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*

IBP IBRAHIMA
FIRST PASS HEPATIC METABOLISM
-

Swallow
;D Dmg extensive 1st pass metabolism
Drugs a- CAN'T go through
- →
is

small intestine oralroutu-noauired.mg/et-T


I

portalyinulation
D

cytochrome p450 responsible for


-
brothers -

Formation OF meds alcohol , ,

herbs , Foods 's toxins

Narrow therapeutic Index


Lithium VTSH-ratnsktornypothynidl.sn
- -

safety issues I Prescription meds


ppl 4nskforPNA Biphosphonates
-
- -

t.mg
!
immediately IF
Atendronatey
stop OF

Bkttemalabsorp . Rlseidwnate esophagitis


statin's
kidneydse
-

Atowastatin

)
omepratote
Lintwhite diazepam carbamazepine , ,
Lorastatin Donlotmixigrapefuit
Phenytoin , ketownaiote Rosurastatin juice
-

Vitti agonist -

Dlotaaysbetoresx Simran
warfarin Ltnstiof rhabdomyolysis
causelnorsensutf-DONOTUselriptsopioglilm.me
-
Abs -

NINHF Class > Chinese :


tnstiofmyopathyl rhabdomyolysis
>
stop it 1- dyspnea , Nigam cough ,
when taking slnivastatihttomgldayor
to niacin
Atypical antipsychotics
-

Risperidone ' 0kt

) ardrtype Dry
'

lonsiaotmuabono syndrome
Olanzapine
metnnidawlePOTIDVQuetiapln.ee
Lfnoosamidq
#
-
Probiotics QDBIDX
Fwm"
's'D
.ME?FftYzmBpBmY9fanniinginiaaer@ clindamycin * nikon
'


Fit
-
lap BRAMAH
DRUGS USED TO TREAT DISEASE
Digoxin #
*

/
For sand Hfdtletolvsystolicdysfxn Drugs that bleeding Risk
therapeutic range : 0.5-2.org/ML Clopidogrel -

No reversal agent
lnilialsxsofob Glsxs :
visual disturbances Lffplayo precipitate -

effective
confusion

¥:*:÷:÷:÷÷÷m :*::7in:¥Ii ÷:*


""

.
. .am.
Tx : Igceanlidigoxin CHIN crisis)
PDEs inhibitors
-

* Warfarin * LDONOI-girewhn.to -

GMOs of MIKVA
Pkg .

category X Avoid >


40mg 1dL →
prolong Qtintirval
1-
Duration of action 2-
bday,
-

.sn#:; :i o:./ i: .: m.n : nu=ormosu


:

target INRCAFIB) : 2-3 Chlorthalidone longer acting 's moreetfeetire


-

Initial dose:L-5mg POOD

consistently stable LNR VINRerery24nksuptoD.ms#KsparingDiuretios*


-

-
-

institutions:#iantiiei ngaiisi mt
" .ua.ro.


Adverse Reaction : purple toes syndrome
skin necrosis located insofar
] * Mineral corticioid
Receptor Antagonists#
breasts , eat thank -

ntinlstfewdaysof tpirinaattone-HTN.AE hirsutism

f-
-

,
,

receiving taxes Epterenoner


-

DIURETICS Adverse Effects gynecomastia


:

* Thiazide Diuretics# toaexcrutionbykianujsg BB warning tnikofbothbenigntmalignant


f. simulate osteoblasts
:

For HTNaaompaniedbyostaopenialosnkbul.la bone tumor


Adverse Effects : *
glucose

unload
/ cholesterol HDL * Loop Diuretics #
Excreted vialoopofltehle ; more potent than
CI: sulfa taboo
loop diuretics) Hotz
IBP KANHA
snorturauralion
Adverse Effects : pancreatitis jaundice, . rash
ototxicity -
-

worse 'Ao aminoglycoside

DRUGSUSEDTTTREATHTN
* BBs*

captopnilassoaatido-agranul/ ocynsis.it/carreailol
Propranolol ) non
-

cardiosuutiro blocks both betel


-

M2 neutropenia neutropenia
Atholl block beta I
( monitor OBC
) potent
more - -

cardioselectin
-

Metopwlol receptors Moistoundino


, Both AOEIARB areexactudmbreastmilk
#

Adverse Effects :
Laepression , fatigue -

oaulionouderly
ED * aB*
AF Htllneiforptso Raynaud phenomenon
Verapamil ponlotmixoeoythromyanldanthnmycin
-

* AoE/ARBs* CI: AVB Utf

Impwiouvef 's survival post MI THR


auingcbBcnitedipin.es tmonaiity
Forptseteffnfafpg
caution c- short - -

, 25% onrerapamilexp constipation .

