NOTES-M1-6-3.0.pdf

MODULE 1 Acidimetry Analysis of acids Alkalimetry Analysis of bases Iodimetry Analysis of Reducing agent Iodometry Analysis of oxidizing agent Neutralization acid + base → salt + water Hydrolysis...

MODULE 1 Acidimetry Analysis of acids Alkalimetry Analysis of bases Iodimetry Analysis of Reducing agent Iodometry Analysis of oxidizing agent Neutralization acid + base → salt + water Hydrolysis salt + water → acid + base Saponification alkali + fats → soap + glycerol Isotopes Same proton = Same element Isotones Same neutron = Different element Isobars Same mass number = Different element 1 H Protium - most abundant 2 H Deuterium - heavy water 3 H Tritium - most radioactive Borate Buffer System For ophthalmic, nasal & external preparations only Astatine (At) Rarest element Nitrogen (N) Most abundant gas in air Hydrogen (H) Most abundant gas in universe Argon (Ar) Most abundant noble gas Krypton (Kr) Least abundant noble gas Beryllium (Be) Most toxic metal Magnesium (Mg) Lightest Structurally Important Metal (SIM)  Lithium (Li) Lightest metal Osmium (Os) Heaviest/Densest metal Francium (Fr) / Most reactive metal Cesium (Cs) Cerium (Ce) 1st via spectroscope Cr-51 Volume of RBC & GFR Co-58 Diagnosis of liver function Fe-59 Iron metabolism Ra-226 Cancer therapy Actinides Atomic #89 - 103 Lanthanides Atomic #57 - 71 Same molecular formula Functional isomer Different order of linkages Meso compound Achiral Achiral Enantiomer - Superimposable Chiral Diastereomer - Non Superimposable Azeotrope Behave like pure substance Streptomycin 1st Aminoglycoside for chemotherapy Dextromorphan Antitussive - Codeine Cod liver Contains vit. A & D Phagocytosis Cell eating Pinocytosis Cell drinking Hg spill Clean up with sulfur powder Copper Release & storage of Iron  Tyndall effect Light scattering Nuclear Magnetic Determine the conformation of organic molecules Resonance Mass Determine the mass of organic molecules spectrophotometry Polarimetry Determine the optical rotation of molecules Molality gram / Kg of solvent Molarity gram / L of solution Normality gram equivalent / L of solution Formality gram formula / L of solution Cassia flask To assay aldehyde, ketone and phenol volatile oils Acetylation flask To assay alcohol volatile oils Sulfanilamide Responsible for the red dye’s antimicrobial activity of Protonsil Hygroscopic Absorbs moisture but does not dissolve in it Dehydrating Removes moisture substance Efflorescent Hydrated salt that loses water Deliquescent Absorbs moisture and dissolves in it An isolable enzyme, a functional component of a cell Drug receptor membrane or an intracellular molecule such as a protein or a nucleic acid Passive transport Not energy requiring Substances are moving from a region of high concentration to Facilitated Diffusion a region of low concentration (along the concentration gradient) Carrier-mediated Saturable  Substances are moving from a region of low concentration to a region of high concentration Active Transport Uses energy from ATP Carrier-mediated Saturable Allotropic Element - exist in two or more crystalline forms Polymorphic Compound - exist in two or more crystalline forms Amorphous No definite form Amphoteric Act either as acids or bases Enthalpy Heat content Entropy Degree of total molecular randomness Heat of Fusion To convert 1g solid to liquid without temp. change Latent heat Heat absorbed or released by an object to change it phase Quartz Silicon dioxide Magnesia Magnesium oxide Alumina Aluminum oxide Carbonic acid gas Carbon dioxide Turnbull’s blue Ferrous ferricyanide precipitate Prussian blue Ferric ferrocyanide