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  • What I want to do is I want to go through the seven chapters

  • And I'm going to go through them on the board from memory as we get to the later chapters

  • I might just do them ahead of time just to make the clips shorter

  • But these first two clips at least I'm going to do it from memory just to show you that

  • hopefully after you've read the book you've got it to the point where

  • you're at the instructor's level. As an instructor

  • with those 200 drugs I

  • see them all as seven pictures. I don't need two hundred note cards

  • I can just do it from memory, and that's where I want you to get to so we'll start with chapter one

  • gastrointestinal. And we'll talk about thirteen medications

  • and while I talk about the thirteen medications I'll also talk about grouping them and grouping them

  • When you're first learning these top 200 drugs when you group them

  • Students are good at grouping them as okay these are analgesics and these are

  • Maybe for some kind of stomach upset and then these are for pain

  • But this is another level where we're connecting all 200 drugs in one

  • order so let's start with two drugs that you're probably very familiar with two antacids

  • And then from the antacids we're going to go to the H2 blockers

  • And these are better known as histamine

  • Two

  • Receptor

  • Antagonists

  • So there is a histamine 1, that's the anti-histamine you think of when you think of Claritin and things like that

  • The receptor just means that the drug is going to affect the receptor and an

  • antagonist means it blocks it. So histamine

  • two must release gastric acid if we're using a drug to block it. And then proton pump inhibitors

  • So within each of these categories, I'm going to alphabetize them

  • Because it makes it easier to remember

  • Although magnesium is above calcium on the periodic table. We're going to put calcium carbonate first

  • So calcium carbonate is Tums

  • But I also want you to know that it's something called Children's

  • Pepto

  • This is important because regular Pepto has a salicylate component. That's a lot like aspirin and

  • that can be very dangerous in children, especially if a child has

  • Some kind of Chickenpox or fever and things like that and get Reye's syndrome

  • spelled Reye

  • apostrophe "s"

  • There's Magnesium hydroxide

  • And that's Milk of Magnesia

  • So these antacids they work very quickly

  • And because they work quickly what we're going to do for the way that we're going to remember them is

  • These work in a couple minutes. Maybe five minutes

  • These work in about 30 minutes the H2 blockers, and then these work in about a day

  • But antacids are probably the first thing you'll reach for because they work so quickly

  • then if it persists you might go to an H2 blocker and

  • We have two that we're going to use, famotidine

  • ranitidine

  • I'm not going to put the brand names yet because I want you to notice that there's a -tidine ending

  • t-i-d-i-n-e

  • The first thing I want you to know is that the -ine is not the ending

  • a lot of the videos on YouTube show that as the ending just because

  • 20% of all drugs end in -ine

  • So you don't want to classify it by that. The -tidine has been set by

  • a couple of organizations [like] the World Health Organization,

  • the United States Adopted Names Council,

  • and they're the ones that make this into a group so that it's a -tidine makes it a

  • cimetidine-like H2 blocker and cimetidine was the first H2 blocker that came out

  • So let's put the brand names in there: Pepcid

  • Which combines peptic and acid

  • Zantac

  • You can kind of see the word antagonist in there for acid, and then two proton pump inhibitors

  • And we're going to see similar ending or that they're going to have similar endings

  • And then I'm going to introduce something new as well there so esomeprazole

  • There's (brand) Nexium (generic) omeprazole

  • (brand) Prilosec, okay

  • -prazole ending is what lets us know it's a proton pump inhibitor,

  • but you'll notice we have omeprazole and omeprazole

  • What's the es- what's this doing? If you look in and

  • Wiki is a good place to look because it has good pictures of molecules.

  • This omeprazole is actually an R- plus S-

  • where this omeprazole is just an S- so what does that mean? There's a left-handed

  • or there's a right-handed rectus and left-handed sinister omeprazole, so it's a mixed

  • there's two sides to the molecule and

  • only the S- does anything so Prilosec came first

  • "protons low secretion" is how you remember the brand name and

  • Then esomeprazole or Nexium came next and you can remember that from Nexium

  • But just notice that these have the same root, okay?

