Lecture covers the pharmacology of anticholinergic drugs. Includes classification, therapeutic uses, adverse effects of anticholinergics. Atropine has been described as prototype drug.
Lecture covers the pharmacology of anticholinergic drugs. Includes classification, therapeutic uses, adverse effects of anticholinergics. Atropine has been described as prototype drug.
Anticoagulants have been thoroughly covered in this SlideShare, including an overview with typical examples, their function in the human body and how they operate (MOA), side effects, contraindications, and uses.
Since they are known to regulate blood clotting, it is crucial to keep an eye on their blood levels lest they have a fatal impact on a patient on anticoagulant treatment.
also we have added novel anticoagulants which got approval in just few years.
Anticoagulants have been thoroughly covered in this SlideShare, including an overview with typical examples, their function in the human body and how they operate (MOA), side effects, contraindications, and uses.
Since they are known to regulate blood clotting, it is crucial to keep an eye on their blood levels lest they have a fatal impact on a patient on anticoagulant treatment.
also we have added novel anticoagulants which got approval in just few years.
pharmacology is the most important part of the pharmacy field and every pharmacist should have the good knowledge about that and there are different parts and one important part is consists of the anticholinesterase drugs.
A good read for undergraduate students in Pharmacy studying at the University of Mumbai. I will highly recommend Essentials of Medical Pharmacology by KD Tripathi. All copyright to the original authors and publishers.
introduction ,classification of cholinergic receptor ,and its function ,anti cholinergic agents -atropine and its pharmacology ,semi synthetic and synthetic atropine substitutes
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.
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.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Anticholinergic part 1, Dr. Kiran Piparva, AIIMS,Rajkot
1. Dr. Kiran G. Piparva,
Assistant professor, Pharmacology,
All India Institute of Medical Science (AIIMS), Rajkot.
Date: 12/02/21
2. Learning objectives….
• Classification of anticholinergic drugs
• Pharmacological actions
• Pharmacokinetics
• Side effects of Atropine
• Drug drug interaction
• Atropine substitutes
3. Cholinergic Receptors blockers
Muscarinic receptors (Nm) Nicotinic receptors
(Nn) (Nm)
Anticholinergic drugs: Drugs are which blocks the actions of Ach action of on
autonomic effectors and in the CNS exerted through muscarinic receptors.
Though nicotinic antagonists also block certain actions of ACh, they are generally
referred to as ‘ganglion blockers’ and ‘neuromuscular blockers’
17. Exocrine glands: ↓ secretions
↓ Salivary ≥ Sweat ≥ Bronchial ˃˃ Lacrimal ≥ Gastric
• Dry skin/ eye- difficulty in talking and swallowing √
• Gastric secretion– only volume decreases- mild action & at higher dose
18. Body temperature: ↑ at higher dose : ↑ Thermostat + ↓ Sweating
Local anaesthetic action: Mild anesthetic action on cornea only
Sensitivity of different organ and tissues to atropine-
Saliva, Sweat, Bronchial secretion > Eye > Bronchial muscle, Heart>
Smooth muscle of intestine, bladder> gastric glands
19. Pharmacokinetics of Atropine
• Atropine- poor blood brain barrier
• Hyoscine- better blood brain barrier penetration
• Dose of Atropine available: 0.6-2mg I.M., I.V.
1-2 % topically eye drop
• Combination of atropine and analgesic and antipyretics are banned
in India .
25. Atropine substitutes……
• Why there is need of atropine substitute ?
- Nonspecific action
- Ocular side effects- mydriasis, Cycloplegia
- Difficulty in micturition: urinary retention
- Drying of skin & difficulty in swallowing
- Constipation
26. Quaternary ammonium atropine substitute
• Poor absorption from G.I. track
• Poor penetration into cornea
• Poor penetration into brain
• Slower elimination –longer acting
• Higher nicotinic blocking property
• At high dose- Nm blockage occurs
31. • Hyoscine butylbromide: Esophageal and gastrointestinal spastic conditions:
PREP: 10 mg tab, 20 mg/ml inj.
• Atropine methonitrate: Abdominal colic and hyperacidity
• Propantheline: peptic ulcer and gastritis
• Use has declined due to availability of H2 blockers which are more efficacious.
• Oxyphenonium: Similar to propantheline, recommended in peptic ulcer and gastric
hypermotility
1. Antispasmodic Antisecretory (Quaternary amine)drugs
Gastric spastic
condition
Hyperacidity
32. • Clinidium/ Isopropamide: Hyperacidity, Nervous dyspepsia, irritable
bowel syndrome (IBS) and other G.I. disturbances especially associated
with mental and emotional disorder.
• Cimetropium bromide: especially for IBS –dryness of mouth is
commonest side effect
• Glycopyrrolate: Exclusively used for preanaesthetic medication
during anesthesia
33. 1. Antispasmodic (Tertiary amine)drugs
• Dicyclomine: Anticholinergic, antispasmodic, antiemetic with few atropinic side
effects. Used in Abdominal colic, dysmenorrhea and irritable bowel, morning
sickness and motion sickness.
Not recommended below 6 months of age.
• Valethamate: visceral anti-spasmodic: (urinary, biliary and intestinal colic)+
Hasten dilatation of cervix when the same is delayed during labor.
• Pirenzepine: peptic ulcer: use is declined due to availability of H2 blocker
35. Ipratropium bromide
• Advantages of ipratropium bromide over atropine
- It has selective action on bronchial smooth muscle >secretion
- Don’t depress mucociliary clearance
• Advantages over sympathomimetic (bronchodilator)
- Gradual onset and late peak-good for regular prophylactic use
- Acts on receptors on larger bronchioles.
