-Management of various of forms of epilepsies including treatment of status epilepticus
-Status of newer anti-epileptic drugs in treatment of epilepsies
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
Hello friends. In this PPT I am talking about antiepileptic drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
Hello friends. In this PPT I am talking about antiepileptic drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
antipsychotics history, managment of psychosis,side effect of antipsychotics, mechanism of antipsychotics, atypical antipsychotics,2nd generation antipsychotics.
antipsychotics history, managment of psychosis,side effect of antipsychotics, mechanism of antipsychotics, atypical antipsychotics,2nd generation antipsychotics.
Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior.
MANAGEMENT OF LOWER ABDOMINAL PAIN IN FEMALES AND GENITAL ULCERSShiksha Choytoo
This power point is about syndromic approach - management of lower abdominal pain in females and genital ulcers. This is an easier approach to treat such conditions as it covers for numerous causative microorganisms at the same time. Moreover treatment can be started earlier and one might not wait for Culture and Sensitivity test to start treatment.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
- 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Anti- epileptic Drugs
1. ANTI-EPILEPTIC DRUGS
•Management of various of forms of
epilepsies including treatment of status
epilepticus
•Status of newer anti-epileptic drugs in
treatment of epilepsies CHOYTOO Shiksha
Roll No 12
2. CONTENTS
• Introduction
• Types of seizures
• Brief description of each type of seizures and
their management
• Status of newer anti-epileptic drugs
3. INTRODUCTION
• Aim : control and totally prevent all types of seizures at an
acceptable level of S/E
• Treatment should be started early with single low dose
• Simple therapy
• Drug withdrawal should be gradual
• Pregnancy : treatment not stopped
dose is reduced
folic acid is supplemented in 1st and 2nd
trimester along with vit k in last trimester
5. GTC SEIZURE
• Sudden loss of consciousness
• Tonic phase
- 1min
- sustained muscle contraction
• Clonic phase
- 2-4 min
- muscle relaxation
• CNS depression follows and patient goes into sleep
6. PARTIAL SEIZURES
Simple Partial Seizures (Jacksonian)
Involves one side of the brain at onset.
motor, sensory or speech disturbances.
Confined to a single limb or muscle group.
Last for 20-60 s
No alteration of consciousness.
7. MANAGEMENT OF PS AND GTCS
• Carbamazepine - preferred drug in PS
Preferred in young girls – cosmetic effects
• Valproate - used in GTCS
cautious with children-hepatotoxicity
• Alternative s- Lamotrigine, gabapentin & topiramate
are good alternatives (either add on or as
monotherapy)
• Complete control in 90% patients with generalised
seizures but, only 50% in patients with partial
seizures.
8. Type First choice Second choice Add on
General tonic-
clonic
Simle Partial
seizures
Carbamazepine,
phenytoin
Valproate,
phenobarbitone
Lamotrigine,
gabapentin,
topiramate,
primidone,
levetiracetam
9. PARTIAL SEIZURE
Complex Partial Seizures
• Produces confusion and inappropriate or
dazed behavior.
• Motor activity appears as non-reflex actions.
• Automatisms (repetitive coordinated movements).
• Purposeless movements like lips smacking or
hand wringing
• Last for 30 s to 2 min, preceded by aura
• Consciousness is impaired or lost.
10. MANAGEMENT OF CPS
• It is usually difficult to control
• Carbamazepine + phenytoin or valproate is
given
• Refractory cases:
levetiracetam, lamotrigine, gabapentin,
topiramate or zonisamide.
