Tuesday, 19 November 2013

Pharmacology

Ranolazine, is an antianginal medication.
Food and Drug Administration(FDA) for the treatment ofchronic angina pectoris.
 Ranolazine, a partial fatty acid oxidation inhibitor,shifts ATP production from fatty acid to more oxygen-efficient carbohydrate
oxidation. Inhibition of fatty acid oxidation (e.g., with etomoxir or ranolazine) was also found to sensitize human leukemia cells to
apoptosis induction.
Antiarrythmia
Ia
fast-channel blockers-affect QRS complex
Quinidine
Procainam
Disopyram
Ib
Do not affect QRS complex
Lidocaine
Phenytoin
Mexiletine
Tocainide
Ic
 Flecainide
Propafeno
Moricizine
II Beta- blockers
Propranol
Esmolol
Timolol
Metoprolo
Atenolol
Bisoprolol
III Amiodaro
Sotalol
Ibutilide
Dofetilide
Dronedaro
E-4031
IV slow-channel blockers
Verapamil
Diltiazem
V Adenosine
Digoxin
Magnesiu
Sulfate
There are five main classes in the Singh Vaughan Williams classification of
antiarrhythmic agents:
Class I agents interfere with the sodium (Na +)channel.
Class II agenFluoxetinei-sympathetic nervous system agents. Most agents in this class are beta blockers.
Class III agents affect potassium (K +) efflux.
Class IV agents affect calcium channels and the AVnode .
Class V agents work by other or unknown
mechanisms.
Growth factors in pharmacology-
Erythropoiten recombinant-epoetin alpha and darbe poetin alpha- t/t of anemia
Filgrastim (G-csf)-neutropenia.
Sargramostim (GM- CSF)-Neutropenia.
Oprelevekin (IL-11)-Thombocytopenia.
ROMIPLASTIN-Idopathic trombocytopenic purpura.
Aprepitant (Neurokinin receptor NK1 antagonist)  -prevent nausea and vomiting from high emitogenic chemo.
Erlotinib-Her1/EGFR Tyrosine kinase inhibitor- Non small cell lung carcinoma.
Rimonabant
Rimonabant (Acomplia) is a recently developed anti-obesity medication. It is
cannabinoid (CB1) receptor antagonist that acts centrally on the brain thus
decreasing appetite.
Orlistat
Orlistat (Xenical) reduces intestinal fat absorption by inhibiting pancreatic lipase.
Some side-effects of using Orlistat include frequent, oily bowel movements
( steatorrhea
thrombolytic drugs
include:
tissue plasminogen
activator t-PA:
alteplase (Activase )
reteplase (Retavase )
tenecteplase (TNKase )
anistreplase (Eminase )
streptokinase (Kabikinase,
Streptase )
urokinase ( Abbokinase)
Fibrates prescribed commonly are:
Bezafibrate (e.g. Bezalip)
Ciprofibrate (e.g.Modalim)
Clofibrate (largely obsolete due to side-effect profile,e.g. gallstones )
Gemfibrozil (e.g. Lopid)
Fenofibrate (e.g. TriCor)
Bile acid sequestrants are the principal therapy for the diarrhea found in bile acid
malabsorption .
Cholestyramine ,
colestipol
 colesevelam
SERMs are used dependent on their pattern of action in various tissues:
Name Uses
clomifene used in anovulation
femarelle managing menopause
symptoms, osteoporosis
ormeloxifene contraception
raloxifene  osteoporosis , breast cancer
tamoxifen breast cancer
ABciximab: antagonist of IIb/IIIa receptors (antiplatelet)
INFliximab: binds TNF (Rheumatoid arthritis and Crohn disease)
TASTtuzumab: ERB-B2 antagonist (breAST cancer)
PaliVIzumab: blocks respiratory syntycial VIrus
Nesiritide (Natrecor) is the recombinant form of the 32 amino acid human B-type
natriuretic peptide, which is normally produced by the ventricular myocardium.
Neseritide was believed initially to be beneficial for acute decompensated
congestive heart failure.
