The document discusses adrenergic and anti-adrenergic drugs. It describes the sympathetic nervous system which uses norepinephrine as a neurotransmitter. Adrenergic drugs can work directly on receptors, indirectly by increasing norepinephrine release, or through a mixed mechanism. Examples provided are epinephrine, phenylephrine, and ephedrine. Anti-adrenergic drugs block sympathetic effects and are divided into alpha and beta blockers such as prazosin, propranolol, and labetalol. Specific indications, mechanisms of action, and considerations for use are described for various adrenergic and anti-adrenergic drugs.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
2. DIVISIONS OF HUMAN NERVOUS SYSTEM
Human
Nervous
system
Central
Nervous
System
Peripheral
Nervous
System
Autonomic
Nervous
System
3. NERVOUS SYSTEM
With
neurotransmitters
norepinephrine and
acetylcholine
*Either “fight and
flight” mode or “rest
and digest”
Includes neurons
and ganglia outside
of the brain and
spinal cord
Peripheral
Nervous
System
*Autonomic
Nervous System
(involuntary)
Sympathetic
Nervous System
(adrenergic)
Parasympathetic
Nervous System
(cholinergic)
Somatic
Nervous System
(voluntary)
4. Sympathomimetic or adrenergic in
sympathetic nervous system—
neurotransmitters are ____________
Parasympathomimetic or cholinergic are
used to describe parasympathetic system—
neurotransmitter is _____________
5. SYMPATHETIC NERVOUS SYSTEM
Fight or flight response results in:
1. Increased BP
2. Increased blood flow to brain, heart and
skeletal muscles
3. Increased muscle glycogen for energy
4. Increased rate of coagulation
5. Pupil dilation
7. REVIEW OF FUNCTIONS OF SYMPATHETIC
NERVOUS SYSTEM RECEPTORS
Alpha 1—smooth muscle contraction
Alpha 2-negative feedback causes less
norepinephrine to be released so BP is
reduced
Beta 1—increased heart rate
Beta 2—bronchodilation
Beta 3—actual site for lipolysis
8. MECHANISMS OF ACTION AND EFFECTS OF
ADRENERGIC DRUGS
Direct adrenergic drug action
Affects postsynaptic alpha 1 and beta
receptors on target effector organs
Examples: epinephrine, Isuprel,
norepinephrine, phenylephrine
9. MECHANISMS OF ACTION CONT.
2. Indirect adrenergic drug action occurs by
stimulation of postsynaptic alpha 1, beta 1
and beta 2 receptors.Cause release of
norepinephrine into the synapse of nerve
endings or prevent reuptake of
norepinephrine.
Examples include cocaine and TCAs
10. MECHANISMS OF ACTION CONT.
3. mixed action. Combination of direct and
indirect receptor stimulation
Examples are ephedrine and
pseudoephedrine
11. MECHANISMS OF ACTION CONT.
Stimulation of alpha 2 receptors in CNS is
useful in decreasing BP
Most body tissues have both alpha and beta
receptors
Effect occurs 2ndary to receptor activated
and number of receptors in the particular
body tissue
12. MECHANISMS OF ACTION CONT.
Some drugs act on both receptors--
dopamine
Some are selective--Isuprel
13. INDICATIONS FOR USE
Emergency drugs in treatment of acute
cardiovascular, respiratory and allergic
disorders
In children, epinephrine may be used to treat
bronchospasm due to asthma or allergic
reactions
Phenylephrine may be used to treat sinus
congestion
14. INDICATIONS OF ADRENERGICS CONT.
Stokes Adams
Shock
Inhibition of uterine contractions
For vasoconstrictive and hemostatic
purposes
15. CONTRAINDICATIONS TO USE OF ADRENERGICS
Cardiac dysrhythmias, angina pectoris
Hypertension
Hyperthyroidism
Cerebrovascular disease
Distal areas with a single blood supply such
as fingers, toes, nose and ears
Renal impairment use caution
17. EPINEPHRINE
Increased glucose, lactate, and fatty acids in
the blood due to metabolic effects
Increased leukocyte and increased
coagulation
Inhibition of insulin secretion
18. EPINEPHRINE
Affects both alpha and beta receptors
Usual doses, beta adenergic effects on heart
and vascular smooth muscle will
predominate, high doses, alpha adrenergic
effects will predominate
Drug of choice for bronchospasm and
laryngeal edema of anaphylaxis
19. EPINEPHRINE
Excellent for cardiac stimulant and
vasoconstrictive effects in cardiac arrest
Added to local anesthetic
May be given IV, inhalation, topically
Not PO
20. EPINEPHRINE
Physiologic antagonist to histamine
Those on beta blockers may need larger
doses
Drug of choice in PEA. Vasopressin has now
become drug of choice in ventricular
tachycardia
Single dose of Vasopressin, 40 units IV
21. OTHER ADRENERGICS
Ephedrine is a mixed acting adrenergic drug.
