Piracetam was first synthesized in 1964 and launched clinically in the early 1970s. It has a dual mode of action involving neuroplasticity and anticonvulsant effects. Piracetam has 100% bioavailability and a half life of 4-5 hours, being excreted through urine. Its indications include cognitive disorders like dementia, hypoxia, dysgraphia, vertigo, dyslexia, and sickle cell anemia. The starting adult oral dose is 800mg twice daily, with pediatric dosing ranging from 400mg twice daily to 1 teaspoon 3-4 times daily depending on age.
Please find the power point on Paracetamol poisoning. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
This document discusses diarrhea, including its definition, types, causes, pathophysiology, clinical presentation, management, and treatment. It defines diarrhea and describes the various types based on duration and clinical presentation. The main causes are infections from bacteria, viruses, parasites, or fungi, certain drugs, dietary factors, and surgical conditions. Management involves treating dehydration and fluid/electrolyte losses orally or intravenously. Drug therapy includes antimicrobials for specific infections, probiotics, and nonspecific antidiarrheal medications.
Pantoprazole is a proton pump inhibitor used to reduce stomach acid production. It is used to treat stomach ulcers, GERD, and Zollinger-Ellison syndrome. Pantoprazole works by covalently binding to proton pumps in the stomach's gastric parietal cells for up to 24 hours to inhibit acid secretion. Potential side effects include nausea, diarrhea, weakness, headaches, and skin rashes. Drug interactions can occur with medications like nelfinavir, warfarin, and digoxin, so caution is recommended when taking other drugs. Pantoprazole should also be used carefully in patients with liver disease or osteoporosis, and its safety during pregnancy
Atarax (hydroxyzine hydrochloride) is an antihistamine used to treat itching from conditions like hives and eczema. It is also used to treat anxiety and as premedication for dental procedures. It works by blocking histamine receptors. Atarax tablets come in 10mg or 25mg doses and should be stored at room temperature between 15-30 degrees Celsius. Common side effects include dry mouth and drowsiness. Atarax can interact with other CNS depressants and its use requires caution in certain conditions.
1) Alcohol is rapidly absorbed into the bloodstream and distributed throughout total body water, reaching peak blood levels around 30 minutes after ingestion when the stomach is empty.
2) Metabolism of alcohol occurs mainly in the liver by alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), accounting for 90-98% of ingested alcohol.
3) Acute alcohol intoxication can impair judgment and motor control at blood alcohol concentrations (BAC) of 20-30 mg/dL and cause gross intoxication over 50 mg/dL, presenting risks such as blackouts, vomiting, and aggression that require medical monitoring.
Piracetam was first synthesized in 1964 and launched clinically in the early 1970s. It has a dual mode of action involving neuroplasticity and anticonvulsant effects. Piracetam has 100% bioavailability and a half life of 4-5 hours, being excreted through urine. Its indications include cognitive disorders like dementia, hypoxia, dysgraphia, vertigo, dyslexia, and sickle cell anemia. The starting adult oral dose is 800mg twice daily, with pediatric dosing ranging from 400mg twice daily to 1 teaspoon 3-4 times daily depending on age.
Please find the power point on Paracetamol poisoning. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
This document discusses diarrhea, including its definition, types, causes, pathophysiology, clinical presentation, management, and treatment. It defines diarrhea and describes the various types based on duration and clinical presentation. The main causes are infections from bacteria, viruses, parasites, or fungi, certain drugs, dietary factors, and surgical conditions. Management involves treating dehydration and fluid/electrolyte losses orally or intravenously. Drug therapy includes antimicrobials for specific infections, probiotics, and nonspecific antidiarrheal medications.
Pantoprazole is a proton pump inhibitor used to reduce stomach acid production. It is used to treat stomach ulcers, GERD, and Zollinger-Ellison syndrome. Pantoprazole works by covalently binding to proton pumps in the stomach's gastric parietal cells for up to 24 hours to inhibit acid secretion. Potential side effects include nausea, diarrhea, weakness, headaches, and skin rashes. Drug interactions can occur with medications like nelfinavir, warfarin, and digoxin, so caution is recommended when taking other drugs. Pantoprazole should also be used carefully in patients with liver disease or osteoporosis, and its safety during pregnancy
Atarax (hydroxyzine hydrochloride) is an antihistamine used to treat itching from conditions like hives and eczema. It is also used to treat anxiety and as premedication for dental procedures. It works by blocking histamine receptors. Atarax tablets come in 10mg or 25mg doses and should be stored at room temperature between 15-30 degrees Celsius. Common side effects include dry mouth and drowsiness. Atarax can interact with other CNS depressants and its use requires caution in certain conditions.
1) Alcohol is rapidly absorbed into the bloodstream and distributed throughout total body water, reaching peak blood levels around 30 minutes after ingestion when the stomach is empty.
2) Metabolism of alcohol occurs mainly in the liver by alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), accounting for 90-98% of ingested alcohol.
3) Acute alcohol intoxication can impair judgment and motor control at blood alcohol concentrations (BAC) of 20-30 mg/dL and cause gross intoxication over 50 mg/dL, presenting risks such as blackouts, vomiting, and aggression that require medical monitoring.
The document defines various terms related to analgesics including opioids and non-opioid analgesics. It describes opioids as originating from the opium poppy and acting primarily through mu receptors to powerfully relieve pain. It notes opioids can cause tolerance, dependence, and withdrawal symptoms. Non-opioid analgesics like paracetamol and NSAIDs inhibit prostaglandin synthesis to reduce pain and fever without dependence. The document provides details on specific opioid and non-opioid analgesic drugs, their uses, mechanisms, and side effects.
Amiodarone is a class III antiarrhythmic drug that is effective for treating atrial fibrillation and flutter as well as ventricular arrhythmias. It works by blocking potassium channels, sodium channels, and adrenergic receptors. Amiodarone has a large volume of distribution, long half-life, and is associated with various adverse effects involving the heart, thyroid, lungs, skin and other organs. It can cause interactions with many other drugs due to its effects on hepatic enzymes and drug transporters.
