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MNEMONICS NAPLEX | PNN
Which drugs are negative chronotrops? - ANSWER-ABCD: amiodarone, beta blockers, calcium channel blockers, digoxin Which beta blockers are B1 selective? - ANSWER-AMEBBBA: atenolol, metoprolol, esmolol, bisoprolol, betaxolol, Bystolic, acebutolol Which beta blockers come in IV form? - ANSWER-"MAPLES": metoprolol, atenolol, propranolol, labetalol, esmolol, sotalol Which beta blockers have intrinsic sympathomimetic activity? - ANSWER-APP: acebutolol, penbutolol, pindolol Which beta blockers are primarily through renal excretion? - ANSWER-"BreNALS" Bisoprolol Nadolol Atenolol Labetalol Sotalol What are the common side effects of beta blockers? - ANSWER-"BLOCKER" B: bradycardia/bronchospasm L: increased lipids/decreased libido O: orthostatic hypotension C: conduction abnormalities K: konstriction of peripheral vasculature (Raynauds) E: exhaustion/emotional depression R: reduced recognition of hypoglycemia What are the 4 treatment considerations for CHF? - ANSWER-4 D's: Diuretics, diet, digoxin (or any + inotrope), dilators What are the common side effects of ACEI? - ANSWER-"CAPTOPRIL" C: cough A: angioedema P: potassium (hyperkalemia) T: taste change O: orthostasis P: pregnancy (C 1st trimester, D 2-3rd trimester) R: rash, bilateral renal stenosis I: increase in K L: leukocytosis (for captopril)
What are the common side effects of amiodarone? - ANSWER-"AMIODARONE" A: Alevoli - pulmonary toxicity; AV blocker - bradycardia IOD: iodine - TSH O: Eye - corneal mico-deposits D: DDI - check LFT O: photosensitivity N: non-PVC if infuse > 2hr E: Electrolyte (Hypo Mg, K increase QTc) Which medications increase lipid? - ANSWER-"PAS BLT" P: protease inhibitor (LAND FIRST) A: antipsychotics S: SGLT- B: Beta-blocker L: Loop diuretics T: Thiazide Which pathway is blocked by warfarin? Which factors are blocked by warfarin? Which lab is used to measure warfarin? - ANSWER-Extrinsic 2,7,9, PT/INR: prothrombin time, international normalized ratio What are the colors for warfarin tablets? - ANSWER-"party like girls then bring peaches to your wedding" 1 mg: pink 2 mg: lavender 2.5 mg: green 3 mg: tan 4 mg: blue 5 mg: peach 6 mg: teal/greenish-blue 7.5 mg: yellow 10 mg: white What medications are given for the initial management of ACS? - ANSWER-MONAA BAS: morphine (or meperidine), oxygen, nitrates, aspirin, antiplatelets (loading dose), beta blocker, ACEI, statin Avoid Beta-blocker in cocaine-induced AMI Avoid NSAID d/t increased CV risk Discharge after ACS: NAABAS What are the statin dose equivalents for 38% LDL reduction (moderate statin)? - ANSWER-"Passionate Real Americans Simply Love Playing Football"
What are the common causes of high anion gap metabolic acidosis? - ANSWER- MUDPILES: methanol, uremia, DKA, paraldehyde, iron/INH, lactic acidosis, ethylene glycol/EtOH, salicylate What is the #1 cause of hyperthyroidism? - ANSWER-"Graves caused Credence to go HYPERnova" Graves Disease = HYPERthyroidism What is the equivalent dosing conversion for glucocorticoids? - ANSWER-"Cute Hot Pretty Pharmacist Makes Triple Digits Bloom!" Which drugs increase uric acid level? - ANSWER-"ABCDE-T"
- Aspirin, Alcohol
- Beta-blocker, B-3, Bempedoic acid
- CCB, chemo
- Diuretics (thiazide, loop)
- Ethambutol, pyrazinamide
- Ticagrelor, Tacrolimus, Paliperidone What are the common side effects of steroid long-term use? - ANSWER-"PREDNISONE" P: PUD/psychiatric R: retention of Na & H2O (high BP) E: eye (cataracts/glaucoma) D: diabetes (increase glucose) N: neurologic (CNS, insomnia) I: immunosuppression S: swelling (Cushing's) O: osteoporosis N: nausea (used for CINV tx) E: electrolyte changes (decreased K) How to manage DKA? - ANSWER-"DIABETES" Dehydrated --> hydrate with NS Insulin (IV 0.1 U/kg/h) Acidosis Bicarbonate (if aPH < 6.9) Electrolyte monitoring (K, Mg, PO4, HCO3) Time (check glucose qh) Electrolyte Sugars (when BG drops below 200-250) What are the common side effects of GLP-1 agonists? - ANSWER-"GLP-1" --> 1 looks like a "T" G: gallbladder dx/GI
