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    pharmacology cases

    Explore "pharmacology cases" with insightful episodes like "Ep 94 Pre-Reg Practice Question 4 Biologic Pharmacology Calculations", "Ep 93 Pre-Reg Practice Question 3 - Pediatric Pharmacology Calculations", "Ep 92 Pre-Reg Practice Question 2 - Pediatric Pharmacology Calculations", "Ep 89 Online Money-Saving Community College Pharmacology Class, PreMed Classes, and Online PreMed Advising" and "Ep 88 Free Pharmacology Audiobook Codes Google Sheet Instructions" from podcasts like ""Memorizing Pharmacology Podcast: Prefixes, Suffixes, and Side Effects for Pharmacy and Nursing Pharmacology by Body System", "Memorizing Pharmacology Podcast: Prefixes, Suffixes, and Side Effects for Pharmacy and Nursing Pharmacology by Body System", "Memorizing Pharmacology Podcast: Prefixes, Suffixes, and Side Effects for Pharmacy and Nursing Pharmacology by Body System", "Memorizing Pharmacology Podcast: Prefixes, Suffixes, and Side Effects for Pharmacy and Nursing Pharmacology by Body System" and "Memorizing Pharmacology Podcast: Prefixes, Suffixes, and Side Effects for Pharmacy and Nursing Pharmacology by Body System"" and more!

    Episodes (47)

    Ep 94 Pre-Reg Practice Question 4 Biologic Pharmacology Calculations

    Ep 94 Pre-Reg Practice Question 4 Biologic Pharmacology Calculations

    While the UK and United States have different methods for assessing their health professionals often the calculations and math(s) strategies are the same. I invite you to enjoy this 12-part series on Part 4 of preparing for the Pre-Reg exam but will also help those in the states that are looking to improve their skills in nursing, pharmacy technician, and pharmacist skills. Here's the Memorizing Pharmacology book link:  https://www.audible.com/pd/Memorizing-Pharmacology-Audiobook/B09JVBHRXK?source_code=AUDFPWS0223189MWT-BK-ACX0-281667&ref=acx_bty_BK_ACX0_281667_rh_us

    Want more options?

    Find the book here: https://geni.us/iA22iZ 

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is a Link to my Pharmacy Residency Courses:  residency.teachable.com

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    As I mentioned earlier, some of these are just much easier than the other ones which are quite hard. So, I’ll just read it. Number four: Mr. A, who weighs 60 kilograms, attends a pre-admission clinic at your hospital two weeks prior to having orthopedic surgery. He’s found to have moderate anemia and his doctor prescribes a course of subcutaneous Eprex (Epoetin Alpha). The Epoetin Alpha is given at 300 units per kg daily for 15 days. How many units of Epoetin Alpha will Mr. A be given for the 15-day course?

    Again, with weights, you generally don’t make any change; you don’t have a conversion. These usually stay singular but we do have a couple of conversion factors: 300 units per kilogram per day and then 15 days for the course. So we want to see what our answer is supposed to be. Well, our answer is going to be the number of units per course.

    We have units per kilogram per day over here and then we have 15 days per course. So we get rid of the day here and we have kilograms; get rid of the kilograms so we have the number of units per course. We check our work, cross off the units and we see that we have 60 kilograms times 15 days per course times 300 units per kilogram per day equals 270,000 units per course.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is a Link to my Pharmacy Residency Courses:  residency.teachable.com

     

    Ep 93 Pre-Reg Practice Question 3 - Pediatric Pharmacology Calculations

    Ep 93 Pre-Reg Practice Question 3 - Pediatric Pharmacology Calculations

    While the UK and United States have different methods for assessing their health professionals often the calculations and math(s) strategies are the same. I invite you to enjoy this 12-part series on Part 3 of preparing for the Pre-Reg exam but will also help those in the states that are looking to improve their skills in nursing, pharmacy technician, and pharmacist skills. Here's the Memorizing Pharmacology book link:  https://www.audible.com/pd/Memorizing-Pharmacology-Audiobook/B09JVBHRXK?source_code=AUDFPWS0223189MWT-BK-ACX0-281667&ref=acx_bty_BK_ACX0_281667_rh_us

    Want more options?

    Find the book here: https://geni.us/iA22iZ 

    and subscribe to my YouTube Channel  TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of The Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com.

    Let’s get started with the show. I took number three because number three is so similar to maybe five or six on that part one and I’m just going to go over it like I would have solved the problem. So, the first thing I don’t know if I would have read the whole question if I have just numbers at the end and I know that I’m given the number of bottles. Put on my laser pointer here and I’m given the number of bottles that I’m supposed to have. Well, if I have bottles then I know I have to have some kind of conversion that gets me bottles over here and there’s only one conversion: 100 mLs is one bottle. So, I put that there and so now I have the bottles but I have mLs and I need to get rid of those.

    I only see 250 milligrams per 5 mL and I can put this upside down: 5 mLs over 250 is the same as 250 over 5. So, I put 5 mLs over 250 milligrams to get rid of mLs but now I have milligrams. Is there anything to get rid of the milligrams with?

    I see 500 milligrams here and this sometimes gives students trouble: four times a day for 10 days. If you think of it as 500 milligrams per dose, four doses a day for 10 days, that might be a little bit easier when it comes to conversions. So, I put 500 milligrams which is in one dose and now I have the milligrams are gone but now I have the doses. So, 500 milligrams from one dose, how many doses per day? Four doses per day.

    And then I run into trouble because there are three: 10 days, 7 days, and five days parts where I would need to know okay well which of those is right? So now, I might read the question slowly and carefully through to better understand after I’d set it up and I would never do the math ahead of time.

    I always set everything up first before I even attempt the math. So, the question reads: Number three you receive a prescription for a 76-year-old patient for phenoxy methyl penicillin 250 milligrams per 5 mLs oral solution, 500 milligrams four times a day for 10 days. You inform the patient that due to the medication’s short life of seven days once it is prepared you will fulfill part of the prescription and supply the remainder at a later date. The patient agrees to take enough for five days today and will call back for the remainder.

    What is the correct number of 100 mL prepared bottles that you would be supplying today? And what you would put maybe in your own header to write down would be versus total. So what I would do is actually calculate both of them to make sure that you didn’t get stuck in that trap because that’s what it is it’s asking you which of those should you put here is it the five, the seven or the ten to get rid of this day? And the correct number of bottles you’ll be supplying today would be five days.

    And if we do our multiplication and personally, I would get rid of the 500 and 250 by putting a two here and a one here so I could do it in my head: Five times four times two times five makes two hundred so forty times two makes eighty eighty times five makes no five times four is twenty twenty times two is forty forty times five is two hundred.

    And then here, I would have one there so it’d just be a hundred so two hundred over a hundred makes two but then I would also calculate versus total now if you’re in the test you don’t have to do this obviously it’s extra time that you need but to check my work.

    I would say okay but what would the total have been so that i know that i have enough on shelf or on the shelf to fill the order when it’s when the patient comes back in five days and total would be for ten days so i could do calculation again ten times four forty forty times two eighty eighty times five four hundred over hundred makes four bottles or i could just say oh if it’s five days and i double that to ten and two bottles doubles to four bottles either way you get answer but that’s how i think i would solve that one.

    And i think mistake many students make when they start doing calculations is they think it’s like math they’ve done all their lives which is what’s three plus three plus four well you take three then add three then four so you get six plus four is ten and they’re adding from left to right with these calculations you want to go from right to left it makes it so much easier because they’ve already given you this gift of units for answer so if you have units for answer only choice has to match in some way units for answer and then that takes you backwards until you get whole equation built from left to right how much you would finally do calculation.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com. Thanks again for listening. Thank you!

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

     

     

     

     

     

    Ep 92 Pre-Reg Practice Question 2 - Pediatric Pharmacology Calculations

    Ep 92 Pre-Reg Practice Question 2 - Pediatric Pharmacology Calculations

    While the UK and United States have different methods for assessing their health professionals often the calculations and math(s) strategies are the same. I invite you to enjoy this 12-part series on Part 2 of preparing for the Pre-Reg exam but will also help those in the states that are looking to improve their skills in nursing, pharmacy technician, and pharmacist skills. Here's the Memorizing Pharmacology book link: https://www.audible.com/pd/Memorizing-Pharmacology-Audiobook/B09JVBHRXK?source_code=AUDFPWS0223189MWT-BK-ACX0-281667&ref=acx_bty_BK_ACX0_281667_rh_us

    Want more options?

    Find the book here: https://geni.us/iA22iZ 

    and subscribe to my YouTube Channel  TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Let’s get started with the show.

    I’ll just read it. The following hospital prescription is written for a seven-year-old child weighing 24 kilograms. The one translation I made or conversion factor I created was reminding you what 10 really means when you have a weight per volume. It’s 10 grams per 100 mLs, so you know 20 would be 20 grams per 100 mLs, and then 0.5 grams per kilogram. Normally I use yellow, but for whatever reason yellow didn’t come up against that gray background.

    The infusion rates, this gets a little bit confusing, so I left it that way, although I really don’t like seeing it that way with two forward slashes. When we see a fraction, we usually we’re used to seeing a numerator over denominator, but here we have a numerator over a denominator and then another four slash. It just makes it a little confusing, but really at 0.6 mL over kilograms and then hours is also a denominator, so those are both on the bottom and we’ll see how that works when we’re doing our conversions.

    How about what we have are three times and then when I say times I mean that quite literally. And let me get my pointer out here. I mean 30 minutes, 30 minutes, 30 minutes, but then an unknown and that’ll be kind of the twist at the end here that makes it a little bit tougher. But what is the total infusion duration of the immunoglobulin if it is infused at the prescribed rate? Well, we know it’s 30 plus 30 plus 30 plus something and we want it to the whole minute, so that’ll also be part of our conversion.

    But the first thing to do I think is just say all right well I know eventually I’m going to have to know how many mLs I’m infusing total and I don’t really have that set up right now so let’s go look at that. All right so I have a 24 kilogram seven-year-old child and 0.5 grams per one kilogram. 100 mL per 10 grams equals the mLs. And I mentioned again I prefer to go right to left so if I see mLs I need a conversion factor that has mLs. Well this one didn’t have mLs but this one does so I put the 100 mLs over 10 grams and then I need to get rid of this gram because the gram is not over here so I see 0.5 grams over kilograms and I don’t see kilograms over here so I need to get rid of it and I get rid of 24 kilograms so then we cross out diagonally our units. I’ll get rid of the kilograms, get rid of the grams and we’re left with the mLs. So the total infusion will be 120 mLs.

    Okay so that’s a nice number to work with and we’ll see we’re going to be able to figure out the infusion quantities for the first three but we’re going to need this 120 for our fourth infusion quantity. So there are two ways you could do this. And I mentioned this long way versus short way. The short way is to recognize that you’re going from 0.6 to 1.2 to 2.4 and you’re really doubling and then doubling again. Okay so you could really just put it over here and go 0.6 plus 1.2 plus 2.4 is going to end up at 4.2.

    Or you can go through each of them and say okay well this one’s going to be 7.2 mLs and this one would be 14.4 and this would be 28.8 all together though we end up with the same product that we’re gonna or sum that we’re going to have 50.4 mLs.

    So again if we have mLs as something that I’m looking for I need to have my conversion factor of mLs over kilograms per hour and as I mentioned we have that strange denominator one on the bottom so we need to multiply by kilograms and by hours because there’s no hours over here in the answer.

    Okay so we can do that three times. I can get this 50.4 so if we’ve used 50.4 so far we know the total is 120 from the last equation that we did then the infusion quantity for the fourth segment is 120 mL minus 50.4 or 69.6 mLs. But unfortunately that’s not what the question asked. The question wanted to know what’s the total infusion duration. So we have that one of the unknowns known now now that we’ve calculated the 69.6 mLs and we can put plug that in.

    So instead of having the hours here where we knew it was 0.5 of an hour or 30 minutes we know the answer we know it’s 69.6 mLs is the total amount so what we do is we do a little bit of rearranging here and we see that we’re going to have to move the 24 over so 1 over 24 when you move it from the left to the right and then again we have to move the 4 under the kilograms per hour and then when we do this calculation eventually we come up with 0.725 hours.

    So I know you could just do 0.725 times 60 but I still like to do the entire thing to make sure that I’ve got the right factors so 0.725 hours times 60 minutes over one hour makes 43.5 minutes. So we already had our 90 at the very beginning of the question, we just need to add our 43.5 minutes to get 133.5 rounded to the nearest whole minute as per the question or 134 minutes.

    So just one kind of caveat that if you’re filling in answers it sounds like you would want to go through the entire test and make sure that every answer is done properly here because you could have just left it at 133.5 and then gone on to the next but I want to make sure that we’re attentive to the actual question.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Ep 89 Online Money-Saving Community College Pharmacology Class, PreMed Classes, and Online PreMed Advising

    Ep 89 Online Money-Saving Community College Pharmacology Class, PreMed Classes, and Online PreMed Advising

    If you need an online asynchronous pharmacology course, go here: https://www.dmacc.edu/programs/pdp/pre-pharmacy/Pages/online-pharmacology-class.aspx 

    If you want pre-med and college advising through the new 1-credit online course I teach, SDV 108, you can go here: https://www.dmacc.edu/schedule/Pages/result.aspx?Term=202401&Subject=SDV course 11395 I'm Anthony Guerra.

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Everyone knows you can save a ton of money going to community college instead of a four year school, but do schools look down on it? While some do, Harvard accepts community college classes, so it's reasonable under our current economic conditions that it's a good choice. 

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet, or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Let’s get started with the show.

    Hey, welcome to the Memorizing Pharmacology podcast. Our pharmacology course is half full here at Des Moines Area Community College for fall, so as you’re going through summer, if you feel like you may not make it, see if you can’t enroll again. It only takes a day. You just become a guest student, but you’re welcome to sign up for pharmacology there if you are maybe pre-med or pre-pharmacy or pre-something.

    This fall is the first time I’m going to be teaching SDV 108, which is Student Development 108: The College Experience. It’s normally like an orientation course to the college, but because I’ve always helped pre-professional students, whether it’s PT school or pharmacy school or med school and all that stuff, a lot of those students like to join me. So it’s SDV 108 and it’s section WWT. If you want to get that kind of advice about what courses to take and those types of things, I can help you there. It’s just a one-credit online class and anybody can take it.

    Something I’ll talk about a little bit more as well is cross enrollment, which is if you are a full-time student at DMACC, you’re welcome to take one course up to three credits at Drake, Iowa State, or Grandview in the fall and spring semester. And what that does is it makes not only their advisors available to you, you get I think even an email to the college, but what it allows you to do is kind of one, see if that’s maybe a college that you’d like to go to to finish up your four years, but what it also does is it reduces the limit. So when you’re applying or going to another four-year school, there’s only so many classes you can take at a community college and I think it’s around 64 credits. And what this does is it gives you four-year degree credits and so that means that if you were to do that for three semesters, let’s say, that would be nine fewer credits that nine more credits you could take at community college because you took them at a four-year school. And again, those courses are free if you take them at the other college.

    So what I wanted to get into now is the actual pre-med curriculum. I think there’s a lot of confusion about it and so what I’m going to do is I’m going to actually show you the courses that you would take here at DMACC. And again, you have to be very careful because each med school is a little bit different and you’re going to apply to probably I think the average is about 15 med schools that people apply to. So you kind of start with your first choice and make sure that you’ve kind of taken enough courses for most of them. And I’ll go through it but I’ll show you what two years of pre-med would look like at a community college.

    So let’s just open up this Excel file and what I’ve done is I’ve put them all in four semesters. I wouldn’t recommend this. This is a very very challenging experience and what I’m going to do after I talk to you about the DMACC pre-med classes is I’m going to show you the exact courses I actually took and the way it actually worked out for me which was not this clean. This makes it look like you just go for four semesters then you go and get a four-year degree and all as well. This will get you an associate of science two-year degree here at DMACC but again 17 credit classes with these types of classes are very challenging. I would spread it out and I’ll talk about that a little bit.

    So let’s start with the first and second semester: The College Experience or SDV 108, the class that I’m teaching this fall. I definitely think that you should take this class really early on because it ensures you’re taking the right classes. You’re not taking too many or too few, and you’ve got somebody that you can talk to every single week about your courses. As your thinking changes, you can also talk to your instructor about that.

    The first thing we usually talk about is General Chemistry one and two. This is why you would want to take it in your first year of college and this is why you wouldn’t. If you took AP Chemistry and you just never took the test, or you had a really good experience with chemistry in high school and you’re very strong at math, then yeah, take Gen Chem. But if you don’t feel so strong about math or college, then I might hold off on taking Gen Chem until later.

    Even Iowa State, which is where more students from DMACC go than any other public college in this state, considers Organic Chemistry a junior level class. So you could take Gen Chem here in the second year and then take Organic up there. Or you could take classes at both. There’s nothing that says that once you’re done with Community College, you have to go and only take classes at a four-year school. I’ve actually done some overlap and that sometimes is even better. We’re only 25 minutes apart so if you live in the middle, it’s 15 minutes to each.

    But General Chemistry one, General Chemistry two, Chem 165, 175, here’s where it gets a little bit goofy with General Biology one and two because some of the schools want you to have Anatomy and Physiology and some of them are just like just have a Biology class or a specific class and some of them even want Genetics and things like that. But I’m just putting the General Biology one and General Biology two here just so you can see them.

    Calculus is a bit of a difficult thing to put in the first semester because many students are not ready to take Calculus first semester. I had already taken it in the summer of my junior year as an audit and then I took it again in the fall and I passed it. And then I really struggled with Calculus two and I’ll talk about my story later but generally either Calculus one or Statistics, you know, you can pick which one. Statistics would probably be a better freshman year class or first semester Freshman Class than Calculus one.

    And then maybe you’ve already taken Sociology or something like that again so important to have someone in your corner just kind of talking you through everything making sure that everything that you’ve done in high school aligns with what you’re doing in college and so forth.

    The second year would be Organic Chemistry one, Organic Chemistry two, General Physics one, General Physics two and this is the non-Calculus based Physics that I’m talking about. And then Intro to Psych, Intro to Ethics, and then Principles of Microeconomics and  fundamentals of world communication, again, these hit all of the requirements for an associate of science degree. You might ask why I’m saying AES and not AA. Well, the Associate of Arts is really more humanities-based and pre-med is super science-based. So, an associate of science tends to hit all of the things. This is the same for pre-pharmacy, pre-physical therapy, and some other things like that.

    The reason I talked about cross-enrollment is because we don’t have biochemistry as a junior year class here. But in that situation where you’ve got cross-enrollment, you would be able to take biochemistry at Iowa State University, which I believe is only three credits without the lab. Often they don’t even want the lab one, they just want that you’ve taken biochemistry. That is a possibility and I believe you would actually take the class for free although you’d have to pay for your own books.

    Here’s where it comes down to biology. Does the school want anatomy and phys1, anatomy and phys2? Are you thinking about a biology degree? Those are each four credits, micro was four credits. Then I teach a pharmacology class because it’s amazing that you take so many classes for pre-med but so few of them actually help you with medical school. Biochemistry would, pharmacology would to some extent, organic chemistry does to some extent, psych does but really many of the classes have very little to do with the actual course content you’ll have in med school.

    Many of the students that I have also are either going to be nursing majors or they’re thinking about physician assistant. But that’s what it looks like on the page where you’re going to have four semesters get your two-year degree all as well. I’m going to show you what it really looks like.