Pantoprazole is a proton pump inhibitor used to treat GERD, erosive esophagitis, and Zollinger-Ellison syndrome. It works by inhibiting the hydrogen-potassium ATPase pump in the stomach's parietal cells to suppress gastric acid secretion. Common side effects include headache, diarrhea, and nausea. Pantoprazole has drug interactions with atazanavir, ceritinib, dipyridamole, ketoconazole, and methotrexate that require dose adjustments or alternative treatment. Overdose symptoms include hypoactivity, ataxia, and tremors, treated with supportive care and discontinuing the drug.
This document discusses opioid analgesics, focusing on tramadol and butorphanol. It defines opioids and their receptor types. Tramadol is described as a centrally acting atypical analgesic that is a racemic mixture with both enantiomers contributing to its analgesic effects. Its mechanisms of action and pharmacokinetics are outlined. Butorphanol is introduced as a synthetic agonist-antagonist opioid with greater agonist and antagonist effects than pentazocin. Its proposed mechanisms of analgesia and adverse effects are summarized. Clinical uses of both drugs for various acute and postoperative pain conditions are mentioned.
Pharmacology of anxiolytic -sedative-hypnotics (2)shanthi priya
This document discusses the pharmacology of anxiolytic and sedative-hypnotic drugs. It begins by reviewing the diagnostic indications for these drugs, including generalized anxiety disorder, phobic disorders, panic disorder, obsessive-compulsive disorder, and sleep disorders. It then covers the pharmacodynamics and mechanisms of action of different drug classes, including benzodiazepines, azapirones, beta-blockers, and clonidine. The document also addresses pharmacokinetics, drug interactions, and treatment strategies for anxiety and sleep disorders.
1) Ethanol is produced commercially by fermenting sugars or starches with yeast. It is then distilled to produce spirits with 40-55% alcohol content.
2) Acute ethanol intoxication causes symptoms like slurred speech and impaired coordination above 80mg/dL blood alcohol content. Treatment focuses on airway protection and supportive care.
3) Chronic heavy ethanol use can lead to tolerance, dependence, and withdrawal symptoms like tremors or seizures upon cessation. Approved medications like naltrexone and acamprosate aim to reduce craving and ease withdrawal.
This document discusses the mechanisms of action of benzodiazepines. It notes that benzodiazepines augment the effects of the inhibitory neurotransmitter GABA at GABA-A receptors. They can be selective for different GABA receptor subunits involved in sleep, anxiety, or addiction. The hypnotic and anxiolytic effects of benzodiazepines are explained by their actions on GABA receptors in the amygdala, hippocampus, and hypothalamic regions involved in sleep/wake regulation. Adverse effects and issues with dependence and withdrawal are also covered. Novel approaches to anxiolytic drugs targeting GABA receptors without addiction liability are mentioned.
Benzodiazepines (BZDs) are a commonly prescribed class of psychotropic drugs that have been used in clinical practice since 1961. BZDs are grouped as sedative-hypnotics, anxiolytics, antiepileptics, and muscle relaxants. They work by enhancing the effects of the inhibitory neurotransmitter GABA at the GABAA receptor. In Egypt, common available BZDs include alprazolam, bromazepam, clordiazepoxide, clonazepam, diazepam, midazolam, and oxazepam. BZDs are indicated for anxiety disorders, insomnia, augmenting other medications, and epilepsy but have
Levetiracetam is a white powder that is wholly soluble in water. It is the S-enantiomer form which has anticonvulsant properties, while the R-enantiomer does not. It inhibits calcium channels and prevents the release of calcium from intracellular stores. It is rapidly absorbed after oral administration, has a high bioavailability, and is excreted unchanged in the urine. Common side effects include somnolence, asthenia, and nausea. It is indicated as an adjunctive treatment for partial onset seizures, myoclonus, and primary generalized tonic-clonic seizures in adults and children.
Amiodarone is used for the prevention and treatment of serious atrial and ventricular arrhythmias. It works by increasing the refractory period in cardiac tissues, decreasing automaticity of fibres in the Purkinje system, and prolonging AV conduction. Amiodarone can interact with several other drugs by increasing their plasma concentrations through inhibition of metabolism, such as digoxin, flecainide, phenytoin, and warfarin. Common adverse reactions include dizziness, bitter taste, headache, flushing, nausea, vomiting, constipation, ataxia, weight loss, tremor, parasthesiae, photosensitivity, and blue-grey skin discolouration. Amiod
Anti-psychotic drugs work by blocking dopamine D2 receptors in the brain and are used to treat schizophrenia and other psychotic disorders. They are categorized as either typical or atypical, with atypical drugs blocking additional serotonin receptors and being less likely to cause motor side effects. Common types include risperidone, olanzapine, quetiapine, and clozapine. While effective in reducing psychotic symptoms, anti-psychotics may cause movement disorders or other side effects depending on their receptor affinities. Long-term treatment can help prevent recurrence of psychotic episodes.
Diazepam is a benzodiazepine used to treat status epilepticus and convulsive disorders by increasing the inhibitory neurotransmitter GABA. It is metabolized in the liver and has a high oral bioavailability. Common side effects include sedation, drowsiness, and respiratory depression. Diazepam levels can be affected by interactions with other CNS depressants, antidepressants, anticonvulsants, and CYP3A4 inhibitors. Improving communication between healthcare professionals through team-based rounding and establishing treatment plans can help ensure patient safety.
This document provides information on status epilepticus, including its definition, epidemiology, etiology, pathophysiology, treatment, and classification. Key points include:
- Status epilepticus is defined as a seizure lasting over 30 minutes or recurrent seizures without regaining consciousness for over 30 minutes.
- It can be caused by acute brain insults, underlying epilepsy, or unknown etiology. Prolonged seizures can cause neuronal damage.
