Post on 08-Apr-2018
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PAIN MANAGEMENT IN PATIENTS WITH CANCERMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) Nonopioidanalgesics
Relieves moderate to severe pain byinhibiting COX in the CNS but not in theperiphery.Beneficial effects are painrelief, suppression of inflammation, andreduction of fever.
NSAIDsAcetaminophen
2.) Opioidanalgesics
Relieves pain by mimicking the actionsof endogenous opioid peptides,
primarily at mu receptors and partly atkappa receptors.
MILD TO MODERATEPAIN
CodeineHydrocodoneOxycodoneTramadol
MODERATE TO SEVEREMorphineFentanylHydromorphoneLevorphanolMethadoneOxymorphone
3.) Adjuvantanalagesics
Used to compliment the effects of opioids.
It is employed in combination with opioids-
not as substitutes.
y Tricyclic
antidepressants
Amitriptyline
Desipramine
Doxepin
Imipramine
Nortriptyline
y Other anti
depressantsBupropion
Duloxetine
Venlafaxine
y Antiseizure drugs
Carbamazepine
Gabapentin
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Lamotrigine
Phenytoin
Pregabalin
y Antidysrythmics
LidocaineMexiletine
y CNS stimulants
Dextroamphetamine
Methylphenidate
y Antihistamines
Hydroxyxine
y
GlucocorticoidsDexamethasone
Predinisone
y Bisphosphonates
Etidronate
Pamidronate
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DRUGS FOR HEADACHE
MNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) Abortivetherapy
Relieves moderate to severe migraineattacks. Alters transmission atserotonergic, dopaminergic, and alpha-adrenergic junctions.
Serotonin
AnalgesicsErgot alkaloidsHaloperidolRecepetor AgonistNaproxen
Telcagepant
2.) PreventiveTherapy
Prophylactic therapy can reduce thefrequency and intensity of migraineattacks. Inhibits reuptake of serotonin,making more transmitter available for action.
y Beta AdrenergicBlocking agents
PropanololTimolol
y Tricyclicantidepressant
Amitriptyline
y Antiepileptic DrugsDivalproexTopiramate
y Estrogens
y Calcium channelblockers
VerapamilFlunarizine
Other drugs for prophylaxis
Modulation of neurotransmitter release,a calcium-dependent process thatCCBs are known to effect
y Calcium channelblockers
verpamil
y Neurostabilizer DivalproexTopiramateLithium
y NSAID
IndomethacinNaproxen
y Ergot alkaloids
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Ergotamine
y Glucocorticoids
prednisone
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Antipsychotic Agents and Their Use in SchizophreniaMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) First-generationantipsychotics:individualagents
FGAs are equally effective at alleviatingsymptoms of schizophrenia. Differencesamong these agents relate primarily toside effects because the high-potencyagents produce fewer side effects thanthe low-potency agents, high potencyagents are generally preferred.
y Low potency agentsChlorpromazineThioridazine
y Medium potencyagents
LoxapineMolindonePerphenazine
y High potency agentsTrifluoperazineThiothixeneFluphenazineHaloperidolPimozide
2.) Second-generationantipsychotics
SGAs and FGAs are equally effective.Major side effects, the SGAs are lesslikely to cause EPS, including TD.However, the SGAs carry an evengreater risk of their own, namely,potentially fatal metabolic effects-weightgain, diabetes, and dyslipidemia-thatcan lead to cardiovascular events andpremature death.
ClozapineOlanzapineRisperidonePaliperidoneQuetiapineZiprasidoneAripiprazole
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AntidepressantsMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) SelectiveSerotoninReuptakeInhibitors
Fluoxetine - Selective inhibition of 5-HTreuptake, and thereby intensifiestransmission of serotonergic synapsesThese drugs are as effective as theTCAs, but do not cause hypotension,sedation, or anti-cholinergic effects arenausea, agitation/insomnia, and sexual
dysfunction.
SertralineFluoxetineCitalopramEscitalopramFluvoxamineParoxetine
2.) Serotonin/NorepinephrineReuptakeInhibitors
Block neuronal reuptake of serotoninand norepinephrine, with minimaleffects on other transmitters or receptors. Pharmacologic effects aresimilar to those of the SSRIs, althoughthe SSRIs may be better tolerated.
DesvenlafaxineVenlafaxineDuloxetine
3.) MonoamineOxidase
Inhibitors
It is an enzyme found in the liver, theintestinal wall, and terminals of
monoamine-containing neurons. Thefunction of MOA in neurons is to convertmonoamine neurotransmitter- NE, 5-HT,and dopamine- into inactive products.
SelegilineIsocarboxazid
PhenelzineTranylcypromine
4.) AtypicalAntidepressants
The mechanism by which depression isrelieved is unclear, but may be relatedto blockade of dopamine uptake. It doesnot affect serotonergic, cholinergic, or histaminergic transmission.
MirtazapineAmoxapineBupropionNefazodoneTrazodone
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Drugs for Bipolar Disorder
MNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) Mood-StabilizingDrugs
Mood stabilizers are drugs that canrelieve an acute manic or depressiveepisodes, prevent recurrence of manicand depression, or accelerate the rateof cycling.
