Nsaids sketchy

Watch a free lesson about NSAIDs from our Blood & Inflammation unit. Sketchy Medical helps you learn faster and score higher on the USMLE Step 1 and Step 2 exams.

Moreover, the lesson covers the use of misoprostol, a synthetic analog of PGE1, in preventing NSAID-induced peptic ulcers and inducing uterine contractions ...Get full access to Sketchy Pediatrics and hundreds more free lessons for 7 days. Plans start at $25/mo, billed bi-annually. Shorter term lengths available. Try 7 Days Free. Stressed about your pediatric shelf exam? Don't be! Sketchy Peds makes learning enjoyable and memorable so you can ace your pediatric shelf exam with ease.Diclofenac sodium (Diclofex DC, Voltaren, Solaraze, Voltaren Gel, Pennsaid) is a non-steroidal anti-inflammatory drug (NSAID). The topical solution is used to treat pain associated with osteoarthritis of the knee. It is more popular than comparable drugs. It is available in multiple generic and brand versions.1. INTRODUCTION. Nonsteroidal anti‐inflammatory drugs (NSAIDs) are among the most commonly prescribed drugs in the world, including over the counter availability. 1, 2 This is due to their wide range of action as agents with anti‐inflammatory and analgesic properties. The classification of NSAIDs can be based on their chemical structure, as well as their selectivity toward cyclooxygenase.Abstract. All nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase, and consequently renal functions dependent upon prostaglandin synthesis can be affected. Fortunately, renal function in normal individuals is relatively independent of the PG system, and thus the NSAIDs don't usually produce any renal dysfunction.

Sketchy Medical Curriculum. Learn all about the Sketchy Medical curriculum. Explore and search through our courses and watch free video lessons to see how we can help you crush the USMLE Step 1 and Step 2. Study smarter, not harder with Sketchy! Reports from the US and Brazil paint an unflattering picture. Facebook says it’s heavily investing in protecting elections around the globe from misinformation, scams, and sketchy ...Hintergrund. Unerwünschte Arzneimittelwirkungen (UAW) auf Schmerzmittel (auch NSAID-Überempfindlichkeit, NSAID-ÜE) gehören zu den häufigsten UAW und betreffen etwa 1,6 % aller Patienten. Obwohl sie häufig sind, stellen sie eine diagnostische Herausforderung dar.When NSAIDs must be used, clinicians should carefully select the appropriate drug and dose . Pediatric Patients . Topical NSAIDs can be safe and effective in pediatric patients. An RCT of 112 children with acute sprains found that ketoprofen gel provided short-term pain relief without an increased risk of adverse events . Another non-RCT found ...NSAIDs are the first line therapy for pain and they are generally administered to acute pancreatitis patients upon admission to the hospital. In addition, these drugs have also been used to prevent post-endoscopic cholangiopancreatography (ERCP) acute pancreatitis. On the other hand, there are several reports indicating that NSAIDs may be the ...1. Introduction. Since the isolation of salicyclate from willow bark in around 1830s, followed by the discovery of aspirin (acetyl salicyclate) by Felix Hoffman of Bayer industry, Germany, in 1897, non steroidal anti-inflammatory drugs (NSAIDs) have been enjoying a blockbuster status in the pharmaceutical industry .In around 500 BCE, even before conceptualization of clinical trials and ...

Clinical research is too sketchy to state definitively that omega-3 does help fibromyalgia. However, omega-3 fatty acids are very well recognized for their anti-inflammatory capabilities in diseases similar to fibromyalgia, such as osteoarthritis and rheumatoid arthritis. Although more studies must be done specifically targeting fibromyalgia, scientists and medical doctors do believe that ...The macrolides video was a chore. I hated the antiemetics Olympics video because they were doing an obnoxious announcer voice and making irrelevant jokes the whole time. They were all good imo. the methotrexate slide is just massive. hated the dyslipidemia drugs. pharm is decent overall but avoid Path like the plague.Learn all about the Sketchy Medical curriculum. Explore and search through our courses and watch free video lessons to see how we can help you crush the USMLE Step 1 and Step 2. Study smarter, not harder with Sketchy! Microbiology. The one that started it all!Abstract. Nonsteroidal antiinflammatory drug (NSAID)-exacerbated respiratory disease (NERD) is characterized by moderate-to-severe asthma and a higher prevalence of chronic rhinosinusitis/nasal polyps, but is a highly heterogeneous disorder with various clinical manifestations. Two major pathogenic mechanisms are: (1) overproduction of ...

