Ondansetron
Class
• Seratonin ( 5-HT3) antagonist.
Uses
1. The management of nausea and vomiting induced by chemotherapy and
radiotherapy .
2. In the prevention and treatment of PONV
Main action
• Antiemetic.
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
Digoxin & Nitroglycerin by Dr. Sanaullah Aslam (Complete)Sanaullah Aslam
Your Feedback will be highly appreciated. This presentation was made for students at pharmacy institute in a project of clinical pharmacy and use of digoxin and nitroglycerin. This presentation is made so that you can present it in a same session, without any change.
Therapeutic Drug Monitoring (TDM)
Discuss the logic for therapeutic drug monitoring, which refer to as (TDM)
List various classes of drugs that require TDM
General description of this therapeutic drag TD
Discuss the proper sample timing and method for TDM
And Discuss analytical methods available for TDM
List various drugs that not require TDM
Steady state
Therapeutic Drug Groups
Digoxin, quinidine, procainamide, disopyramide.
- Aminoglycosides (amikacin, gentamicin, kanamycin, tobramycin) - vancomycin
leucovorin rescue ?
First-pass metabolism
HPLC methods
Digoxin & Nitroglycerin by Dr. Sanaullah Aslam (Complete)Sanaullah Aslam
Your Feedback will be highly appreciated. This presentation was made for students at pharmacy institute in a project of clinical pharmacy and use of digoxin and nitroglycerin. This presentation is made so that you can present it in a same session, without any change.
Therapeutic Drug Monitoring (TDM)
Discuss the logic for therapeutic drug monitoring, which refer to as (TDM)
List various classes of drugs that require TDM
General description of this therapeutic drag TD
Discuss the proper sample timing and method for TDM
And Discuss analytical methods available for TDM
List various drugs that not require TDM
Steady state
Therapeutic Drug Groups
Digoxin, quinidine, procainamide, disopyramide.
- Aminoglycosides (amikacin, gentamicin, kanamycin, tobramycin) - vancomycin
leucovorin rescue ?
First-pass metabolism
HPLC methods
Emetics & Anti-emetics presentation for pharmacy studentsLokesh Patil
Emetics and antiemetics are drugs used to induce and prevent vomiting, respectively. Emetics, such as ipecac syrup and apomorphine, stimulate the vomiting center in the brain or irritate the stomach lining to induce vomiting, often used in cases of poisoning. Antiemetics, including drugs like ondansetron, metoclopramide, and promethazine, work by blocking neurotransmitters like serotonin, dopamine, and histamine, which are involved in triggering the vomiting reflex. They are commonly used to treat nausea and vomiting caused by conditions such as motion sickness, chemotherapy, and postoperative recovery. Understanding the mechanisms and applications of these drugs is crucial for effectively managing emesis in various clinical scenarios.
Operation
The layout of the Operating Room
Rules in the Operating Theatre
General rules of asepsis concerning the personal attire
Behaviours and movements in the sterile operating room
General rules of the aseptic operating room
Anticholinsterases are chemicals that prevent the breakdown of the
neurotransmitter acetylcholine or butyrylcholine.
• This increases the amount of the acetylcholine or butyrylcholine in the
synaptic cleft that can bind to muscarinic receptors, nicotinic receptors
and others.
Intravenous Anaesthetics are a group of fast-acting
compounds that are used to induce a state of impaired
awareness of complete sedation.
These are drugs that, when given intravenously in an
appropriate dose, cause a rapid loss of consciousness.
• The PRISMA 2020 Statement was published in 2021.
• It consists of a checklist and a flow diagram, and is intended
to be accompanied by the PRISMA 2020 Explanation and
Elaboration document.
A document that provides an unbiased and comprehensive synthesis
of relevant studies and research.
Characteristics of a Systematic Review
Purposes of a systematic review
Surgery is the treatment of injuries or disorders of the body by incision or manipulation often with the use of instruments.
Surgery is a procedure that involves cutting of a patients tissues or closer of a previously sustained wound.
On The Basis Of Planning
On The Basis Of Risk
On The Basis Of Purpose
On The Basis Of Technique
On The Basis Of Site
Case presentation of Orthopedic Cse Anaesthesia ManagementMr.Harshad Khade
A 43 year old male patient was transferred with an ambulance in the emergency department of the hospital with bleeding from right thigh after a motorcycle accident. He had become a trapped under the motorcycle.
