GPAT Important content

FROM SHIKIMIC ACID PATHWAY

Ornithine derived
1. L-hyoscymine (phenylalanine) 2. Tropine 3. Nicotine 4. Cocaine

Lysine derived
1. Lupinine 2. Anabasine 3. Isopelletietine

Phenylalanine derived
1. Ephedrine 2. Mescaline

Tyrosine
1. Papaverine 2. Thebaine 3. Codeine 4. Morphine 5. Emetine 6. Colchicine

Tryptophan derived
1. Cinchonine(other-secocoganin) 2. Reserpine 3. Quinine 4. Quinoline

Shikimic acid gives aromatic amino acids (phenylalanine,tyrosine,tryptophan)

Squalene is precursor of beta- amyrin
Cholesterol is da precursor for diosgenin, yamogenin, sarsapogenin, tigogenin.

Cyanogentic glycosides (from shikimic acid pathway)

1. Phenyl alanine-phenacin 2. Tyrosine-dhurrin 3. Valine-? 4. Isoleucine-?

Anti biotic source Anti biotic source Anti biotic source Anti biotic source

Chloramphenicol- s.venizulae
Bacitracin- b.subtilis
Polymyxin- b.polymyxa
Rifampicin- s.mediterraniae
Sreptomycin- s.griseus
Penicillin- p.notatum and p.chrysogenum
Amphotericin b- s.nodosus
Nystatin- s.noursei
Neomycin- s.fradiae
Kanamycin- s.kanamyceticus
Gentamycin- micromonospora purpurea(gram -ve
Cephalosporins- c.acremonium
Cephalosporin n- penicillum sps
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Cephalosporin p- fusidium coccineum

Paramomycin- s.rimosus(antehelmenthic)
Oxytetracyclin- s.rimosus
Mitomycin - s.caespitotus
Rubidomycin- coeruleorubidus
Cycloserine- s.orchidaceous
Capreomycin- s.capreolus

URINE COLOUR CHANGES

Orange- Rifampcin , Phenozopyridine, Doxorubicin, Warfarin

Blue- Amitryptalline , Indomethacin
Red/Brown- Food Dyes
Pink- Beet Root
Golden Yellow- Excess of laxatives
Neon Yellow- Excess of vitamin supplements

Descriptive terms for solubility

Very soluble less than 1

Freely soluble From 1 to 10
Soluble From 10 to 30
Sparingly soluble From 30 to 100
Slightly soluble From 100 to 1000
Very slightly soluble From 1000 to 10,000
Insoluble More than 10,000
IP 2010

This new edition of the indian pharmacopoeia entitled 6th edition (indian pharmacopoeia 2010)
is published by the indian pharmacopoeia commission (ipc) in accordance with a plan and
completed through the untiring efforts of its members, secretariat and laboratory over a period of
about two years. It supersedes the 2007 edition but any monograph of the earlier edition that
does not figure in this edition continues to be official as stipulated in the second schedule of the
drugs and cosmetics act, 1940.

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Common ADRs ( Adverse Drug Reactions)

1 Grey Baby Syndrome chloramphenicol

2. Pin Point Pupil morphine
3 Reyes Syndrome asprin
4. Urine Coloration rifampcin
5. Frontal Headache indomethacin
6. Captopril persistant dry cough
7. Bleomycin pulmonary fibrosis
8. Vancomycin red man syndrome
9. Nicotinic acid flush
10. Steven Johnsons syndrome allopurino
11).sulphonamides kernicterus
12).aminoglycosides ototoxicity
13).discolouration of teeth tetracyclines
14) doxorubucin & duanorubucin cardiomyopathy.
15). chloroquine cardiotixicity
16). doxycycline Esophageal Ulceration
17). vincristin & vinblastin Neuropathy
18). cyclophosphamide Alopecia
19). cimetidine & spironolactone Gynaecomastia

Drug & its analogue

Zidovudine - Thymidine
Didanosine- Deoxyadenosine
Lamivudine- Cytosine
Stavudine- Thymidine
Abacavir- Guanosine
Ganciclovir- Acyclic analogue of guanosine
Zalcitabine- Homologue of cytosine
Foscornet- Pyrophosphate
Tribavirin- Guanosine
Sulphonamide- Paba
Mithotrixate & folate = pteridin
Streptomycin = Streptidin
Gentamycin = Deoxy streptamine
Aztreonam = Mono bactam
Cephalosporin = Cepham
Merapenam , imipenam = Carbapenam