Nesiritide is only administered intravenously
Rotigotine (Neupro) is a dopamine agonist of the non-ergoline class of medications indicated for the treatment of Parkinson's disease (PD) and Willis- Ekbom Disease  (WED) formerly known as restless legs syndrome (RLS) in Europe and the United States. It is formulated as a once-daily transdermal patch which provides a slow and constant supply of the drug over the course of 24 hours.Like other dopamine agonists, rotigotine has been
shown to possess antidepressant
DRUGS OF CHOICE:-
1. Paracetamol-poisoning :- acetyl cysteine
2. acute bronchial- asthma :-salbutamol
3. acute gout :- NSAIDS
4. acute hyperkalemia:- calcium gluconate
5. severe DIGITALIS toxicity :- DIGIBIND
6. acute migraine :- sumatriptan
7. cheese reaction :- phentolamine
8. atropine poisoning :- physostigmine
9. cyanide poisoning :- amyl nitrite
10. benzodiazepine poisoning:- flumazenil
11. cholera :- tetracycline
12. KALA-AZAR :- lipozomal amphotericin- B
13. iron poisoning :- desferrioxamine
14. MRSA :- vancomycin
15. VRSA :- LINEZOLID
16. warfarin overdose :- vitamin-K
17. OCD :- fluoxetine
18. alcohol poisoning :- fomepizole
19. epilepsy in pregnency :- phenobarbitone
20. anaphylactic shock :-Adrenaline
Some poisons & their specific antidotes :-
1. Anticholinergics --> Cholinergics.
2. Atropine and/or scopolamine --> Physostigmine.
3. benzodiazepines and barbiturates --> flumazenil.
4. Calcium Channel Blockers (Verapamil, Diltiazem) --> Calcium Gluconate.
5. Isoniazid --> Pyridoxine.
6. Magnesium --> Calcium Gluconate.
7. opioids --> naloxone.
8. paracetamol (acetaminophen) --> N-acetylcysteine.
9. Thallium --> Prussian blue.
10. Nicotine --> Bupropion and other ganglion blockers.
11. ethylene glycol --> ethanol or fomepizole, and thiamine.
12. methanol --> ethanol or fomepizole, and folinic acid.
Filgrastm used in: neutropenia
Vit k cofactor in carboxylatn
Ezetimibe: dec absorptn of cholestrol

Clopidogrel less neutropenia dan ticlopidine
DABIGATRAN is an oral anticoagulant from the class of the direct thrombin inhibitors . It is used for various clinical indications, and in some cases it offers an alternative to warfarin as the preferred orally
administered anticoagulant ("blood thinner"),
Mechanism of action
Ingested orally, dabigatran is a competitive and reversible direct thrombin inhibitor. Bivalent
Hirudin and derivatives were originally discovered in
Hirudo medicinalis:
Hirudin
Bivalirudin (transient inhibition - is cleaved by thrombin)
Lepirudin
Desirudin
Univalent
Univalent DTIs include:
Argatroban
Melagatran (and its
prodrug ximelagatran)
Dabigatran
Argatroban (as well as the
hirudins) are used for heparin-induced
thrombocytopenia ,
Ximelagatran showed good efficacy compared with warfarin in several trials in
prevention and treatment of deep vein thrombosis and as thromboprophylaxis in atrial fibrillation

abciximab (ReoPro)
eptifibatide (Integrilin)
tirofiban (Aggrastat)
Use
Glycoprotein IIb/IIIa inhibitors are frequently
used during percutaneous coronary intervention ( angioplasty with or without
intracoronary stent placement).
Factor Xa has been developed. These
include the drugs rivaroxaban , apixaban,
betrixaban , LY517717,
darexaban (YM150),
edoxaban
Do not give Proton pump inhibitors
to patients who are on Clopedogrel,
as they inhibit CYP2C19, which is
required for the metabolism of
Clopedogrel, hence the anti-platelet
effect of the Clopedogrel will be
decreased.
