And I'm going to go through them on the board from memory as we get to the later chapters

I might just do them ahead of time just to make the clips shorter

But these first two clips at least I'm going to do it from memory just to show you that

hopefully after you've read the book you've got it to the point where

you're at the instructor's level. As an instructor

with those 200 drugs I

see them all as seven pictures. I don't need two hundred note cards

I can just do it from memory, and that's where I want you to get to so we'll start with chapter one

gastrointestinal. And we'll talk about thirteen medications

and while I talk about the thirteen medications I'll also talk about grouping them and grouping them

When you're first learning these top 200 drugs when you group them

Students are good at grouping them as okay these are analgesics and these are

Maybe for some kind of stomach upset and then these are for pain

But this is another level where we're connecting all 200 drugs in one

order so let's start with two drugs that you're probably very familiar with two antacids

And then from the antacids we're going to go to the H2 blockers

And these are better known as histamine

Two

Receptor

Antagonists

So there is a histamine 1, that's the anti-histamine you think of when you think of Claritin and things like that

The receptor just means that the drug is going to affect the receptor and an

antagonist means it blocks it. So histamine

two must release gastric acid if we're using a drug to block it. And then proton pump inhibitors

So within each of these categories, I'm going to alphabetize them

Because it makes it easier to remember

Although magnesium is above calcium on the periodic table. We're going to put calcium carbonate first

So calcium carbonate is Tums

But I also want you to know that it's something called Children's

Pepto

This is important because regular Pepto has a salicylate component. That's a lot like aspirin and

that can be very dangerous in children, especially if a child has

Some kind of Chickenpox or fever and things like that and get Reye's syndrome

spelled Reye

apostrophe "s"

There's Magnesium hydroxide

And that's Milk of Magnesia

So these antacids they work very quickly

And because they work quickly what we're going to do for the way that we're going to remember them is

These work in a couple minutes. Maybe five minutes

These work in about 30 minutes the H2 blockers, and then these work in about a day

But antacids are probably the first thing you'll reach for because they work so quickly

then if it persists you might go to an H2 blocker and

We have two that we're going to use, famotidine

ranitidine

I'm not going to put the brand names yet because I want you to notice that there's a -tidine ending

t-i-d-i-n-e

The first thing I want you to know is that the -ine is not the ending

a lot of the videos on YouTube show that as the ending just because

20% of all drugs end in -ine

So you don't want to classify it by that. The -tidine has been set by

a couple of organizations [like] the World Health Organization,

the United States Adopted Names Council,

and they're the ones that make this into a group so that it's a -tidine makes it a

cimetidine-like H2 blocker and cimetidine was the first H2 blocker that came out

So let's put the brand names in there: Pepcid

Which combines peptic and acid

Zantac

You can kind of see the word antagonist in there for acid, and then two proton pump inhibitors

And we're going to see similar ending or that they're going to have similar endings

And then I'm going to introduce something new as well there so esomeprazole

There's (brand) Nexium (generic) omeprazole

(brand) Prilosec, okay

-prazole ending is what lets us know it's a proton pump inhibitor,

but you'll notice we have omeprazole and omeprazole

What's the es- what's this doing? If you look in and

Wiki is a good place to look because it has good pictures of molecules.

This omeprazole is actually an R- plus S-

where this omeprazole is just an S- so what does that mean? There's a left-handed

or there's a right-handed rectus and left-handed sinister omeprazole, so it's a mixed

there's two sides to the molecule and

only the S- does anything so Prilosec came first

"protons low secretion" is how you remember the brand name and

Then esomeprazole or Nexium came next and you can remember that from Nexium

But just notice that these have the same root, okay?

but they still have this ending -prazole Be careful some of those YouTube videos call it -azole and

Those are maybe people that haven't had organic chemistry

an -azole is just an organic chemistry compound

But -prazole is an actual stem by the

United States Adopted Names Council, so let's look at our first six drugs in order we start with antacids