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Hintergrund. Unerwünschte Arzneimittelwirkungen (UAW) auf Schmerzmittel (auch NSAID-Überempfindlichkeit, NSAID-ÜE) gehören zu den häufigsten UAW und betreffen etwa 1,6 % aller Patienten. Obwohl sie häufig sind, stellen sie eine diagnostische Herausforderung dar.Piroxicam: learn about side effects, dosage, special precautions, and more on MedlinePlus People who take nonsteroidal anti-inflammatory medications (NSAIDs) (other than aspirin) s...Get full access to Sketchy Pharmacology and hundreds more free lessons for 7 days. Plans start at $25/mo, billed bi-annually. Shorter term lengths available. It's the one, the only, Sketchy Pharm! Get ready for a med school learning adventure that will make you laugh, cry, and remember pharmacology forever.loop diuretics - stimulate PGE release >> vasodilatory effect on afferent arteriole (guy with the baseball bat) Class of pain medication can interfere with loop diuretics. NSAIDs inhibit the release of PGE due to loop diuretics >> lower renal blood flow >> less water loss (fire exstinguisher) 3 main indications for loop diuretics.

Non-steroidal anti-inflammatory drugs (NSAIDs) are used commonly but can cause foregut symptoms, peptic ulcer disease and small bowel enteropathy. Such iatrogenic injury can be complicated by gastrointestinal bleeding and perforation. Limiting NSAID use or co-administration with proton pump inhibitors (PPIs) reduce dyspepsia, peptic ulcer disease and rates of complications. Selective cyclo ...Diclofenac sodium 1% gel ( Voltaren Arthritis Pain, now available as an OTC). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day).Maternal use of NSAIDs in the third trimester of pregnancy may have adverse effects for the mother, fetus and neonate. 1,2 Possible adverse effects include the following. Maternal effects: prolonged labour, post-partum haemorrhage. Fetal effects: premature closure of the ductus arteriosus, fetal renal impairment, oligohydramnios.Diflunisal: learn about side effects, dosage, special precautions, and more on MedlinePlus People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such a...I use sketchy for everything; even path, watching path videos once makes the entire content stick for me. I started out hating long sketchy videos like the NSAIDs one but after realizing how effective it was for me it is now my go to for prep. Honors or close to honors everytime using sketchy, but it is purely anecdotal and my experience, n=1 only. Sketchy turns what you need to know into creative visual stories you’ll remember forever. Try 7 days free. Plans as low as $25/mo. Made for students. Built by experts. Of 1,221 DILIN cases that were adjudicated, 30 cases were attributed to 8 different NSAIDs. The mean age was 52 years old, 24 (80%) were women, and 21 (70%) were Caucasian. The mean latency to onset of laboratory abnormalities was 67 days. Common signs and symptoms at presentation were nausea (73%), jaundice (67%), and dark urine (67%).Anti-inflammatories are used to relieve pain in various conditions, including: Joint pain. Muscle and ligament pain (strains and sprains). Period pain. Pain after operations. Headache, migraine. Some other types of pain. After a single dose, they work at least as well as paracetamol to ease pain.NSAIDs are widely used for various indications, mostly in cardiovascular events and rheumatology. Aging populations are naturally burdened with these diseases. Just because of its antipyretic, analgesic, anti-inflammatory, anti-rheumatic, and anticoagulant effects, [1,2] NSAIDs and low-dose aspirin are commonly prescribed for elderly people in ...Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a heterogeneous group of drugs used to treat inflammation, pain, and fever. Despite substantial differences in their chemical structure, they present a common mechanism of action consisting of the inhibition of the enzymes responsible for prostanoid synthesis, namely, cyclooxygenases (COX ...Sketchy is a revolutionary visual learning platform. We turn what you need to know into engaging, artful stories that you'll remember forever. Rooted in an ancient memorization technique called ...I use sketchy for everything; even path, watching path videos once makes the entire content stick for me. I started out hating long sketchy videos like the NSAIDs one but after realizing how effective it was for me it is now my go to for prep. Honors or close to honors everytime using sketchy, but it is purely anecdotal and my experience, n=1 only.

