Hallucinogen Intoxication

Mnemonic: DISTORT
D -DISTORTED (blurred) VISION
I -INCOORDINATION
S -SWEATING
T -TACHYCARDIA
O -OPENING (dilation) OF THE PUPIL
R -RACING HEART (palpitations)
T -TREMOR

Alcohol Withdrawal

Mnemonic: PAST NITE
P -PSYCHOMOTOR AGITATION
A -ANXIETY
S -SEIZURES (GRAND-MAL)
T -TRANSIENT HALLUCINATIONS OR ILLUSIONS
N -NAUSEA OR VOMITING
I -INSOMNIA
T -TREMOR (hand) INCREASED
E -EXCITABILITY-AUTONOMIC

Alcohol Intoxication

Mnemonic: SAM’S GIN
S -SPEECH SLURRED
A -ATTENTION IMPAIRMENT
M -MEMORY IMPAIRMENT
S -STUPOR OR COMA
G -GAIT UNSTEADY
I -INCOORDINATION
N -NYSTAGMUS

Patient counseling example (beta blocker dose increase for angina)

Oral Antihypertensives

Hypercalcemia causes

Hyperinsulinemia

Insulin Preparations

Antihypertensive Agents for Hypertensive Crises

Parenteral Antihypertensives Used in Hypertensive emergencies

Complications of Malaria

Mnemonic: CHAPLIN
Cerebral malaria/Coma 
Hypoglycemia
Anemia
Pulmonary edema
Lactic acidosis
Infections
Necrosis of renal tubules

Drugs adminstered by Endotracheal tube

Mnemonic: ONAVEL
Oxygen
Naloxone
Atropine
Vasopressin
Epinephrine
Lidocaine

Haemolytic anaemia haematological features

Mnemonic: BLUHR
Biliburin, unconjugated (INCREASE)
Lactate dehydrogenase (INCREASE)
Urinary urobilinogen (INCREASE)
Haptoglobin (DECREASE)
Reticulocytosis and polychromasia

Lymphoma treatment

Hodgkin’s Lymphoma                                          Non-Hodgkin’s Lymphoma
Mnemonic: ABVD                                                Mnemonic: R-CHOP
Adriamycin                                                             Rituximab
Bleomycin                                                              Cyclophosphamide
Vinblastine                                                             Hydroxydaunorubicin
Dacarbazine                                                           Oncovin (Vincristine)
                                                                              Prednisolone

Non-GI Causes of Vomiting

Mnemonic: ABCDEFGHI

Acute renal failure
Brain (Increased ICP)
Cardiac (Inferior MI)
DKA
Ears (labyrinthitis)
Foreign substances (Tylenol, theo, etc)
Glaucoma
Hyperemesis Gravidarum
Infections (pyelonephritis, meningitis)

Serious Complications of Oral Birth Control Pills

Mnemonic: ACHES Abdominal Pain Chest Pain Headache Eye Problems Severe Leg Pain

PDE isoenzymes

Drug induced sexual dysfunction

Decreased sexual desire        ---  CNS depressants and OCPs
Decrease Vaginal lubrication  ---  Antihistamines and Anticholinergics
Erectile Dysfunction               ---  Beta-blockers, TCAs, Dopamine antagonists
Enhanced Erection                 ---  Dopamine agonists
Priapism                                ---  Trazadone
Impair Ejaculation                  ---  Alpha1-blockers, SSRIs

Monoclonal Antibodies

ABciximab: antagonist of IIb/IIIa receptors (antiplatelet)
INFliximab: binds TNF (Rheumatoid arthritis and Crohn disease)
TASTtuzumab: ERB-B2 antagonist (breAST cancer)
PaliVIzumab: blocks respiratory syntycial VIrus

The 2 Mabs used in immunosuppression are: (no mnemonic for these)
Dacliximab: transplants (IL-2 receptor antagonist)
Muromonab: transplants (CD3 antagonist)

Extrapyramidal Symptoms

Mnemonic: DISCO IN THIS INN
4 hrs       -   Acute DYStOnia (DISCO)
4 days    -   AkINesia (IN)
4 weeks  -  AkaTHISia
4 months -  Tardive dyskINesia