Drug Of Choice - SEIZURES
Valproate - GTCS, tonic, atonic, clonic,                              myoclonic, atypical absence
Lorazepam - status epilepticus
Diazepam - febrile seizures
Carbamazapine - trigeminal neuralgia &                                  partial seizures
Absence seizures - <3y ethosuximide
                                >3y  valproate
Infantile spasm - vigabatrine
Ganaxolone - catamanial epilepsy
Gabapentin - post herpitic and diabetic                              neuralgia
MgSO4 - ecclampsia
Infantile-ACTH now
Absence--all case valproat
Vaccines and strains used:
Measles-edmonston zagreb strain
Rubella-RA27/3
BCG-Danish 1331 strain
Mumps-jeryl lynn strain
Hypertension Drug of Choice in various coexisting conditions--------------------------------------------------------------------
*Best initial therapy= Thiazide
*Excellent treatment of systolic HTN= CCB
*HTN + Recurrent stroke= ACEI, Thiazide
*HTN + Migraine = CCB
*HTN + Raynaud's phenomena= CCB
*HTN + Essential tremor= BB
*HTN + Glaucoma= BB
*HTN + Hyperthyroidism= BB
*HTN + Depression= avoid BB
*HTN + Asthma= avoid BB
*HTN + CHF + AF from ischemia= BB
*HTN + LVH= BB, CCB
*HTN + CAD= BB, ACEI, ARB
*HTN + Heart failure= ACEI, ARB, BB, Spironolactone
*HTN + Osteoporosis= Thiazide 
*HTN + ADPKD= ACEI
*HTN + Pregnancy= M.dopa , nifedipine
Lorglumide ( CR-1409 ) is a drug which inhibits gastrointestinal motility and reduces gastric secretions, acting as a cholecystokinin antagonist ,  with fairly high selectivity for the CCKA subtype.  It has been
suggested as a potential treatment for a variety of gastrointestinal problems including stomach ulcers, irritable bowel syndrome, dyspepsia , constipation and
pancreatitis
Name penicillins causing
Seizure-procaine penicillin
Hepatitis-oxacilin
Neutropenia-nafcillin
Bleeding-Carbenicillin
Interstitial nephritis-methicillin
Diarrhoea-Ampicillin/Amoxicillin
Drugs used in hypertensive emergency-nitroprusside
nitroglycern
clevidipine
nicardipine
fenoldopam
labeatalol
esmolol
hydralazine
enalaprilat
phentolamine
(mostimp - nifedipine not used..)
Drug's causing disulfiram like action.
Metronidazole
Sulfonamides(CTX)
Cefoperazone
Cefotetan
Cefamandole
Griseofulvin
Moxalactam
Chlorpropamide
Procarbazine
Phenylbutazone
Furazolidone
SOME PRODRUGS AND ACTIVE FORMS
1. LEVODOPA ------------------- dopamine
2. ENALAPRIL ------------------- enalaprilat
3. SULINDAC --------------------- sulfide metabolite
4. BECAMPICILLIN –---------- ampicillin
5. SULFASALAZINE –---------- 5 – aminosalicyclic acid
6. PREDNISONE ----------------- prednisolone
7. ZIDOVUDINE ----------------- zidovudine triphosphate
8. CYCLOPHOSPHAMIDE --- aldophosphamide
DRUGS CAUSING GYNAECOMASTIA
1. spironolactone
2. ketoconazole
3. estrogens
4. testosterone
5. digitalis
6. clomiphene
7. phenytoin
8. griseofulvin
9. calcium channel antagonists
10. reserpine
11. isoniazid
12. methyldopa
13. ethionamide
Drugs causing Fatty liver
1. Antiarrythmics - Amiodarone
2. Antibiotic - Tetracycline ( high-dose, intravenous )
3. Anticonvulsant - Valproic acid
4. Antiviral - Dideoxynucleosides ( eg: Zidovudine ), protease
inhibitors ( indinavir, ritonavir )
5. Oncotherapeutics - Asparginase, Methotrexate .
1) doc fr invasive aspergilloma? VORICONAZOLE
2) doc for mucaromycosis? POSACONAZOLE
3)Only S/ E of micafungin?  Histamine release..itching
4)Wat r 3 C of fuconazole and 2 C of flucytocine?3c- Rx against candida, coccidiomycosis and cryptococcal meningites
5) visual disturbance seen in wich anti fungal drug? Voriconazole...oyhers diarrhoea, rash, QT prolongation
Alpha 2 agonists
Brimonidine apraclonidine in glaucoma
Tizanidine muscle relaxant
Clonidine and alpha methyl dopa RX  of htn
Dexmeditomidine- pre anaesthetic medication
1.vinca alkaloids act on which phase of cell cycle?
M phase
2.mtor inhibitor?
Tacrolimus
3.pfox inhibitor?
Trimetazidine raanazoline
4.irreversible otoxicity by which fluriquinolone?
Streptomycin
5.dreaded complication of clozapine?
