Adrenergic agonists include adrenaline, noradrenaline, and other drugs that act on alpha and beta receptors. They have various effects depending on the receptor subtype activated and dose administered. Common uses include treating anaphylaxis, cardiac arrest, nasal congestion, and bronchodilation in asthma. Potential adverse effects include hypertension, arrhythmias, peripheral ischemia, and pulmonary edema at high doses due to cardiovascular effects. The kinetics and receptor selectivity determine appropriate routes of administration and clinical applications for each adrenergic agonist.
SYMPATHOMIMTIC AND SYMPATHOLYTICS DRUGS.pptxMsSapnaSapna
Drugs that bind to these receptors and augment the system are called sympathomimetics, while those that bind to these receptors and inhibit or prevent the binding of endogenous ligands are called sympatholytics.
SYMPATHOMIMTIC AND SYMPATHOLYTICS DRUGS.pptxMsSapnaSapna
Drugs that bind to these receptors and augment the system are called sympathomimetics, while those that bind to these receptors and inhibit or prevent the binding of endogenous ligands are called sympatholytics.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. Adrenergic Agonists
Adrenaline
Epinephrine
Noradrenaline
Norepinephrine
β1>β2>α1>α2
Heart: β1(+ve ino,chrono,dromotropic) increase all cardiac properties
Low dose<0.1µg/kg :β2(vasodilatation in liver,coronary&skeletal muscles)
Blood
vessels High dose>0.1µg/kg :α1(vasoconstriction in skin&mucous membrane)
RT β2: potent bronchodilator
GIT
α1 on sphincters(closing) & β2 on walls(relaxation)
α2 presynaptic on parasympathetic nerve to wall A.Ch. (relaxation)
UT
α1 on sphincter of detrusor muscle (closing)
Hyperglycemia
β2 in liver (glycogenolysis &↑ glucagon)
α2 in pancreas (↓ Insulin)
Lipolysis β1 & β3 in adipocytes (↑lipase enzyme ↑FFA)
Uses
Drug of choice in Acute Anaphylactic shock (bronchspasm&vasodilatation)
Acute cardiac arrest
Local haemostatic to stop hemorrhage from nasal mucosa
Local anesthetic Vasoconstriction (↓bleeding & ↑duration of action)
Adverse
effects
β2 & β3 on walls of urinary bladder = detrusor muscle (relaxation)
β2 on walls of pregnant uterus (relaxation)
Indirect CNS disturbances as catecholamines can not pass BBB
Cardiac arrhythmias (tachycardia) Ventricular fibrellation
Gangrene of peripheral tissues due to severe vaso constriction
Cerebral hemorrage Net result of blood pressure (Hypertension)
Large dose
Pulmonary edema due to +ve inotropic & vasoconstriction
contra-indications
No.& sensitivity of β receptors (up regulation)
COMT = increase adrenaline in synapse
Beta blockers as in low dose, vasoconstriction occurs (Hypertension)
Cocaine as it prevents reuptak=incrase adrenaline&exaggerated CVS action
Diabetes due to low insulin
Hyperthyroidism
( ↑ T3 & T4 )
Non
selective
α & β
Releasers
α1>α2>β1
α 1(vasoconstriction &↑↑ Reflex bradycardia”- vechronotropic”)&β1(weak+veinotropic)
uses Cardiogenic shock & Severe Hypotension
contra-indications Bronchial astma as no effect on B2 & Local anethetic due to potent V.C.
side-effects similar to epiniphrine , Blanching&Sloughingof skin due to potent V.C
α2 in pancreas (↓ Insulin)
Kinetics
Not orally (destroyed by MAO) Not I.M. (no B2 effect) Not S.C.(potent V.C.)
