📚 Pharmacology Exam Q&A

mkdir -p /home/daytona/workspace/pharma-flashcards && ls /home/daytona/workspace…

~/pharma-flashcards/generate.js

const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Pharmacology ADR Flashcards";
pres.author = "Orris";

// ─── Design tokens ───────────────────────────────────────────────────────────
const FRONT_BG  = "1A1A2E";   // deep navy - question side
const BACK_BG   = "16213E";   // slightly lighter navy - answer side
const ACCENT    = "E94560";   // vivid red - headings / labels
const GOLD      = "F5A623";   // gold - drug name highlight
const WHITE     = "FFFFFF";
const LIGHT     = "C9D1D9";   // soft grey for body text
const BULLET_OK = "4CAF50";   // green for normal ADRs
const BULLET_WRN= "FF6B35";   // orange for serious/dangerous ADRs
const DIVIDER   = "E94560";

// ─── Flashcard data ──────────────────────────────────────────────────────────
const cards = [
  // ── COVER ──────────────────────────────────────────────────────────────────
  {
    type: "cover",
    title: "ADR Flashcard Deck",
    subtitle: "Adverse Drug Reactions – Pharmacology Quick Reference",
    tag: "Paper I & II | Exam Ready"
  },

  // ── SECTION DIVIDER ────────────────────────────────────────────────────────
  { type: "divider", label: "SECTION 1", title: "General Pharmacology & CVS" },

  // ── DRUG CARDS ─────────────────────────────────────────────────────────────
  {
    drug: "ACE Inhibitors",
    subtitle: "Enalapril | Ramipril | Lisinopril",
    category: "CVS – Antihypertensive",
    adrs: [
      { text: "Dry persistent cough (most common – bradykinin accumulation)", warn: true },
      { text: "First-dose hypotension", warn: true },
      { text: "Hyperkalemia", warn: true },
      { text: "Angioedema (rare, potentially life-threatening)", warn: true },
      { text: "Teratogenic – contraindicated in pregnancy", warn: true },
      { text: "Renal impairment (bilateral renal artery stenosis)", warn: true },
    ],
    memory: "🧠 ACE = Accumulates Cough Enzyme (bradykinin not degraded)"
  },
  {
    drug: "Digoxin",
    subtitle: "Cardiac Glycoside",
    category: "CVS – CCF / Arrhythmia",
    adrs: [
      { text: "Nausea, vomiting, anorexia (early GI toxicity)", warn: false },
      { text: "Visual disturbances – yellow/green halos (xanthopsia)", warn: false },
      { text: "Bradycardia, heart block, arrhythmias", warn: true },
      { text: "Narrow therapeutic index – toxicity risk is HIGH", warn: true },
      { text: "Hypokalemia increases toxicity risk", warn: true },
    ],
    memory: "🧠 Digoxin toxicity → Yellow vision + Slow heart"
  },
  {
    drug: "Nitrates",
    subtitle: "GTN | Isosorbide Mononitrate",
    category: "CVS – Angina",
    adrs: [
      { text: "Headache (most common – meningeal vessel dilation)", warn: false },
      { text: "Postural hypotension / dizziness", warn: false },
      { text: "Reflex tachycardia", warn: false },
      { text: "Tolerance with prolonged use (nitrate-free interval needed)", warn: false },
      { text: "Methaemoglobinaemia (at very high doses)", warn: true },
      { text: "Contraindicated with PDE-5 inhibitors (sildenafil) – severe hypotension", warn: true },
    ],
    memory: "🧠 Nitrates = Headache + Hypotension; No sildenafil!"
  },
  {
    drug: "Propranolol (Beta Blockers)",
    subtitle: "Non-selective β-blocker",
    category: "CVS – HT / Angina / Arrhythmia",
    adrs: [
      { text: "Bronchospasm – contraindicated in asthma", warn: true },
      { text: "Bradycardia and heart block", warn: true },
      { text: "Masking of hypoglycaemia symptoms in diabetics", warn: true },
      { text: "Cold extremities, fatigue, depression", warn: false },
      { text: "Rebound angina / hypertension on abrupt withdrawal", warn: true },
      { text: "Impotence", warn: false },
    ],
    memory: "🧠 Beta Blockers → Bronchospasm + Bradycardia (BB)"
  },
  {
    drug: "Furosemide (Loop Diuretic)",
    subtitle: "Frusemide",
    category: "CVS – CCF / HT / Edema",
    adrs: [
      { text: "Hypokalemia (most common)", warn: true },
      { text: "Hyponatremia, hypomagnesemia", warn: false },
      { text: "Ototoxicity – tinnitus, deafness (dose-related)", warn: true },
      { text: "Hyperuricemia → gout", warn: false },
      { text: "Dehydration, hypotension", warn: false },
      { text: "Metabolic alkalosis", warn: false },
    ],
    memory: "🧠 Furosemide = Flush out K⁺ + Hear less (ototoxic)"
  },