Agranulocytosis
6.truth serum?
Sodium penthotal amibarbitone
7.km and vmax in competitive inhibition?
Km increase vmax same
8.height of DRC indicate?
Efficacy
9.shift of DRC to left indicate?
Increase potency
10.which drug usedc to keep pda patent?prostaglandin e1 analogue like alprostadil
1.Tetracycline wit vestibular toxicity ?minocycline
2. Max incidence of phototoxicity among quinolones? Sparfloxscin
3. Doc of legionnare's? Erythromycin
4.  pseudo jaundice adverse effect of? 
5. Where s docosanol used n it's moa?
6. Protease inhibitor which doesn't cse lipodystrophy? Aztazanavir
7. Doc of late cns stage of trypanosomiasis? Pentamidine
8. Antimalarial drug known  to cause neuropsychiatric adverse reaction? Chloroquine
. Absorption of whixh anti malarial,  anti fungal, anti cancer,  anti viral increases wit food.?
10.Whats log kill hypothesis?
1 Hypertrophic pyloric stenosis due to drug ? Erythromycin
2 mobeius synd ? Misoprostol
due to intake of misoprostl.6 nd 7 cranial nrv palsy
3 t/t mountain sickness?
Acetazolamide
4 doc for cheese rxn ?
Phentolamine
5 t/t of choice beta blocker poisoning?
Glucagon
6 doc pvd ? Periph vasc disease ? Pentoxyphylline
7 doc mgso4 toxicity?
Calcium gluconate
8 post herpetic neuralgia ???
Gabapentin
9 anti craving drug alcohol ??? Acamprost
10 alcohol withrawal doc ?Long acting bzd
Doc kala azar?sodium stibo
Doc sea sickness?meclizine
Shortest acting nitrate?gtn
Where is storcit used?stroke
Hand foot syndrome by?5fu capecitabine
Red man?vanco
Radiation recall reaction in?adriamycin
Doc for various condition :
Absence seizure - typical :
Ethosuccimide ,
If it is atypical : sod valproate ,
Ocd: fluoxetine ,
Lithium induce DI : amiloride ,
Myclonic seizure : valproic acid .
Mrsa : vancomycin ,
Vrsa : linezolid ( thrombocytopenia ) ,
Px of febrile seizure ie complicated : phenobarbitol n valproate ,
1.DOC for pertussis? Macrolide
2.Shortest acting mydriatic is? Tropicamide
3.Beta blocker with alpha activity? Carvedilol
4.Max dose of ezetimide is? 10mg daily
Gemifibrozil is a? Fibric acid derivative
5:Drug for actinomycetes?  Penicillin
Fentanyl (also known as fentanil , brand names Sublimaze, Actiq , Durogesic , Duragesic, Fentora, Matrifen, Haldid, Onsolis, Instanyl, Abstral , Lazanda and others is a potent, synthetic opioid analgesic with a rapid onset and short duration of action. [9] It is a strong agonist at the ╬╝- opioid receptors.
Fentanyl transdermal patch
(Durogesic/Duragesic/Matrifen) is used in chronic pain management Remifentanil is a potent ultra short-acting synthetic opioid
analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic .Remifentanil is used for
sedation as well as combined with other
medications for use in general anesthesia .
Broad spectrum.anti convulsants??
Valproate
Levrtericitam
Broad spec anti arrythmics??
Amiodarone
Broad spec anti cancer
Doxorubicin
Cetuximab
Pegvisomant (trade name Somavert) is a growth hormone receptor antagonist used in the treatment of acromegaly.[1] It is used if the tumor of the pituitary gland causing the acromegaly cannot be controlled with surgery or radiation, and the use of somatostatin analogues is unsuccessful. It is delivered as a powder
that is mixed with water and injected under the skin
Pegvisomant blocks the action of growth hormone at
the growth hormone receptor to reduce the production of IGF-1.[3][4] IGF-1 is responsible for most of the symptoms of acromegaly thus normalising its levels is effective to control the symptoms. Side effects Side effects of Pegvisomant include reactions at the injection site, swelling of the limbs, chest pain, hypoglycemia, nausea and hepatitis. Blocking of the growth hormone's receptor reduces feedback control of the growth hormone regulation leading to approximately doubled GH levels