    This is what pre-med really looks like, well at least it did for me. Don’t worry about the years, it’s a long time ago but it’s actually amazingly the same. The summer that I was between my junior and senior year I thought I might want to be an engineer. I thought might want to be a physician again. I really didn’t know what these were as I have nobody in my family that was in these professions. My parents were both in computers and I just said okay well let me go see what a college class is like.

    I’d never been in a college classroom before and I audited calculus one where I would go to class. I didn’t take the tests, I could have if I wanted to but the reason why I audited it was because I had an engineering camp in the middle of classes and so there’s no way I would have passed the class if I had taken it for credit.

    So by auditing it, I got to know a little bit about courses and that made things a lot easier in the fall. I’d already been in the class, I kind of knew what was going on and then I ended up with a B but then I’d never gotten anything lower than a C.

    I did get a D in my midterm but I brought it up to a C in one time but I’d never gotten anything below a C and all of a sudden I got an F in calculus 2. That’s a really bad thing for two reasons and it was unnecessary.

    Firstly, I recognized that I was not passing the class early enough that I could have withdrawn so the most important thing I can tell you here is that it’s better to take a W than it is to take an F.

    If you look at the rest of my courses you’ll see I’ve taken three W’s no F’s because I learned my lesson and maybe I had to learn my lesson that way but taking a five credit F is a really bad thing if you know and and did manage to get out of it by doing so well on the entrance exam.

    Let me talk more about this in a little bit so then I go on to four-year School in the University of Florida and you know Three B’s and two two A’s.

    I did well in chemistry and micro and my honors class and then brought my calculus one grade up to an A. You might ask why did you take that again didn’t you already take calculus? And yes, indeed, did and thought that well maybe what happened with Calculus 2 was i didnt “Learn it well enough,” I said. "Alright, let me take it again and see if I’ve learned it better. Maybe that’s the thing, but I found out that’s not really the case. What had happened was, I just wasn’t focused. It was my senior year of high school. I just wasn’t as focused as I needed to be to pass a course like that. So, I’ll talk about when I did actually pass it later. Okay, let me maybe make these a little bit bigger. I think it’s a little bit tough to see at the font I’m working at right now.

    So there we go. Now you can kind of see them a little bit better and I can make that even bigger there. Alright, so that was my experience in first semester. I did well, it was about a 3.4 or 3.5 GPA, I think it was closer to a 3.4. Then I really struggled in the spring and I learned from that calculus mistake that okay, when you’re struggling and you’ve got a lot of responsibilities in a semester, then maybe it’s time to let something go.

    What I did was, I said okay well, I’m actually enjoying this bio lab. It’s tough to take the lab without the course but I still got a C plus and chem lab, I got a C plus and Kim, I got a B. So again, I was struggling a bit with chemistry. I realized that maybe that was too many credits and you know, I took the honors class, took the writing class, did okay but again it was more like uh…I think it was maybe a 2.9 or a 3.1 somewhere around there but it was not a good GPA compared to the 3.4.

    But again, I persisted and kept going and my GPA was not ruined by failing biology; that was the key. Okay so then then you know, I realized that man having all those labs was just absolutely devastating so I was like, ‘I’m going to take a semester with no labs.’ So integrated bio one wasn’t…I already taken the lab so I got a C Plus organic, got a B and organic was a bear but the way they do it at Florida is they put the two lab credits in the second semester none in the first.

    Then I had my honors class uh…General psych, did okay and then stats…I really struggled with stats…the math…I just understood calculus better than stats and it just was a thing where I just wasn’t that great at it.

    Okay and then this was my really bad semester and I think a lot of us have this where you know it’s just fatigue…I think whereas just like man…I really don’t know where I’m going…I don’t know that um…this pre-med journey or pre-professional journey is something I really want…I don’t even really have a major…I think my major was chemistry if you were to like look at my transcript.

    And see what’s his major? I think it was chemistry but I really didn’t know what was going on and this was just a survival semester so…I got a C in BIO two, C in bio2 lab, D plus an organic two, C in the lab, C plus in philosophy class and…I was just like…I cannot do physics on top of all of this.

    So that was really really a low point and two things had me move: first the University of Florida if you’re an honor student you get what was At least at the time, I had an out-of-state tuition waiver, so I was paying in-state prices. And at in-state prices, it was better and cheaper to go to Florida than it was to go to my home school of Maryland. But then once that tuition waiver was gone, Maryland actually became a little bit cheaper. But the other thing was I kind of needed a fresh start. I needed a new environment and I was like, you know what, let’s do this over and see how I can do. Okay, so I transferred to the University of Maryland College Park.

    And you know, you say, okay, well, they’re going to go easy on you or whatever. No, absolutely not. This is my first semester at the University of Maryland: organic chemistry 2. I had to retake the lab because although I passed the lab, organic chemistry doesn’t come without a lab at Maryland, so I had to take that. I took calculus 2 and then I took the first semester of a three-semester calculus-based physics. You don’t have to do that for med school. I just didn’t know. I’m like, well, maybe I’ll still be an engineer. It just took me on my third year to get to calculus 2. I mean, I was taking calculus and organic and physics and I took them all in the same semester. And then I took intro to theater. And I think it’s crazy that I get a B in theater and I get a B in organic, right? And calculus and physics. Like, I’m really proud of that 3.0. Like, it was, I recovered from my bad fourth semester there at Florida. I was back on the right track and all that stuff.

    And right around here was when I kind of discovered that maybe I’m going to try other health professions. And that’s when I looked into physical therapy and physician assistant and pharmacy. And with pharmacy, I could actually go to a pharmacy on campus and volunteer. And that’s what ended up being my major.

    So I ended up going in spring and signing up for the other physics that I had to take. But then this happens to a lot of people: you’re like, well, I’ve already kind of taken everything. So all I was doing was saying if I don’t get into pharmacy school, I’m still going to want to get a degree. And I could still get a BA in chemistry or a BA or a BS in biology. So I still was on track to get a degree of some kind or another.

    And what I did was: I took my Shakespeare and took my required English class or literature class and took microbiology because even if I don’t need it, I can still take it. And I actually really enjoyed micros like one of the very few A’s I got in my college career. But for some reason microbiology is very hands-on, very great. We had a great teaching assistant, great professor. I really enjoyed it.

    Physics was still a struggle and I made the shift: I was like, “I am not taking calculus-based physics again.” Like, “I really just…my engineering dreams were dashed.” Like “Okay, I’m not getting a BS in chemistry,” which is different than a BA. “I’m not getting…not going to become an engineer.” Let’s just take the non-calculus based physics 2 and move on.

    And then also took biochemistry and what happened was: “I got my acceptance so early that” “I was like well” “I don’t really need biochem.” “I can still go to class but” “I don’t need the stress of trying to pass biochem and physics at the same time.” And “I was really worried about not passing physics.” So this may seem strange but it’s better to withdraw from a class that you aren’t going to pass and pass the one that you need so that you can keep moving forward because if “I hadn’t passed physics” “I either would have to take it in summer if they would conditionally accept me or” “I might have to wait another year.” So “I was like alright well let’s let’s just go to biochem class” “I’m not gonna” “I’m just gonna audit it.” And “I must not have filled out the paperwork to audit it.” “I meant to audit it but” “I ended up withdrawing from it.” And then B in Shakespeare, A in micro, C in physics and then “I made it on to pharmacy school.” At least at the time, I had an out-of-state tuition waiver, so I was paying in-state prices. And at in-state prices, it was better and cheaper to go to Florida than it was to go to my home school of Maryland. But then once that tuition waiver was gone, Maryland actually became a little bit cheaper. But the other thing was I kind of needed a fresh start. I needed a new environment and I was like, you know what, let’s do this over and see how I can do. Okay, so I transferred to the University of Maryland College Park.

    And you know, you say, okay, well, they’re going to go easy on you or whatever. No, absolutely not. This is my first semester at the University of Maryland: organic chemistry 2. I had to retake the lab because although I passed the lab, organic chemistry doesn’t come without a lab at Maryland, so I had to take that. I took calculus 2 and then I took the first semester of a three-semester calculus-based physics. You don’t have to do that for med school. I just didn’t know. I’m like, well, maybe I’ll still be an engineer. It just took me on my third year to get to calculus 2. I mean, I was taking calculus and organic and physics and I took them all in the same semester. And then I took intro to theater. And I think it’s crazy that I get a B in theater and I get a B in organic, right? And calculus and physics. Like, I’m really proud of that 3.0. Like, it was, I recovered from my bad fourth semester there at Florida. I was back on the right track and all that stuff.

    And right around here was when I kind of discovered that maybe I’m going to try other health professions. And that’s when I looked into physical therapy and physician assistant and pharmacy. And with pharmacy, I could actually go to a pharmacy on campus and volunteer. And that’s what ended up being my major.

    So I ended up going in spring and signing up for the other physics that I had to take. But then this happens to a lot of people: you’re like, well, I’ve already kind of taken everything. So all I was doing was saying if I don’t get into pharmacy school, I’m still going to want to get a degree. And I could still get a BA in chemistry or a BA or a BS in biology. So I still was on track to get a degree of some kind or another.

    And what I did was: I took my Shakespeare and took my required English class or literature class and took microbiology because even if I don’t need it, I can still take it. And I actually really enjoyed micros like one of the very few A’s I got in my college career. But for some reason microbiology is very hands-on, very great. We had a great teaching assistant, great professor. I really enjoyed it.

    Physics was still a struggle and I made the shift: I was like, “I am not taking calculus-based physics again.” Like, “I really just…my engineering dreams were dashed.” Like “Okay, I’m not getting a BS in chemistry,” which is different than a BA. “I’m not getting…not going to become an engineer.” Let’s just take the non-calculus based physics 2 and move on.

    And then also took biochemistry and what happened was: “I got my acceptance so early that” “I was like well” “I don’t really need biochem.” “I can still go to class but” “I don’t need the stress of trying to pass biochem and physics at the same time.” And “I was really worried about not passing physics.” So this may seem strange but it’s better to withdraw from a class that you aren’t going to pass and pass the one that you need so that you can keep moving forward because if “I hadn’t passed physics” “I either would have to take it in summer if they would conditionally accept me or” “I might have to wait another year.” So “I was like alright well let’s let’s just go to biochem class” “I’m not gonna” “I’m just gonna audit it.” And “I must not have filled out the paperwork to audit it.” “I meant to audit it but” “I ended up withdrawing from it.” And then B in Shakespeare, A in micro, C in physics and then “I made it on to pharmacy school.”

    I had worked in such difficult classes though because the Pharmacy College admissions test only tested calculus one and really mostly first semester organic chemistry. And I was so far ahead of that that I scored a 99th percentile overall. It’s unusual for someone to be so strong in English as I was but I just had you know kind of a passion for it. So I did really well on my entrance exam. And this is back when it was harder to get into pharmacy school than Medical School. The numbers were much higher.

    Believe it or not, back in the late 80s, there was actually a glut of Physicians. That is, there were too many Physicians and it just was not necessarily the most desirable field to get into as it is now. You have to have a 3.8 cumulative, 3.5 or 3.6 overall when you’re looking at med school as far as the GPA.

    But this is what I want to show you is that since I was kind of a chemistry major and maybe I would have ended up being a chemistry teacher or biology teacher and I was gonna finish that chemistry degree but then I did four years of pharmacology or pharmacy school. I’m like well, I already kind of did a chemistry degree like do I really want to finish that? And so I decided much later that you know I would like to finish my bachelor’s degree but I really did like the Shakespeare class and the writing classes and the theater class and all that stuff.

    So let’s take a look at my English major which I did finish at Iowa State which is an engineering school. It’s just so funny. But I want you to look at the grades: the only A- I received in my English classes was in grammar. So you know my inability to do those, I just could not put grammar together in a way that I could get the full A.

    And so when you’re looking at the best major for pre-med, the reality is that many of us are going to struggle with those chemistry classes right? And this hard science is and there’s a reason they’re called the hard Sciences.

    But what I did was in that second half of things is I got all A’s. So if you were to add up all of my grades, basically, I had about a 3.0 from undergrad first and second year and then I had almost a four point on the second. I would have been around a 3.5. And yeah, I would have been on the way low side of things but my strength has always been in test taking.

    So if I had taken the MCAT, I think it would have done well. The reason I can say that is that I did take the GRE and I scored in the 98th percentile in English and the 87th percentile in math which is really really unusual usually like the engineers scored 99 in math and like you know low on English and then the English major score high on English but low in math.

    So, by completing an English degree by completing a hard science degree, everything came out a lot better. And then now, looking at my life, now, I’m really more of an author and a teacher because of these classes that I took in the liberal arts.

    There are a couple of things I did want to talk about with this degree is that some of the courses I took here when as a community college professor because I was like huh, “I get to take free classes.” And “I’d always been interested in taking literature.” So “I started taking some lit classes creative writing classes” um just you know when “I wasn’t working.”

    And then “I also was like well” “I have to get this language requirement.” And “I don’t remember if there was a language requirement with this particular college with Iowa state but” “I was like okay well” “let me just see if” “I can pass the test.” And so “the CLEP test” “I spoke enough Spanish” “that” “I was able to get through immediate intermediate Spanish too.” And “I got those 12 credits for a hundred dollars.” Like “that was all” “I needed to do.”

    But again, “I think” “the combination of taking a course” “the pre-med coursework with a major like English or history or those types of things which actually have a much higher acceptance rate than med school than biology major does.” It makes you much more balanced and it makes things a lot easier because there are other things you also need to be able to do in that med application which is you need to be good at the interview, you need to be good in writing your letter and all of those things. And obviously, an English major is going to write an amazing med school letter.

    So, I’ll go back to that page of the DMACC as and kind of maybe shrink it up a little bit so you can see it all on one page. But really, this whole idea that people actually complete this in this way is unusual. It’s much more likely that a rising junior senior in high school is going to have completed many of these classes. You want to kind of look at them in a way that is going to work well with your school.

    And so the last thing I wanted to point out was there’s always that kind of talk about, do colleges take Community College classes? And this is the AAMC document guidance documents for 2024 and here’s the University of Iowa and they say we have no problem with Community College classes. That’s fine, you go ahead and take them. You say okay well that’s Iowa, that’s a state school, that’s fine. What about more prestigious schools? Alright, let’s look at Harvard. Harvard said Community College classes, those will be just fine. That’ll be great. Online courses maybe not. Community College classes yeah if you go to them that’s great.

    So when you’re looking at the colleges or Med schools that you’re looking at it’s actually much more rare that a college would not want Community College classes because community colleges represent if you’re a minority student we represent half of minority students going into college like we’re just much more diverse we just are. Many reasons socioeconomic for one of them but there are many reasons why we have that.

    But the other thing is I just don’t know why you would want to take an organic chemistry class where you have 300 people in the class versus where you have 24 people in the class. I mean that you literally would it is impossible in a DMACC for you to be more than 30 feet from the professor like you physically cannot like you would have to leave the room.

    Like I just don’t understand why you would want to be all the way back in an organic chemistry class trying to pass that class in a much larger section. So I understand why some people might say oh well it’s easier well it’s easier because it’s easier to get help there’s only one Professor. I mean maybe there’s a bunch of TAs but how long have they been teaching? All the professors here we don’t have grad students here we all are have doctorates and so forth.

    So I just think that I’m really bullish on Community College as a way to get these classes and to move in especially with the way things have been going with expenses and things. I mean seriously 175 dollars a credit hour, you can go to college here for less than five thousand dollars a year so your total cost of tuition is less than ten thousand dollars here to get a degree. For some of you, that’s a quarter or a semester or a part of a semester.

    So again I’m you know,  I really think it’s a great opportunity that you can have taking community college credits. And one last thing that I want to point out is, as I was doing this pre-med thing, I wasn’t like, “I’m gonna be a doctor, burn the ships,” and all of that. I was saying, “I might want to be an engineer physician.” And then as I’m kind of going through this, I’m like, “Well, I’m struggling and I’m learning how to do this. Maybe I might want to be a teacher,” which I ended up being eventually. So maybe I could be a chemistry teacher or biology teacher or something like that, maybe even a math teacher. I finally get through calculus three which I heard is easier in calculus two.

    So you know, I know I went to almost 30 minutes in this episode but I really just wanted to let you know that when you’re thinking about pre-med, don’t feel like everybody actually gets it right. Like that you never see what other people do. It’s actually much different and it’s actually probably a much more zigzag path than it is just this straight and narrow take these classes go to med school live a perfect life and so forth.

    So need my help? Well, Tony the pharmacist at gmail.com happy to help you out. Thanks for listening to the memorizing pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

     

    Ep 88 Free Pharmacology Audiobook Codes Google Sheet Instructions

    Ep 88 Free Pharmacology Audiobook Codes Google Sheet Instructions

    I just wanted to go over the free audiobook codes Google Sheet that will be sent out to our email list on Tuesday June 27th, 2023 

    Find my book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet, or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Let’s get started with the show.

    All right, I just wanted to kind of explain audiobook codes and how to use them in our next email, which should go out Tuesday. Today is the 27th, so if you’re on the email list, the way to get on it is go to memorizingfarm.com and then scroll down to “Our Best Pharmacology Cheat Sheet - Yours Free”. It’s just a name and an address. But I just wanted to let you know what’s coming to you. It’s going to be a link to a spreadsheet that has all of the books that I’ve written, whether I’ve written it or it was in collaboration with someone else, but anything that my name is on. The 30 books that I have my name on. We have this individually on the website under “Books”, but I thought it would be easier to just make a spreadsheet. So if you ever want to like, okay, I’ve done this one, what’s the next book? How does that help and so forth? I think that that’s going to be useful. So again, I’ll send this link out to the website. But what I want to do is kind of explain how it works.

    So here are the books, and it’s just literally like here’s the link to this book, and you know how to hear it on Audible, to hear the five-minute free introduction. And then what I’m going to do is I’ve just put the first seven books on there. The questions, answers, and rationales. The ones that go by pathophysiologic class: GI, musculoskeletal, respiratory, immune, neurocardio, and endocrine. Those are on sheet two. Those are the codes for each book. And you can see that there’s US versus Great Britain. And I will explain how that works in just a minute.

    But I’ve separated all the books by: it’s either pharmacology books; residency, if you’re looking for a residency and the interviews and things that go along with that; a couple of pre-med/pre-pharmacy/pharmacy student books I’ve written a long time ago; and then one family book that I wrote.

    But again, these are the links to get to the free five-minute audio preview. And then if you want the book free, if you’ve never been on Audible, you can get it free there. But what these codes are: these are like free-free, if you want to use double of the same thing.

    But I wanted to explain the difference between a US code and a UK code. So a US code is one where you are on audible.com. Okay? So audible.com is the US codes. Audible.co.uk is the UK codes.

    But where the confusion comes is: well, I’m in the United States but I’m from England or Europe even; or I’m in Europe and I’m from the United States; or I actually have accounts in both.

    So it has nothing to do with where you actually live. It has to do with which one you have an account to or which one you want to have an account to. So again, I think you could just make an account if you just wanted the code because there are more GB codes (Great Britain codes) than there are US codes simply because my fan base is mostly US and I’m an American in the middle in the Heartland in Iowa.

    So but it doesn’t mean that you can’t use it. So what I want to do is kind of explain how it works.

    So the first thing is: so you go down and you just kind of pick which book you want. So there’s seven books here. And if it’s GB up here, that means it’s only Great Britain codes; that’s all I’ve got left.

    If it starts with “4 US codes”, that means I have four US codes left and the rest are Great Britain.

