Causes Of Drug-induced Lupus

Cytochrome P450 Inducers & Inhibitors

The main ones can be remembered using "CRAP GPs spend all day on SICKFACES.COM".

Cytochrome P450 Inducers

These induce CYP450 activity, and thus reduce the concentration of drugs which are metabolised by this system.

Carbemazepine Rifampicin Alcohol (chronic use) Phenytoin Griseofulvin Phenobarbitone Sulphonylureas, St John's Wort, Smoking

Also topiramate.

Cytochrome P450 Inhibitors

These inhibit CYP450 enzyme activity and thus increase the concentration of drugs which are metabolised by this system.

Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol (acute use), Amiodarone, Allopurinol Chloramphenicol Erythromycin Sulfonamides, SSRIs Ciprofloxacin Omeprazole Metronidazole

Also grapefruit, cranberry juice, diltiazem, verapamil, clarithromycin.

Common Interactions

Medications which commonly interact with CYP450 inhibitors and inducers are:

Warfarin

Phenytoin

Combined Oral Contraceptive Pill (COCP)

Theophylline

Corticosteroids

Tricyclic antidepressants

Statins

Lamotrigine

Midazolam

Basic pharmacology of neuromuscular junction

ACh acts on N2 receptors (ligand-gated Na+/K+ receptors)

Block Na+ channels that propagate nerve impulse - local anaesthetics (lidocaine), tetrodotoxin

Inhibit ACh release - tetanus toxin, botulinum toxin

Competitive antagonists - vecuronium

N2 agonists - suxamethonium

Flaccid paralysis

Only cleared by plasma cholinesterase

Reversible anticholinesterases - edrophonium, neostigmine, physostigmine

Block activity of AChE

Diagnose and treat myasthenia gravis and treat glaucoma respectively

Irreversible anticholinesterases - organophosphates (pesticides, nerve gases)

Long-lived flaccid paralysis

Treat with pralidoxime within 10 minutes - cleaves OP-AChE complex

Hypokalaemia ECG changes

U have no pot and you have no T but you have a long PR and a long QT

Low potassium causes:

U waves (small deflection immediately after T wave)

Flattened/inverted T waves

Prolonged PR interval

Apparent prolonged QT interval (due to fusion of T and U waves)

Also:

Increased P wave amplitude

Widespread ST depression

Branches of external carotid artery

Some Anatomists Like F*cking, Others Prefer S & M

Superior thyroid artery

Ascending pharyngeal artery

Lingual artery

Facial artery

Occipital artery

Posterior auricular artery

Superficial temporal artery

Maxillary artery

The superior thyroid, ascending pharyngeal, lingual and facial arteries are ANTERIOR branches.

The occipital and posterior auricular arteries are POSTERIOR branches.

The superficial temporal and maxillary arteries are TERMINAL branches.

“Some Anatomists Like F*cking, Others Prefer S & M” 

is a mnemonic my professor just mentioned in class for the branches of the external carotid artery askjvb;askjbv;

Carpal bones mnemonic

So Long Till Pinky, Here Comes The Thumb

Scaphoid

Lunate

Triquetrum

Pisiform

Hamate

Capitate

Trapezoid

Trapezium

(going anti-clockwise in this diagram)

Common ototoxic medications

"FAV Q&A"

Furosemide (and other loop diuretics) Aminoglycosides Vancomycin Quinine Aspirin

Can - Citrate

I - Isocitrate

Keep - α-Ketoglutarate

Selling - Succinyl-CoA

Sex - Succinate

For - Fumarate

Money - Malate

Officer - Oxaloacetate

oh we are starting my favorite topic in biochemistry the tca cycle because whenever someone’s like :( it’s so hard to remember the intermediates :( i get to tell them about Can I Keep Selling Sex For Money Officer

Causes of Acute Pancreatitis

In the UK and US, the main causes are gallstones and alcohol.

Use the mnemonic 'I GET SMASHED':

Idiopathic

Gallstones

Ethanol

Trauma

Steroids

Mumps / Malignancy

Autoimmune

Scorpion stings

Hypercalcaemia / Hypertriglyceridaemia / Hypothermia

ERCP

Drugs (including azathioprine, mesalazine, bendroflumethiazide, furosemide, steroids, sodium valproate)

clearance = (urine concentration x urine volume passed over time) / plasma concentration

the only useful thing my prof ever taught me for the renal physiology portion of my physiology course is that clearance is calculated by the equation “pissing under the sun” ( C = UV/P)

The renin-angiotensin system that helps regulate the constriction of blood vessels and blood pressure.