- Treatment involves maintaining airway, breathing, and circulation. Benzodiazepines like lorazepam or diazepam are first line to stop seizures. Phenytoin, fosphenytoin, phenobarbital, and val
This presentation is all about information regarding paracetamol drug. This presentation includes introduction of paracetamol, uses of paracetamol, side effects of paracetamol, paracetamol overdose, paracetamol used for children, paracetamol intersections, paracetamol combinations etc. Source of this presentation is www.paracetamol-information.blogspot.in
Atropine is a naturally occurring anticholinergic that blocks the effects of acetylcholine at muscarinic receptors. It is derived from plants like Atropa belladonna and Datura stramonium. Atropine has wide distribution in the body after absorption and is metabolized in the liver. It causes decreased secretions from glands, relaxes smooth muscles, increases heart rate, and can cause CNS stimulation in high doses. Adverse effects include dry mouth, blurred vision, urinary retention in elderly, and toxicity can cause hyperthermia and delirium. It is used for biliary colic, cystitis, pre-anesthesia, Parkinsonism, AV block, and urinary incontin
This document provides information on the loop diuretic furosemide, including its chemical and pharmacological classification, dosing, pharmacokinetics, mechanism of action, indications, adverse effects, contraindications, and drug interactions. Furosemide is a loop diuretic that works by inhibiting sodium reabsorption in the loop of Henle, promoting increased excretion of sodium, chloride, potassium, and water. It is indicated for conditions like edema, hypertension, and hyperkalemia. Adverse effects include ototoxicity and electrolyte disturbances. It can interact with other diuretics or drugs that affect electrolyte levels.
This document discusses alcohols, including ethanol and methanol. It covers the pharmacology of alcohol including its mechanisms of action in the body, metabolism, effects of acute and chronic consumption, toxicity, and treatment of alcoholism. Specifically, it describes how alcohol is absorbed and distributed in the body, metabolized primarily in the liver, and can cause intoxication, organ damage, and diseases with heavy long-term use such as cirrhosis and fetal alcohol syndrome.
The document discusses various types of alcohols such as ethyl alcohol and methyl alcohol, how alcohols like ethanol are manufactured through fermentation, and the pharmacological effects of acute and chronic alcohol consumption including intoxication, organ damage, and diseases like cirrhosis as well as the potential benefits and uses of alcohol in small amounts.
The document defines various terms related to analgesics including opioids and non-opioid analgesics. It describes opioids as originating from the opium poppy and acting primarily through mu receptors to powerfully relieve pain. It notes opioids can cause tolerance, dependence, and withdrawal symptoms. Non-opioid analgesics like paracetamol and NSAIDs inhibit prostaglandin synthesis to reduce pain and fever without dependence. The document provides details on specific opioid and non-opioid analgesic drugs, their uses, mechanisms, and side effects.
Amiodarone is a class III antiarrhythmic drug that is effective for treating atrial fibrillation and flutter as well as ventricular arrhythmias. It works by blocking potassium channels, sodium channels, and adrenergic receptors. Amiodarone has a large volume of distribution, long half-life, and is associated with various adverse effects involving the heart, thyroid, lungs, skin and other organs. It can cause interactions with many other drugs due to its effects on hepatic enzymes and drug transporters.
Pantoprazole is a proton pump inhibitor used to treat GERD, erosive esophagitis, and Zollinger-Ellison syndrome. It works by inhibiting the hydrogen-potassium ATPase pump in the stomach's parietal cells to suppress gastric acid secretion. Common side effects include headache, diarrhea, and nausea. Pantoprazole has drug interactions with atazanavir, ceritinib, dipyridamole, ketoconazole, and methotrexate that require dose adjustments or alternative treatment. Overdose symptoms include hypoactivity, ataxia, and tremors, treated with supportive care and discontinuing the drug.
This document discusses opioid analgesics, focusing on tramadol and butorphanol. It defines opioids and their receptor types. Tramadol is described as a centrally acting atypical analgesic that is a racemic mixture with both enantiomers contributing to its analgesic effects. Its mechanisms of action and pharmacokinetics are outlined. Butorphanol is introduced as a synthetic agonist-antagonist opioid with greater agonist and antagonist effects than pentazocin. Its proposed mechanisms of analgesia and adverse effects are summarized. Clinical uses of both drugs for various acute and postoperative pain conditions are mentioned.
Pharmacology of anxiolytic -sedative-hypnotics (2)shanthi priya
This document discusses the pharmacology of anxiolytic and sedative-hypnotic drugs. It begins by reviewing the diagnostic indications for these drugs, including generalized anxiety disorder, phobic disorders, panic disorder, obsessive-compulsive disorder, and sleep disorders. It then covers the pharmacodynamics and mechanisms of action of different drug classes, including benzodiazepines, azapirones, beta-blockers, and clonidine. The document also addresses pharmacokinetics, drug interactions, and treatment strategies for anxiety and sleep disorders.
1) Ethanol is produced commercially by fermenting sugars or starches with yeast. It is then distilled to produce spirits with 40-55% alcohol content.
2) Acute ethanol intoxication causes symptoms like slurred speech and impaired coordination above 80mg/dL blood alcohol content. Treatment focuses on airway protection and supportive care.
3) Chronic heavy ethanol use can lead to tolerance, dependence, and withdrawal symptoms like tremors or seizures upon cessation. Approved medications like naltrexone and acamprosate aim to reduce craving and ease withdrawal.
This document discusses the mechanisms of action of benzodiazepines. It notes that benzodiazepines augment the effects of the inhibitory neurotransmitter GABA at GABA-A receptors. They can be selective for different GABA receptor subunits involved in sleep, anxiety, or addiction. The hypnotic and anxiolytic effects of benzodiazepines are explained by their actions on GABA receptors in the amygdala, hippocampus, and hypothalamic regions involved in sleep/wake regulation. Adverse effects and issues with dependence and withdrawal are also covered. Novel approaches to anxiolytic drugs targeting GABA receptors without addiction liability are mentioned.
Benzodiazepines (BZDs) are a commonly prescribed class of psychotropic drugs that have been used in clinical practice since 1961. BZDs are grouped as sedative-hypnotics, anxiolytics, antiepileptics, and muscle relaxants. They work by enhancing the effects of the inhibitory neurotransmitter GABA at the GABAA receptor. In Egypt, common available BZDs include alprazolam, bromazepam, clordiazepoxide, clonazepam, diazepam, midazolam, and oxazepam. BZDs are indicated for anxiety disorders, insomnia, augmenting other medications, and epilepsy but have
Levetiracetam is a white powder that is wholly soluble in water. It is the S-enantiomer form which has anticonvulsant properties, while the R-enantiomer does not. It inhibits calcium channels and prevents the release of calcium from intracellular stores. It is rapidly absorbed after oral administration, has a high bioavailability, and is excreted unchanged in the urine. Common side effects include somnolence, asthenia, and nausea. It is indicated as an adjunctive treatment for partial onset seizures, myoclonus, and primary generalized tonic-clonic seizures in adults and children.