Stimulates alpha and beta receptors. Longer
lasting than epinephrine.
See in Primatene mist
23. ISUPREL (ISOPROTERENOL)
Synthetic catecholamine that acts on beta 1
and 2 receptors
Stimulates heart, dilates blood vessels in
skeletal muscle and causes bronchodilation
No alpha stimulation
Used in heart blocks (when pacemaker not
available) and as a bronchodilator
24. NEOSYNEPHRINE (PHENYLEPHRINE)
Pure alpha
Decreases CO and renal perfusion
No B1 or B2 effects
Longer lasting than epinephrine
Can cause a reflex bradycardia
Useful as a mydriatic
25. TOXICITY OF ADRENERGICS IN CRITICALLY ILL
PATIENTS
Affects renal perfusion
Can induce cardiac dysrhythmias
Increases myocardial oxygen consumption
May decrease perfusion of liver
Tissue necrosis with extravasation
26. TOXICITY
Do not give epinephrine and Isuprel at same
time or within 4 hours of each other. Could
result in serious dysrhythmias.
28. ANTIADRENERGIC S—MECHANISMS OF ACTION
AND EFFECTS
Can occur by blocking alpha 1 receptors
postsynaptically
Or by stimulation presynaptic alpha 2
receptors. Results in return of norepineprhine
to presynaptic site. Activates alpha 2
resulting in negative feedback. Decreases
release of additional norepinephrine.
29. ALPHA-ADRENERGIC AGONISTS AND BLOCKING
AGENTS
Alpha 2 agonists inhibit release of
norepinephrine in brain; thus, decrease
effects on entire body
Results in decrease of BP
Also affects pancreatic islet cells, thus some
suppression of insulin secretion
30. ALPHA 1 ADRENERGIC BLOCKING AGENTS
Act on skin, mucosa, intestines, lungs and
kidneys to prevent vasoconstriction
Effects: dilation of arterioles and veins,
decreased blood pressure, pupillary
constriction, and increased motility of GI tract
31. ALPHA 1 ADRENERGIC BLOCKING AGENTS
May activate reflexes that oppose fall in BP
such as fluid retention and increased heart
rate
Can prevent alpha medicated contraction of
smooth muscle in nonvascular tissues
Thus, useful in treating BPH as inhibit
contraction of muscles in prostate and
bladder
32. ALPHA 1 ANTAGONISTS
Minipress (prazosin)—prototype.
Hytrin (terazosin) and Cardura (doxazosin)—
both are longer acting than Minipress.
33. ALPHA 1 ANTAGONISTS CONT.
Flomax (tamsulosin). Used in BPH. Produces
smooth muscle relaxation of prostate gland
and bladder neck. Minimal orthostatic
hypotension.
Priscoline (tolaxoline) used for vasospastic
disorders. Pulmonary hypertension in
newborns. Can be given sub Q, IM or IV.
34. ALPHA 2 AGONISTS
Catapres (clonidine). PO or patch.
Tenex (guanfacine)
Aldomet (methyldopa). Can give IV. Caution
in renal and hepatic impairment.
35. BETA ADRENERGIC BLOCKING MEDICATIONS
Prevent receptors from responding to
sympathetic nerve impulses, catecholamines
and beta adrenergic drugs.
36. EFFECTS OF BETA BLOCKING DRUGS
Decreased heart rate
Decreased force of contraction
Decreased CO
Slow cardiac conduction
Decreased automaticity of ectopic
pacemakers
37. EFFECTS OF BETA BLOCKING DRUGS
Decreased renin secretion from kidneys
Decreased BP
Bronchoconstriction
Less effective metabolism of glucose. May
result in more pronounced hypoglycemia and
early s/s of hypoglycemia may be blocker
(tachycardia)
38. EFFECTS OF BETA BLOCKING AGENTS
Decreased production of aqueous humor in
eye
May increase VLDL and decrease HDL
Diminished portal pressure in clients with
cirrhosis
39. INDICATIONS FOR USE
Alpha 1 blocking agents are used for tx of
hypertension, BPH, in vasospastic disorders,
and in persistent pulmonary hypertension in
the newborn
May be useful in treating pheochromocytoma
May be used in Raynaud’s or frostbite to
enhance blood flow
40. REGITINE (PHENTOLAMINE)
Used for extravasation of potent
vasoconstrictors (dopamine, norepinephrine)
into subcutaneous tissues
41. INDICATIONS FOR USE
Alpha 2 agonists are used for hypertension—
Catapres
Epidural route for severe pain in cancer
Investigationally for anger management,
alcohol withdrawal, postmenopausal hot
flashes, ADHD, in opioid withdrawal and as
adjunct in anesthesia
42. BETA BLOCKING MEDICATIONS
Mainly for cardiovascular disorders (angina,
dysrhythmias, hypertension, MI and
glaucoma)
In angina, beta blockers decrease
myocardial oxygen consumption by
decreasing rate, BP and contractility. Slow
conduction both in SA node and AV node.
