Saturday, August 15, 2015

Pharmacology Mnemonics


Pharmacology Mnemonics


RTI: drugs to treat viral respiratory infections "You'd get
respiratory infection if you shoot an ARO (arrow) laced with 
viruses
 into the lungs":
ARO:
Amantadine
Rimantadine
Oseltamivir


Medication administration: short checklist TRAMP:
· Before dispensing medication, ensure have correct:
Time
Route
Amount
Medication
Patient


Opiates: overdose findings "Cool to the touch, unresponsive
to pain,
Hunger diminished, and scars over vein.
Pupils pinpointed, and blood pressure low,
Urine diminished, and breathing is slow."


Cocaine: cardiovascular effect COcaine causes blood
vessels to
COnstrict (unlike other local anesthetics which cause vasodilation).


Aminoglycosides: common characteristics AMINO:
Active Against Aerobic gram negative
Mechanism of resistance are Modifying enzymes
Inhibit protein synthesis by binding to 30S subunit
Nephrotoxic
Ototoxic


Sulfonamides: common characteristics SULFA:
Steven-Johnson syndrome/ Skin rash / Solubility low
Urine precipitation/ Useful for UTI
Large spectrum (gram positives and negatives)
Folic acids synthesis blocker (as well as synthesis of nucleic acids)
Analog of PABA


Diuretics: groups "Leak Over The CAN":
Loop diuretics
Osmotics
Thiazides
Carbonic anhydrase inhibitors
Aldosterone inhibitors
Na (sodium) channel blockers
· Note: "leak" is slang for urination and "can" is slang for a toilet.


Thalidomide: effect on cancer cells "Thalidomide
makes the blood vessels hide":
Use thalidomide to stop cancer cells from growing new blood vessels.


Tuberculosis: treatment If you forget your TB drugs, you'll
die and might need a PRIEST":
Pyrazinamide
Rifampin
Isoniazid (INH)
Ethambutol
STreptomycin


Warfarin: interactions ACADEMIC QACS:
Amiodarone
Cimetidine
Aspirin
Dapsone
Erythromycin
Metronidazole
Indomethacin
Clofibrates
Quinidine
Azapropazone
Ciprofloxacin
Statins


Patent ductus arteriosus: which prostaglandin keeps it open
kEEp opEn with prostaglandin E.


Carbamazepine (CBZ): use CBZ:
Cranial Nerve V (trigeminal) neuralgia
Bipolar disorder
Zeisures


Morphine: side-effects MORPHINE:
Myosis
Out of it (sedation)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis


Corticosteroids: adverse side effects CUSHINGS BAD MD:
Cataracts
Up all night (sleep disturbances)
Suppression of HPA axis
Hypertension/ buffalo Hump
Infections
Necrosis (avascular)
Gain weight
Striae
Bone loss (osteoporosis)
Acne
Diabetes
Myopathy, moon faces
Depression and emotional changes


Tricyclic antidipressents (TCA): side effects TCA'S:
Thrombocytopenia
Cardiac (arrhymia, MI, stroke)
Anticholinergic (tachycardia, urinary retention, etc)
Seizures


Bromocriptine [for USA gang members] The CRYPTS are
an LA street gang that likes to smoke DOPE.
BromoCRYPTine is a DOPamine agonist.


Beta blockers: members "The NEPAL Prime
Minister":
Timolol
Nadolol
Esmolol
Pindolol
Atenolol
Labetalol
Propranolol
Metoprolol


Microtubules: drugs that act on microtubules. "The 
M
icroTubule Growth Voiding Chemicals":
Thiabendazole
Mebendazole
Taxol
Griseofulvin
Vincristine/ Vinblastine
Colchicine


Insulin: mixing regular insulin and NPH "Not Ready,
Ready Now":
Air into NPH
Air into Regular
Draw up Regular
Draw up NPH


Benzodiazepins: 3 members that undergo extrahepatic metabolism
"Outside The Liver":
Oxazepam
Temazepam
Lorazepam
These undergo extrahepatic metabolism and do not form active metabolites.


Guanethidine: mechanism GuaNEthidine prevents NE
(norepinephrine) release.


Parasympathetic vs. sympathetic neurotransmitters "No
sympathy for a Pair of Aces":
Norepinephren is secreted in by the Sympathetic nervous system
while Acetylcholine is secreted in the Parasympathetic nervous
system.