Rotigotine
This was d drug used for transdermal patch to rx parkinson  disease ,
Once daily regimen , it slowly release d drug in 24 hrs of time
*Doc in leukemias
A.CLL- fludarabine
B.CML-Imatinib
C.hairy cell--cladiribine
D.multiple myeloma-- melphan
E.resistant multiple myeloma--bortezomib
Drugs of choice in Psychiatric disorders
1. Body dysmorphic disorder - Fluoxetine
2. Obsessive Compulsive disorder - Fluoxetine/Clomipramine
3. Depression with cardiac disease - Fluoxetine, Mianserine.
4. Trichotillomania - Fluoxetine
5. Nocturnal enuresis - Imipramine
6. Panic disorder - Imipramine
7. Panic attack/disorder - Imipramine
8. Suicidal depression - ElectroConvulsive Therapy (ECT)
9. Catatonic Schizophrenia - ElectroConvulsive Therapy (ECT)
10. Manic depressive psychosis (Bipolar disorder) - Lithium
carbonate
11. Pregnancy with Bipolar disorder - Carbamazepine
12. Rapid cycling Bipolar disorder - Sodium valproate
13. Gilles de la tourette syndrome - Haloperidol
14. Attention Deficit Hyperactivity Disorder (ADHD) - Methylphenidate
15. Narcolepsy - Methylphenidate (amphetamine)
16. Monosymptomatic hypochondriacal psychosis - pimozide.
17. Somatization disorder - amitriggtilline
18. Depression with acid peptic disease - doxepin
19. Generalized Anxiety Disorder (GAD) - Benzodiazepines, Buspirone
20. Borderline Personality Disorder - Antidepressants,
Fluoxetine
21. Phobias - MAO inhibitors, Paroxetine
22. Delusional disorder - Antipsychotics
**
Drug Of Choice - SEIZURES
*Valproate - GTCS, tonic, atonic, clonic,   *myoclonic, atypical absence
*Lorazepam - status epilepticus
*Diazepam - febrile seizures
*Carbamazapine - trigeminal neuralgia & partial seizures
*Absence seizures -
<3 yrs ethosuximid
>3y valproate
*Infantile spasm - vigabatrine
Bt
Doc -acth
If infantil+tuberous sclerosis---vigabatrine
*Ganaxolone - catamanial epilepsy
*Gabapentin - post herpitic and  Diabetic neuralgia
*MgSO4 - ecclampsia
**
Doc
Focal---lamotrigine
Gtcs--valproate
Absence<3M-ETHOSUXI
           >3M-VALPROATE
Mc typ
Newborn-subtle
Children-absence
All over--gtcs
**
Amiodarone:
action, side effects 6 P's: Prolongs action potential duration Photosensitivity Pigmentation of skin Peripheral neuropathy Pulmonary alveolitis and fibrosis Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism
**
Properties of halothane
Mnemonic-Halothane CC
H-hyperthermia(malignant)
A-analgesic action absent
L-liver toxic
O-orthostatic hypotension
T-Tocolytic
H-heart(decrease CO)
A-asthma(bronchodilator)
N}Non
E}explosive
C-chills
C-children(safe)
One more property of halothen is reduce portal blood flow...
**
Longest acting NM blocker               ----------> PANCURONIUM
Shortest & fastest acting NM blocker ------------> Succinyl choline
Shortest acting competitive blocker -------------> Mivacurium
Fastest acting competitive blocker   -------------> Rocuronium
Maximal vagal block is seen in ------------------> Pancuronium
Max ganglionic blockade         -------------------> dTc
vagal and ganglionic stimulation -----------------> Succinyl choline
Mc muscle relaxant used for routine surgery ---> Vecuronium
Most potent skeletal muscle relaxant ------------> Doxacurium
least potent S.M.R                     ------------------>Sch
Least potent compititive blocker   -----------------> Rocuronium
only comp. blocker metabolized by plasma cholinesterase -->Mivacurium
**
chief judicial magistrate - 7 yrs.. Unlimited fine
first class judicial magistrate- 3 yrs+5000 fine....
