ACE Inhibitor Side Effects CAPTOPRIL C ough A naphylaxis P alpitations T aste O rthostatic hypotension P otassium elevated R enal impairment

I mpotence L eukocytosis Anti-Epileptic Side Effect ABCDEFGH A taxia B lood dyscrasia C left lip D upuytrens / Vit D deficiency E xfoliation of skin & Stevens Johnson's F its G I upset/gum hypertrophy H epatitis/hairy Barbiturate Side Effects ABCD A taxia B ehavioral disturbance C oncentration decreased/coma D epression/drowsy/diplopia Cholinergic OD Side Effects DUMB BELS D iarrhea U rination M iosis/muscle weakness B ronchorrea B radycardia E mesis L acrimation S alivation/sweating Cyclosporin Side Effects 4HRT

ACE Inhibitor Side Effects 4H yperkalemia, hypertension, gum hypertrophy, hair R enal toxicity T remor Gynacomastia Causing Drugs DISCO MTV D igoxin I soniazid S pironolactone C imetidine O estrogens M ethyldopa/metronidazole T CAD V erapamil MAOI Side Effects The 3Hs H epatocellular jaundice H yperthermia H ypertension Propranolol, contra-indications ABCDE A sthman B lock (heart) C ardiac failure D M (hypoglycemic shock) E xtremities (occlusive arterial disease) Pulmonary Edema, Non-Cardiac PONS P hosgene/paraquat/phenothiazines O pioids/organophosphates N itrous dioxide S alicylate TCAD Side Effects CAN WOO C VS A nticholinergic N euro W ithdrawal O verdose

ACE Inhibitor Side Effects O thers Rat Poison RATS PANIC R ed squill A rsenic T hallium S trychnine P NU/phosphorus/ZN phosphide A lpha naphtha thiurea (ANTU) N orbormide I ndanediones C oumarin/cholecalciferol Steroid Side Effects HIGH COMPACT IMPS H ypertension I mmunosuppresion G astric ulcer (bleeding) H eartburn C ataract O steoporosis M uscle weakness P ath #/psychosis A cne/altered glucose C ushingoid T hin skin I ncreased appetite M yopathy P oor wound healing S tress response reduced or AM CUSHINGOID A cne M yopathy/proximal muscle weakness C ushingoid/cataract U lcers S triae, skin thinning/bruising H ypertension/hairy

ACE Inhibitor Side Effects I nfection G lycosuria O besity/osteoporosis/oedema I mmunosuppression/insomnia D epression Warfarin WEPT W arfarin E xtrinsic pathway Measure PT Class IC Antiarrhythmics FEP F lecainide E ncainide P ropafenone Class III Antiarrhythmics SIBA S otalol I butilide B retylium A miodarone Beta 1 Selective Blockers A-BEAM A cebutalol B etaxolol E smolol A tenolol M etoprolol Gynacomastia, Drugs That Cause "Some Drugs Create Awesome Knockers S pironolactone D igistalis C isplatin A lcohol K etoconozole Drugs Causing Pulmonary Fibrosis BABE B leomycin

ACE Inhibitor Side Effects A miodarone B usulfan E (empty) Drugs that Cause Hepatic Necrosis HAVE H alothane A cetaminophen (liquefactive necrosis) V alproic acid E (empty) Drugs Causing Agranulocytosis The 3Cs C lozapine C olchicine C arbamazepine Drugs for All Types of Seizures (except petit mal) CAPHE CA rbamazepine PHE nytoin/phenobarbital Drugs for Petit Mal Seizures VALET VAL proic acid ET hosuximide Vancomycin "A Red Van Drove Into The Wall" A ntihistamines (prevents redman syndrome) R ed man syndrome V ancomycin D -ala D-ala I nhibitor T hrombophlebitis W all (as in cell wall) Tuberculosis Drugs RESPI R ifampin E thambutol S treptomycin Pyrazinamide I soniazid Short Acting Benzodiazepines