Discuss the medical, surgical and anesthetic management of this patient.
A 43 year old male patient was transferred with an ambulance in the emergency department of the hospital with bleeding from right thigh after a motorcycle accident. He had become a trapped under the motorcycle.
Discuss the medical, surgical and anesthetic management of this patient.
A breathing system is a device that conducts gases such as oxygen and anesthetic agents to the patient and conducts waste gases such as CO2 away.
Breathing systems are classified as
Open,
Semi-open,
Semi-closed
Closed.
Semi-closed systems are further divided into
Rebreathing Systems With CO2 Absorption,
Rebreathing Systems Without CO2 Absorption
Non-rebreathing Systems.
More simply, systems can be classified in two groups:
systems with CO2 washout (includes open and semi-open systems)
systems with CO2 absorption (includes closed and semi-closed systems).
Diathermy
• Diathermy uses an electric current to cause localized heating,
permitting cutting of tissue and coagulation of blood.
• It may be unipolar or bipolar, the former having several settings
depending on which function is required.
Unipolar diathermy
Bipolar diathermy
• Advantages
• Allows surgery to proceed with better hemostatic control than using sharp
instruments.
• Different modes can be used to achieve different effects on different
tissues.
• Disadvantages
• High currents used in diathermy equipment cause induction in cables
used for other purposes. This results in interference in the ECG and other
monitors when diathermy is in use.
Safety
The anaesthesia gas machine is a device which delivers a preciselyknown but variable gas mixture, including anesthetizing and lifesustaining gases.
• Original Boyle was made by the firm COXTERS.
• There are several differences between newer and older anesthesia
machines.
• Advanced ventilators are the biggest difference between newer and
older gas machines.
Types Of Anaesthesia Machine
• Intermittent Anaesthesia Machine
-Gas flows only during inspiration
• Ex:-
• Entonox apparatus ,
• Mackessons apparatus
• Continuous Anaesthesia Machine
-Gas flows both during inspiration
and expiration.
• Ex:-
• Boyle Machine
• Forregar
• Dragger
Blood transfusion therapy
• A Blood Transfusion is the infusion of whole blood or a blood
component such as plasma, red blood cells, or platelets into
the patient’s venous circulation.
• A blood transfusion is given because of red blood cell loss,
such as with haemorrhage or when the body is not
adequately produce in a cells such as platelets. The person
receiving the blood is the Recipient.
• A blood group also called a Blood Type.
• Classification of blood is based on the presence or absence
of inherited antigenic substances on the surface of red blood
cells (RBCs).
• These antigens may be proteins, carbohydrates,
glycoproteins, or glycolipids, depending on the blood group
system.
Components Of Blood (For Transfusion)
• Each unit of blood is tested for evidence of hepatitis-b,
hepatitis-c, Human Immune deficiency Virus I & II.
• The blood is then processed into sub-components.
• Whole blood
• Packed cell volume
• Fresh frozen plasma
• Platelets
• Cryoprecipitate
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
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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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
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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.
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
3. Ondansetron
Class
• Seratonin ( 5-HT3) antagonist.
Uses
1.The management of nausea and vomiting induced by chemotherapy and
radiotherapy .
2. In the prevention and treatment of PONV
Main action
• Antiemetic.
4. Presentation
• As a clear, colourless aqueous solution in 2/4 ml ampoules
• containing 2 mg/ml ondansetron hydrochloride dihydrate.
• It is also available as 4/8 mg tablets,
• as a strawberry-flavoured lyophilizate (4/8 mg), and
• as a suppository containing 16 mg of ondansetron.
Mode of action
• Ondansetron is a highly selective antagonist at 5HT3 receptors and acts
both centrally and peripherally.
• Emetogenic stimuli appear to cause release of 5HT in the small intestine
and initiate a vomiting reflex by activating vagal afferents via 5HT3
receptors; ondansetron blocks the initiation of this reflex.
• Activation of vagal afferents may also result in the release of 5HT in the
area postrema, promoting emesis via a central mechanism.
