Vasodilators and antihypertensive agents-Dr.Jibachha Sah,M.V.Sc,LecturerDr. Jibachha Sah
Dr. Jibachha Sah,M.V.Sc( Veterinary pharmacology, TU,Nepal),posted lecturer notes on AUTONOMIC AND SYSTEMIC PHARMACOLOGY for B.V.Sc & A.H. 6 th semester veterinary students of College of veterinary science,Nepal Polytechnique Institute, Bharatpur, Bhojard, Chitwan, Nepal.I hope this lecture notes may be beneficial for other Nepalese veterinary students. Please send your comment and suggestion .Email:jibachhashah@gmail.com,moble,00977-9845024121
Vasodilators and antihypertensive agents-Dr.Jibachha Sah,M.V.Sc,LecturerDr. Jibachha Sah
Dr. Jibachha Sah,M.V.Sc( Veterinary pharmacology, TU,Nepal),posted lecturer notes on AUTONOMIC AND SYSTEMIC PHARMACOLOGY for B.V.Sc & A.H. 6 th semester veterinary students of College of veterinary science,Nepal Polytechnique Institute, Bharatpur, Bhojard, Chitwan, Nepal.I hope this lecture notes may be beneficial for other Nepalese veterinary students. Please send your comment and suggestion .Email:jibachhashah@gmail.com,moble,00977-9845024121
Individualized Webcam facilitated and e-Classroom USMLE Step 1 Tutorials with Dr. Cray. 1 BMS Unit is 4 hr. General Principles and some Organ System require multiple units to complete in preparation for the USMLE Step 1 A HIGH YIELD FOCUS IN Biochemistry / Cell Biology, Microbiology / Immunology and the 4 P’s-Phiso, Pathophys, Path and Pharm. Webcam Facilitated USMLE Step 2 Clinical Knowledge and Clinical Skills diadactic tutorials /1 Unit is 4 hours, individualized one-on-one and group sessions, Including all Internal Medicine sub-sub-specitialities. For questions or more information.. drcray@imhotepvirtualmedsch.com
Anatomy and physiology of the cardiac system
The electrocardiogram a, curves and interpretation of the first and second heart sounds. Generation of action potential within the myocardium ,the gap junctions and how they propagate electrical pilese from sinoatrial mode and ectopoic heartbeat.
A transmembrane electrical gradient (potential) is maintained, with the interior of the cell negative with respect to outside the cell.Caused by unequal distribution of ions inside vs. outside cell ,Na+ higher outside than inside cell,Ca+ much higher “ “ “ “
K+ higher inside cell than outside Maintenance by ion selective channels, active pumps and exchangers
This slide set provides an introduction at new learner to intermediate level to some of the most common drugs that are used clinically to modulate the rate and force of contraction of the heart. Created by Prof. JA Peters, University of Dundee School of Medicine.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
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.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
2. Arritmia
Kondisi jantung dimana terjadi gangguan pada
Pembentukan impuls oleh ‘pacemaker’
Konduksi impuls kontraksi
Kombinasi keduanya
Yang menyebabkan gangguan kecepatan
dan/atau waktu kontraksi otot jantung shg tidak
mampu mempertahankan curah jantung (COP)
yang normal
4. Electrophysiology - resting potential
A transmembrane electrical gradient (potential) is
maintained, with the interior of the cell negative
with respect to outside the cell
Caused by unequal distribution of ions inside vs.
