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Mivacurium - "My vac"um cleaner.

Moves around quickly and is very mobile (ChE in plasma, which moves/is mobile)

There's dust and dirt kicked up, which makes my nose run (some histamine release).

It moves so fast, which means it breaks down fast (SHORTEST duration).

Succinylcholine -> "Sucks an eel"

This guy gets dared to "suck an eel", but he gets scared so his BP GOES UP, and his HEART TRACES (HTN + tachycardia).  But, if he would have sucked a young eel, his heart would have slowed down (BRADYCARDIA IN CHILDREN).

The eel is very mobile (plasma ChE) and fast (FAST ONSET AND DURATION).

Guy has some snot, HISTAMINE release.

The eel's shocks make his muscles ache (MYALGIAS), his eyes want to pop out and his head explode (INCREASED INTRACRANIAL AND INTRAOCULAR PRESSURE).

The eel finally shocks him so hard his heart stops (CARDIAC ARREST).

#Mivacurium

#Succinylcholine

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Tubocurarine - "tub o' curry" WTF is the curry pink? KIDNEY excretion.

When you eat curry, you can't get the taste out of your mouth (Longest lasting of class) and my nose always run (HISTAMINE release). 

But the curry doesn't taste good so it had a WEAK reception at the GANG'S block party (weak block on autonomic ganglia).

Atracurium and Cisatracurium - Two sisters that want to "ATTRACT UR" man. They both get frustrated easily and DISAPPEAR if they don't steal your man (spontaneous termination).

They both try for about 30 mint but "sis" doesn't mind a little over time (atracurium = 20-30 min, cisatracurium = 30-45)

Atracurium has some snot (some HISTAMINE release).

#Tubocurarine

#Atracurium

#Cisatracurium

[sketchrx]

Tammy the sex pot is Full of Sin.  She has those lips that men just love (potent oral agent).  She’s a working girl, the alpha of Bill’s Personal Harem (1st alpha 1 antagonist approved for BPH).  She’s so hot that men get dizzy and can’t stand up (CNS, CV-orthostatic hypotension).  They then jizz their pants (abnormal ejaculation).  In response, they try to take viagra but that won’t help because she’s so hot (caution with PDE5 inhibitors).  She’s holding a bladder of wine because she wants to relax at the end of the night (relaxes bladder neck and improves urine flow for BPH symptoms).  After drinking the wine, it gets metabolized by the liver CYP3A4, 2D6

[sketchrx]

Pyrimidine Pyramid

5-FU is represented by 5 flowers at the base of the pyramid.  Hidden in the depths of the pyramid is a magical lamp (inhibits thymidilate synthetase, S-phase specific).  When you you see the pyramid you BIRP in awe (breast, intestine, renal cell, pancreatic cell cancers).  5-FU has different side effects depending on how you deliver it.  Bolus --> myelosuppression. Continuous IV or capecitabine pill --> Hand+Foot Disease, diarrhea, mucositis (For the pill think of taking a pill in your HAND and swallowing it.  Follow it through its natural course through the gastric mucosa and to diarrhea)

Gemcitabine - On this beautiful pyramid gems were incorporated (incorporated into DNA and prevents stacking and replication).  At the base of the pyramid is a snake that longs to be (Lung cancer, uterine sarcoma, NHL, GI malignancies, 2XB breast cancer, bladder cancer) a human but doesn’t have enough bones (myelosuppression --> neutropenia, thrombocytopenia, anemia).  Other snakes look at him and say his head is in the clouds (flulike symptoms).  The snake is sliding on its belly which causes a rash.  It also accidentally bit himself while hissing (s phase active but not specific) and he’s bleeding (hemolytic uremic syndrome)

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Prays to Rid his Sin.  He is a competitive (alpha 1 competitive antagonist) stockbroker (Oral HTN drug) dick head (off label Tx for BPH).  He has sinced realized that his past life was full of SHIT (excreted via bile in feces.  adverse effect of GI pain, NVD) and is praying on the floor.  It’s his first time praying after a long time and he accidentally falls asleep (first dose syncope).  On his knees he’s feeling impotent and incontinent (causes impotency and incontinence).  If you are impotent you can’t get any vagina (angina precaution).

