2020-06-11

Xueba's Note: Super Complete Pharmacological Pitfalls

Are you still struggling with difficult to remember pharmacology? Don't worry, I will take you into the world of academic dominance and teach you how to memorize pharmacology cleverly. Without much ado, I will provide you with a complete set of pharmacology tips. Cholinergic drugs are divided into two categories: excitatory receptor inhibitory enzymes; Pilocarpine acts on the eyes and is used externally to treat glaucoma; Neostigmine esterase, mainly used for treating myasthenia gravis; Toxine is highly toxic and can lower intraocular pressure in ophthalmology.

Atropine, scopolamine like atropine, inhibits glandular smooth muscle; Pupils dilate and intraocular pressure increases, regulating the paralyzed heart rate quickly; Massive improvement of microcirculation and prevention of central excitation; The wide range of effects has advantages and disadvantages, and attention should be paid to the cardiovascular system when applied. There are six clinical uses, immediate relief of gastrointestinal colic; Before inhibiting secretion anesthesia, dilate the pupils and perform fundus examination with glasses; Preventing "rainbow crystal sticking" can treat bradycardia; Infection shock relieves spasms, and organic phosphorus poisoning is the first choice. Scopolamine has significant sedation and is characterized by its ability to resist dizziness; It can treat asthma and tremors, while the rest are like atropine, but it doesn't need to be used for eye contact.

adrenaline α、β Receptor agonists, represented by adrenaline; Blood pressure increases due to vasoconstriction, local anesthesia prolongs time, local hemostatic effect is obvious, allergic shock is the first choice, heart excitation and tracheal dilation, asthma persists, it can slow down, sudden heartbeat stops "triple", and attention should be paid to cardiovascular system when using it, α The receptor is blocked, and the pressor effect can be reversed. Norepinephrine strongly constricts blood vessels and does not reverse its pressor effect. It can only be administered intravenously slowly, causing kidney failure. During medication, urine volume should be monitored and hydroxylamine should be used early in shock.

Isoproterenol can dilate the bronchi, alleviate acute asthma, dilate blood vessels to treat "infection", and enhance blood volume. Exciting the heart to restore heartbeat, accelerating the conduction rhythm without disorder, resisting asthma to prevent sudden death, and avoiding hyperthyroidism and coronary heart disease. α Receptor blocking drugs α Receptor discontinuation, phentolamine and benzylamine, dilation of blood vessels for embolization, decreased blood pressure for diagnosis and treatment of tumors, NA release for increased cardiac strength, treatment of shock and heart failure.

β Receptor blocking drugs β Receptor blockers, represented by propranolol, are used in clinical treatment of hypertension, arrhythmia, and angina. Three taboos to remember: heart to heart, asthma, heart failure, and bradycardia. The application of efferent N-drug in shock treatment

(1) The types of drugs are divided into two categories: anti shock drugs and vasodilators; Hydroxylamines in the normal kidney and pararenal interstitium, as well as constricting blood vessels, belong to the same category; Hyoscyamine like isoproterenol, plus α Receptor blockers; There is also a type of dopamine that dilates blood vessels and promotes circulation.

(2) The selection of drugs for common shock is allergic shock, and the selection of accessory kidneys is combined with hormones to enhance the therapeutic effect; Infection medication is divided into stages, with dilation, acid correction, and anti infection. In the early stage, vasodilation is necessary, and anisodamine is the first choice; In the later treatment of vasoconstriction, hydroxylamine replaces the positive kidney. Cardiogenic shock requires caution and the use of "diamine". Explanation: "Diamine" refers to dopamine and meta hydroxylamine local anesthetics, which have high toxicity and are safe without anesthesia; Lido versatile waist is carefully selected. Ventricular rhythm disorder is commonly used as sedative and hypnotic drugs, such as sedative and hypnotic barbital, and benzodiazepine diazepam; Anti convulsive, anti epileptic, anti anxiety, central muscle relaxant diazepam. Different doses have different effects. In case of excessive poisoning, rescue should be carried out quickly, gastric lavage and fluid replacement should be done, and oxygen should be provided. Alkaline urine should be used to promote excretion.

The selection of antiepileptic drugs for small seizures, the first choice is ethylsuccinamine; Localized major seizures, phenytoin sodium and luminol; Carbamazepine is psychotic, and its sustained state is stabilized; Slowly increase the dosage and gradually stop medication, and adhere to medication to prevent sudden cessation.

The antipsychotic drug chlorpromazine blocks the receptor dopamine, calms, stops vomiting, and cools down. Artificial hibernation has a remarkable effect, and long-term medication is highly toxic, causing tremors, paralysis, and hypotension. Analgesics, morphine analgesics, are highly addictive; Respiratory suppression is severe, choose carefully when using; Analgesic effect Ling, cardiac asthma stop; Excessive poisoning, antagonizing naloxone.