Adrenoceptors: vasomotor function of alpha vs. beta ABCD:
Alpha = Constrict.
Beta = Dilate.


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


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 DND is also after me:
Desipramine
Norrtriptyline
Doxepin


Asthma drugs: leukotriene inhibitor action zAfirlukast:
Antagonist of lipoxygenase
zIlueton: Inhibitor of LT receptor


Torsades de Pointes: drugs causing APACHE:
Amiodarone
Procainamide
Arsenium
Cisapride
Haloperidol
Eritromycin


Serotonin syndrome: components Causes HARM:
Hyperthermia
Autonomic instability (delirium)
Rigidity
Myoclonus


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.


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


Therapeutic index: formula TILE:
TI = LD50 / ED50


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
Ksupplement


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


Ribavirin: indications RIBAvirin:
RSV
Influenza B
Arenaviruses (Lassa, Bolivian, etc.)


Parkinsonism: drugs SALAD:
Selegiline
Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine)
L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide)
Amantadine
Dopamine postsynaptic receptor agonists (bromocriptine, lisuride,
pergolide)


Morphine: effects at mu receptor PEAR:
Physical dependence
Euphoria
Analgesia
Respiratory depression


Thrombolytic agents USA:
Urokinase
Streptokinase
Alteplase (tPA)


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


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


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


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 drugsy:
Valproate
Valproate
Valproate
ACTH
Carbamazepine
Ethosuximide


Respiratory depression inducing drugs "STOP
breathing":
Sedatives and hypnotics
Trimethoprim
Opiates
Polymyxins


Pulmonary infiltrations inducing drugs "Go BAN Me!":
Gold
Bleomycin/ Busulphan/ BCNU
Amiodarone/ Acyclovir/ Azathioprine
Nitrofurantoin
Melphalan/ Methotrexate/ Methysergide


Migraine: prophylaxis drugs "Very Volatile 
P
harmacotherapeutic Agents For Migraine Prophylaxis":
Verpamil
Valproic acid
Pizotifen
Amitriptyline
Flunarizine
Methysergide
Propranolol
· Bare bones version [eg Lippincott's two], just Migraine Prophylaxis,
as above.


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


Vigabatrin: mechanism Vi-GABA-Tr-In:
ViGABA Transferase Inhibition


TB: antibiotics used STRIPE:
STreptomycin
Rifampicin
Isoniazid
Pyrizinamide
Ethambutol


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


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


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


Nicotinic effects MTWTF (days of week):
Mydriasis/ Muscle cramps
Tachycardia
Weakness
Twitching
Hypertension/ Hyperglycemia
Fasiculation


Muscarinic effects SLUG BAM:
Salivation/ Secretions/ Sweating
Lacrimation
Urination
Gastrointestinal upset
Bradycardia/ Bronchoconstriction/ Bowel movement
Abdominal cramps/ Anorexia
Miosis


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, headache


Gynaecomastia-causing drugs DISCOS:
Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens
Stilboestrol


Hypertension: treatment ABCD:
ACE inhibitors/ AngII antagonists (sometimes Alpha agonists
also)
Beta blockers
Calcium antagonists
Diuretics (sometimes vasoDilators also)


Diuretics classification in order of site of action "COLT
P
ee:"
· In their sequential site of action along the nephron:
Carbonic anhydrase inhibitors (at the proximal tubule)
Osmotic diuretics (at the Loop of Henle)
Loop diuretics (at the ascending loop)
Thiazides (at the distal tubule)
Potassium-sparing diuretics (at the collecting tubules)
· Diuretics make patient pee like a horse, hence "Colt Pee".


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)


Clopidogrel: use CLOPIdogrel is a drug that prevents
CLots, an Oral Platelet Inhibitor (OPI).


Teratogenic drugs: major non-antibiotics TAP CAP:
Thalidomide
Androgens
Progestins
Corticosteroids
Aspirin & indomethacin
Phenytoin


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


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


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 Carve
r, 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.


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


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


Monoamine oxidase inhibitors: members "PIT of
despair":
Phenelzine
Isocarboxazid
Tranylcypromine
· A pit of despair, since MAOs treat depression.


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


Patent ductus arteriosus: treatment "Come In and 
Close
 the door":
INdomethacin is used to ClosePDA.


