Pharmacology

Block angiotensin II, with cough from bradykinin

A memory aid for the uses, side effects and monitoring of ACE inhibitors.

Proton pump inhibitors, H2 antagonists and antacids

A memory aid for the drugs reducing gastric acid.

Alpha-1 vasoconstricts, beta-1 stimulates the heart, beta-2 vasodilates

A memory aid for the cardiovascular actions of each adrenoceptor subtype.

ABCDE: Augmented, Bizarre, Chronic, Delayed, End of treatment

A mnemonic for classifying adverse drug reactions.

Agonists activate, antagonists block, partial agonists do both depending on context

A memory aid for the types of receptor ligand.

CAGE: Cut down, Annoyed, Guilty, Eye opener

A mnemonic for the CAGE screening questions and the dependence features.

Long acting benzodiazepine plus thiamine, with seizure and delirium risk

A memory aid for treating alcohol withdrawal.

Concentration-dependent killing with a post-antibiotic effect, allowing once daily dosing

A memory aid for the safe use of gentamicin.

Lungs, liver, thyroid, eyes, skin and nerves

A memory aid for the organ toxicity and monitoring of amiodarone.

Adrenaline intramuscularly into the anterolateral thigh, immediately

A memory aid for recognising and treating anaphylaxis.

Adenosine for supraventricular tachycardia, amiodarone broadly, digoxin for rate control

A memory aid for choosing antiarrhythmic drugs by arrhythmia.

Cell wall, protein synthesis, nucleic acid and folate synthesis

A memory aid for the targets of the antibiotic classes.

Surgical, medical and post-exposure indications

A memory aid for when antibiotic prophylaxis is indicated.

Enzymatic destruction, target alteration, reduced entry and efflux

A memory aid for how bacteria become resistant.

Susceptible, intermediate or resistant, defined against a breakpoint

A memory aid for reading a sensitivity report and the resistance mechanisms behind it.

Each class has a signature adverse effect

A memory aid for the characteristic toxicity of each antibiotic class.

Gram positive, Gram negative, anaerobic and atypical cover

A memory aid for which antibiotics cover which organisms.

Many drugs each contribute a little, and the total predicts harm

A memory aid for the cumulative effect of anticholinergic drugs.

Warfarin blocks vitamin K, heparin activates antithrombin, DOACs block Xa or thrombin

A memory aid for how the anticoagulants work and are monitored.

SSRIs, SNRIs, tricyclics and MAO inhibitors

A memory aid for the antidepressant classes and their distinguishing features.

Each major poison has a specific antidote acting by a defined mechanism

A memory aid for the specific antidotes and their poisons.

Choose the drug by the receptor pathway driving the nausea

A memory aid for matching antiemetics to the cause of vomiting.

Sodium channel blockade, GABA enhancement or calcium channel blockade

A memory aid for how anticonvulsants work and their key toxicities.

Antifungals target ergosterol or the cell wall; antivirals target viral enzymes

A memory aid for the targets of antifungal and antiviral drugs.

ACE inhibitors, calcium channel blockers, thiazides, then spironolactone or beta blockers

A memory aid for the main antihypertensive drug classes and their side effects.

Folate, thymidylate, purine and ribonucleotide reductase pathways

A memory aid for where antimetabolite drugs act.

Start Smart Then Focus

A mnemonic for the principles of responsible antibiotic prescribing.

Aspirin blocks thromboxane, clopidogrel blocks ADP, abciximab blocks GPIIb/IIIa

A memory aid for the antiplatelet classes and their targets.

Extrapyramidal effects with typicals, metabolic effects with atypicals

A memory aid for the adverse effects of antipsychotics.

RIPE: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

A mnemonic for the first line antituberculous drugs and their toxicity.

Resuscitate, identify, decontaminate, give an antidote, enhance elimination

A memory aid for the general management of poisoning.

Beta-2 agonists, antimuscarinics, corticosteroids and leukotriene antagonists

A memory aid for the classes of inhaled respiratory drug.

GABA-A enhancement giving anxiolysis, sedation, anticonvulsant and muscle relaxant effects

A memory aid for the benzodiazepines and their clinical uses.