Calcium carbonate and Magnesium hydroxide alphabetized although on the periodic table. I know magnesium comes first

It's 12 calcium carbonate is 20

H2 Blockers alphabetize them: famotidine,

ranitidine, notice the -tidine stem the -tidine and then the proton pump inhibitors

esomeprazole, omeprazole

Although omeprazole came first

esomeprazole should be alphabetized before omeprazole, and this es- means that it's the S- isomer and

That's supposed to work a little bit better

Alright, let's move on to the next group. So after you have a stomachache sometimes you get diarrhea

So let's look at some drugs for that

Okay, so the we're going to do again two anti diarrheals

And then what we want to do is we want to do the opposite so we'll do

two laxatives

and so the anti-diarrheals we'll start with and again alphabetical order: bismuth

subsalicylate

Pepto-bismol, okay and loperamide

That's Imodium

So the -sal- is the stem s-a-l and the way to remember this is bismuth subsalicylate. It's this big pink bottle

many people know about it, but just recognize that bismuth subsalicylate

Pepto-bismol is different than Pepto Children's

Loperamide you see lo-

for slow and -per- for peristalsis

so slowing peristalsis or

Making Imodium, Imodium looks a little like immobilized, so we're slowing things down

If a patient has diarrhea now again, we don't use those drugs if the patient has some kind of infection

We'll treat that with antibiotics, but let's go to the opposite. Let's go to the laxatives on what we can use

Let's start with Docusate

And you can see as docusate or docusate sodium

That's Colace and then we'll also see polyethylene glycol

That's MiraLax.

Polyethylene Glycol, sort of has a stem. The p, the e, and the g tells you that it's pegylated

but docusate sodium I know I have it under laxative

It's really a stool softener, but think of the word docusate and penetrate as rhyming and then polyethylene glycol

this is the miracle laxative is a way you can remember it, but also

Colace

allowing the colon to race now giving a laxative

So we've gone from the stomach now to the intestines and

These have all been over-the-counter, so let me put that in front of these

OTC

OTC and

What we want to do is we, again, want to have a logical order of things so we're going to go from

OTC to Rx and

The Rx drugs, we'll look at are the antiemetics

Antiemetics are those drugs that help with nausea and vomiting and a very important drug that came out, It's called ondansetron

Ondansetron is [brand] Zofran and

It has the -setron

stem you'll see another couple of medications that have the -setron stem and then

We use promethazine

Which is Phenergan

I'm also going to put something here next to the Zofran and [it's] ODT

Zofran comes as an orally disintegrating tablet because

Sometimes if somebody's vomiting even just taking a little bit of water would make them vomit again

So the orally disintegrating tablet allows it to just dissolve

The Phenergan comes as a rectal suppository, again

because the patient is vomiting, they would lose the medication if they took it as a pill. It's another form

Okay, so what we've done is we've gone from the stomach down to the intestines

back up to the mouth if you want to put

it that way, and then we're going to go back to the intestines. There's two ways that I look at it

You're already there if you're thinking of the rectal suppository promethazine ulcerative colitis

and so the last one we're going to do is something for ulcerative colitis

And this drug is infliximab

And that's Remicade

"Remission Aide" so sometimes ulcerative colitis can go into remission, and that's how you remember it. This says one of the most complex stems

It's a monoclonal antibody so m-a-b

for mab, monoclonal antibody, the -li- and -xi- both have meaning and I go over into detail in the book

But just since we're just reviewing but the -liximab is actually the stem

And the monoclonal antibody doesn't tell you anything really about what it does,

it just tells you it's a monoclonal antibody

The -li- and the -xi- are much more useful because we're going to see in later chapters

things like Xolair

And etanercept and other biologics that have these complicated stems

But again if you're going to try to memorize it you really want to memorize the GI drugs where they're working.

So we went to the intestines

Down to the rectum with this promethazine and then ulcerative colitis

we would give some kind of injection of Remicade, but that's

The ulcers and the inflammation are there in the intestines