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Clavulanic acid = Oxapenam

Pencillin = Penam
Ethacrynic acid = Phenoxy acitic acid
Metrindazole = 1,2,4 thiazolidin
Amiloride = Pyrazin & guanidin
Spiranolactone = Thioacetic acid at 6th position
Atorvastatins- Pyrrole
Fluvastatins- Indole
Cerivastatins- Pyridine
Rosuvastatins- Pyrimidine
Fibrates- Isobutyric acid derivatives
Aziritidine- Ezetimibe
Pyrazine- Acipimox
Acetazolamide- 1,3,4-thiadiazole
Thiazide- 1,2,4-thiadiazine

DRUGS APPROVED IN 2011:-

1. EDARBI (azilsartan medoxomil) For the treatment of hypertension.

2. GRALISE (gabapentin) For the treatment of prosthetic neuralgia.
3. SYLATRON (peginterferon alfa-2b) For the treatment of melanoma.
4. YERVOY (ipilimumab) For the treatment of metastatic melanoma.
5. DUEXIS (ibuprofen and famotidine) For the relief of rheumatoid arthritis and osteoarthritis
and prevention of Gastric ulcers.
6. BENLYSTA (belimumab) For the treatment of systemic lupus erythematosus.
7. DALIRESP (roflumilast) For the treatment of chronic obstructive pulmonary disease.
8. ACTEMRA (tocilizumab) For the treatment of systemic juvenile idiopathic arthritis.
9. ABSTRAL (fentanyl sublingual tablets) For the treatment of break through cancer pain in
opioid-tolerant patients.
10. HORIZANT (gabapentin enacarbil) For the treatment of restless legs syndrome.
11. VIIBRYD (vilazodone hydrochloride) For the treatment of major depressive disorder.
12. MAKENA (hydroxy progesterone caproate injection) For the prevention of risk of prterm
birth.
13. VANDETANIB (vandetanib) For the treatment of thyroid cancer.
14. AFINITOR (everolimer) For the treatment of advanced pancreatic neuro endocrine tumors.
15. SUTENT (sunitinib malate) For the treatment of pancreatic neuro endocrine tumors.
16. TRADJENTA (linagliptin) For the treatment of type II diabetes.
17. INCIVEK (telaprevir) For the treatment of genotype I chronic hepatitis c.
18. VICTRELIS (boceprevir) For the treatment of chronic hepatitis c genotype I.
19. EDURANT (rilpivirine) For the treatment of HIV-I.
20. ZYTIGA (abiraterone acetate) For the treatment of prostate cancer.
21. POTIGA (ezogabine) For the treatment of seizures.
22. CREON (pancrelipase) Patients with exocrine pancreatic insufficiency due to cystic
fibrosis.
23. NULOJIX (belatacept) Treatment for organ transplant-rejection prophylaxis.

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24. ISTODAX (romidepsin) Treatment for: with peripheral T-cell lymphoma who have
received at least One prior therapy.
25. OXECTA (oxycodone) For the treatment of pain.
26. RECTIV (nitroglycerin) ointment For the treatment of anal fissure and fistula.
27. LAVIV (azficel-T) For the treatment of wrinkles.
28. ZUTRIPO (chloropheniramine, hydrocodone & pseudoephedrine) For the treatment of
cough and nasal congestion.
29. REZIRA (hyrocodone and pseudoephedrine) For the treatment of cough and nasal
congestion.
30. FLUZONE (influenza virus vaccine,inactivated) Fluzone intradermal-sanofi pasteurs new
influenza vaccine delivered by Intradermal microinjection.

Emulsifiers with HLB Values:-

HLB values sorted by HLB from lowest to highest:

Glycol Distearate HLB = 1

Sorbitan Trioleate HLB = 1.8
Propylene Glycol Isostearate HLB = 2.5
Glycol Stearate HLB = 2.9
Sorbitan Sesquioleate HLB = 3.7
Glyceryl Stearate HLB = 3.8
Lecithin HLB = 4
Sorbitan Oleate HLB = 4.3
Sorbitan Monostearate NF HLB = 4.7
Sorbitan Stearate HLB = 4.7
Sorbitan Isostearate HLB = 4.7
Steareth-2 HLB = 4.9
Oleth-2 HLB = 4.9
Glyceryl Laurate HLB = 5.2
Ceteth-2 HLB = 5.3
PEG-30 Dipolyhydroxystearate HLB = 5.5
Glyceryl Stearate SE HLB = 5.8
Sorbitan Stearate (and) Sucrose Cocoate HLB = 6
PEG-4 Dilaurate HLB = 6
Methyl Glucose Sesquistearate HLB = 6.6
Lecithin HLB (variable) PEG-8 Dioleate HLB = 8
Sorbitan Laurate HLB = 8.6
PEG-40 Sorbitan Peroleate HLB = 9
Laureth-4 HLB = 9.7
PEG-7 Glyceryl Cocoate HLB=10
PEG-20 Almond Glycerides HLB = 10
PEG-25 Hydrogenated Castor Oil HLB = 10.8
Stearamide MEA HLB = 11

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Glyceryl Stearate (and) PEG-100 Stearate HLB = 11

Polysorbate 85 HLB = 11
PEG-7 Olivate HLB = 11
Cetearyl Glucoside HLB = 11
PEG-8 Oleate HLB = 11.6
Polyglyceryl-3 Methyglucose Distearate = 12 Oleth-10 HLB = 12.4
Oleth-10 / Polyoxyl 10 Oleyl Ether NF HLB = 12.4
Ceteth-10 HLB = 12.9
PEG-8 Laurate HLB = 13
Cocamide MEA HLB = 13.5
Polysorbate 60 NF HLB = 14.9
Polysorbate 60 HLB = 14.9
Polysorbate 80 HLB = 15
Isosteareth-20 HLB = 15
PEG-60 Almond Glycerides HLB = 15
Polysorbate 80 NF[ HLB = 15
PEG-20 Methyl Glucose Sesquistearate HLB = 15
Ceteareth-20 HLB = 15.2
Oleth-20 HLB = 15.3
Steareth-20 HLB = 15.3
Steareth-21 HLB = 15.5
Ceteth-20 HLB = 15.7
soceteth-20 HLB = 15.7
Polysorbate 20 HLB = 16.7
Polysorbate 20 NF HLB = 16.7
Laureth-23 HLB = 16.9
PEG-100 Stearate HLB = 18.8
Steareth-100 HLB = 18. 8
PEG-80 Sorbitan Laurate HLB = 19.1

List of drugs which are approved by FDA in liposomal drug delivery systems.
Amphotericin B : Amphoterecin B is an antibiotic and is an antifungal drug, it is required to
be injected intravenously and has some seriously bad side effects like acute reaction and fever
with chill , nausea, anorxia and weekness, all these side effects depend up on the concentration
of Amphoterecin B
Cytarabine (Ara-C ) : is an anticancer drug it is an nucleotide anti metabolite drug , and is
cytotoxic , it also brings damage to other tissue cells when it come in contact with other normal
tissue cells , along with cancer cells . Formulations of Cytarabine (Ara-C) in liposome
reduce its untoward toxic effect on other tissue cells,

Cyclophosphamide : It is a anticancer drug , like cytrabin it too has cytotoxicity it belonging

to category cyclic nitrogen mustard. These drugs are very unstable in biological fluids in fact it
is a prodrug which when come in contact with biological fluid at ph 5 to 7 becomes active and
exert their effect and kill cancer cell by alkylating DNA and thus making it inactive for any

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activity they are called as alkylating agents, Formulating cyclophosphamide in liposomes

help in reducing its cytotoxic effects , as the drug concentration required for desired
anticancer effect .
Doxorubicin: It is also an anticancer drug it is an antibiotic drug and has similar cytotoxic
effects of anticancer chemotherapy, formulations of liposome formulations of these drug help in
bringing down their cytotoxicity andand help in optimizing therapeutic efficacy.

Hepatitis A and Influenza vaccines: Vaccines are developed in liposome to render their
untoward sensitizing effect on immune system, further they can be combined with
polyethylene glycol which further render vaccines less immunogenic and specific.
Verteporfin: It is a drug used as photosesitizer in photodynamic therapy for macular
degeneration, it is used to treat and eliminated damaged tissue in macular region during macular
degeneration.This drug absorbs energy from light at 693 nm and produce reactive oxygen ,
which help in treating damaged blood vessels in eye. Liposome help in optimizing the therapy
with minimal concentration of drug and and targeting the damaged tissue.

