Step 1

1 red ox went to con 2 old lazy polar bears 

Phase 1:  cyp450 oxidation-reduction (+ hydrolysis); usually yields slightly polar water-soluble metabolites (often still active) geriatrics lose phase 1 first

Phase 2:  conjugation (acetylation, glucuronidation, sulfation, methylation) —> usually yields very polar renally excreted inactive metabolites. Geriatric patients have GAS (glucuroniation, acetylation, sulfation) 

(1 red ox went to con 2 old lazy GASSY polar bears)

I think of how old people sitting around at home on the internet are often the victims of internet scams 

My - Macrolides

Sullen - Sulfonamides

Robot - Ritonavir

And  Amiodarone

A cute - Acute alcohol abuse (alt: Angry) 

Kangaroo - Ketoconazole

Couldn’t - Ciprofloxacin

Quickly - Quinidine

Get the - Gemfibrozil

Cement -Cimetidine

Gliding on - Grapefruit juice

Ice - Isoniazid

I picture them tired and Cipping on Grapefruit juice, trying to find the Key to their problem 

Momma - Modafinil

Grizzly - Griseofulvin

Bear - Barbituates

Cruelly - Chronic alcohol use

Steals - St. John’s wort

Phen-phen (and) - Phenytoin, Phenobarbital

Races- Rifampin

Cars - Carbamazepine

artwork EDITED from original source: http://apotential.wordpress.com/

FirstAids mnemonic is:  "Popular FACTSSS" but I have a hard time remembering drugs from just the first letters so here is an alternative: 

Probe your patients Fur Thier Celect Sulfa Allergies (and you’ll be an ACE) 

Probenecid (gout drug) Furosemide (and other loop diuretics other than Ethracrynic acid) Thiazides (diuretics) Celecoxib (selective COX2 inhibitor) Sulfonamide/Sulfasalazine/Sulfonylureas, Acetazolamide (CA inhibitor)  which you can remember with just the first letter because its another diuretic or you can add on “and you’ll be an Ace” if you dont want to rely on the first letter.

mikmonics: 

Respiratory Patterns and Brainstem Lesions mnemonic:

Check For HAARD Breathing (from rostral to caudal) 

Cheyne-Stokes – Forebrain 

Hyperventilation – Midbrain

Apneusis – Rostral Pons

Ataxic – Caudal Pons

Respiratory Arrest – Upper Medulla

Death

Hola! Me again!

Drugs and their mechanisms can be difficult to remember.. I like pairing the action with the drug name to make it easy. We are doing anti-fungals today (Yaay!)

Mr. Ampho tears holes in the fungal membrane. Mister rhymes with Nyster and it reminds me of Nystatin. Ampho is Amphotericin.

The word “Squatter“ reminds me that Squalene epoxidase is inhibited by terbinafine.

"Azole pazole” sounds so funny! *giggles*

Anyway, P450 inhibited by Azole. Hope pazole works for you as well =D

“Casper the friendly ghost”

Caspofungin the friendly glycan inhibitor xP

Griseofulvin is greasy. And if you put grease on tubules, they won’t move!

Griseofulvin inhibits the formation of the microtubule.

That’s all! Pray for me =)

Azoles: 

Fluconazole - Fluid Fluco flows into CNS (used for cryptococcal meningitis)

Clotrimazole - Cutaneous (topical) (also Miconazole, a stretch!) 

 Voriconazole - inVasive aspergillosis, Visual disturbances

Posaconazole - Potent Posa - decreases Potassium levels, Platelet count, Prophylaxis for invasive aspergillosis, candida in immunocomp.  

Echinocandins: 

EchinocanDIN’s- end in GIN: Glucan INhibitors: CaspofunGIN, MicafunGIN

Caspofungin used for invasive Candida, Aspergillosis, 

ClASPs MAST cells - side effect - flushing from histamine release (picture clasping the mast cells so hard that they release histamine) 

Terbinafine - makes nails fine,  takes away the squalor - inhibits squalene epoxidase, treats onychomycosis- can also picture putting a little terbin (turban) on a toe character that falls down too low - can’t see (visual disturbances) 

Polyenes Punch Holes- AmphoTerrible and Nasty Nystatin

AMPHTERICIN B

A nemia M uscle spasms P hlebitis H eadaches/hypotension/hypokalemia T hrombocytopenia E mesis, encephalopathy R espiratory strida I ncreased temperature (fever) C hills I mmediate hypersensitivity (anaphylaxis) N ephrotoxicity–important! B ronchospasm

alternative- Just think of a terrible chef making a shake n bake (fever, chills) - its SO terrible that you grow pale at the sight of it (anemia) heart starts racing (arrthymia) and almost faint (hypotension). To make it better you wash it down with tons of water (so it doesnt hurt your kidneys) and you sprinkle on supplemental K/Mg.  

Selegeline, Rasagiline: MAO inhibitors

C is for COMT inhibitors: Entacapone, Tolcapone

Mild disease: intact functional status (less bradykinesia)

Anticholinergics: for pts <60 y.o. Relieve tremor and rigidity. CI: BPH, glaucoma

Amantidine: for pts >60 y.o

Severe disease: inability to care for themselves (significant bradykinesia)

Dopamine agonists: best initial tx

L-Dopa + Carbidopa: most effective. SE: “on-off” effect

COMT inhibitors: adjunct tx with L-Dopa + Carbidopa, extends its duration. Use in “on-of” effect

MAO inhibitors: retard the progression of parkinsonism. Adjunct or single tx.

Deep brain stimulation: electrical stimulation for tremors & rigidity for pts who can’t tolerate or respond to medication.