second class judicial magistrate - 1 yr imprisonment+ 1000 fine
Drugs of choice in Psychiatric disorders
1. Body dysmorphic disorder - Fluoxetine
2. Obsessive Compulsive disorder - Fluoxetine/Clomipramine
3. Depression with cardiac disease - Fluoxetine, Mianserine.
4. Trichotillomania - Fluoxetine
5. Nocturnal enuresis - Imipramine
6. Panic disorder - Imipramine
7. Panic attack/disorder - Imipramine
8. Suicidal depression - ElectroConvulsive Therapy (ECT)
9. Catatonic Schizophrenia - ElectroConvulsive Therapy (ECT)
10. Manic depressive psychosis (Bipolar disorder) - Lithium
carbonate
11. Pregnancy with Bipolar disorder - Carbamazepine
12. Rapid cycling Bipolar disorder - Sodium valproate
13. Gilles de la tourette syndrome - Haloperidol
14. Attention Deficit Hyperactivity Disorder (ADHD) -
Methylphenidate
15. Narcolepsy - Methylphenidate (amphetamine)
16. Monosymptomatic hypochondriacal psychosis - pimozide.
17. Somatization disorder - amitriggtilline
18. Depression with acid peptic disease - doxepin
19. Generalized Anxiety Disorder (GAD) - Benzodiazepines,
Buspirone
20. Borderline Personality Disorder - Antidepressants, Fluoxetine
21. Phobias - MAO inhibitors, Paroxetine
22. Delusional disorder - Antipsychotics
S/e of cyclophosphamide---->>
Se is haemorrhagic cystitis
Mesna given fr treatment
Ifosfamide is more potent congener of cyclophosphamide
Mesna is drug of choice but treatment of choice is---->>
Continuous irrigation and followed by mesna
intravesical bcg fr bladder carcinoma
Doc for chemotherapy induced vomiting---->>
Palensetron
(Palensetron as it prevents delayed vomiting also)
1st line chemotheraputic agent in ovarian carcinoma--->>Carboplatin and Cisplatin
Cisplatin has max emetogenic potential
what is used for cisplatin induced emesis--->>  APRIPITANT which is NK1 receptor and Substance P antagonist
Doc for febrile neutropenia ---- Ceftazidine
Anticancer Drug causing disulfiram like reaction--
Busulfan,bleomycin nd carmustine cause pulled.fibrosis as side effect
Drug causing radiation recall synd:
Doxorubicin
 docetaxel,
paclitaxel,
 gemcitabine,
capecitabine
Amifostine is radiiprotector( ammijaan protects)
Cisplatin is a radiosensitizer(CIS sense)
Cerebellar ataxia s.e of--->>cytarabine nd 5fu
Cerebellar ataxia is also a side effect of phenytoin remember
Most common side effects of anticancer drugs overall--->>
Nausea and vomiting
Max ototoxic nd nephrotoxic is tacrolimus na
Tacrolimus other name is---->>Fk 506
Hand foot syndrome caused by---->> 5FU and capecitaben
Vinca alkaloids r mitotic inhibitors.. Bind to tubulin n prevent polymerization.
Taxanes has opposite action. Enhance polumerization of tubulin and lead to stablization.
Cell cycle specific drugs
G1-- Vinblastine
S -- Mtx, Cytarabine, 6-MP, hydroxyurea, mitomycin C,
Doxorubicin, Daunorubicin.
G2 -- Daunorubicin, Bleomycin, Etoposide, Topotecan.
M -- Vincristine, Vinblastine, paclitexel.
S/e of cyclophosphamide---->>
Se is haemorrhagic cystitis
Mesna given fr treatment
Ifosfamide is more potent congener of cyclophosphamide
Mesna is drug of choice but treatment of choice is---->>
Continuous irrigation and followed by mesna
intravesical bcg fr bladder carcinoma
Doc for chemotherapy induced vomiting---->>
Palensetron
(Palensetron as it prevents delayed vomiting also)
1st line chemotheraputic agent in ovarian carcinoma--->>Carboplatin and Cisplatin
Cisplatin has max emetogenic potential
what is used for cisplatin induced emesis--->>  APRIPITANT which is NK1 receptor and Substance P antagonist
Doc for febrile neutropenia ---- Ceftazidine
Anticancer Drug causing disulfiram like reaction--
Busulfan,bleomycin nd carmustine cause pulled.fibrosis as side effect
Drug causing radiation recall synd:
Doxorubicin
 docetaxel,
paclitaxel,
 gemcitabine,
capecitabine
Amifostine is radiiprotector( ammijaan protects)
Cisplatin is a radiosensitizer(CIS sense)
Cerebellar ataxia s.e of--->>cytarabine nd 5fu
Cerebellar ataxia is also a side effect of phenytoin remember
Most common side effects of anticancer drugs overall--->>
Nausea and vomiting
Max ototoxic nd nephrotoxic is tacrolimus na
Tacrolimus other name is---->>Fk 506
Hand foot syndrome caused by---->> 5FU and capecitaben
Vinca alkaloids r mitotic inhibitors.. Bind to tubulin n prevent polymerization.