43. BETA BLOCKERS
Possibly work by inhibition of renin,
decreasing cardiac output and by decreasing
sympathetic stimulation
May worsen condition of heart failure as are
negative inotropes
May reduce risk of “sudden death”
44. BETA BLOCKERS
Decrease remodeling seen in heart failure
In glaucoma, reduce intraocular pressur by
binding to beta-adrenergic receptors in ciliary
body, thus decrease formation of aqueous
humor
45. BETA BLOCKERS
Inderal (propranolol) is prototype
Useful in treatment of hypertension,
dysrhythmias, angina pectoris, MI
Useful in pheochromocytoma in conjunction
with alpha blockers (counter catecholamine
release)
migraines
46. BETA BLOCKERS
In cirrhosis, Inderal may decrease the
incidence of bleeding esophageal varices
Used to be contraindicated in heart failure,
now are standard
Known to reduce sudden death
Often given with ACEIs
Indications include: htn, angina, prevention of
MI
47. RECEPTOR SELECTIVITY
Acetutolol, atenolol, betaxolol, esmolol, and
metoprolol are relatively cardioselective
These agents lose cardioselection at higher
doses as most organs have both beta 1 and
beta 2 receptors
Byetta is new agent that is cardioselective
48. NON-RECEPTOR SELECTIVITY
Carteolol, levobunolol, metipranolol, nadolol,
propranolol, sotalol and timolol are all non-
selective
Can cause bronchoconstriction, peripheral
vasoconstriction and interference with
glycogenolysis
49. COMBINATION SELECTIVITY
Labetalol and carvedilol (Coreg) block alpha
1 receptors to cause vasodilation and beta 1
and beta 2 receptors which affect heart and
lungs
Both alpha and beta properties contribute to
antihypertensive effects
May cause less bradycardia but more
postural hypotension
Less reflex tachycardia
50. INTRINSIC SYMPATHOMIMETIC ACTIVITY
Have chemical structure similar to that of
catecholamines
Block some beta receptors and stimulate
others
Cause less bradycardia
Agents include: Sectral (acebutolol), Cartrol
(carteolol), Levatol (penbutolol) and Visken
(pindolol)
51. SPECIFIC CONDITIONS-ALPHA AGONISTS AND
ANTAGONISTS
In tx for BPH, patient should be evaluated for
prostate cancer
With alpha 2 agonists, sudden cessation can
cause rebound BP elevation
With alpha 1 blockers, first dose syncope
may occurr from hypotension. Give low
starting dose and at hs. May also cause
reflex tachycardia and fluid retention.
52. SPECIFIC CONDTIONS-BETA BLOCKERS
With significant bradycardia, may need med
with ISA such as pindolol and penbutolol
Patient with asthma, cardioselectivity is
preferred
For MI, start as soon as patient is
hemodynamically stable
53. SPECIAL CONDITIONS—BETA BLOCERS
Should be discontinued gradually. Long term
blockade results in increase receptor
sensitivity to epinephrine and
norepinephrine. Can result in severe
hypertension. Taper 1-2 weeks.
54. ETHNIC CONSIDERATIONS
Monotherapy in African Americans is less
effective than in Caucasians.
Trandate (labetalol) with both alpha and beta
effects has been shown to be more effective
in this population than Inderal, Toprol or
timolol.
Editor's Notes
2. Decreased flow to viscera
Also increased rate and depth of respiration, increased blood sugar, increased mental acuity, increased muscle strength
Alpha 1 receptors are in blood vessels, kidney, liver, pregnant uterus, male sexual organs, intestinal smooth muscle. Causes vasoconstriction, decreased renin secretion , uterine contraction
Alpha 2—Inhibits release of norepinephrine. affects vascular smooth muscle, inhibits insulin secretion, platelet aggregation
B1—affects heart and kidneys
B2—affects lundgs, liver, blood vessel vasodilation, decreased motility and tone
Dopamine—blood vessels of kidneys, heart, viscera; brain