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NSAIDs like celecoxib can cause swelling or fluid buildup. Normally, this is most noticeable in the legs and ankles, but it can happen anywhere in the body. Too much fluid buildup can be harmful if you have certain medical conditions, like heart failure and chronic kidney disease. Let your healthcare provider know if you have these conditions ...Dr Matt & Dr Mike. 608K subscribers. Subscribed. 2.2K. 81K views 1 year ago Pathophysiology and Pharmacology 1 & 2. In this 2 minute video, Dr Mike explains …Aug 19, 2022 ... https://bit.ly/sketchylearning-yt Welcome to our Sketchy Spotlight Series, where we share stories from the Sketchy ... NSAIDs | Farmacología | ...Manic-depressive patients experience severe mood changes, ranging from an excited or manic state (eg, unusual anger or irritability or a false sense of well-being) to depression or sadness. It is not known how lithium works to stabilize a person's mood. However, it does act on the central nervous system. It helps you to have more control …Bolded Side Effects: For all NSAID's: Decreased gastric mucosa, bleeding, increased bleeding time, acute nephritis, kidney injury, hyperkalemia due to hypoaldosteronism Other notes/Sketchy Pharm: apPROXimately 100mph. Acetic acids (includes diclofenac, ketorolac, indomethacin)Jul 21, 2023 ... {{c2::Duloxetine (Cymbalta)}} is an SNRI that is indicated for the treatment of {{c1::fibromyalgia::MSK pathology}}. Extra. Text, NSAIDs can ...Is there a deck anywhere that has cards for Sketchy pharm 3.1; the NSAIDs video? I've tried lolnotacop's, Zanki, and the pepper deck. comments sorted by Best Top New Controversial Q&A Add a Comment McAnki_Agar Resident • Additional comment actions. Pretty sure Pepper deck has them! ...Naltrexone, a Œº-opioid antagonist distinct from naloxone, serves a primary role in aiding opioid-dependent individuals to maintain abstinence. Additionally, naltrexone offers promise in curbing alcohol and nicotine cravings. In recent times, its beneficial effects on weight reduction have gained attention. Stream.MedicineNet.com indicates that Advil and ibuprofen are the same thing. Ibuprofen is the generic name of the medication, while Advil is a brand of ibuprofen. Motrin and Nuprin are t...Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used drugs worldwide, as either prescriptions or over-the-counter medications. 1 Adverse drug reactions (ADRs) of NSAIDs account for 12% to 29.6% of all ADRs in hospital admissions. 2 Most ADRs of NSAIDs belong to type A, 3 which are dose-dependent and predictable from ...