Given I.V. Infusion Not bolus (due to short duration of action)
HOCM = IHSS
Kinetics
Given I.V. bolus in ICU not I.C.(still V.D.) I.M.(B2=V.D.) Inhalation(local B2 broncodilatation)
Not orally (destroyed by MAO) Not eye dps(little absorption& destroyed by alkaline tears)
Angina
If patiend take M-blocker, No reflex bradycardia occurs
Non selective
β1 & β2
Isoproterenol
Isoprenaline
Heart: β1(+ve ino,chrono,dromotropic) increase all cardiac properties
β2 (vasodilatation in liver,coronary & skeletal muscles)
systolic, diastolic,peripheral resistance Heart Rate
Systolic&Heart rate Diastolic&peripheral resistance
Kinetics
Destroyrd by COMT NOT by MAO
Acute bronchial asthma & Heart stimulant in ICU
uses
Dopamine
Low dose: D1=vaodilatation=incrase renal&visceral blood flow
Intermediate dose: β1 ("↑COP=+ve ino"&chronotropic effect)
High dose: α1 ( vasoconstriction=Hypertension )
Given orally & inhalation
Shock due to myocardialinfraction,Renal failure,Trauma
correct tissue perfusion rather than blood pressure
uses
kinetics
Destroyed by COMT&MAO into homovanillic acid
Given I.V. Infusion (short duration&dose dependent)
Selective β1
Dobutamine
"↑COP = +ve ino", dromotropic effect
Little change in H,R,=Not elevate O2demand for myocardium
uses
Acute CHF & Inotropic support after cardiac surgery
Adverse
effects
caution in atrial fibrillation to avoid ventricular fibrillation
Tolerance (down rgulation)
Selective β2
Ritordine
SABA
Salbutamol=albuterol, Pirbuterol& terbutaline
Acute asthma as MDIs (Rapid onset&Short duration)
due to +ve dromotropic of dobutamine
LABA
salmeterol & formoterol as single inhaled dose
Chronic astha (Slow onset &Long duration=12h)
Tocolytic(uterine relaxant) in premature labor
Noct urnal asthma & combined with corticosteroids
Noncatecholamines=pass BBB
Not hydrolized by MAO or COMT
Tachycardia(large dose=nonselective)Tremors,Tolerance(downregulation)
Nonselective
α 1 & α 2
Oxymetazoline
Nasal decongestant
Relief redness of eye
Vasoconstriction
side effect
Rebound
CNS depression at children
Selective α1
Phenylephrine
Methoxamine
Vasoconstriction=vasopressor=increase Blood Pressure(I.V.)
Nasal decongestant,Relief eye redness,Mydriatic
Reflex brady cardia (-ve chronotropic)
for supraventricular(atrial) tachycardia due to
Not Ventricular as no parasympathetic supply to ventricles
side effects
Hypertensive headache, nausea&vomiting
Clonidine
Brimonidine
Selective α2
Presynaptic
Eye dps (↓mydriasis of α1↓aq.humor of β2)
Not I.V.(α2 in blood vessels=sudden hypertension)
Given orally or as transdermal patches
Treat Hypertention &Withdrawal symptoms
VMC in CNS, sympathetic outflow(N.E.)
side-effect
sidation,salt&H2Oretention(give diuretic)
Reflex renin system=hypertensice crisis متبطلوش
فجأة
Safe to renal failure (act centrally not peripherla)
Amphetamine
CVS: α (Hypertension) & β (Tachycardia)
CNS
dopamine&N.E.(stimulation)
Fatigue,Insomnia,Appetite
use
Attention Defficiency Hyperactivity Disorder
Narcolepsy
Contra-indication
Pregnancy,Epilipsy,cardiac proplems
Obesity بالش
لمرضى
القلب
Tyramine
Noncaticholamine=pass BBB
addictive
contraindicated with MAO Inhibitors=vassopressor episodes
Cocaine
CNS stimulant&Local anethetic as eye dps
Inhibit N.E.reuptake
sympathetic activity
Mixed
Ephedrine
Pseudoephedrine
Noncatecholamines=pass BBB
Not hydrolyzed by MAO or COMT
Given orally
CNS stimulant opposing hypnotic effect of antihistamine
α & β
Agonists
broncho dilatation
N.E.
Nasal decongestant
Systolic & Diastolic blood pressure
CVS: α (Hypertension) & β (Tachycardia)
Cause Urine retention
OTC common cold drugs
Indirect Releaser
Reuptake Inhibitor
fermentated food= drug-food interaction
Diastolic blood pressure & peripheral resistance
Diastolic blood pressure & peripheral resistance
Systolic blood pressure & Heart Rate
Not hydrolized by COMT
treat hypotension due to inhaled halothane anethetic
over dose Anginal pain, tachycardia, nausea & vomiting