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