive” Thyroid dysfunction Peripheral neuropathy Myocardial depression Lung fibrosis Liver toxicity (cirrhosis) Corneal microdeposits Photosensitivity
  29. 29. To remember the special features of pravastatin(compared to other statins) Remember the code: “5 MINIMUMs” *Pravastatin  metabolized by non-microsomal enzymes  lesser risk of drug interactions! ** Food  increases absorption of all statins except pravastatin! Minimum drug interactions* Minimum food interactions** Minimum risk of myopathy Minimum CNS penetration Minimize (decrease) fibrinogen level
  30. 30. To remember the drugs that cause gynecomastia Remember the code: “DISCO” Other drugs that cause gynecomastia include “Ketoconazole” & “Anti-testosterones”! Digitalis INH Oestrogens Cimetidi ne Spironola ctone
  31. 31. ENDOCRINE SYSTEM
  32. 32. To remember the indications of somatostatin analogs Remember the code: “SOMATOStatin” Secretory diarrhea Overdose of sulfonylureas TSH- secreting adenoma Acromegaly Malignancy(Islet cell tumors) Oesophageal varices
  33. 33. To remember the indications of bromocriptine Remember the code “DOPAMINe” Diabetes Mellitus(Type II) Acromegaly Milk secretion inhibition(suppression of lactation) Parkinsonism Oversecretion of prolactin
  34. 34. To remember the risk factors for developing lactic acidosis with metformin therapy Remember the code: “LAURELS” Liver disease Alcoholics Severe hypoxemia Unstable CHF Renal dysfunction Elderly Lactic acidosis history(or any form of acidosis)
  35. 35. To remember the adverse effects & contraindications of steroids Remember the code: “GLUCOCORTICOIDS” G: Glaucoma(on topical use) T: Tuberculosis* L: Limb muscle atrophy I: Impaired healing U: Ulcer(Peptic Ulcer) C: CHF(Contraindicated!) C: Cushing syndrome O: Oedema O: Osteoporosis(contraindicated!) I: Infections(owing to immunosuppression) C: Cataract(on systemic use) D: Diabetes mellitus O: Osteonecrosis(avascular necrosis) S: Suppression of HPA-axis R: Renal failure(contraindicated!) *Corticosteroids are contraindicated in ileo-caecal TB!
  36. 36. To remember the protective effects of tamoxifen Remember the code “BBB(TRIPLE B)” Bone(reduces bone resorption) Blood(reduces LDL & increases HDL) Breast(prevents breast carcinoma)
  37. 37. To remember the indications of Mifepristone Remember the code: “MIFEPRIStone” Meningioma Induction of abortion Fibroid Endometriosis Progesterone receptor positive breast cancer Increased steroids(Cushing Syndrome)
  38. 38. To remember the non-contraceptive protective effects of oral contraceptives Remember the code: “Other BENEFITS” Other: Ovarian cyst F: Fibroids B: Benign breast disease I: Iron-deficiency anemia E: Ectopic pregnancy T: Tension(Pre-menstrual tension syndrome) N: Neoplasia(ovarian, endometrial, colon cancer) S: Skeletal benefits(RA & Osteoporosis) E: Endometriosis
  39. 39. CENTRAL NERVOUS SYSTEM
  40. 40. To remember the drugs that are contraindicated in porphyria Remember the code: “SEVERE PORPHYriA” *Also other barbiturates like thiopentone. S: Sulfonamides P: Phenobarbitone* E: Erythromycin OR: Oral contraceptives V: Valproate acid P: Phenytoin E: Ergot alkaloids HY: Hydralazine R: Rifampicin A: Alcohol E: Estrogens
  41. 41. To remember the names of short-acting benzodiazepines Remember the code: “LOT*” *Estazolam is also a short-acting benzodiazepine Lorazepam TriazolamTemazepamOxazepam
  42. 42. To remember the adverse effects of phenytoin Remember the code: “MILK OATH” M: Megaloblastic anemia O: Osteomalacia I: Inhibition of insulin release(hyperglycemia) A:Ataxia, arrhythmias L: Lymphadenopathy T: Teratogenicity K: Vitamin “K” deficiency H: Hirsutism, hypertrophy of gums.