precipitate Barium sulfate radiopaque contrast medium Titanium dioxide solar ray protective or sun block Sodium nitrate preservative Spermaceti Waxy substance from the head of sperm whale Carrageenan Gum from red seaweeds  Fucoidan Sulfated polysaccharide from brown algae Eudistomin From sponges Alginic acid From brown seaweed Opiates Natural - Morphine, Codeine, Thebaine, Papaverine Opioids Synthetic - Methadone Small Intestines Drug absorption Liver Drug metabolism Kidney Drug excretion Acid Sour taste - blue → red Base Bitter taste - red → blue Aluminum silicates Kaolin, Bentonite, Pumice Magnesium silicates Talc, Asbestos Zinc silicates Natural calamine Isolated by Carlo Perrier & Emilio Segre Technetium (Tc) Derived from Technetos = Artificial Zsigmondy or The protective power of the lyophilic colloids is expressed in Gold Number terms of gold number Heisenberg’s The momentum and the position of an electron cannot be Uncertainty Principle determined simultaneously Hund’s Rule of Electrons fill up orbitals singly first before pairing up Maximum Multiplicity Pauli Exclusion No two electrons in an atom can have the same set of four Principle quantum numbers First 33 Elements in the periodic table Antoine Lavosier Law of conservation of mass - matter: neither created nor destroyed Johann Wolfgang Arranged the first 33 elements = Dobriener’s triad Dobriener John Newland Arranged elements by 8’s (octaves) Dmitri Mendeleev Arranged elements by atomic weight Henry Moseley Arranged elements by atomic number = modern PTE Theorized isotopes - certain elements might exist in forms that Frederick Soddy differ in atomic weight Democritus “Atomos" - tiny indivisible particles Atomic theory John Dalton Billiard ball model - hard indestructible sphere Raisin Bread/Plum Pudding/Chocolate Chip - sphere: (+) embedded with (-) particles JJ Thomson Cathode Ray experiment Discovered Electron Nuclear model - atoms completely empty space Ernest Rutherford Gold film experiment Discovered Proton Planetary model - electrons move around nucleus in circular Neils Bohr orbits with increasing energy levels Schrodinger Quantum mechanical model - electrons are 3D space: orbitals Robert Millikan Quantity of charge of an electron Law of definite proportions - Contain a fix ratio of elements by Joseph Proust mass John Dalton Law of multiple proportions - Ratios of whole number Hind & Goyan Modified Palitzsch buffer system James Chadwick Discovered neutron  Atomic Theory All matter is made up of very tiny, indivisible particles called atoms All atoms of a given element have same chemical properties In ordinary chemical reactions, no atom of any element disappears or is changed into an atom of another element Compounds are formed by the chemical combination of two or more different kinds of atoms A molecule is a tightly bound combinations of two or more different kinds of atoms that act as a single unit Mass number (A) Proton + Neutron Atomic number (Z) Proton Electrons Proton - charge Neutrons A-Z Li > K > Na > Ba > Ca > Mg > Al > Mn > Zn Gold (Au) Least reactive metal Principal N Size, Energy & Distance of electron 1,2,3… (whole #) Azimuthal ℓ Shape - subshell/sublevel 0,1,2,3 Magnetic M or Mℓ Orientation -3,-2,-1,0,1,2,3 ↑: (+)1/2 Spin Ms Spin or rotation ↓: (-)1/2 Silicon Germanium Polonium Metalloids Antimony (Sb) SiGe Po Sb ni ATe Baby Arsenic Tellurium Boron Atomic # Symbol Element Mnemonics 110 Ds Darmstadtium Darm zero 111 Rg Roentgenium roent≈one 112 Cn Copernicium 2nd coper 113 Nh Nihonium Niho three 114 Fl Flerovium F = four 115 Mc Moscovium 5th Mosco 116 Lv Livermorium 6 lives 117 Ts Tennessine