Cardioselective agents spare beta-2 receptors; non-selective agents do not

A memory aid for the differences between beta blockers.

All inhibit cell wall synthesis, differing in spectrum and stability

A memory aid for the penicillins, cephalosporins and carbapenems.

The fraction of a dose reaching the systemic circulation unchanged

A memory aid for bioavailability and the routes that avoid the liver.

Bisphosphonates, denosumab, teriparatide and romosozumab

A memory aid for the drugs used in osteoporosis.

Dihydropyridines act on vessels, non-dihydropyridines on the heart

A memory aid for the two classes of calcium channel blocker.

Carbon monoxide blocks oxygen carriage; cyanide blocks its use

A memory aid for the two classic poisonings of fire and smoke.

Ion channel, G protein coupled, enzyme linked and intracellular receptors

A memory aid for the main types of cell surface receptor.

Neutropenic sepsis, tumour lysis, spinal cord compression and hypercalcaemia

A memory aid for the acute complications of cancer treatment.

Half-life depends on both clearance and volume of distribution

A memory aid for the relationship between clearance, volume and half-life.

PT tests the extrinsic pathway, APTT the intrinsic, both the common

A memory aid for interpreting prothrombin time and APTT together.

A pulse oximeter reads two wavelengths and can be badly misled

A memory aid for carboxyhaemoglobin, methaemoglobin and the pulse oximeter's blind spots.

Pharmacokinetic interactions alter concentration; pharmacodynamic interactions alter effect

A memory aid for how drugs interact with one another.

Differing glucocorticoid and mineralocorticoid potency between agents

A memory aid for comparing corticosteroids and their effects.

Inducers speed metabolism and reduce effect; inhibitors slow it and increase effect

A mnemonic for the common enzyme inducers and inhibitors.

Alkylating agents, antimetabolites, antitumour antibiotics and mitotic inhibitors

A memory aid for the chemotherapy classes and their signature toxicities.

Cholinesterase inhibitors first, memantine second

A memory aid for the drugs used in dementia and what to avoid.

Confirm cortisol excess, then localise with ACTH and high dose suppression

A memory aid for investigating suspected Cushing's syndrome.

Nausea, confusion, yellow vision and arrhythmia, worsened by hypokalaemia

A memory aid for recognising and treating digoxin toxicity.

Prescribed, over the counter, herbal, recreational, and the allergy detail

A memory aid for taking a complete medication history.

Hepatocellular, cholestatic or mixed; intrinsic or idiosyncratic

A memory aid for recognising and classifying drug induced liver injury.

Phase I modifies the molecule; phase II conjugates it

A memory aid for the two phases of drug metabolism.

Ion channels, G protein coupled, kinase linked and nuclear receptors

A memory aid for the receptor types drugs act on and their speed.

Working backwards from the symptom to the likely drug

A memory aid for the drug causes of frequently seen adverse effects.

Warfarin, retinoids, ACE inhibitors, valproate and tetracyclines among others

A memory aid for the recognised teratogens.

Acetazolamide proximal, loop diuretics in the loop, thiazides distal, potassium sparers in the collecting duct

A memory aid for where each diuretic class acts and its electrolyte effects.

Site predicts organism, and organism predicts the antibiotic

A memory aid for first line antibiotics by infection site.

Km reflects affinity and Vmax reflects capacity

A memory aid for Michaelis-Menten kinetics and enzyme inhibition.

Crystalloids distribute by tonicity; colloids stay longer in the plasma

A memory aid for the composition and distribution of intravenous fluids.

Un-ionised drug is absorbed, so weak acids favour the stomach and weak bases the intestine

A memory aid for how gut pH affects drug absorption.

Propofol for induction, volatile agents for maintenance

A memory aid for the intravenous and inhalational anaesthetic agents.

ACE inhibitor, beta blocker, mineralocorticoid antagonist and SGLT2 inhibitor

A memory aid for the drugs that improve survival in heart failure.

Triple therapy: a proton pump inhibitor plus two antibiotics for 7 days

A memory aid for the treatment of Helicobacter pylori infection.

Oestrogen for symptoms, progestogen to protect the endometrium

A memory aid for the risks and benefits of hormone replacement therapy.