Type First choice Second choice Add on
Complez partial
seizure
Carbamazepine
Valproate
Phenytoin
Gabapentin
Lamotrigine
Levetiracetam
Clobazam
Zonicamide
Topiramate
11. ABSENCE SEIZURE
• Sudden onset of impaired conciousness
• With staring
• Last less than 30 min
• attack may be associated with mild clonic
jerking of the eyelids or extremities
• postural tone changes
• autonomic phenomena
12. MANAGEMENT OF ABSENCE SEIZURE
• Both valproate and Ethosuximide can be use
• Valproate : most commonly used - prevent kindling
& emergence of GTCS
• Lamotrigine is a good alternative
• Clonazepam limited by sedative effects, and
development of tolerance
• clobazam- more sustained response
13. Type First choice Second
choice
Add on
absence valproate Ethosuximide
, lamotrigine
Clobazam,
clonazepam
14. ATONIC SEIZURES
• Akinetic epilepsy
• Unconsciousness , Relaxation of all muscles
• Sudden loss of postural tone
• Due to excessive inhibitory discharges
• Patient may fall
MYOCLONIC SEIZURES
• Sudden , brief, shock like contraction of muscles
• It may be limited to one part of the body or
whole body
15. MANAGEMENT OF ATONIC &
MYOCLONIC SEIZURES
• Valproate is preferred
• Lamotrigine preferred alternative
• Topiramate & levetiracetam may be added in
unresponsive or poor response
Type First choice Second choice Add on
myoclonic valproate Lamotrigine,
topiramate
Levetiracetam,
clonazepam
atonic valproate Clonazepam,
clobazam
lamotrigine
16. MANAGEMENT OF FEBRILE
CONVULSIONS AND INFANTILE SPASMS
• Rectal diazepam 0.5mg/kg
• Anti epileptics ineffective in infantile spasms
• corticosteroids provide symptomatic relief.
• Valproate, clonazepam or Vigabatrin has some efficacy
Type First choice Second choice Add on
febrile Diazepam-rectal
17. STATUS EPILEPTICUS
• continuous seizure lasting more than 30 min,
• or two or more seizures without full recovery of
consciousness between any of them.
• medical emergency associated with significant
morbidity and mortality
Type First choice Second choice Add on
Status epilepticus Lorazepam &
diazepam IV
Fosphenytoin,
phenobarbitone
GA
18. MANAGEMENT OF STATUS EPILEPTICUS
• Lorazepam 0.1 mg/kg IV inj at 2mg/min
(effective and longer acting anticonvulsant)
If lorazepam is unavailable,
• Diazepam 5-10 mg every 10-15 min (max. 30 mg)
• Phenytoin 500 – 1000 mg (max 1000 in 24 hr)
IV
• Nowadays fosphenytoin is prefered
max 1000 phenytoin equivalent
19. • No respond to phenytoin,
phenobarbitone is used , 100 -200 mg
• Seizure continues
GA with propofol or thiopental in the last
resort.
• This is guided by EEG.
• General measures
▫ Maintenance of airways , oxygenation, fluid and
electrolyte balance, BP, Pulse rate
21. LAMOTRIGINE
• Dose 50mg/day initially, increase upto 300mg/day
as needed
• not to be used in children
• MOA: same as carbamazepine
• Broad spectrum anti-epileptic
• Abs orally, half life 24 hours
• Better tolerated than carbamazepine or phenytoin,
no negative effect on cognitive function
22. GABAPENTINE
• Modifies maximal electro shock and inh. PTZ induced
clonic seizure
• Add on to first line of drug
• Can even be used as monotherapy
• Reduces seizure frequency in refractory partial seizures
• No change in primary antiepileptic drug is required
when gabapentine is added
• Dose: start with 300 mg OD, inc up to 300- 600mg
TDS as required
23. TOPIRAMATE
• Weak carbonic anhydrase inhibitor
• broad spectrum anti convulsant activity in partial
tonic seizures & kindling model
• Monotherapy & adjuvant drug
• Great results in myoclonic epilepsy
• Dose: initially 25mg OD increase weekly upto 100-
200mg BD as required
24. ZONISAMIDE
• Weak carbonic anhydrase inhibitor
• Add on drug in refractory partial seizures
• Dose : 25-100mg BD
25. LEVETIRACETAM
• Unique- suppresses kindled seizures but
ineffective against PTZ or maximal electroshock.
• Free of drug interactions. Good tolerability
hence, use increasing in complex partial
seizures, grand mal epilepsy & myoclonic
epilepsy.
• Dose : 0.5mg BD, increase upto 1.0g BD
26. TIAGABINE & VIGABATRIN
• Tiagabine : Potentiates GABA
• Add on therapy of partial seizures
• Vigabatrin : (-) of GABA transaminase
• effective in refractory epilepsy
• only adjuvant medication.