to start with three OTC medications. Most people don't know that insulins are

over-the-counter because they aren't literally over-the-counter they're in

the refrigerator in the pharmacy but they don't require a prescription or two

of them don't. Regular insulin which is humulin R and NPH insulin which is humulin

N and alphabetically you say that well why didn't you put the N first why did

you put the R first? traditionally insulins

when we talk about them and list them, we list them in the order of the speed that

they work so I'll mention these in the insulin column but regular insulin works

for less time than NPH insulin so that's how we would put it, regular then

NPH. Emergency contraception: so the stem here is the -gest- that lets you know it's

a progestin so levonorgestrel is Plan B one step. Why is it called one

step? Well it used to be two steps, used to be two pills and the plan B comes

from, well plan A might have been a condom or something like that that broke

and Plan B was to take this pill for emergency contraception it used to be by

prescription then it went behind the counter then recently it's gone

over-the-counter and available readily. So let's go with the prescription

medications now so we'll start with the oral anti-diabetics and to remind us

that diabetes is an issue of a blood glucose that's elevated so what we're

trying to do is reduce that blood glucose the order that I put them in is

by alphabetically by their class so that if you have other medications you want

to put in you can just put in more biguanides or more DPP-4 inhibitors

but the B proceeds the D proceeds the sulfonylurea. So metformin has the

-formin stem, f-o-r-m-i-n but you'll usually see some kind of g-l-

in these generic names and metformin is the exception. So the manufacturer made

Glucophage, the gl- is in the gluco for glucose and then phage to phage something

is to eat it so if you've heard of cell eating it's phagocytosis, cell drinking is

pinocytosis so that's kind of where that comes from. The DPP-4 inhibitor sitagliptin

some people just call them 'gliptins' because it's just hard to say

DPP-4 and that's Januvia. So the second generation sulfonylureas, glipizide and

we have the gli- prefix its brand name Glucotrol so you can see glucose

control is what I think they were going for with a brand name and then glyburide

the gly- prefix and Diabeta is the brand name so you can see most of the

word diabetes is in there or you can think of the beta cells and insulin

secretion and what they do there and the islets of Langerhans so those are if

you have a patient that has too much blood sugar, however sometimes we have a

condition of hypoglycemia and you would use glucagon when the glucose is gone is

the best way I think to think of that and that brand name is Glucagen

so we are generating glucose where there isn't any. So let's go on to the insulins

and another situation where we have too much or too little of a hormone. So I've

put the insulins here in order of how long they work so insulin lispro works

very quickly should be taken with a meal and because it works so quickly it's by

prescription and the brand name is Humalog which is a combination of human

insulin and analog insulin. The regular insulin and NPH I already talked about

but this is where they would be placed if you were to put the four insulins

together in terms of how long they work so insulin

lispro, regular insulin, NPH insulin then insulin glargine I've heard lazy

Lantus to remind you that it's very slow acting it works all day and then Toujeo is

a newer brand name but those four insulins in that order

just as diabetes was an issue with high glucose and sometimes we get

hypoglycemic, hypothyroidism is simply adding thyroid if you want to treat that

so levothyroxine is the actual hormone and the brand name comes from Synthroid

which is synthetic thyroid is how they came up with that brand I believe and

then hyperthyroidism when we have too much thyroid hormone we would use

something like propylthiouracil which just uses the P, the T, and the U from

propylthiouracil to make PTU. Hormone replacement, so testosterone the

-ster- is the stem indicating it's a steroid

and then Andro- meaning man and then gel because testosterone is generally

regarded as a male hormone. So from there let's go on to some birth control and

issues with the bladder. So beginning with the combined oral contraceptives or

the pill as most people would call it. The estr- is an estrogen and then the

'gest' again is a progestin and these get really complicated but if you want to

look at the estrogens you see that in all four of these ethinyl estradiol is

the estrogen so we don't have to change anything there what we're doing is we're

either adding a supplement or we're adding a progestin. So the first one is

norethindrone ethinyl estradiol and ferrous fumarate which makes

Loestrin 24 and then we use the Fe, the abbreviation

from the periodic table of elements for iron.