Amiodarone is used for the prevention and treatment of serious atrial and ventricular arrhythmias. It works by increasing the refractory period in cardiac tissues, decreasing automaticity of fibres in the Purkinje system, and prolonging AV conduction. Amiodarone can interact with several other drugs by increasing their plasma concentrations through inhibition of metabolism, such as digoxin, flecainide, phenytoin, and warfarin. Common adverse reactions include dizziness, bitter taste, headache, flushing, nausea, vomiting, constipation, ataxia, weight loss, tremor, parasthesiae, photosensitivity, and blue-grey skin discolouration. Amiod
Anti-psychotic drugs work by blocking dopamine D2 receptors in the brain and are used to treat schizophrenia and other psychotic disorders. They are categorized as either typical or atypical, with atypical drugs blocking additional serotonin receptors and being less likely to cause motor side effects. Common types include risperidone, olanzapine, quetiapine, and clozapine. While effective in reducing psychotic symptoms, anti-psychotics may cause movement disorders or other side effects depending on their receptor affinities. Long-term treatment can help prevent recurrence of psychotic episodes.
Diazepam is a benzodiazepine used to treat status epilepticus and convulsive disorders by increasing the inhibitory neurotransmitter GABA. It is metabolized in the liver and has a high oral bioavailability. Common side effects include sedation, drowsiness, and respiratory depression. Diazepam levels can be affected by interactions with other CNS depressants, antidepressants, anticonvulsants, and CYP3A4 inhibitors. Improving communication between healthcare professionals through team-based rounding and establishing treatment plans can help ensure patient safety.
This document provides information on status epilepticus, including its definition, epidemiology, etiology, pathophysiology, treatment, and classification. Key points include:
- Status epilepticus is defined as a seizure lasting over 30 minutes or recurrent seizures without regaining consciousness for over 30 minutes.
- It can be caused by acute brain insults, underlying epilepsy, or unknown etiology. Prolonged seizures can cause neuronal damage.
- Treatment involves maintaining airway, breathing, and circulation. Benzodiazepines like lorazepam or diazepam are first line to stop seizures. Phenytoin, fosphenytoin, phenobarbital, and val
This presentation is all about information regarding paracetamol drug. This presentation includes introduction of paracetamol, uses of paracetamol, side effects of paracetamol, paracetamol overdose, paracetamol used for children, paracetamol intersections, paracetamol combinations etc. Source of this presentation is www.paracetamol-information.blogspot.in
Atropine is a naturally occurring anticholinergic that blocks the effects of acetylcholine at muscarinic receptors. It is derived from plants like Atropa belladonna and Datura stramonium. Atropine has wide distribution in the body after absorption and is metabolized in the liver. It causes decreased secretions from glands, relaxes smooth muscles, increases heart rate, and can cause CNS stimulation in high doses. Adverse effects include dry mouth, blurred vision, urinary retention in elderly, and toxicity can cause hyperthermia and delirium. It is used for biliary colic, cystitis, pre-anesthesia, Parkinsonism, AV block, and urinary incontin
This document provides information on the loop diuretic furosemide, including its chemical and pharmacological classification, dosing, pharmacokinetics, mechanism of action, indications, adverse effects, contraindications, and drug interactions. Furosemide is a loop diuretic that works by inhibiting sodium reabsorption in the loop of Henle, promoting increased excretion of sodium, chloride, potassium, and water. It is indicated for conditions like edema, hypertension, and hyperkalemia. Adverse effects include ototoxicity and electrolyte disturbances. It can interact with other diuretics or drugs that affect electrolyte levels.
This document discusses alcohols, including ethanol and methanol. It covers the pharmacology of alcohol including its mechanisms of action in the body, metabolism, effects of acute and chronic consumption, toxicity, and treatment of alcoholism. Specifically, it describes how alcohol is absorbed and distributed in the body, metabolized primarily in the liver, and can cause intoxication, organ damage, and diseases with heavy long-term use such as cirrhosis and fetal alcohol syndrome.
The document discusses various types of alcohols such as ethyl alcohol and methyl alcohol, how alcohols like ethanol are manufactured through fermentation, and the pharmacological effects of acute and chronic alcohol consumption including intoxication, organ damage, and diseases like cirrhosis as well as the potential benefits and uses of alcohol in small amounts.
This document discusses ethyl and methyl alcohols. It notes that ethyl alcohol is produced by fermenting sugars from sources like molasses. It is found in alcoholic beverages in varying concentrations depending on the type of beverage. The document also discusses the pharmacokinetics of alcohol metabolism and potential adverse effects ranging from mild symptoms to chronic conditions. Guidelines for safe alcohol consumption are provided. Methyl alcohol is also summarized as being toxic and potentially fatal even in small doses due to its metabolism producing toxic compounds that can cause blindness or death.
1. Ethyl alcohol is produced by fermenting sugars from sources like molasses and is used in alcoholic beverages.
2. Alcohol acts as a central nervous system depressant in a dose-dependent manner, affecting functions like sedation, sleep, and respiration.
3. Alcohol is metabolized in the liver but high doses can cause adverse effects like hypoglycemia, liver damage, and dependence.
This document provides information on the pharmacology of ethyl and methyl alcohol. It discusses that alcohols are hydroxy derivatives of aliphatic hydrocarbons and are manufactured by fermentation. Ethanol is produced by fermentation of sugar by yeast, while methanol is mostly produced synthetically. Ethanol can cause drowsiness at high amounts, while only a small amount of methanol is able to cause blindness. The effects of ethanol are dose dependent, while methanol is metabolized to toxic compounds that can damage the retina. Treatment for methanol poisoning involves inhibiting its metabolism using fomepizole or ethanol.
Pharmacology of Ethyl and Methyl AlcoholManoj Kumar
This document provides information on ethyl and methyl alcohol. It discusses that alcohols are produced by fermenting sugars and starches and the major commercial source is molasses. It then describes different types of alcoholic beverages and their alcohol contents. Key differences between ethanol and methanol are highlighted, including that ethanol is safe for consumption in moderation while methanol is highly toxic.