    And then if I have this many US codes and then I have that many US codes.

    And so what you do is: you kind of pick whichever one it’s going to be.

    If you’re in the US then you go to audible.com ACX promo and it looks like this. Okay, and you just literally copy and paste the code in here and you redeem. Okay, and you can see this is my Audible account. So, hi Anthony, I’ve got one credit available. Buy three extra credits if you want. I am someone who loves audiobooks as a listener, not only as an author. So I think I have over 700. It’s when you have kids that that happens. Okay, and you’ll notice that the one for the UK is the exact same, it’s just audible.co.uk. I’m not signing in there because my account is with Audible proper.

    Okay, but you’re going to get something like this if you try to go to audible.co.uk. They’ll look at your location and say okay well you’re in Iowa, are you sure you meant to go to audible.co.uk? And if you just click on it then you get sent to audible.co.uk which looks the exact same except things are spelled in this way so instead of a Z with customize it would be S with a customize and everything is in pound sterling rather than in dollars.

    So in terms of like where you go, it’s really up to you. Just with what I’ve talked to people about is they said it’s usually easier on a tablet or a computer to use promo codes that are in another country. They’re just a little bit easier. I think it can be done on smartphones and so forth, it’s just a little bit harder.

    But I just wanted to explain what those were. So again thanks for being a loyal subscriber as it were. We just hit a big milestone recently so I’m glad to see so many of you are getting good value out of it.

    If you do join, you get the cheat sheet which is basically top 350 drugs with the stems underlined for the ones that have stems and an orderly way to remember pharmacology. So if you’re in a class what usually happens is that you get some kind of list of okay well here’s the medication if you’re lucky and it might be an alphabetical order.

    And what you want to do is put it in the best order to memorize. So for example for GI, you would put the antacids first then the H2 blockers and the proton pump inhibitors because clinically most people are going to start with an antacid go over the counter find out that doesn’t work exactly go to an H2 blocker that’s twice a day and then if they have some kind of ulceration they’ve got a proton pump inhibitor.

    But if you do it in that way not only are you learning the drug but you are learning the therapeutics. And so what I did was I did that for all the drugs like diuretics.

    You absolutely want to learn starting at the glomerulus then you do the proximal convoluted tubule with Mannitol and acetazolamide then you go to the ascending Loop of henle with the Loop Diuretics like furosemide then you go to the distal convoluted tubule Hydrochlorothiazide and then the collecting duct where you really know you’re talking about the potassium sparing diuretics, spironolactone better known.

    So what I’ve actually done is already put everything in order in the pharmacology book and that’s really what the mnemonics are is it’s putting it in a memorizable order.

    So my Tony farm D YouTube channel just started really with seven videos I made that was me just going up in front of the board and doing all the drugs for memory so no that wasn’t it. It was that I took the time to put them in order to make it easiest to remember everything by pathophysiologic class.

    So again watch for this on your email on Tuesday the 27th. I’ll get that out there and then again you can just kind of explore and see which links you know you like and certainly give me some feedback if you can.

    I think I titled it something like You can always contact me at tonythepharmacist@gmail.com but ive got For example, the Medical Coding Mnemonics has been really popular with that group of medical coders. They don’t get a ton of audiobooks, and then the Pharmacy Technician one also made one that makes it a lot easier to just study for the test, you know, on your way to work and back and so forth. So let me know what you think. But yeah, that’s going to be the audiobooks and again I’ll put that in your email next Tuesday, June 27th. So if you do get on the list now, we’ll have it to you next week.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Thanks again for listening. Thank you.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Ep 87 Antibiotic Prefixes and Suffixes

    Ep 87 Antibiotic Prefixes and Suffixes

    Antibiotic Prefixes and Suffixes

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Let’s get started with the show.

    I’ve recorded penicillins and cephalosporins, but before I go on, I have to address antibiotic prefixes and suffixes. These can be really useful, but you can also fall into a number of mistakes because there are so many mistakes on the electronic note cards. I’ve contacted a couple of the companies and said, “Hey, you know, my stuff is up on your note cards. I don’t care that my stuff is on your note cards. Well, I do, but what I really care about is that they’re wrong.”

    And I know that it’s a lot easier to use somebody else’s note cards when you’re on one of those websites, but you have no idea what grade they’re getting in their class. You don’t know if they’re taking it again and they failed the class or what. So I want to go over prefixes and suffixes for 14 of the most common antibiotic prefixes and suffixes that will help you. But let me first define this term heuristic cognitive bias.

    A heuristic is a shortcut. Someone who’s making these note cards says, “Well, I saw penicillin, amoxicillin, ampicillin. They all end in -cillin. Therefore, all penicillin-class antibiotics end in -cillin.” And we don’t really teach logic anymore, and anyone going to college probably would take ethics instead of formal logic. So these errors I’m talking about have their names in formal logic, and I’m not going to get into that as much as just kind of explain the issue.

    So they found that this was true, and what they did was say, “Well, here I am finding that -cillin has a shortcut for penicillins. Then I can make shortcuts for other drug classes.” So here’s where the cognitive bias comes in. The cognitive bias is the error from the shortcut. “Every antihistamine I’ve seen ends in -ine. Therefore, all antihistamines end in -ine.” But diamohedronate is an antihistamine and that doesn’t end in -ine.

    So again, it’s that cognitive bias that everything they had seen in their experience was -ine, so it must be right. And that’s just not true. The real issue comes from the next step that they make. And again, I’m not going to go into the formal logic. But if all antihistamines end in -ine, then all drugs that end in -ine are antihistamines. Let’s put that in online flash card and help other people.

    Their intent is solid. They want to help other people by publicly posting their note cards. That’s great. But they’re just plain wrong. Morphine ends in -ine and that’s an opioid. Fluoxetine ends in -ine and that’s a selective serotonin reuptake inhibitor. Cephyroline is a cephalosporin and that ends in -ine.

    What they’re trying to do is they’re trying to create a shortcut so they can make sense of pharmacology. And that’s completely understandable. But the issue is that they’re just wrong with the stems because they’re not coming from a reliable source. And I can look pretty quickly at one of those note card sets and say, “Yep, that one’s wrong,” or “That one’s right.”

    So what I want to do is go over the correct antibiotic prefixes and suffixes of the most common drugs, explain a little bit about some confusion between -mycin and -mycin, and then show you some of the errors that you’re going to see, just to create an awareness of these antibiotic prefixes and suffixes and how you can use them, how you can rely on them, but where the pitfalls are, where you can’t really use part of it. Okay, so the first one is ceph, the cephalosporins: cephalexin, ceftriaxone, cefepime, and cephyroline. So cephalexin, first generation; ceftriaxone, third generation with the tri; cefepime is that maxipeam, the fourth generation; cephyrholenus, fifth. And this is consistent. Okay. And it’s common that penicillins and cephalosporins are two of the first drugs that a pharmacology teacher will teach because they affect the cell wall and they’re related. Cyclin, this is a tetracycline type antibiotic. And sometimes you’ll see them cut it off where they say l-i-n-e is what makes it tetracycline or just in. And those are both incorrect. So it has to have that cycline to make it a tetracycline class antibiotic. And again, tetra meaning four and then cyclin, four rings with organic chemistry. Floxacin, this is a fluoroquinolone. It’s not going to be on the stem list. And I’ll go into oxyacin in a little bit. The FL is actually a substem saying that there’s a fluorine atom in there. And then the oxyacin is really what’s telling you that it’s a quinolone antibiotic. But this again is pretty consistent. So ciprofloxacin, levofloxacin, you can be pretty confident that it’s going to be a fluoroquinolone. Casein, so an antibiotic obtained from the streptomyces canamyceticus and then related to canomycin. Or we have to be careful here is that we’re saying okay casein comes in amication and we can say it’s an antibiotic but we can’t necessarily say it’s a certain class of antibiotics. So amicasin just happens to be an amino glycoside but we’re going to see in just a second that it might be an antibiotic but it doesn’t necessarily tell you what class of antibiotic. So the ones that we had before though, the ceph for cephalosporin, bacillin for penicillin, the cyclin for tetracycline and then even the floxacin for fluoroquinolone, those were reliable for helping us know the class of antibiotic. But casein, this might not be one that we can do that with. And let me get to the next slide. Mycin is really a troublemaker. So mycin, the antibiotics coming from the micro monospora strains: you have gentamicin which is an amino glycoside but you have fedexamicin which is a macrolide. So already we see two completely different antibiotic classes with identical suffixes. So some of these suffixes will allow you to learn that it is an antibiotic and some will allow you to learn that it’s an antibiotic and a specific class. It just depends. Okay? This mycin which many people pronounce as myosin, they insert an a vowel in there, it’s actually difficult to pronounce this together. This comes from the streptomycy strain and clarithromycin is a macrolide; clindamycin is a lincosamide; and vancomycin is a glycopeptide. So the mycin isn’t reliable for telling you the class that it comes from and I’ll talk a little bit more about that t-h-r-o substem in clarithromycin how you might be able to use it to help you with macrolides in the United States but we have we can’t really use this mycin to help with classification and we also want to be careful because midamycin is actually for cancer. Okay? Nitazole or nidazole depending on how you pronounce it this is an antiprotozoal and we see metronidazole quite often and I’ll talk about how this stem gets a little bit messed up with that azul uh functional group oxacin so antibacterials and I mentioned the fluoroquinolone before so this is the quinolone derivative and oxacin is the actual stem that the World Health Organization has come up with but we really only see fluoroquinolones these days so the floxacin tends to be what most use to say okay well this is a fluoroquinolone antibiotic all right uh just five more here uh prim so it’s a trimethoprim like and then trimethoprim is one that you use often with urinary tract infections very simple urinary tract infections or in combination with number 12 you know it’s alpha methoxazole as that smz TMP the rifa antibiotic which is erythromycin derivative, so in the US we call it rifampin but outside the US and on the World Health Organization essential medicines list you’ll see rifampicin. So again, this prefix is pretty consistent and then rifibutin. I’ll talk about that in a sec but this rifa rifa is a pretty consistent prefix. Rifabutin is what we substitute for rifampin when we’re working with TB patients that have HIV and we are using a protease inhibitor. So we don’t want to use rifampin in that case or a phampasin. 12 is sulfur, again another prefix that’s pretty consistent: sulfamethoxazole and sulfadiazine. Sulfadiazine’s for severe burns. Sulfamethoxazole usually in combination with trimethoprim, we’ll see for UTIs. Number 13 is thromycin. I see this a couple times on those note cards. It’s not actually on the stem list. The mycin is as part of that streptomycy strain but you can be pretty confident with azithromycin, clarithromycin and erythromycin that those three are macrolides in the United States. However, fedaxomycin is a macrolide and it doesn’t end in t-h-r-o-m-y-c-i-n. So again, we want to be careful with this one, kind of put a little asterisk next to it. Number 14 is zolid, oxazolidanone antibacterials like linezolid and that’s a solid one. Okay, so going on to the errors that you’ll see, a lot of times you’ll see these note cards saying that own means a steroid and they’re thinking of prednisone or deltasone or prednisolone, testosterone. Okay, the stem in testosterone is s-t-e-r for steroid. Stem in prednisone is p r e d for a prednisone type steroid. You’ll also see some of the note cards saying that own is for opioids like hydrocodone or oxycodone and you might even see and I didn’t put this on here own is for a diuretic like spironolactone. Okay, so that own is completely unreliable. You can’t use that because here you see it’s at the end of ceftriaxone and it’s a cephalosporin. That’s not a stem that’s going to really lead you astray. I mentioned earlier about the in from antihistamine but I’ve even seen someone say that on one of the note cards that it’s CNS stimulants and what they were thinking of um was like dexedrine, one of the brand names for uh the ADHD medication and those types of things. So again, in actually is at the end of around 18 and 19% of all medications, completely unreliable for giving you a drug classification. The next one we want to watch out for is this l-i-n-e so line is not uh a stem but I’ve seen many many cards say that it’s a tricyclic antidepressant. What they’re referring to is amitriptyline and the whole of tryptaline is what makes a tricyclic antidepressant. And I think the reason that this happens so much is that we don’t really see nortriptyline much anymore but if you were to have seen amitriptyline and nortriptyline next to each other then you say oh okay I see there’s a much longer stem there t-r-i-p-t-y-l-i-n-e. Same thing with fluoroquinolone, they’ll actually put the drug class with the own saying that that is a steroid or something like that. So again, another one to really watch out for and the next one you’ll see all the time that azole is the ending for antifungals. I can give you many many examples where this is wrong so metronidazole is an antiprotozoal then you have something like a proton pump inhibitor like esomeprazole that ends in azole and the stem there is prezzle sorry and then you have drugs like aripiprazole which are antipsychotics and the stem is piprazole so azole a-z-o-l-e this is an organic chemistry stem it’s unreliable for drug classification and you’ll also see this and I put this In the next slide with sulfamethoxazole, the azole stem will lead you wrong as well. Okay, so what I want you to take away from this is that you can use prefixes and suffixes if you get them from the proper source. 

    The United States Adopted Names Council list, the World Health Organization list, those are the ones that I used for memorizing pharmacology and that’s really what you want to use. If you’re going to use those note cards, I know it takes a lot of time to make your own but that’s ideal. If not, at least take the time to look at these 14, make sure that the cards that you’re using don’t have these errors. 

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile. Thanks again for listening.

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    Find my book here: https://geni.us/iA22iZ

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    Ep 86 Cutting Pharmacology Study Time in Half

    Ep 86 Cutting Pharmacology Study Time in Half

    Cutting Pharmacology Study Time in Half

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

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    In this episode I go over why it takes so much longer to study for pharmacology than other classes and what to do about it. 

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Let’s get started with the show.

    Okay, welcome to the Memorizing Pharmacology podcast. I just wanted to teach you how to cut your pharmacology studying in half. So before I get started, online pharmacology class is still available. We opened up a second section because it looks like the first section might fill. So just go to DMACC, DMACC and then pharmacology PHR185 is the name of the class or the class number.

    Okay, so what I want to do is just give you a quick example. So I live in North Ankeny and there is a grocery store HyVee that we go to and then there is also a South Ankeny HyVee. When you go to the North Ankeny HyVee, this is the one I know, this is the one I go to all the time, the groceries are on the left of the building. If I need something that is not grocery, I know it’s on the right of the building. But if my kids say, okay, well Dad we’re out of milk and orange juice and cheese or something like that, I know to go in the right part of the building. I know to go to the back refrigerator section and if it’s just milk I can just go to the registers and I can go to the back right. I can go get what I need and come right back out and be done. On the other Ankeny one, I would have to go all the way to the left side, go all the way to the back left and then come out in the left door.

    So I just want to give you that quick example because when we talk about pharmacology and why I wrote the book Memorizing Pharmacology: A Relaxed Approach and you know somebody just put a comment on my YouTube video, hey you know thanks for cutting down my study time. That’s the whole point of mnemonics is to make it so that your time is much more efficient whether using the second edition or the first edition it doesn’t matter.

    But when people say oh okay well it’s just about the endings and the suffixes and things like that, that is incomplete and I want to show you why. Okay so besides the endings and suffixes and things like that, what I’m looking at right now is you can go online look on Amazon and this is the free preview of the book and when you look at GI for example and we’re going to start with too much acid.

    The first thing you would give somebody or something somebody would take is they just go to over-the-counter and just get some antacids and they take those and that would reduce the amount of acid in their stomach. Okay, the next thing they would go to is an H2 blocker. That is a little bit more potent, it’s going to last quite a bit longer than an antacid. It can be taken on a regular basis maybe two weeks if somebody is having chronic acid or chronic GERD or chronic reflux.

    And then if they were to go into a situation where they were actually going to be treated with antibiotics and an acid reducer, it’s more likely you would get a proton pump inhibitor. Now yes I talk about the endings. The generic antacids are actually the same chemical name as generic names kind of unique in the way they do that. And what we do is we put calcium carbonate and magnesium hydroxide one is constipating one causes diarrhea we put those opposite each other and we put them in a pair.

    Then for histamines we have cimetidine which is the first one that came out has all of the side effects and then famotidine which has many fewer side effects which is the newer one and then it has that new Zantac brand name in addition to Pepcid.

    And then we go to our proton pump inhibitors esomeprazole and omeprazole you know the S and R if you need to get into that in your particular pharmacology class where you have the right hand and left hand but more important thing is that it is in an order.

    So in same way that I would go into HyVee in North Ankeny HyVee and if I need to go get dairy and maybe a card for someone I would go into right side of store and then I would go into back right of store but then if I know I need to get like a frozen pizza or something I would know I’d go to middle of store and then if I need to go get some dessert or something like that back left of store If I needed to get some crab rangoons, you know, just a snack or something like that, they would be on the left of the store. And then maybe some Starbucks on the way out, left of the store. But if I go to the South Ankeny HyVee, that actually reverses almost. Because if I need to get dairy, it’s on the left hand side of the store. The Starbucks is in the middle of the store on the left side. And so maybe I would start there, kind of get that thing to go in your cart. And then I would put the pizza and the milk and everything and I would go get it on the left side of the store.

    So what I’m telling you is that yes, okay, those prefixes, infixes and suffixes are helpful. But the more important thing is that you have a list that’s going to have things in order. And that order is how you’re supposed to learn it. And the order you’re going to want to learn it in is the one where, okay, what is the least invasive medication that we’re going to use? What is the next least invasive and so forth until you get to the very strongest medicine? Or with beta blockers, first generation, second generation, third generation. Calcium channel blockers, non-dihydropyridines versus dihydropyridines. Okay, when you talk about antihistamines, it’s going to be which ones are the non-sedating versus the sedating. The sedating came first and then the non-sedating came second. First generation, second generation.

    What I’ve done is, the reason this can cut your time in half is that I’ve already done it for you. I’ve already told you this is what has allowed students to be successful in the past already. They’ve already found that this is the order that makes it so much easier for them. This is the order that makes sense for them. And for you visual learners, this is the one that you want to draw it and you want to draw this drug first, this drug second, this drug third. Or with something like the RAAS, the renin-angiotensin-aldosterone system, you would of course put something that is going to affect angiotensin II like an ACE first and then an ARB second because that’s what the order is going to be in the picture. Or with diuretics, you’re going to start with the glomerulus and you’re going to start with mannitol and then you’re going to go down the loop of Henle like a water slide. You’re going to come back up and you’re going to use furosemide and then you’re going to go to the distal convoluted tubule into hydrochlorothiazide and then you’re going to go into the collecting duct where you have spironolactone or eplerenone, those potassium-sparing diuretics.

    There is an order for everything and the reason why it’s taking you so long to figure out pharmacology is because you are figuring out the order for yourself. You are reinventing the wheel. I’m telling you I’ve already done this. I’ve been teaching this for 15 years. The reason why so many people want to use this book and I want to say it’s close to almost 10 000 a year that will use this book is because I’ve already put everything in order for you.

    And yes I get it, you’re gonna get some maybe some of your lectures are going to have like study notes for the exam and things like that but the question is and you can figure this out really quickly does the order match the order that I’ve put them in? Okay when you look at GI does it look like this is in an order from least to worst something like that?

    Alright well if you got questions donateguerra@gmail.com but again the easiest way to do this use videos on YouTube or whether you get book Audible lets you get it for free if you’ve never had one with them before but if you are not doing things in an order that you’ve already established or somebody has established for you then you’re probably making it twice as hard as it needs to be. You’re spending twice as much time on pharmacology than you need to.