Etoposide: action, indications, side effect "eTOPoside":
· Action:
Inhibits TOPoisomerase II
· Indications:
Testicular carcinoma
Oat cell carcinoma of lung
Prostate carcinoma
· Side effect:
Affects TOP of your head, causing alopecia


Antibiotics contraindicated during pregnancy MCAT:
Metronidazole
Chloramphenicol
Aminoglycoside
Tetracycline


Lithium: side effects LITHIUM:
Leukocytes Increased (leukocytosis)
Tremors
Hypothyroidism
Increased Urine
Moms beware (teratogenic)


Quinolones [and Fluoroquinolones]: mechanism "Topple
the Queen":
Quinolone interferes with Topoisomerase II.


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


Osmotic diuretics: members GUM:
Glycerol
Urea
Mannitol


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)


Benzodiazepenes: antidote "Ben is off with the
flu":
Benzodiazepine effects off with Flumazenil.


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


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.


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


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


Myasthenia gravis: edrophonium vs. pyridostigmine eDrophonium
is for Diagnosis.
pyRIDostigmine is to get RIDof symptoms.


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


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


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.


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
Sedations


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


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


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.


4-Aminopyradine (4-AP) use "4-AP is For AP":
For AP (action potential) propagation in Multiple Sclerosis.


Direct sympathomimetic catecholamines DINED:
Dopamine
Isoproterenol
Norepinephrine
Epinephrine
Dobutamine


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, ValacyclovirViracept, 
Vir
amune, Zanamivir, Zovirax.


Nitrofurantoin: major side effects NitroFurAntoin:
Neuropathy (peripheral neuropathy)
Fibrosis (pulmonary fibrosis)
Anemia (hemolytic anemia)


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)


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)


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


Lead poisoning: presentation ABCDEFG:
Anemia
Basophilic stripping
Colicky pain
Diarrhea
Encephalopathy
Foot drop
Gum (lead line)


Beta-blockers: main contraindications, cautions ABCDE:
Asthma
Block (heart block)
COPD
Diabetes mellitus
Electrolyte (hyperkalemia)


Lupus: drugs inducing it HIP:
Hydralazine
INH
Procanimide


Lithium: side effects LITH:
Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria]
Tremor/ Teratogenesis
Hypothyroidism


SSRIs: side effects SSRI:
Serotonin syndrome
Stimulate CNS
Reproductive disfunctions in male
Insomnia


Metabolism enzyme inducers "Randy's Black Car
Goes Putt Putt and Smokes":
Rifampin
Barbiturates
Carbamazepine
Grisoefulvin
Phenytoin
Phenobarb
Smokingcigarettes


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


Cholinergics (eg organophosphates): effects If you know
these, you will be "LESS DUMB":
Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating
Diarrhea
Urination
Micturition
Bronchoconstriction


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


Depression: 5 drugs causing it PROMS:
Propranolol
Reserpine
Oral contraceptives
Methyldopa
Steroids


Hepatic necrosis: drugs causing focal to massive necrosis "Very
Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane


Warfarin: action, monitoring WePT:
Warfarin works on the extrinsic pathway and is monitored by PT.


Beta-blockers: side effects "BBC Loses Viewers
IRochedale":
Bradycardia
Bronchoconstriction
Claudication
Lipids
Vivid dreams & nightmares
-ve Inotropic action
Reduced sensitivity to hypoglycaemia


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)


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.


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.


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.


Pupils in overdose: morphine vs. amphetamine "MorPHINE:
Fine. AmPHETamine: Fat":
Morphine overdose: pupils constricted (fine).
Amphetamine overdose: pupils dilated (fat).


Atropine use: tachycardia or bradycardia "A goes with
B":
Atropine used clinically to treat Bradycardia.


Reserpine action Reserpine depletes the 
Reser
ves of catecholamines [and serotonin].


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).


Ipratropium: action Atropine is buried in the middle:
iprAtropium, so it behaves like Atropine.


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


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.


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.

Pediatrics Mnemonics


Pediatrics Mnemonics


Gastroschisis: usual location GasTRoscHIsis
usually occurs on the
RIGHT side of the umbilicus.
(Unscramble the letters).