Autoimmune inflammation of any organ, ending in -itis

A memory aid for the toxicity of checkpoint inhibitors.

Steroids, calcineurin inhibitors, antimetabolites and biologics

A memory aid for the immunosuppressant classes used in transplantation and autoimmunity.

Aminosalicylates, steroids, immunomodulators and biologics

A memory aid for the drugs used in Crohn disease and ulcerative colitis.

Promotes storage of glucose, fat and protein, and drives potassium into cells

A memory aid for the anabolic actions of insulin.

Rapid, short, intermediate and long acting, matched to basal and prandial needs

A memory aid for the classes of insulin by duration of action.

Bulk, osmotic, stimulant and softening agents

A memory aid for the laxative classes and when to use each.

A narrow therapeutic index drug requiring regular level, renal and thyroid monitoring

A memory aid for the safe use of lithium.

Block voltage-gated sodium channels from the inside of the axon

A memory aid for how local anaesthetics work and why they fail in infection.

Perioral tingling and tinnitus first, then seizures and cardiac arrest

A memory aid for recognising and treating local anaesthetic systemic toxicity.

About 25 to 30 ml/kg/day of water with 1 mmol/kg each of sodium and potassium

A memory aid for daily fluid and electrolyte requirements.

Uncontrolled calcium release causes sustained contraction and hypermetabolism

A memory aid for the mechanism and treatment of malignant hyperthermia.

The suffix tells you the source, the syllable before it the target

A memory aid for reading the name of a monoclonal antibody.

FEVER: Fever, Encephalopathy, Vitals unstable, Elevated CK, Rigidity

A mnemonic for the features of neuroleptic malignant syndrome.

Acetylcholine acts on nicotinic receptors and is broken down by acetylcholinesterase

A memory aid for transmission at the neuromuscular junction.

Glutamate excites, GABA inhibits, and the monoamines modulate

A memory aid for the main central neurotransmitters and their roles.

Nicotinic at all ganglia, muscarinic and adrenergic at effector organs

A memory aid for autonomic receptor types and their drugs.

The tides and the flozins, with benefits beyond glucose

A memory aid for the GLP-1 agonists and SGLT2 inhibitors.

Nitric oxide donation causes venodilatation, reducing preload and wall stress

A memory aid for how nitrates relieve angina.

Cyclo-oxygenase inhibition giving analgesia at the cost of gastric, renal and cardiovascular risk

A memory aid for the actions and risks of NSAIDs.

Divide by two from oral to subcutaneous morphine, and remember the breakthrough dose

A memory aid for converting between opioids and routes.

The triad of reduced consciousness, respiratory depression and pinpoint pupils

A memory aid for recognising and treating opioid toxicity.

Mu receptors give analgesia along with the main side effects

A memory aid for the actions mediated by opioid receptors.

Reduce hepatic output, increase secretion, increase sensitivity, or increase excretion

A memory aid for how each class of diabetes drug works.

Target saturations of 94 to 98 per cent, or 88 to 92 per cent if at risk of hypercapnia

A memory aid for prescribing oxygen safely.

Transduction, transmission, modulation and perception

A memory aid for the transmission of pain from periphery to cortex.

NAPQI depletes glutathione, causing centrilobular necrosis

A memory aid for the mechanism and monitoring of paracetamol toxicity.

Levodopa with a decarboxylase inhibitor, dopamine agonists, MAO-B and COMT inhibitors

A memory aid for the drug classes used in Parkinson disease.

Distinguish true IgE-mediated allergy from intolerance or a non-allergic rash

A memory aid for evaluating a reported penicillin allergy.

ADME: Absorption, Distribution, Metabolism, Excretion

A mnemonic for the stages of drug handling.

Potency is the dose needed, efficacy is the maximum effect achievable

A memory aid for distinguishing potency from efficacy.

Reduced metabolism, reduced protein binding and increased sensitivity

A memory aid for adjusting drugs in liver disease.

Reduce the dose or lengthen the interval for renally cleared drugs

A memory aid for adjusting drugs when renal function is reduced.