Complications of atherosclerosis

Mnemonic: HE-PARTS
Hypertension
Embolism
Peripheral Vascular Disease
Aneurysm -> Rupture
Thrombosis -> Stenosis

Platelet Aggregation Agonists

Mnemonic: PET CAT
Platelet activation factor
Epinephrine
Thrombin
Collagen
Adenosine diphosphate
Thromboxane A2

Antibiotic Mechanisms

Reference: Medpedia

Inhalational corticosteroids

Mnemonic: BBFFT
BECLOMETHASONE DIPROPIONATE
BUDESONIDE
FLUTICASONE PROPIONATE
TRIAMCINALONE
FLUNISOLIDE

Drugs Used in Glaucoma

Mnemonic: AABCDE
Alpha agonist (non-selective) : Epinephrine
Alpha2 agonist : Apraclonidine
Beta blocker : Timolol
Cholinomimetic : Pilocarpine
Diuretic: Acetazolamide, Mannitol
Eicosanoid: Latanoprost

Functions of Interleukins

Mnemonic: Few T Bones Eaten At Arbys Need Seasoning Nowadays
 IL 1 - Fever
 IL 2 - T cell stimulation
 IL 3 - Bone marrow stimulation
 IL 4 - IgE production
 IL 5 - IgA production
 IL 6 - Acute-phase reactant production
 IL 8 - Neutrophil attraction
 IL 10 - Stimulates Th2
 IL 12 - NK cell activation

Drugs that raise Urea levels

Mnemonic: CAN'T LEAP
Cyclophosphamide
Aspirin (low dose)
Nicotine
Thiazides
Loop diuretics
Ethambutol
Alcohol
Pyrazinamide

Sickle cell disease Signs

Mnemonic: SICKLE 
Splenomegaly / Sludging
Infection
Cholelithiasis
Kidney – haematuria
Liver congestion / Leg ulcers
Eye changes

Aspirin overdose – Early symptoms

Mnemonic: DAFT HID
Deafness
Appear flushed
Fever
Tinnitus
Hyperventilation
Increased sweating
Dizziness

Shock: signs and symptoms

Mnemonic: TV SPARC CUBE
Thirst
Vomiting
Sweating
Pulse weak
Anxious
Rapid shallow breathing
Cold, clammy skin
Cyanotic
Unconscious
BP low
Eyes blank

Secondary Hypertension Causes

Mnemonic: CHAPS
Cushing's syndrome
Hyperaldosteronism
Aorta coarctation
Pheochromocytoma
Stenosis of renal arteries

Varicose veins: symptoms

Mnemonic: AEIOU
Aching
Eczema
Itching
Oedema
Ulceration/ Ugly (haemosiderin, varicosities)

Clinical features of anaphylaxis

Mnemonic: S ECG
Skin, 90%
Expiratory wheezing and other respiratory symptoms, 70%
Cardiovascular, 40%
GI and oral, 24%

Hypoxia Signs

Early Signs of Hypoxia                                       Late Signs of Hypoxia
Restlessness                                                           Bradycardia
Agitation                                                                Extreme Restlessness
Tachycardia                                                           Dyspnea
                                                                              Cyanosis

Advantages of doxycycline over other tetracyclines

• High potency
• Completely absorbed from the intestine with no interference by food
• Long plasma half life (T 1/2) of 18 to 24 hours
• Least effect on the normal flora of the intestine
• Less propensity to cause diarrhoea

Theophylline: Drug interactions

Certain drugs inhibit theophylline metabolism, thus increasing blood levels and cause toxicity
Ciprofloxacin
Cimetidine
Erythromycin
Allopurinol
Oral contraceptives

Some others increase theophylline metabolism, decreasing blood levels
Phenobarbitone
Phenytoin
Rifampicin

Smoking and consumption of charcoal boiled meat also increase theophylline metabolism.