  // ── SECTION DIVIDER ────────────────────────────────────────────────────────
  { type: "divider", label: "SECTION 2", title: "Autonomic Nervous System" },

  {
    drug: "Atropine",
    subtitle: "Anticholinergic / Muscarinic blocker",
    category: "ANS – Anticholinergic",
    adrs: [
      { text: "Dry mouth (xerostomia)", warn: false },
      { text: "Blurred vision, photophobia, cycloplegia", warn: false },
      { text: "Urinary retention (especially in elderly men – BPH)", warn: true },
      { text: "Constipation", warn: false },
      { text: "Tachycardia, palpitations", warn: false },
      { text: "CNS excitement, confusion (especially in elderly)", warn: false },
    ],
    memory: "🧠 'Hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter'"
  },
  {
    drug: "Organophosphates",
    subtitle: "Irreversible Anticholinesterase",
    category: "ANS – Toxicology",
    adrs: [
      { text: "SLUDGE: Salivation, Lacrimation, Urination, Diarrhoea, GI cramps, Emesis", warn: true },
      { text: "Miosis (pinpoint pupils)", warn: true },
      { text: "Bradycardia, bronchospasm", warn: true },
      { text: "Muscle fasciculations → paralysis (nicotinic)", warn: true },
      { text: "CNS: anxiety, seizures, coma", warn: true },
      { text: "Treatment: Atropine + Pralidoxime (PAM)", warn: false },
    ],
    memory: "🧠 OP toxicity = SLUDGE; Rx = Atropine + PAM"
  },
  {
    drug: "Adrenaline (Epinephrine)",
    subtitle: "Alpha + Beta agonist",
    category: "ANS – Adrenergic",
    adrs: [
      { text: "Palpitations, tachycardia, arrhythmias", warn: true },
      { text: "Hypertension, headache", warn: false },
      { text: "Tremor, anxiety, restlessness", warn: false },
      { text: "Hyperglycemia (beta-2 effect)", warn: false },
      { text: "Tissue necrosis if extravasation occurs (IV)", warn: true },
      { text: "Contraindicated in hyperthyroidism, severe CAD", warn: true },
    ],
    memory: "🧠 Adrenaline ADR = Fight-or-Flight overdrive"
  },

  // ── SECTION DIVIDER ────────────────────────────────────────────────────────
  { type: "divider", label: "SECTION 3", title: "CNS Drugs" },