CAPSULE NO & THEIR APPROXIMATE CAPACITY IN mg & ml

CAPSULE NO mg ml
000 - 950 - 1.37
00 - 650 - 0.95
0 - 450 - 0.68
1 - 300 - 0.50
2 - 250 - 0.37
3 - 200 - 0.30
4 - 150 - 0.21
5 - 100 - 0.13

PROPORTIONS REQUIRED FOR A PRIMARY EMULSION

(oil: water: gum)

Fixed oils :- 4: 2: 1
Volatile oils:- 2: 2: 1
Mineral oils:- 3: 2: 1
Oleoresins:- 1: 2: 1
CODE: LPSO ( apply this for tweens & spans)

for eg .. spans 20 mean sorbitan mono laurate

tween 80 mean Polyoxyethylene sorbitan monooleate

L : Laurate - 20
P : Palmitate - 40
S : Stearate - 60
O : Oleate - 80

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STORAGE TEMPERATURE
Cold - 2 - 8 degree centi
Cool - 8 - 25
Room - temp prevailing in the working area
Warm - between 30 - 40
Excessive heat - > 40 degree

SUCROSE BASED DILUANTS

Dipac - 97 % sucrose + 3% moddified dextrose

Nutab - 95 % sucrose + 4 % invert sugar
Sugar tab - 90 - 93 % sucrose + 7 - 10 % invert sugar

Compressibility index / carrs index = tapped density - bulk density / tapped density
hausners ratio = tapped density / bulk density

% CI RATIO FLOW CHARACTER HAUSNER

< or = 10 excellent 1 - 1.11
11 - 15 good 1.12 - 1.18
16 - 20 fair 1.19 - 1.25
21 - 25 passable 1.26 - 1.34
26 - 31 poor 1.35 - 1.45
32 - 37 very poor 1.46 - 1.59
>38 very very poor > 1.6

ANGLE OF REPOSE FLOW CHARACTER

25 - 30 - Excellent
31 - 35 - Good
36 - 40 - Fair
41 - 45 - Passable
46 - 55 - poor
56 - 65 - Very poor
>66 - very very poor
Types of Glass used in Pharmaceutical Industries
Parenteral Use Type I Glass: Highly Resistant Borosillicate.
Used for Buffered and Unbuffered aqueous solution.

Type II Glas:
Highly Resistant Sodalime glass.
Buffered aqueous solution below pH 7.0

Type III Glass:

Moderately Resistant Sodalime glass.
Used for dry powder and oily solution.

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Non-Parenteral Use
Type IV Glass:
General Purpose Sodalime glass.

SYNONYMS AND THEIR COMMON NAMES

SYNONYM - COMMON NAME

Rochelle salt - sodium potassium tartarate
Dakins solution - sodium hypochloride
Glaubers salt - sodium sulphate
Epsom salt - magnesium sulphate
china clay - heavy kaolin
Gypsum - calcium sulphate
Calomel - mercurous chloride
Soap clay - bentonite
French chalk - talc
Alum - potassium aluminium sulphate
Hypo - sodium thiosulphate
precipitated chalk - calcium carbonate
Slaked lime - calcium hydroxide
Bleaching powder - chlorinated lime
Burrows solution - aluminium acetate solution
laughing gas - nitrous oxide
Lugols solution - aqueous iodine solution
Iodine tincture - weak iodine solution
knock out drops - chloral hydrate

VACCINES

VACCINES LIVE ATTENUATED 1. Measles

2. Mumps
3. Polio
4. Rubella
5. Typhoid
6. Varicella
7. Tuberculosis
8. Yellowfever
INACTIVATED: 1. Rabies
2. Influenza
3. Tetanus
4. Hepatits a
RECOMBINANT: HEPATITIS B
TOXOID: Diptheria
Tetanus

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Test Organism For Microbiological Assay Of Antibiotics