Ethyl alcohol is produced by fermenting sugars using yeast. It can be used to produce beverages like beer, wine, and spirits. Alcohol acts as a central nervous system depressant, initially causing excitation but then impairing functions. It can also impact the cardiovascular, gastrointestinal, and liver systems. Chronic alcohol abuse can lead to conditions like hypertension, pancreatitis, and cirrhosis.
This document summarizes information about ethyl alcohol (ethanol). It discusses how ethanol is manufactured through fermentation of sugars by yeast, its pharmacological actions including central nervous system depression, and metabolic effects. Potential acute and chronic effects of alcohol consumption are outlined. The mechanisms of action and pharmacokinetics of ethanol are described. Interactions with other drugs and treatment of alcohol dependence and methanol poisoning are also summarized.
Ethanol acts as a central nervous system depressant by enhancing the effects of the inhibitory neurotransmitter GABA at GABA-A receptors. It is metabolized in the liver by alcohol dehydrogenase and aldehyde dehydrogenase. Acute intoxication can cause impairment, loss of coordination, and respiratory depression, while chronic use is associated with conditions like cirrhosis of the liver and cardiomyopathy. Treatment for acute intoxication involves maintaining airway and circulation, gastric lavage, glucose supplementation, and benzodiazepines for seizures. Chronic alcoholism is treated with supervised withdrawal, benzodiazepine substitution, psychotherapy, and disulfiram to produce an aversive reaction if alcohol is consumed. Methanol poisoning is treated
This document provides an overview of alcohol dependence, including its history, pharmacology, clinical criteria, mechanisms of dependence, and pharmacotherapy options. It discusses how alcohol is metabolized and absorbed in the body, its acute and chronic effects, and the neuropharmacological basis of dependence and withdrawal. Several pharmacotherapies for alcohol dependence are described in detail, including disulfiram, naltrexone, acamprosate, topiramate, ondansetron, gabapentin, pregabalin, SSRIs, and aripiprazole. The document also reviews genetic variations affecting alcohol metabolism and newer treatment targets beyond the three FDA-approved medications.
DISORDERS INDUCED BY USE OF ALCOHOL-1.pptxHappychifunda
This document discusses several alcohol-induced mental disorders including acute intoxication, withdrawal, alcoholic hallucinosis, and pathological jealousy or Othello's syndrome. Acute intoxication causes impairment that varies with blood alcohol concentration. Withdrawal can cause symptoms like anxiety, seizures, and delirium tremens. Hallucinosis involves auditory hallucinations during or after heavy drinking. Pathological jealousy involves delusions of infidelity related to issues like alcohol-caused impotence. Treatment focuses on managing symptoms, withdrawing alcohol use, and sometimes using antipsychotics.
This document provides an overview of alcohol abuse and treatment. It discusses the types of alcoholic beverages and their alcohol concentrations. Moderate drinking is defined as up to 2 drinks per day for men and 1 for women, while binge drinking is 5 or more drinks in 2 hours for men and 4 for women. It then covers the pharmacokinetics of alcohol absorption, distribution and elimination in the body. Medical complications of alcohol abuse are outlined affecting the nervous system, GI tract, liver, nutrition, endocrine system and increasing cancer risk. Treatments discussed include medications like disulfiram, naltrexone, acamprosate, topiramate and psychological therapies. Adaptations for treating alcoholics in the workplace
AN OVERVIEW ABOUT PHARMACOLOGICAL ACTIONS,TOXICITY PHARAMETERS,GUIDELINES FOR SAFE DRINKING,CLINICAL USES,METHYL ALCOHOL.THIS FOR ALL MEDICAL AND PHARMACY STUDENTS.
The patient presented with difficulty breathing, blurred vision, vomiting, and abdominal pain after consuming cheap alcoholic beverages. The diagnosis is acute alcohol intoxication based on the history and symptoms. Ethyl alcohol is produced by fermenting sugars and can be found in beverages like beer, wine, and spirits in varying concentrations. At high doses, alcohol causes central nervous system and cardiovascular depression which can lead to coma and death. Treatment for acute intoxication focuses on airway support, glucose supplementation, and hastening alcohol metabolism.
Methanol poisoning causes metabolic acidosis, optic neuritis, renal toxicity, and CNS depression. Symptoms include odor on breath, acid urine with acetone and albumin, retinal ganglion cell degeneration, and convulsions. Death is mainly due to metabolic acidosis from formic acid production and respiratory depression from CNS effects.
The document discusses ethanol (ethyl alcohol) and its effects as an inebriant substance. It defines alcohol and its origins, describes its production and metabolism in the body, acute and chronic effects on health, signs of alcohol poisoning and withdrawal symptoms, and treatments for alcoholism. Alcohol acts as a depressant on the central nervous system and can cause intoxication, coma and death in high doses.
1) Alcohol is metabolized in the liver, where it is oxidized and can cause fatty liver disease if consumed in excess over long periods of time.
2) Both short and long term effects of alcohol consumption are outlined, with short term effects including intoxication and long term effects including liver damage, increased cancer risk, and neurological effects.
3) The biochemical alterations caused by alcohol in the liver are described, including increased acetaldehyde and NADH levels inhibiting the Krebs cycle and causing fatty liver.
measurement of GFR and creatinine clearence-- design of dosage for hepatic patients -- therapeutic drug monitoring and clinical pharmacokinetics fifth pharm D notes
Genetic polymorphism in drug transport and drug targets.pavithra vinayak
This document discusses genetic polymorphisms in drug transporters and drug targets. It defines genetic polymorphisms as variations in gene sequences that occur in at least 1% of the general population. The most common type is a single nucleotide polymorphism (SNP) resulting from a change in a single nucleotide base pair. SNPs can be synonymous or non-synonymous, with non-synonymous SNPs potentially altering the protein's structure and function. The document outlines various drug transporters including P-glycoprotein and discusses genetic polymorphisms that can affect their expression and activity levels. It also discusses how genetic polymorphisms in drug metabolizing enzymes and drug receptors can influence drug response and side effects.
