Drug of the day 4

Ouu, two in a day, you can tell I’m avoiding studying

Ibuprofen (Advil)

What it is: analgesic (pain killer), anti-inflammatory, antipyretic (lowers fever)
Indications: Pain, inflammation, fever
Administration: Oral
Mechanism of action: Ibuprofen is a non-selective COX inhibitor, meaning that it blocks both COX-1 and COX-2. By blocking COX (any immature thoughts there?), ibuprofen blocks prostaglandin (particularly PGE2) production. PGE2 causes a lot of the nasty side effects associated with injury like pain and inflammation because it brings in all of the inflammatory cells and can make pain neurons fire even more. As a side note, COX-1 is floating around the body most of the time anyways, particularly in the gut, while COX-2 is thought to only be around when there’s inflammation. This is why people who take ibuprofen or aspirin for a long time end up getting ulcers (the body needs the COX-1 in the stomach) and why scientists thought it would be an excellent idea to make selective COX-2 inhibitors like celecoxib (Celebrex). While COX-2 inhibitors don’t cause as many gastrointestinal problems, they’ve been shown to have a bunch of other nasty side effects such as cardiotoxicity (this is why Vioxx no longer exists).
Interactions: Not a whole lot, but people with kidney disease might watch out for ibuprofen
Adverse effects: GI ulcers

I might need some ibuprofen now since Wii boxing kicked my butt last night and now my shoulders are sore.

Drug of the day 3

Drug #3 (so I didn’t do one yesterday, oops) and yes, I chose this one because of its silly name too.


What it is: small molecule (aren’t they all?) antineoplastic
Indications: Cancer
Administration: Oral, intravenously
Mechanism of action: This small molecule inhibits the tyrosine kinase receptor domain of the epidermal growth factor (EGF) receptor. Without EGF, there’s not a whole lot of signaling to grow, so the idea is that the cancer is stunted.
Interactions: Other lovely CYP3A4 enzyme substrates.
Adverse effects: All the nasty antineoplastic side effects. The tolerated “nasty effects” for cancer drugs are actually much higher than most, just because the disease will likely be deadly, so they figure you can put up with more discomfort than if you were taking a med for your headache.

Don’t panic icon

Every year the 2nd year class puts out a handy-dandy “DON’T PANIC” guide for the incoming class. This year I was asked to do the cover and decided to go with something way different from the previous year (which was a ominous looking stethoscope). I thought, of course, that the most important thing is to have DON’T PANIC written in large, friendly letters. And you can’t getting larger or friendlier (or Britishier) than good old Gill Sans.

I’ll post the actual cover later though, once all of the changes have been made. I doubt that it will really give anything away to the next year’s class (except maybe Mike) but I’d rather wait until the writers of the book tell me what changes I need to make and how I really can’t spell and should mostly just avoid putting text in any of my designs.

So for now here is one of the 4 icons I made for the cover. This one is for “money issues” as in lines of credit and just how crazy in debt we will all be in 4 years.

Don't Panic: money issues

Drug of the Day 2

Drug #2 (I’ll get up to at least 4 by the exam)


What it is: statin (right in the name)
Indications: High cholesterol, living in North America
Administration: Oral
Mechanism of action: Statin drugs bind the enzyme HMG-CoA reductase. This enzyme is the rate limiting step in the synthesis of endogenous cholesterol. So if you block it, your body isn’t nearly as good at synthesizing cholesterol and it also start to up regulate LDL (“bad cholesterol“) receptors. This makes statins close to a miracle drug, since they’re limiting how much cholesterol you make and at the same time increasing the receptors that take the “bad” cholesterol out of the blood. Some people argue that statins should just be put in the drinking water (since hypercholesterolemia is so rampant in North America).
Interactions: None really. See, this is a miracle drug.
Adverse effects: In rare cases it can cause rhabdomyolysis (ouu, sounds like a House diagnosis), which is the breakdown of skeletal muscle. Fortunately this goes away once you take someone off the drug.

Drug of the Day 1

I figure that this sort of counts as studying, just much more amusing (well, I suppose that would depend on who you talk to).