norgestimate with ethanol estradiol is Tri-Sprintec, the Tri- comes from

that it's triphasic. And those are oral contraceptives, so if we're trying to

remember something again we try to go head to toe and the patch would probably

be something you put on the belly and norelgestromin, the -gest- for the

progestin with ethanol estradiol is Ortho Evra so that patch you can put on

your belly the ring is a vaginal ring so we're going further down. Etonogestrel

and ethanol estradiol. Again we're using those stems and the brand name I think

comes from new vaginal ring where they just took the Nu- from and make the sound

new, the -va from vaginal and then ring. While the tablets or the pill we have

you know seven-seven-seven and then usually off for a week for 28-day cycle

these, the patch and the ring, are used for seven days and then a new one

replaces it. Overactive bladder so some of these brand names actually helped

quite a bit so with oxybutynin, the detrusor muscle

is an issue with overactive bladder so Ditropan alludes to the detrusor muscle

and then that -trol- from control you could think of you're in control with

Oxytrol OTC. the -fenacin in solifenacin is the stem and VESIcare

vesicae actually means bladder in latin and somebody must have been a classics

major that helped make this brand name but VESIcare is care for the bladder

and then tolterodine, again detrusor muscle control

in the brand-name. Urinary retention, so we've talked about a little bit about

cholinergic versus anticholinergic and a side effect of anticholinergics is that

everything is dry so there's anhidrosis, stopped sweating

there's blurry vision secondary to dry eyes, there's dry mouth,

there's urinary retention, there's constipation, and then tachycardia

but that urinary retention is what would normally cause this kind of state so to

treat an anticholinergic state what we would do is we would give a cholinergic

so bethanechol, -chol and that's not actually a stem so I'll erase it, is a

cholinergic medication and you can see the part of acetylcholine that's in the

brand name but again that's not a stem I just wanted to point it out. Erectile

dysfunction so these have the -afil stem and I believe there's actually an

infix in here because there's a vardenafil and a sildenafil and those

have that same -den- in there but I won't mess with that right now.

So sildenafil is Viagra it's the first that came out it's prominently talked

about in Love & Other Drugs, a recent movie, and via- means life and gr- are the

first two [letters] in growth. So give life, growth, however you want to take that for

erectile dysfunction. Tadalafil is also an erectile dysfunction medication with

a much longer half-life. They call it the weekend pill this is the one where

the the couples there with the bath tubs next to each other at sunset. I can't

mention the mnemonic really my students used something to the effect of tada but

I'm not going to get to that. Okay alright so we just have

four drugs left we've done 196 so we're going to go on to the benign prostatic

hyperplasia alpha blocker and then benign prostatic hyperplasia 5-alpha

reductase inhibitor. So I mentioned that alpha blockers are used for hypertension

but they also are helpful for a condition called benign prostatic

hyperplasia or BPH and this is a benign growth of the prostate where there's an

issue with urine flow. So to make the brand name the manufacturer must have

thought of you know the urine flow being slowed so now we're going to get maximum

flow to make Flomax. And then alfuzosin also alludes to this urine with

the 'ur-' [in the brand name] and then control '-tral' instead of '-trol' the -osin at the end of

tamsulosin and alfuzosin it's not an actual stem, but some students use it to

remind themselves that the BPH drugs are related. The last two drugs so BPH

5-alpha reductase inhibitors so the dutasteride and finasteride. Avodart is

the brand name for dutasteride. Finasteride is interesting that it has

two brand names and I should have put Proscar first for prostate care because

that really matches up with the Avodart but interestingly enough as people were

taking the finasteride they were growing hair, something called hirsutism, and not

to lose an opportunity the manufacturer said okay well let's create a medication

name that's going to indicate that the person has is going to grow hair so

alopecia is the loss of hair, propecia I guess would be adding here so that's how

that name came about. At the end of movies in the old black and whites

there was always 'fin' or 'fini' or done. So we have finished our 200 medications

and hopefully these videos were helpful.