• COPD: higher parasympathetic tone so ipratropium bromide is more
effective in COPD than in bronchial asthma.
• ADR: less- dryness of mouth, scratching sensation in trachea, bad taste
and nervousness
• 250ug/ml, 2 puffs , 3-4 times daily.
36. Tiotropium bromide
• Tightly binding to
M1/M3- Longer acting
• High bronchial selectivity
• Less ADR- Not absorbed
from respiratory and G.I.
mucosa
37. 3. Vesicoselective anticholinergic(M3/ M1 selective)
• Oxybutynin
• Tolterodine
• Flavoxate
• Darifenacin
• Solifenacin
Therapeutic use
• Detrusor instability- urinary frequency and
urge incontinence
• Post prostatectomy vasical spasm
• Neurogenic bladder
• Nocturnal enuresis
• Spina bifida
38. • Oxybutynin/ Flavoxate:
• M3/M1 selectivity
• Oral: anticholinergic side effect
Intravesical instillation: few side effect
• Tolterodine
• Selective M3 - less ADR (M1 –dryness of
mouth - other anticholinergic action)
Metabolized by CYP3A4
Dose reduction with CYP34 inhibitors
CYP3A4 inhibitors:
Clarithromycin, erythromycin,
diltiazem, itraconazole,
ketoconazole, ritonavir, grapefruit
• Derifenacin/ Solifenacin: M3 selective, long t1/2 - 24hrs by SR preparation
39. Drotaverine:
• Non anticholinergic antispasmodic
• M/A:
PDE-4 (phosphodiesterase-4 inhibitors) inhibitors- increases cAMP/cGMP
• Use:
Intestinal/biliary and renal colic, IBS
• ADR:
- No anticholinergic side effect
- Headache, dizziness, constipation, flushing
- fall in BP (I.V.)
40. 4. Mydriatics
• Limitation of Atropine :
Potent and long lasting mydriatic and cycloplegic – subject is visually
handicap.
• Short acting agents:
Homatropine
Cyclopentolate
Tropicamides
41. Mydriasis Cycloplegia Remarks/ADR
Atropine
30-40 minutes 1 week
Visually handicap for 1 week
Undesirable for refraction
testing
Homatropine (10times
less potent)
45- 60 minutes 1-3days Accommodation recovers in
2 days
Cyclopentolate 30-60 minutes 1 day
Potent and rapidly acting
Transient behavioural
abnormalities in children
Tropicamide
20-40minutes
3-6hrs,
unreliable
cycloplegia
Best for refraction error
testing and short acting
mydriatic for fundoscopy
42. Therapeutic uses of Atropine/ atropine substitute
• Antisecretory
• Antispasmodic
• Bronchial asthma
• Mydriatic and cycloplegic
• Cardiac vagolytic
• Central action
• To antagonize muscarinic effects if drugs and poisons
43. 1. Antisecretory
1. Preanesthetic medication:
- Irritant GA - check increased salivary and tracheobronchial
secretion
- Along with halothane –vagal slowing- NA mediated ventricular
arrhythmias
- prevent reflex laryngospasm
- Prevent vasovagal attack
2. Pulmonary embolism
- reduces pulmonary secretions
3. Antiparkinson: to check excessive sweating or salivation
4. Peptic ulcer: NOT USED
47. 4. Ophthalmic use: Mydriatic & Cycloplegic
• Diagnostic:
• Refraction error testing: both
mydriasis & cycloplegia both required
• Best- tropicamide –faster and stronger
action
• For children- atropine/cyclopentolate
• For fundoscopy: only mydriasis is
required
• sympathomimetic preferred
• Therapeutic:
• Irits/ iridocyclitis/ chorioiditis/
keratitis / corneal ulcer
• Atropine
• Long lasting mydriatic-cycloplegic
• Local anodyne action on cornea
• Rest to intraocular muscles- cut down
painful spasm
• Along with miotics- break adhesion
between iris and lens
48. 5. Cardiac vagolytic
• Increased vagal tone (myocardial infraction / digitalis toxicity) - sinus
bradycardia, partial heart block
• Only in selected cases.
49. 6. Central action
• Parkinsonism:
• Central anticholinergic used in “ Drug induced
parkinsonism”
• Motion sickness:
• Most effective – hyoscine, Dicyclomine(2nd option)
• Start before journey
• Prophylactic use: 0.2mg oral –action last 4-6hrs
• TDS: applied behind pina 4hrs before journey-
protect 3 days
50. 7. To antagonize muscarinic effects of drugs and poisons…
• In mashroom poisoning
• To reverse muscarinic action neostigmine for mysethenia gravis,
decurarization, cobra envenomation.
51. Belladonna poisoning
• Overdose /overconsumption of seeds / barriers of belladonna/
dhatura plant
• Children
• Symptoms: exaggerated pharmacological
action of atropine- 7Ds
• Diagnosis: Methacholine/neostigmine-
fail to produce muscarinic action
• Rx: Symptomatic Mx only
• Gastric lavage
• Patient should be kept in dark quite room
• Cold sponging
• ABC management – no ChE effective- more ADR
52. •Rapid fire….
• Atropine produces active mydriasis or passive mydriasis?
• Atropine induced cycloplegia last for????
• Best substitute for Irritable bowel syndrome???
• Best substitute for preanesthetic medication??
• Best short acting mydriatic?
• Mydriatic of choice in pediatric?
• Non anticholinergic smooth musce relaxant?
• Y anticholinergic is better for COPD than BA?
• Drug of choice for motion sickness?