High-Yield Exam Mnemonics
- Generic = Government approved name.
Recall: Generic name (INN) is the official non-proprietary name.
- First Pass = Liver’s first attack.
Recall: Orally administered drugs pass through the portal circulation to the liver before reaching systemic circulation, where hepatic enzymes metabolize them.
- Vd = Virtual distribution space.
Recall: Vd is a theoretical/apparent volume relating total drug in body to plasma concentration.
- BBB = Barrier of tightly Bound cells.
Recall: Brain capillary endothelial cells have tight junctions preventing passage of polar/large molecules.
- CYP = Chief Your Pharmacokinetics.
Recall: Cytochrome P450 (CYP) enzymes metabolize >75% of drugs, primarily in liver microsomes.
- Kidneys = Key excretory organs.
Recall: Kidneys excrete most drugs and metabolites via glomerular filtration, tubular secretion, and reabsorption.
- 4-5 for Steady-State.
Recall: Steady-state occurs when drug input equals elimination, reached after 4-5 half-lives regardless of dose or frequency.
- Phenytoin = Peculiar kinetics.
Recall: Phenytoin exhibits saturation kinetics–at high doses, metabolizing enzymes saturate, shifting from first-order to zero-order (constant amount eliminated).
- DRC = Dose-Response Connection.
Recall: Dose-response curves show relationship between drug dose (x-axis) and response magnitude (y-axis), typically sigmoidal.
- Narrow Window = Need monitoring.
Recall: Narrow therapeutic window means small difference between therapeutic and toxic concentrations (digoxin, lithium, warfarin).
- Competitive = Curve shifts right.
Recall: Competitive antagonists bind reversibly to same receptor site as agonist, causing rightward shift of dose-response curve (reduced potency) without reducing maximum response.
- Synergism = Super combined effect.
Recall: Synergism (potentiation): combined effect > sum of individual effects (1+1=3).
- A = Augmented and anticipated.
Recall: Type A reactions are augmented pharmacological effects, dose-dependent, predictable, and common (80% of ADRs).
- Kinetic = Changes in drug handling.
Recall: Pharmacokinetic interactions affect ADME (absorption, distribution, metabolism, excretion).
- ED50 = Effect in half.
Recall: ED50 (effective dose 50) produces therapeutic effect in 50% of population.
- Protective = Toxic (not lethal) over Effective.
Recall: Protective index = TD50/ED50, using toxic dose instead of lethal dose–more relevant for human therapeutics.
- COX-1 = Constitutive, protects gut.
Recall: COX-1 is constitutive, maintaining gastric mucosa (cytoprotective prostaglandins), platelet function, and renal blood flow.
- Celecoxib = Selective for COX-2.
Recall: Celecoxib selectively inhibits COX-2, reducing inflammation with less GI toxicity than traditional NSAIDs.
- First-gen = Fatigue (sedation).
Recall: First-generation antihistamines (diphenhydramine, chlorpheniramine) are lipophilic, cross BBB, and block central H1 receptors causing sedation.
- Sumatriptan = Serotonin for migraine.
Recall: Sumatriptan is a 5-HT1B/1D agonist causing cranial vasoconstriction and inhibiting neurogenic inflammation, aborting migraine.
- Misoprostol = Mucosa protection.
Recall: Misoprostol (PGE1 analog) replaces protective prostaglandins inhibited by NSAIDs, reducing gastric acid and enhancing mucus/bicarbonate.
- Naproxen = Notably safer for heart.
Recall: Naproxen has relatively balanced COX-1/COX-2 inhibition with lower cardiovascular risk than selective COX-2 inhibitors (etoricoxib) or diclofenac.
- Montelukast = blocks Leukotriene receptors.
Recall: Montelukast blocks CysLT1 receptors, preventing leukotriene-mediated bronchoconstriction.
- Penicillin = Peptidoglycan synthesis stopped.
Recall: Penicillins are β-lactams that inhibit transpeptidase (penicillin-binding proteins), blocking peptidoglycan cross-linking in bacterial cell walls, causing cell lysis.
