Disulfiram is a drug used to treat alcohol dependence by producing unpleasant reactions when alcohol is consumed while taking the drug. It works by inhibiting the breakdown of acetaldehyde, causing levels to rise over 10 times higher than normal when alcohol is ingested and resulting in symptoms like flushing, nausea, and increased heart rate. The drug is usually taken daily in tablet form to discourage drinking and support abstinence during treatment. Side effects are generally mild but can include headaches and drowsiness.
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
This slide contains information regarding Lithium Toxicity. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Part of the Addiction counselor training curriculum
This slide contains information regarding Lithium Toxicity. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Part of the Addiction counselor training curriculum
This presentation tackles the growing problem of chronic toxicity and its effects on living systems, including the living system that is you. It describes toxin types, detoxification pathways, and a systems medicine model for supporting your body's detox capacity, and for thinking about what's really needed to reduce the pollution we're spewing into the world.
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Global Medical Cures™ | Harmful Interactions
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Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
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Ciplar-LA (Propranolol HCl Long Acting Tablets) is a beta blocker used to treat high blood pressure, irregular heartbeats, shaking (tremors), and other conditions as determined by your doctor. This medicine is used after a heart attack to improve survival. It is also used to prevent migraine headaches and chest pain (angina). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Preventing chest pain can help improve the ability to exercise.
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.
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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
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
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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
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. Deterrent agents are
given to desensitize
the individual to the
effects of alcohol &
Abstinence.
The Most commonly
Used Drug is
Disulfiram or
Tetraethyl thiuram
disulfide or Antabuse.
3. Disulfiram (tetraethyl thiuram disulfide) was
discovered in 1930s, when it was observed
that workers in the rubber industry
developed unpleasant reactions to alcohol
intake, due to accidental absorption of
antioxidant disulfiram.
4. Disulfiram is used to
ensure Abstinence in the
Treatment of Alcohol
Dependence. Its Main
effect is to Produce a
rapid & Violently
Unpleasant Reaction in a
Person who ingests even
a Small amount of
alcohol While Taking
Disulfiram.
5. Disulfiram is a medicine used in the long
term treatment of patients with alcohol
misuse.
It produces extremely unpleasant reactions
in a person who ingests even a small amount
of alcohol while taking Disulfiram.
This effect is used in the treatment of
patients with alcohol problems.
It’s Chemical name is Tetraethylthiuram
disulfide
6. The knowledge that taking alcohol will be
unpleasant serves as a reinforcement or
additional support to their decision not to
drink.
It also Protects them from giving in to sudden
urges to drink, or pressure from friends.
It is supplied in tablets of 250mg. The ususal
dosage ranges from 125 to 500mg a day. The
dosage should not usually exceed 500mg a
day.
It should be taken before bed time to avoid
drowsiness in day time.
7. Disulfiram is completely absorbed from
the stomach after oral administration.
It is broken down in the liver & excreted in
the urine.
One or two weeks may be needed before
disulfiram is totally eliminated from the
body after the last dose has been taken.
So the disulfiram effect may last up to two
weeks.
8. Generally Disulfiram is not used in:
Children
Pregnant Women
Recent “Heart Attack”
Liver Damage (Cirrhosis of Liver & Acute Hepatitis)
Fits (Epileptic Seizures)
Psychosis
Major Depression
Recent Stroke
Patients Unwilling to take, or those who do not know
that they are being given.
9. In some people, Disulfiram in the absence of
alcohol can produce:
Lethargy, Drowsiness – 45%
Decreased Memory – 40%
Headache – 35%
Itching – 33%
Decreased Sleep – 27%
Dizziness – 22%
Sexual Problems – 10%
10. Peripheral Neuropathy – Tingling &
Numbness of hands & Legs.
Worsening Depression & Psychosis in
some patients.
Less than 10 patients out of a 100 taking
disulfiram, develop serious side effects
which require withdrawal of the drug.
11. Disulfiram interferes with the normal
breakdown of alcohol in the body by producing
a marked increase in a normal breakdown
product of alcohol called Acetaldehyde.
