Fundamentals of Clinical Pharmacology // Drug Repurposing

Fundamentals of Clinical Pharmacology

USMLE Step 1 PharmacologyAlong with biochemistry, pharmacology has the power to induce terror in the majority of medical students preparing for their USMLE Step 1 exam. This is a shame, since so much of pharmacology is simply learning a large volume of basic information – once you know enough basic information, you can get the majority of questions correct. In other words, pharmacology = free points on your USMLE Step 1! Here, I outline 6 simple steps to set up highly efficient cards, to learn the basic information necessary for each drug. Note: this specifically deals with learning the drugs for Step 1, Step 2, and Step 3; the basic principles of pharmacology (e.g. competitive inhibitors, kinetics curves, etc.) can be learned using the basic principles of Anki card-making detailed here.

First Aid Cardiovascular Pharmacology1. Use electronic resources to facilitate “copy + paste” of basic information

First, get a copy of First Aid for the USMLE Step 1 (note: I HIGHLY recommend getting an electronic copy like the Kindle copy linked to here, as the “copy + paste” functionality will save you LOTS of time). For the vast majority of drugs, knowing the information in First Aid is sufficient for getting the questions correct.

Second, decide which drugs you will cover. This may sound simple, but given that it can be such an overwhelming topic, simply having a jumping off point is a huge step.

Anki for USMLE Step 1 PharmIf you are still in the classroom-portion of medical school (i.e. not yet in serious Step 1 mode): the drugs you choose should be part of the organ system/block you are currently in, and identify the “pharmacology” section for the block in First Aid, typically the last section per organ block. For example, if I was studying cardiology, I would turn to the back of the cardiology section:

2. Use simple cards to save time and improve retention

Next, and this is critical, make separate forward AND reverse cards for “mechanism, ” “clinical use, ” and “toxicity.” This means that you will likely have at least 6 cards per drug.

USMLE Step 1 Pharmacology Add ReverseFor question/answer design, I prefer simple cards. For example, “(Drug) – mechanism, ” “(Drug) – use, ” and “(Drug) – toxicity, ” with appropriate reverse cards. Then, on the reverse side, I will use my electronic copy of FA to copy/paste the information into my card.

In Anki, this would look like:

What the $β↑α% happened to my symbols?

When copying symbols from electronic copies of books, it often will not recognize it, and so instead of having nice symbols like ↑ or →, I end up with things like atomic death. By using the super-useful text expander aText program, I can replace all of the symbols quickly to their original form.

3. Check the “add reverse” box to save time on making cards

Note that I put a “y” in the “Add Reverse” text box, signifying that I want to make a reverse card. A “Forward” card means that the front box (i.e. “Hydralazine – mechanism”) is the question, and the back box (“↑ cGMP → smooth muscle relaxation…”) is the answer. A “Reverse” card is the opposite, where the back box is now the question, and I have to identify that the drug is from the mechanism itself.

USMLE Step 1 Pharmacology Pre-Edit USMLE Step 1 Pharmacology USMLE Step 1 Pharmacology Toxicities USMLE Step 1 Pharmacology Toxicities Edit

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This atty claims stress/trauma can raise BAC

by sc460x

'In a study entitled Pharmacokinetics of Ethanol in Plasma and Whole Blood: Estimation of Total Body Water by the Dilution Principle, (Jones, Hahn, and Stalberg, 42 European Journal of Clinical Pharmacology 445 (1992))' ... where an individual has experienced trauma, as in an automobile accident, the body's percentage of water will decrease. '
if the water % goes down but alcohol stays the same, the BAC will be higher.
maybe the water is absorbed into the muscles leaving a higher BAC ?

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In 2000, North Carolina was able to pass legislation that created a clinical pharmacist practitioner (CPP). We were able to work with the medical director for Medicare's Fiscal Intermediate to allow a CPP to bill for medical care as a provider.

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