Anterior Pituitary Hormones

Mnemonic: FLAGTOP
Follicle Stimulating Hormone
Luteinizing Hormone
ACTH
Growth Hormone
Thyroid Stimulating Hormone
MSH - melanOcyte stimulating hormone
Prolactin

Proteases in the Duodenum

Mnemonic: Eat Tender Chicken Chunks Elegantly
Enterokinase
Trypsin
Chymotrypsin
Carboxypeptidase
Elastase

Drugs Contraindicated In Breast Feeding

Mnemonic: BREAST
Bromocryptin / Benzodiazepines
Radioactive isotopes / Rizatriptan
Ergotamine / Ethosuximide
Amiodarone/Amphetamines
Stimulant Laxatives / Sex hormones
Tetracyclins / Tretinoin

Hormones that Increase Blood Glucose

Mnemonic: STENGG
Somatotropin (growth hormone)
Thyroid hormones (thyroxine and triiodothyronine)
Epinephrine
Norepinephrine
Glucagon
Glucocorticosteroids
Immunoglobulins

Days of appearance of rashes

Mnemonic: Very Sick Patients Must Take Double Exercise
Varicella (chickenpox)- 1st day
Scarlet fever - 2nd day
Pox (smallpox) - 3rd day
Mumps - 4th day
Typhus - 5th day
Dengue - 6th day
Enteric fever (typhoid) - 7th day

Case Study

After 2 weeks of diarrhea, a 22 year old college female reports to the emergency room feeling faint. She says she recently took a trip to Mexico for spring break and became sick on her last day there. She has now had diarrhea for 2 weeks, with 3 watery bowel movements per day. She denies vomiting. Her mucous membranes are dry, and her capillary refill is 4 seconds. Her respiratory rate is 30 per minute.
What explains her increase respiratory rate?

A.   Anion-gap metabolic acidosis
B.   Normal anion gap metabolic acidosis
C.   Respiratory acidosis
D.   Respiratory alkalosis
E.    Metabolic alkalosis

Signs and Symptoms of Hypernatremia

Mnemonic: Fried
Fever (low grade), flushed skin
Restless (irritable)
Increased fluid retention and increased BP
Edema (peripheral and pitting)
Decreased urinary output, dry mouth

Signs and Symptoms of Increased Serum Potassium

Mnemonic: MURDER
Muscle weakness
Urine - oliguria, anuria
Respiratory distress
Decreased cardiac contractility
ECG changes
Reflexes - hyperreflexia, or areflexia (flaccid)

Causes of Increased Serum Potassium (Hyperkalemia)

Mnemonic: Machine
Medications - ACE inhibitors, NSAIDS
Acidosis - Metabolic and respiratory
Cellular destruction - Burns, traumatic injury
Hypoaldosteronism, Hemolysis
Intake - Excesssive
Nephrons, renal failure
Excretion - Impaired

IMPORTANT POINTS

• The Percentage of blood alcohol in the stage of "dead drunk" is 0.5%.
• Fatal period of Datura poisoning is 24 hours.
• While dispatching blood and urine for chemical analysis, sodium fluoride is added as preservative in concentration of 50 mg/10ml.
• Critical level of alcohol in blood is 0.15%.
• Gas rigidity appears after 72 hours.
• Ratio between ethyl alcohol in blood to urine is 1:1.33.
• Fatal dose of opium is 2 gm.
• Fatal period of sulphuric acid poisoning is 18-24 hours.
• After death, benzidine test is positive upto 150 years. Bones begin to decompose after death in 3-10 years.
•  In poisoning by salicylates, the Gastric lavage is useful upto 24 hours. 
• Physostigmine can be regarded as the specific antidote of Datura.
• Copper sulphate is used as an antidote to phsophorus.
• Haemorrhagic spots are found in poisoning by thallium.
• Amyl nitrate is antidote of cocaine poisoning.
• In sea water drowning, there is steep rise in Na+ and Mg++.
• In methyl alcohol poisoning treatment recommended is ethyl alcohol and sodium bicarbonate.