outside cell
Na+ higher outside than inside cell
Ca+ much higher outside than inside cel
K+ higher inside cell than outside
Maintenance by ion selective channels, active
pumps and exchangers
5. ECG (EKG) showing wave
segments
Contraction
of atria
Contraction of
ventricles
Repolarization of
ventricles
6. Cardiac Action Potential
Aksi potensial bisa tjd pd :
- Conducting tissue (SA node, AV node) – selalu ada depolarisasi
bertahap s.d threshold – muncul spike (peran Ca 2+)
- Non conducting tissue(atrium, ventrikel) – butuh impuls dr
conducting tissue-depolarisasi s.d spike (diawali peran Na+)
Divided into five phases (0,1,2,3,4)
Phase 4 - resting phase (resting membrane potential)
Phase cardiac cells remain in until stimulated
Associated with diastole portion of heart cycle
Addition of current into cardiac muscle (stimulation) causes
Phase 0 – opening of fast Na channels and rapid
depolarization
Drives Na+ into cell (inward current), changing
membrane potential
Transient outward current due to movement of Cl- and K+
Phase 1 – initial rapid repolarization
Closure of the fast Na+ channels
Phase 0 and 1 together correspond to the R and S
waves of the ECG
7. Cardiac Action Potential (con’t)
Phase 2 - plateau phase
Opening of slow Ca2+ channel
sustained by the balance between the inward movement of Ca+ and
outward movement of K +
Corresponds to ST segment of the ECG.
Phase 3 – repolarization
Due to closure of the Ca2+ and K+ channels remain open, causing
a massive loss of K+ out off the cell
Allows K+ to build up outside the cell, causing the cell to repolarize
K + channels finally close when membrane potential reaches certain
level
Corresponds to T wave on the ECG
8.
9. Mechanisms of Cardiac Arrhythmias
Result from disorders of impulse
formation, conduction, or both
Causes of arrhythmias
Cardiac ischemia increased Ca2+
entry
Excessive discharge or sensitivity to
autonomic transmitters , stimulation R/
β1 increased Ca2+ entry
Increased Na+ entry depolarisation
11. Group IA
Cause moderate Phase 0
depression
Prolong repolarization
Increased duration of action
potential
Includes
– Quinidine – 1st antiarrhythmic
used, treat both atrial and
ventricular arrhythmias,
increases refractory period
– Procainamide- increases
refractory period
– Disopyramide – extended
duration of action, used only for
treating ventricular arrthymias
12.
13. Group I B
Weak Phase 0 depression
Shortened phase 3 repolarization
Decreased action potential
duration
Includes
– Lidocaine (also acts as local
anesthetic) – blocks Na+ channels
mostly in ventricular cells, also good
for digitalis-associated arrhythmias
– Mexiletine - oral lidocaine derivative,
similar activity
– Phenytoin – anticonvulsant that also
works as antiarrhythmic similar to
lidocane
14. Group I C
Strong Phase 0 depression
No effect of depolarization
No effect on action potential duration
Includes
– Flecainide (initially developed as a
local anesthetic)
»Slows conduction in all parts of
heart,
»Also inhibits abnormal
automaticity
– Propafenone
»Also slows conduction
»Weak β – blocker
»Also some Ca2+ channel blockad
15. Class II : β–adrenergic blockers
Based on two major actions
1) blockade of myocardial β–adrenergic receptors
2) Direct membrane-stabilizing effects related to Na+
channel blockade
Includes
Propranolol
– causes both myocardial β–adrenergic blockade
and membrane-stabilizing effects
– Slows SA node and ectopic pacemaking
– Can block arrhythmias induced by exercise
– Other β–adrenergic blockers have similar
therapeutic effect
Metoprolol , Nadolol, Atenolol, Acebutolol,
Pindolol, Satalol, Timolol, Esmolol
16. Group III- K+ channel blockers
Developed because some patients
negatively sensitive to Na channel
blockers (they died!)
Cause delay in repolarization and
prolonged refractory period
Includes
Amiodarone – prolongs action
potential by delaying K+ efflux but
many other effects characteristic
of other classes
Ibutilide – slows inward movement
of Na+ in addition to delaying K +
influx.
Bretylium –suppress ventricular
fibrillation associated with
myocardial infarction
Dofetilide - prolongs action
potential by delaying K+ efflux with
no other effects
17.
18. Group IV
Ca2+ channel blockers
slow rate of AV-conduction
in patients with atrial
fibrillation
Includes
Verapamil – blocks Na+
channels in addition to Ca2+;
also slows SA node in
tachycardia
Diltiazem