  43. 43. To remember the adverse effects of valproate Remember the code: “VALPROATE” V: Vomiting O: Obesity A: Alopecia A: Agranulocytosis L: Liver damage T: Tremors P: PCOD, Pancreatitis E: Epigastric pain R: Rash
  44. 44. To remember the uses of anti-psychotics Remember the code: “ANTI PSY-CHO-TIC” Anti-emetic Psychosis Tic disorders (Gilles de la Tourette syndrome) Chorea
  45. 45. To remember the indications of antidepressants Remember the code: “DEPRESSION” D: Depression S: Smoking cessation(bupropion) E: Enuresis(imipramine) S: Stress disorder(Post-traumatic) P: Phobia I: Impulse disorder(Kleptomania) R: Recurrent panic attacks O: Obsessive compulsive disorder E: Eating disorder(bulimia) N: Neuropathic pain
  46. 46. To remember the drugs that cause disulfiram-like reaction Remember the code: “Cyclic-GMP” Cefoperazone CefomandoleChlorpropamideCefotetan Griseofulvin Metronidazole, moxalactam Procarbazine
  47. 47. To remember the names of drugs that reduce alcohol craving Remember the code: “None Of The Above” Naltrexone Ondansetron Topiramate Acamprosate
  48. 48. ANAESTHETICS
  49. 49. To remember the names of local anesthetics that cause methemoglobinemia Remember the code: “BPL” *Prilocaine has maximum risk of causing methemoglobinemia Benzocaine Prilocaine* Lignocaine
  50. 50. To remember the properties of halothane Remember the code: “HALOTHANE CCC” H: Hyperthermia(malignant hyperthermia) H: Heart(cardio depressant activity  reduces C.O) A: Arrhythmias(sensitizes heart to adrenaline A: Asthma(bronchodilator) L: Liver toxic NE: Non-Explosive O: Orthostatic hypotension C: Chills(Post- anesthetic shivering) T: Tocolytic C: Children(Safe in children)
  51. 51. To remember the names of inhalational anesthetics that can cause seizures Remember the code: “SEIzure” *Enflurane  maximum potentiality to precipitate seizure! Sevoflurane IsofluraneEnflurane*
  52. 52. To remember the properties of ketamine Remember the code: “KETAMINE” *Hallucinations, illusions, vivid dreams, etc. observed while recovery from anesthesia ** Responsible for dissociative anesthesia *** Maximum analgesic property among all anesthetics! K: Kids(i.v anesthetic of choice in children) M: Meals(can be given in full stomach) E: Emergence reaction* I: Increases all pressures (ICT, IOP, BP) T: Thalamocortical junction(site of action)** N: NMDA antagonist A: Analgesic*** E: Excellent for asthmatics
  53. 53. To remember the drugs useful for day care surgery Remember the code “Dr. Manmohan Singh Is A Prime Minister” *Benzodiazepine Dr. : Desflurane A: Alfentanil Manmohan: Midazolam(BZD)* Prime: Propofol Singh: Sevoflurane Minister: Mivacurium(Muscle relaxant) Is: Isoflurane
  54. 54. HEMATOLOGICAL SYSTEM
  55. 55. To remember the causes of megaloblastic anemia Remember the code : “Prime BATSMAN” *Also folic acid deficiency! Prime: Primidone, phenytoin S: Sulfasalazine B: B-12 vitamin deficiency* M: Metformin A: Alcohol A: Antifolates(methotrexate, pyrimethamine, proguanil) T: Trimethoprim N: Nitrous oxide
  56. 56. ANTIBIOTICS
  57. 57. To remember the names of antibiotics that can be safely used in renal disease Remember the code: “DANCER*” *Lincosamides(clindamycin) are also safe in renal disease! D: Doxycyline C: Cefoperazone, ceftriaxone A: Ampicillin E: Erythromycin N: Nafcillin R: Rifampicin
  58. 58. To remember the names of acid-resistant penicillins Remember the code: “VODKA” Penicillin V Oxacillin Dicloxacillin Cloxacillin Amoxicillin, ampicillin
  59. 59. To remember the names of anti-pseudomonal penicillins Remember the code: “CT-MAP” Carbenicillin Ticarcillin Mezlocillin Azlocillin Piperacillin
  60. 60. To remember the principal indications of Penicillin ‘G’ Remember the code: “LASTMAn” *Non-penicillinase producing **Ciprofloxacin can also be considered as 1st line choice. Leptospira Actinomyces Streptococcus, Staphylococcus* Treponema, Tetanus Meningococcus Anthrax**
  61. 61. To remember the indications of tetracyclines Remember the code: “RBC In PLASMA” R: Rickettsia, relapsing fever L: LGV(Lymphogranuloma venereum) B: Brucellosis A: Atypical pneumonia C: Cholera, chlamydia S: SIADH In: Inguinale(granuloma) M: Malaria P: Plague, peptic ulcer, pleurodesmosis A: Amoebiasis.