L: lowers weight P: pancreatitis 1 (T): thyroid tumors BBW What are the common side effects of DPP-4? - ANSWER-DPP- Pancreatitis, joint Pain What drugs are DPP-4 inhibitors? - ANSWER-"SALSA! JNTO" Sitagliptin (Januvia) Alogliptin (Nesina) Linagliptin (Tradjenta) Saxagliptin (Onglyza) What are the common side effects of SLGT2 inhibitors? - ANSWER-"SGLT2" S: increased SCr (renal impairment) G: genital fungal infections L: increased LDL, lower weight + BP, labs (increase K, Mg, PO) T: bone fracTures 2(K): increased K and ketoacidosis What can you use to reduce cisplatin nephrotoxicity? - ANSWER-"Cisplatin goes HAM on your kidneys" H: hydrate (aggressive IV fluid) A: amifostine M: Mannitol IV What chemo cause peripheral neuropathy? - ANSWER-makes "PPT" for neuropathy topic
- Platinum (cisplatin)
- Plant alkaloids including vinca alkaloids
- Taxans What are important facts you have to remember about paclitaxel? - ANSWER-PAC- TAX: P: no PVC A: Alcohol in diluent C: castor oil allergy is CI Taxne: hypersensitivity, peripheral neuropathy Premedicate with dexamethasone, IV diphenhydramine, IV histamine H2 antagonist (ranitidine/famotidine) What PO antibiotics are recommended for MRSA? - ANSWER-"MRSA likes BCD tofu with LIght DEcent RIce "
C: chlamydia L: legionella Treatment: These are treated with MQT (me cutie) macrolide(azith, clarith Quinolones(cipr, levo Tetracyclimes(Doxy, minocycline What is an important side effect to remember about voriconazole? - ANSWER-VVV: Voriconazole (Vfend) can cause vision changes Which penicillins are penicillinase resistant and what are they used for? - ANSWER-"CONDM used for MSSA" C: cloxacillin O: oxacillin N: nafcillin D: dicloxacillin M: methicillin What class do second generation cephalosporins have greater activity against? - ANSWER-"HENPEKS" Gram (-) organisms H. influenzae Enterobacter aerogenes Neisseria Proteus mirabilis E. coli Klebsiella pneumonia Serratia What antibiotics are consider safe in pregnancy? - ANSWER-"P.A.C.E" penicillins azithromycin cephalosporins erythromycin Which cephalosporins are first line for N. gonorrhea? - ANSWER-"Please TRI to fix MY gonorrhea" First line: cefTRIaxone 500 mg IM x 1 dose (1g if greater than 150 kg) If did not exclude chlamydia: Add Doxycycline (VibraMYcin) 100 mg PO BID x 7 days Cephalosporin Allergy: azithroMYcin + gentaMicin
Neonatal ocular ppx: ErythroMYcin eye cream What are the side effects of fluroquinolones? - ANSWER-"CiPRO" C: Crystalluria, CNS (seizure, delirium), C diff colitis P: photosensitivity, peripheral neuropathy (myasthenia gravis), hyPer + hyPOglycemia R: Rupture of the tendon (increased with steroid) + aortic O (Q): QT prolongation OATP inhibitors decrease cipro: Orange, Apple, Tea QuinALONE: Give alone, sepetate antacids, vitamins and didanosine, Not for pt < (cannot live alone) What bacterias are not covered by Tigecycline? - ANSWER-"Tigers don't pee" Tigecycline doesn't cover the Ps (Pseudomonas, Proteus, Providencia) Which are the respiratory fluoroquinolones? And urinary quinolones? - ANSWER-MGLD = my good lung day
- respiratory
- Moxi, Gemi, levo, dela CL
- urinary quinolones
- cipro, levo What are the facts and side effects of tetracycline? - ANSWER-"Tetracycline" T
- thirty S subunit
- teeth discoloration
- teratogenic
- aTypical pathogens (Chlamydia, mycoplasma)
- toxicity (hepatotoxic, nephrotoxic except doxycycline, phototoxicity)