    And I assure you it will make it so much easier because once you make this class take up less of your time you can spend more time on other classes and then you feel so much better because once you’ve made it so that okay now I’ve got enough time to do everything that’s when anxiety starts to go away. That’s when you start to feel confident. That’s when you’re helping your classmates and when you’re helping your classmates you’re learning it even better.

    And we get on this kind of wheel of just success where it just builds on each other because now you’re helping other people learn and you totally remember it. Alright Tony the pharmacist gmail.com if you’ve got questions otherwise I will talk to you in the next episode.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets and more at memorizingfarm.com. Again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/p/mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Courses:  residency.teachable.com

    Ep 79 Acid Reducers and Peptic Ulcer Disease Pharmacology Mnemonics

    Ep 79 Acid Reducers and Peptic Ulcer Disease Pharmacology Mnemonics

    Acid Reducers and Peptic Ulcer Disease Pharmacology Mnemonics

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Peptic Ulcer Disease has several important concepts to remember; in this episode, I touch on some mnemonics to help you remember them. If you're interested in checking out the course online for a refresher you can go here: https://residency.teachable.com/p/mobile or if you need a credit course, here: https://www.dmacc.edu/programs/pdp/pre-pharmacy/Pages/online-pharmacology-class.aspx 

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Auto Generated Transcript:

    Hey, welcome to Memorizing Pharmacology Podcasts, Episode 79: GI Medications Pharmacology Mnemonics. So let’s just talk a little bit about the ulcer and then we’ll get on with it. The big thing is that once you get this ulcer, you can’t really fix it as much as you can create an environment for it to heal. So the number of things that you can do to kind of do that include eradicating H. pylori which is found in a greater percentage of the ulcers, smoking cessation, alcohol reduction, stress reduction, spicy food reduction; all those things can help. But again, making it so that the body can heal itself.

    So what are some drugs that cause ulcers? Again, alcohol is a drug so ETOH (ethanol), then bisphosphonates like alendronate, ibandranate (again watching for those stems), the NSAIDs ibuprofen, naproxen. Even though Celebrex or celecoxib is supposed to do it less, it still can be a problem. And then steroids like prednisone.

    So we start with things that we could maybe not use a medication for to help deal with these kind of GI symptoms and issues and make things better. And so we’ll use the mnemonic SAFER: SAFER for Smoking, Alcohol, Food diary, Exercise, Reducing stress and NSAIDs. I didn’t really know how to put that in there because we’re taking away a drug so is that non-drug? Sort of. So I just had a little breathe image here for smoking, alcohol just kind of reducing that; have your coffee instead. Here’s your food diary, then getting some exercise, reducing some stress (yoga whatever it takes) but all the things that would make it so that there’s less acidic environment and of course not using the NSAIDs if possible.

    Antacids: You are probably familiar with these colorful chalky tasting limestone things and the big thing to know about antacids first is that they’re the only drug whose generic name is their chemical name. So calcium carbonate is Tums, aluminum hydroxide is half of Maalox (it’s really Amphojel) and then magnesium hydroxide would be Milk of Magnesia.

    So when we talk about antacids we’re really looking at which ones are constipating which ones cause diarrhea and you kind of have a little guess which is which here. So pick C or D and with calcium carbonate that one is constipating, aluminum hydroxide is constipating (again it’s Amphojel is going to be the brand name) but if you mix them together magnesium hydroxide and aluminum hydroxide it makes Maalox and then magnesium hydroxide Milk of Magnesia.

    So which cause constipation which cause diarrhea? So the idea is calcium carbonate is constipating, aluminum hydroxide constipating, magnesium hydroxide causes diarrhea. So if we mix constipating drug like aluminum and a diarrhea causing one like magnesium hydroxide then we end up with something that is more comfortable for the patient.

    Alright H2 blockers: I’ve talked about the antihistamines NO MAN where one nose so that you remember the H1 antihistamines are the ones that are in the nose for allergies and the H2 (the buttons by his stomach) those are H2 blockers.

    So H2 blockers all end into -dine so famotidine is Pepcid and now Zantac it used to be ranitidine nice addedine is acid and cymetidine is Tagamet and ranitidine and Zantac but again there’s a reason I put them in this order and the reason is that it’s the ones that we prefer versus the ones that we don’t and the reason we don’t is because of side effects.

    So cymetidine can interact with diazepam lidocaine phenytone propranolol warfarin can cause gynecomastia and then ranitidine; the problem with the NDMA had it pulled off the shelves. Proton pump inhibitors: It’s -prizol ending and then you might see Omeprazole with S Omeprazole and Lansoprazole would duck Pantoprazole and wondering those look awfully the same what’s different and we’re really talking about either changing the rotation of plane polarized light or an enantiomer more of an organic chemistry thing but basically there’s a mirror image and the active one is the one that became the new drug but you know just having the active one versus having the mix of the active and inactive doesn’t necessarily make it better so a lot of times like Dexilant hasn’t really taken over for Prevacid and Nexium maybe to some extent over Prilosec so be careful here because the prizol it’s not Azul you go on the internet and you find these drug cars and they say oh if it ends in a Zoll it’s a proton pump inhibitor that is false if it ends in prazole it might be a proton pump inhibitor but if it ends in conazole It’s actually an antifungal so Fluconazole which is Diflucan, Voriconazole which is Vfend both of those are antifungals so it’s not the azol ending then Aripiprazole which is Abilify and Brexpiprazole which is Rexulti uh those are antipsychotics so really rare to see a stem within a stem that the prizole is in piprazole uh the World Health Organization frowns on such thing and it’s really rare but just be careful make sure that you know if you’re looking at something you know is it de fungal with conazole is it an antipsychotic with piprazole or is it a proton pump inhibitor with prazole so gobs of side effects gobs is our mnemonic or gastroenteritis and you’re going to reduce the acidity which is great for that ulcer but it also allows bacteria to have a chance to thrive osteoporosis B for B12 deficiency and S for secretion rebound so once you stop taking that proton pump inhibitor acid can rebound quite a bit so G-O-B-S is our mnemonic uh H pylori therapy there are many therapies I just put a couple examples of triple and quad therapy so triple therapy is going to be two antibiotics and one acid reducer so Amoxicillin, Clarithromycin, and Esomeprazole makes ACE A C E is the first letter of each of those drugs Amoxicillin, Chlor thermice in the antibiotics, Acetomeprazole the acid reducer or Amoxicillin, Metronidazole, and Omeprazole so Amoxicillin, Metronidazole or the antibiotics Omeprazole the acid reducer again we want to reduce resistance so we use lower doses of more drugs now we can make a quad therapy here where we actually use you know three antibiotics and one acid reducer so a Tetracycline like Doxycycline uh that’s not the brand name it’s a tetracycline so uh it should have really put Tetracycline kind of a Doxycycline and then put the brand names in the parentheses uh that’s antibiotic Omeprazole for Prilosec is NASA reducer Metronidazole is Flagyl which is an antibiotic and Bismuth Salicylate when put in this situation has antimicrobial effects so I put TOMB as the mnemonic Tetracyclin T, Omeprazole O, Metronidazole M, B for Bismuth because once this group comes together it’s curtains for H pylori so it would be buried in a tomb uh Misoprostol or Cytotec so if you think of it as Miso protect all from NSAIDs it’s really what it does and I was just thinking of miso soup delicious uh but that’s the thing I could think of but Misoprostol and it prevents NSAID induced ulcers but it also can be used as a medication absorb abortion labor induction cervical ripening it’s a prostaglandin analog so we see The Prost in the Misoprostol and it is pregnancy category X if you’re not trying to use it for any of the above indications you don’t want to risk it with a patient and that’s why it’s fallen out of favor when you have a Here is the corrected text:

    “Medication that could, you know, harm a fetus, you really try to find something different. I’m going to Cisapride or Propulsid. Again, we don’t really see the brand names but see the soccer ball being propelled through the goal so gastroparesis is usually what the issue is so that kind of stomach that just will not empty so it empties much faster and it’s a prokinetic. So Pro meaning toward and or you know kind of helping out and then kinetic like Kinesiology movement so it is for movement. 

    The problem is that some of its mechanism is dopamine antagonist so dopamine antagonist can result in extrapyramidal symptoms (EPS) and the problem with that is that if someone has Parkinson’s and they have a dopamine deficiency, the last thing you want to do is block the dopamine they do have. So what we want to do is make sure to tell the patient about that EPS and possibilities that come along with it but rarely used medication Sucralfate or Carafate. It sugar coats the crater is how I remember it. It’s a GERD add-on so physician might say okay well let’s give you, you know, Prilosec for the month and we’ll give you a couple weeks of the Sucralfate so that with each meal we’re putting that coating down. It coats the ulcers in that kind of sugary coat. It can cause Bezoars which is really kind of like it’s just a knotted ball of stuff. It can be broken up or surgically removed and then the big issue is this isn’t an absolute contraindication but if you’re a diabetic and you’re taking four sugar pills a day just have to account for that in however you’re reducing the sugar in your bloodstream and then it’s four times a day before meals so again getting that sugar may not be the best thing. So if you can think of Sucralfate or Carafate as a kind of candy, you can remember the concerns about diabetes. 

    This information is provided for you for your informational purposes only and not intended to provide and should not be relied upon for medical or any other advice. I urge readers to consult with a medical professional with any medical condition. Thanks again for listening to the memorizing pharmacology podcast.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Ep 78 College Online Pharmacology Course - Registration is Open Now

    Ep 78 College Online Pharmacology Course - Registration is Open Now

    College Online Pharmacology Course - Registration is Open Now

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Here is the link to the summer online course:  https://www.dmacc.edu/programs/pdp/pre-pharmacy/Pages/online-pharmacology-class.aspx 

    and to the audiobook if you want to get a head start:

    https://www.audible.com/pd/Memorizing-Pharmacology-Audiobook/B09JVBHRXK?source_code=AUDFPWS0223189MWT-BK-ACX0-281667&ref=acx_bty_BK_ACX0_281667_rh_us 

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Okay, welcome. This is a video showing how to register for the online pharmacology class and the books you’ll need. Tuition, try to get everything in here, questions that everybody has. So first, if you want to find it just put in DMACC pharmacology or DMACC pharmacology class. DMACC stands for Des Moines Area Community College. It’s a 10-week class and it is completely online. It is completely asynchronous so that means that you have deadlines each week.

    You do not have to be in a video at any time or any specific time. Rather, you watch the videos, complete the exercises, and then you’re graded on your submissions there and the discussions as well. Okay, so we do have a limitation of the number of students that can register for it but you would register here. So again, you put in DMACC pharmacology, it’s going to bring you to this page and then you register. If you’re not from DMACC, you just register as a guest student. It takes like a day total to get you registered and that just means that you’re not planning on getting a degree from here, you’re just signing up. And then if you are a DMACC student, you can just normally register for classes through that registration started for non-DMACC students on the 15th of March 2023.

    To find out if the syllabus is something that’s appropriate for you, you can also find the summer syllabus from last year here and the fall syllabus as well. It’ll be the same books, same content this summer as it was last except for those things when I update something as far as maybe a change in a drug that’s approved or something new and things like that. Tuition is not non-resident tuition if you are out of state rather it is the online tuition. It’s a four credit course and we did that because a lot of schools that are maybe four-year schools want to see an extra credit if it’s coming from a community college but again 208 dollars per credit hour seems reasonable. It’s 178 in tuition plus thirty dollars in online support fee per credit hour so you can do the math on that times four but again it is a 10-week course.

    This was when everybody was able to register for summer so March 15th, you register for summer if you’re thinking about spring or fall it’s taught every single semester. It’s just in summer we have so much demand for it we actually open two sections usually in the summer but that’s not always the case hopefully we will again open two sections okay.

    The dates start on May 23rd of 2023 and end on August 3rd of 2023. You will get if you are trying to transfer this out a couple of days after that you will be able to transfer it and what you can do is you can just say hold my transcript for final grades and that will allow it to transfer to wherever it is that you need it to transfer to make up for if for example you had a bad spring and weren’t able to pass pharmacology some colleges allow this some don’t and again it’s really up to your college to decide if that’s going to be appropriate for them.

    For those of you that are in maybe high school or are thinking about medicine or nursing or Pharmacy as a career or maybe and this happens quite a bit if you have pharmacology coming up in fall and you want to take pharmacology now so that when you get into fall with some colleges if you fail pharmacology you would have to repeat the entire year and by doing this with your hardest class it makes sense that okay well I’m just gonna give myself some insurance I’ve already taken the class learned the pharmacology language so that when I go into the class I’m well prepared for it.

    I did this with biochemistry I knew that I would be taking biochemistry in pharmacy school in the first year I knew that was the very hardest class available and so I took it and then ended up actually auditing it for non-credit because that was what I was doing and I didn’t really necessarily want to take the tests and all that but I did attend the courses at Maryland and it was super helpful to have already taken it. I’ve already gone through the Krebs cycle, I’ve already gone through those things. So whether you’re taking it and these are the biggest three reasons people take it: they either take it because they did not pass a pharmacology course and their college does not offer one in the summer or spring or fall or whenever it is. Two, if they’re getting into PA school or they are getting into another type of program that requires pharmacology. Three, they are a student that is interested in the Health Professions, has a little bit of an opening in a class that they want that’s relevant, that’s going to help them in their next phase and this can be nursing or Pharmacy or medicine but many different people you’ll have in the pharmacology class. But again, the fact that it’s only 10 weeks and that is completely asynchronous is helpful to a lot of people.

    So just with the course syllabus, just let you know, the CRNs are not what they are for this time but I’ll just kind of go through the big pieces at the end here. These are the things that we’re going to go over and again it’s in the syllabus that you can download but this is the course schedule and again it’s over 10 weeks. We’re going to use three books and I’ll show you those and give you the rationale for using each of them. These due dates obviously will be updated for 2023.

    Okay, the first one is an open educational resource nursing pharmacology. Unfortunately, it was used for a two credit course so not enough of a book to completely cover everything that we need but because so many of our students are nursing, it was important that we use a nursing book as part of it so that these case studies relate to the nursing profession. Then, the pieces you know, the other credits that we need we use Pharmacology Made Simple and I wrote this book for Elsevier because what we wanted was a book that really makes things quite straightforward but the other big deal is that you can rent it for fifteen dollars for the semester usually around there fifteen to twenty dollars. And so, the OER book is free if you get the eBook and don’t buy the print book. This one was fifteen dollars to rent.

    And then one thing that I find is a real concern is students can’t pronounce the names of the medications or if you’re taking a course that’s online and it’s something like this where you really want to know the medication names an audiobook is an option for this one. You can get the paperback, you can get the audiobook and get the Kindle because I’m on my own Amazon you can’t see it but the audiobook actually is free if you become a member of Audible. So if you decide to do that you can.

    And then I think that was it yeah so again, the way to sign up for the online course is to go to that original page just put in pharmacology DMACC in a Google search, you’ll get to this page whether you’re a guest student or somebody who’s trying to transfer in. It’s a reasonable course to take over summer to kind of either get it out of the way to fix something that happened or again to just get that extra step ahead so that when you come in to take pharmacology at your own College, it is so much easier because you are helping other people rather than being lost in the weeds.

    So if you’ve got questions there’s my link to my email a-a-g-u-e-r-r-a at dmacc.edu. If you call me and leave a message it will actually email me that message so if that’s the way you prefer to contact me as well that’s fine but I’m happy to answer any questions about PHR185 Pharmacology completely asynchronous and online course that’s 10 weeks this summer at Des Moines Area Community College.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

     

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Ep 77 B Vitamin Pharmacology Mnemonics

    Ep 77 B Vitamin Pharmacology Mnemonics

    B Vitamin Pharmacology Mnemonics

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help? You can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before: https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    B vitamins can be hard to remember with skipped numbers and names for each B vitamin. In this video, I go over some ways to help you remember.  

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Alright, today we’re going to go over B vitamin mnemonics. So here we go. First thing of course is that we have water-soluble vitamins versus fat-soluble vitamins. B vitamins are water-soluble as are C vitamins. So here are the names and the trick is how do you remember the number with the name? So B1 is thiamin, B2 is riboflavin, B3 is niacin, B5 is pantothenic acid. Notice there’s a skip between three and five, there is no four. B6 is pyridoxine, B7 is biotin, B9 is folic acid, and B12 it’s cobalamin.

    So let’s kind of move on to the next and what we’ll do is we’ll divide this into thirds. First we’ll take a look at thiamin, riboflavin, and niacin. So the way we’re going to do this is we’re going to go from the bottom up. So we’re going to say that B1 is thiamin looking at this skeleton’s thigh, riboflavin is rib so ‘thi’ from thigh, ‘rib’ from riboflavin and then if you pronounce it I thought it was an Australian accent but it actually comes out more of a South African accent if you say ‘Nick’ rather than ‘neck’ you can get the ‘Nic’ that’s in niacin.

    So again it’s the thigh, the rib and the ‘Nic’. So by the rib and the neck reminds you the B1, B2 and B3 going from the bottom up are thiamine, riboflavin and niacin.

    The next three and we’ll get a little crazy with the picture here but we’re going to have pantothenic acid so pants uh and I have no idea why there was this skeleton with the jeans but it was available for purchase so I was able to get the picture. Pyridoxine think of a pyramid so upside down pyramid the way the rib cage kind of comes down right you guys are old enough to remember Mork and Mindy yeah that was the kind of symbol on the front of Mork uh and then biotin uh the tin hat uh on top of the skeleton.

    So we have B5 is pantothenic acid with pants, B6 is pyridoxine but the pyramid upside down and then biotin is the tin hat okay.

    The last two we’ll use just a forest and a beautiful blue sky so forest for folic acid that’s B9 and then B12 is cobalamin with the cobalt sky. I know this isn’t exactly Cobalt it’s not exactly that blue it’s actually kind of a green but just roll with me here forest and cobalt sky folate and cobalamin are B9 and b12.

    So let’s dive into what they’re good for three at a time so first B1 or thiamin this converts carbs to glucose prevents Wernicke’s encephalopathy in alcoholism or liver disease so a little picture of a beer there and some cirrhotic liver.

    B2 is riboflavin deficiency due to alcoholism vegan vegetarian lifestyle malabsorption just can’t absorb it or lactose intolerance.

    And then B3 niacin is great for high triglycerides where we’re really trying to stabilize that plaque as an add-on for statins where the statins maybe they get the LDL down but just not the triglycerides where you want to be so you can avoid pancreatitis and you would need maybe to give an aspirin 30 minutes before to avoid that flushing effect okay all right let’s move on to the next.

    So B5 pantothenic acid it synthesizes coenzyme A for fatty acid metabolism and you can think of the A in acid and the word acid for coenzyme A and fatty acid metabolism.

    B6 pyridoxine this is for alcoholism and peripheral neuropathy from isoniazid. Isoniazid is one of those drugs for TB okay so again the ripe mnemonic when you have a TB in duration that’s ripe okay so Rifampin isoniazid uh and so forth okay so.

    The XYZ mnemonic is to take the X and Y from pyridoxine and match it up to Z in ice niazid okay and that peripheral neuropathy is really this picture we have this exclamation point and somebody’s really having trouble feeling their fingers uh so fingers and toes That uh, a lot of times for that peripheral neuropathy shows up, it may show up as not being able to button a shirt as well. So it doesn’t necessarily show up as pain, it’s just can’t always just really use your fingers as you’d like to. Biotin that helps enzymes break down carbs, fats and proteins but really skin and hair is where we see it in beauty products especially. So the ‘in’ from Biotin for skin and then the hair again. I just got a picture of someone who’s an athlete, good hair, good skin.