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Fennel - Old and Mean - He is a short tempered (short acting alpha antagonist) old guy who isn’t good with computers.  He goes nuts when browsing the internet with chrome browser doesn’t work (antihypertensive for pheochromocytoma).  Unfortunately he can’t watch his favorite Youtube channels (5-HT receptor, K+ channel blocker).  Because of this, he’s very sad and his heart is broken (precaution: CV issues, MI, angina).  

Other important details: he’s a snotty old man (can cause histamine release).  He has age spots (prevents dermal necrosis following extravasation of alpha agonists)

Oxy-Clean guy-driving-a-benz - Billy Mays has just finished promoting his best selling (wide tissue distribution) oxiclean product that forms a stable bond with grease (noncompetitive selective alpha 1 antagonist, effects last up to 7 days).  He is driving away in his benz and for some reason snorts a bump of oxiclean which causes his pupils to constrict as well as stuffs up his nose (miosis and nasal congestion).  He also is driving with his hand outside the window at high speeds which makes it very cold and turns it blue (used to treat acrocyanosis, raynaud’s disease, and frostbite).  Just like his oxyclean sits on shelves, the adrenal gland sits on top of the kidneys (renal disease is a precaution)

[sketchrx]

eating pot makes him high (high dose MTX and CNS toxicity) good thing he's a leucovore (leucovorin is antidote to MTX poisoning) so he can eat a lot of salt but he's allergic to eggs, penne, four sided pizza, salad, and Hi-C which makes him sad (support with sodium bicarb, watch drug interactions with sulfa, phenytoin, tetracyclin, salicylate, vit C and NSaids) he also loves carp caviar but it's expensive (glucarpidase for delayed clearance)

[sketchrx]

the surgical violin

Think of a violin with one string (first generation cephalosporin).  Instead of a bow, you use a syringe (IV).  The bow and syringe form a plus sign (gram positive).  The violinist is a surgeon (workhorse perioperative abx for preventing surgical site infexn).

[sketchrx]

PROpranolol - defensive lineman that blocks the pass rush (nonselective beta blocker).  Use for htn, angina, tachycardia etc.

Metoprolol - Mets 1st Baseman (competitive B1 antagonist)

Pandalol - cute panda wants your sympathy (intrinsic sympathomimetic activity).  So cute that it decreases anxiety (partial 5-ht agonist and augments SSRI’s anxiolytic effects).  Chubby (so beware of diabetes).

Timonolol - Lion king is a sappy movie makes you cry (decrease IOP by decreasing aq. humor production)

A-perfect-ten olol - A sexy model cat.  Before you bone remember to wear protection (pregnancy risk D).  You’ll have to last long to please her (long acting)

[sketchrx]

This is Tyra Banks, she’s crazy (and can give anyone a severe headache (a side effect)).  She’s running around causing increases in HR, BP and other SNS effects (mydriasis, fever, headache).  This drug, found in many, often protein containing (meat), food causes increase in catecholamine release.  The cat with a cold (sneezing) indicates catecholamine release.  Terrible cat I know.  Avoid tyramine foods if on MAO-I.

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This is Ace (for acetyl), he’s a paratrooper (this indicates that ACh activates much all of the parasympathetic system).  He’s coming down to land in SLUDGE quickly (it’s fast acting).  SLUDGE is an acronym for too much parasympathetic activity.  Salivation, Lacrimation, Urination, Defecation, GI issues, Emesis.  It would decrease heart rate and cause miosis (constriction of the pupil).  ACh acts on skeletal muscles, so you would get muscle spasm.

