anesthetics and these are OTC and what a local anesthetic is it's just something

that's going to numb a certain area. Anesthetics, when injected, will make a

person pass out but what I want to talk about is the ester vs the amide so

benzocaine is an ester it's a type of organic chemistry molecule and that

tells you that the esters we don't really want to inject because they can

become allergenic where a patient might have an allergic reaction

lidocaine has less of that allergenicity but they're both related by this -caine

stem c-a-i-n-e and that might look like cocaine and that's right because cocaine

was one of the original anesthetics and they found or developed some anesthetics

that weren't addicting but if you look at Anbesol you see two of the letters

from the word numb so that's one way to remember that one and then Solarcaine

Solarcaine takes the -caine ending that's still frowned upon by the World Health

Organization but solar meaning sun so we're using something to take care of

the pain from a sunburn but lidocaine has many uses, an injectable in an

emergency, patch, some other different things that it can be used for. OTC anti-

vertigo so meclizine if you put this, if I were to do meclizine in small letters

like this, m-e-c-l-i-z-i-n-e you could kind of put this C in this L

together to make a D and then you see dizzy so it's for dizziness but the

brand name's Dramamine that you might know but there was also a brand name

that was a prescription item, Antivert for anti vertigo but that one told the

whole story, anti-vertigo. Another OTC under neuro would be a sedative

hypnotic and we see diphenhydramine you might say well I remember that one but

that was an antihistamine you told me and that's what's kind of infuriating

about pharmacology is that things can be, for prescription drugs can be for many

different things and all this is OTC but diphenhydramine as an adverse effect

made someone drowsy but here we're using that side-effect as a good thing so

tylenol acetaminophen diphenhydramine the antihistamine that

makes you tired Tylenol PM and that PM means post-meridian after literally

afternoon but we just use it at night time so Tylenol PM is something used at

night time sometimes sleep is disturbed because of pain and that's what the

acetaminophen is there for. Benzodiazepine-like sedative hypnotics

now we're going to the prescription items and benzodiazepine-like means

it's not a benzodiazepine but it works a little like one so eszopiclone with the

-clone stem and we see this es- again so the S isomer and you can think of Luna

or rest in Lunesta and then zolpidem -pidem is the stem, p-i-d-e-m

and this is Ambien or Ambien CR, Ambien controlled release so Ambien works to

help somebody fall asleep but if the person has trouble staying asleep the

controlled release, much longer acting version works well. Melatonin receptor

agonist so ramelteon the -melteon is the stem and it looks like melatonin for

a reason because it is a melatonin receptor agonist and you can think of

Rozerem, roz- rhymes with doze, REM for rapid eye movement sleep, so a lot of

hints in these brand names certainly worth remembering. So those are some

OTC neuro drugs something to help you sleep. In the next column we're going to

go into antidepressants and how those can help us. The first thing that throws

students off is the classifications as SSRI, SNRI, TCA, MAOI and each one has

its own acronym so an SSRI is a selective serotonin

reuptake (I didn't think about space there) inhibitor okay and that means that

serotonin is going to normally be re-uptaken or if you want to think of it as

recycling that's maybe a better way but instead what happens is we inhibit that

recycling it stays in the synapse and it's supposed to make the patient

happier. It's that hypothesis of norepinephrine

and serotonin not having enough of it so there's five of them I'm going to

go over citalopram and escitalopram we see two drugs with the same root just

like we saw esomeprazole and omeprazole. Celexa was the first one that came out

it reminds me of relaxed these SSRIs can also be used for anxiety

and then Lexapro you can think of a professional upgrade from the first one

so it takes part the ending of Celexa and then just adds -pro to make Lexapro

but those are related in the escitalopram is supposed to be better than the

citalopram. The -traline stem for Zoloft so it lofts your mood and then the

-oxetine. So -oxetine is a little bit tricky the adopted names council calls -oxetine

a fluoxetine-like entity but fluoxetine and paroxetine are SSRIs then we're

going to see that duloxetine is an SNRI and later we're going to find a non

stimulant ADHD medication atomoxetine so this -oxetine ending you really have to

be careful. Fluoxetine is interesting it's got two brand names

Prozac was the first brand name that came out it was

antidepressant sounds like a strong drug with the P, Z and the C or with a K sound

and then Sarafem I'm not sure what they were going for a seraphim it's like the

highest angel so maybe it was the work of angels but that's for something

called premenstrual dysphoric disorder, PMDD. Paroxetine, Paxil and then

Paxil controlled release so again another medication that works a little

bit longer. Then we have the serotonin norepinephrine reuptake inhibitor and

I'll try to do a little better job with my writing here serotonin norepinephrine,

and I'll abbreviate it NE, reuptake

inhibitor and so we're just affecting different neurotransmitters where

selective serotonin reuptake inhibitor was just serotonin now we're talking

about serotonin and norepinephrine again the -oxetine be careful with that

it's supposed to indicate a SSRI Cymbalta so my mnemonic was to remember

that symbol players all would always seem to be happy and alta means above in

Spanish so higher mood maybe. Then the -faxine is the stem here in

venlafaxine and for Effexor so that's a way to remember that one. So the TCA so

this SNRI and SSRI are are both named after neurotransmitters but

amitriptyline is named after or the tricyclic antidepressant is named after the

three rings so you can see that -t-r-i- in the stem -tripyline and Elavil elevates

your mood. Isocarboxazid I didn't have a stem that I saw but I had a

student that said I sew car boxes and it just seemed very sad so it's a monoamine

oxidase inhibitor so mono, m-o-n-o, a-m-i-n-e and oxidase inhibitor and

what that monoamine really means is that we're still kind of going back to

serotonin which is a monoamine and that we're affecting it we're just calling it

by a different name. Smoking cessation so bupropion was first

an antidepressant it was Wellbutrin so ideally you would get well or get out

of the rut you're in so you see the r-u-t and then -i-n in there but then they

found that a lot of these antidepressants stop smoking so though

this is great let's make it an anti smoking drug so they renamed it Zyban or

repackaged it that way. Varenicline it's chantix so the new

-nicline stem indicates a smoking cessation medication and and I had a student that

said in a southern accent oh when I take varenicline on their inclined to quit so

or with Chantix, my chant is that I don't need my fix so anyway it just

stuck in my head. So these are antidepressants all the way down to

bupropion which can also be used for smoking cessation then varenicline is

specifically a smoking cessation medication. Next we're going to go on to

some anti-anxiety and ADHD medications and antipsychotics as well.