ANTIBIOTIC - TEST ORGANISM
Amikacin - Staphlococcus aureus
Amphotericin B - Saccharomyces cerevisiae
Bacitracin - Micrococcus luteus
Bleomycin - Mycobacterium smegmatis
Carbenicillin - Pseudomonas aeruginosa
Doxycycline - Staphlococcus aureus
Erythromycin - Micrococcus luteus
Framycetin - Bacillus pumilis , staphylococcus aureus
gentamycin - Staphylococcus epidermidis
Kanamycin - Bacillus pumilis, staphylococcus aureus
kanamycin B - Bacilus subtilis
Neomycin - Staphlococcus epidermidis
Novobiocin - Staphlococcus epidermidis
Oxyteracycline - Bacillus cereus, staphylococcus aureus
Polymyxin B - Bordetella bronchiseptica
Rifamycin - Bacillus subtilis
Streptomycin - Bacillus subtilis , klebsiella pneumoniae
Tetracycline - Bacillus cereus, staphylococcus aureus
Nystatin - Saccharomyces Cerevisiae

Disease associated with altered neurotransmitters levels in brain

Parkinsonism : Decreased DOPAMINE in striatum

Schizophrenia : Increased DOPAMINE levels
Depression : Decreased NOREPINEPHRINE & 5-HT
Mania : Decreased NOREPINEPHRINE & 5-HT
Hallucination : Increased 5-HT
Alzhiemer's : Decreased ACETYLCHOLINE & Destruction of Cholinergic
Neurons
Athetosis : Decreased GABA in Putamen
Chorea : Decreased GABA in Caudate Nucleus
Amyotropic lateral sclerosis: Decreased ACETYLCHOLINE

Enzymes And Their Metal Cofactors

FE2+ - CYTOCHROMEOXIDASE, CATALASE, PEROXIDASE
CU2+ - CYTOCHROME OXIDASE
ZN2 + - DNA POLYMERASE, CARBONIC ANHYDRASE, ALCOHOL
DEHYDROGENASE
MG2 + - HEXOKINASE, GLUCOSE-6-PHOSPHATE
MN2+ - ARGINASE

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K+ - PYRUVATE KINASE
NI2+ - UREASE
MO - NITRATE REDUCTASE
SE - GLUTATHIONE PEROXIDASE

Microsomal Enzymes Inducers And Inhibitors

Microsomal Enzyme Inducers Microsomal Enzyme Inhibitors

Alcohol Allopurinol
Chloralhydrate Oral antidiabetics
Cortisone Disulfiram
Nicotine Metronidazole
Prednisoslone Oral anticoagulants
Phenytoin Anabolic agents
Chlordiazepoxide Chloramphenicol
Imipramine Isoniazid
Phenobarbital Monoamine oxidase inhibitors
Testosterone Cemetidine

Disease And Their Defective Enzyme

Albinism - tyrosine-3-mono oxygenase

Alkaptonuria - homogentisate1,2-dioxygenase
Galactosemia - galactose-1-phosphate iridylyl transferase
Homocystinuria - cystathione B- synthase
Phenylketonuria - phenylalanine-4-mono oxygenase
Taysachs disease - hexosaminidase A
Hypervalinemia - valine transaminase
Arginosuccinic - arginosuccinate lyase acidemia
krabbes disease - beta galactosidase
Fabrys disease - alpha galactosidase
Niemann pick disease - sphingomyelinase
farbers disease - ceramidase
gauchers disease - beta gluosidase

Diagnostic Tests for Diseases

a)Syphilis- VDRL test,kahn test,wasserman test Treponema immobilization

test,
Fluroescent antibody-absorbed serum test.
B)Diptheria- Schick test,elex test

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C) T.B- Tuberculin,mantoux test

D) leprosy- Lepromin tsest
E)typhoid or enetric fever- Widal test
F)Rhumetoid arthritis- Rose water test
G) Small pox- Ouchterlony
E)Pneumonia- Cold hemaglutination test, streptococcus MG hemaglutination test
F)brucellosis- Coombs test(opsonization test)
G)lymphogranuloma venerum- Frei test

H)typhus fever- Weil felix test

I)hemophillius- Ducrey test
G) scarlet fever- Dick test
H)to detect human chornic Radio immuno assay(RIA)
gonadotrophin in serum of
woman-

Bioassays Of Drugs

Adrenaline - bp raising effects in spinal cats

noradrenaline- bp raising effects in spinal cats
histamine- contraction of isolated guinea pig ileum
insulin- hypoglycemic convulsions in mice
acetylcholine- contraction of isolated frog rectus muscle
d-Tc - rabbit head drop due to pralysis of neck muscles
digitalis- death due to cardiac arrest in guinea pig
oxytocin- contraction of guinea pig uterine muscles
androgens - growth copons comb
adreno cortico tropic hormone- adrenal ascorbic acid estimation in
hypophysectomised rats

