Drugs: Reactions

SALICYLATE POISONING
Le THIN
Le - Lethargy/excitability
T - Tinnitus
H - Hyperventilation
I - Increased temperature (98.6)
N - Nausea & vomiting
*Severe toxicity = Metabolic acidosis & seizures
*Toxic level for a 30lb. child = 12 adult aspirin or 48 baby aspirin

LIDOCAINE TOXICITY
SAMS
S - Slurred speech or Difficult speech (Paresthesias, numbness of lips/tongue)
A - Altered CNS (drowsiness, dizzinesss, arrhythmias, restlessness, confusion)
M - Muscle twitching (tremors)
S - Seizures ( Convulsions, resp. depression, resp. & cardiac arrest)

THESE DRUGS CAN INTERACT
TDCI
T - Theophyline
D - Dilantin
C - Coumadin
I - Ilosone (Erythromycin)

"CUTIES" SAY NO TO OBs
"Cuties" (Q.T.s)
Quinolones & Tetracyclines CONTRAINDICATED
during
Pregnancy and Lactation

AMINOGLYCOSIDE TOXICITY
Major TOXIC effects are:
OTOTOXICITY & NEPHROTOXICITY
*Amikacin, Neomycin, Tobramycin, Gentamycin

ATROPINE OVERDOSE
"Hot as a Hare" - increased temperature
"Mad as a Hatter" - confusion, delirium
"Red as a Beet" - flushed face
"Dry as a bone" - decreased secretions, thristy

SERIOUS COMPLICATION OF ORAL BIRTH CONTROL PILLS
ACHES
A - Abdominal pains
C - Chest pain (SOB)
H - Headaches (sudden/persistent); CVA or inc. BP
E - Eye problems (vascular accident or inc. BP)
S - Severe leg pain (thromboembolic process)

EMERGENCY DRUGS TO LEAN ON:
L - Lidocaine
E - Epinephrine
A - Atropine
N - Narcan

BETA-BLOCKERS ACTIONS
Beta-blockers 1 affect the heart
Beta-blockers 2 affect the lungs

SIDE EFFECTS OF ADRENERGIC ANTAGONISTS B-BLOCKERS
Hypotension
Symptoms of CHF (coughing, SOB, edema, fatigue)
Bradycardia (AV-block)
Drowsiness & Depression
*Propranolol (Inderal), Tenormin (Atenolol), Lopressor (Metoprolol)

SIDE EFFECTS OF ADRENERGIC ANTAGONISTS ALPHA-BLOCKERS
Orthostatic hypotension
Vertigo
Tachycardia
Sexual dysfunction
* Doxazosin (Cardura), Prazosin (Minipress), Methyldopa (Aldomet)

CALCIUM ANTAGONISTS
Very Nice Drugs
V - Verapamil
N - Nifedipine
D - Diltiazem
*S/E: decreased BP, bradycardia, may precipitate AV block, headache, abdominal discomfort (constipation,nausea), peripheral edema
*Action: blocks calcium access to celss = decreasing contractility, conductivity of the heart & demand for oxygen

DRUGS FOR BRADYCARDIA & DECREASED BP
IDEA
I - Isoproterenol
D - Dopamine
E - Epinephrine
A - Atropine

ANTI-HYPERTENSIVE DRUGS
1. ACE Inhibitors: ends in aPRIL
BEN's CAP
B - Lotensin (BenzaPRIL)
En - Vasotec (EnalaPRIL)
Cap - Capoten (CaptoPRIL)
*Action : decreases peripheral vascular resistance WITHOUT:
INCREASED cardiac output, cardiac rate, cardiac contractiliy
*S/E : Dizziness, orthostaic hypotension, GI distress, cough, headache

2. Beta-blockers: ends in OLOL
I - Inderal (PropranOLOL)
T - Tenormin (AtenOLOL)
*Action : blocks beta receptors in the heart causing:
DECREASED heart rate, force of contraction, rate of AV conduction
*S/E : Bradycardia, lethargy, GI disturbance, CHF, dec. BP, depression

3. Calcium Antagonists
Very Nice Drugs
V - Calan/Isoptin (Verapamil)
N - Procardia (Nifedipine)
D - Cardizem (Diltiazem)

ANTI-CANCER DRUGS
Adverse Reactions/Precautions
Bone marrow suppression
Nausea & vomiting
Anorexia
GI disturbances
Alopecia
Avoid pregnancy

CHOLINERGIC CRISIS
SLUD
S - Salivation
L - Lacrimation
U - Urination
D - Defecation

MIXING INSULIN
"Draw up the CLEAR before the CLOUDY"
Regular - Clear and fast-acting
NPH - Cloudy and long-acting

HEPARIN/COUMADIN
Corresponding lab tests:
Coumadin - PT (prothrombin time)
Warfarin - PT
Heparin - PTT & aPTT (partial thromboplastin time + activated PTT)

MAO INHIBITORS
PNM or NPM "No Popular Meds"
P - Parnate
N - Nardil
M - Marplan
"No Popular Meds" such as: Barbiturates, TCA's, anti-histamines, CNS depressants, anti-hypertensives, OTC cold meds
"NO" = cheese, wine, pickled foods (tyramine containing foods)
*These foods CAUSE: sweating, tremors, elevated temperature, bounding heart

MEDICATIONS AND VITAMIN B6
INH (Isoniazide) : INCREASE the B6
Levodopa : DECREASE the B6