- Cilastatin = Saves imipenem in kidney.
Recall: Cilastatin inhibits renal dehydropeptidase-1 (DHP-1), which would otherwise inactivate imipenem in kidneys, increasing urinary levels and reducing nephrotoxicity.
- Vancomycin = Vital for MRSA, binds D-Ala-D-Ala.
Recall: Vancomycin (glycopeptide) binds D-Ala-D-Ala terminal of peptidoglycan precursors, blocking transglycosylation and transpeptidation.
- Tetracyclines = Thirty S blockers.
Recall: Tetracyclines bind 30S subunit, blocking aminoacyl-tRNA attachment to ribosome A site, inhibiting protein synthesis.
- Aminoglycosides = Auditory and renal damage.
Recall: Aminoglycosides (gentamicin, amikacin) cause dose-dependent nephrotoxicity (reversible) and ototoxicity (often irreversible–vestibular and cochlear).
- Azithromycin = Amazing long half-life.
Recall: Azithromycin has long tissue half-life (~68 hours), allowing short courses (3-5 days) with once-daily dosing.
- Clindamycin = Covers anaerobes.
Recall: Clindamycin has excellent anaerobic coverage (Bacteroides fragilis) and gram-positive activity.
- Quinolones = Quit using in kids (cartilage damage).
Recall: Fluoroquinolones cause arthropathy and cartilage damage in weight-bearing joints in juvenile animals and potentially children.
- Ampho-terrible toxicity but binds ergosterol.
Recall: Amphotericin B (polyene antifungal) binds ergosterol in fungal cell membranes, creating pores causing leakage and cell death.
- Crypto = Ampho + flucytosine first.
Recall: Amphotericin B + flucytosine for 2 weeks is preferred induction for cryptococcal meningitis, followed by fluconazole consolidation/maintenance.
- Acyclovir = Anti-herpes.
Recall: Acyclovir is first-line for HSV (genital, oral, encephalitis) and VZV (chickenpox, shingles).
- Navir = blocks protein cleavage.
Recall: HIV protease inhibitors end in “-navir” (ritonavir, lopinavir, atazanavir, darunavir).
- Grey baby = Glucuronidation deficiency with chloramphenicol.
Recall: Grey baby syndrome occurs in neonates given chloramphenicol–immature liver cannot glucuronidate the drug, causing accumulation, cardiovascular collapse, and grey discoloration.
- First PASS through the liver = First Pass Effect.
Recall: The hepatic first-pass effect refers to the metabolism of a drug by the liver before it reaches systemic circulation, significantly reducing bioavailability.
- LOAD up quickly to reach therapeutic LEVEL.
Recall: A loading dose is a higher initial dose given to rapidly achieve therapeutic plasma concentration, especially important for drugs with long half-lives.
- Phenobarb INDUCES enzymes → warfarin INEFFECTIVE.
Recall: Phenobarbital is a potent inducer of hepatic CYP450 enzymes, increasing warfarin metabolism and reducing its anticoagulant effect.
- ZERO-order = ZERO change in rate regardless of concentration.
Recall: In zero-order kinetics, a constant amount of drug is eliminated per unit time regardless of plasma concentration (enzyme saturation).
- EFFICACY = EFFECT ceiling – how HIGH can it go?
Recall: Efficacy refers to the maximum effect a drug can produce regardless of dose.
- TACHY = FAST, phylaxis = protection wearing off FAST.
Recall: Tachyphylaxis is rapid tolerance developing within minutes to hours of repeated dosing, common with nitroglycerin due to depletion of sulfhydryl groups.
- PARTIAL agonist = PARTIAL response (never reaches maximum).
Recall: Partial agonists have lower intrinsic activity, producing submaximal response even at 100% receptor occupancy.
- SYN = together, working SYNERGISTICALLY = greater together.
Recall: Synergism occurs when combined effect of two drugs exceeds the sum of individual effects, often seen when drugs work through different mechanisms.