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Celecoxib doses up to 200 mg per day have similar cardiovascular risk estimates but seem to have poorer analgesic effects; at doses >200 mg per day, the cardiovascular thrombotic risk escalates ...NSAIDs are associated with adverse renal outcomes, and their risk must be weighed against the benefit of improved pain control. An accurate risk assessment must be highly individualized based on CKD stage, age, comorbid conditions, and concomitant medication use. Although historically avoided in kidney disease, NSAIDs should be considered for ...Summary. Analgesics are drugs that help ease pain. Tylenol and nonsteroidal anti-inflammatory drugs (NSAIDs) are both analgesics. However, Tylenol is not an NSAID. Tylenol is the brand name for ...Antigout medications, as their name implies, are medications used to treat gout, which is a form of inflammatory arthritis.. The underlying cause of gout is hyperuricemia - which is too much uric acid in the blood, resulting in the formation of monosodium urate crystals.. These sharp, needle-like crystals deposit in areas of slow blood flow, such as joint spaces, or kidney filtration tubules.Nonsteroidal anti-inflammatory agents (NSAIDs) are a group of medicines that relieve pain and fever and reduce inflammation. There are nearly two dozen different NSAIDs available, but they all work in the same way, and that is by blocking a specific group of enzymes called cyclo-oxygenase enzymes, often abbreviated to COX enzymes.Indications of NSAIDs. NSAIDs are widely used as anti-analgesic, antipyretic, and anti-inflammatory agents [].They are available both over the counter and through medical prescription and are some of the mostly commonly prescribed and utilized medications worldwide [21,22].NSAIDs for pain: Dysmenorrhea is a common condition among women, characterized by cramping abdominal pain and high levels ...Analgesics are frequently used in chronic kidney disease (CKD), including non-steroidal anti-inflammatory drugs (NSAIDs) in 12-33% [1,2,3].Notably, the increasing prevalence of NSAIDs use in CKD has been attributed to limited therapeutic options, lack of evidence for pain management in CKD, and opioid avoidance due to the opioid crisis [].In the prospective Chronic Renal Insufficiency Cohort ...We would like to show you a description here but the site won't allow us.NSAID identification on label of generic ibuprofen, an over-the-counter non-steroidal anti-inflammatory drug. Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots.Side effects depend on the specific drug, its dose and duration of use, but largely include an increased risk of ... ….

Introduction: NSAIDs are widely used. Almost 10% of people in The Netherlands used a non-aspirin NSAID in 1987, and the overall use was 11 defined daily doses per 1000 population a day. In Australia in 1994, overall use was 35 defined daily doses per 1000 population a day, with 36% of the people receiving NSAIDs for osteoarthritis, 42% for ...Learn all about the Sketchy Medical curriculum. Explore and search through our courses and watch free video lessons to see how we can help you crush the USMLE Step 1 and Step 2. Study smarter, not harder with Sketchy! Microbiology. The one that started it all!Loperamide is a medication used in the treatment of diarrhea. It classifies as an anti-diarrheal agent. The use of loperamide in high doses has been associated with a significant increase in morbidity and mortality. This activity reviews the indications, contraindications, activity, adverse events, and other key elements of loperamide abuse related to the essential points needed by members of ...NSAIDs work on a chemical level. They block the effects of special enzymes -- specifically Cox-1 and Cox-2 enzymes. These enzymes play a key role in making prostaglandins. By blocking the Cox ...Non-steroidal anti-inflammatory agents (NSAIDs) help alleviate the symptoms of fever, edema, and pain linked to inflammation by inhibiting the synthesis of prostaglandins. Central to this mechanism is arachidonic acid (AA), a precursor molecule transformed by cyclooxygenase (COX) enzymes into a series of inflammatory and thrombogenic compounds.1. Introduction. The nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed medications worldwide. They consist of a group of drugs that are used in fever, pain, and inflammation because these drugs possess antipyretic, analgesic, and anti-inflammatory properties.Diflunisal: learn about side effects, dosage, special precautions, and more on MedlinePlus People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such a...Get ratings and reviews for the top 10 foundation companies in Murray, UT. Helping you find the best foundation companies for the job. Expert Advice On Improving Your Home All Proj...NSAIDs are a class of medications