Milk protein: women vs. cows Woman: Whey
(mostly)
Cow: Casein (mostly)


Short stature: differential ABCDEFG:
Alone (neglected infant)
Bone dysplasias (rickets, scoliosis, mucopolysaccharidoses)
Chromosomal (Turner's, Down's)
Delayed growth
Endocrine (low growth hormone, Cushing's, hypothyroid)
Familial
GI malabsorption (celiac, Crohn's)


Breast feeding: contraindicated drugs BREAST:
Bromocriptine/ Benzodiazepines
Radioactive isotopes/ Rizatriptan
Ergotamine/ Ethosuximide
Amiodarone/ Amphetamines
Stimulant laxatives/ Sex hormones
Tetracycline/ Tretinoin


Paediatric history taking · Begin with standard things:
patient name, presenting complaint, history of presenting complaint and past
medical history.
· Then ask BIFIDA:
Birth details and problems
Immunisations
Feeding
Infection, exposure to
Development, normality of
Allergies
· End by customary review of the rest of the standard things: medications,
family history and social history.


APGAR score components APGAR:
Appearance: cyanosis--peripheral, central, none
Pulse: pulse rate
Grimace: response to stimulation
Activity: movement of the baby (muscle tone)
Respiration: respiratory rate


Beckwith-Widemann syndrome: features HOMO:
Hypoglycemia
Omphalocel
Macroglossia/ Macrosomia
Organomegaly


Neonatal resuscitation: successive steps "DWhat
Pediatricians Say To, OBInviting
Costly Malpractice":
Drying
Warming
Positioning
Suctioning
Tactile stimulation
Oxygen
Bagging
Intubate endotracheally
Chest compressions
Medications


APGAR score components · Five B's:
Breathing (respiratory effort)
Beating (heart rate)
Buff (tone)
Bothered (response to stimulation)
Blue (cyanosis)


Cystic fibrosis: exacerbation of pulmonary infection CF
PANCREAS:

Cough (increase in intensity and frequent spells)
Fever (usually low grade, unless severe bronchopneumonia is present)
Pulmonary function deterioration
Appetite decrease
Nutrition, weight loss
CBC (leukocytosis with left shift)
Radiograph (increase overaeration, peribronchial thickening, mucus
plugging)
Exam (rales or wheezing in previously clear areas, tachypnea,
retractions)
Activity (decreased, impaired exercise intolerance, increased
absenteeism)
Sputum (becomes darker, thicker, and more abundant, forming plugs)


Pyloric stenosis (congential): presentation Pyloric
stenosis is 3 P's:
Palpable mass
Paristalsis visible
Projectile vomiting (2-4 weeks after birth)


Cyanotic heart diseases: 5 types · 5 T's:
Tetralogy of Fallot
Transposition of the great arteries
Truncus arteriosus
Tricuspid atresia, pulmonary aTresia
Total anomalous pulmonary venous drainage


Breast feeding: benefits ABCDEFGH:
· Infant:
Allergic condition reduced
Best food for infant
Close relationship with mother
Development of IQ, jaws, mouth
· Mother:
Econmical
Fitness: quick return to pre-pregnancy body shape
Guards against cancer: breast, ovary, uterus
Hemorrhage (postpartum) reduced


Perez reflex Eliciting the PErEz reflex will
make the baby PEE.


WAGR syndrome: components WAGR:
Wilm's tumor
Aniridia
Gential abnormalities
Mental retardation


Haematuria: differential in children ABCDEFGHIJK:
Anatomy (cysts, etc)
Bladder (cystitis)
Cancer (Wilm's tumour)
Drug related (cyclophosphamide)
Exercise induced
Factitious (Munchausen by proxy)
Glomerulonephritis
Haematology (bleeding disorder, sickle cell)
Infection (UTI)
IJury (trauma)
Kidney stones (hypercalciuria)


Vitamin toxicities: neonatal Excess vitamin AAnomalies
(teratogenic)
Excess vitamin EEnterocolitis (necrotizing enterocolitis)
Excess vitamin KKernicterus (hemolysis)


Rubella: congenital signs "Rubber Ducky, I'm so blue!"
(like the "Rubber Ducky" song):
RubberRubella
Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
I'mEyes (cataracts, retinopathy, micropthalmia, glaucoma).
Blue: "Blueberry Muffin" rash (extramedullary hematopoesis in skin
+purpura)
· Also, deafness, growth retardation, and some more.