Classification Of Potassium Channel Openers

Benzopyran derivatives:
kromokalmn
bimakalim
erikalim

Biological indicators in sterilization

Moist heat sterilisation (121 degre Centi ): Bacillus stearo thermophilus

Dry heast sterilisation (160 degre centi) : Bacillus subtilis var niger
Hydrogen peroxide and peracetic acid : Bacillus stearo thermophilus
Ethylene oxide , formaldehyde : Bacillus subtilis var niger
Ionising radiation Bacillus pumilis

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Tests and their uses

watson schwartz test - urobilinogen
schumms test - heme
carrprice test - vit A
gmelins test - bile pigments
gothlin test - scurvy
gofmann test - serum cholesterol
murexide test - uric acid
reinsch test - heavy metals
gordons test - spinal fluid
biuret test - peptides
legals test- for estimation of acetone
ames test - carcinogenicity

Side Effects Nd Shortcuts

Morphine side effects :MORPHINE

Myosis
Out of it(sedation)
Respiratory depression
Pneumonia(aspiration)
Hypotension
Infrequency(constipation,urina
ry retention)
Nausea
Emesis

Aspirin side effects :ASPIRIN

Asthma
Salicylism
Peptic ulcer disease/phosphorylation-oxidat
ion uncoupling/platelet disaggregation
Intestinal blood loss
Reye's Syndrome
Idiosyncracy
Noise(tinnitus)

SSRIs side effects :SSRI

Seratonin syndrome
Stimulate CNS
Reproductive disfunction in male
Insomnia

Inhalation anesthetics : SHINE

Sevoflane
Halothane
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Isoflurane
Nitrous oxide
Enflurane

Teratogenic drugs :"Win TERATogenic

Warfarin
Thalidomide
Epileptic drugs:Phenytoin,Valproate,Carb amazepine
Retinoid
ACE inhibitor
Third element :Lithium

Gynaecomastia causing drugs:DISCOS

Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens
Stilboestrol

Methyldopa Side effects :METHYLDOPA

Mental retardation
Electrolyte imbalance
Tolerance
Headache/ Hepatotoxicity
psYcological upset
Lactation in female
Dry mouth
Oedema
Parkinsonism

Antirheumatic agents :CHAMP

Cyclophosphamide
Hydroxycloroquine and choloroquinine
Auranofin and other gold compounds
Methotrexate
Penicillamine

Phenytoin: adverse effects PHENYTOIN

P-450 interactions
Hirsutism
Enlarged gums
Nystagmus
Yellow-browning of skin
Teratogenicity
Osteomalacia
Interference with B12 metabolism (hence anemia)
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Neuropathies: vertigo, ataxia, and headache

Sodium Valproate side effccts VALPROATE

Vomiting Alopecia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Appetite increase
Tremor
Enzyme inducer (liver)

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

Antiparkinson Drugs :SALAD

Selegiline
Anticholinenergics (trihexyphenidyl, benzhexol, ophenadrine)
L-Dopa + peripheral decarboxylase inhibitor (carbidopa, benserazide)
Amantadine
Dopamine postsynaptic receptor agonists (bromocriptine, lisuride, pergolide)

CAPTOPRIL Side effects CAPTOPRIL

Cough Angioedema
Agranulocystosis
Proteinuria/ Potassium excess
Taste changes
Orthostatic hypotension
Pregnancy contraindication/ Pancreatitis/ Pressure drop (first dose
hypertension)
Renal failure (and renal artery stenosis contraindication)/ Rash
Indomethacin inhibition
Leukopenia/Liver toxicity

Lithium: side effects LITH

Leukocytosis
Insipidus [diabetes insipidus, tied to polyuria]
Tremor/ Teratogenesis
Hypothyroidism

Myocardial Infarction(MI): signs and symptoms PULSE

Persistent chest pains
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Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating

MI: basic management BOOMAR

Bed rest
Oxygen
Opiate
Monitor
Anticoagulate
Reduce clot size

Treatment of Heart Failure: ABCDE

ACE inhibitors
Beta-blockers
Calcium channel blockers
Diuretics
Endothelin-converting enzyme inhibitors

Essential Amino acids

My True Love Is Throug Valentine Love Phrases
Methionine
Threonine
Leucine
Isoleucine
Tryptophan
Valine
Lysine
Phenyl alanine

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