used to treat pain, fever, and other inflammatory processes. This activity describes the … Nsaids sketchy, Antigout medications, as their name implies, are medications used to treat gout, which is a form of inflammatory arthritis.. The underlying cause of gout is hyperuricemia - which is too much uric acid in the blood, resulting in the formation of monosodium urate crystals.. These sharp, needle-like crystals deposit in areas of slow blood flow, such as joint spaces, or kidney filtration tubules., The second most common type of adverse effect occurring with NSAID use involves the renal system. In the setting of high angiotensin and low intravascular flow (eg, congestive heart failure, cirrhosis, or dehydration), NSAID-induced decrease in prostaglandins leads to a decrease in renal blood flow and subsequently the glomerular filtration rate., Medications are prescribed throughout the world for a variety of reasons including pain. NSAIDs, opioids, and other non-opioid modalities have been used to treat both acute and chronic pain. In this chapter we will discuss the pharmacokinetics, indications, function and associated complications for commonly used pain medications to include NSAIDs, opioids, antidepressants, cannabinoids, and ..., Summary. Pharmacodynamics pertains to the study of a drug's activity on the body, examining the effects and mechanisms of drug action. For instance, NSAIDs operate by inhibiting COX, which results in decreased prostaglandin synthesis leading to analgesia and reduced inflammation. Interactions between drugs at their sites of action, known as ..., Bolded Side Effects: For all NSAID's: Decreased gastric mucosa, bleeding, increased bleeding time, acute nephritis, kidney injury, hyperkalemia due to hypoaldosteronism Other notes/Sketchy Pharm: apPROXimately 100mph, Celecoxib, sold under the brand name Celebrex among others, is a COX-2 inhibitor and nonsteroidal anti-inflammatory drug (NSAID). It is used to treat the pain and inflammation in osteoarthritis, acute pain in adults, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, painful menstruation, and juvenile rheumatoid arthritis. It may also be used to decrease the risk of colorectal ..., The second most common type of adverse effect occurring with NSAID use involves the renal system. In the setting of high angiotensin and low intravascular flow (eg, congestive heart failure, cirrhosis, or dehydration), NSAID-induced decrease in prostaglandins leads to a decrease in renal blood flow and subsequently the glomerular filtration rate., We would like to show you a description here but the site won’t allow us., The Advil website instructs users to take one 200-milligram tablet every four to six hours while symptoms are present. A second tablet can be taken if one does not provide relief f..., The use of nonsteroidal antiinflammatory drugs (NSAIDs) is associated with an increased risk of adverse cardiovascular events. Both nonselective NSAIDs and cyclooxygenase (COX)-2 selective NSAIDs (coxibs) increase the risk of such events. Although the risk of adverse cardiovascular events is heterogeneous across NSAIDs, the precise absolute and ..., Nonsteroid anti-inflammatory drugs (NSAIDs) are a class of medications used to treat pain and inflammation in the body, says Dr. Koval. According to a study in the journal Arteriosclerosis ..., The degree of risk from NSAIDs varies greatly from person to person, she says, and depends on things like your medical condition and the medicines you take. "Pain is a serious problem and it needs ..., Anyone else find studying and learning through stories and pictures WAY EASIER than powerpoints and textbooks?? If you do or THINK you maybe might, this vide..., Cyclooxygenase (COX): is the central enzyme involved in the synthesis of prostanoids from arachidonic acid (including the synthesis of prostaglandins, prostacyclin and thromboxane). Two isoforms (COX-1 & …, A brand new MSK and inflammation deck is 244 cards (FA2017 + NSAIDs sketchy, Gout Drugs sketchy, and Prostaglandin mimics / Endothelin inhibs / PDE5 inhibs sketchy) A brand new Reproductive deck is 92 cards As you can see, all of the added decks are relatively not that much added on in comparison to the existing pharm decks. Now. Micro., Non-steroidal anti-inflammatory drugs (NSAIDs) are medications used to reduce inflammation and to relieve pain. They are one of the most commonly used medications in adults. NSAIDs are frequently used for their analgesic, anti-inflammatory, and antipyretic properties. 