mineralocorticoid receptor antagonist Adverse Effect: HA -


vasodilation
1st trimester category o peripheral edema
2nd 3rd
-

D
* Alpha Blockers #
* Direct Inhibits inhibitor'* Adverse Effects :
Miskin blocks
-

catalytic action Knin priapism rflomax


-

Notrewmmendedas initial Tx Ponotgireaunrigoataraettglauwmasx → FILIP't


GI: EAOEIARBS syndrome
ptssylo
angioedema

.¥int:0#mi.:.au:-monaas/
-

pregl breastfeeding Most heart attacks ocuirdurrrig Morning 16AM-

12pm)
IBP KEMBA
Bactericidal bacteria
ANTIBIOTICS f kill
-

Bacteriostat-0 limit bacterial growth ertreplicatron


-

* tetracycline's# category D
-

ftp.y neiohlamyaiaiatypicalbau-uial/HMd4-BpoBnYf /
-

Bacteriostat Antibiotic Drug Interactions


treat Acne For 13-14410 's
Macrolide -
CI: MG

Doxycycline
'LL Maidana
-

' 'M

cause, "reitano
Minocydmi -

Notusedaslstllni :
more ladrones AVOID c-
hxofjallndieel hepatitis
-

rxns

tetracycline lsthnei moderate acne , rosacea


-

tf cannot tolerate erythromycin


Adverse reaction : -

bsvutetitodahithromycin
INR14nskofbkcding-ifwarfarmterythnlswallowo.tw
Esophageal ulcerations may prolong
-

rare

glass of mycinlolanthromyoin
H2O

DONOTuscomildacnomayket e tiwn.es cephalosporin Category


oops * # B
minooyaineicanbousedasanainrnamretoretmcyuine.tw Beta lactam family

[ acne Bactericidal interfere a- cell wall


bacteria
, synthesis of actively growing
canoausercnigo -
-
morewmmonin females

resolresminl-2daysp.dk 1st gen cephalosporin grant Wai


-

L
canoausepscudomotoroerebn poor anaerobic coverage
babsorpofbiieacidseauestrants Not effective beta-lactamase 's MRSA
Frisk ofonssreauiviiy # allergic to pay
* Macrolide # Category B Hagen cephalosporin broadspeutmmabx bothgramti
.
- -
-
-

Bacteriostats'O bacteria

oorergramtwai staph ,
-
aureus , strep pyogenes 's atypical
.
3rd gen cephalosporin tesseeteetiroforgramt bacteria
-

bacteria Lbuterpwtutionagainstentewbauan.at gram -


bacteria
Associated a- More drug interaction MRSA n'Fxn -

DORIOT use cephalosporins

Erythromycin tstlinetx: TMP SMX


jpotentoyp.zan-innibito.rs
boxyoyaln.ee/treatx-b-
-

'

Uarithromyan todays
category Cfaan'thnmycin minocyainei
tuithwmycin clindamycin
Adreno Effects : cholesterol jaundice
's
risk OF Torsades de pointe
IBP MEHMET
ANTIBIOTICS Broadspeummamnolones
-

I .mn#: i :* : i n :i o-/. : : :i
INDICATIONS OF CEPHALOSPORIN or MACROUDES Lewfloxalin
Istgenoephalosponin utlcpreg) -

moxittoxauis
oepnaiexin oelmniis , impetigo Gemittoxacin
2nd genoephalosporin BB warning Krisko Achilles tendon rupture
:

ceturoxlmov Rhinoslmlsitis 0M ,
LAND sttenoualt .

: "mi÷÷÷¥÷i÷±÷
"

:÷÷:
Ceftriaxone PID , pyelonephritis ciprofloxacin anthraxlhfxhtprophyiaxis
-

aetixlmir Auton , rhinosinuslh's Ottoxacin UM pyelonephritis epididymis prostate


-

, , ,

cetdinir pyelonephritis CAP , Lerofloxacin -

Triska hypoglycemia
Pows Btoadspatmm Fluoroquinolones -

CAP , exacerbation # chronic

Amoxtaav
Didoxacillin
cystitis
Penicillinasci resistant
-

PW.ca/ulilis ,
( pyelonephritis epididymis prostatitis
bronchitis ,sinusitis , ammo

, ,

impetigo erysipelas
,
OM
Adverse Rxn OWS effects
-

QT prolongation , torsadesdepoinres
* PONS # peripheral neuropathy
Bactericidal double vision
Amoxicillin
) Bwadspeetmmpavs triskfmoprnteendonronsloroids
Ampicillin 1- probiotic.sk/ogurtdaily older 60410 >

Adverse Reaction : vaginitis -

candidate Amoxicillin Enewonsetondifiiauty walking orderutttorlo Achilles


-

Steven Johnsons syndrome tendon mplurolpeoipneralnelt


-

AVOID using Amoxicillin c- mono ocauses -

generalized rash Npathy


Luse PONVK ciprofloxacin -

best out .