Lithium
y Antiepileptic DrugsValproic AcidCarbamazepineLamotigrine
2.) Antipsychoticdrugs
Control symptoms during manicepisodes, and long term to help stabilizemood.
OlanzapineQuetiapineRisperidoneAripiprazoleZiprasidoneclozapine
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Sedative-Hypnotic Drugs
MNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) Benzodiazepines
Enhances actions of GABA by bindingto specific receptors in asupramolecular structure known as theGABA receptor-chloride channelcomplex.
TriazolamFlurazepamQuazepamEstazolamTemazepam
2.) Benzodiazepine-Like Drugs
They all act as agonist at thebenzodiazepine receptor site on GABAreceptor-chloride channel complex.
EszopicloneZolpidemZaleplon
3.) MelatoninAgonist
Activates receptors for melatonin-specifically the MT1 and MT2 subtypes,which are key mediators of the normalsleep-wakefulness cycle.
Ramelteon
4.) Barbiturates Bind to GABA receptor-chloride channelcomplex. These drugs can enhance the
inhibitory actions of GABA and directlymimic the actions of GABA.
Other Hypnotics Decrease sleep latency and prolongsleep duration and does not causetolerance or physical dependence.
TrazodoneAntihistaminesAlternative medicines
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Management of Anxiety DisordersMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) GeneralizedAnxietyDisorder
Enhancing responses to GABA. Onseteffects are immediate, and the marginof safety is high. Principal side effectsare sedation and psychomotor slowing.
AntidperessantsBenzodiazepinesBuspirone
2.) Panic Disorder Decreases frequency and intensity of attacks, anticipatory anxiety, and
avoidance behaviour.
SertralineFluoxetine
Paroxetine
3.) Obsessive-CompulsiveDisorder
All enhances serotonergic transmission. ParoxetineCitalopramEscitalopramFluoxetineFluvoxamineSertraline
4.) Social Anxiety
Disorder
Inhibits CNS neuronal uptake of
serotonin; blocks uptake of serotoninwith weak effect on norepinephrine.
Fluvoxamine
ParoxetineSertraline
5.) Post-TraumaticStressDisorder
Potentiates serotonergic activity in theCNS, resulting antidepressant effect.
ParoxetineSertraline
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DRUGS ABUSE II: ALCOHOLMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) To FacilitateWithdrawal
Benzodiazepines- Stabilizes vital signs, reduce symptomintensity, and decrease risk of seizuresand delirium tremens.
Beta-Adrenergic Blockers-Improve vital signs; decrease craving,decrease autonomic component of
withdrawal symptoms.
Alpha-Adrenergic Blocker -Decrease autonomic component of withdrawal symptoms.
Antiepileptic Drug- Decreases withdrawal symptoms;prevent seizures.
ChlordiazepoxideDiazepamOxazepamLorazepam
AtenololPropranolol
Clonidine
Carbamazepine
2.) To Maintain
Abstinence
It blocks the pleasurable effects of
alcohol and decreases craving.
Disulfiram Aversion
TherapyNaltrexoneAcamprosateTopiramateOndansetron
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DRUGS ABUSE: MAJOR DRUGS OF ABUSEMNEMONICS:
Classifications:
CLASSIFICATIONCATEGORY
MECHANISM OF ACTION DRUGS DrugMNEMO
NICS
1.) Opioids high lipid solubility, which allows thedrug to cross the blood brain barrier with ease. Thereby producing effectsthat are both immediate and intense,
HeroinMorphineMeperidineHydromorphone
2.) Psychostimulants Amphetamines and cocaine canstimulate theheart, blood vessels, and
other structures under sympatheticcontrols. Because of these peripheralactions, these agents are also referredto as sympathomimetics.
CocaineDextroamphetamine
MethamphetamineMethylphenidate
3.) Depressants Produce substantial physicaldependence. Cross-dependence existsbetween barbiturates and other CNSdepressants but not with opioids. Incontrast, the opioid abstinencesyndrome is rarely life threatening.
y BarbituratesAmobarbitalSecobarbitalPentobarbitalPhenobarbital
y BenzodiazepinesDiazepam
FlunitrazepamLorazepam
y MiscellaneousAlcoholMethaqualoneGamma-hydroxybutyrateMeprobamate
4.) Psychedelics Acts multiple sites in the brain andspinal cord. However, effects are most
prominent in the cerebral cortex and thelocus ceruleus.
LSDMescaline
PsilocybinDimethyltryptamine
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5.) DissociativeDrugs
Distort perception of sight and sound,and produce feelings of dissociationfrom the environment. High dosesproduce sedation, immobility, analgesia,and amnesia.
PhencyclidineKetamine
6.) Anabolic steroids Enhances athletic performance. Theprincipal benefit is increased musclemass and strength.
NandroloneOxandroloneTestosterone
7.) Miscellaneous Nicotine can activate nicotinic receptorsat several locations. Most effects resultfrom activating nicotinic receptors inautonomic ganglia and the adrenalmedulla.Marijuana - Activation of specificcannabinoid receptors found in variousparts of the brain.
DextromethorphanMarijuanaNicotineNitrous oxideAmyl nitrite