- Ten: avoid use < 8 years old What are the facts about metronidazole? - ANSWER-"METRONIDazole" M: metallic taste E: Empty stomach T: TID R: re dissolved crystal on warming to room temp. May be refrigerated O: protect from light N: neuro (seizure, peripheral, optic neuropathy) I: gI upset, contraindicated 1st trimester, 1st line for bacterial vaginosis
G: GI bleed (caution with warfarin, NSAID use) What side effects do you have to worry about for lithium? - ANSWER-LITHIUM: L: levels (0.6 - 1 mEq/L) / leukocytosis I: increased urination (polyuria/polydipsia) T: tremor / TSH / take with food H: hypercalcemia / hyperthyroidism I: increased CNS / dermatologic U: BUN and SCr (renal function) M: monitor WEB (weight, EKG, Beta-hCG) What are common side effects of antipsychotics? - ANSWER-"WASH MEN" Weight gain (Olanzapine, Clozapine) Anticholinergic (Clozapine) Sedation Hypotension (Clozapine, iloperidone), Hyperprolactinemia Movement disorders EPSE: dystonic reaction, akathisia, pseudoparkinsonism, Tardive dyskinesia Neuroleptic malignant syndrome What are the side effects of anticholinergic? - ANSWER-Anti-SLUDGE Anti S: salivation L: lacrimation U: urination D: defecation/diaphoresis G: GI motility E: excretion/emesis What are the side effects of barbituates? - ANSWER-BARBituates: B: bone disease/bone marrow suppression A: ataxia R: rash/respiratory depression B: behavior changes, bradycardia What are the major CYP inducers? - ANSWER-SR COP S: smoking, St. John's Wort R: rifampin C: carbamazepine O: oxcarbazepine P: phenobarbital, phenytoin What are the major CYP inhibitors? - ANSWER-G-PACMAN G: grapefruit
P: protease inhibitors (i.e. ritonavir) A: azole antifungals C: cyclosporine, cimetidine, cobicistat M: macrolides (not azithromycin) A: amiodarone N: non-DHP CCBs Which drugs should not be put into PVC IV containers? - ANSWER-LATIN L: lorazepam A: amiodarone T: tacrolimus I: insulin N: nitroglycerin Which antibiotics have photosensitivity? - ANSWER-"Too Much ****ing Sunlight" T: tetracyclines M: macrolides F: fluoroquinolones A: sulfonamides Which IV drugs cannot be used with D5W? - ANSWER-"ACID APE" A: ampicillin C: caspofungin (Cancidas) I: infliximab (Remicade) D: daptomycin (Cubicin) A: ampicillin/sulbactam (Unasyn) P: phenytoin E: ertapenem (Invanz) Which IV drugs cannot be used with saline? - ANSWER-"ABS" A: amphotericin B B: Bactrim S: Synercid Which IV drugs require a 0.22 micron filter? - ANSWER-"PLAAG" needs a filter cuz of his dirty language P: phenytoin L: lorazepam A: amiodarone A: abciximab G: golimumab (Symponi) Lipids require 1.2 microns. Ampho B requires 5 micron
Which drugs belong to class 1a antiarrthymics? - ANSWER-"Double Quarter Pounder - QDP" Quinidine, Disopyramide, Procainamide *intermediate (atrial and ventricular arrhythmias) Which drugs belong to class 1b antiarrthymics? - ANSWER-"Lettuce and Mayo - PLM" Phenytoin, Lidocaine, Mexiletine (ventricular arrhythmias) *Mexiletine only comes in PO *fast/rapid Which drugs belongs to class 1c antiarrthymics? - ANSWER-"Fries Please - PF" propafenone, flecainide (atrial and ventricular arrhythmias) *slowest Which drugs belongs to class 3 antiarrthymics? - ANSWER-"IASDDD" Ibutilide, Amiodarone, Sotalol, Dofetilide, Dronedarone (Multaq) Which proton pumps inhibitors are injectable? - ANSWER-POLE (first and last has injectables) pantoprazole Omeprazole: has ODT lansoprazole: has ODT Esomeprazole what encapsulated bacteria should you be treated for asplenia patients? - ANSWER- Please shine my sky Pseudomonas S. pneumoniae, Streptococcus agalactiae Haemophilus influenzae Neisseria meningitidis E. coli salmonella klebsiella What drugs are nucleoside reverse transcriptase inhibitors? - ANSWER-"ZALES DT" Zidovudine (Retrovir) Abacavir (Ziagen) Lamivudine (Epivir) Emtricitabine (Emtriva) Stavudine (Zerit)