1 For many acute pain conditions, NSAIDs have similar or better efficacy ..., Possible side effects of NSAIDs include: indigestion - including stomach aches, feeling sick and diarrhoea. stomach ulcers - these can cause internal bleeding and anaemia; extra medicine to protect your stomach may be prescribed to help reduce this risk. headaches. drowsiness. dizziness. allergic reactions., Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and fever and to reduce swelling and inflammation caused by injury or diseases such as arthritis. Aspirin, ibuprofen, ketoprofen, and naproxen are commonly used NSAIDs. NSAIDs may cause side effects. The most common are stomach upset, heartburn, and nausea., Non-steroidal anti-inflammatory drugs (NSAIDs) are inexpensive, widely-used, non-addictive drugs used to treat pain, inflammation, and fever., Cochrane authors investigated whether non‐steroidal anti‐inflammatory drugs (NSAIDs) helped reduce heavy menstrual bleeding (HMB) in women before they reach the menopause. Background. NSAIDs reduce prostaglandin levels, which are elevated in women with excessive menstrual bleeding., Globally, the cost of NSAID prescription reached 98.026 million US dollars in 2020 and is projected to rise to 125.552 million dollars by 2028 ([8].According to a literature review carried out by Bruno et al. (2014), the analgesic benefit and anti-inflammatory properties of NSAIDs depend on COX-2 activity (Bruno A, 2014)., Dexmedetomidine is a useful non-opioid drug used to manage pain and sedation in the ICU and operating room. The drug is effective, but its use does require monitoring of vital signs. Both the pharmacist and clinician should ensure the administration of the right dose to prevent adverse effects., Prevalence of nonsteroidal anti-inflammatory drug use. Adequate pain management is a widespread clinical concern, and both prescription and over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for pain relief.1 NSAID use may also be increasing, as indicated by a 2010 National Health Interview Survey (NHIS) that found that 12.8% of adults in the United States ..., aspirin. clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta), cangrelor (Kengreal) CLASS. NSAID. ADP receptor inhibitors. MECHANISM OF ACTION. Irreversibly inhibits cyclooxygenase enzymes (COX-1, COX-2) Reduces thromboxane A2 synthesis by platelets. Reduces platelet activation and aggregation., NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding: can happen without warning symptoms. may cause death. The chance of a person getting an ulcer or bleeding increases with: taking medicines called "corticosteroids" and "anticoagulants"., NONSTEROIDALANTI-INFLAMMATORYDRUGS. (NSAIDS) The term "nonsteroidal" is used to distinguish these drugs from steroids, which have a similar eicosanoid-depressing, anti- inflammatory action. NSAIDs are non-narcotic, non-opioid, aspirin-like analgesics. Most currently available NSAIDs act by inhibiting the prostaglandin (PG) synthase enzymes., For example, B&B video on HTN mentions NSAIDs as a cause of secondary HTN, but you may not find that card tagged to the B&B video. Instead, it is tagged for the video it was made from (NSAIDs sketchy pharm video)., This includes etodolac (Lodine), indomethacin (Indocin), meloxicam ( Mobic ), and nabumetone (Relafen). Follow the directions and warnings on OTC NSAIDs, and talk with your doctor before using them for more than 10 days. 2. NSAIDs have several uses. NSAIDs are useful mainly for relieving pain and inflammation., Lithium can also cause a condition known as diabetes insipidus because it reduces the kidney's ability to concentrate urine. Notably, lithium is not metabolized; rather, it is substantially excreted in the urine, so factors affecting kidney function, like diuretics and NSAIDs, can affect lithium levels. Lithium has also been linked to fetal ..., Abstract. Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the isoenzymes COX-1 and COX-2 of cyclooxygenase (COX). Renal side effects (e.g., kidney function, fluid and urinary electrolyte excretion) vary with the extent of COX-2-COX-1 selectivity and the administered dose of these compounds. While young healthy subjects will rarely ..., 1. Acute myocardial Infarction. 2. Signs/Symptoms suggestive of recent cerebrovascular accident. Hypersensitivity, children<12, Pregnancy. 81 mg chewable tablets. 324 mg. PO. Study with Quizlet and memorize flashcards containing terms like (Aspirin) Class, (Aspirin) Action, (Aspirin) Onset and more., In the past 100 years aspirin has demonstrated its value as an analgesic, anti-inflammatory, and antithrombotic agent. However, by 1938, it was clear that aspirin was gastrotoxic. Non-steroidal anti-inflammatory drugs (NSAIDs), developed since the 1960s, failed to achieve the goal of "a safer aspiri …, Confession: I don’t like Sketchy. The title basically says it all. I’m not a fan of Sketchy. I know it’s a popular study aid and I gave it an honest try, especially with micro and pharm as most people seem to swear those are amazing. I can summarize why I feel this way with two points: I feel like I have to learn everything everything twice.