PAIN MANAGEMENT IN PATIENTS WITH CANCER

MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS

1.) Nonopioid Relieves moderate to severe pain by NSAIDs

analgesics inhibiting COX in the CNS but not in the Acetaminophen
periphery.Beneficial effects are pain
relief, suppression of inflammation, and
reduction of fever.
2.) Opioid Relieves pain by mimicking the actions MILD TO MODERATE
analgesics of endogenous opioid peptides, PAIN
primarily at mu receptors and partly at Codeine
kappa receptors. Hydrocodone
Oxycodone
Tramadol

MODERATE TO SEVERE
Morphine
Fentanyl
Hydromorphone
Levorphanol
Methadone
Oxymorphone

3.) Adjuvant Used to compliment the effects of opioids.  Tricyclic

analagesics It is employed in combination with opioids- antidepressants
not as substitutes. Amitriptyline
Desipramine
Doxepin
Imipramine
Nortriptyline

 Other anti
depressants
Bupropion
Duloxetine
Venlafaxine

 Antiseizure drugs
Carbamazepine
Gabapentin
Lamotrigine
Phenytoin
Pregabalin

 Antidysrythmics
Lidocaine
Mexiletine

 CNS stimulants
Dextroamphetamine
Methylphenidate

 Antihistamines
Hydroxyxine

 Glucocorticoids
Dexamethasone
Predinisone

 Bisphosphonates
Etidronate
Pamidronate
 DRUGS FOR HEADACHE
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS

1.) Abortive Relieves moderate to severe migraine Serotonin

therapy attacks. Alters transmission at Analgesics
serotonergic, dopaminergic, and alpha- Ergot alkaloids
Haloperidol
adrenergic junctions.
Recepetor Agonist
Naproxen
Telcagepant

2.) Preventive Prophylactic therapy can reduce the  Beta Adrenergic

Therapy frequency and intensity of migraine Blocking agents
attacks. Inhibits reuptake of serotonin, Propanolol
making more transmitter available for Timolol
action.  Tricyclic
antidepressant
Amitriptyline
 Antiepileptic Drugs
Divalproex
Topiramate
 Estrogens
 Calcium channel
blockers
Verapamil
Flunarizine

Other drugs for Modulation of neurotransmitter release,  Calcium channel

prophylaxis a calcium-dependent process that blockers
CCBs are known to effect verpamil
 Neurostabilizer
Divalproex
Topiramate
Lithium

 NSAID
Indomethacin
Naproxen
 Ergot alkaloids
 Ergotamine
 Glucocorticoids
prednisone

Antipsychotic Agents and Their Use in Schizophrenia

MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS

1.) First-generation FGAs are equally effective at alleviating  Low potency agents
antipsychotics: symptoms of schizophrenia. Differences Chlorpromazine
individual among these agents relate primarily to Thioridazine
agents side effects because the high-potency  Medium potency
agents produce fewer side effects than agents
the low-potency agents, high potency Loxapine
agents are generally preferred. Molindone
Perphenazine
 High potency agents
Trifluoperazine
Thiothixene
Fluphenazine
Haloperidol
Pimozide

2.) Second- SGAs and FGAs are equally effective. Clozapine

generation Major side effects, the SGAs are less Olanzapine
antipsychotics likely to cause EPS, including TD. Risperidone
However, the SGAs carry an even Paliperidone
greater risk of their own, namely, Quetiapine
potentially fatal metabolic effects-weight Ziprasidone
gain, diabetes, and dyslipidemia-that Aripiprazole
can lead to cardiovascular events and
premature death.

Antidepressants
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS

1.) Selective Fluoxetine - Selective inhibition of 5-HT Sertraline

Serotonin reuptake, and thereby intensifies Fluoxetine
Reuptake transmission of serotonergic synapses Citalopram
Inhibitors These drugs are as effective as the Escitalopram
TCAs, but do not cause hypotension, Fluvoxamine
sedation, or anti-cholinergic effects are Paroxetine
nausea, agitation/insomnia, and sexual
dysfunction.

2.) Serotonin/Nore Block neuronal reuptake of serotonin Desvenlafaxine

pinephrine and norepinephrine, with minimal Venlafaxine
Reuptake effects on other transmitters or Duloxetine
Inhibitors receptors. Pharmacologic effects are
similar to those of the SSRIs, although
the SSRIs may be better tolerated.

3.) Monoamine It is an enzyme found in the liver, the Selegiline

Oxidase intestinal wall, and terminals of Isocarboxazid
Inhibitors monoamine-containing neurons. The Phenelzine
function of MOA in neurons is to convert Tranylcypromine
monoamine neurotransmitter- NE, 5-HT,
and dopamine- into inactive products.