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This is Phil (close to Pilo), who’s catching a carp.  Phil is really hungry so he’s salivating, it’s used to help dry mouth in Sjorgren syndrome patients.  There’s a pine tree behind him.  It’s bright out, indicating it causes miosis.  It’s often used for both open and closed angle glaucoma, the constriction helps both conditions.  The carp is supposed to be drawn with messed up eyes, indicating it causes blurred vision.  Phil’s cat, Sjorgren, is by his feet.  This cat is domesticated, therefore lives at home, which represents closed angle glaucoma.  The other, wild cat is drawn next to the pine tree, this cat lives out in the open, for open angle glaucoma (it’s a stretch I know).  One of the CONTRAINDICATIONs is posterior synechiae (iris and lens adherence), can think of Phil and Sjorgren as the initials for this CONTRA (retinal detachment, iritis, and asthma are also contraindications).  The asthma contraindication, think of Sjogren the cat as having asthma (if anyone has heard of Sufjan Stevens, the musician, he owns Asthmatic Kitty records).  

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This guy is depressed because he just MAOed (chowed down) on  a big funnel cake (funnel close to phenel).  He needs to stop MAOing so much (MAO inhibitor) on food in order to help his depression (2nd line depression tx, and used for other anxiety disorders).  So you get increases in NE, DA and 5HT with MAO-I.  Gives you sympathetic effects (CNS, sweaty, tremors, tachy, HTN, mydriasis).  I’d be sweating and hypertensive if I ate a giant funnel cake too.  Precautions for CV, renal and hepatic disease, also pheochromocytoma, other SNS increasers, diabetes, and tyramine containing foods (increases SNS NTs).  His Radiohead t-shirt indicates that MAO-Is can induce seizure in some patients when undergoing radiocontrast imaging.

[sketchrx]

Parrot + Ox is close to the name of this drug.  It’s a selective serotonin reuptake inhibitor (SSRI), indicated by the brand on the ox.  These are often used for depression (don’t be sad the parrot says) or anxiety (off label uses for premature ejaculation and hot flashes).  The table has 2 cups of eggnog, meaning its metabolized by 2 CYPs (2D6 and 3A4).  Eggnog is sugary and eggy, which means it gets glucuronated and sulfated during metabolism.  Its a pissing parrot (62% of excretion), the ox is pooping (36% of excretion).  You get some CNS and GI issues.  CONTRA with MAO inhibitors.  Also be careful with renal and hepatic disease, it’s a pregnancy class D drug.

[sketchrx]

This is an ox (like a bull) in a china shop.  I think plates when I think china shop.  It has a brand with NVDM for nausea (neuropathy), vomiting, diarrhea, myelosuppression.  The unique side effect is cold induced neuropathy, so the ox is shivering.  It is used to treat colorectal and GI cancers.  I thought of it as cows, which are similar to oxen, have multiple stomachs, so this one is used to treat stomach and other GI malignancies.

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This is NorMaN, nicotine works on Nn and Nm receptors, therefore this drug works in the para and sympathetic systems, the CNS and the PNS.  Norman is therefore torn, his buddy Nico (on the left) wants him to come out and drink and smoke with him.  The beer drinking indicates that nicotine is metabolized in the liver.  Nico is his laid back, more loose friend, on the periphery, a shady character.  This side is the parasympathetic side, so diarrhea inducing.  The other side is his mother who is representing his CNS, wants him to stop partying so much.  She’s more up tight than Nico, meaning constipation.  Weird precautions: patients with pheochromocytoma, or thyroid disease (can cause thyrotoxicosis).

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On the left is a meth user who has dx on his shirt.  Dx stands for diagnosis, you inhale meth, this drug is used to diagnosis hyperactive airways (preasthmatic).  You inhale it via a nebulizer, for some reason I think of little kids having to use a nebulizer, so I drew the baby.  Meth users itch their skin, which is one of the side effects.  Other adverse effects (headache, sore throat, lightheaded) all have to do with inhaling something.  I wanted to show the meth user moving quickly (the black lines on the ground) to indicate it acts fast (30-45min).  It does have slight nicotinic activity (you can smoke meth).