ACE Inhibitor Side Effects TOM thumb T riazolam O xazepam M idazolam Beta 2 Agonists SMART S almeterol M etaproterenol A lbuterol R itodrine T erbutaline Stevens-Johnson Syndrome LESS L amotrigine E thosuximide S ulfonamides S tevens-Johnson Fluconazole The 3Cs C andidiasis C occidiomycosis C ryptocococcal meningitis Class IB Antiarrhythmics "Medical Lab Technician" M exilietine L idocaine T ocainide Lithium LITHIUM L eukocytosis I nhibits PIP2, cAMP and 5' deiodinase T eratogenic/thiazide contraindicated H ypothyroidism/hyponatremia increases toxicity I nsipidus (nephrogenic diabetes) visUal dysfunction M ovement disorders: CATS (choreoathetosis, ataxia, tremors, seizures) Drugs Contraindicated During Pregnancy SAFE CT

ACE Inhibitor Side Effects S ulfonamide A minoglycoside F louroquinolones E rythromycin C larithromycin T etracycline Benzodiazepines Metabolized Outside the Liver "Outside The Liver O xazepam T emazepam L orazepam Drugs Cuasing Megaloblastic Anemia MAPLE M ethotrexate A ZT = zidovudine P henytoin (causes folate deficiency) L iver disease E thanol Amphotericin Toxicities AMPHOTERICIN B A nemia M uscle spasms

ACE Inhibitor Side Effects P hlebitis H eadaches/hypotension/hypokalemia T hrombocytopenia E mesis, encephalopathy R espiratory strida I ncreased temperature (fever) C hills I mmediate hypersensitivity (anaphylaxis) N ephrotoxicity--important! B ronchospasm CNS Effects of Morphine SCREAMNT S edation C ough suppression/convulsions R espiratory depression E uphoria A nalgesia M yosis (but may cause mydriasis in doses causing asphyxia) N ausea and vomiting T runcal rigidity (especially with fentanyl)

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 Antiarrhythmics: class III members BIAS: Bretylium Ibutilide Amiodarone Sotalol Ca++ channel blockers: uses CA++ MASH: Cerebral vasospasm/ CHF Angina Migranes Atrial flutter, fibrillation Supraventricular tachycardia CHASM

Cererbral vasospasm / CHF Hypertension Angina Suprventricular tachyarrhythmia Migranes 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 Anticholinergic side effects "Know the ABCD'S of anticholinergic side effects": Anorexia Blurry vision Constipation/ Confusion Dry Mouth Sedation/ Stasis of urine Antimuscarinics: members, action "Inhibits Parasympathetic And Sweat": Ipratropium Pirenzepine Atropine Scopolamine _Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic. 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) Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam Oxazepam Temazepam Benzodiazepenes: antidote "Ben is off with the flu": Benzodiazepine effects off with Flumazenil. 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. 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 selective blockers "BEAM ONE up, Scotty": Beta blockers:

Esmolol Atenolol Metropolol 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). Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": or SLUDGE Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction Delerium-causing drugs ACUTE CHANGE IN MS: Antibiotics (biaxin, penicillin, ciprofloxacin) Cardiac drugs (digoxin, lidocaine) Urinary incontinence drugs (anticholinergics) Theophylline Ethanol Corticosteroids H blockers Antiparkinsonian drugs Narcotics (esp. mepridine) Geriatric psychiatric drugs ENT drugs Insomnia drugs NSAIDs (eg indomethacin, naproxin) Muscle relaxants Seizure medicines Direct sympathomimetic catecholamines DINED: Dopamine Isoproterenol Norepinephrine Epinephrine Dobutamine Inhalation anesthetics SHINE: Sevoflurane Halothane Isoflurane Nitrous oxide Enflurane _ If want the defunct Methoxyflurane too, make it MoonSHINE. Ipratropium: action Atropine is buried in the middle: iprAtropium, so it behaves like Atropine. Lead poisoning: presentation ABCDEFG:

Anemia Basophilic stripping Colicky pain Diarrhea Encephalopathy Foot drop Gum (lead line) Lithium: side effects LITH: Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism 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. Methyldopa: side effects METHYLDOPA: Mental retardation Electrolyte imbalance Tolerance Headache/ Hepatotoxicity psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic) Monoamine oxidase inhibitors: members "PIT of despair": Phenelzine Isocarboxazid Tranylcypromine _ A pit of despair, since MAOs treat depression. Morphine: effects MORPHINES: Miosis Orthostatic hypotension Respiratory depression Pain supression Histamine release/ Hormonal alterations Increased ICT Nausea Euphoria Sedation Morphine: effects at mu receptor PEAR: Physical dependence Euphoria Analgesia Respiratory depression Narcotic antagonists The Narcotic Antagonists are NAloxone and NAltrexone. _ Important clinically to treat narcotic overdose. Parkinsonism: drugs

SALAD: Selegiline Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine) L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide) Amantadine Dopamine postsynaptic receptor agonists (bromocriptine, lisuride, pergolide) Phenytoin: adverse effects PHENYTOIN: P- interactions Hirsutism Enlarged gums Nystagmus Yellow-browning of skin Teratogenicity Osteomalacia Interference with B metabolism (hence anemia) Neuropathies: vertigo, ataxia, headache 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 Pupils in overdose: morphine vs. amphetamine "MorPHINE: Fine. AmPHETamine: Fat": Morphine overdose: pupils constricted (fine). Amphetamine overdose: pupils dilated (fat). Serotonin syndrome: components Causes HARM: Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus 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) 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. Tricyclic antidepressants: members worth knowing "I have to hide, the CIA is after me": Clomipramine Imipramine Amitrptyline _ If want the next worth knowing, the DNDis also after me: Desipramine Norrtriptyline

Doxepin Tricyclic antidipressents (TCA): side effects TCA'S: ThrombocytopeniaCardiac (arrhymia, MI, stroke) Anticholinergic (tachycardia, urinary retention, etc) Seizures Vigabatrin: mechanism Vi-GABA-Tr-In: Via GABA Transferase Inhibition Antibiotics contraindicated during pregnancy MCAT: Metronidazole Chloramphenicol Aminoglycoside Tetracycline 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 Metabolism enzyme inducers "Randy's Black Car Goes Putt Putt and Smokes": Rifampin Barbiturates Carbamazepine Grisoefulvin Phenytoin Phenobarb Smoking cigarettes Morphine: side-effects MORPHINE: Myosis Out of it (sedation) Respiratory depression Pneumonia (aspiration) Hypotension Infrequency (constipation, urinary retention) Nausea Emesis Therapeutic index: formula TILE: Code: TI = LD / ED 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) Asthma drugs: leukotriene inhibitor action zAfirlukast: Antagonist of lipoxygenase zIlueton: Inhibitor of LT receptor Beta- vs Beta- receptor location "You have heart and lungs": Beta- are therefore primarily on heart. Beta- primarily on lungs. Hepatic necrosis: drugs causing focal to massive necrosis

"Very Angry Hepatocytes": Valproic acid Acetaminophen Halothane Adrenoceptors: vasomotor function of alpha vs. beta ABCD: Alpha = Constrict. Beta = Dilate. 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. Beta-blockers: main contraindications, cautions ABCDE: Asthma Block (heart block) COPD Diabetes mellitus Electrolyte (hyperkalemia) Beta-blockers: nonselective beta-blockers "Tim Pinches His Nasal Problem" (because he has a runny nose...): Timolol Pindolol Hismolol Naldolol Propranolol 1.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 2.Cholinergics (eg organophosphates): effects If you know these, you will be "LESS DUMB": Lacrimation Excitation of nicotinic synapses Salivation Sweating Diarrhea Urination Micturition Bronchoconstriction 3.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 4.Methyldopa: side effects METHYLDOPA: Mental retardation Electrolyte imbalance Tolerance Headache/ Hepatotoxicity

psYcological upset Lactation in female Dry mouth Oedema Parkinsonism Anaemia (haemolytic) 5.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) 6. 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 7.Lithium: side effects LITH: Leukocytosis Insipidus [diabetes insipidus, tied to polyuria] Tremor/ Teratogenesis Hypothyroidism 8.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 9.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