4.) Atypical The mechanism by which depression is Mirtazapine

Antidepressant relieved is unclear, but may be related Amoxapine
s to blockade of dopamine uptake. It does Bupropion
not affect serotonergic, cholinergic, or Nefazodone
histaminergic transmission. Trazodone
 Drugs for Bipolar Disorder
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS
1.) Mood- Mood stabilizers are drugs that can
Stabilizing relieve an acute manic or depressive Lithium
Drugs episodes, prevent recurrence of manic  Antiepileptic Drugs
and depression, or accelerate the rate Valproic Acid
of cycling. Carbamazepine
Lamotigrine

2.) Antipsychotic Control symptoms during manic Olanzapine

drugs episodes, and long term to help Quetiapine
stabilize mood. Risperidone
Aripiprazole
Ziprasidone
clozapine
 Sedative-Hypnotic Drugs
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS
1.) Benzodiazepin Enhances actions of GABA by binding Triazolam
es to specific receptors in a Flurazepam
supramolecular structure known as the Quazepam
GABA receptor-chloride channel Estazolam
complex. Temazepam

2.) Benzodiazepin They all act as agonist at the Eszopiclone

e-Like Drugs benzodiazepine receptor site on GABA Zolpidem
receptor-chloride channel complex. Zaleplon

3.) Melatonin Activates receptors for melatonin- Ramelteon

Agonist specifically the MT1 and MT2 subtypes,
which are key mediators of the normal
sleep-wakefulness cycle.

4.) Barbiturates Bind to GABA receptor-chloride channel

complex. These drugs can enhance the
inhibitory actions of GABA and directly
mimic the actions of GABA.

Other Hypnotics Decrease sleep latency and prolong Trazodone

sleep duration and does not cause Antihistamines
tolerance or physical dependence. Alternative medicines
 Management of Anxiety Disorders
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS
1.) Generalized Enhancing responses to GABA. Onset Antidperessants
Anxiety effects are immediate, and the margin Benzodiazepines
Disorder of safety is high. Principal side effects Buspirone
are sedation and psychomotor slowing.

2.) Panic Disorder Decreases frequency and intensity of Sertraline

attacks, anticipatory anxiety, and Fluoxetine
avoidance behaviour. Paroxetine

3.) Obsessive- All enhances serotonergic transmission. Paroxetine

Compulsive Citalopram
Disorder Escitalopram
Fluoxetine
Fluvoxamine
Sertraline

4.) Social Anxiety Inhibits CNS neuronal uptake of Fluvoxamine

Disorder serotonin; blocks uptake of serotonin Paroxetine
with weak effect on norepinephrine. Sertraline

5.) Post-Traumatic Potentiates serotonergic activity in the Paroxetine

Stress CNS, resulting antidepressant effect. Sertraline
Disorder
 DRUGS ABUSE II: ALCOHOL
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS
1.) To Facilitate Benzodiazepines Chlordiazepoxide
Withdrawal - Stabilizes vital signs, reduce symptom Diazepam
intensity, and decrease risk of seizures Oxazepam
and delirium tremens. Lorazepam

Beta-Adrenergic Blockers Atenolol

-Improve vital signs; decrease craving, Propranolol
decrease autonomic component of
withdrawal symptoms.

Alpha-Adrenergic Blocker Clonidine

-Decrease autonomic component of
withdrawal symptoms.

Antiepileptic Drug Carbamazepine

- Decreases withdrawal symptoms;
prevent seizures.

2.) To Maintain It blocks the pleasurable effects of Disulfiram Aversion

Abstinence alcohol and decreases craving. Therapy
Naltrexone
Acamprosate
Topiramate
Ondansetron
 DRUGS ABUSE: MAJOR DRUGS OF ABUSE
MNEMONICS:

 Classifications:

CLASSIFICATION MECHANISM OF ACTION DRUGS Drug

CATEGORY MNEMO
NICS
1.) Opioids high lipid solubility, which allows the Heroin
drug to cross the blood brain barrier Morphine
with ease. Thereby producing effects Meperidine
that are both immediate and intense, Hydromorphone

2.) Psychostimulants Amphetamines and cocaine can Cocaine

stimulate theheart, blood vessels, and Dextroamphetamine
other structures under sympathetic Methamphetamine
controls. Because of these peripheral Methylphenidate
actions, these agents are also referred
to as sympathomimetics.
3.) Depressants Produce substantial physical  Barbiturates
dependence. Cross-dependence exists Amobarbital
between barbiturates and other CNS Secobarbital
depressants but not with opioids. In Pentobarbital
contrast, the opioid abstinence Phenobarbital
syndrome is rarely life threatening.  Benzodiazepines
Diazepam
Flunitrazepam
Lorazepam
 Miscellaneous
Alcohol
Methaqualone
Gamma-
hydroxybutyrate
Meprobamate

4.) Psychedelics Acts multiple sites in the brain and LSD

spinal cord. However, effects are most Mescaline
prominent in the cerebral cortex and the Psilocybin
locus ceruleus. Dimethyltryptamine
5.) Dissociative Distort perception of sight and sound, Phencyclidine
Drugs and produce feelings of dissociation Ketamine
from the environment. High doses
produce sedation, immobility, analgesia,
and amnesia.
6.) Anabolic steroids Enhances athletic performance. The Nandrolone
principal benefit is increased muscle Oxandrolone
mass and strength. Testosterone

7.) Miscellaneous Nicotine can activate nicotinic receptors Dextromethorphan

at several locations. Most effects result Marijuana
from activating nicotinic receptors in Nicotine
autonomic ganglia and the adrenal Nitrous oxide
medulla. Amyl nitrite
Marijuana - Activation of specific
cannabinoid receptors found in various
parts of the brain.