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CYP450 Enzymes, Major Inducers of

๐Ÿ‘‰๐Ÿป Drugs that are inducers increase CYP450 enzyme activity by increasing enzyme synthesis. โ 
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๐Ÿ‘‰๐Ÿป A drug also may be metabolized by the same CYP450 enzyme that it induces. Carbamazepine (Tegretol), a potent enzyme inducer, must be initiated at a low dose and then increased at weekly intervals as its half-life gradually decreases over time.โ 

CYP450 Enzymes, Major Inhibitors of

The CYP450 enzymes are essential for the production of numerous agents including cholesterol and steroids. Additionally, these enzymes are necessary for the detoxification of foreign chemicals and the metabolism of drugs.โ 
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Drugs that are CYP450 inhibitors block the metabolic activity of one or more of the CYP450 enzymes. The extent to which an inhibitor affects the metabolism of a drug depends upon factors such as the dose and the ability of the inhibitor to bind to the enzyme.โ 

Diuretics Sites of Action

Diuretics work to enhance sodium and water excretion through 4 main sites on the nephron.

1– Proximal convoluted tubule: Mannitol and acetazolamide (extends into the descending loop of Henle)

2– Ascending loop of Henle: loop diuretics

3– Distal convoluted tubule: thiazides

4– Collecting ducts: Potassium-sparing diuretic (e.g., spironolactone and triamterene)

Drug Names #1

There are a plethora of drug facts to memorize for school, but it is definitely helpful when their names hint at what they are used for, their mechanism of action, frequency, or duration.
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๐Ÿ’Š Lasix: short for ‘last six hours’ because of the 6-hour duration of action. Try not to administer this diuretic to patients after 4 pm to decrease nighttime awakenings.โ 
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๐Ÿ’Š Macrobid: this formulation of Macrodantin is given BID (twice a day). Macrodantin is recommended to be given 4 times a day. Ensure you are using the right formulation for the right frequency. โ 
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๐Ÿ’Š Protonix: Protonix belongs to a class of proton pump inhibitors. Its brand name, Protonix, tells you that it is used to ‘nix protons’ or acid and is used to treat GERD and acid-reflux disorders. โ 
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๐Ÿ’Š Lopressor: brand name for metoprolol, a beta-blocker that is used for high blood pressure. The brand name, lo-pressor, tells you that it is used to help ‘lower pressures’. โ 
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๐Ÿ’Š Flonase: brand name for fluticasone nasal spray. Its name, Flonase, sounds an awful lot like ‘flow nasal’ which tells you that it is used to treat allergies that commonly cause nasal congestion. โ 
๐Ÿ’Š Ambien: AM is the sig for morning and Bien means good in Spanish. It is a sleeping aid medication that translates into ‘good morning’. โ 

Drug Names #2

Part 2 of It’s all in the name! Hope these mnemonics make it easier for you to memorize these medications.
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๐Ÿ’Š Flomax: brand name for tamsulosin, a medication used to treat urinary retention or benign prostatic hyperplasia (BPH). Its name tells you that it is used to ‘maximize flow’. โ 
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๐Ÿ’Š Lunesta: a sleep aid medication whose root word Luna means moon in Latin. โ 
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๐Ÿ’Š Xarelto: brand name for rivaroxaban, an oral anticoagulant. Its name hints at its mechanism of action, inhibiting factor Xa in the clotting cascade. โ 
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๐Ÿ’Š Fosamax: brand name for alendronic acid, it is a medication used to treat osteoporosis or bone weakening. Its name means os = bone, and max = great in Latin. โ 
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๐Ÿ’Š Prevacid: brand name for lansoprazole, it belongs to a class of proton pump inhibitors. Its name tells you that it ‘prevents acid’ and is used to treat GERD and acid-reflux disorders. โ 
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๐Ÿ’Š Glucophage: brand name for metformin. It is a medication used to treat type 2 diabetes. Its name derives from the Greek words gluco= glucose and phage = eat or consume. โ This helps you remember metformin’s mechanism of action is to increase uptake of glucose by cells in the body to be used as energy (or in other words increase insulin sensitivity). โ 

Drug Names #3

๐Ÿ’Š Vicodin is the brand name for hydrocodone/acetaminophen. Its component hydrocodone is approximately 6 times (VI) times as potent as codeine (codin). โ 
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๐Ÿ’Š Levitra is the brand name for vardenafil, a medication used to treat erectile dysfunction. The article ‘Le’ is used to describe masculine nouns in French (‘La’ is used with feminine nouns) and vitra is similar to the word vitality. So together, the name masculine vitality will help you remember the indication for Levitra. โ 
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๐Ÿ’Š Actigall is the brand name for ursodiol, a medication used to dissolve certain types of gallstones. It sounds a lot like “ACTS ON THE GAL-bladder” to help you remember what it is used for. โ 

