This document provides information on various aminoglycoside antibiotics, including gentamicin, amikacin, kanamycin, neomycin, and streptomycin. It discusses their indications, mechanisms of action, pharmacokinetics, adverse effects, and ways to maximize therapeutic effects and minimize adverse effects when using these antibiotics. The most important aspects covered are the serious risks of nephrotoxicity and ototoxicity, and the need to closely monitor peak and trough drug levels when patients are receiving aminoglycoside therapy.
Pharmacological Classification, Mechanism of Action, Clinical Uses, Administration Routes, Dosing for Adults and Pediatrics, Pharmacokinetics, Dose Adjustments, Patient Counseling, Adverse Effects, Drug Interactions, Contraindications, Personal Experience with Ondansetron, Future Clinical Uses of Ondansetron
Pharmacological Classification, Mechanism of Action, Clinical Uses, Administration Routes, Dosing for Adults and Pediatrics, Pharmacokinetics, Dose Adjustments, Patient Counseling, Adverse Effects, Drug Interactions, Contraindications, Personal Experience with Ondansetron, Future Clinical Uses of Ondansetron
The fixed dose combination of trimethoprim and sulfamethoxazole is called cotrimoxazole.
Adverse Drug Reaction, Spectrum, Resistance and Use of Cotrimoxazole.
This is my first word document, converted into pdf format!
This document deals with AMOXICILLIN drug profile in brief.
It includes significant pharmacological headings, including an additional heading, stating important catchpoints with respect to amoxicillin!
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
Penicillin (PCN or pen) is a group of antibiotics, derived originally from common moulds known as Penicillium moulds; which includes penicillin G (intravenous use), penicillin V (use by mouth), procaine penicillin, and benzathine penicillin (intramuscular use).
The fixed dose combination of trimethoprim and sulfamethoxazole is called cotrimoxazole.
Adverse Drug Reaction, Spectrum, Resistance and Use of Cotrimoxazole.
This is my first word document, converted into pdf format!
This document deals with AMOXICILLIN drug profile in brief.
It includes significant pharmacological headings, including an additional heading, stating important catchpoints with respect to amoxicillin!
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
Penicillin (PCN or pen) is a group of antibiotics, derived originally from common moulds known as Penicillium moulds; which includes penicillin G (intravenous use), penicillin V (use by mouth), procaine penicillin, and benzathine penicillin (intramuscular use).
Aminoglycosides(medicinal chemistry by p.ravisankar)Dr. Ravi Sankar
Aminoglycosides,Aminocyclitols,Source,Structures of streptomycin,Dihydrostreptomycin,A mention of other aminoglycoside antibiotics,Acid hydrolysis,Mechanism of action,SAR,Dihydrostreptomycin and its importance,therapeutic uses, toxicity.
Antibiotics,antibiotics resistances,classification of antibiotics,misuse of antibiotics details discussed here. for more information visit my blog helpful for pharmacy and medical student.thanks.
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Clindamycin. a potent lincosamide antibiotic is similar in
mechanism of action (inhibits protein synthesis
by binding to 50S ribosome) and spectrum of
activity to erythromycin.
Oral absorption of clindamycin is good. It
penetrates into most skeletal and soft tissues,
but not in brain and CSF; accumulates in neutrophils
and macrophages. It is largely metabolized and
metabolites are excreted in urine and bile. The
t½ is 3 hr.
Vancomycin is a glycopeptide antibiotic discovered in 1956
as a penicillin substitute which assumed special
significance due to efficacy against MRSA,
Strep. viridans, Enterococcus and Cl. difficile.
Bactericidal action is exerted on gram-positive
cocci, Neisseria, Clostridia and diphtheroids.
However, in hospitals where it has been
extensively used for surgical prophylaxis, etc.
URINARY ANTISEPTICS
Some orally administered AMAs attain antibacterial
concentration only in urine, with little or
no systemic antibacterial effect. Like many other
drugs, they are concentrated in the kidney tubules,
and are useful mainly in lower urinary tract
infection. They have been called urinary
antiseptics because this may be considered as
a form of local therapy. Nitrofurantoin and
methenamine are two such agents; infrequently
used now. Nalidixic acid can also
be considered to be a urinary antiseptic.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
5. Introduction
The Aminoglycosides have been in use since 1944.
They are extremely effective antibiotics for treating
severe infections.
