Dopamine postsynaptic receptor agonists ...bromocriptine, lisuride, pergolide
Beta-1 vs Beta-2 receptor
You have 1 heart and 2 lungs
Beta-1 are therefore primarily on heart
Beta-2 primarily on lungs
HEPATIC ENZYME INHIBITORS
SICKFACES. COM
Sodium valproate
Isoniazide
Cimetidine
Ketoconazole
Fluconazole
Alcohol..binge drinking
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
HEPATIC ENZYME INDUCERS
GP PARCS
Griseofulvin
Phenytoin
Phenobarbitone
Alcohol..chronic use
Rifampicin
Carbamazepines
Sulfonyl ureas
DRUGS EXTENSIVELY BOUND TO PROTEINS
PDF SWAMP
Propranolol
Diazepam
Fibrates
Sulfonyl ureas
Warfarin
Aspirin
Montelukast
Phenytoin
Phenytoin: adverse effects
PHENYTOIN
P-450 interactions
Hirsutism
Enlarged gums
Nystagmus
Yellow-browning of skin
Teratogenicity
Osteomalacia
Interference with B12 ----bolism ..hence anemia
Neuropathies: vertigo, ataxia, headache
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
MORPHINE'S PHYSIOLOGICAL ACTIONS
HECK of a DREAM
Histamine and Hormonal actions..increased prolactin, decreased GRH, CH, FSH, ACTH
EmesisContraction of biliary smooth muscle
Cardiovascular changes..there's verry little
CV changes at normal dosages, orthostatic hypotension may occur
Decrease cough reflex, Decrese GI motility, Depression of mental functioning,,,seddation
Respiratory depression
Euphoria
Analgesia
Miosis
THE ADVERSE REACTIONS OF CHOLINERGIC AGONISTS
DUMBLES
Diarrhea and decreased blood pressure
Urination
Miosis
Bronchoconstriction
Lacrimation
Excitation of skeletal muscle
Salivation and sweating
THERAPEUTIC USES OF BETHANECHOL..cholinergic
BBB
Bethanechol stimulates the
Bladder and Bowel
TOXIC EFFECT OF MUSCARINIC ANTAGONISTS
Dry as bone, Hot as a hare, Red as a beet, Blind as a bat, Mad as a hatter
Dry mouth
Inhibition of sweating specially in young children
Tachycardia and cutaneous vasodilation
Blurred vision
Hallucination and delirium
Beta-blockers: main contraindications, cautions
ABCDE
Asthma
Block...heart block
COPD
Diabetes mellitus
Electrolyte ...hyperkalemia
Beta 1 selective blockers
"BEAM ONE up, Scotty"
Beta 1 blockers
Esmolol
Atenolol
Metropolol
Beta-blockers: nonselective beta-blockers
"Tim Pinches His Nasal Problem" (because he has a runny nose)
Timolol
Pindolol
Hismolol
Naldolol
Propranolol
Hypertension: treatment
ABCD
ACE inhibitors/ AngII antagonists...sometimes Alpha agonists also
Beta blockers
Calcium antagonists
Diuretics...sometimes vasoDilators also
microsomal enzyme inhibitors:''sick mice''
S-sulfonamide
I-INH
C-clarithromycine
K-ketoconazole
M-metronidazole
I-itraconazole
C-chloramphenicol
E-erythromycine
Horner's syndrom
PEMAorPAME
P = ptosis
E = enophthalmus
M = myosis
A = anhydrosis
Beta blockers with CYP2D6 polymorphic metabolism
"I Met Tim Carver, 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: 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.
Opiods: mu receptor effects "MD CARES":
Miosis
Dependency
Constipation
Analgesics
Respiratory depression
Euphoria
Sedation
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
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.
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
Sedation
Direct sympathomimetic catecholamines: DINE
Dopamine/ Dobutamine
Isoproterenol
Norepinephrine
Epinephrine
Anticholinergic side effects
"Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine
Atropine use: tachycardia or bradycardia
"A goes with B": Atropine used clinically to treat Bradycardia
Morphine: effects at mu receptor PEAR:
Physical dependence
Euphoria
Analgesia
Respiratory depression
Methyldopa: side effects
METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism
Anaemia (haemolytic)