Altered pharmacokinetics and pharmacodynamics with high polypharmacy risk

A memory aid for the principles of safe prescribing in older people.

Only the free fraction is active, and only the free fraction is cleared

A memory aid for why protein binding matters in prescribing.

The As: antiarrhythmics, antibiotics, antipsychotics, antidepressants, antiemetics

A mnemonic for the drug classes that prolong the QT interval.

The seven Ps, from preparation to post-intubation management

A mnemonic for the preparation and steps of rapid sequence induction.

Agonists downregulate receptors; antagonists upregulate them

A memory aid for tachyphylaxis, tolerance and rebound.

Filtration of free drug, active secretion, and passive reabsorption depending on pH

A memory aid for how the kidney eliminates drugs.

Renin, angiotensinogen, angiotensin I, ACE, angiotensin II, aldosterone

A memory aid for the steps of the renin-angiotensin-aldosterone cascade.

Enteral routes are convenient; parenteral routes bypass first pass metabolism

A memory aid for the advantages of each route of drug administration.

A mixed respiratory alkalosis and metabolic acidosis, with tinnitus

A memory aid for the features and treatment of aspirin poisoning.

Respiratory alkalosis from central stimulation plus a high anion gap metabolic acidosis

A memory aid for the mixed acid-base picture of aspirin overdose.

Autonomic, neuromuscular and mental state changes, with clonus

A memory aid for recognising serotonin syndrome and separating it from its mimic.

Never stop insulin, monitor more often, and maintain fluid and carbohydrate intake

A memory aid for managing diabetes during intercurrent illness.

Effective but slow, with early worsening and a discontinuation syndrome

A memory aid for the practical points of prescribing SSRIs.

Statins inhibit HMG-CoA reductase; ezetimibe blocks absorption; PCSK9 inhibitors preserve LDL receptors

A memory aid for the lipid-lowering drug classes.

Steroids act on intracellular receptors and alter gene transcription

A memory aid for how steroid hormones differ from peptide hormones.

Monoclonal antibodies, tyrosine kinase inhibitors and checkpoint inhibitors

A memory aid for the classes of targeted anticancer drug.

Narrow therapeutic index drugs where effect cannot be measured directly

A memory aid for which drugs need level monitoring and when to sample.

The ratio of the toxic dose to the effective dose

A memory aid for the concept of therapeutic window.

Levothyroxine for replacement, thionamides for suppression

A memory aid for the drugs used in thyroid disease.

Receptor downregulation, enzyme induction and physiological adaptation

A memory aid for the mechanisms of drug tolerance and dependence.

Anticholinergic, cholinergic, sympathomimetic, opioid and sedative patterns

A memory aid for the classic poisoning syndromes.

Anticholinergic, cardiac and neurological toxicity together

A memory aid for the features and treatment of tricyclic overdose.

Triptans are 5-HT1 agonists causing cranial vasoconstriction

A memory aid for acute and preventive migraine treatment.

Smear, culture and NAAT for active disease; Mantoux and IGRA for latent

A memory aid for the tests used in latent and active tuberculosis.

Typicals cause movement problems, atypicals cause metabolic ones

A memory aid for the two generations of antipsychotic and their side effects.

Live attenuated give strong lasting immunity; inactivated are safer but need boosters

A memory aid for the types of vaccine and their properties.

Vasopressors squeeze the vessels; inotropes squeeze the heart

A memory aid for classifying vasoactive drugs by their receptor actions.

Sodium blockers, Beta blockers, Potassium blockers, Calcium blockers

A mnemonic for the classes of antiarrhythmic drug.

Cofactor for gamma-carboxylation of factors II, VII, IX and X plus proteins C and S

A memory aid for the role of vitamin K in clotting.

The theoretical volume needed to contain the dose at the measured plasma concentration

A memory aid for the meaning and use of volume of distribution.

Non-opioid, then weak opioid, then strong opioid, with adjuvants at every step

A memory aid for the stepwise approach to analgesia.

Any reaction to a black triangle drug, and serious reactions to any drug

A memory aid for what to report to the UK pharmacovigilance scheme.

First order clears a constant proportion, zero order a constant amount

A mnemonic for the two patterns of drug elimination.