Acetylsalicylic acid, an antipyretic and analgesic drug, inhibits PGE; Antipyretic and analgesic, anti-inflammatory and anti rheumatic; Inhibiting platelets, preventing and treating thromboembolism; There are many adverse reactions, including two types of central stimulants known as "making you famous first": brain stimulants such as caffeine and nicosamibelin, which act on the medulla oblongata; Indicating treatment for respiratory depression, children should choose lobelin. Morphine poisoning can cause death if the dosage is too high.

Antihypertensive drugs such as central antihypertensive clonidine, fight against undesired reserpine, α- R block piperazine, vasodilator "hydrazine", diuretic hypotensive chlorthiazide, "tension conversion" captopril, vasodilator sodium nitroprusside, crisis myocardial infarction only choose it, combined Ladder Individualization requires detailed investigation of lung, liver, and kidney functions. The use of antihypertensive drugs accompanied by coronary heart disease and angina pectoris is prohibited. The use of guanidine and hydrazine, propranolol and nifedipine, can lower blood pressure and prevent heart pain. Cerebrovascular disease, unable to use guanethidine; Renal function, if there is a decrease, it is prohibited to use carbinolone acetonide, but can be treated with dopamine clonidine, accompanied by ulcers, clonidine, mental illness, elevated blood pressure, and reserpine should be considered first.

Anti angina drugs, three types of anti angina drugs, nitroglycerin to dilate blood vessels, block calcium influx, nitropyridine to block β- R propranolol; Increase blood supply, reduce oxygen consumption, and increase the effectiveness of combined medication. Anti arrhythmic drugs are complex and are controlled by electrophysiology. Three types of ions, potassium, sodium, and calcium, make it easy to separate the three types of drugs. Two sentences on the principle of reducing self-discipline and eliminating setbacks. Atropine with slow arrhythmia and ventricular arrhythmias "Likain". Atrial fibrillation, atrial flutter, digoxin, cardiac glycoside poisoning, phenytoin.

β- R blocks supraventricular and blocks calcium influx with verapamil. The "atrioventricular junction" can be positive, amiodarone, and it is versatile. Cardiac glycosides are slow, medium, and fast, enhancing cardiac strength and free calcium; Positive muscle strength is the most fundamental indication for heart failure; Slow down heart rate and conduction, paroxysmal atrial fibrillation and flutter; Toxic reactions in three aspects: arrhythmia can lead to death; Maintain the therapy of digoxin and keep in mind the prohibition of calcium and potassium supplementation.

Anticoagulant drugs for thrombotic diseases require anticoagulation. Heparin has a strong and fast effect, and anticoagulation is suitable for both in vivo and in vitro. Protamine antagonists are fast, while dicoumarin is only used in vivo. Excessive poisoning with vitamin K and sodium citrate are used in vitro. Large amounts of blood transfusion are used to prevent hypocalcemia.

Use VK to correct hemostatic prothrombin deficiency; II, VII, IX, and X are synthesized frequently, resulting in reduced liver function. Injecting pituitrin is like a medical hemostatic forceps; Pulmonary hemoptysis with portal hypertension, effective in constricting blood vessels; The symptoms of diabetes insipidus can be treated, and attention should be paid to the heart and blood vessels. Fibrinolytic hyperglycemia can be corrected by aminomethylbenzoic acid; The effect is strong and the toxicity is low, and attention should be paid to thrombosis.

Diuretics are strong to weak in strength and act on the excretion of sodium from the kidneys; Severe edema and renal failure, it is advisable to choose furosemide for emergency treatment; Medium effective double gram is commonly used, with good effect on cardiac edema and weak diuretic effect on potassium retention. It is used in combination with various types of edema; Be cautious of the 'Four One Syndrome' in strong cases, and pay attention to potassium excess in weak cases. Note: "Four One Syndrome" refers to the four low and one high syndromes of strong diuretics (low blood volume, low blood potassium, low blood sodium, hyperuricemia) and the four high and one low syndromes of medium diuretics (high blood ammonia, high blood sugar, high urea nitrogen, hyperuricemia, hypokalemia).

Antiallergic H1 receptor blockers, represented by diphenhydramine; Skin and mucosal allergies can be corrected by using this medication; The treatment of insomnia and antiemesis has a strong and opposite effect; Adverse reactions are relatively rare, and dry mouth and drowsiness are common.

There are many combinations of antacids and antacids, which can correct each other's shortcomings and increase the effectiveness; Neutralize gastric acid and protect the mucosa, with significant local effects.

Magnesium sulfate, a laxative, has different effects depending on the usage; Oral diarrhea and cholagogue, defecation, detoxification, and insect repellency; Injecting antihypertensive and anticonvulsant drugs for eclampsia and tetanus; Local hot compress can relieve swelling and pain, only for those who have not suppurated; Pregnant women during menstruation should be cautious and choose sodium salts for renal dysfunction; Do not panic if poisoned excessively. Calcium salt is used to counteract and detoxify.