    B9 is folate. This is where we want to prevent those neural tube defects and think of the F in folate and F in defects. Deficiency is a reduced hemoglobin level and really B9 is critical for red blood cell production. To be honest, you need B9, iron and B12 and if you think of a nine iron if you know golf a little bit, a nine iron being used on the 12th hole you can put the nine, the iron and the 12 all together. And there’s a very famous shot on the 18th hole that where someone just yelled out ‘be right’ and the B from ‘be right’ is just you know, be right, be the right shot.

    And so here again we’re using that B so B9 iron on the B12 hole um hopefully that helps you remember that iron B9 and b12 need to go together to really form those red blood cells properly.

    B12 is cobalamin so it’s for macrocytic not microcytic and pernicious anemia so the ‘ma’ in cobalamin for macrocytic, the ‘ni’ in cobalamin for pernicious anemia and then a lot of the letters from anemia are in cobalamin so if you’re somebody that can kind of do those word scrambles I think that’s helpful.

    A lot of those people that have gastric bypass surgery you think oh my gosh that’s so great they you know they don’t aren’t hungry and things like that but really it does cause a lot of problems in terms of B12 um uh Celiac and Crohn’s disease these are two issues that would definitely necessitate adding some B12.

    And then deficiency again just like with B9 and folate I will D equal reduced hemoglobin level for red blood cell production so again both of these really work in tandem to help you know those red blood cells properly form.

    And then this was supposed to be uh the nine iron and the golf course and all of that but it turned out to be just grass and sky but think of a nine iron on the 12th hole and uh I think it’ll be a lot easier to remember.

    Again this is for informational purposes only it is not medical advice so if you’ve got a medical condition consult a medical professional. Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Ep 76 Poisons and Antidotes Pharmacology Mnemonics

    Ep 76 Poisons and Antidotes Pharmacology Mnemonics

    Poisons and Antidotes Pharmacology Mnemonics

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help? You can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Another kind of niche topic is antidotes and poisons where you are expected to know which matches which. In this video, I give you some ways to better pair them together. 

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Hey, and we’re going to okay welcome to Poisons and Antidotes Pharmacology Mnemonics. What I’m really doing here is just um, I kind of always have to find some way to put things in an order and when you talk about poisons and antidotes it’s really by definition is just matching. So how do you match things up? So what I did was I put them in alphabetical order first. So I took a number of poisons or drugs that you can overdose on and five of them happen to start with A.

    Then a couple started with B, C, D then E then H and then I finished up with O, P, P, S, and W. And so when we talk about these poisons and antidotes it’s really about just keeping them straight in your head and then making a small connection uh to try to help you remember which medication or which uh poison ends up with which antidote.

    So let’s start with the A’s. First of all, acetaminophen’s antidote is acetylcysteine so you can use the ‘acete’ in the very beginning of both of those. Alprazolam and diazepam have Flumazenil as their antidote so the A’s in Alprazolam the A’s and azepam and more generally the stems azolamine azepam for all the benzodiazepines uh flumesonil is the antidote there.

    Anthrax you can if you think of a mirror as Anthrax is the poison and ciprofloxacin is the antidote well if you put a mirror in front of this ax turns around x a so just think of this be xing out Anthrax or something like that okay amitriptyline and aspirin have the same antidote it’s both sodium bicarb and the nice thing is that both of them start with an A so A for amitriptyline goes with the B and C for bicarb so ABC a and aspirin goes with the B and C for bicarb so ABC again.

    So once you get these first five down then you can kind of move on to the next one we’re going to use a couple different letters to kind of move along with those so we’re going to go B, C, D, E, H it didn’t quite work out the way I wanted but again uh you know we’re just trying to get some kind of order so that when we look at the um antidotes it works out.

    So beta blockers and calcium channel blockers both use glucagon as a way to have an antidote and a couple of things I was thinking about here when you have a beta blocker it masks the signs and symptoms of hypoglycemia that normal increased heart rate and things like that it tends to be gone so glucagon is something that you use when the glucose is gone.

    And if you think of beta blockers masking hypoglycemia maybe it’ll all kind of stick in your head and then glucagon again especially with non-dihydropyridines that are going to affect the heart much like beta blockers do we try not to use beta blockers and non-dihydropyridine pyridine calcium channel blockers together maybe that helps you as well um digoxin and digibind.

    I think that that really helps that you know first three letters are the exact same but digibind or Jackson immune Fab that tends to be one most people can remember ethylene glycol is a poison well it’s not it’s a poison if you try to ingest it and from episode uh which is an ADH antagonist those are an E and F okay so we’re going B, C, D, D, E, F.

    And then Heparin and protamine you might not see this but it’s kind of a word scramble if you take the e p a r i n from Heparin you can find e p a r i n in protamine so just a way to connect them and hopefully kind of burn these into your brain uh.

    The last five I was going to go over are two that also have the same antidote organophosphates which maybe we do or don’t think about it as cholinergic and it would be atropine which is the Anticholinergic drug right, if isostigmine which is also cholinergic. Well, it’s an acetylcholinesterase inhibitor which keeps that acetylcholine from being broken down so it is in effect cholinergic. Atropine again is anticholinergic, works against it. Potassium, you think about K Plus on the periodic table of elements, what’s right next to potassium? Well, it’s Buddy calcium CA plus plus and they both have that hard k sound in the beginning to maybe help you put those together. But the calcium or calium that the K represents which is potassium and then the calcium CA gluconate that you would use for that.

    Serotonin syndrome and although I heard it called cyproheptadine, you can call it cyproheptadine to make it easier. Serotonin syndrome and ciproheptadine to use an S sound to connect those and then Warfarin and vitamin K. And if you think of killing happening in warfare, that’s one way to remember vitamin K goes with Warfarin as an antidote.

    So again, this is very much an educational video meant to help you just remember many of the poisons and overdose and antidotes but if something does happen make sure to call your poison control center. As always this is for informational purposes only, it is not medical advice. If you have a medical question contact a medical professional.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Ep 75 Eye and Ear Pharmacology Mnemonics in 5 minutes

    Ep 75 Eye and Ear Pharmacology Mnemonics in 5 minutes

    Eye and Ear Pharmacology Mnemonics in 5 minutes 

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help? You can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    A lot of time, eyes and ears get short shrift, but there are a lot of medications that you can readily remember with a few suffixes in this group. 

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Hey, welcome to the Memorizing Pharmacology podcast. Today we’re going to go over eye and ear infection pharmacology and some mnemonics that can help you. Let’s get started here with what is maybe better known as swimmer’s ear but external ear infection. So when you have an infection on the outer ear then it actually makes sense to just use drops and put something on it. So you can use something that would be an antibiotic that would take care of the infection but also there’s going to be some inflammation so we’ll use some kind of steroid.

    So the medication that we can use is something like Ciprodex which is a combination of ciprofloxacin and the floxacin ending tells us it’s a fluoroquinolone antibiotic. The FL is for fluoro and then the oxygen is for quinolone and then the dexamethasone, we’ve seen that sewn ending before, that’s a steroid for inflammation. Now you do it a little bit differently for a child versus an adult. A child, you’ll put the head horizontally, pull the earlobe down and then apply the drops. So the word child ends in d and then use that for d for down whereas an adult has a u in it and we go adult up.

    So the head will be again horizontal, we pull the earlobe up and we apply the drop. So child down, adult up. When you have a middle ear infection, the drops aren’t going to be able to get to that infection so we need an oral medication. And I remember my daughter had the tubes put in and a physician said okay well you know what this is our week meeting we’ll give her amoxicillin like well she’s already been on amoxicillin for a whole week. It’s like oh all right well what that means is that it is a beta lactamase producing bacteria that is resistant to Amoxicillin.

    So beta lactamase is an enzyme that the bacteria secretes and it destroys the beta-lactam ring and makes it ineffective in penicillin. So just to be clear, the amoxicillin didn’t work for a week, my daughter still had an infection in her ear and it was because the bacteria made an enzyme that basically broke the amoxicillin ring. So we switched to something a little bit different so we cross off amoxicillin and include amoxicillin with something called clavulanate.

    So Augmentin is just that something that augments amoxicillin by itself and what clavulanate does is it kind of has the bacteria attack it instead of the amoxicillin allowing the amoxicillin to do its job. You can do some work with cephalosporins again cephalosporins tend to begin with CEF or ceph so cephachlor which is seclor and cephyroxine which is sinus F those are both second generation or you might see suffixine which is suprax that’s third generation.

    So what we’re really doing with this middle ear infection is it’s a resistant infection we’re going to give what’s quotation figures a stronger antibiotic now why don’t you want to give clavulanate why don’t you just give that in the first place well you want to reserve it for resistant infections but also it tends to cause a lot of GI upset unlike amoxicillin by itself.

     

    Let’s move on to the eyes. There’s really three big conjunctivitises that you have to deal with. There’s the allergic where we kind of put in an eye drop antihistamine is usually a good way to do it. Something viral, we might have to take an oral medication like oral acyclovir or if it’s bacterial, we have lots and lots of eye drop antibiotics. Fluoroquinolones like we talked about with the ear, Amino glycosides Gentamicin Tobramycin, macrolides like erythromycin and then others will see the kind of neomycin type of thing.

    Alright, well let’s start with the allergy eye drops, the antihistamines. There’s just a number of them and there’s not really as good a stem as this although if you’re familiar with Loratadine which is Claritin, you notice olopatadine which is Pat a day then open which looks a lot like ketoprofen which is a non-steroidal but that’s zaditor and then pheneramine. You may remember the chloropheneramine which is color trimeton from a long time ago that was also an antihistamine which is Opticon A or part of afcon A.

    So again, if the patient has allergy eyes we’re going to try to put an antihistamine drop in there. Usually there’s some water, some redness that’s how allergic conjunctivitis presents. We talk about bacterial conjunctivitis, you’re going to get some crud as it were and you’re going to have eye drops and ointments available. You can use the fluoroquinolones again that’s the floxacin stem ciprofloxacin levofloxacin, aminoglycosides Tobramycin Gentamicin, the macrolides erythromycin and azithromycin.

    So again be careful with that mycin stem, a lot of drugs end in mycin and it just means that the streptomyces bacteria was used to actually make the antibacterial and then the other is like neomycin polymixon B and Bacitracin or polymixon B and trimethoprim. So lots and lots of options when it comes to bacterial conjunctivitis. Viral conjunctivitis actually usually clears up in a week or two maybe three weeks at worst. You’ll probably use an oral medication like oral acyclovir if that’s something we’re going to use.

    Well let’s talk about actually instilling the drop itself so you want to tilt the head back while looking up that’s the first thing and this is kind of a natural thing you kind of look up to the sky you tend not to look down you’re going to pull the lower eyelid down and away foreign drops into that pocket then this is kind of the key is that you’re going to and you’ll probably do this automatically you’ll close the eye okay to get those drops in there so kind of four steps here tilt your head back while looking up pull the lower eyelid down and away squeeze the drops into the pocket and then close the eye.

    Again this information is informational only if you have a medical condition contact a medical professional. Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com. Again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

     

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Ep 74 Glaucoma Pharmacology Mnemonics in 10 minutes

    Ep 74 Glaucoma Pharmacology Mnemonics in 10 minutes

    Glaucoma Pharmacology Mnemonics in 10 minutes

    Glaucoma is one of those topics that you see a lot of contraindications with, but not necessarily a good explanation of the pathophysiology. I do a 10-minute run down of the most important aspects of glaucoma with a few mnemonics to help out.  

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help? You can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingpharm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Alright, welcome to the Memorizing Pharmacology podcast. Tony Guerra, we’re going to do glaucoma pharmacology mnemonics and talk a little bit about the eye. So let’s get started here. So the first thing is what are we really doing with these treatments? The first thing we’re doing is we’re either decreasing aqueous humor out or we are increasing aqueous humor outflow. So we’re actually decreasing the amount of the fluid or we’re helping it get out of there and the big issue is that usually this drainage canal is going to be blocked and it’s just too much fluid in there and that increases pressure. Increased pressure creates damage to the optic nerve.

    So let’s start with acute angle closure glaucoma. So there’s the two types: there’s open angle where we see it wide open here just before the cornea and then there’s closed angle where it’s a bit sharper in the angle here and the real issue is some form of mydriasis so pupillary dilation and that might be that someone put in eye drops so atropine, epinephrine drops which are an anticholinergic or an adrenergic agonist respectively. So atropine is an anticholinergic, epinephrine is an adrenergic agonist that open the eye really wide.

    If you go into a dark room what happens to your eye? Well your eye goes really wide so got our anticholinergic Bud cat here with this really wide open eyes and then excitement and stress. So if there’s some kind of something that makes your fight or flight open up and your body’s epinephrine going then your eyes open up wide there maybe is a crisis. So not only is the crisis causing the excitement and stress but this is an emergency so this acute angle closure glaucoma is something that needs to be treated right away. We’ll talk about some treatments in a bit.

    So let’s talk about or contrast that with open angle glaucoma. So open angle glaucoma is where this angle is still wide open so not an emergency this is going to be something that’s a lot slower. So what’s happening here is the fluid can’t get out okay so it’s just this decrease of aqueous humor outflow and because of that outflow is not happening we have an open ankle glaucoma so it’s much slower than the acute angle closure.

    And causes could be family history, age, ancestry, myopia or you’re nearsighted or elevated intraocular pressure so the FAME mnemonic: F for family history, A for age ancestry, M for myopia and then E for elevated intraocular pressure but again a much slower thing.

    And when we talk about what happens you know what you would expect I was just thinking of the DC Metro and anyone that’s ridden the DC Metro can knows this kind of tunnel that it’s just iconic these concrete tunnels and you can’t help but look down the line and you can’t really see what’s going on in the left you can’t really see what’s going on on the right.

    So not only do you have this kind of tunnel vision but it’s really a synonym for losing that peripheral vision so if you’re a glass half full person you know you have tunnel vision you can still see what’s in the middle if you’re a glass half empty person you can’t see to the sides so just peripheral vision tunnel loss of peripheral vision tunnel vision those are synonyms really.

    Well let’s use this ABCD and two P’s glaucoma stems as a way to memorize which medications work how. So first we could decrease aqueous humor production: You can use an alpha agonist like brimonidine and this works both to decrease aqueous production or increase aqueous outflow beta blockers like timolol also decrease aqueous humor.

    Carbonic anhydrase inhibitors so dorzolamide or dorzolamide really acetazolamide this IV dorzolamide is the eye drop and then a diuretic like mannitol it’s a little more complicated but it made the ABCD mnemonic work but mannitol as well.

    So when you talk about increasing outflow we think of two P’s so you’ve got cholinergic pilocarpine again sludge cat was our cholinergic cat and then prostaglandin and that’s what PG is for and then F2 alpha that’s the receptor so the pH GF2 Alpha analogs, so Latina Pros, there are some other ones but you can see the Prost ending that helps you with that one. So again, the endings on these really help you distinguish Alpha Agonist versus beta blocker versus Carbonic anhydrase inhibitor versus maybe a prostaglandin analog. Alright, so getting into the much bigger ones and we’re really just going to focus on the indication, the mechanism, and the adverse effect. The alpha Agonist promonidine, that’s you know it’s open angle glaucoma and that’s kind of a thing to take home which is some of these are for open angle, some are foreclosed, some are for both. This mechanism is to decrease aqueous humor and increase aqueous humor outflow so it’ll do both but you really have to watch for hypertension and then fatigue. What really might help you with this is that clonidine has those issues in clonidine is that one that kind of stopped the faucet of norepinephrine and if you look at the endings, the CL of clonidine and the brim of bromonidine they’re really really close together.

    Okay, the beta blocker timolol, okay so open angle or acute closed angle glaucoma. Let me get my head out of the way so it’s not blocking the slide. It decreases aqueous humor by blocking beta receptors as it sounds and a lot of times you can use the drug class as the mechanism and then bradycardia is really what we’re worried about again this stimul can get into the systemic system C so Carbonic anhydrous inhibitor dorsolamid which is the trusop or the IV acetozolomide either of those can help with our open angle glaucoma or acute closed angle glaucoma. It decreases that aqueous humor by inhibiting Carbonic anhydrase and again so many times the mechanism and the drug class are the same but watch out you can get quite a bit of blurry vision.

    Our diuretic Mannitol or osmetrol, I don’t want to go into kind of the weeds on this one but it it’s really an emergency drug. The acute closed angle glaucoma, it decreases aqueous humor through a bit of a complex process and with Mannitol because it is such a potent diuretic so close to the glomerulus where where it works in that proximal convoluted tubule hypovolemia is a real concern.

    Okay, the two P’s okay so the first p is cholinergic so pilocarpine or pilocar that’s closed angle glaucoma and it works by contrasting Contracting so ciliary contraction to increase the outflow of aqueous humor kind of squeezes it out through the canal slim and we want to think about the adverse effects as our sludge cat here so those are supposed to be pinpoint pupils. I know cats don’t really have pinpoint pupils the way humans do but think of sludge B so that salivation, bradycardia but pinpoint pupil pilocarpine and I’ll say that 10 times fast that might be an easier way. Pinpoint pupil pilocarpine pinpoint pupil pilocarpine easier way to remember this is the one that’s going to help with that closed angle glaucoma by really narrowing the pupil and ciliary contraction.

    Our second P P2 is a prostaglandin analog so it’s going to mimic that effect so latinoprost or xeletan. The indication is open angle glaucoma increases outflow of aqueous humor by mimicking taking the prostaglandin effect is an analog and then it has this weird pigmentation of the iris or lashes but again now we’re probably not going to use it unilaterally because that would make one eye a different color than the other one but again maybe just a little image here to help you out.

    Okay, so again this is for informational purposes only it is not medical advice so if you have a medical condition consult a medical professional. Thanks for listening to the memorizing pharmacology podcast you can find episodes cheat sheets and more at memorizingfarm.com again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile thanks again for listening thank you.

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Ep 73 Antiarrhythmics Pharmacology Mnemonics

    Ep 73 Antiarrhythmics Pharmacology Mnemonics

    Antiarrhythmics Pharmacology Mnemonics

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help? You can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Antiarrhythmics are usually more of a "can you figure out which class this drug is in" and I give you a number of mnemonics to put the right drug in the right place. 

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingpharm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let’s get started with the show.

    Alright, we’re going to go into antiarrhythmics or antidysrhythmics is really more correct pharmacology mnemonics and the first step is really to see where these are. You’re going to hear class one usually with Roman numerals rather than these kind of numbers but class 1 sodium channel blockers. Class 2 is the beta blocker, class 3 are potassium channel blockers, class 4 calcium channel blockers and class 5 are kind of the unknown or extras. Beta blockers and calcium channel blockers may be familiar from hypertension drugs but these other ones might be a little bit new.

    So there’s Vaughn Williams which is how we kind of classify these and usually your questions are going to be in some way you have to know what the sodium channel blockers are or which ones are potassium channel blockers. So we’re going to do a couple of mnemonics to just kind of get you knowing what’s what and then we’ll go from there.

    So, I made up a little story: NAB money in Kansas City, police are mad. A way to remember that number one is NA which is it’s actually for natrium but it’s sodium so sodium channel blockers and then the B in NAB and you can put two B’s here to make it more clear that it’s going to be beta blockers. And then Kansas City represents three and four which are going to be potassium which is calcium or calium that’s the K and then CA are the calcium from calcium channel blockers so NAB KC and then mad. The others that are kind of in this fifth group are magnesium, adenosine, and digoxin.