Their general use, however, is limited because of the
potential for serious adverse effects, especially
ototoxicity and nephrotoxicity.
Aminoglycosides include gentamicin, amikacin,
kanamycin, netilmicin, tobramycin, paromomycin and
streptomycin.
6. Introduction
The most frequently used aminoglycosides are
gentamycin, tobramycin and amikacin.
Gentamicin is the most widely used, possibly because
of its availability as a generic formulation, and its
prototype drug for the aminoglycoside family.
7. Pregnancy Category C
inhibits protein synthesis in susceptible strains of gram-
negative bacteria.
Gentamicin must be transported across the cell memb.
in order to enter the cell and disrupt protein synthesis.
This process requires oxygen; therefore, gentamicin and
other aminoglycosides are ineffective against
anaerobes.
Gentamicin
8. Gentamicin
Action
Gentamicin, like all antibiotics, has no direct effect on
the cells of the body.
It exerts its effect by entering the bacterial cell and
binding to the 30S ribosomal subunit.
This event leads to a misreading of the information
used within the cell to form proteins.
The cell then produces amino acids that do not link
correctly.
9. Gentamicin
The result is a change in metabolic function that in turn
prevents bacterial reproduction and weakens the cell
wall, leading to cell wall rupture and death.
Many strains of bacteria are resistant to the
aminoglycosides and do not allow them to enter the
cell.
Because of this, aminoglycosides are often given with
synergistic antibiotics to increase their effectiveness or
to alter the cell wall so that the aminoglycoside can
enter.
10. Indications
Gentamicin is effective in managing infections caused
by gram-negative bacilli.
Susceptible organisms include: Pseudomonas
aeruginosa, Proteus mirabilis, Escherichia coli,
Klebsiella, Enterobacter, Serratia, and Citrobacter
species; and staphylococci (gram+).
Gentamicin
11. Gentamicin is NOT considered useful in treating
meningitis unless it is administered intrathecally.
Gentamicin is also indicated for topical treatment of
eye or skin infections caused by susceptible
organisms.
Gentamicin
12. Clinically, gentamicin is useful for urinary tracts
infections (UTIs), such as pyelonephritis, gynecological
infections, peritonitis, endocarditis, pneumonia,
bacteremia and sepsis, respiratory infections, including
those associated with cystic fibrosis, osteomyelitis, and
foot and other soft tissue infections associated with
diabetes.
Gentamicin
13. Pharmakinetics:
Parenteral genta is widely distributed through the body
in ECF; however, it does NOT penetrate appreciably
into the CNS.
It crosses the placenta and is secreted in breast milk.
Genta concentrates in the kidney, reaching levels 50
times higher than those in serum.
Gentamicin
14. It is also concentrates in the endolymph and perilymph
of the inner ear.
High concentration of genta in these fluids are
associated with its major adverse effects “
nephrotoxicity and ototoxicity.
Parenteral genta is excreted unchanged in urine,
whereas oral genta is excreted unchanged in feces.
Gentamicin
15. Because it is poorly absorbed when taken orally, genta
is usually reserved for parenteral or topical use.
It may, however, be given orally to exert a local
decrease in GIT bacteria before surgical or other
invasive procedures.
Gentamicin
16. o Most Common Adverse Effects:
o Nephrotoxicity occurs most frequently in infants or
elderly patients, or with prolonged or high-dose therapy.
o Ototoxicity occurs most frequently when serum trough
levels are elevated, in infants or elderly patients, or with
prolonged or high-dose therapy.
o Neuromuscular blockade may result in profound
respiratory depression. It occurs most frequently in patients
with myasthenia gravis and in patients receiving general
anesthetics or nondepolarizing skeletal muscle relaxants.
Gentamicin
17. CNS: confusion, depression, disorientation, numbness,
tingling and weakness.
Hemato: leukemoid rxns and depressed bone marrow
function.
GI: nausea, vomiting, diarrhea, w.t loss, stomatitis, and
hepatic toxicity.
CV: palpitations, hypotension, hypertension.
Hypersensitivity rxns.
Other: superinfections, fever, apnea, and joint pain may
also occur.
Gentamicin
18. Contraindications:
Pregnancy and lactation
Known allergy to any aminoglycoside
Cautions:
Renal and Hepatic disease
Dehydration
Pre-existing hearing loss
Myasthenia gravis
Parkinsonism
Infant botulism
Gentamicin
19. Maximizing Therapeutic Effects
Make sure that patients receive the full course as
prescribed.