ss = seven 118 Og Oganesson oga≈octa Avogadro’s number 6.02 x 1023 = 1 mole 𝐿 𝑥 𝑎𝑡𝑚 R constant 0.08205 𝑚𝑜𝑙 𝑥 𝐾 Pressure 1 atm = 760 mmHg Volume 22.4 L Temperature 273.15 K Ebullioscopic constant water 0.52℃/m Cryoscopic constant water 1.86℃/m Curie (Ci) 3.7 x 10-1 Bq [SI unit] Bq 2.7 x 10-1 Ci 1 𝑗𝑜𝑢𝑙𝑒 [SI unit] Gray (Gy) 1 𝑘𝑔 𝑡𝑖𝑠𝑠𝑢𝑒 Boyle’s law 𝑃1𝑉1 = 𝑃2𝑉2 Isothermic 𝑇1 𝑇2 Charle’s law 𝑉1 = 𝑉2 Isobaric 𝑇1 𝑇2 Gay-lussac’s law 𝑃1 = 𝑃2 Isochoric  Acid Base Arrhenius H+ OH- Bronsted-Lowry Proton donor Proton acceptor Lewis Electron acceptor Electron donor Boiling point elevation ΔTb = Kbm Freezing point depression Δ Tf = mKf Weak acid 𝑝𝐻 = 𝑝𝐾𝑎 + 𝑙𝑜𝑔 𝑠𝑎𝑙𝑡 𝑎𝑐𝑖𝑑 Weak base 𝑝𝑂𝐻 = 𝑝𝐾𝑏 + 𝑙𝑜𝑔 Law of Thermodynamics Law of Conservation Energy is neither created nor destroyed but 1st of Energy converted/transformed to form another Entropy of the universe increases in a spontaneous 2nd Law of Entropy process and remains unchanged in an equilibrium process Entropy of a perfect crystalline substance is zero at 3rd Nernst Heat theorem absolute zero temperature (0K) If two systems are at equilibrium with a third system, Zeroth law then they must be at equilibrium with each other Type AKA Allows exchange of Open system Non conservative Matter & Energy Closed system Conservative Energy only Isolated system Adiabatic None  Anode Cathode Oxidation Reduction Positive electrode Negative electrode Zinc rod Copper rod An Ox with Positive Zinc rod Red Cat with Negative Copper rod Penetrating Mass # Atomic # Ionizing power power Alpha (α) -4 -2 3rd 1st Beta (𝛽) Stay the same +1 2nd 2nd Gamma (𝛾) Stay the same 1st 3rd IA Alkali metal H, Li, Na, K, Rb, Cs, Fr IIA Alkaline earth metal Be, Mg, Ca, Sr, Ba, Ra IB Coinage metal Cu, Au, Ag IIB Volatile metal Zn, Cd, Hg Chalcogen/Oxygen VIA O, S, Se, Te, Po, Lv “ore-forming” VIIA Halogen F, Br, I, Cl, At “salt-forming” VIIIA Inert/Noble gas He, Ne, Ar, Kr, Xe, Rn, Og I: Fe, Co, Ni VIIIB PTE triad II: Ru, Rh, Pd III: Os, Ir, Pt “Symbol” = representative element Activity series for Halogens F2 > Cl2 > Br2 > I2  Priority series for IUPAC functional groups Carboxylic acid > Acid anhydride > Carboxylic ester > Amide > Nitrile Type of Buffer pH Acid Basic Feldman’s 7 - 8.2 H3BO3, NaCl, H2O Na borate, H2O Atkins & Pantin 7.6 - 11 H3BO3, NaCl, H2O Na2CO3・H2O, H2O Gifford’s 5-9 H3BO3, KCl, H2O Na2CO3・H2O, H2O Palitzsch 7-9 H3BO3, NaCl, H2O Na borate, H2O Sorensen’s 6-8 Na phosphate salt, NaCl Millon’s test Tyrosine Seliwanoff’s test Fructose Ninhydrin test Alpha-amino acid Barfoed test Differentiate Lactose from fructose Hopkin’s cole test Indole ring Duquenois test Cannabis sativa (Marijuana) Baudouin test Sesamum indicum Thallequin test Cinchona calisaya Halphen test Gossypium hirsutum (Cottonseed) Marquis test P. Somniferum (Morphine) Beilstein test Halogens Vitali-Morin Test Tropane Alkaloids (Atropine) FeCl3 Test Polyphenols (Hesperidin) 2-deoxysugars present in Digitalis Keller-Killiani Test glycosides (Digoxin)  Doll’s test Ocular movement Rinne’s & Weber’s test Auditory Snellen’s test Visual activity Cyclosporine Graft rejection HTN emergency Na Nitroprusside Ca gluceptate Neonatal tetany AlCl3 Hyperhidrosis West African T. brucei gambiense Eflornithine Trypanosomiasis East African T. brucei rhodesiense Suramin Na Trypanosomiasis American T. cruzi Nifurtimox Trypanosomiasis USP-NF Reagents % Requirements Conc. HCl 36.5 - 38% Conc. HNO3 69 - 71% H3PO4 85 - 88% Conc. H2SO4 95 - 98% ↑ # of carbon ↑ Boiling point ↓ pKa ↑ Degree of ionization Faster decay of isotope Less stable Vogel’s solution Cobaltous solution + Ammonium thiocyanate Hartmann’s solution