  62. 62. To remember the adverse effects of tetracyclines Remember the code: “KAPIL DEV” *All tetracyclines are contraindicated in kidney dysfunction except minocycline. K: Kidney failure* L: Liver toxicity(hepatic necrosis) A: Antianabolic effect D: Dentition & bone defects P: Photosensitivity(maximum with demeclocycline) E: Expired drugs  can cause Fanconi’s syndrome I: Insipidus(diabetes insipidus, maximum with demeclocycline) V: Vestibular dysfunction(maximum with minocycline)
  63. 63. To remember the principal indications of macrolides Remember the code : “CLAW” *Azithromycin single dose is given. C: Chancroid* by hemophilus ducreyi, Corynebacterium(diphtheria) & campylobacter A: Atypical pneumonia L: Legionella infections W: Whooping cough(by Bordetella pertussis)
  64. 64. To remember the common indications of azithromycin & clarithromycin Remember the code: “CHAT” C: Chlamydia A: Avium complex(MAC) H: H.influenzae T: Toxoplasma.
  65. 65. To remember the adverse effects of macrolides Remember the code: “MACRO” *Motilin receptor agonism  leads to diarrhea Motilin receptor agonism* Allergy Reversible ototoxicity Cholestasis
  66. 66. To remember the indications of clindamycin Remember the code: “PACT” P: Pneumocystis jiroveci, plasmodium parasite C: Cocci(Gram +ve) A: Anaerobes T: Toxoplasma gondii
  67. 67. To remember the chief indications of co-trimoxazole Remember the code: “Punjab National Bank” Pneumocystis Burkholderia cepacia Nocardia
  68. 68. To remember the adverse effects of sulfonamides Remember the code: “ABC RASH” *Most common adverse effect **In G-6-PD(Glucose-6-phosphate dehydrogenase) deficient patients. A: Aplastic anemia R: Rash* B: Bilirubin displacement(kernicterus) AS: Acetylation leads to SLE C: Crystalluria H: Hemolysis**
  69. 69. To remember the antibiotics that are effective against anaerobes Remember the code: “Cyto Megalo Virus(CMV)” N.B: Trovafloxacin was also active against anaerobes, but the drug is banned now. C: Clindamycin, cefmetazole, cefotetan, cefoxitin, chloramphenicol M: Moxifloxacin, metronidazole V: Vancomycin
  70. 70. To remember the names of substances that cause “ototoxicity” Remember the code: “DEAFNESS Causing Vital Medicines” D: Diclofenac S: Salicylates E: Ethacrynic acid S: Smoking A: Aminoglycosides Causing: Cisplatin F: Furosemide Vital: Vancomycin, vinblastine N: Nitrogen mustards Medicines: Malarial drugs(quinine) E: Erythromycin
  71. 71. ANTI-VIRALS
  72. 72. To remember the anti-virals that are effective against both HBV & HIV viruses Remember the code: “LET” L: Lamivudine E: Emtricitabine T: Tenofovir
  73. 73. ANTI-TUBERCULARS
  74. 74. To remember the names of aminoglycoside antitubercular drugs Remember the code: “SACK” Streptomycin KanamycinCapreomycinAmikacin
  75. 75. To remember the names of Group 1 antitubercular drugs* Remember the code: “RIPE” *Based on RNTCP guideline-associated classification. Rifampin EthambutolPyrazinamideIsoniazid
  76. 76. ANTI-MALARIALS