Cough suppressant, nausea, expectorant, chloramphenicol, excitation, vagus, and dilution of phlegm; The phlegm dissolves and is easy to clean, while the sulfur bond breaks and the phlegm undergoes degeneration; After oral administration of the prodrug, it should be selected locally and reasonably without delay. Antiasthmatic drug aminophylline has a significant inhibitory effect on esterase; Relaxing the smooth muscle of the trachea can prevent and treat acute and chronic asthma; It is important to control the dosage for strengthening the heart, diuresis, and stimulating the brain.

It is important to control the dosage when choosing uterine stimulants; Relatively safe oxytocin, suitable for both prenatal and postpartum use; After delivery, ergot preparations can also be used to treat migraines.

Antithyroid drugs are mainly used for the treatment of hyperthyroidism in the internal medicine department, and thiourea is the main choice; Peroxidase is inhibited and takes effect slowly for a long period of time; Medications reduce granulocytes, and regular blood checks are important; Preoperative surgery for hyperthyroidism crisis requires the addition of a large amount of Lugo fluid; Prevent and treat small amounts of iodine in the thyroid gland, and combat high doses of hyperthyroidism. The peak effect is two weeks, and attention should be paid to the use of "iodine cold".

Insulin must be supplemented for all types of severe diabetes; The hypoglycemic effect is fast and strong, promoting the entry of blood sugar into cells; Increase utilization and storage, reduce glycogen decomposition and neogenesis; Reduce blood sugar levels and prevent shock and hypoglycemia.

Oral hypoglycemic drugs are two types of oral hypoglycemic drugs, with slow and weak characteristics of action; Insulin function is lost, and sulfonylureas are ineffective; Phenylmetformin is still effective and cannot replace insulin.

X-ray contrast agent, clinical application of iodine barium gas; Barium sulfate for gastrointestinal imaging and iodine for cholangiorenal imaging; Liver and kidney function test drug, sulfonylbromophenol sodium phenolsulfonphthalein; Need to check cardiovascular system, fluorescein sodium azo blue; To check gastric function, use pentapeptide gastrin; Air oxygen can develop, and it is used in gynecological imaging.

Penicillin narrow-spectrum bactericidal penicillin competes for bacterial transpeptidase; Mucin synthesis is disrupted and positive bacteria are killed; Allergic reactions pose a high risk. Ask, try, and observe. Explanation: First question: Ask about an allergy history; Second try: Conduct a skin allergy test before medication; Three observations: Observe for 30 minutes after medication.

Aminoglycoside fungicides, which inhibit bacterial proteins; Fight against negative bacilli and treat tuberculosis with chain card; Ear and kidney toxicity are the most severe, and dosage should be controlled with caution.

Streptomycin Streptomycin is easily resistant to drugs and has a high degree of rapid persistence. Generally, infections are less commonly used, and the combination of medication increases the therapeutic effect. Combined isoniazid to treat tuberculosis; Cooperate with penicillin to stop endocarditis; Combined use of tetracycline to treat brucellosis; Combined use of SD, pestis and tularemia.

Erythromycin macrolide erythromycin enhances the effect in alkaline environments; The combination of green and red is not correct, and the phenomenon of salting out should be remembered. Lin Hong competes for binding points, while the combination of four red drugs increases liver toxicity. Tetracycline has an antibacterial spectrum of two bacteria, four bodies, and one insecticide, which is basically ineffective in damaging green nodules. Explanation: Two bacteria refer to bacteria and actinomycetes, four bodies refer to Rickettsia, Mycoplasma, Chlamydia, and Spirochetes, and one insect refers to Amoeba.

Sulfonamide antibacterial spectrum combines two bacteria and one insect, plus tuberculosis and leprosy. Explanation: Two bacteria refer to bacteria and actinomycetes, one refers to Chlamydia, and the other refers to Plasmodium. Sulfonamide side effects prevention, alkalization of urine, drinking more water, regular inspection of routine urine anti tuberculosis drugs against isoniazid tuberculosis, the role of three strong types of Ling; Drug resistance is rapid and has low toxicity, affecting nerve and VB.

Disinfection and anti-corrosion drugs: nine types of drugs, phenolic aldehyde acid halogens; Oxidizing dyes, heavy metals, and surfactants can inhibit and kill microorganisms. Choose external use instead of internal use.

The selection of antimalarial drugs is controlled with chloroquine, and radical treatment requires the addition of primaquine. What to do when entering a malaria stricken area, and take precautions with pyrimethamine. Primaquiline is highly toxic and should be used with caution for specific conditions. The mechanism of action of antimalarial drugs is chloroquinine red phase, and the adverse reactions of pyrimidine red chloroquine are relatively few, including headache, tinnitus, and gastrointestinal tract; Long term medication is prone to accumulation, and attention should be paid to blood, heart, and eyes.

Metronidazole and metronidazole are effective against anaerobic bacteria such as Trichomonas. Enteral and extraintestinal amoeba is the preferred choice for good results.

Symptom Three of Organic Phosphorus Poisoning: Central M-like Skeletal Muscle, Appropriate Medication for Rescuing Organic Phosphorus Poisoning, N-like Symptoms: Phosphodine, Peripheral Central Atropine, Early and Sufficient Repeated Use.

Source: Dingxiangyuan


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