I’m going to start with Cisplatin, because I like the sound of it (contains the sound “splat,” making it just fun to say. Unfortunately the fun does not carry through to the drug).


What it is: antineoplastic (anticancer)
Indications: Cancer (bladder, ovarian, testicular)
Administration: Intravenously
Mechanism of action: Binds covalently to DNA, causes little hitches, DNA can’t divide, cell thinks, “WTF?!” and there is a p53-mediated apoptosis (suicide). This mechanism is very similar to alkylating agents.
InteractionsEchinacea, taxane derivatives (such as paclitaxel, another antineoplastic), topotecan (yet another antineoplastic)
Adverse effects: Nausea, neurotixicity, myelosuppression, alopecia

Mmm, chai

For some reason we had spring (almost summer) weather and then, reality struck and it’s been a miserable last couple days weather-wise. So after a day of trying to learn cardiovascular drugs (and seeing a patient who was on a lot of them), I decided to unwind with some chai. Made on the stop top in milk no less (I’m pretty classy).

chai (I swear that's what's in the mug)

(yes, I realize that this photo doesn’t really show off what I was drinking)

Tomorrow I get to go talk to my new optometrist and ask why she gave me a cruddy new prescription (as in, less strong than my old one) and why they thought giving me contacts with less of an astigmatism correction was a smart idea. After tomorrow I don’t think I’ll be returning to this particular optometrist again.

Periaquaductal Grey Pain Modulation Pathway

This and my other scientific images have now been moved over to Sketchy Medicine.com, my new website dedicate exclusively to scientific and medical images!

See it there!

The way our curriculum is set up, sometimes we need to know things that we won’t officially learn until next year. For example, right now we’re in pharm, but we’re talking about analgesics and how/where they work. It makes things a little bit more difficult when up until this point the brain has pretty much been a vacant circle at the top of a tube with neurons (ouuu). Since I actually have the benefit of knowing that the brain is further subdivided into at least a couple other blobs within that circle, I dug out the ole’ neuroanatomy textbook and redrew on of the pathways that was causing major headaches (myself included). Seriously, there are so many double/triple/quadruple negatives in this pathway it makes the head spin. Who knew that the activation of the inhibitory interneuron would inhibit the other inhibitory interneuron, releasing inhibition of another neuron only to inhibit pain?

PAG Pathway

So here’s the periaquaductal grey pathway in all of its cartoon glory. Yes, I realize that I didn’t really draw the medulla and totally left out the pons. No one like them anyways. For a printable version, here is the PDF.

P.S. I wrote the text, so it’s probably riddled with spelling errors and other typos. C’est la vie.

Donate platelets

donate platelets (says the Giant Microbe)

Just a friendly reminder that you can not only donate whole blood, but plasma and platelets too. These are just individual components of blood, so because it isn’t whole blood, you can donate more often! It doesn’t hurt any more than giving blood (just the one needle) and you are treated like royalty.

Just so, you know.

The Giant Microbes platelet (which I received from my parents for Easter, because nothing says Easter like blood’s ability to clot) is not affiliated with me, or Canadian Blood Services. But it’s cute. Terribly cute.

Scrub caps

All year I’ve been doing a surgery elective, which means that once a week when I go to the OR I get to wear the most excellent “buffont hat”. The sort of disposable blue poofy hat that you’d imagine someone in the food industry wearing. For the most part I don’t mind, even though it makes my ears and forehead look huge, but everyone else (doctors, nurses, orderlys) has cool scrub caps. Most of the time I figured that this was a right of passage. A1 agreed (even though she really wanted one too).

So finally, when I went back toy parents’ house for Easter this past weekend I though, “screw it, I want a cool hat.” So I went to the fabric store and bought some fabric and then I made A1 and I both scrub caps, I even embroidered “A1″ and “A2″ on them (the other Allison being A1 and me being A2). I made the pattern up myself, using a guide I found on Craftster. I’m pretty proud of them. I even wore it in the OR today! Makes me want to get a sewing machine of my own.

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