Drug Names #5

๐Ÿ’Š Cisplatin is a chemotherapy medication used to treat a number of different cancers. Its name tells you that it is an isomer of a platinum-containing compound. โ 
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๐Ÿ’Š Maalox is used to treat heartburn, acid indigestion, sour stomach, and upset stomach. The name is an acronym that refers to the solution’s compositional elements: MAgnesium and ALuminum Oxide.โ 
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๐Ÿ’Š Sonata is the brand name of Zaleplon, a sedative used to treat insomnia. The prefix Sona means ‘sleepy’ in Portuguese to help you remember its indication. โ 

Drug Names #4

๐Ÿ’Š Bactroban is the brand name of mupirocin, an antibiotic ointment that works to inhibit the growth of bacteria, hence the name ‘ban bacteria’ or Bactroban. โ 
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๐Ÿ’Š Emend is the brand name of aprepitant, an anti-nausea medication indicated to prevent nausea and vomiting caused by chemotherapy. The name emend has the components of ‘end emesis’ in it. โ 
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๐Ÿ’Š Morphine is an opioid pain medication. The drug was named after Morpheus, the Greek god of dreams because in addition to its long-lasting analgesic effects, it would also induce sleep. โ 

Drug Names #6

๐Ÿ’Š Premarin is an estrogen-replacement drug prescribed for the treatment of menopause. It is made from horse urine noted by the drug’s name Premarin which is short for ‘PREgnant MARes’ urINe’. โ 
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๐Ÿ’Š Ursodiol‘s active chemical, ursodeoxycholic acid, is one of the acids found in bear bile that has been shown to be effective in treating gallstones. Since the 1950s, the drug has been produced synthetically.โ 
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๐Ÿ’Š Forfivo is the brand name of the once-daily bupropion 450 mg formulation. It is indicated for the treatment of major depressive disorder (MDD). The brand name hints at its dosing ‘four-five-O’ for 450 mg. โ 
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Entrestoยฎ (Sacubitril/Valsartan)

๐Ÿ“– Angiotensin receptor-neprilysin inhibitors (ARNI) is a new class of heart failure medications. โ 
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โ˜๐Ÿป The first drug in this class is Entrestoยฎ (sacubitril/valsartan). It is a combination medication comprised of a neprilysin inhibitor (sacubitril) and an angiotensin II receptor blocker (valsartan). โ 
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๐Ÿ’Š Sacubitril is a prodrug that inhibits neprilysin thus preventing it from breaking down natriuretic peptides. This mechanism leads to an increase in vasodilation and diuresis as levels of natriuretic peptides rise. โ 
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๐Ÿ’Š Valsartan directly blocks angiotensin II receptors inhibiting angiotensin II from binding onto the receptors and causing vasoconstriction and aldosterone release.โ 
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Calcium Channel Blockers

Calcium channel blockers (CCBs) are used in the treatment of many cardiovascular conditions. They are divided into subclasses, non-dihydropyridines and dihydropyridines.

The non-dihydropyridine CCBs cause less vasodilation and more cardiac depression than dihydropyridine CCBs (hence why they are not recommended in decompensated heart failure). They cause reductions in heart rate and contractility.

Dihydropyridine CCBs have more vascular selectivity and fewer cardiac effects. They are indicated in the treatment of hypertension and angina. They do not suppress AV conduction or the SA node automaticity.

Hyperkalemia, Signs and Symptoms of

Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal, usually greater than 5.0 mEq/L to 5.5 mEq/L. While mild hyperkalemia is usually asymptomatic, high levels of potassium may cause life-threatening cardiac arrhythmias, muscle weakness, or paralysis.โ 
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True hyperkalemia may be caused by increased potassium intake, transcellular movement of intracellular potassium into the extracellular space, and decreased renal excretion.โ 

Hypernatremia, Signs & Symptoms of

๐Ÿ–‡๏ธ High levels of sodium can lead to a condition called hypernatremia, where the serum sodium concentration > 145 mEq/L (> 145 mmol/L). โ 
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๐Ÿ–‡๏ธ Sodium is a dominant cation in extracellular fluid and necessary for the maintenance of intravascular volume. When there is a large increase in sodium in the serum, the signs and symptoms often relate to fluids as you can see with today’s mnemonic.โ 
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๐Ÿ–‡๏ธ The human body maintains sodium and water homeostasis by concentrating the urine secondary to the action of antidiuretic hormone (ADH) and increased fluid intake by a powerful thirst response.โ 

Hypoglycemia, Symptoms of

Hypoglycemia is often defined by a plasma glucose concentration below 70 mg/dL; however, signs and symptoms may not occur until plasma glucose concentrations drop below 55 mg/dL.โ 
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โญ It is important to note that beta-blockers can mask common signs and symptoms that diabetics use to recognize hypoglycemic episodes (tremors and palpitations).โ