Didanosine (Videx) Tenofovir (nucleotide)
- TDF (viread)
- TAF (vemlidy) What drugs are non-nucleoside reverse transcriptase inhibitors? - ANSWER-"RNEEDD" Rilpivirine (Edurant) Nevirapine (Viramune) Efavirenz (Sustiva) Etravirine (Intelence) Doravirine (Pifelto) Delavirdine (Rescriptor) What drugs are protease inhibitors? - ANSWER-"LAND FIRST" ("navir") Lopinavir/ritonavir (Kaletra) Atazanavir (Reyataz) Nelfinavir (Viracept) Darunavir (Prezista) Fosamprenavir (Lexia) Indinavir (crixivan) Ritonavir (Norvir) Saquinavir (Invirase) Tipranavir (Aptivus) What drugs are integrase inhibitors? - ANSWER-"RBEDC"("tegravir") Raltegravir (Isentress) Bictegravir Elvitegravir Dolutegravir (Tivicay) Cabotegravir (Vocabria) What drugs are in the Viekira pak for Hep B? - ANSWER-"PORD" Paritaprevir + Ombitasvir + Ritonavir + Dasabuvir What are the combinations for TAF and TDF? - ANSWER-"DOG has TICS" Descovy: Emtricitabine + TAF Odefsey: Descovy + Rilpivirine Genvoya: Descovy + Elevitegravir + cobistat Truvada: Emtricitabine + TDF Complera: Truvada + Rilpivirine Stribild: Truvada + Elevitegravir + cobistat
Cyclosporine SE is just like tacrolimus, but with the addition of "gingival hyperplasia, hirsutism". non-PVC only What drugs are use for overactive bladder? - ANSWER-"SOFT BladDAR" (relaxed bladder) Solifenacin (Vesicare) Oxybutynin (Ditropan, Oxytrol-OTC) Fesoterodine (Toviaz) Tolterodine (Detrol) Trospium - less CNS SE Beta-3 adrenergic agonist DARifenacin (Enablex) - less CNS SE *Beta-3 adrenergic agonist (-begron) for pt > 70 y/o or with cognitive impairment Mirabegron (Myrbetriq): severe HTN Vibegron (Gemtesa) What are the side effects of FLibAnSeriN (Addyi)? - ANSWER-FLibAnSeriN L: Liver A: contraindicated with alcohol S: serotonin mixed agonist and antagonist, syncope, CYP3A4 substrate N: take it at Night qhs Add-yi 淫 Anticholinergic Drugs/Combos with SABA - ANSWER-"SALT IS Salty Crunchy Delicious" S= Spiriva Handihaler - Tiotropium DPI A= Atrovent HFA - Ipratropium MDI L= Lonhala Magnair - Glycopyrrolate NEB T= Tudorza Pressair - Aclidinium DPI I= incruse Ellipta - Umeclidinium DPI S= Spiriva Respimat - Tiotropium MDI Salty = Seebri Neohaler - Glycopyrrolate Crunchy = Combivent Respimat - Alb/Ipra Delicious = Duoneb - Alb/Ipra NEB LABA/Anticholinergic - ANSWER-Steak Under A Broil
Stiolto Respimat - Tiotropium/Olodaterol Utibron Neohaler - Indacat/Glycopyr Anoro Ellipta - Vilanterol/Umeclidinium Bevespi Aerosphere - Formoterol/Glycopyr LABA/Corticosteroid - ANSWER-BAS (Think of the fish Bass) Breo Ellipta - Vilanterol/Fluticasone Advair Diskus - Salmeterol/Fluticasone Symbicort - Formoterol/Budesonide LABA - ANSWER-"Open In Fridge And Seek Vanilla" = LABA's only Olodaterol - Striverdi Respimat MDI Indacaterol - Arcapta Neohaler DPI Formoterol - Perforomist NEB Aformoterol - Brovana NEB Salmeterol - Serevent Diskus DPI Vilanterol - *Both Formoterol and Aformoterol are refrigerated ;) *Vanilla sounds like Ellipta, vilanterol comes in combos only that are Ellipta's. Know your chemo man - ANSWER- Which SSRI are stimulating? and sedating? - ANSWER-Fly to the sky. pee and floss at night Fluoxetine is stimulating SSRIs. Take in AM Paroxetine and Fluvoxamine are sedating SSRI. Take in PM What are the key things to watch for Topiramate and Zonisamide? - ANSWER-Zoning your kidney, Sit on Top of your head Zonisamide (Zonegran) and Topiramate (Topamax) both has watch out for Kidney stones (signs of flank pain, recommend to drink lots of water). Topiramate is also indicated for Migraine prophylaxis. What are the side effects and monitoring parameters for Leflunomide? - ANSWER-"Leflunomide (Arava)"
