Pharmacology Neumonics

PHARMACOLOGY NEUMONICS
As a pharmacy student, I learned about the value of acronyms and mnemonics.

I will never forget things like “CONDOM for anti-staphylococcal penicillins (cloxacillin, oxacillin, nafcillin, dicloxacillin, oxacillin [again], methicillin), or “RIPE” for a common Mycobacterium tuberculosis regimen (rifampin, isoniazid, pyrazinamide, ethambutol).

The mneuomonic “Barbie’s race car goes phast” for inducers of cytochromes P450 (barbituates, rifampin, carbamazepine, griseofulvin, phenytoin) will also stay with me forever.

As a pharmacy resident rotating through a medical intensive care unit (ICU), I was introduced to the extremely valuable acronym “FAST HUG” for assessing ICU patients (feeding, analgesia, sedation, thromboembolic prophylaxis, head of bed elevation, ulcer prophylaxis, glycemic control).

With all of the tasks I performed each day, this easily memorized checklist proved invaluable in ensuring that I reviewed key clinical information on every patient.

In an effort to employ this strategy of using an acronym-oriented checklist to assist in clinical decision-making within the area of infectious diseases, I have created the acronym “ID ADVISER” for pharmacists and other health care professionals to use.

The following is by no means all-inclusive of the considerations one must account for when prescribing or dispensing antimicrobial drugs, but it does cover most of the fundamentals that should be addressed as we make decisions and advise patients or other health care professionals on safe and appropriate antimicrobial drug use:

I – indication
D – duration
A – allergies
D – dose
V –vaccination
I – interactions
S – side effects
E – education
R – route

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

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

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

Sulfonamide: major side effects SSSS
Steven-Johnson syndrome
Skin rash
Solubility low (causes crystalluria)
Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin binders like warfarin)

Busulfan: features ABCDEF:
Alkylating agent
Bone marrow suppression
CML indication
Dark skin (hyperpigmentation)
Endrocrine insufficiency (adrenal)
Fibrosis (pulmonary)

Physostigmine vs. Neostigmine LMNOP:
Lipid soluble
Miotic
Natural
Orally absorbed well
Physostigmine
· Neostigmine, on the contrary, is:
Water soluble
Used in myesthenia gravis

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, and 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)

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)

Methyldopa: side effects METHYLDOPA:
Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity 
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism
Anaemia (haemolytic)

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

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

The views expressed in this article are those of the author and do not necessarily reflect the position or policy of the any Department or any government.

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