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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2018)
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Page 245 -

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First Aid for the USMLE Step 1 (2018) | Medicine (MD/DO) School Study Aid

Page 245 -
34 Picmonics to Learn | 1 hr 3 mins
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
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2 mins
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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2 mins
Linezolid (Zyvox)
Mechanism Of Action
Oxazolidinone Antibiotic
Binds 23S rRNA of 50S Subunit
Inhibits Protein Synthesis
Indication
Gram-Positive Organisms
MRSA
VRE (Vancomycin Resistant Enterococci)
Side Effects
Bone Marrow Suppression
Decreased Platelet Count
Peripheral Neuropathy
Lactic Acidosis
Serotonin Syndrome
Considerations & Patient Education
Avoid Tyramine Containing Foods
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4 mins
Cyclophosphamide
Mechanism
Requires Bioactivation by Liver
Cross-links DNA
Guanine N7 Position
Indications
Autoimmune Disorders
Leukemia
Lymphoma
Solid Tumors
Side Effects
Myelosuppression
Hemorrhagic Cystitis
Prevent with Mesna
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3 mins
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
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3 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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2 mins
Fluoroquinolones Toxicities
Diarrhea
Skin Rash
Headache
Tendon Rupture in Adults
Myalgias in Kids
Damage to Cartilage
Teratogen
QT Prolongation
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1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Daptomycin (Cubicin)
Mechanism Of Action
Lipopeptide Antibiotic
Disrupts Cell Membrane
Causes Rapid Depolarization
Indication
Gram-Positive Cocci
MRSA
Side Effects
Myopathy
Rhabdomyolysis
Peripheral Neuropathy
Considerations & Patient Education
Inactivated by Surfactant
Not Used (Avoid) for Pneumonia
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3 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
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1 min
Ganciclovir
Indications
Cytomegalovirus (CMV)
Immunocompromised
Mechanism
Guanosine Analog
Disrupts DNA Synthesis
Inhibits Viral DNA Polymerase
Side Effects
Hematologic Effects
Nephrotoxicity
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1 min
Carbamazepine
Indications
First-line Seizure Medication
First Line for Trigeminal Neuralgia
Mechanism of Action
Stabilizes Inactive State of Na+ Channels
Side Effects
Stevens-Johnson Syndrome
Induce Cytochrome P450
Teratogen
Hepatotoxicity
Blood Dyscrasias
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2 mins
Protease Inhibitors
End in "-navir"
Indications
HIV/AIDS
Hepatitis C
Mechanism
Inhibit Protease
Unable to Cleave Proteins
Inhibits Maturation of New Virus
Side Effects
GI Distress
Nephropathy
Lipodystrophy
Hyperglycemia
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3 mins
Lamotrigine
Indications
Seizure Treatment
Bipolar Disorder
Mechanism of Action
Blocks Voltage-Gated Na+ Channels
Side Effect
Stevens-Johnson Syndrome
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1 min
Sulfa Drug Allergies
Sulfasalazine
Sulfonylureas
Thiazide Diuretics
Acetazolamide
Furosemide Diuretic
Celecoxib
Probenecid
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49 secs
Phenytoin
Indications
Status Epilepticus
Tonic-Clonic Seizures
Mechanism of Action
Blocks Na+ Channel Activation
Inhibition of Glutamate Release
Class IB Antiarrhythmic
Side Effects
Teratogenic
Macrocytic Megaloblastic Anemia
Induce Cytochrome P450
Drug-induced Lupus
Neuropathy
Hirsutism
Gingival Hyperplasia
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1 min
Hydralazine
Indications
Reduce Afterload
Severe Hypertension
Safe during Pregnancy
CHF
Mechanism of Action
Increases cGMP
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
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1 min
Valproic Acid (Valproate) Side Effects
V-A-L-P-R-O-A-T-E
Vomiting
Alopecia
Liver Toxicity
Pancreatitis/Pancytopenia
Retain Fat (Weight Gain)
Oedema (Edema)
Appetite Increase
Tremor
Enzyme Inhibitor (P450)
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2 mins
Statins
Rhabdomyolysis
Hepatotoxicity
HMG-CoA reductase inhibitors
Decrease LDL
Decrease Triglycerides
Increase HDL
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2 mins
Clozapine (Clozaril)
Mechanism
Atypical Antipsychotic
Indications
Schizophrenia
Levodopa-Induced Psychosis
Side Effects
Weight Gain
Hypersalivation (Sialorrhea)
Myocarditis
Agranulocytosis
Sedation
Orthostatic Hypotension
Constipation (Risk of Bowel Ileus)
Considerations
Weekly Lab Tests
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2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
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1 min
Niacin Therapy (Vitamin B3)
Mechanism
Inhibits Lipolysis in Adipose Tissue
Reduces Hepatic VLDL Secretion
Indications
Decrease Triglycerides
Decrease LDL
Increase HDL
Side Effects
Flushing
Decreased by Aspirin
Hyperglycemia
Hyperuricemia
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2 mins
Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
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1 min
Penicillin
Gram Positive
Spirochetes
Bind PBPs
Block Transpeptidase Cross-linking of Cell Wall
Activate Autolytic Enzymes
Bactericidal
Hypersensitivity Reactions
Hemolytic Anemia
Beta-lactamase Sensitive
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2 mins
Fibrates
Indications
Hyperlipidemia
Mechanism of Action
Upregulate LPL
Decreases Triglycerides
Slight Increase in HDL
Slight Decrease in LDL
Side Effect
Hepatotoxicity
Cholesterol Gallstones
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1 min
Aromatase Inhibitors
Indications
Estrogen Receptor-positive (ER+) Breast Tumors
Systemic Metastases
Drugs
Reversible, non-steroid
Letrozole
Anastrozole
Irreversible, steroid
Exemestane
Side Effects
Osteoporosis
Arthritis
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1 min
Cephalosporins Overview
Mechanism of Action
Beta lactam drug
Inhibits cell wall synthesis
Bactericidal
Side Effects
Hypersensitivity reactions
Vitamin K Deficiency
Disulfiram like reaction with Alcohol
Increased Nephrotoxicity of Aminoglycosides
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1 min
Propylthiouracil (PTU) and Methimazole (MMI)
Indications
Hyperthyroidism
Mechanism
Inhibits Thyroid Peroxidase
PTU Blocks Peripheral Conversion of T4 to T3
Side Effects
Agranulocytosis
Skin Rash
Hepatotoxicity (PTU)
Teratogen (MMI)
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1 min
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
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2 mins
Proton Pump Inhibitors (PPIs)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Inhibit H+/K+/ATPase
Side Effects
Hip fracture
Pneumonia
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2 mins
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
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4 mins
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
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2 mins
Metoclopramide
Indications
Antiemetic
Promotility Agent
Mechanism
Increased Resting Tone
Antagonist at D2 Receptor
Side Effects
Parkinsonian Symptoms
Galactorrhea
Contraindication
Small Bowel Obstruction
Parkinson's Disease
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2 mins

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