Drugs: Psychia

DRUGS FOR ANXIETY
VEALS
V - Valium
E - Equanil
A - Atarax
L - Librium
S - Serax
BATS
B - Beta-adrenergic blockers, Benzodiazepines
A - Antihistamines -- COPD or potential abuse of benzodiazepines
T - Tricyclics and MAO inhibitors for panic attacks
S - SSRI's

ANTI-DEPRESSANTS
1. (TCA's)
TINA
T - Trimipramine
I - Imipramine
N - Nortryptiline
A - Amitryptiline

2. MAO INHIBITORS
P - Parnate
M - Marplan
N - Nardil
* Avoid tyramine containing foods/drugs such as: OTC's, cola, beer, wine, cheese, liver, rolls with yeast, figs, chocolates
* These foods can cause hypertensive crisis - elevated temperature, tremors, tachycardia and increased BP

DRUG FOR MANIC PATIENTS
LITHIUM
l - Levels (monitor)
I - Incontinence
T - Thirst, Thyroid studies
H - Hand tremors
I - Increase fluids
U - Unsteady gait
M - Manic, Morton's Salt

UNDESIRABLE EFFECTS OF ANTI-PSYCHOTICS
STANCE
S - Sedation, Sunlight sensitivity
T - Tardive dyskenesia
A - Anticholinergic effects, Agranulocytosis
N - Neuroleptic Malignant Syndrome
C - Cardiac Arrhythmias
E - Extrapyramidal (akathesia)

Drugs : Antidotes

Agents/Reactions : Antidotes

1. Acetaminophen : acetylcysteine (Mucomyst)
2. Anticholinesterase : atrophine or pralidoxime
3. Anticholinergics : physostigmine
4. Antifreeze : fomepizole
5. Benzodiazepines : flumazenil (Romazicon)
6. Beta-blockers : glucagon
7. Calcium channel blockers : glucagon
8. Coumadin : phytonadione (Vit. K)
9. Cyanide : amyl nitrate, sodium nitrate, or sodium thiosulfate
10. Cyclophosphamide : mesna

11. Digoxin : digoxin immune Fab (Digibind)

12. Dopamine : phentolamine (Regitine)

13. Extrapyramidal symptoms : diphenhydramine (Benadryl)

14. Ethylene glycol : fomepizole

15. Flourouracil : leucovorin calcium

16. Heparin : protamine sulfate

17. Insulin reaction : IV glucose (D50)

18. Iron (Fe) : deferoxamine

19. Lead : dimercaprol, edetate calcium disodium, or succimer

20. Methotrexate : leucovorin calcium

21. Narcotics : naloxone (Narcan) or nalmefene

22. Neuromuscular blockade (paralytics):

a. Non-depolarizing such as - pancuronium, vecuronium : anticholinesterase agents (usually with atropine d/t muscarinic effects)

b. Depolarizing such as - succinylcholine : maintain patent airway and ventilation until normal respirations attained

23. Opioid analgesics : nalmefene or naloxone (Narcan)

24. Organophosphate (OPP) : atropine

25. Potassium (KCl) : albuterol inhaler, insulin & glucose, NaCHO3 or sodium polystyrene sulfonate (Kayexalate)

26. TCA's : physostigmine or NaCHO3

27. Tylenol : acetylcysteine

28. Warfarin : phytonadione (Vit. K)

Drugs: Emergency

(Name: Initial Dose [indication])

1. ADENOSINE : 6mg rapid IVP; rpt 12 mg x 2 [SVT]

2. AMIODARONE : 300 mg IVP, [VF, VT, SVT]

3. ATROPHONE : 0.5 mg q3-5min upt to 2mg [bradycardia]

4. EPINEPHRINE : 1mg q3-5 min [cardiac arrest]

5. LASIX : 0.5-1mg/kg IV [pulmonary edema]

6. LIDOCAINE : 1-1.5mg/kg IV q5-10 min. max 3mg/kg [VF, VT]

7. MAGNESIUM : (MgSo4) 1-2g IVP [VT r/t hypomagnesemia]

8. MORPHINE : (MSO4) 1-3 mg [CP, pulmonary edeman]

9. NARCAN : 0.02-0.2 mg q2-3min [ narcotic resp depression]

10. NITROGLYCERIN : 0.4mg SL q3-5 min x [CP, pulmonary edema]

11. ROMAZICON : 0.2 mg q min up to 1 mg [benzodiazepine OD]

12. SOLU-MEDROL : 1-2 mg/kg [allergic reaction]

13. VASOPRESSIN : 40 units IVP [cardiac arrest]

Drugs: Name Endings

What they can tell you:
Drugs with these endings___usually belongs to this class
- caine ____________________ Local anesthetics
- cillin_____________________ Antibiotics
- dine _____________________ Antiulcer agents (Histamine H2 blockers)
- done _____________________Opioid analgesics
- ide ______________________ Oral hypoglycemics
- lam ______________________Anti-anxiety drugs
- micin _____________________Antibiotics
- mide _____________________ Diuretics
- mycin ____________________ Antibiotics
- nium _____________________ Neuromuscular blocking agents
- olol ______________________ Beta-blockers
- oxacin ____________________Antibiotics
- pam ______________________Anti-anxiety drugs
- pril _______________________ACE inhibitors
- sone ______________________Steroids
- statin _____________________Anti-hyperlipidemics
- vir ________________________Anti-virals
- zide ______________________ Diuretics