Heart valves: sequence of flow

Mnemonic: TRIPS BIAS
TRIcuspid
Pulmonary
Semilunar
BIcuspid
Aortic
Semilunar

Drugs that act on Microtubules

Mnemonic: The MicroTubule Growth Voiding Chemicals
Thiabendazole
Mebendazole
Taxol
Griseofulvin
Vincristine/ Vinblastine
Colchicine

Anesthesia stages

Mnemonic: Anesthesiologists Enjoy S &  M 
Analgesia
Excitement
Surgical anesthesia
Medullary paralysis

Emphysema types

Mnemonic: Cigarettes Is Primary Problem":

Types:                                               Important feature 
Centrilobular                                       Cigarrettes
Irregular                                              Inflammation healed to scar
Pancinar                                              Protease inhibitor deficiency (a1-antitrypsin)
Paraseptal                                           Pneumothorax
 

Benign Prostatic Hyperplasia - Symptoms

Mnemonic:  WISE refers to obstructive symptoms:
Weak urinary stream
Intermittent flow
Straining to urinate
Incomplete Emptying


Mnemonic:  FUN refers to irritative symptoms:
Frequency (>8 times in 24 hrs)
Urgency (the strong need to urinate immediately)
Nocturia (frequency of urination at night)

MAO isoenzymes: Location

MAO-A in:                                                               MAO-B in: 
Adrenergic peripheral structures                                  Brain
Alimentary mucosa [intestine]                                      Blood platelets

Progesterone: actions

Mnemonic: PROGESTE
Produce cervical mucous
Relax uterine smooth muscle
Oxycotin sensitivity down
Gonadotropin [FSH, LH] secretions down
Endometrial spiral arteries and secretions up
Sustain pregnancy
Temperature up / Tit development
Excitability of myometrium down

Drugs removed by haemodialysis

Mnemonic: BLAST
Barbiturates
Lithium
Alcohol
Salicylates
Theophylline

Drugs causing pancreatitis

Mnemonic: GLAD Organ Pancreas iS Traumatised n Destroyed Very Much
Glucocorticoids
L-asparaginase
Alcohol
Diuretics
Oral contraceptives
Pentamidine
Sulfonamides
Tetracyclines
Didanosine
Valproate
Methyldopa

Ventricular tachycardia: treatment

Mnemonic: LAMB
Lidocaine
Amiodarone
Mexiltene/ Magnesium
Beta-blocker

Supraventricular tachycardia: treatment

Mnemonic: ABCDE
Adenosine
Beta-blocker
Calcium channel antagonist
Digoxin
Excitation (vagal stimulation)

Cardioselective betablockers

Mnemonic: Betablockers Acting Exclusively At Myocardium
Betaxolol
Acebutelol
Esmolol
Atenolol
Metoprolol

Anti-arrythmics: for AV nodes

Mnemonic: Do Block AV
Digoxin
B-blockers
Adenosine
Verapamil

Nonselective beta-blockers

Mnemonic: Tim Pinches His Nasal Problem

Timolol

Pindolol

Hismolol

Naldolol

Propranolol

Sodium valproate: side effects

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

Inhalation anesthetics

Mnemonic: SHINE
Sevoflurane
Halothane
Isoflurane
Nitrous oxide
Enflurane

Physostigmine vs. Neostigmine

Physostigmine: LMNO                                                                Neostigmine, on the contrary, is:

Lipid soluble                                                                                          Water soluble
Miotic                                                                                                        Used in myesthenia gravis
Natural                                                                                                      Synthetic
Orally absorbed well                                                                           Poor oral absorption

Torsades de Pointes

Drugs causing  are APACHE
Amiodarone 
Procainamide 
Arsenium 
Cisapride 
Haloperidol 
Eritromycin

Migraine: prophylaxis drugs

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

Ca++ channel blockers: uses

Mnemonic:   CHASM

Cererbral vasospasm / CHF
Hypertension
Angina
Suprventricular tachyarrhythmia
Migranes

Methyldopa: side effects

Mnemonic:   METHYLDOPA

Mental retardation

Electrolyte imbalance

Tolerance

Headache/ Hepatotoxicity

psYcological upset

Lactation in female

Dry mouth

Oedema

Parkinsonism

Anaemia (haemolytic)

Morphine: effects at mu receptor

Mnemonic: PEAR

Physical dependence

Euphoria

Analgesia

Respiratory depression

Nitrofurantoin: major side effects

Mnemonic: NitroFurAntoin

Neuropathy (peripheral neuropathy)

Fibrosis (pulmonary fibrosis)

Anemia (hemolytic anemia)

Propythiouracil mechanism

Mnemonic: It inhibits PTU

Peroxidase/ Peripheral deiodination

Tyrosine iodination

Union (coupling)

Captopril (ACE inhibitor): side effects

Mnemonic: 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

Prophylaxis Use of antibiotics in emergency conditions

     

        Reference: Medscape

Metronidazole

Class: Nitroimidazole derivative
Mech.: Inhib. DNA synth, degrades DNA, e- acceptor for reduced substrates.


