Mnemonics & Tips
Pheochromocytoma: A before B (Alpha before Beta).
Hyperkalemia: Stabilize before you lower.
Cocaine: The "No Beta-Blockers" Rule.
Hepatic Encephalopathy: Nuanced Mechanisms
| Medication |
Specific Mechanism |
High-Yield Tip |
| Lactulose |
Acidifies gut (H+) to trap NH3 as NH4+ |
Also acts as an osmotic laxative. |
| Rifaximin |
Kills urease-producing bacteria |
Non-absorbable; stays in the gut. |
| Neomycin |
Kills NH3-producing bacteria |
Rarely used now due to ototoxicity/nephrotoxicity. |
Comparison Summary
| Clinical Scenario |
Standard/Trap Medication |
Correct "Nuance" Medication |
| Pheochromocytoma |
Beta-blocker |
Alpha-blocker (Phenoxybenzamine) |
| Cocaine Toxicity |
Beta-blocker |
Benzodiazepines |
| Hyperkalemia (ECG changes) |
Insulin/Dextrose |
Calcium Gluconate |
| TCA Overdose |
Lidocaine/Amiodarone |
Sodium Bicarbonate |
| Acute Gout |
Allopurinol |
NSAIDs/Colchicine |
| C. Difficile |
Metronidazole |
Oral Vancomycin |