Pediatric milestones in development 1 year:
-single words
2 years:
-2 word sentences
-understands 2 step commands
3 years:
-3 word combos
-repeats 3 digits
-rides tricycle
4 years:
-draws square
-counts 4objects


Williams syndrome: features WILLIAMS:
Weight (low at birth, slow to gain)
Iris (stellate iris)
Long philtrum
Large mouth
Increased Ca++
Aortic stenosis (and other stenoses)
Mental retardation
Swelling around eyes (periorbital puffiness)


Russell Silver syndrome: features ABCDEF:
Asymmetric limb (hemihypertrophy)
Bossing (frontal)
Clinodactyly/ Cafe au lait spots
Dwarf (short stature)
Excretion (GU malformation)
Face (triangular face, micrognathia)


Dentition: eruption times of permanent dentition "Mama
IIPain, Papa Can Make Medicine":
1st Molar: 6 years
1st Incisor: 7 years
2nd Incisor: 8 years
1st Premolar: 9 years
2nd Premolar: 10 years
Canine: 11 years
2nd Molar: 12 years
3rd Molar: 18-25 years


Cyanotic heart diseases: 5 types · Use your five fingers:
1 finger up: Truncus Arteriosus (1 vessel)
2 fingers up: Dextroposition of the Great Arteries (2 vessels
transposed)
3 fingers up: Tricuspid Atresia (3=Tri)
4 fingers up: Tetralogy of Fallot (4=Tetra)
5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)


Cyanotic congenital heart diseases 5 T's:
Truncus arteriosus
Transposition of the great arteries
Tricuspid atresia
Tetrology of Fallot
Total anomalous pulmonary venous return


Head circumference with age · Remember 3, 9, and multiples
of 5:
Newborn 35 cm
3 mos 40 cm
9 mos 45 cm
3 yrs 50 cm
9 yrs 55cm


Weights of children with age Newborn 3 kg
6 mos 6 kg (2x birth wt at 6 mos)
1 yr 10 kg (3x birth wt at 1 yr)
3 yrs 15 kg (odd yrs, add 5 kg until 11 yrs)
5 yrs 20 kg
7 yrs 25 kg
9 yrs 30 kg
11 yrs 35 kg (add 10 kg thereafter)
13 yrs 45 kg
15 yrs 55 kg
17 yrs 65kg


Hemolytic-Uremic Syndrome (HUS): components "Remember to
decrease the RATE of IV fluids in these patients":
Renal failure
Anemia (microangiopathic, hemolytic)
Thrombocytopenia
Encephalopathy (TTP)


Cough (chronic): differential When cough in nursery, rock
the "CRADLE":
Cystic fibrosis
Rings, slings, and airway things (tracheal rings)/ Respiratory
infections
Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
Dyskinetic cilia
Lung, airway, and vascular malformations (tracheomalacia, vocal cord
dysfunction)
Edema (heart failure)


Cystic fibrosis: presenting signs CF PANCREAS:
Chronic cough and wheezing
Failure to thrive
Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
Alkalosis and hypotonic dehydration
Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
Clubbing of fingers/ Chest radiograph with characteristic changes
Rectal prolapse
Electrolyte elevation in sweat, salty skin
Absence or congenital atresia of vas deferens
Sputum with Staph or Pseudomonas (mucoid)


Sturge-Weber syndrome: hallmark features Sturge-Weber:
1. Seizures
2. PortWine stain


Guthrie card: diseases identified with it "Guthrie 
C
ards Can Help Predict Bad Metabolism":
Galactosaemia
Cystic fibrosis
Congenital adrenal hyperplasia
Hypothyroidism
Phenylketonuria
Biotidinase deficiency
Maple syrup urine disease


Croup: symptoms 3 S's:
Stridor
Subglottic swelling
Seal-bark cough


Ataxia-Telangiectasia (AT): common sign AT:
Absent
Thymus


Cerebral palsy (CP): most likely cause CPCerebral
Palsy
Child Premature
· The premature brain is more prone to all the possible insults.


Vacterl syndrome: components VACTERL:
Vertebral anomalies
Anorectal malformation
Cardiac anomaly
Tracheo-esophageal fistula
Exomphalos (aka omphalocele)
Renal anomalies
Limb anomalies


Guthrie card: diseases identified with it GUTHRIE:
Galactosaemia
Urine [maple syrup urine disease]
THyRoid [hypothyroidism]
Inborn Errors of metabolism [eg: PKU]


Duodenal atresia vs. Pyloric stenosis: site of obstruction
Duodenal Atresia: Distal to Ampulla of vater.
Pyloric stenosis: Proximal to it.


Bilirubin: phototherapy BiLirUbin
absorbs light maximally in the
BLUe range.


Septic Arthritis: most common cause Staphylococcus 
A
ureus is the most common cause of
Septic Arthritis in the pediatric population.

Related Posts Plugin for WordPress, Blogger...