NaCl + KCl + CaCl + Na lactate Povidone-Iodine Polyvinylpyrrolidone (surfactant) + Iodine  Tincture of Iodine 2% iodine + ethanol + water + sodium or potassium iodide Lugol’s Solution or 5% Iodine + water + sodium or potassium iodide Strong Iodine Solution Test for Cholesterol Liebermann-burchard test Conc. Sulfuric acid + Acetic anhydride Salkowski test Conc. Sulfuric acid + Chloroform Electronegativity difference < 0.4 Non Polar > 0.4 Polar Quinolones 1st 2nd 3rd 4th Nalidixic acid Ciprofloxacin Levofloxacin Trovafloxacin Cinoxacin Lomefloxacin Sparfloxacin Ofloxacin Gatifloxacin Norfloxacin Moxifloxacin Enoxacin Pneumocystis Carinii Pneumonia (PCP) Trimethoprim + Sulfamethoxazole Toxoplasmosis Pyrimethamine + Sulfadiazine Metronidazole, Iodoquinol, Emetine and Amoebiasis Dehydroemetine  MODULE 2 ALKALOIDS Lob ni Nico ang PyPi ni Coline Pyridine-Piperidine Lobeline Nicotine Arecholine SHAt Coc sabi ni TROPA Scopolamine Tropane Hyoscyamine Atropine Cocaine OSHIT Opium Isoquinoline Sanguinarine Hydrastine Ipecac Tubocurarine QQ CC Quinidine Quinoline Quinine Cinchonine Cinchonidine PRENC Physostigmine Rauwolfia (Reserpine) Indole Ergot Nux vomica (Strychnine, Brucine) Catharanthus (Vincristine, Vinblastine)  White hellebore Steroidal Green hellebore Caffeine Purine/ Theophylline Methylxanthine Theobromine LIQUID ALKALOID in C.A.N.S. Conine Arecoline Nicotine Spartein SHRUB & TREE EXUDATES (Ka-GhAT) Karaya Ghatti Acacia Tragacanth MARINE GUM (ACADs) Agar Carrageenan Algin Danish Agar SEED GUM (PCyLo-Guar) Psyllium Cydonium Locust bean Guar MICROBIAL GUM (XanDex) Xanthan Dextran Non-Drying 120 (LiCoD) Linseed oil Cod Liver oil SPECIAL STRUCTURES Labia - hair Peppermint Glandular hair Spearmint (Labiatae) Thyme Lavender Oregano Pipe - Pare Modified Parenchymal cells (Piperaceae) Black pepper Pansit-pansitan Belli - Vittae Vittae (oil tubes) Fennel (Umbelliferae/Apiaceae) Coriander Caraway Poison hemlock Ruth & Pina - Genous Schizogenous & Lysigenous passages Pine tree (Pinaceae & Rutaceae) White pine Chinese orange  Kreb’s cycle Citrate Citrate Is Isocitrate Krebs alpha-Ketoglutarate Starting Succinyl CoA Substrate Succinate For Fumarate Making Malate Oxaloacetate Oxaloacetate YIELDS: CO2 and H2O 2CO2 and *10 ATP/cycle *NADH=2.5 ATP FADH2=1.5 ATP GTP=1 ATP NOTE: 1 glucose molecule = 20 ATP B.A.B.Y. P.L.A.N.T.S. Bayabas Psidium guajava Antiseptic Akapulko Cassia alata Antifungal Bawang Allium sativum Anti-HTN Yerba buena Mentha cordifolia Analgesic Pansit-pansitan Peperomia pellucida Anti-gout/ lowers uric acid Lagundi Vitex negundo Cough prep. Ampalaya Momordica charantia Anti-DM Niyog-niyogan Quisqualis indicum Anthelmintic Tsaang gubat Carmona retusa Anti-diarrheal Antispasmodic Sambong Blumea balsamifera Diuretic  Rate Limiting Steps Glycolysis Phosphofructokinase/ Fructose 6-phosphate Gluconeogenesis Fructose 1,6-biphosphate Kreb’s Cycle Isocitrate dehydrogenase Glycogenesis Glycogen synthase Glycogenolysis Glycogen phosphorylase Pentose Phosphate Pathway Glucose-6-Phosphate dehydrogenase Glycolysis Glucose → Pyruvate Promoted by Glycogenesis Glucose → Glycogen Insulin Glycogenolysis Glycogen → Glucose Promoted by Glucagon or Gluconeogenesis Non-Carbohydrate → Glucose Epinephrine Serine Cysteine Alcohols Threonine & Tyrosine Amides Glutamine C(see) Y(why) Asparagine Glycine Methionine Alanine Aliphatic Valine Tryptophan M.W.F. Leucine Isoleucine Phenylalanine Proline POLAR - NONPOLAR  Turpentine oil Water Distillation Wa-Tur Peppermint Spearmint Direct Steam Distillation Steamy P.S. Clove oil Water & Steam Distillation Cinnamon oil Destructive Distillation/Pyrolysis Tar