Coordinate the administration of drugs to decrease
potential drug interactions.
Evaluate C/S reports to make sure that genta is the
appropriate drug.
Administer extended penicillins, such as carbenicillin
or ticarcillin at least 2 hrs apart to ensure the efficacy of
genta.
Gentamicin
20. Minimizing Adverse Effects:
To reduce the occurrence of adverse effects, it is
imperative to maintain blood levels of genta within a
therapeutic margin that is very narrow.
To do this, Peak and Trough drug levels are monitored
throughout therapy.
Blood for Peak levels is drawn 30 minutes after the
completion of IV administration and 1 hr after IM
administration.
Bloods for Trough levels is drawn just before the next
dose.
Gentamicin
21. Monitor for signs of ototoxicity. Before administering
each dose, assess the patient’s balance and gross
hearing.
Monitor for signs of nephrotoxicity. Assess the
hydration status of the patient and be alert for dilute
urine or proteinuria.
Monitor the patient for gentamicin-induced diarrhea
because diarrhea may also cause dehydration.
Gentamicin
22. If CNS effects occur, safety measures should be
instituted to protect the patient.
Small, frequent meals can be arranged for patient with
GI effects, and frequent mouth care and ice chips can
be offered to relieve stomatitis and sore mouth.
If a patient receiving genta requires surgery, the chart
should indicate prominently that genta has been given.
Remember that genta may interact with neuromuscular
blocking agents commonly used during surgery.
Gentamicin
23. Monitor lab. Tests such as renal and hepatic functions
( KFT & LFT ), Peak and Trough levels of genta, and
the fluid intake and output status of the patient.
Gentamicin
24. Memory Chip “ GentamicinGentamicin”
Used for serious gram-negative infections.
Major contraindications: hypersensitivity, pregnancy,
and breast-feeding.
Most common adverse effects: nausea, vomiting,
diarrhea, and w.t loss.
Most serious adverse effects: nephrotoxicity,
ototoxicity, neuromuscular blockade.
25. Maximizing therapeutic effects: administer al least 2 hrs
before or after extended infusions of penicillins.
Minimizing adverse effects: monitor Peak and Trough
levels throughout therapy.
Most important patient education: teach the patient the
S&S of both nephrotoxicity and ototoxicity and also the
importance of contacting the health care provider
immediately if any symptoms should occur.
Memory Chip “ GentamicinGentamicin”
26.
27. AmikacinAmikacin
Amikin ®
Is a parenteral aminoglycoside with a broader spectrum of
activity than gentamicin for gram-negative bacilli.
AmikacinAmikacin is also less likely to induce bacterial resistance.
Although some hospitals use AmikacinAmikacin as first-line
treatment of systemic infection because of an increased
resistance to gentamicin, may others reserve its use for
infections that do not respond to other aminoglycoside
antibiotics.
Its contraindications, adverse effects, drug interactions, and
patient management are similar to those of gentamicin.
28.
29. KanamycinKanamycin
Kantrex ®
Is used orally to reduce ammonia-forming bacteria in
hepatic coma and as an adjunctive therapy to decrease
GI flora.
It use for systemic infections is limited by the number
of bacteria that are resistant to it and the availability of
genta in its less expensive generic formulation.
Its contraindications, adverse effects, drug interactions,
and patient management are similar to those of
gentamicin.
30.
31. NeomycinNeomycin
Mycifradin ®
Has the highest risk for toxicity of all of the aminoglycosides.
Because it is so toxic, it is not administered parenterally.
It is available orally to decrease GI flora as a preparation for
bowel surgery and to treat hepatic encephalopathy.
Because it is not absorbed from the GI tract, it frequently
causes superinfection within the bowel.
Neomycin is also available in OTC drugs as a topical
antibiotic.
Its contraindications, adverse effects, drug interactions, and
patient management are similar to those of gentamicin.
32. StreptomycinStreptomycin
Is a parenteral aminoglycoside.
It is used as part of combination therapy for both active
TB and for treating streptococcal or enterococcal
endocarditis.
As a single agent, it is used for mycobacterial
infections, plague, tularemia, and brucellosis.
In addition to ototoxicity and nephrotoxicity,
streptomycin may include neurotoxicity.