  {
    drug: "Morphine",
    subtitle: "Opioid Analgesic – μ receptor agonist",
    category: "CNS – Opioid",
    adrs: [
      { text: "Respiratory depression (most dangerous – can be fatal)", warn: true },
      { text: "Constipation (no tolerance develops)", warn: false },
      { text: "Nausea and vomiting", warn: false },
      { text: "Miosis (pinpoint pupils – diagnostic sign of toxicity)", warn: false },
      { text: "Euphoria, dependence, addiction", warn: true },
      { text: "Urinary retention", warn: false },
      { text: "Histamine release – itching, bronchospasm, hypotension", warn: false },
    ],
    memory: "🧠 Morphine: 3 M's – Miosis, nausea (veMitus), constipation"
  },
  {
    drug: "Benzodiazepines (BZD)",
    subtitle: "Diazepam | Lorazepam | Alprazolam",
    category: "CNS – Sedative Hypnotic",
    adrs: [
      { text: "Sedation, drowsiness (most common)", warn: false },
      { text: "Anterograde amnesia", warn: false },
      { text: "Respiratory depression (especially with opioids or alcohol)", warn: true },
      { text: "Physical dependence, tolerance, withdrawal seizures", warn: true },
      { text: "Paradoxical excitement (especially in elderly/children)", warn: false },
      { text: "Ataxia, confusion in elderly – fall risk", warn: false },
    ],
    memory: "🧠 BZD reversal = Flumazenil (competitive antagonist)"
  },
  {
    drug: "Phenytoin",
    subtitle: "Anti-epileptic – Na⁺ channel blocker",
    category: "CNS – Antiepileptic",
    adrs: [
      { text: "Gingival hyperplasia (gum overgrowth) – unique to phenytoin", warn: false },
      { text: "Hirsutism (excess hair growth)", warn: false },
      { text: "Coarsening of facial features", warn: false },
      { text: "Nystagmus, ataxia, diplopia (dose-related toxicity)", warn: true },
      { text: "Teratogenic – fetal hydantoin syndrome", warn: true },
      { text: "Drug interactions: enzyme inducer (CYP450)", warn: true },
      { text: "Megaloblastic anaemia (folate deficiency)", warn: false },
    ],
    memory: "🧠 Phenytoin = Gum, Hair, Nystagmus + Teratogen"
  },
  {
    drug: "Sodium Valproate",
    subtitle: "Broad-spectrum Anti-epileptic",
    category: "CNS – Antiepileptic",
    adrs: [
      { text: "Hepatotoxicity – most serious, especially in children <2 yrs", warn: true },
      { text: "Teratogenic – neural tube defects (folic acid must be given)", warn: true },
      { text: "Tremor, weight gain", warn: false },
      { text: "Alopecia (reversible hair loss)", warn: false },
      { text: "Thrombocytopenia", warn: false },
      { text: "Pancreatitis (rare)", warn: true },
      { text: "Polycystic ovaries with long-term use in women", warn: false },
    ],
    memory: "🧠 Valproate: Hepatotox + Neural tube defect – give folate!"
  },
  {
    drug: "Levodopa",
    subtitle: "Anti-Parkinson – Dopamine precursor",
    category: "CNS – Parkinsonism",
    adrs: [
      { text: "Dyskinesias (involuntary movements) – long-term use", warn: true },
      { text: "On-off fluctuations (wearing-off phenomenon)", warn: true },
      { text: "Nausea, vomiting (peripheral dopamine) – reduced by carbidopa", warn: false },
      { text: "Postural hypotension", warn: false },
      { text: "Psychosis, hallucinations, confusion", warn: true },
      { text: "Arrhythmias (rare)", warn: false },
    ],
    memory: "🧠 L-DOPA long-term → Dyskinesia + On-Off swings"
  },

  // ── SECTION DIVIDER ────────────────────────────────────────────────────────
  { type: "divider", label: "SECTION 4", title: "Hormones & Metabolic Drugs" },

  {
    drug: "Metformin",
    subtitle: "Biguanide – OAD (First-line T2DM)",
    category: "Hormones – Diabetes",
    adrs: [
      { text: "GI side effects: nausea, diarrhea, metallic taste (most common)", warn: false },
      { text: "Lactic acidosis (rare but potentially fatal – esp. renal failure)", warn: true },
      { text: "Vitamin B12 deficiency with long-term use", warn: false },
      { text: "No hypoglycemia (euglycemic drug)", warn: false },
      { text: "Contraindicated: eGFR <30, hepatic failure, IV contrast use, alcoholism", warn: true },
    ],
    memory: "🧠 Metformin: GI upset + Lactic acidosis (check kidneys!)"
  },
  {
    drug: "Sulfonylureas",
    subtitle: "Glibenclamide | Glipizide | Gliclazide",
    category: "Hormones – Diabetes",
    adrs: [
      { text: "Hypoglycemia (most important – especially in elderly)", warn: true },
      { text: "Weight gain", warn: false },
      { text: "GI upset: nausea, vomiting", warn: false },
      { text: "Disulfiram-like reaction with alcohol (chlorpropamide)", warn: false },
      { text: "Cholestatic jaundice (rare)", warn: false },
    ],
    memory: "🧠 Sulfonylureas: SU = Sugar too low (hypoglycemia)"
  },
  {
    drug: "Propylthiouracil (PTU)",
    subtitle: "Antithyroid – Thionamide",
    category: "Hormones – Hyperthyroidism",
    adrs: [
      { text: "Agranulocytosis (most dangerous – fever + sore throat = STOP drug)", warn: true },
      { text: "Skin rash, urticaria, pruritus", warn: false },
      { text: "Hepatotoxicity (more with PTU than carbimazole)", warn: true },
      { text: "Lupus-like syndrome (rare)", warn: false },
      { text: "Hypothyroidism with overdose", warn: false },
    ],
    memory: "🧠 PTU: Agranulocytosis = EMERGENCY. Check CBC if fever!"
  },
  {
    drug: "Radioactive Iodine (I-131)",
    subtitle: "Antithyroid – Definitive Therapy",
    category: "Hormones – Hyperthyroidism",
    adrs: [
      { text: "Hypothyroidism (most common long-term ADR – nearly inevitable)", warn: true },
      { text: "Radiation thyroiditis (acute – painful swelling, transient worsening)", warn: false },
      { text: "Worsening of Graves' ophthalmopathy", warn: false },
      { text: "Sialadenitis (in high-dose thyroid cancer treatment)", warn: false },
      { text: "Absolute contraindication: Pregnancy and lactation", warn: true },
    ],
    memory: "🧠 I-131: Burns thyroid → Hypothyroidism in 6–12 months"
  },

