📜 The Toddler Scroll of Pupil Size, Cytochrome P-450, and Sulfa Drugs
“How different medicines make Bodyland’s pupils big or small, and how helpers inside Bodyland work together!”
👁️ Drugs Affecting Pupil Size
- Big pupils (dilation): Caused by Anticholinergics like atropine, TCAs, tropicamide, scopolamine, and antihistamines. Also by drugs of abuse like amphetamines, cocaine, LSD, and Sympathomimetics.
- Small pupils (constriction): Caused by Sympatholytics (like alpha-2 agonists), drugs of abuse like heroin and opioids, and Parasympathomimetics like pilocarpine and organophosphates.
🧪 Cytochrome P-450 Interactions (Helpers Inside Bodyland)
Bodyland has special helpers called Cytochrome P-450 enzymes that help break down medicines. Some medicines speed up these helpers (inducers), some are changed by these helpers (substrates), and some slow down these helpers (inhibitors).
- Inducers (speed up): Modafinil, chronic alcohol use, St. John’s wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine.
Mnemonic: Most chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs. - Substrates (broken down): Warfarin, Anti-epileptics, Theophylline, Oral contraceptive pills (OCPs).
Mnemonic: War Against The OCPs. - Inhibitors (slow down): Sodium valproate, Isoniazid, Cimetidine, Ketoconazole, Fluconazole, Acute alcohol abuse, Chloramphenicol, Erythromycin/clarithromycin, Sulfonamides, Ciprofloxacin, Omeprazole, Metronidazole, Amiodarone, Grapefruit juice.
Mnemonic: SICKFACES.COM (when I Am drinking Grapefruit juice).
🧴 Sulfa Drugs
Sulfa drugs include sulfonamide antibiotics, sulfasalazine, probenecid, furosemide, acetazolamide, celecoxib, thiazides, and sulfonylureas.
Some people allergic to sulfa may get fever, urinary infections, rashes like Stevens-Johnson syndrome, anemia, and swelling (urticaria or hives).
Mnemonic: Scary Sulfa Pharm FACTS.
Bodyland’s pupils change size depending on the helpers, and inside helpers work fast or slow to keep medicines balanced. Sulfa drugs are helpful but can cause allergies in some.