Taxanes has opposite action. Enhance polumerization of tubulin and lead to stablization.
CARDIOTOXICITY is a unique adverse effect Of which anticancers--->
Anthracycline group of drugs--->>
Daunorubicin, Doxorubicin(adriamycin)
Dose of chemotheraputic drug is commonly caluclated by---->> BSA
Dose of Carboplatin is caluculated by--->> Renal Function Test also known as CALVERTS formula
Cell cycle specific drugs
G1-- Vinblastine
S -- Mtx, Cytarabine, 6-MP, hydroxyurea, mitomycin C,
Doxorubicin, Daunorubicin.
G2 -- Daunorubicin, Bleomycin, Etoposide, Topotecan.
M -- Vincristine, Vinblastine, paclitexel.
Rituximab uses??
CHINA
CLL
HEMOLYTIC ANEMIA (AIHA)
ITP
NHL
ARTHRITIS (RHEUMATOID)
All anti cancer causes bone marrow suppression except??
BLEOMYCIN $ VINCRISTINE✅
DRUGS ADVERSE EFFECT
QUINIDINE.--- Diarrhea, thrombocytopenia
ACARBOSE--- Flatulence, GI distress
METHIMAZOLE--- Agranulocytosis, aplastic anaemia
PRAZOSIN---- First dose syncope
ETHOSUXIMIDE--- GI upset
TOLCAPONE.---- HEPatotoxicity
THIORIDAZINE.--- retinal deposits, torsade
VANCOMYCIN--- RED MAN syndrome
CHLORAMPHENICOL--- GRAY BABY syndrome
CIMETIDINE---- Gynaecomastia
KETOCONAZOLE-- Gynaecomastia
THIOGLITAZONE,TACRINE--- Hepato toxicity
ETOMIDATE-- Adrenal suppression
CHLOROFORM,ETHER--- Hyperglycemia
NICOTINIC ACID--- Icthyosis
CALCIUM AGONISTS--- Constipation
AZATHIOPRINE, VALPROATE, THIAZIDES---- Pancreatitis
PROTON PUMP INHIBITORS--- Rediatribution of fat, hyperglycemia
OUTDATED TETRACYCLINES, NALIDIXIC ACID--- Pseudo tumour cerebri
GLYCOGEN STORAGE DISORDERS
VON GIERKES-- G6PD
POMPES-- acid maltase
CORIS--- Debranchin enzyme
ANDERSONS--- Branchin
MCARDLES--- Muscle phosphorylase
HERS-- Hepatic phosphorylase
TAURIS--- Phosphofructokinase 1
Drugs increasing QT interval...
I CHEAT!!
I Imipramine
C Cisapride
H Haloperidol
E Erythromycin
A Amitryptiline and Amiodarone
T Terfenidine
E. granulosus – common hydatid.
E. multilocularis – alveolar type.
E. oligarthus – in the Americas
E. vogeli – polycystic hydatid.
 PAIN in
1.external hemorroids due to inferior rectal nerve branch of
pudendal nerve
2.internal hemorroids due to inferior hypogastric nerve from sym plexus (l1,l2)
MEDIAN NERVE [labourer's nerve]--C5,6,7,8,T1
Pen test
Ape thumb
Loss of opposition
Pointing index
Positive OSCHNER CLASP BENEDICTION TEST
ULNAR NERVE [muscian nerve]---C8,T1
Supply ADDuctor pollicis
Book test(Fromet sign)
Card test
Egawa's test
RADIAL NERVE---C5,6,7,8,T1
Wrist drop
Thumb drop
Finger drop
Mackler triad
Sc emphysema
Vomiting
Chest pain
quinkes triad
Jaundice 
upper gi bleed
Biliary colic
Dieufaloys triad
Tendernes
Guarding
Hyperaesthesia[al 3 at mc burney pt]

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