Clinical pharmacokinetics and its application--
1)definition
2) APPLICATIONS OF CLINICAL PHARMACOKINETICS
Design of dosage regimens:
a) Nomograms and Tabulations in designing dosage regimen,
b) Conversion from intravenous to oral dosing,
c) Determination of dose and dosing intervals,
d) Drug dosing in the elderly and pediatrics and obese patients.
Pharmacokinetics of Drug Interaction:
a) Pharmacokinetic drug interactions
b) Inhibition and Induction of Drug metabolism
c) Inhibition of Biliary Excretion.
Therapeutic Drug monitoring:
a) Introduction
b) Individualization of drug dosage regimen (Variability – Genetic, Age and Weight, disease, Interacting drugs).
c) Indications for TDM. Protocol for TDM.
d) Pharmacokinetic/Pharmacodynamic Correlation in drug therapy.
e) TDM of drugs used in the following disease conditions: cardiovascular disease, Seizure disorders, Psychiatric conditions, and Organ transplantations
Dosage adjustment in Renal and Hepatic Disease.
a. Renal impairment
b. Pharmacokinetic considerations
c. General approach for dosage adjustment in renal disease.
d. Measurement of Glomerular Filtration rate and creatinine clearance.
e. Dosage adjustment for uremic patients.
f. Extracorporeal removal of drugs.
g. Effect of Hepatic disease on pharmacokinetics.
Population Pharmacokinetics.
a) Introduction to Bayesian Theory.
b) Adaptive method or Dosing with feedback.
c) Analysis of Population pharmacokinetic Data
Therapeutic drug monitoring for immunosuppressive agents ( organ transplants)pavithra vinayak
Therapeutic drug monitoring (TDM) is used to measure drug concentrations in body fluids to aid in managing drug therapy for diseases. TDM is integral for immunosuppressive drugs used after organ transplants as they have a narrow therapeutic index and concentrations vary between individuals. Common immunosuppressive drugs monitored include cyclosporine, tacrolimus, sirolimus, and mycophenolic acid. Monitoring is important as supratherapeutic and subtherapeutic concentrations of these drugs can have serious negative health outcomes for transplant recipients. Factors like metabolism, drug interactions, and individual pharmacokinetics require close monitoring to optimize efficacy and safety.
conversion from INTRAVENOUS TO ORAL DOSING----- design of dosage regimenpavithra vinayak
conversion from INTRAVENOUS TO ORAL DOSING----- TYPES OF IV TO PO THERAPY CONVERSIONS: MEDICATIONS INCLUDED IN AN IV TO PO CONVERSION PROGRAM: SELECTION OF PATIENTS FOR IV TO PO THERAPY CONVERSION: design of dosage regimen--clinical pharmacokinetics and therapeutic drug monitoring-- fifth pharm D notes
Nomograms and tabulations in design of dosage regimens pavithra vinayak
Nomograms and tabulations in the design of dosage regimens --- NOMOGRAM IN UREMIC PATIENTS: NOMOGRAM FOR RELATIONSHIP BETWEEN CREATININE CLEARANCE AND ELIMINATION RATE CONSTANT FOR FOUR DRUGS clinical pharmacokinetics and therapeutic drug monitoring ---fifth PharmD notes
adaptive methods are doing with feedback in population pharmacokinetics---- clinical pharmacokinetics and therapeutic drug monitoring-- fifth pharm D notes
Bayesian theory in population pharmacokinetics--
1) INTRODUCTION TO BAYESIAN THEORY
2)BAYESIAN PROBABILITY TO DOSING OF DRUGS
3)APPLICATIONS AND USES OF BAYESIAN THEORY IN APPLIED PHARMACOKINETICS:
therapeutic drug monitoring and clinical pharmacokinetics-fifth pharm d notes
This document provides an overview of protocol writing for clinical research. It defines a research protocol as outlining the study plan to safely answer research questions while protecting participants. The summary outlines key components of a protocol including objectives, methodology, and management plans. A protocol allows researchers to plan, review steps, and guide the investigation. Developing a protocol requires considering factors like the research question, importance, methods, and resources needed before writing each required component.
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
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The document discusses vasomotor reversal of Dale and re-reversal of vasomotor reversal. It explains that adrenaline initially causes a biphasic blood pressure response due to its effects on α1 and β2 receptors. Blocking α1 receptors with an alpha blocker causes adrenaline to only decrease blood pressure via β2 receptor activation, known as vasomotor reversal. Re-reversal involves blocking β2 receptors after vasomotor reversal, so adrenaline increases blood pressure solely through α1 receptor activation.
This document discusses genes and gene expression. It begins by defining genes as subunits of DNA that carry the genetic blueprint and code for specific proteins. It then explains that gene expression is the process by which genes are used to direct protein assembly. There are several mechanisms that regulate gene expression, including controlling transcription, RNA processing, translation, and more. Gene expression can be regulated positively or negatively. Key examples of gene regulation discussed are the lac and tryptophan operons in prokaryotes. The document also covers gene expression in eukaryotes and some of the control points involved.
Glaucoma is an optic neuropathy that is the leading cause of irreversible blindness. It is commonly associated with elevated intraocular pressure but can occur with normal pressure. There are two major types: open-angle and closed-angle glaucoma. Treatment focuses on lowering intraocular pressure through decreasing aqueous humor production or increasing outflow, using various eye drops such as beta-blockers, alpha-2 agonists, carbonic anhydrase inhibitors, prostaglandins, or parasympathomimetics. Additional options include laser or surgical procedures. While treatment aims to slow progression, glaucoma can still cause vision loss.
Congestive heart failure is a condition where the heart muscle is unable to pump enough blood to meet the body's needs. It can be caused by high blood pressure, heart attacks, heart rhythm problems, or valve disorders damaging the heart muscle over time. Digitalis is a cardiac glycoside drug that is often used to treat congestive heart failure by increasing the strength of heart muscle contractions and decreasing heart rate, which improves the heart's pumping ability. It works by inhibiting the sodium-potassium pump in heart cells. Common side effects include vision changes, nausea, diarrhea and bradycardia. Careful dosage adjustment is required based on individual factors and renal function.