  • but they still have this ending -prazole Be careful some of those YouTube videos call it -azole and

  • Those are maybe people that haven't had organic chemistry

  • an -azole is just an organic chemistry compound

  • But -prazole is an actual stem by the

  • United States Adopted Names Council, so let's look at our first six drugs in order we start with antacids

  • Calcium carbonate and Magnesium hydroxide alphabetized although on the periodic table. I know magnesium comes first

  • It's 12 calcium carbonate is 20

  • H2 Blockers alphabetize them: famotidine,

  • ranitidine, notice the -tidine stem the -tidine and then the proton pump inhibitors

  • esomeprazole, omeprazole

  • Although omeprazole came first

  • esomeprazole should be alphabetized before omeprazole, and this es- means that it's the S- isomer and

  • That's supposed to work a little bit better

  • Alright, let's move on to the next group. So after you have a stomachache sometimes you get diarrhea

  • So let's look at some drugs for that

  • Okay, so the we're going to do again two anti diarrheals

  • And then what we want to do is we want to do the opposite so we'll do

  • two laxatives

  • and so the anti-diarrheals we'll start with and again alphabetical order: bismuth

  • subsalicylate

  • Pepto-bismol, okay and loperamide

  • That's Imodium

  • So the -sal- is the stem s-a-l and the way to remember this is bismuth subsalicylate. It's this big pink bottle

  • many people know about it, but just recognize that bismuth subsalicylate

  • Pepto-bismol is different than Pepto Children's

  • Loperamide you see lo-

  • for slow and -per- for peristalsis

  • so slowing peristalsis or

  • Making Imodium, Imodium looks a little like immobilized, so we're slowing things down

  • If a patient has diarrhea now again, we don't use those drugs if the patient has some kind of infection

  • We'll treat that with antibiotics, but let's go to the opposite. Let's go to the laxatives on what we can use

  • Let's start with Docusate

  • And you can see as docusate or docusate sodium

  • That's Colace and then we'll also see polyethylene glycol

  • That's MiraLax.

  • Polyethylene Glycol, sort of has a stem. The p, the e, and the g tells you that it's pegylated

  • but docusate sodium I know I have it under laxative

  • It's really a stool softener, but think of the word docusate and penetrate as rhyming and then polyethylene glycol

  • this is the miracle laxative is a way you can remember it, but also

  • Colace

  • allowing the colon to race now giving a laxative

  • So we've gone from the stomach now to the intestines and

  • These have all been over-the-counter, so let me put that in front of these

  • OTC

  • OTC and

  • What we want to do is we, again, want to have a logical order of things so we're going to go from

  • OTC to Rx and

  • The Rx drugs, we'll look at are the antiemetics

  • Antiemetics are those drugs that help with nausea and vomiting and a very important drug that came out, It's called ondansetron

  • Ondansetron is [brand] Zofran and

  • It has the -setron

  • stem you'll see another couple of medications that have the -setron stem and then

  • We use promethazine

  • Which is Phenergan

  • I'm also going to put something here next to the Zofran and [it's] ODT

  • Zofran comes as an orally disintegrating tablet because

  • Sometimes if somebody's vomiting even just taking a little bit of water would make them vomit again

  • So the orally disintegrating tablet allows it to just dissolve

  • The Phenergan comes as a rectal suppository, again

  • because the patient is vomiting, they would lose the medication if they took it as a pill. It's another form

  • Okay, so what we've done is we've gone from the stomach down to the intestines

  • back up to the mouth if you want to put

  • it that way, and then we're going to go back to the intestines. There's two ways that I look at it

  • You're already there if you're thinking of the rectal suppository promethazine ulcerative colitis

  • and so the last one we're going to do is something for ulcerative colitis

  • And this drug is infliximab

  • And that's Remicade

  • "Remission Aide" so sometimes ulcerative colitis can go into remission, and that's how you remember it. This says one of the most complex stems

  • It's a monoclonal antibody so m-a-b

  • for mab, monoclonal antibody, the -li- and -xi- both have meaning and I go over into detail in the book

  • But just since we're just reviewing but the -liximab is actually the stem

  • And the monoclonal antibody doesn't tell you anything really about what it does,

  • it just tells you it's a monoclonal antibody

  • The -li- and the -xi- are much more useful because we're going to see in later chapters

  • things like Xolair

  • And etanercept and other biologics that have these complicated stems

  • But again if you're going to try to memorize it you really want to memorize the GI drugs where they're working.

  • So we went to the intestines

  • Down to the rectum with this promethazine and then ulcerative colitis

  • we would give some kind of injection of Remicade, but that's

  • The ulcers and the inflammation are there in the intestines

What I want to do is I want to go through the seven chapters

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B2 US calcium carbonate calcium carbonate histamine magnesium proton

(CC) Top 200 Drugs Chapter 1 Gastrointestinal Nursing Pharmacology by Suffix Memorizing Pharmacology

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    Mark Lu posted on 2018/06/18
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