- Vd = 5L = PLAsma volume (PLA-5).
Recall: Vd of 5 liters approximates plasma volume (3-5L), indicating drug is largely confined to plasma, likely due to high plasma protein binding or large molecular size.
- Type B = Bizarre, unpredictable, allergic – not related to normal pharmacology.
Recall: Type B (Bizarre) reactions are unpredictable, dose-independent, and often immunological (allergic reactions).
- ASPIRIN + VIRUS + CHILD = AVOID (Reye’s syndrome).
Recall: Aspirin is contraindicated in children with viral infections due to risk of Reye’s syndrome (hepatic failure and encephalopathy).
- ASPIRIN = ACetylates = permanent platelet paralysis.
Recall: Aspirin irreversibly acetylates platelet COX-1, preventing thromboxane A2 synthesis for the platelet’s entire lifespan (7-10 days).
- NAC = N-Acetyl Cysteine replenishes GSH (Glutathione).
Recall: N-acetylcysteine (NAC) is the antidote for paracetamol poisoning.
- 2nd gen = TOO polar to enter brain = no sedaTION.
Recall: Second-generation antihistamines (cetirizine, loratadine, fexofenadine) are more polar and have limited CNS penetration due to P-glycoprotein efflux pumps, causing less sedation.
- FEXOfenadine is FIXED – no QT problems like its parent terfenadine.
Recall: Terfenadine (prodrug of fexofenadine) was withdrawn due to QT prolongation and fatal arrhythmias when combined with CYP3A4 inhibitors.
- Too much SEROTONIN = SHAKING, SWEATING, SEIZING (altered), and high TEMPERATURE.
Recall: Serotonin syndrome results from excessive serotonergic activity, characterized by hyperthermia, autonomic instability, neuromuscular changes (rigidity, clonus), and altered mental status.
- ASPIRIN first = permanent protection; IBUPROFEN blocks its access if taken first.
Recall: Ibuprofen reversibly binds to COX-1 at the same site as aspirin, competitively preventing aspirin’s irreversible acetylation.
- Type I = Immediate, IgE, anaphylaxIs.
Recall: Penicillin allergy causing anaphylaxis is a Type I hypersensitivity reaction mediated by IgE antibodies bound to mast cells, triggering histamine release.
- AZtreonam = Attacks only gram-negatives, Zero gram-positive/Anaerobic activity.
Recall: Aztreonam is active only against aerobic gram-negative bacteria and has minimal cross-reactivity with penicillins, making it safe in penicillin-allergic patients.
- Oral Vanco stays in the GUT = GUT-level treatment.
Recall: Oral vancomycin is not absorbed from the GI tract, achieving very high concentrations directly in the gut lumen where C. difficile resides.
- FOSFOmycin = FOr Simple FOurth-UTI (simple urinary tract infection).
Recall: Fosfomycin inhibits early cell wall synthesis (MurA enzyme) and achieves very high urinary concentrations.
- BACI-tracin BAD for kidneys (Back off from systemic use).
Recall: Bacitracin causes significant nephrotoxicity when given systemically, limiting use to topical application for skin and eye infections.
- TETRA-cyclines + MINERALS = won’t ABSORB (chelated out).
Recall: Tetracyclines chelate with divalent and trivalent cations (Ca²⁺, Mg²⁺, Al³⁺, Fe²⁺) in dairy products, antacids, and iron supplements, forming insoluble complexes that reduce absorption.
- Amino-GLY-cosides damage EAR GLIAL cells (hair cells) = ototoxicity.
Recall: Aminoglycosides accumulate in cochlear and vestibular hair cells causing irreversible ototoxicity.
- AZIthromycin = AMAZing pharmacokinetics, not AMAZing gram-positive activity.
Recall: Azithromycin has longer half-life (68 hours), better tissue penetration (concentrates intracellularly), and fewer drug interactions (minimal CYP450 inhibition).