    That’s kind of one way to do it. Another way is to maybe make a sentence like some block Kings and castles with mad moves. So the sum is for sodium okay and that would be NA plus block would be for beta blockers. K would be for potassium and kings CA from castles would be calcium channel blockers and then mad moves. The Mad represents the Magnesium, adenosine, and digoxin.

    I’ve got a little picture here of a king and a Castle in chess okay so two different ways to remember those but some students have to remember like all of them like a lot of the drugs within the classes so the class ones actually divided up into class one A, one B, and one C.

    Traditional way to remember this is Double Quarter Pounder with lettuce tomato mayo and more fries please so class 1A is disopyramide, quinidine, procainamide that’s the Double Quarter Pounder. The lettuce tomato Mayo is class 1B lidocaine, mexiletine, tocainide and then class 1C more fries please is moricizine, flecainide, propafenone.

    So if you have to remember all of those then hopefully this is helpful and then we kind of add the other ones so a beta blocker. The nice thing is that the endings are the same so it’s like bisoprolol, atenolol, metoprolol ending with the OLOL. I just put the three Bam Bam for bisoprolol atenolol metoprolol you can think of Class 2 because they are they are you know have two B’s in beta blocker to remind you that’s class two.

    Class three is potassium blockers: The sad poets so sad is for sotalol amiodarone dofetilide and The Poets is for potassium to remember that one, class four is the calcium channel blockers with four very dill pickles. So it’s class four and the Very Dill stands for verapamil and diltiazem. Okay, and then the class five, the Mad group is magnesium, adenosine, and digoxin. So if you have to remember all of them, this is a way to do it. So we can do a little quiz here, make sure that you’ve got this down. So on the left I have sodium, beta blockers, potassium, calcium channel blockers, and then the unknown. And then adenosine, procainamide, metoprolol, diltiazem and amiodarone are not in the right order.

    So how do we get the right order? Well we think about our mnemonics here and our sodium again it’s going to be that Double Quarter Pounder so the P from procainamide. The beta blockers end in OLOL so that’s group two and again two B’s to remind you it’s group two. The potassium is going to be that sad poet and the A in sad poet is amiodarone. Then our four very dill pickles are the diltiazem and the verapamil that’s four. And then the Mad group is adenosine so that magnesium adenosine digoxin that’s in our fifth group.

    And so it would look like this if the answers are correct. Okay so let’s just take a look at some of the characteristics of some of these. So for example if you’ve got group 1A procainamide this is the P in the Double Quarter Pounder it’s good for atrial fib supraventricular tachycardia vtac it’s really chemical cardioversion our mechanism is sodium and hypotension is really the big one here can cause a wide QRS but if we have hypotension as an adverse effect we probably don’t want to give it to a hypotensive patient then congestive heart failure second third degree heart block all of these would be contraindications.

    And then what are we going to do? Well we’ll make sure to watch their labs and then an ECG would also be important as well so that’s procainamide. Get to amiodarone now we’re talking about ventricular fibrillation rather than atrial fibrillation resistant v-tac you can give it for atrial and ventricular dysrhythmias but that’s probably where you would put it potassium is our mechanism again this is group three we kind of skipped over the beta blockers.

    And there’s a number of things that you’re going to have with adverse effects you really want to tell the patient about first the hypotension so just get that blood pressure just kind of dropping blue facial hue I couldn’t use the Blue Man Group because those guys are actually a thing so I just found this picture of and I thought it was clever that they’re kind of pacing and waiting in line and they’ve got blue faces and well blue bodies too and then vision changes.

    So while it’s kind of tough to say well what does vision change look like having this rainbow iris just kind of reminds you that vision changes so hypotension blue facial hue and vision changes bradycardia and shock are really contraindications for this one. And then what do we want to monitor? We want to make sure to put cardiac monitor on and modified valsalva maneuver has just proven to be a bit better.

    And then the Valsalva if you aren’t familiar with it it’s where you kind of plug your nose to pop your ears alright so again this is informational purposes only it’s not medical advice if you have a medical condition contact a medical professional.

    Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes cheat sheets and more at memorizingpharm.com. Again you can sign up for the email list at memorizingpharm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

     

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Ep 70 OTC Cough and Cold

    Ep 70 OTC Cough and Cold

    OTC Cough and Cold 

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help; you can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    Cough and Cold treatments really don't have a ton of medications, and this will episode will help you remember them.

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash metal games. Let’s get started with the show.

    Alright, welcome to OTC allergy cough and cold. We’ll go over antihistamines, decongestants, nasal inhalers, expectorants, cough suppressants, and analgesics but it’s an amazingly small number of medications with all of these different lists. So let’s start with antihistamines and we need to talk about the antihistamine snowman first to make sure we know what antihistamine we’re talking about.

    So we’re talking about H1 antihistamines versus H2 antihistamines. So an H1 antihistamine and this snowman has one nose our allergy antihistamine it’s like diphenhydramine which is Benadryl or Loratadine which is Claritin. So when we say antihistamine we’re thinking H1 but technically an H2 antihistamine and that’s why we have two buttons at the stomach our H2 blockers so they’re also antihistamines but we don’t call them that.

    And so famotidine which is Pepcid and now zantac’s brand name has taken famotidine which has always been Pepcid cymetidine and Tagamet nicetidine and acid for acid reduction. So just to be clear the antihistamines we’re talking about are the ones in the nose in this particular video.

    So let’s talk about the first versus second generation. The first generation is diphenhydramine or Benadryl and if you’ve ever gotten Tylenol PM that’s the PM part of it so Tylenol PM is actually two different drugs chlorpheniramine or Chlor trimeton is one that we don’t use a ton anymore uh it only lasted about four hours but it used to be in packages when you had some kind of really bad allergic issue they make you super sleepy so really not a good thing especially if you’ve got someone driving or somebody does driving for a living.

    So the second generation came along and what you’ll notice is that each one of these has a pair so the second generation non-drowsy antihistamines were loratadine and then when that went off patent all of a sudden destler adidine showed up which is Clarinex so Claritin declaren X when cetirizine’s packet patent went away levocetirizine comes along which is xyzel the owl if you’ve seen the commercials and then terphenidine was removed from the market because of cardiac issues but Fexofenadine which is the safe metabolite is Allegra.

    So those are our five second generation antihistamines that we use. So let’s take a look at Benadryl or diphenhydramine and it’s again we’re going to use the eye match mnemonic so indication mechanism adverse contraindications and what a healthcare professional should do to make it so that’s easier to take.

    So allergy and insomnia that’s the indication. The mechanism well it’s an H1 antihistamine so it’s first generation though so it’s also going to have anticholinergic effects that’s going to be important for adverse effects. So as we’ve kind of gone into really a lot of depth anticholinergic was our Bud cat so the drowsiness dry mouth confusion and there’s a paradoxical effect where in young children a lot of times it’ll actually make them hyper instead of tired so confusion is a little bit of an addition to the mnemonic I’ve used before.

    So uh angle closure glaucoma that’s one of the contraindications and then on the beers list so we want to avoid it in the elderly because of that drowsiness and confusion and we don’t want to have Falls and things like that. So A couple mnemonics some people call it better drill because you’re so tired and then no dryfin hydramine so no driving hydramine reminds you not to drive on this one.

    Claritin and alivert levocetirizine which is xyzel Fexofenadine which is Allegra these tend to be the popular ones now. The ones that have kind of Taken hold. So in terms of indication it’s all the same thing it’s all an allergy they’re all H1 blockers they’re all second generation not sedating and they really in terms of adverse effects and contraindications we really don’t have a ton there but you really do want to tell them to prophylax before allergy season not wait until allergy season and say okay we’ll take your antihistamines if you know allergy.

     Season is coming, go ahead and get on that regimen right away. So Loratadine has the adidine ending, be careful that’s a little bit close to t-i-d-i-n-e which is the H2 blocker so it’s famotidine and so forth. Uh levocetirizine or even cetirizine if you take that TIR make it a tear to remind you that it’s allergy eyes, it’s the saddest owl I could ever find. And then Allegra if you put the r here it makes a-l-l-e-r-g change the a to a y and you have allergy. So I got paid a million dollars to figure that out, I want to be that guy.

    Alright let’s go to the next one Alpha One Agonist and vasoconstriction like what’s going on? I thought we were just doing OTC stuff. Well an alpha one Agonist you’ll probably know pseudoephedrine which is Sudafed, oxymetazolin or oxymetazoline sometimes I hear is Afrin and then phenylephrine which is neo-sinephrine. The big difference is pseudoephedrine is something you take every day or you can take daily, it’s a tablet whereas oxymetazolin and phenylephrine are both inhaled or nasal inhalers and that’s going to make a really big difference when it comes to some side effects in terms of those.

    And I always use the pop mnemonic so just like your ears pop on the plane nasal congestion just think of a big pop once that nasal congestion goes away. So pseudoephedrine starts with a P, oxymetazoline with an O, phenylephrine with a p going on the pseudoephedrine um.

    So let’s start with what it’s for sinus congestion and it can be used as an adjunct in allergic rhinitis. It does have that alpha-1 vasoconstriction but the problem is it’s systemic versus that nasal which is a little bit more local so we’re going to get that anxiety and insomnia just kind of a restlessness that comes along with it.

    So the contraindications and I’ve got this little hand holding a heart so it’s angina coronary artery disease closed angle glaucoma hypertension all these things are really things you don’t want to have if you’re going to be taking pseudoephedrine. And the way that I think about all the adverse effects I just think of energy drinks if you have one too many energy drinks anxiety insomnia restlessness that’s pseudoephedrine.

    And then the next ones we’ll see in a second so watch out for any other stimulants that might interact with Sudafed. Okay oops next one here is oxymetazoline which is Afrin and phenylephrine neosinephrine we’re going to see it’s the exact same thing as sudafed or Pseudoephedrine with the i the M the a except we have something called rebound congestion.

    So around three to five days you might get rhinitis medicamentosa rhinitis medicamentosa is where and I’ve got this picture here of somebody who has congestion, the word breathe because now they can breathe they’ve taken their medication the phenylephrine and oxymetazolin and now they’ve got it again. So the rebound congestion that’s something that is really inherent to these and nasal inhalers contrasting the Sudafed or the pseudoephedrine tablets.

    Fluticasone mometasone we see that sewn ending so common with many of the steroids these are nasal versions of it so with those oral versions we’re always washing our mouth out to make sure that we don’t get candidiasis we don’t get dysphonia which is that hoarseness or difficulty speaking.

    So looking at the names, the brand names kind of give it away Flonase and Nasonex but they’re both for allergic rhinitis they’re both anti-inflammatory steroids. The adverse effect tends to be a dry nose and nosebleeds infections like TB and varicella are something that we really want to avoid reducing the immune response.

    And then you really want to use this daily as soon as that allergy season starts so it takes about three to four days to see that optimal effect and we do want to watch growth rate because it is a steroid after all. So they’ve got a guy here looking at his clock like I don’t understand when I took the oxymetazolin, the Afrin my nose was cleared in a couple minutes well it’s going to take a couple days with these guys.

    Alright dextromethorphan so this is the D and M so the dextro makes the D, the methorphan makes the m in Robitussin DM or Mucinex DM, they both have the same ingredients, the dextromethorphan part. Okay, we’ll get to the guaifenesin in a minute, that’s the cough suppressant for a non-productive cough. Okay, it works in the medullary cough Center and it can get that CNS toxicity, dizziness or something called robocopping that if you use it illicitly. Hepatitis is a contraindication and really what you want to try to do is stop that cough from happening in the first place, a cool humidifier can sometimes do that. You might call it instead of dextromethorphan, you might call it dry cough methorphan because that’s really what you want is if that’s a dry cough it’s not really producing anything uh dextromethorphan is your man.

    Okay guaifenesin so this is Robitussin or Mucinex with or without the DM so without the DM it is just guaifenesin with the DM it’s guaifenescent and dextromethorphan. So I want to make clear this is an expectorant we’ll talk about a mucolytic in a minute so this is an expectorant for mucose secretion that loosens and thins the phlegm makes it easier to expectorate. Adverse effects are just less common same with contraindications and really it’s just if you have that cough for a week maybe you should see a physician or a provider and I’ve just got a picture of kind of some slime here and exit for expectorant uh and I’ve heard it sometimes called Green flemisin instead of guaifenesin just kind of an easier way to remember what this thing does.

    Okay acetylcysteine now this is a mucolytic now this is not over the counter but what I wanted to do was contrast it because sometimes you’ll see that they say guaifenesin is a mucolytic, it’s an expectorant. So acetylcysteine though the actual utility in cystic fibrosis is somewhat unclear cystic fibrosis acetaminophen overdose those are two uses we would have for acetylcysteine or muco Mist. It is mucolytic and it loosens those bronchial secretions if you inhale it and then it replenishes the glutathione in the liver from the acetaminophen metabolites so if you’re doing those kinds of chemistry in your particular pharmacology class that’s really how it protects it against an acetaminophen overdose.

    Nausea and vomiting are adverse effect as well as you know you just want to be careful with asthma maybe a GI bleed or something like that and then there’s a poor taste when it’s inhaled. So the way to remember acetylcysteine is for Cystic Fibrosis is we have this cyst in cystic fibrosis and then when you look at acetyl you take the acetyl group and you think about n acetyl paraaminophenol what is an acetyl peraminophenol well that is acet amino fin okay so that’s the whole chemical name or APAP if you’ve had it abbreviated before okay uh so this is just a bigger picture of it if you want to see kind of how the cystic fibrosis compares to a healthy lung.

    Alright ibuprofen so Advil and Motrin and then the naproxen is the Aleve pain fever and inflammation this is important because we’re going to contrast it with acetaminophen in a minute mechanism. It’s a non-steroidal anti-inflammatory drug and NSAID so non-steroidal is just a way of saying it’s not prednisone but it’s an anti-inflammatory, it’s cycloxygenase inhibitor and we’re not going to get into the weeds with that right now. If you want to talk about Celebrex and celecoxib, you can kind of get into the weeds when you start putting in prescription drugs but GI distress, ulceration certainly adverse effects especially if you used a long term. If you have any kind of an allergy to aspirin or stomach ulcer, heart failure, liver disease this really tends to hold on to fluid and those are conditions where you really don’t want to hold on to fluid.

    And then always mentioning take it with food, it does tend to upset the stomach. So one contrast is well when do I take Ibuprofen when do I take them peroxin well ibuprofen you have to generally take like four times a day where an approxen maybe two times a day or three times a day so that tends to be it. And then I had a pretty decent graphic about peptic ulcers and then here is a larger version if you wanted to look at that uh just kind of explaining what’s going on we didn’t talk about helicobacter pylori which is really the causative factor in many ulcers but that’s getting into prescriptions and triple and quad therapy which we will not.

    Alright last one here is going to be acetaminophen or Tylenol. You’ll notice that in the indications it has pain and fever just like ibuprofen but the inflammation is missing so that’s the one question you get over and over again. It’s a non-narcotic analgesic and it’s just really liver damage, liver conditions that’s really one place we really want to be careful.

    And then watch for overdose with RX meds and what I mean by that is maybe somebody’s on something called Vicodin and there is acetaminophen in it and then they’re taking Tylenol over the counter or they’re maybe taking some combination cold product that has acetaminophen in it. Really you don’t want to go over 3 000 milligrams in a day, you know the upper end is 4 000 but you really want to be careful there.

    So n acetyl peroaminophenol that’s how we made acetaminophen or APAP and then here are the stages of liver damage and I just wanted to have it up here so that if that’s something you wanted to kind of go through you could. And then a larger version of the same graphic okay all right again this is for informational purposes only it is not medical advice if you have a medical condition consult a medical professional.

    Thanks for listening to the memorizing pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile. And thanks again for listening.

     

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Ep 68 Asthma COPD Pharmacology Mnemonics in about 10 minutes

    Ep 68 Asthma COPD Pharmacology Mnemonics in about 10 minutes

    Asthma COPD Pharmacology Mnemonics in about 10 minutes

    A quick rundown of asthma, COPD, and how to memorize the beta-2 agonists vs. anticholinergics vs. inhaled corticosteroids. 

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    Need more help; you can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before.  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us 

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com. Let’s get started with the show.

    Okay, here I wanted to go over a little bit about asthma and COPD and kind of take it from a level where we can kind of get the big picture here. So first thing, asthma this is that episodic bronchoconstriction and inflammation where sometimes the smooth muscle tightens up and you get this inflammation that makes it you know a narrowed Airway and then certainly during an asthma attack that narrowing increases where COPD is more about you’re going to hear these two terms chronic bronchitis which is inflammation and excess mucus and then emphysema where the alveolar membranes are breaking down it’s down here in the bottom left of the graphic.

    Okay, so let’s talk about how drugs work on the bronchiole and The receptors and if you keep this kind of tripod together I think it makes it a lot easier. So on the left hand side we have beta 2 agonism these open up the bronchioles okay so you might hear again adrenergic agonism it just means adren which is your adrenal gland that is add on top in Latin Rin of the kidney or renal on the right hand side we have muscarinic which was referring to the mushroom or cholinergic antagonism you might also see these as anticholinergics or anti-muscarinics so these open up the bronchioles.

    So just be clear we have two completely different mechanisms we have adrenergic agonism versus the cholinergic antagonism but both of them do the same thing they both open up the bronchiole to relax the bronchioles and then in the middle we kind of have these inhaled corticosteroids ICS which reduce inflammation but that’s what asthma is it’s these two pieces where you’ve got bronchi that are constricting and there is inflammation involved.

    So here is the acronym Madness a Saba is a short-acting beta-2 Agonist a laba is a long-acting beta-2 Agonist an ultralaba is an ultra long-acting beta-2 Agonist then what basically happened was is that we’ve got the rescue inhaler which works quickly then you’ve got the long acting which was working half the day you’d have to use it twice a day and then the ultra long acting are the ones that would last all day.

    Then the Sama which is a short-acting muscarinic antagonist it’s an anticholinergic the long-acting muscarinic antagonist the llama and then you have ICS the inhaled corticosteroid but this is the picture you want to have in your head when you’re talking about treatment as we treat Asthma as it gets worse we start with the inhaled corticosteroid then go to a long-acting bronchodilating or beta 2 Agonist and then maybe a long-acting muscarinic Agonist antagonist.

    COPD side we go the other way we go from muscarinic to beta 2 to steroid so if you can keep those two kind of opposite arrows in mind when you’re thinking about asthma and COPD I think it’ll go a long way. And then all are both conditions we have a Saba so we want to do is we want to convert these acronyms into actual drugs so Savas albuterol level albuterol lava salmeterol for motorol ultralaba indacotroll and volanterol.

    Then the Sama epitropium teotropium aclidinium euclidinium and then ICS fluticasone mometasone bechlomethazone there are more but I just didn’t want to overwhelm you. So first thing we do is we look at stems and suffixes here so Saba albuterol level Albuterol interroll labas end in Terrell ultralabas end in tyrol well that’ll be a problem we’ll see but samas lamas end either tropium clydinium but could just look at ium as something that’s in common with both them see sewn from fluticasone mometasone becamethasone.

