thing that we're going to talk about are the first group of drugs and all of this

that I'm going to put up there is all in my head so I'm just going to do this

from memory but you might learn it piece by piece. I'm going to show you the

pieces and how they group together and then within those groups we'll have three

larger groups so that you can learn this column then hopefully next column the

next column. So the first column I'm going to talk about are the OTC NSAIDS

The non-steroidal anti-inflammatory drugs There are three of those. Start

with aspirin, ibuprofen which has two brand names, Advil and Motrin and then naproxen

So the first thing we want to do is make sure that we check for any stems

and a stem is something that indicates what drug class it's in. -profen is a

non-steroidal anti-inflammatory stem. -proxen isn't. It looks very similar though so if

you're trying to memorize it that's one good way to do it. So we go from the OTC

NSAIDs aspirin ibuprofen naproxen to what would be a non narcotic analgesic

also over-the-counter

and the one that you're probably most familiar with is

acetaminophen Tylenol. There's no stem here but what you can see just like with

the aspirin, aspirin is actually acetylsalicylic acid which is abbreviated ASA

We also have an abbreviation that actually comes from acetaminophen which

is from N-acetyl-para-aminophenol which is APAP and we'll use that in just a

minute. So then we've got those and these take

care of most things that most analgesia most pains over-the-counter but maybe

it's some kind of a migraine or something like that so we're going to

combine them and we'll combine the OTC NSAID plus non-narcotic in a

medication called Excedrin Migraine that includes aspirin ASA, Tylenol APAP, and

also caffeine and the caffeine is a vasoconstrictor it helps narrow the

blood vessels in the brain so that there's less pain

So we started with the OTCs and the natural movement or progression is from

OTC to Rx so let's go to the Rx NSAID and the first one we'll look at is

meloxicam and this also has a stem -icam okay and that's mobic and then we

also have another Rx NSAID that's a COX-2 inhibitor. That one's going to

be Celebrex or celecoxib

And that's Celebrex. So the first kind of panel,

first group of drugs that we want to look at are these seven and we see that

we have nonsteroidals and non-narcotic we're going to combine the two to help

memorize these two groups then we're going to have prescription NSAID that

works just like ibuprofen and naproxen, meloxicam

And then we have this COX-2 inhibitor which is supposed to protect the stomach

Okay so again in order, aspirin ibuprofen naproxen acetaminophen aspirin

acetaminophen caffeine meloxicam and celecoxib. So that's the first group

and that's how we would do that within the groups though make sure that you

want to try to alphabetize it so A comes before I before N and I'll show you

where I'll break that rule a little bit here. Okay so the next group we're

going to look at are the opioids and narcotic antagonist

And we'll start with the scheduled two so again the DEA schedules, one is one

that has no medical value two is the most addicting three is less addicting

than that four is less addicting than that and five and so forth so we'll go

over a two or three and a four. So the first one is morphine

MS Contin

And fentanyl has a couple brand names. One is Duragesic

an analgesic that lasts for a long duration and Sublimaze although it's not subQ

you can think of it going intramuscularly

Then we have hydrocodone

with acetaminophen

That's Vicodin

And then oxycodone with acetaminophen and that's Percocet

That's an R. Okay all right so we've got four C-II opioids and you'll notice that I've got

it alphabetically here but not here. Why? Well morphine was the first drug

It's a prototypical drug. If you have something like that you want to take it

and put it at the top and then you'll alphabetize the ones that come after it

But now we're going to go in DEA order from C-II to narcotic C-III

And the C-III is going to be Tylenol with codeine but we call it

Acetaminophen with codeine

and one of them is Tylenol #3 then we have a narcotic C-IV

It's a mixed opioid so I'll just call it a mixed opioid but it is

scheduled four

and that's tramadol

and we'll just underline -adol and that's

the stem there. So over here we used the NSAIDs and we did them from OTC

to Rx over here what we're going to do is we're going to use the number of DEA

schedules from two to three to four to help memorize them and then we've got a

narcotic antagonist

and it's nice to have usually the agonist before the

antagonist it just makes sense intuitively and that's noloxone

Or Narcan and the stem there is the nal- So these are the opioids and how

you remember them use them in DEA schedule order agonist first

antagonist next. Next we're going to go actually in the body from head to toe

and the first group that we're going to have

are the triptans and the triptans are going to be the migraine medications

eletriptan Relpax and you can think of relief and pax means peace in

Latin and then sumatriptan which is Imitrex there's an IM version so you can

think of the IM and imitrex but really it's these -triptan stems

that tell you what kind of medication you have then from there we're going to

go to what are called the DMARDs and DMARDs are disease-modifying

antirheumatic drugs and I'll show you why I'm going to put this not in

alphabetical order

Methotrexate Rheumatrex because it's

for rheumatoid arthritis and methotrexate has the -trexate stem

and this is a non-biologic then we have two biologics, abatacept and

etanercept. So [brand names] Orencia and Enbrel

I'm going to underline the -cept because that's the stem for these

biologics but also the -ta- so we'll double underline the -cept and the -ner-

and so the -tacept and -nercept means that it's a certain kind of disease

modifying antirheumatic drug but you see we don't have alphabetical order here

because we have a non biologic then we have two biologics in alphabetical order

so after the DMARDs come, the way I remember it is we start

with the head then we go to the joint and then from the joint we're going to

go to the bone. So we have two bisphosphonates,

alendronate

Ibandronate

[brand] Fosamax. Students like to think of fossil. [brand] Boniva has the word bone in it

that's how I remember those. And these aren't for osteoarthritis like the NSAIDs would be

these are for osteoporosis so some degradation of the bone from there we

have the muscle relaxants up and then the -dronate stem that tells you that

these are bisphosphonates. Then we have the muscle relaxers and the muscle

relaxers include cyclobenzaprine which is Flexeril and diazepam which is Valium

and the -azepam is a stem so cyclobenzaprine you can see the word

-benz- and it's like you're bending and then flex for Flexeril. diazepam it's a

benzodiazepine we'll see benzodiazepines in the neuro section but these are also

used for muscle relaxation so I put one here we actually have one more set of

drugs but I want you to notice where we've gone we started with the head so

triptans for headache then we went into the joint and then from the joint

we went to the bone and then out to the muscle so you're thinking inside out and

I'll put it over here anti-gout okay so I'm going to have 2 anti-gout

medications allopurinol which is Zylorpim and febuxostat which is Uloric

and the -xostat is the stem. These anti gout medications are for

chronic gout so what we're doing is we're preventing uric acid from forming

and you can kind of see the uric from uric acid in here and then the -lo- for lower

so "you lower" uric acid. Both of these prevent having too much uric acid if

you have less uric acid you'll have less gout but again alphabetize them within

the group and here we are gout 50% of the time is in the toe so a

good place to memorize

so those are the 25 musculoskeletal drugs in a nutshell