So the first thing with the benzodiazepines is that on a lot of YouTube channels you'll see

-lam and -pam are stems and that's just incorrect you want to be careful because

there's a drug lamotrigine which is an anti epileptic and there's verapamil

which is a calcium channel blocker and that's for high blood pressure those are

not benzodiazepines so use the whole stem -azolam or -azepam. Xanax has part

of the word anxiety and it's so easy enough to remember. Versed, I can't

remember the verse you just said. Klonopin and clonazepam are very similar

and then Ativan I don't even remember what I use for that one so but really

stick with the generic stems that's what you want to use for the benzodiazepines.

Dexmethylphenidate, methylphenidate I couldn't really find a stem for them

but you can see what the brand names what they're for so these are stimulant

schedule twos for ADHD they can help you focus, Focalin, or they can help you

concentrate and they just kind of turn the last couple letters around there.

Non-stimulant ADHD medication atomoxetine again we see this -oxetine

stem this does not mean it's an SSRI you have to memorize that it's a non-

stimulant ADHD medication, Strattera can straighten out your attention. Bipolar is

a simple salt so lithium and Lithobid so BID, bis in die, is the Latin for twice

daily so lithium is taken twice daily in this particular dose. First generation

antipsychotics there's also a term called so these would be the typical, t-y-p-i-c-a-l

antipsychotics and then when we get to second generations those are atypical

but we don't usually use antipsychotic as a term because to say someone is

psychotic is just not a nice way of saying it so usually we say anti

schizophrenic. So chlorpromazine was the first one that came out its Thorazine

and this is low potency that's important because the low potency drugs tend to

cause sedation and low potency just means that you need a hundred milligrams

to get the same thing out of chlorpromazine as two milligrams of

haloperidol which is high potency can do. So the haloperidol has the -paridol stem

and a lot of students think of the halo to remind them or the halo in

haloperidol to remind them that this is high potency first-generation

antipsychotic but you can also replace first-generation with typical anti

schizophrenic. So that's first generation some of the drugs for anxiety ADHD

bipolar and psychosis let's look at the second generation antipsychotics and the

anti-epileptics. So the second generation antipsychotics

the -peridone in risperidone and the

haloperidol and Haldol are very similar somebody said that the 'risper' sounds

like whispers so like you're hearing the whispering voices. Quetiapine if you

change this T and I and then put the I over one and kind of turn it around you

end up with quiet so quiet the voices but the stem is -tiapine

and that's Seroquel to quell something is to calm something down so

risperidone quetiapine are both second-generation antipsychotics we

would also call these atypical. Why is that important?

atypical antipsychotics have less extrapyramidal symptoms but would have

more dyslipidemia, more dyslipedema, diabetes, weight gain, things like that in

general again you don't want to generalize too much there's certainly a variation

within the class. Anti-epileptics we break them down into traditional versus

newer so we've got carbamazepine (I missed a B there)

carbamazepine and the -pine just means that we have some kind of, I think it's a

tricyclic molecule, but the way to maybe remember it is that you carb or curb the

convulsions or you control them so you see the T the R the O and the L that

could be from the word control that's one way to look at it.

Divalproex is Depakote 2nd traditional one and then phenytoin has the -toin, t-o-i-n

stem and this is Dilantin and you would want to remember it from the -toin

stem. The newer ones now I only just happen to pick two drugs that happen to

have gab in them, gab is a stem it's for the gamma-aminobutyric acid and

gabapentin is Neurontin and you can think of the n-e-u which is pronounced

new as the newer anti epileptic and then Lyrica also is a newer one.

Lyrica if something's lyric it's musical so we're taking this very disordered

epilepsy and making it more ordered so that's one way to think of it.

Parkinson's disease so dopamine or lack thereof is a real problem

so levodopa goes, you can't put dopamine in the brain directly the blood-brain

barrier will block it but levodopa can as a precursor get into the brain and

then be converted to dopamine but we lose so much as we get there so

carbidopa is really there as a protectant to protect levodopa, allow

more of it to enter the brain. the -giline stem selegiline that's an MAO-B it's

Eldepryl and so you can see the word elderly in there that Parkinson's

affects many elderly people but certainly it affects younger people as

well, that's highlighted in a couple movies and then the actor Michael J Fox

certainly so that's Parkinson's and then let's look at just our last two here

Alzheimer's and motion sickness.

Alzheimer's donepezil so the way that I remembered it was my memory is done I

can't remember zilch and just put z-i-l-c-h or you can think of perception and

Aricept and maybe you lose some degree of perception. Memantine, the m-e-m from

memory tends to ring a bell but then Namenda has the NMDA and that's what

kind of receptor it affects. The last medication is for motion sickness so

scopolamine is Transderm-Scop so across - trans, derm - skin, scope and then

taking the first four letters of scopolamine. This is usually used for cruise

ships and things like that, a person puts on a patch and they don't have to keep

taking Dramamine or something like that. That's neuro in a nutshell.