  77. 77. To remember the names of fast-acting erythrocytic schizonticides Remember the code: “Mango ACHAR”** **Also lumefantrine, piperaquine. Mango: Mefloquine H: Halofantrine A: Atovaquone, amodiaquine A: Artemisinins C: Chloroquine R: Res-Q(Quinine)
  78. 78. To remember the uses of chloroquine Remember the code: “REDMI-LPG” R: Rheumatoid arthritis I: Infectious mononucleosis E: Extraintestinal amoebiasis L: Lepra reaction D: Discoid lupus erythematosus P: Photogenic reactions M: Malaria G: Giardiasis
  79. 79. DRUGS FOR AMOEBIASIS
  80. 80. To remember the preferential indications of metronidazole Remember the code: “GUPTA” G: Giardiasis, gardernella vaginalis(bacterial vaginosis) T: Trichomoniasis U: Ulcer(H.pylori-associated peptic ulcer disease) A: Amoebiasis, anaerobic bacteria(bacteroides, clostridium) P: Pseudomembranous colitis, induced by Clostridium difficile
  81. 81. ANTI-FUNGALS
  82. 82. To remember the adverse effects of Amphotericin-B Remember the code: “AMPHOTERICIN-B” A: Anemia R: Respiratory stridor M: Muscle spasms I: Increased temperature(fever) P: Phlebitis C: Chills H: Headache, hypotension, hypokalemia I: Immediate hypersensitivity(anaphylaxis) O: Ototoxicity N: Nephrotoxicity T: Thrombocytopenia E: Emesis, encephalopathy B: Bronchospasm
  83. 83. ANTI-CANCERS
  84. 84. To remember the uses of methotrexate Remember the code: “Inhibit CANCER” Inhibit: Immunosuppressant C: Choriocarcinoma C: Crohn’s disease E: Ectopic pregnancy A: Abortion R: Rheumatoid arthritis(RA) N: Non-Hodgkin’s lymphoma(NHL)
  85. 85. To remember the uses of rituximab Remember the code: “ReLIANCe” Re: Rheumatoid arthritis A: Autoimmune hemolytic anemia L: Lupus(SLE) N: Non-Hodgkin Lymphoma I: ITP(Idiopathic thrombocytopenic purpura) Ce: CLL
  86. 86. To remember the tyrosine kinase inhibitors used for CML** Remember the code: “BIND Proteins” ** Chronic myelogenous leukemia. B: Bosutinib D: Dasatinib I: Imatinib Proteins: Ponatinib N: Nilotinib
  87. 87. To remember the names of tyrosine kinase inhibitors used for NSCLC** Remember the code: “Operate After ECG” **Non-small cell lung cancer Operate: Osimertinib C: Crizotinib, ceritinib After: Afatinib, alectinib G: Geftinib E: Erlotinib
  88. 88. To remember the tyrosine kinase inhibitors indicated in GIST** Remember the code: “SIR”! **Gastro-intestinal stromal tumor Sunitinib RegorafenibImatinib
  89. 89. To remember the tyrosine kinase inhibitors used for RCC** Remember the code : “PASS” **Renal cell carcinoma P: Pazopanib S: Sorafenib A: Axitinib S: Sunitinib
  90. 90. To remember the tyrosine kinase inhibitors indicated for malignant melanoma Remember the code: “Cause DVT” Cause: Cobemetinib V: Vemurafenib D: Dabrafenib T: Trameltinib
  91. 91. THANK YOU!!!
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...and this is my 100th powerpoint.....!! Sincerely thanking everyone who have supported me in my journey till now :) :) This powerpoint deals with drug mnemonics, easy to remember mnemonics, that can be helpful for easy memory of some aspects of Pharmacology!! Happy reading!!

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