These guidelines provide advice on cardiopulmonary resuscitation for children, including:
- Initial steps of establishing airway, breathing and circulation
- Obtaining vascular access via intravenous or intraosseous routes
- Recommended doses of adrenaline for different age groups
- Details on ventilation rates, cardiac compression rates, and equipment such as endotracheal tubes
- Guidance on establishing and maintaining an airway, and obtaining intravenous or intraosseous access
- Use of an ECG monitor to identify shockable vs. non-shockable rhythms and guide treatment according to algorithm
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Thinking of getting a dog? Be aware that breeds like Pit Bulls, Rottweilers, and German Shepherds can be loyal and dangerous. Proper training and socialization are crucial to preventing aggressive behaviors. Ensure safety by understanding their needs and always supervising interactions. Stay safe, and enjoy your furry friends!
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
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How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
2. Alcohols are hydroxy derivatives of aliphatic
hydrocarbons
Ethyl Alcohol
(Ethanol)
Methyl Alcohol
(Methanol)
3. How Manufactured ?
• Fermentation – Sugar to Alcohol and Carbon
dioxide
C6H12O6→ 2(CH3-CH2-OH) + 2CO2
(Yeasts +sugar + water = CO2 + ethanol)
• Yeasts are living micro-organisms which die in
concentrations of alcohol greater than 10 to 15%
Starch Maltose
• Commercially - obtained from Mollases
Convertase
4. Alcoholic Beverages
Malted Liquors: Fermentation of germinating cereals (malts) –
mostly Barley – Beers (3-6%)
Wines: fermentation of Natural Sugars – grapes, apples and
other fruits
No distillation, <15%
Fortified (port) – up to 22%
Champagne – 12-16% (effervescent wine)
Spirits (Distilled after fermaentation) – Rum, Whisky, Brandy
and Gin
40 - 55% v/v
Standard 42.8% v/v or 37% w/w
Sources:
Whiskey - distilled grain
Rum - distilled molasses
Gin – any sugar source
Brandy – Distilled wine (Grapes)
Vodka – fermentation of any of grain, rye, wheat, potatoes, grapes,
sugar beet or mollases
5. Alcohol – Percentage Calculations
Alcohol content of beverages:
specific gravity of alcohol is 79
Therefore, 1 litre alcohol weighs 790g
Percent may be by weight or by volume
By volume:
1 litre alcohol add 1 litre water = 50% (vol)
By weight:
1 litre alcohol (790g), add 790g water = 50%
(weight)
40% alcohol by weight = 50% by volume
6. 1litre water
1litre alcohol
+
=
2 litres 50% (volume)
1 kilo water 1 kilo alcohol
2 kilos 50% (weight)
+ =
40% alcohol by weight = 50% by volume
7. Pharmacological actions of
alcohol - Local
1. Rubefacient and counterirritant to skin
2. Irritant – soft skin and mucus
membrane
3. Pain, inflammation and necrosis –
injection
4. Astringent: Antiseptic (20 – 90%)
100% is dehydrating
5. No action on spores
8. Effects of alcohol consumption -
Acute
CNS: Neuronal depressant – dose dependent manner
Plasma concentration Expected effects
30 – 100 mg/dl Anxiolytic, euphoria and excitation,
Hesitation, restraint, caution and self – critisim are
lost
Impaired coordination – mood and feelings are
altered
100 -150 mg/dl Mental clouding, ataxia, disorganization of thought
and impairment of memory and drowsiness
150 – 200 mg/dl Sloppy, ataxia and drunkenness
- Slurring of speech, loss of judgment and inhibition
200 – 300 mg/dl Stupor and unconsciousness
9. Effects of alcohol consumption
(acute) - contd.
Impaired performance, slowing of reflexes and
fine discrimination impaired
Induces sleep – but not ideal hypnotic
Analgesic – but no ideal analgesic
Anticonvulsant action – but not ideal
anticonvulsant
Mechanism:
GABAA receptor mediated synaptic inhibition by
chloride channel opening
Inhibition of NMDA excitatory amino acid receptor
Stimulates 5-HT3 receptors
10. Effects of alcohol consumption
(acute) - contd.
CVS:
Small doses – cutaneous vasodilatation, flushing
Medium dose – tachycardia and mild rise in BP
Large dose - Vasodilatation due to direct vascular
smooth muscle dilatation and vasomotor centre
depression (clinical implication)
Respiration:
Stimulation of Respiration – by irritation of pharyngeal
and buccal mucosa
Central action – depression
Blood:
Moderate drinking increases HDL-cholesterol level
Decrease in LDL oxidation
Anaemia (Folate Metabolism)
11. Effects of alcohol consumption
(acute) - contd.
GIT:
Dilute alcohol at low doses
- stimulate GI secretion –
flavour, aroma or direct
action on gastrin secretion
Higher doses inhibit GI
secretion
Acute consumption –
pylorospasm, gastritis,
vomiting, reflux etc
Mallory-Weiss lesion
12. Effects of alcohol consumption –
(acute) - contd.
Kidney: Diuresis – increased water
ingestion and inhibition of ADH
Uterus: Relaxation of uterine muscles
Endocrine:
Low dose – Adrenaline release and
hyperglycemia
High dose – Hypoglycemia
Sex - Aphrodisiac
13. Rapidly absorbed from small intestine,
and colon but slowly from stomach
First pass metabolism in stomach and
liver
Maximal blood concentration within 30
to 90 minutes
Can be absorbed through the lungs
Can be absorbed through skin
Absorption
14. Uniformly distributed throughout tissues and body
fluids
Readily crosses placenta, to exposure fetus
Crosses BBB readily
Distribution
Elimination
Urinary Excretion
Exhalation
Metabolism
17. Metabolism III
80-90% Metabolized
Also metabolized in small amounts by hepatic
microsomal enzyme
Rate is constant (not increased by
concentrations in the blood) – zero order (8-12
ml/H of absolute alcohol)
About 30 ml (1 oz) in 3 hours
Concentration in exhaled air is 0.05% of blood
concentration – used in medico legal purposes
18. Adverse Effects of Alcohol
Acute Effects
Nausea, Vomiting, hangover and traffic accidents
CNS Depressant
Depression of inhibitory control
Vasodilatation, warm, flushed, reddish skin
Emotional outbursts
Decreased memory & concentration
Poor judgment
Decreased reflexes
Decreased sexual response
19. Adverse Effects of Alcohol –
contd.