The increase in the acetaldehyde is 10 times
higher than in the normally occurring
metabolism of alcohol. The accumulation of
acetaldehyde produce a vast array of
unpleasant reactions. This is the so called
Disulfiram – Alcohol Reaction. The reactions are
Characterized by:
12. Throbbing headache
Facial flushing
Blurring of vision
Giddiness
Chest Pain
Difficulty in Breathing
Nausea & Vomiting
Sweating
Thirst
Low Blood Pressure & Shock – Which untreated may
rarely lead to death.
The reaction occurs almost immediately after the
ingestion of just one drink.
13. It is an Aldehyde Dehydrogenase inhibitor that
interferes with the metabolism of alcohol & Produces
a marked increase in blood acetaldehyde levels.
Accumulation of acetaldehyde( more than 10 times
which occurs in the normal metabolism of alcohol)
produces a wide array of Unpleasant reactions Called
DISULFIRAM-ETHANOL REACTION (DER).
Characterized by Nausea, Throbbing headache,
Hypotension, Sweating, thirst, Chest Pain,
tachycardia, Vertigo, blurred Vision associated with
Severe Anxiety.
14.
15. Even a small amount of alcohol will bring on the
unpleasant Disulfiram – Alcohol Reaction.
The person taking Disulfiram should not use or
have the Alcohol containing preparation such as:
Cough Syrups, Vitamin Tonics, Ayurvedic Tonics,
After Shave lotion, Perfumes, Spirits, Spirit based
Paints, glues, thinners, etc., and Stale or fermented
foods.
The Disulfiram – Alcohol Reaction may occur as
long as one or two weeks after the last dose of
disulfiram.
16. Some patients hear false information
regarding the Disulfiram – Alcohol Reaction.
It does not cause:
Vomiting Blood
Passing blood in the urine or Stool
Swelling all over the body
Going Mad
Going Blind
The above symptoms usually will not occur in
Disulfiram – Alcohol Reaction.
17. Disulfiram helps a person:
To start a period of being SOBER.
To give cover over a high risk period.
To resist impulses to drink.
To reduce drinking days.
To help the organs recuperate & the individual
to change his life style.
(By prolong abstinence a person can learn new
coping skills & the damaged organ can return
to normal state).
18. For long term recovery & to learn new ways
of coping with life, a period of abstinence
needs to be at least 1 & probably 2 years.
So it is appropriate to take disulfiram tablet
for at least 6 months & probably upto 2
years.
19. It is convenient to take disulfiram in the
morning hours after coffee or breakfast.
Disulfiram treatment is more effective if
supervised by the wife of the patient or a
close family member.
Taken before bed time to avoid drowsiness.
Effective begins within 12 hours first dose
remains 7 – 10 days after last dose.
20. The person is highly motivated.
Daily use of disulfiram under supervision.
Abstinence prior to treatment.
Regular contact with the doctor or treating
team.
21. The patient should always carry identification
cards describing the Disulfiram – Alcohol
Reaction.
If any person develops Disulfiram – Alcohol
Reaction:
Stop Disulfiram.
Immediately go to the near by doctor and show
the card.
For further information, they can contact duty
psychiatrist.
22. If Disulfiram – Alcohol Reaction is severe, the
person might need admission to a hospital or
nursing home so that his pulse and blood
pressure can be monitored and symptomatic
treatment with intravenous fluids may be given.
Inj. Avil for the allergic reaction and dopamine to
elevate the blood pressure may be required
according to the patients symptoms.
23. An informed Consent should be taken before
Starting treatment.
Ensure that at least 12hours have elapsed since
the last ingestion of Alcohol before Administering
the Drug.
Patient should be warned against Ingestion of any
alcohol-containing preparations such as Cough
Syrups, Sauces, Aftershave Lotions, Etc.,
Caution patient against taking CNS Depressants
& Over-the-Counter(OTC) Medications during
disulfiram therapy.
Instruct The Patient to avoid driving or other
activities requiring alertness.
24. Patients should be warned that the Disulfiram-
alcohol Reaction may continue for as long as
1or 2 weeks after the last dose of disulfiram.
Patients should carry identification cards
describing Disulfiram-alcohol reaction & listing
the name & phone number of the physician to
be called.
Emphasize the Importance of Follow-Up visits
to the physician to monitor progress in long-
term therapy.