Absorption: Complete, quick oral absorption.
Dist.: Well distrib to all tissues and fluids (including CSF)
Metab.: Hepatic metab.
Excretion, t_:
Toxicity/S.E.s: GI, metallic taste, neurotox (vertigo), disulfiram-like effect w/alcohol, neutropenia. Not for first trimester preg (mutagenic). Not for patients w/active CNS disease or hist. of blood dyscrasias.

Utility: IV treatment of anaerobic infects. Oral for amebiasis, giardiasis, and genital infects of Trichomonas vaginalis. H. pylori (PUD).
Special Features: Antiparasitic and antibacterial activity. All anaerobic cocci and anaerobic gram- bacilli, including Bacterioides. Trichomoniasis, amebiasis, giardiasis.

Cimetidine

Class: H2 Receptor Antagonist
Mech.: Competitive inhib. of the histamine H2 receptor, but not of the H1 receptor → inhib. of fasting and stim. acid secretion. No disruption of circadian rhythm of acid secretion. Inhib. of 80-90% of gastrin and
vagal-stim. acid secretion.

Absorption: Oral → rapid, good absorption. Single nighttime dose.
Dist.:
Metab.: Partial hepatic metab.
Excretion, t_: Excreted intact in urine. 1.5-3 hr.
Toxicity/S.E.s: Uncommon. Diarrhea, headaches, myalgias, skin rashes. Large doses over prolonged periods assoc. w/impotence & gynecomastia. Inhib. cyt. P-450 → dose adjustment with phenytoin, warfarin, & theophylline. Occasional cardiac arrhythmias.
Utility: PUD, Zollinger-Ellison synd., acute stress ulcers, GERD

Special Features: Potency—famotidine > ranitidine/nizatidine > cimetidine.
Tachyphylaxis—50% less effective after 6 months. Rebound hypersecretion 2° to receptor upregulation and inhib. of ATPase recycling.

Omeprazole

Class: Proton Pump Inhibitor
Mech.: Irreversible inhib. of H+/K+ ATPase → > 95% inhib. of acid secretion.

Absorption: Oral → 30-40% bioavail. Peak plasma levels at 0.5-3.5 hr. Give prior to meals, preferably in the morning. Additional dose, if necessary, should be given later in the day.
Dist.:
Metab.:
Excretion, t_: 0.5-1 hr.
Toxicity/S.E.s: Rare headache, diarrhea, rash. Inhib. of cyt. P-450 requires altered doses of warfarin, phenytoin, diazepam, and cyclosporin. Inhib. of vitamin. B12 absorption.

Utility: PUD, erosive esophagitis, Zollinger-Ellison synd., GERD.
Special Features: Mismatch between pharmacokinetics & pharmacodynamics. Short t_, but actions last > 24 hr (irreversible binding). Acid inhib. → ↑ gastrin

Ranitidine

Class: H2 Receptor Antagonist
Mech.: Competitive inhib. of the histamine H2 receptor, but not of the H1 receptor → inhib. of fasting and stim. acid secretion. No disruption of circadian rhythm of acid secretion. Inhib. of 80-90% of gastrin and
vagal-stim. acid secretion.


Absorption: Oral → rapid, good absorption. Single nighttime dose.
Dist.:
Metab.: Partial hepatic metab.
Excretion, t_: Excreted intact in urine. 1.5-3 hr.
Toxicity/S.E.s: Uncommon. Diarrhea, headaches, myalgias, skin rashes. Inhib. cyt. P-450 (less than cimetidine) → dose adjustment with phenytoin, warfarin, & theophylline. Occasional cardiac arrhythmias.


Utility: PUD, Zollinger-Ellison synd., acute stress ulcers, GERD
Special Features: Potency—famotidine > ranitidine/nizatidine > cimetidine.
Tachyphylaxis—50% less effective after 6 months. Rebound
hypersecretion 2° to receptor upregulation and inhib. of ATPase recycling.