    So maybe a little bit better to look at it this way where the beta Agonist is the tyrol. Sama is tropium or clinic clydinium and then the ICS is sewn but be careful because it tells you what it is but it doesn’t tell you how long acting it is okay. So when we put this into our arrows we can say that okay if I’m going to have a muscarinic antagonist that’s going to be the ium, the beta 2 Agonist is the tyrol and the corticosteroid is the Zone. The sabbas are going to be those you know still end with tyrols, the Albuterol and Lev albuterol okay.

    And you might have said oh he messed up at the bottom he underlined turol but also albuterol. I was just trying to show you that Lev Albuterol and albuterol are basically the same thing but both would have the Terrell stem. So again if you can put the drugs in here in this way then it makes it a lot easier to figure out okay well what am I dealing with and you’ve got these kind of the big three which are the muscarinic antagonist, The beta-2 Agonist and the corticosteroid okay.

    Alright well let’s try one so this is a drug that actually has all three in it you’ve got Trella geolipta so identify the laba, the lamba and the ICS okay. And so what we do is we underline our endings if we take a Zone, the mclendonium and then volanterol then we can put it into our arrows so the cladinium is over here in the log acting muscarinic antagonist, the volantrol is in the Middle with the long-acting beta 2 Agonist and then the ICS is the inhaled corticosteroid fluticasone okay.

    And we still keep our Saba you know, the albuterol level albuterol as our rescue inhaler. So let’s look at you know using our eye match mnemonic where we say okay well what’s the indication mechanism adverse effects contraindications and some of the considerations. So the short activated to agonists for asthma and COPD that’s what the indication is and really as a rescue inhaler okay but it is not meant as a controller and some people that can’t afford the controllers may use it in that way and that would lead to some of the you know adverse effects.

    The anxiety, insomnia, nausea, tachycardia, Tremors there’s more but you got to get the picture that there’s a jitteriness that comes from a coronary artery disease certainly a consideration. And then I really want to avoid NSAIDs like ibuprofen and Naproxen make sure that there’s a minute between the Puffs don’t just puff puff you want to give it a minute with the lungs open up then use the next one. It is a rescue inhaler and these are the ones we would use before the controllers so that we’re going to get a little bit more of the controller in the lungs okay.

    And you’ve got lavas so from motorol salmeterol long-acting beta 2 but we’re going to see it’s very similar same adverse effects same contraindications avoid NSAIDs like ibuprofen we’ll use these after the rescue inhaler okay but this is the big thing and they’re going to be in combination they’re not to be used alone there was a study that showed that when you use these alone, outcomes are actually worse so although you’re seeing them alone they’re "Actually, in combination, I didn’t want to put the combinations in here because there’s like 30 of them so it just gets absolutely overwhelming. Okay, ipritropium so here we have again COPD and Asthma anticholinergic anti-muscarinic if you hadn’t seen the bud cat video for anticholinergic effects it’s blurry vision urinary retention dry mouth constipation anhydrosis and tachycardia for ipritropium when you’re talking about something like this you’re really talking about that dry mouth the constipation and the tachycardia those three are the ones that you would probably see the most.

    Then considerations glaucoma bladder bowel obstruction certainly and then you want to because you don’t want to cause constipation when somebody already has an obstructive bowel and you again want to use this before the steroid but it is not a rescue inhaler. I’ll tell you a little bit about it when I refer to my daughters as they’d gotten out of the hospital they were preemies okay.

    So this Albuterol and iprotropium can be used in combination you’ll see them in these nebules that have them both together and you just put them in this little cup and either the child would put this in their mouth or you would put it near them and they would inhale it but a combination sabot lava as a beta-2 Agonist and anticholinergic allows you to get lower doses of both but to get that great bronchial relaxation that they need okay.

    So the next piece here are the ICS again we generally we can see these in combination or alone but be careful this fluticasone you might see it over the counter as a nasal inhaler for allergies as Flonase or you might see it behind the counter as a prescription for asthma which is flow vent so vent is for asthma and COPD Nace is for allergic rhinitis then becamethasone also qvar.

    So the indications asthma COPD it’s these are steroids they reduce inflammation but they do it locally and that’s a big deal because now we’re getting fewer systemic effects thrush which is candidiasis and then hoarseness which is dysphonia these are common if you don’t rinse your mouth out so because we’re using a steroid we are locally reducing the or immunosuppressing just like prednisone will be used as an immunosuppressant for transplant we can get this very localized immunosuppression.

    And then so make sure that the patient knows to rinse their math on and I just wanted to be clear about the devices the nebulizer like this is kind of what we had where we got that nebula out and they could either put their mouth on it or just kind of get into the Mist there and then the spacers for those that can’t do it themselves. I’m not talking about veterinary medicine but it just kind of makes it you know if you’ve got a cat something like that it’s obviously not going to be able to use an inhaler normally and so what happens is it goes into this chamber and it can just allow the cat to breathe and there’s a little flap in here that tells you that the cat is taking breaths. So it’s kind of a neat device but nebulizers versus spacers as always this is for informational purposes only it’s not medical advice. If you’ve got a medical problem, consult the medical professional. Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile and thanks again for listening. Thank you!

     

    Like to learn more?

    Find my book here: https://geni.us/iA22iZ

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd

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    Ep 64 Making Pharmacology Stick and Gaining Peace of Mind

    Ep 64 Making Pharmacology Stick and Gaining Peace of Mind

    Making Pharmacology Stick and Gaining Peace of Mind

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

    If you want the peace of mind that comes from knowing you know the material, I have two book recommendations, Make it Stick: The Science of Successful Learning and this Memorizing Pharmacology Mnemonics that came 4 years after they wrote their book  https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us 

    Here is the Link to my Pharmacy Residency Coursesresidency.teachable.com

    It might be free if you've never had an audible book before. 

     

    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.

    Let’s get started with the show. All right, I usually just talk about certain drug names, drug classes but I know that a number of you have emailed me about it being late in the second third week of your pharmacology and things are just a real struggle. So I want to give you a book that is actually not pharmacology but will help you quite a bit with pharmacology, patho and a number of other classes. It’s called Make It Stick: The Science of Successful Learning. It’s by Peter Brown, Henry Rodiger and Mark McDaniel.

    Basically, it teaches you what myths there are about learning and how some of the ways that you might be trying to study don’t work. So if you’re anyone who has gone through a ton of note cards and still done poorly on a test, this episode is for you. So if there’s one book I would recommend for somebody going to school, it’s my kids go to college. I would hope they would have this but I couldn’t expect them to maybe read an entire book like okay Dad, I’ll read the whole book right.

    So if you can’t read the whole book, I would at least start with chapter eight which is Make It Stick and although they summarize the entire book in the chapter and talk about stories that are in those chapters and it’s better to read the chapters before if you only have time for one chapter then that would be it. But if you only have time for one story to convince you that this is the book for you, I would go to chapter eight at the 23-minute mark where they talk about Michael Young, the medical school student.

    And how he went from getting barely enough of an MCAT score to get into medical school to being the top of his medical school class and I’m going to give you a couple of kind of pointers that I’ve used in Pharmacology class that I use but the big problem I have is the discomfort that comes along with some of the recommendations that they make especially the masked practiced one.

    Okay so first of all, the retrieval practice it feels like you’re doing your homework again but no you’re trying to remember but it feels like you’re failing at something versus Mass practice which makes you feel like you’re succeeding. So the example they give is about someone who’s going to just hit fastballs and get really good at hitting fastballs. You feel really good about it and then later on a different day you hit curveballs and you try to hit curveballs and feel really good about it. You get good at it but when you try to hit in a game, you don’t do very well because in a game they don’t tell you what’s coming.

    The fastball or the curveball and the same thing is true here might not make sense to do your patho home or your patho homework and then your farm homework and then back to your patho homework but that’s kind of how your semester goes and then within a class so if you’re doing pharmacology and you’re talking about respiratory drugs and then you go to diuretics and then back to respiratory drugs that may seem like it doesn’t make sense but it’ll be a lot easier on the exam when you get those drugs in different orders and so forth.

    So the first thing is retrieval practice and I’ll show you a little bit what I mean at the end but it’s unfortunate they use the word quizzes and don’t make clear what quizzing means and I’ll show you what I believe quizzing means but I don’t think quizzing means multiple choice questions where you can kind of pick up the answer from one of the answer choices. I think it means something a little bit harder so we’ll talk about that so first one’s retrieval practice next one is elaboration. So when I’m in discussion, I want the student to elaborate on their answer. Okay, they got it right but let’s hear your own words. And so if I’m talking about okay, well what’s a second-generation antihistamine? They say Loratadine, great they’ve answered the question okay but now I want them to expand. Alright, well why did they need Loratadine? Well because you don’t want an antihistamine making somebody drowsy. Okay well how did they make it from the drowsy antihistamine like diphenhydramine and Benadryl into something that isn’t drowsy? Well, they figured out how to make it not go through the blood-brain barrier.

    Okay so you don’t go through the blood-brain barrier and now that avoids drowsiness. So now that you have kind of a little story that goes with it, you now know diphenhydramine or Benadryl is first generation makes you drowsy and Loratadine which is Claritin is non-drowsy why because it doesn’t go through the blood-brain barrier to get to your brain to make you sleepy.

    That kind of elaboration helps. The other elaboration is talking about something in your own situation where oh yeah I used to take Claritin and I remember those Claritin clear commercials where you can hear oh Claritin clear clearing your sinuses or clearing your well it’s really an antihistamine so clearing your allergies is maybe better.

    Again, elaboration that’s why the instructor keeps talking even though you’ve answered the question because if you elaborate you have a story to go with it sticks in your brain then space practice. I think this is the one thing that’s the toughest to kind of put together which is studying three times as much they say that you should study three times but no it’s studying three times to study less.

    So what I mean by that is when you’re studying let’s say you are going to study total three hours over a whole week if you expend those three hours the night before it’s much less useful than if you spent it on Tuesday Thursday and Saturday before maybe a test on Monday right. So that’s really hard to do because you say well I’m so behind well you’re so behind because you’re spending all that time and what you find is that you don’t actually need to study three hours each time they find that you only need to study half an hour each time and that you get another hour and a half back to study for another class.

    So spaced practice just pick three days they can be together. You know so if you’re studying for a Monday test and classes on Friday just okay that’s gonna be Friday Saturday Sunday okay or if you have a class on Wednesday then Thursday Friday Saturday something like that but try to space it out at least a day so that you’ve got this time for your brain to kind of process what was going on.

    You come back to it, you’re like oh okay I remember and then all of a sudden some I would call Revelations come to you like oh I made this connection or that connection. You literally need to sleep on it to make it work better sharing this is one that often students hate which is when they get called on and it’s like well am I doing my homework again? You know why am I sharing this?

    Well if you go to the pyramid the learning pyramid, you see that there’s at the top it’s lecture, you get about five percent retention and at the bottom it’s 90 for someone who is teaching it. So when you are sharing and when you are presenting to the class maybe you’re just called on, you’ll remember that question and you don’t really think about it because it maybe happens once or twice or maybe even three times in a class but the more you’re sharing the more you’re going to remember.

    And it feels uncomfortable at the time but it doesn’t feel uncomfortable when you do really well in the exam okay all right so let’s go on to mnemonics. It’s one thing that everybody seems to know me for so Tony farm D the mnemonic guy uh I’m not supposed to memorize I’m supposed to understand right well mnemonics are for building structures for understanding.

    So if you’re trying to remember Loop Diuretics if you can put a mnemonic in that gets you from the glomerulus to the collecting duct on the right that can put the diuretics in order of mannitol than furosemide then Hydrochlorothiazide than spironolactone well, you understand that there is more diuresis at the beginning with Mannitol and a little bit less at furosemide a little bit less at Hydrochlorothiazide and then certainly less when spironolactone.

    So mnemonics aren’t just okay I memorized it, it’s that you’ve memorized it in an order that makes sense pathophysiologically or physiologically. So let’s take a look at that learning pyramid think it’s a little bit misunderstood but the big thing is is that when you are in discussion so maybe you have a recitation where you break out and you talk to your professor and that’s when you’re learning. Well, the more you’re part of the discussion the more you’re getting to that 50 retention that you’ll remember about half of it okay. However, if they give you an activity like sorting medications into certain drug classes and saying okay well go ahead and on your own go ahead and try to sort the diuretics from glomerulus to the collecting duct okay as you do that that’s the practice doing.

    And then when you get called on and you show others and tell others what you’ve learned that’s the teaching part. You get 90 so it’s almost 100 percent that you are going to remember what you were called on for. So it’s almost like if you really want to do well in the test, you want to get called on for every question. Obviously, it’s not true but the wanting to get called on with every question but the whole point is that you’re teaching others.

    So again, the more you participate in the discussion, the more you practice by doing the activities that were assigned and the more you help others and that’s why people get paired up or put in threes or fours so that you can show others what you learned. The more you do these guys, the better off you are. The more you sit and listen or just read it’s just not going to work anywhere near as well.

    So let’s see what that looks like here’s kind of my half of the pyramid that I care about the discussion, the practice doing and the teaching others. So I did write a book by Rising pharmacology mnemonics and and the point wasn’t for you to just absorb it like a lecture. It was okay I learned this cool mnemonic I want to share it with you that’s how you learn it.

    So I won’t belabor that but here’s an example of one of those mnemonics and I only took part of it because they’re pretty detailed because it’s meant for advanced pharmacology really those that are really going into clinical care and those types of things.

    So what are four second-generation antihistamines okay easy enough go find them cetirizine Des Loratadine levocetirizine loratadine okay well it’s an alphabetical list of them. It’s often what you have on the other side of a note card so the question is how can we change this in such a way that it’s more valuable to us?

    Well, we put a mnemonic together and we say well the order or the prescription called for non-drowsy so C cetirizine a avoid drowsiness l levocetirizine l Loratadine e entering the brain is prohibited is how that happens and then D desclaratidine is Clarinex.

    And so this is what’s in your brain all of these things but I don’t tend to put them on the cards because you don’t want to muddle the cards so much that your brain can’t remember what’s what but tear sounds awful lot like tears from allergy tears cetirizine should be second generation before levocetirizine which is third because two comes before three.

    The avoid drowsiness is what a second and third-generation antihistamine does Loratadine well that had the Claritin clear commercials so that would be easier to remember. The allergies, you can kind of picture that sunshiny very blue sky day and we would want the third generation Des Loratadine third generation after it Clarin next is the next Claritin right so it’s third generation.

    And how does it all work? How did diphenhydramine go to Loratadine? Well in entering the brain is prohibited. The mechanism of action of non-drowsy versus drowsy is that somebody figured out that well if I give histamine not go into the brain then it won’t make someone drowsy but really we want this kind of nice clean clear type of note card so we’re not sitting there muddled with all that other clutter but that’s definitely how I would do it.

    So again, really if you’re really stuck and you just need to hear a story I really recommend chapter eight uh the story about Michael Young. I think it’s one that’s both inspirational and telling as how someone who barely made it into Medical School ended up at the top of his medical school class and this applies to Pharmacists and nurses and other health professionals. But I know you’re maybe discouraged if you’re again your second year third week of classes and pharmacology is kicking your butt. Well, the way to kind of turn that around is to really understand what you should be doing and going back to those lessons you know retrieval practice where you ask yourself the question if you can’t remember it before the test how are you going to remember it on the test?

    So you really want to do that ahead of time and then that spaced practice so important to study on different days rather than try to keep it all for one day because that’s not really that short-term memory doesn’t work as well as the work that you’re going to do to get it into long-term memory.

    Thanks for listening to the memorizing pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash T forward slash mobile. Thanks again for listening.

     

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    Find my book here: https://geni.us/iA22iZ

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    Ep 63 Cholinergics Video Pharmacology SLUDGE CAT

    Ep 63 Cholinergics Video Pharmacology SLUDGE CAT

    Cholinergics Video Pharmacology SLUDGE CAT

    In this episode, I go over how you can use SLUDGE CAT, to remember the cholinergics and what that means for pharmacology indications and adverse effects in that drug group.

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    Memorizing Pharmacology Mnemonics HERE

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    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com. Let’s get started with the show.

    Okay, if you ran into this video before you ran into the anticholinergic Bud cat, I recommend that you go to episode 62 and go check that out. But the cholinergic sludge CAD is gonna get us through the opposite effects of antichrominergic anti-anti and we’re going to kind of make a U-turn here. So again, we are making a U-turn. We’re going from anticholinergic to cholinergic so many of the things that you’ll see are somewhat familiar but what we want to do is make sure that we have these clear in our head.

    The first thing is to get the vocabulary clear. If something is cholinergic, it is also a muscarinic Agonist. Again, this is our muscarin mushroom and this is where it all began. So people use that as synonyms or use them interchangeably. Oh that’s cholinergic oh that’s muscarinic they don’t say this as much but it also counts it is parasympathomimetic.

    Okay, so what were the opposites right? The opposite of cholinergic is anti-cholinergic. The opposite of muscarinic is anti-muscarinic or muscarinic antagonist. The opposite of parasympathomimetic is parasympatholytic.

    Okay, so let’s kind of look at how we can use these opposites. We learned but the wide-eyed tachycardic cat how that gives us the anticholinergics so let’s go to the opposite which is cholinergic Crisis that is we have way too much cholinergic activity too much acetylcholine and what we’ll do is we’ll kind of take a look at our new cat so our last cat was wide-eyed in the desert very dry our new cat Sledge cat is in the water with pinpoint pupils and is a bit bradycardic.

    Okay so the mnemonic itself sludge will get to but the Cat part is that it is a cholinergic starts with C Agonist begins with a ends with t okay all right so here are the Opposites so on the left hand side we have Bud cat from our anticholinergic presentation and blurry vision because of dry eyes urinary retention dry mouth or xerostomia constipation and hydrosis which is a lack of sweat and was tachycardic so again we had to say wide-eyed tachycardic Bud cat because there is a b and a t in the mnemonic and madriasis again is that wide-eyed m-y-d-r-i-a-s-i-s.

    Now you’ve probably seen the sludge mnemonic but what I want to do is show you where it comes from so the opposite of blurry vision because of dry eyes is lacrimation now yours starts with an L now you’re still blurry it’s just for a different reason before it was because your eyes were so dry now it’s because your eyes are so wet urinary retention the opposite is urinary incontinence dry mouth the opposite of salivation constipation obviously the opposite is diarrhea and hydrosis is sweating and then the opposite of tachycardia is bradycardia.

    Now to be fair you will have initial tachycardia in the presentation but it’ll eventually go to bradycardia and then meiosis the pinpoint pupils are the opposite of madriasis oh so let’s put those in the sludge order now and add the other pieces so we saw the salivation the lacrimation urinary incontinence and diarrhea and then we have the GI cramping and emesis so I have this crisis just ahead signpost with a big thunderstorm lots of rain coming to remind you that sludge is sludge because it’s so wet where does this come from well cholinergic crisis can come from pesticides and organophosphates.

    So I’ll put a little chalkboard thing here but the idea is that okay where where’s someone gonna get it okay it’s going to be the farm okay but we have two competing conditions we have a myosthenic crisis and we have a colon urgent crisis. The issue is that both of them are going to look very similar on presentation but one is because of low acetylcholine stimulation and then the other is because of excess acetylcholine stimulation. So I have a question down at the bottom which explains it better, but we use an antibody test now which can let us know which it is. But why did edrifonium, an acetylcholinesterase inhibitor, result in improvement in myasthenic crisis but worsening of cholinergic crisis?