- IdiosyncRATIC = unpredictable, IRREVERSIBLE, RATe not related to dose.
Recall: Chloramphenicol causes two types of bone marrow toxicity: dose-related reversible suppression (common) and idiosyncratic aplastic anemia (rare, dose-independent, irreversible, often fatal).
- CLINDA-mycin = C. diff CLINICALLY associated.
Recall: Clindamycin is strongly associated with Clostridioides difficile-associated pseudomembranous colitis due to disruption of normal gut flora.
- QuinoLONES = stop DNA reLONgation (topoisomerases unwind/rewind).
Recall: Fluoroquinolones inhibit DNA gyrase (topoisomerase II) in gram-negatives and topoisomerase IV in gram-positives, preventing DNA supercoiling and replication.
- ARTEMISININ = RAPID (ARTemis the goddess = swift) but short-lived = needs partner drug.
Recall: Artemisinin compounds provide rapid parasite clearance (fastest-acting antimalarials) but have short half-lives (1-3 hours).
- Ampho-TERRIBLE infusion reactions → PRE-medicate.
Recall: Infusion-related reactions (fever, chills, rigors) are common with amphotericin B due to cytokine release.
- AZOLE = inhibits A to E (lanosterol to Ergosterol) at CYP51 = 14 Alpha demethylase.
Recall: Azoles inhibit fungal CYP51 (14-alpha-demethylase), preventing conversion of lanosterol to ergosterol.
- FOS-carnet = Fires directly at polymerase (no activation needed).
Recall: Foscarnet directly inhibits viral DNA polymerase by blocking the pyrophosphate binding site, without requiring kinase activation.
- PIs = Protease Inhibitors = Problems with fat and glucose metabolism.
Recall: Protease inhibitors (ritonavir, lopinavir) are associated with metabolic syndrome: lipodystrophy, hyperlipidemia, insulin resistance, and increased cardiovascular risk.
- Myopia = My book is fine, far is fuzzy.
Recall: Myopia (short-sightedness) causes difficulty with distant vision while near vision remains intact.
- Astigmatism = Asymmetric cornea = All distances blurred.
Recall: Astigmatism results from unequal curvature of the cornea (or lens) in different meridians, causing blurred vision at all distances.
- Hyper-kid accommodates too hard → eyes turn in.
Recall: Hypermetropia requires excessive accommodation to focus light on the retina.
- Long eye = stretched retina = retinal detachment risk.
Recall: This patient has axial myopia.
- Hypermetropia = Half-sized eye = needs Help with plus lenses.
Recall: A small eyeball (short axial length) with a shallow anterior chamber and difficulty with near vision is classic hypermetropia.
- Myopia = too much power → LASIK flattens to fix.
Recall: LASIK for myopia removes corneal stromal tissue centrally to flatten the central cornea, reducing its refractive power so that light focuses on the retina instead of in front of it.
- Oblique = Odd angles (neither vertical 90° nor horizontal 180°).
Recall: When the principal meridian of astigmatism lies between 30°–60° or 120°–150°, it is classified as oblique astigmatism.
- Compound Myopic = Completely in front – both lines Miss the retina forward.
Recall: In compound myopic astigmatism, both principal meridians are myopic, so both focal lines fall in front of the retina.
- Accommodation retires at 60 – just like many people.
Recall: Accommodation progressively decreases with age due to lens hardening (nuclear sclerosis).
- Green clearer = Gone too far (overcorrected). Red clearer = Reduce minus still needed.
Recall: The duochrome test exploits chromatic aberration.
- Hasner’s membrane has not opened → tears has no way out.
Recall: Persistent watery eye with mucopurulent discharge since birth is characteristic of congenital dacryocystitis caused by a blocked nasolacrimal duct (Hasner’s membrane persistence).
- Press sac → pus comes back = Regurgitation test = blocked Road below.
Recall: Regurgitation test positive (mucopurulent reflux on pressing the lacrimal sac) confirms chronic dacryocystitis with nasolacrimal duct obstruction.