Acute Alcohol Intoxication:
Estimated ED50: 150 mg/100 ml and LD50 = 500
mg/100ml
Therapeutic index about 3.5
Hypotension, hypoglycemia, respiratory depression
coma and death
Death due to respiratory depression or inhaled vomit
Treatment:
Gastric lavage
Endotracheal intubations
Fluid and electrolyte balance
Glucose infusion
Thiamine injection 100 mg in 500 ml of glucose IV
Haemodialysis
20. Toxic Effects - Chronic
Alcoholism
GIT:
Gastritis and damage to the mucosa –
anaemia
Intestinal damage: Lack of absorption -
Deficiency of water soluble vitamins and
amino acids (protein deficiency)
Less or no food intake (enough calorie) -
Vitamin and Protein deficiency
21. Chronic Alcoholism – contd.
Liver cirrhosis – scarring of liver
Usually fatal if drinking is not
stopped
Fatty infiltration (excess in
NADH)
Oxidative stress and
cellular necrosis
Damage to hepatocytes
and inflammation –
aldehyde
Glutathione depletion
Microsomal enzyme
induction
22. Chronic Alcoholism – contd.
Neurological: Polyneuritis, pellagra, tremors,
seizures, loss of brain mass, Korsakoff`s
psychosis (Alcholic Dementia)
CVS: Hypertension, cardiomyopathy, CHF
arrhythmias and stroke
Hormonal: Impotence, gynaecomastia and
infertility
Acute pancreatitis
23. Chronic Alcoholism – contd.
Reproduction
Alcohol is a teratogen, it causes birth
defects.
Fetal Alcohol Syndrome (FAS) or Fetal
Alcohol Effects (FAE), or Alcohol-Related
Birth Defects (ARBD)
Symptoms include retardation, poor
coordination, loss of muscle tone, low birth
weight, slow growth, malformation of internal
organs and peculiar facial characteristics
24. Fetal Alcohol Syndrome (FAS)
Characteristics
Growth retardation
Facial malformations
Small head
Greatly reduce
intelligence
25. • Craving: A strong need, or compulsion, to drink
• Loss of control: The inability to limit one’s drinking on any given
occasion
• Tolerance: The need to drink greater amounts of alcohol in order to
“get high” – pharmacokinetic or cellular tolerance
• Physical dependence: Withdrawal symptoms, such as nausea,
sweating, shakiness, sleep impairment, hallucinations, delirium
tremens and anxiety, occur when alcohol use is stopped after a
period of heavy drinking
• Withdrawal syndromes: long acting BZDs like chlordizepoxide
and diazepam
• Naltrexone (50 mg)
Chronic Alcoholism - features
26. Ethanol – Usefulness:
1. Local:
antiseptic, rubefacient and counterirritant in sparins
and to prevent bedsores
antiperspirant and aftershave
Alcohol sponges – to reduce body temperature
2. Appetite stimulant and carminative: 30 – 60 ml of 7-10%
3. Neuralgias: severe cancer pain – injection round the
nerve
4. Protection from cold
5. Alcohol may have a protective effect from heart attack
6. Methanol Poisoning
27. Disulfiram (Antabuse)
Internationally marketed as antabuse
ALDH enzyme inhibitor
Alcohol + disulfiram rise in concentration of aldehyde in
blood and tissue distressing aldehyde syndrome
Symptoms: flushing, burning sensation, throbbing headache,
perspiration, dizziness, vomiting, visual disturbance, mental
confusion, fainting and circulatory collapse
Uses: aversion technique in chronic alcoholics: only to
motivated persons
Technique: abstain alcohol overnight and start with 1 gm on
day 1 followed by 0.75 gm next day and 0.50 gm next day
and so on. Effects start within few hrs of 1st dose and lasts
for 2 weeks
Mechanism: irreversible inhibition of ALDH and synthesis of
new enzyme takes time and thus person resolves not to
drink for distressing symptoms
Available as 250 mg tablets
28. Ethanol as Antidote
Methanol, Ethylene glycol, Diethylene glycol
Methanol poisoning – toxicological importance –
unscrupulous mixing with alcoholic beverages
Formic acid is toxic: above 50 mg/dl, lethal dose 75 – 100
ml, even 15 ml can cause blindness
Methanol poisoning: vomiting, epigastric pain dyspnoea,
bradycardia, acidosis – permanent retinal damage and
Death
Mechanism: Ethanol saturates alcohol dehydrogenase
enzyme - no metabolism of Methanol to form Formic acid
Methanol formaldehyde Formic acidADH ALDH
29. Methanol Poisoning
treatment
Patient in dark room, Ventilation and BP supportive measures
Gastric lavage with sodibicarb if brought immediately
IV sodibicarb to combat acidosis – large quantity may be required
Ethanol 10% in water – nasogastric tube with loading dose of 0.7 ml/kg
followed by 15 ml/kg/hr by infusion – continue treatment for several days
(methanol is oxidized slowly)
Potassium chloride if hypokalemia occurs
Folinic acid or Calcium leucovorin ijection 50 mg IV every 6 Hrly – to
enhance oxidation of formic acid
4-methylpyrazole – specific inhibitor of ALD – 15 mg/kg IV and 10 mg/kg
12 Hrly. till methanol level is <20 mg/dl
Haemodialysis
30. Summary
Alcohol is a neuronal depressant
Long term exposure to alcohol brings about
adaptive changes in the neuronal system
Chronic alcoholism causes toxic effects on all
the organs especially liver
Withdrawal syndrome in alcoholics are treated
by BZDs and Naltrexone
Antbuse/disulfiram is the drug is use as
aversion technique in chronic alcoholics
Ethanol is used as antidote in Methanol
Poisoning
Editor's Notes
The drunkometer collected a motorist's breath sample directly into a balloon inside the machine. The breath sample was then pumped through an acidified potassium permanganate solution. If there was alcohol in the breath sample, the solution changed colour. The greater the colour change, the more alcohol there was present in the breath.