  // ── SECTION DIVIDER ────────────────────────────────────────────────────────
  { type: "divider", label: "SECTION 5", title: "Master ADR Comparison Chart" },

  // ── SUMMARY CARD ───────────────────────────────────────────────────────────
  {
    type: "summary",
    title: "UNIQUE ADRs – Must Know",
    rows: [
      ["Drug", "Unique / Classic ADR"],
      ["ACE Inhibitors", "Dry cough (bradykinin ↑)"],
      ["Digoxin", "Yellow vision (xanthopsia)"],
      ["Atropine", "Dry mouth + Urinary retention"],
      ["Morphine", "Constipation (no tolerance)"],
      ["Phenytoin", "Gingival hyperplasia"],
      ["Valproate", "Neural tube defects"],
      ["Metformin", "Lactic acidosis"],
      ["PTU", "Agranulocytosis"],
      ["Furosemide", "Ototoxicity (deafness)"],
      ["Levodopa", "Dyskinesias (long-term)"],
    ]
  },

  {
    type: "summary2",
    title: "DRUGS CONTRAINDICATED IN PREGNANCY",
    rows: [
      ["Drug / Class", "Reason"],
      ["ACE Inhibitors / ARBs", "Fetal renal toxicity, oligohydramnios"],
      ["Phenytoin", "Fetal hydantoin syndrome"],
      ["Sodium Valproate", "Neural tube defects"],
      ["Tetracyclines", "Bone/teeth deposition"],
      ["Warfarin (1st & 3rd trim)", "Warfarin embryopathy, fetal bleeding"],
      ["Radioactive Iodine", "Fetal thyroid destruction"],
      ["Methotrexate", "Abortifacient, teratogen"],
    ]
  },

  {
    type: "summary3",
    title: "ANTIDOTES – Quick Reference",
    rows: [
      ["Drug Toxicity", "Antidote"],
      ["Morphine / Opioids", "Naloxone"],
      ["Benzodiazepines", "Flumazenil"],
      ["Organophosphates", "Atropine + Pralidoxime (PAM)"],
      ["Paracetamol overdose", "N-Acetylcysteine (NAC)"],
      ["Warfarin overdose", "Vit K + FFP"],
      ["Heparin overdose", "Protamine sulphate"],
      ["Digoxin toxicity", "Digoxin-Fab antibodies"],
      ["Iron overdose", "Deferoxamine"],
    ]
  },

  // ── BACK COVER ─────────────────────────────────────────────────────────────
  {
    type: "backcover",
    text: "Good Luck with Your Exam! 🎯",
    subtext: "Remember: Know the UNIQUE ADR for each drug – that's what examiners test!"
  }
];

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// ─── Render each card ─────────────────────────────────────────────────────────
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  // ── COVER ────────────────────────────────────────────────────────────────
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    // ADRs header
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  // ── SUMMARY TABLE ─────────────────────────────────────────────────────────
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  if (card.type === "backcover") {
    const s = pres.addSlide();
    s.addShape(pres.ShapeType.rect, { x:0, y:0, w:10, h:5.625, fill:{ color:"0D0D1A" }, line:{ color:"0D0D1A" } });
    s.addShape(pres.ShapeType.rect, { x:0, y:0, w:10, h:0.08, fill:{ color:GOLD }, line:{ color:GOLD } });
    s.addShape(pres.ShapeType.rect, { x:0, y:5.545, w:10, h:0.08, fill:{ color:ACCENT }, line:{ color:ACCENT } });
    s.addText(card.text, { x:1, y:2.0, w:8, h:1.0, fontSize:32, bold:true, color:WHITE, align:"center" });
    s.addShape(pres.ShapeType.rect, { x:3.5, y:3.1, w:3, h:0.04, fill:{ color:GOLD }, line:{ color:GOLD } });
    s.addText(card.subtext, { x:1, y:3.25, w:8, h:0.8, fontSize:13, color:LIGHT, align:"center", italic:true });
  }
}

// ─── Write file ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/pharma-flashcards/ADR_Flashcards.pptx" })
  .then(() => console.log("✅ Saved: ADR_Flashcards.pptx"))
  .catch(e => { console.error("❌ Error:", e); process.exit(1); });

cd /home/daytona/workspace/pharma-flashcards && node generate.js 2>&1

ls -lh /home/daytona/workspace/pharma-flashcards/ADR_Flashcards.pptx