- Pus near the eye + open surgery = Endophthalmitis disaster.
Recall: Chronic dacryocystitis harbors organisms (especially *Staphylococcus* and *Streptococcus*) in the lacrimal sac.
- Rheumatoid + dry eyes = Rose bengal stains the Sjögren’s damage.
Recall: Rheumatoid arthritis is associated with Sjögren’s syndrome, which causes keratoconjunctivitis sicca (dry eye).
- Red, painful swelling below medial canthus + pus from punctum = Acute Dacryocystitis.
Recall: Acute dacryocystitis presents as a painful, red, tender swelling over the lacrimal sac (below the medial canthal tendon) with purulent discharge expressible through the punctum.
- NLD block → fluid enters sac → escapes via the other (opposite) punctum.
Recall: In nasolacrimal duct obstruction, saline injected through the lower punctum cannot drain into the nose.
- Dye stays = drainage stuck.
Recall: The FDDT assesses lacrimal drainage.
- Jones I positive = passage is patent. Dye reaches the nose = no block.
Recall: A positive Jones I test means fluorescein has traveled from the eye through the entire lacrimal drainage system into the nose – confirming a patent (functional) system.
- TBUT < 10 = Tear film is too unstable.
Recall: Normal TBUT is ≥10 seconds.
- Eating + crying = Crocodile tears (crocodiles supposedly cry while eating prey).
Recall: Crocodile tears (Bogorad syndrome) occur due to aberrant regeneration of facial nerve fibers after Bell’s palsy – salivatory fibers regenerate along the lacrimal pathway, causing tearing during eating.
- Plug the drain → pool the tears → wetter eye.
Recall: Punctal plugs (silicone or collagen) occlude the lacrimal puncta, preventing tear drainage and thereby increasing the tear film volume on the ocular surface.
- Old person suddenly reads without glasses = nuclear cataract’s myopic gift (temporary!).
Recall: “Second sight” occurs when progressive nuclear sclerosis increases the refractive index of the lens, creating a myopic shift.
- Steroids → Subcapsular Posterior (SSP).
Recall: Chronic corticosteroid use (systemic or topical) is classically associated with posterior subcapsular cataract.
- White pupil in a child → Rule out Retinoblastoma before anything else.
Recall: Retinoblastoma is the most important and dangerous cause of leukocoria in children.
- Morgagnian = nucleus sinks in milky fluid – like a stone in milk.
Recall: In Morgagnian (hypermature) cataract, the cortex undergoes complete liquefaction, causing the dense brown nucleus to sink to the bottom of the capsular bag.
- Phacolytic = leaking proteins in hypermature stage. Lysis of proteins → logging the meshwork.
Recall: Phacolytic glaucoma occurs in hypermature cataracts where high-molecular-weight lens proteins leak through the intact but permeable capsule.
- After surgery → After-cataract (PCO). Treated with YAG laser – no second surgery needed.
Recall: Posterior capsule opacification (PCO), also called after-cataract, is the most common late complication of cataract surgery.
- Diabetes = Double trouble – PSC + Snowflake.
Recall: Diabetes mellitus is associated with two types of cataracts: posterior subcapsular cataract (common in all diabetics) and true diabetic “snowflake” cataract (widespread white cortical opacities, seen in young type 1 diabetics).
- Rubella = Pearly white nucleus – the virus turns the lens into a pearl.
Recall: Congenital rubella causes a characteristic pearly white, dense nuclear cataract, often bilateral.
- Myotonic dystrophy = Multicolored Christmas tree in the lens.
Recall: “Christmas tree” (multicolored iridescent) cataract is classically seen in myotonic dystrophy – fine, polychromatic, needle-shaped crystals scattered throughout the lens cortex.
- YAG opens the back door → vitreous moves forward → retina may peel off.
Recall: Nd:YAG laser capsulotomy disrupts the posterior capsule, which can allow vitreous to prolapse forward and exert traction on the retina, increasing the risk of retinal detachment (especially in myopic eyes).