oil Ecuelle Lemon oil (rind) Lavender Rose Enfleurage Fleur = Flower Enzymatic action Mustard oil 1 Terpene = 2 Isoprene(C5H8) units Sesquiterpene 1.5 x 2 = C(5x3) H(8X3) = 3 isoprene units C15H24 Tryptophan - W Isoleucine - I Both Ketogenic & Glucogenic Phenylalanine - F W.I.F.T.Y. Threonine - T Tyrosine - Y Protein Synthesis (ActInET) Activation Initiation Elongation Termination  Duquenois test Marijuana nois = ↑nice (Cannabis sativa) Baudouin test Sesame Bad un Sesame (Sesamum indicum) Thallequin test Quinine ll = ff OR 2 quins (Cinchona officinalis) Halphen test Mexican cotton/Cottonseed Halphen (has) Cotton (Gossypium hirsutum) Marquis test Morphine Mar tests (for) Mor (Papaver somniferum) Kwashiorkor Marasmus High mortality rate Low mortality rate Protein deficiency Protein & Calorie deficiency Due to late gradual weaning Due to early abrupt weaning  MODULE 3 DOH Primary Emergency hospital - Secondary Non-departmentalized Intermediate care Tertiary Departmentalized Intense care Quaternary Teaching & Training - MEANS OF SELECTION OF ITEMS TO STOCK: ABC Analysis A 20% of stock 70-80% of consumption Tight inventory control B 30% of stock 15-20% of consumption Moderate control C 50% of stock 5-10% of consumption Fast moving products VEN System Vital Life-saving Essential Effective and necessary for diseases Non-Essential Vitamins & Minerals Ampules Vials Single use Multiple use Glass type Glass + Rubber stopper + Al crimp  ➔ Electrolyte imbalance ➔ Fluid replacement NSS ➔ Vehicle for medicine ➔ Conjuct with blood product ➔ Electrolyte imbalance Hartmann’s Solution ➔ Fluid replacement ➔ Vehicle for medicine ➔ Electrolyte imbalance Na Lactate ➔ Fluid replacement ➔ Fluid replacement 5% Dextrose ➔ Nutrition supplement ➔ Vehicle for medicine Invert Sugar ➔ Nutrition supplement ➔ Fluid replacement 5% Albumin ➔ Nutrition supplement ➔ Conjuct with blood product ➔ Fluid replacement Amino acid injection ➔ Nutrition supplement Luer Lock Luer Slip/Slip tip 1st syringe developed Slip or push on connection Universal attachment May dislodge Antineoplastic  Eccentric tip Catheter tip Off-center tip Wound irrigation For surface veins(Intradermal) or Enteral feeding artery injections Garbage Disposal Color Coding Green Biodegradable waste Hazardous waste Black *Recyclables Yellow Infectious/Chemical waste Orange Radioactive waste Aerosol containers Red *Syringes Parts of a Syringe  Lumen Openings Subcutaneous(SQ/SC) 24 or 25 Intramuscular (IM) 19 - 22 Parenteral compounding 18 - 20 Finest 27 Largest 13 Needle Lengths Parenteral compounding 1½ inches Intradermal or Subcutaneous ¼ - ⅝ inches IV infusion 1¼ - 2½ inches Intra-Spinal 3½ inches Routes of Administration Intradermal 10-15* Intravascular 25* 45* (Palm facing upward) Subcutaneous 90* (Palm facing downward) Intramuscular 90* Parts of a Stethoscope  Medication Errors for Pediatrics Stage - Duration Neonate 1 day to 1 month Infant 1 month to 1 year Toddler 1 to 3 years Pre-schooler 3-5 years School age 5-11 years Pre-Teen 11-12 Teen 13 years above Category of Medication Errors A Capacity to cause error B (+) Error but (-) reach patient C (+) reach patient but (-) patient harm D (+) reach patient and (+) patient harm → monitoring/intervention E Temporary harm and requires intervention F Require initial or prolonged hospitalization G Permanent harm H Required intervention necessary to sustain life I Death  Categories of Adverse Drug Reaction Nephrotoxicity - ➔ Dose dependent A aminoglycosides ➔ Related to pharmacological Augmented Bleeding - action of drug anticoagulants ➔ Dose independent B ➔ Not related to pharmacological Urticaria - Penicillin Bizzare action of drug ➔ Rare ➔ Dose & time dependent C Cushing syndrome - ➔ Long term exposure Continuous Cortisone ➔ Rare ➔ Time dependent D Kidney disease - ➔ Prolonged exposure Delayed NSAIDs ➔ Very rare ➔ Time dependent E Rebound phenomenon - ➔ Relapse End of Use Opioids ➔ Rare Categories of Pregnancy Risk ➔ Appropriate human studies Folic acid A ➔ Safe FeSO4 ➔ Animal studies = issues Amoxicillin B ➔ Human studies = safe Paracetamol ➔ Relatively safe ➔ Animal studies = unsafe Rifampicin C ➔ Human studies = none Theophylline ➔ Unsafe ➔ Human studies = fetal risks Phenytoin D ➔ For treating other conditions Tetracycline ➔ Benefit outweighs risk Isotretinoin X ➔ Teratogenic Thalidomide  Consideration for Drugs to require Therapeutic Drug Monitoring (TDM) Drugs with: Narrow therapeutic index Marketed pharmacokinetic variability Target concentrations are difficult to monitor Known therapeutic and adverse effects Study Designs ➔ Prevalence of disease is determined Cross-Sectional ➔ Both outcome and exposure are determined ➔ Exposed group vs Unexposed group Cohort/Prospective ➔ Monitor for disease development Case-Control/ ➔ Outcome of interest is already determined Retrospective ➔ Gold standard Randomized Controlled ➔ Participants are randomly decided Trials (RCT) ➔ Single blind vs Double blind ➔ Statistical analysis that summarize multiple Meta-Analysis scientific studies Systematic Review ➔ Comprehensive summary of best available evidence Drug Management Cycle  Dialysis need for patients with: A cidosis E lectrolyte imbalance I ntoxication O verload of fluids U remia Color Coding for IV fluids Normal Saline Solution (NSS) Dark Green 5% Dextrose in 0.9% NaCl (D5NSS) Yellow 5% Dextrose in 0.3% NaCl (D5 0.3NaCl) Light Blue Lactated Ringer’s Solution (LRS) Blue 5% Dextrose in Lactated Ringer’s Solution Pink (D5LRS) 5% Dextrose in Water (D5 water) Red Balanced Multiple Maintenance Solution Violet with 5% Dextrose (D5IMB)  Hospital Color Code For Emergency Philippine Practice Standards for Pharmacists (PhilPSP) A Academe R Regulatory M Manufacturing CHI Community, Hospital, Institutional P Public health Prescription record book kept for 2 years Dangerous drug record book kept for 1 year Poison book kept for 5 years Terminal Sterilization Enzyme Inhibitor vs Enzyme Inducer ENZYME INHIBITORS - Queen Sulli Is In GRAVE FACKing Dicks She Met ENZYME INDUCERS - Rina’s Barbie Car Greases PhePhe Priming John who Smokes Alcohol Chronically, Omsim!  Established Proven to occur in clinical studies Probable Very likely to occur but not proven clinically Suspected Might/May occur with some data available Possible Could occur but limited data Unlikely Doubtful and without good evidence E(h) P(e)ro Sus Po Un Un Do Po Co Sus May Pro Like Es Prov DRUGS TO BE TAKEN WITH FOOD TO INC. ABSORP. WITHOUT FOOD Theophylline Penicillamine Phenytoin Penicillin Dicoumarol Acetaminophen Propoxyphene Alendronate Griseofulvin Aspirin Acarbose NSAIDs Itraconazole Isoniazid Metoprolol Captopril Morphine Erythromycin Ethanol Quinolone Tetracycline Mnemonics: Theo’s Pen Dick Properly Greases Acar I(n)tra Meto Morph  Types of Bizzare ADRs I ➔ IgE-mediated anaphylactic shock Allergies II ➔ IgG/IgM-mediated cytotoxic reaction Body dyscrasias Multi-system III ➔ IgG-mediated immune complex reaction involvement (HIPS) IV ➔ T cell-mediated delayed reaction Dermatitis Formulary List Vol. I List of drugs Vol. II Drug monograph Vol. III Index of generic or brand names Normal Levels of Vital signs Body temperature 37±0.5℃ Pulse rate 60-100 beats/minute Respiratory rate 16-20 breaths/minute Blood pressure