    Well, if hydrophonium is an acetylcholinesterase inhibitor (capital A, capital C, little h, capital E), that means that it stops the breakdown of acetylcholine and there’ll be more of it around. So we’re basically adding acetylcholine. If we add acetylcholine to myasthenic crisis where we have low acetylcholine, it makes sense that they’re going to improve. It’s actually the class of drugs we’ll give, though this is not the one we’ll give because that one only lasted a very short amount of time.

    However, if you are in cholinergic crisis and you give them more acetylcholine in addition, well now you’re in trouble. Now you’re doing the wrong thing. So the reason we don’t give it anymore is because well we were adding it and making it a little bit worse and we don’t want to make it worse.

    So treatments on the myasthenic crisis side where we have too much acetylcholine right too little acetylcholine take it back so myostendic crisis too little acetylcholine we give an acetylcholine State race acetylcholine esterase inhibitor because what we want to do is have them have more acetylcholine so we stop the breakdown. It’s also an immune condition so we give immunosuppressants cyclosporin azathioprine steroids to suppress the immune attacking itself or the immune system attacking itself.

    On the coal energy crisis side, we treat, we remove the acetylcholinesterase inhibitor and we provide ventilation if they need it and then IV atropine. Why does IV atropine make sense? If you get that then you know you’ve gotten what I’m throwing down. Well Ivy atropine makes sense because you had a situation where you have too much acetylcholine. Atropine is anti-cholinergic so it goes against that acetylcholine.

    Okay, let me give you a visual make me make it a little more clear so here’s Myasthenia on the left is the normal neuromuscular Junction and then on the right we have Myasthenia with the antibodies against the receptor and those antibodies are not letting acetylcholine get through so the idea is we need more acetylcholine but we don’t do it directly we don’t say here you go here’s some more acetylcholine just the way that you know when we have certain conditions that in the blood-brain barrier we just can’t give dopamine well we have ways around it okay.

    So what we do is we treat myasthenia gravis which I call missing acetylcholine Gravely so just play on words to try to remember what the problem is by creating a situation where there will be more acetylcholine because we stop breaking it down okay one of the more telling signs is this ptosis ptosis which is where the upper eyelid droops over the eye okay all right so let’s move on to the symptoms.

    So myasthenia gravis symptoms: The D’s because everything seems to start with D so diplopia double vision drooping of one or both eyelids difficulty swallowing difficulty speaking chewing difficulty using your arms and hands and holding up your head because muscles are weak and so what do we do well if you need acetylcholine we’re going to use an acetylcholinesterase inhibitor and just kind of do this again and my autocorrect keeps correcting that Capital C to a lowercase C it’s capital a capital c lower h um acetylcholinesterase Inhibitors mechanism of action okay.

    We block the enzyme that breaks down acetylcholine called acetylcholine esterase ache, so you have more acetylcholine. If you have more acetylcholine, it enhances cholinergic action. Okay, how do we recognize acetylcholinesterase inhibitors? Well, they’re probably going to end with stigmine. Now some of them are for other conditions: isostigmine usually for toxicity and glaucoma, neostigmine from myasthenia gravis, pyridostigmine from myasthenia gravis. Doesn’t mean it’s the only thing they’re for like neostigmine, you can use as a reversal agent for pancuronium which is a neuromuscular blocker.

    So again, I haven’t gotten into nmbs in here but that’s the kind of toxicity we can talk about. Okay, alright well so we’ve talked a little bit about what cholinergic can do for Myasthenia and how it’s kind of the opposite of anticholinergic but let’s talk about the bladder control that we talked about with anticholinergic.

    So in anticholinergic, we had medications for an overactive bladder. Okay and that made sense. Okay so if the overactive bladder, we want to use the urinary retention that an anticholinergic causes but with bethenticol you’re a choline or devoid or two of the brand names we can use the U and the sludge mnemonic that cholinergics cause urinary incontinence.

    It’s a side effect but for people with atonic bladder or urinary retention it is a therapeutic effect. So again it’s a side effect for those that are taking you know cholinergics but if you have a tonic bladder or urinary retention it’s actually a therapeutic effect. It’s a relief that you can now void or you couldn’t okay.

    So the mechanism of action itself is to activate those cholinergic receptors and help someone as the brand name said do void so we just spell it d-o-v-o-i-d okay okay all right there are some considerations though with the then a call and and these cholinergic drugs remember a petropium as an anticholinergic that opened up the Airways well if you’re gonna give bethen a call and you’re going to give a cholinergic then asthma is a concern because it can constrict the Airways okay.

    If we think about that bradycardia which is the opposite of the tachycardia in Bud cat right when you decrease heart rate you can decrease blood pressure decrease blood pressure you can end up with orthostasis when you think of cholinergic the opposite of the anticholinergic constipation we would have diarrhea or defecation but if you have these kind of GI issues like a peptic ulcer or intestinal obstruction you could perf or perforate that ulcer which would be terrible or you can worsen the condition of intestinal obstruction.

    So imagine someone is impacted for example and you give them a laxative well if that impaction is uh you know some kind of obstruction something’s in the way it’s just going to make it worse. You’re just gonna make it so that you’re trying to get through this wall but it’s not working okay.

    So these would be the things that I really consider or to some extent contraindications asthma orthostasis um that’s more kind of a side effect um peptic ulcers and intestinal obstruction disclaimer this information is provided to you for your informational purposes only and is not intended to provide it should not be relied upon for medical or any other advice.

    I urge readers and listeners to consult with a medical professional with any medical condition foreign thanks for listening to the memorizing pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash Melbourne thanks again for listening!

     

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    Ep 61 Beta Agonists Mnemonic IMACH Isoproterenol Albuterol Salmeterol Terbutaline

    Ep 61 Beta Agonists Mnemonic IMACH Isoproterenol Albuterol Salmeterol Terbutaline

    Beta Agonists Mnemonic IMACH Isoproterenol Albuterol Salmeterol Terbutaline

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    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.

    Com forward slash P forward slash moving. Let’s get started with the show. Hey, welcome to Memorizing Pharmacology podcast. I’m Tony Guerra. I wanted to give you with the beta agonists a more general way to look at drugs and remember what you’re supposed to know about them and I’m going to use a mnemonic eye match but it’s actually i-m-a-c-h and I’ll explain what I’m talking about here. So the way that I do this or kind of put drugs in my head to make it simple and create a story and I know many of you are like why am I taking English 1 and

    English 2 or comp one and comp2 to become a health professional and as an undergraduate English major although I’ve got my you know doctorate in healthcare and pharmacy my background in English reminds me that you know to remember something you really got to get the story together and the story comes from I am a considerate health professional so that’s my I match mnemonic uh I couldn’t get the T in there but what we’re trying to do is really say you know for indications mechanism of action which many people

    Overdue like you can say you know Methotrexate is going to affect certain enzyme but you can just say it’s an anti-metabolite. I don’t have to get too into it or something is cholinergic or anticholinergic that’s the mechanism of action and some of you call that drug class so however you want to do that but we start with indication mechanism of action adverse effects then some people call this contraindications really I think of it as considerations like if the patient is this then we don’t want to give this but in this

    Exception we might so it’s more of a consideration but many times we’ll call this a contraindication and we’re really being empathetic to what it is that their other conditions are and then health professionals so I am a considerate health professional and the H is really just as a health professional what do I need to do to help the patient and that depends on what you do. I mean are you a pharmacist physician nurse physician assistant you know what what are you what are you and what is your role in helping the

    Patient so indication mechanism of action adverse effects consideration slash contraindications and then how can we help the patient better take the medicine and I’ll show you how this works with the beta Agonist that we have in this group okay so let’s just start with I always like to just do one slide like what’s it for so indications when you have something like isoproterinol which is isopril inotrope is in the word and I’ll show you how to do that but this is something that’s you know for

    Shock or you know bradycardia those types of things Albuterol and we can underline the stem the tyrol stem let’s just know it’s a beta2 Agonist which is pro air brand name tells you what it’s for it’s a rescue inhaler so it provides air by you know bronchodilating salmeterol some people call it salmeterol. I like that the word meter is in there because it’s a metered dose inhaler but that’s also a terol and so we had this problem with the beta blockers where wait a minute you’ve got Albuterol and

    Salmeterol and they’re they do the same thing but they’re different why are they different well albuterol is short acting some meteorol is long-acting and I’ll talk a little bit about that mechanism of action in a minute but usually so meteorol has to be added to fluticasone there was a study that showed that salmeterol alone was no bueno so fluticasone has that sewn ending for a steroid and then we add these together to get error so that’s what Advair is but this is that what patients would call a controller inhaler

    Something they have to take every day sometimes twice a day those types of things and then terbutylene or breaking now that’s a subcutaneous there’s some other dosage forms but that’s even more short acting than albuterol but these are the indications that’s what it’s for but how do we remember all this okay well the mechanism of action can be really helpful if you know what to look for so isoproterinol or icprow this is that beta1 beta 2 agonists so it’s going to affect the heart and the lungs you’ve heard that mnemonic where you have two lungs so beta two one heart beta one albuterol that’s Pro air is just going to be beta 2 and we’ll talk a little bit how that isn’t always the case so beta 2 if it’s used properly but many uh patient cannot afford Advair or doesn’t take Advair on a regular basis their controller inhaler they need more and more Albuterol they keep complaining they’re well I’m so jittery and just you know got Tremors and all these things that’s from coming and using albuterol

    Wrong you’re not using it as a rescue inhaler you’re trying to use it as a controller inhaler that’s not what it’s meant for uh some meat roll with fluticasone is Advair so we have a beta 2 Agonist to open up the lungs for a long time and a steroid and so the steroid is to help with inflammation the two components of asthma are that bronchospasm and inflammation and then terbutaline that’s beta2 okay so this mechanism of action you’re going to see these terms so I just want to make them clear short acting selective

    Beta 2 Agonist is a mouthful so we just call it a Saba Saba that’s Albuterol and terbutylene and then a long-acting selective beta2 Agonist is a laba which is cell meteorol not the fluticasone it just happens to be in there all right so let’s start with isoproterinol and the kind of the mnemonic here so if you take the word isoproterinol and you get rid of the so the ER and the L you actually have all the letters for inotrope and that’s what it does so if you don’t remember what an inotrope is it increases the force of

    Contraction of the heart it’s also a chronotrope which increases heart rate but again inotrope is really when we’re talking about what it does that’s what it’s going to be so if we use our eye match mnemonic here and I get it you you probably get big lists of all these things like well it’s not that I don’t get what the adverse effect is is I don’t get which of the 10 adverse effects are in there or which of the 10 contraindications are in there and what I like to do is just say well let me

    Just start with the ones that I understand based on the mechanism of action so I can make a story okay so I put the different types of shock in here we’re not going to go into that I mean you know you can you know obstructive distributive cardiogenic hypovolemic and then you can get into the three types of distributive with septic and anaphylactic and neurogenic shock that’s going way down the rabbit hole what we want to do is just say all right well what is shock well shock is a decrease in blood pressure you know

    We’re going to have a decrease in cardiac output well what’s cardiac output made up of it you learn that cardiac output is heart rate type stroke volume well if we increase this heart rate we can increase the cardiac output we can increase the blood pressure which does the opposite of what shock is which is lowering it and then increasing heart rate obviously is the opposite of bradycardia so when we look at the indications of shock and bradycardia having an inotrope that’s going to increase heart rate increase blood

    Pressure cardiac output it’s a good thing. The mechanism of action can affect beta 1 and beta 2. So we’re going to affect that heart, affect the lungs. Adverse effects, so when you’re thinking about beta 1 especially really think about the CNS and how it just really kind of makes you jittery increasing that heart rate. So if we’re increasing heart rate, what would be a contraindication or consideration? Well, if somebody’s got hypertension, we’re trying to lower their you know heart rate blood pressure All that probably not the best medication for that and then in terms of how can we help the patient well when we get to you know you can kind of go in the weeds with shock but and losing that systemic vascular resistance but the big thing is that you know we we need to have that volume uh to make this all work so we want to definitely avoid dehydration okay okay with the albuterol um again this is for asthma COPD but this is the rescue inhaler so this is that short acting bronchodilating agent so it’s beta2 it opens up the two lungs

    And then again the CNS adverse effects you’re like well wasn’t that beta one well you can lose selectivity if you take this too much and that’s when we would kind of get that jitteriness the tremors and then you say well how can hypertension be it it’s beta 2 Agonist again if you lose selectivity then hypertension can be an issue then how can we help the patient well you know you want to open up the lungs before you take that next inhaler breath I know some people like to just squirt the inhaler a couple times right away get it

    Done with but really let’s wait a minute between Puffs to to help open up those bronchi especially if we’re going to use it before the controller inhaler so better to open up the lungs so more controller inhaler gets to the lungs and then kind of a you know bfo blinding flash of the obvious if you’re using a beta Agonist you probably don’t want to have beta antagonists on board especially something like Propranolol which specifically goes after those beta-2s uh so salmeterol and fluticasone or Advair same thing it’s an asthma COPD

    But the contrast is to that albuterol this is the controller inhaler the one that long acting beta 2 Agonist and the mechanism of action we’re opposing both sides of that asthma now with this controller inhaler the beta 2 Agonist open up the lungs deal with that bronchospasm and then the steroid for the as an anti-inflammatory okay got the little muscled lungs here as an image and then CNS when you lose selectivity again you get that kind of jitteriness that comes along with it but when we think about a steroid one of the things

    That it does and we use it for is an immunosuppressant but if your immunosuppressing locally like in the mouth you’re gonna get thrush so that’s why the washing the mouth out with water you know after each use makes so much sense and then pneumonia because again we’re immunosuppressing a little bit here hypertension so again that beta one you know if we lose that selectivity and diabetics you know that especially with when you add some kind of steroid you’re going to get that hyperglycemia because you know when

    Your body needs is when your body feels steroid it’s like okay well something’s gonna happen I’m going to need sugar for whatever events happening so it makes you hyperglycemic but obviously if you’re a diabetic that’s an issue and so again we’ve got that beta antagonist we want to watch out for and here we want to wash out the mouth with water and not swallow but expectorate and get that out of our mouth so we don’t get the thrush okay terbutylene don’t really see this as much but this again bronchosmith

    Bronchospasm and asthma exacerbation it’s a beta-2 Agonist it’s even shorter acting than albuterol it’s like super short acting and you know we can again get those CNS effects when you lose selectivity but there is a laundry list of adverse effects that can come along with terbutylene uh and then hypertension again we want to watch out for that and diabetic so it’s kind of the same as the other ones and of course we want to watch out for beta antagonists but I put a little image here of subcutaneous versus IM injection Although they did bring I am back during covid to avoid using a nebulizer um but really Sub-Q is where you go with tributaline as always uh disclaimer the information is provided for informational purposes only not intended to provide should not be relied for medical or other advice I urge readers to consult with a medical professional if you have a medical condition foreign thanks for listening to the memorizing pharmacology podcast you can find episodes cheat sheets and more at memorizingfarm.com again you can sign up

    For the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash mobile thanks again for listening.

     

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    Ep 60 Alpha Agonists Mnemonic POP CAN - Phenylephrine Oxymetazoline Pseudoephedrine Clonidine

    Ep 60 Alpha Agonists Mnemonic POP CAN - Phenylephrine Oxymetazoline Pseudoephedrine Clonidine

    Alpha Agonists Mnemonic POP CAN - Phenylephrine Oxymetazoline Pseudoephedrine Clonidine

    In this episode, I go over how you can use the POP CAN mnemonic to remember the alpha agonists and what that means for pharmacology indications and adverse effects.

    Find the book here: https://geni.us/iA22iZ 

    or here: https://www.audible.com/pd/B01FSR7HLE/?source_code=AUDFPWS0223189MWT-BK-ACX0-059486&ref=acx_bty_BK_ACX0_059486_rh_us

    and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd

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    Auto Generated Transcript:

    Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com.

    Let’s get started with the show. Hey, welcome to the Memorizing Pharmacology podcast. This one is on Alpha Agonist. The mnemonic is ‘pop can’ and the idea is just to remember a couple of medications that maybe are a little bit different so that we can kind of compare and contrast and do that kind of thing.

    So when we look at Alpha One agonists, we think of pseudoephedrine which is Sudafed, oxymetazolin which is Afrin, and phenylephrine which is Neosinephrine. There aren’t really stems; the only stem here is pseudoephedrine which has that driven sympathomimetic stem which just means it works like the sympathetic system but specifically it’s the alpha one that’s the big deal.

    We’ll look at that mechanism of action specifically on the alpha receptor. So pseudoephedrine or the pseudofed, it’s usually an oral tablet that you’re going to take. This stimulates Alpha receptors systemically so it’s going to go throughout the whole body. The nice thing about oxymetazolin which is Afrin and phenylephrine which is neo-sinephrine, they both stimulate Alpha receptors locally in the nose so you don’t get as much of that issue with cardiac contraindications and so forth.

    So again anybody that has heart issues they’re going to be very wary about using either these medications but all three result in vasoconstriction and decongestion and are adjuncts for allergic rhinitis treatment. So the big kind of take-home thing is if you’ve got vasoconstriction you’ve got a little bit increase in blood pressure and that’s something you don’t want with a cardiac patient.

    But when you talk about side effects though really with Pseudoephedrine it’s more excitability and nervousness just kind of a jitteriness rarely you’re going to see something like tachycardia oxymetazolin Afrin and phenylephrine eosinephrine the big thing here is that rebound congestion and it’s possible around three days you might see four or five days whatever but it’s called rhinitis medicamentosa so that’s the actual name for that rebound congestion.

    If something like that does happen you may need to take an oral steroid or you may need to have a steroid in such a way that we go one nostril at a time but that rebound congestion is very real thank you contraindications really it comes down to those cardiac issues so angina coronary artery disease and hypertension because it’s CAD coronary artery disease it also just happens to be closed angle glaucoma which is the more more concerning type of glaucoma and either of those would definitely be a contraindication to using these types of medications.

    The Alpha 2 you know the can of the pop can mnemonic so when you think pop you think okay well once my nose clears it kind of Pops open but the can part is just to remind you that c and N are in clonidine and clonidine has a couple of brand names that might help you remember what it’s for catapress so if you think of catabolizing blood pressure and then catapress TTS was the patch that also helped with blood pressure and then Cafe which is for ADHD or that’s how it’s marketed.

    But the mechanism of action is quite a bit different so it stimulates an alpha 2 receptors that decreases norepinephrine so norepinephrine would normally bind to Alpha One Alpha 2 beta 1 so you get a decrease in blood pressure and that seems a little bit counter-intuitive to say I’m stimulating something but I’m decreasing so that’s just the big thing is that it’s stimulating Alpha two it’s kind of shutting off the norepinephrine faucet and that’s why blood pressure decreases okay indications include hypertension ADHD ticks and Tourette Syndrome it can be an adjunct for cancer pain it can also be an adjunct for neonatal opioid withdrawal syndrome but again not the safest drug in the world not something we use a ton anymore but to be complete to have an alpha Agonist and not to go into those super medications that have many many alphas and betas this one is the alpha two prototype then adverse effects which you would expect when you lose epinephrine you would expect a decrease in blood pressure and that decrease in blood pressure tends to result in some dizziness and some light headedness but also quite a bit of fatigue imagine that you’re trying to turn on the system to increase your heart rate and blood pressure and all those things only to find out that the faucet for that particular neurotransmitter is not available so anyway just a reminder with all these this is just informational purposes this is not medical advice if you’ve got a medical problem contact a medical professional foreign thanks for listening to the memorizing pharmacology podcast you can find episodes cheat sheets and more at memorizingfarm.com again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com. Thanks again for listening.

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