against Pseudomonas aeruginosa


Llstunirdrugfortreating pseudomonas PNA
'

in

* Fluoroquinolones * pts EOF


Bactericidal Moxittoxacin -

morelikelytocauiohyperrensitiniyrxn

isomealymioalbauvnahl
gram
urcrgen
-

auireagainstgramtiaxoellentaetcstrep
also PNA)
lap KEMBA
ANTIBIOTICS IOTCDRUGSORLRHERBS

"÷:÷÷÷÷÷÷÷÷:÷: :÷
* SULFONAMIDES # category C -

-
* topical nasal Decongestants #

.am#lMeditaranean-/snortrepmusuCL:66PD-
'm
Bacteriostat HIKMET .AT#YfnEn6PDExi0xymetazollnoNasalsprayCAt- RIN)
Gram bacteria
frailty
-

hemolysis Coridotoeatingfarabeans)
medicamentosa-ohwmiuse73dayspreginordnima.tw
causes rhinitis
tniskoffbitirubinlkerniotems
-

Drug Interactions: warfarin * Antihistamine #


ASKMIIOIU Loratadivic Foretderlypts
-

nonbllstunngmorbiliiformrash
Adverse Effects : Fever , Ltlricidenoeof sedation
EUTonwarfarinshouldwotbegireno-TMP-SMX-tn.sk

:÷÷÷:÷:÷÷÷÷÷÷÷:: : m mm * Antitussives#
.

whirring
%ff wajmf hf pnngstynjtms.fm begqegqyn.thorpnano-minkldaysot-mao.is/
CAPSAICIN
-

.im#n.i:oin:or. .
NSAIDS
Forneuropatnicpain
Warnings :
Maytakeuptohwkstowork
AVOIDED n' Hfiserereclbse cause
temporary banning sensation
DONOTUIUON broken skin

÷: :÷÷÷:÷÷÷÷:÷÷:*:::
COX -2 inhibitors -

brisk of 6113

May worsen HTN controlled BP


'

in pts c-
lap KANHA

.fi#o: i: :i En:i :i anm


IMMUNE SYSTEM DRUGS OTHER DRUGS at
TOPICAL serows
SAFETY ISSUES
Clobetasol -

superpotent COLOSSI)
"

÷:÷÷÷÷÷÷:* .. ..
.

Acutance cataracts -

knight vision ,

Ultra potent steroids should NOT be occluded for >Inks auto anglo closure
Topamax glaucoma
- -

sererecaseofpoisonivyloakrashrequliekl -21 days 4kt mydriasis ,

OF oral steroids Magnani neuropathy permanent loss


-

, # vision
# I

/
* a'sapriaotx
ILLEGAL DRUGS
Finna.mg?FIno9hsoaraiaoanny+nmias
"

¥ggymna¥s*
psychomotor effects lasts 12-240 * Theophylline Interaction #
Dmg
-515
Level MOGIML
-
!

US FDA DEA Toxicity e' exp persistent vomiting


-

-
-

FDA Drug classifications


'

schedule -1 -

Heroin ectdsy
,

Illegal prescribe
to Pregnancy
!
LID ,
include into potential risks
I -

Narcotics totems
IT -

Tylenol iodine ,
Vicodin ,testosterone Lactation :
Nsg Mothers
.
,
med notated for
13205 , Ambient lunula, Soma Breastfeeding
wughmodciwdaneiaomotil , Females 's mates of Reproductive Potential :
lyrical Effect on Fertility , prey
resting Hoss
wdBirth control
'
Finasteride't
ftp.agelprgwomensnouid/HERBAL#ADan-nisoA
NOT handle this med Feverfew
Isoflawnes
-

migraine'rHA
-

estrogen like
effects
-
Saw Palmetto -

of BPH
urinalysis
MANNE HMMM 8mm.EMRMEIEIAIMWEMBHROB.li " WAN

4fIY¥Hi9an|
US HEALTH STATISTICS
* skinonwunsaingtx
* Leading cause of mortality BY age group # ages 10-240 fair skin
Age I -44410 unintentional injuries

tnenttttattageusxswnosmoned
kscreeningoutz
USPSTF
* Dmt
* Aspirin prevent all } Colorectal At#
use to Age 40 Toitorerntlobeser
-

Age 50-59021040 Ohsnik


-

÷ ÷ ÷: ÷: :÷ : ÷
c- life
expectancy of atleast IOYB VACCINES
* Breast CA # * Pneumococcal vaccine#
start at age 50410 repeat every 2yB until 74410
, age 6514 -

give PCVBIA rpkmos


-
administer
cprernar)
ppsrzzcpnusmorax)
* colorectal Atx

stan-atage.JO -75410 * shingles vaccine#


..

:÷÷÷÷÷÷÷÷÷÷÷÷÷:
*
"

loyrnstiabetentzlo.to
7618 MOHXOFMIIAA

* Lung Atx
smoke palkyrslquitm past B-yrs
ago -5g -80ps annual screening Etidosect
-

* Ovarian OAK start at age 30410


Very prism : transraginaiutzoserumat antigen

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