5. Routes of administration/doses
• For prevention of chemotherapyor radiotherapy-induced nausea and
vomiting, the route of administration and dose of ondansetron should be
flexible in the range of 8–32 mg/day.
• For prophylaxis against PONV, the drug may be administered as a single
dose of 4 mg by intramuscular or slow intravenous injection.
• The paediatric dose is 0.1 mg/kg.
• Identical doses are recommended for treatment of established PONV.
Onset Less than 30 minutes
Duration 9 hours
Elimination Hepatic (95%
6. Effects
• CNS Headache
• RS
• The drug has no effect on the ventilatory response to CO2 .
• CVS
• May cause cardiac rhythm or ECG changes by prolongation of the QT
interval.
• GI Constipation, elevation of liver enzymes.
• Misc.
• Elimination of ondansetron is prolonged when given with other drugs
metabolized by cytochrome P450 system.
7. Prochlorperazine
Uses
1. Nausea and vomiting
2.Vertigo
3. Psychotic states, including mania and schizophrenia, and
4. In premedication.
Main actions antiemetic.
8. Presentation
• As tablets containing 3/5/25 mg, suppositories containing 5/25 mg,
• As a clear, colourless solution for injection containing 12.5 mg/ml of
prochlorperazine maleate, and
• As a syrup containing 1 mg/ml of prochlorperazine mesilate.
Mode of action
• The antiemetic and neuroleptic effects of the drug appear to be mediated
by central dopaminergic (d2) blockade,
• Leading to an increased threshold for vomiting at the chemoreceptor
trigger zone; in higher doses, prochlorperazine appears to have an
inhibitory effect at the vomiting centre.
9. Routes of administration/doses
• The adult dose is 5–20 mg 8 to 12 hourly, and
• the corresponding intramuscular dose is 12.5 mg 6-hourly
Onset 10-20 minutes
Duration 3-4 hours
Elimination Enterohepatic
Effects
• Prochlorperazine has anticholinergic properties which are additive to the
anticholinergic effects of other drugs.
• As a phenothiazine, it also has the potential to cause extrapyramidal
symptoms.
10. • CNS
• Sedative effects which are additive to other-hypnotics> May cause extra-
pyramidal syndromes (motor restlessness, oculogyric crisis, opisthotonus,
dystonias),especially in young male patients.
• RS The drug may cause mild respiratory depression.
• CVS
• Hypotension caused by #-adrenergic blocking effect. May potentiate
hypotensive effect of vasodilators and diuretics.
• Causes QT interval prolongation.
• Misc.
• Diminishes effects of anticoagulants. Possible hyperthermia in the
presence of hypothalamic dysfunction.
• Neuroleptic malignant syndrome.
11. Metoclopramide
Uses
1. digestive disorders, e.g. hiatus hernia, reflux oesophagitis, and gastritis.
2. nausea and vomiting due to a variety of causes, e.g. drugs (general
anaesthetic agents, opiates, and cytotoxic gents), radiotherapy, hepatic and
biliary disorders.
3. diagnostic radiology of the gastrointestinal tract.
4. migraine, and 5. post-operative gastric hypotonia.
Main actions
Increased gastrointestinal motility and antiemetic.
12. Presentation
• As 10 mg tablets,
• A syrup containing 1 mg/ml, and as a clear,
• Colorless solution for injection containing 5 mg/ml of metoclopramide
hydrochloride.
Mode of action
• The antiemetic effects of the drug appear to be mediated by:
1. Central dopaminergic (d2) blockade, leading to an increased threshold
for vomiting at the chemoreceptor trigger zone and
2. Decrease in the sensitivity of visceral nerves supplying afferent
information to the vomiting center.
13. Mode of action
The effects of metoclopramide on gastrointestinal motility appear to be
mediated by:
1. Antagonism of peripheral dopaminergic (D2) receptors
2. Augmentation of peripheral cholinergic responses, and 3. Direct action
on smooth muscle to increase tone.
Routes of administration/doses
• Metoclopramide may be administered orally, intravenously, or
intramuscularly;
• The adult dose by all routes is 10 mg 8-hourly.
• A dose of 1–2 mg/kg is recommended for the treatment of nausea and
vomiting associated with cisplatin treatment.
14. Effects
• CVS
• There have been occasional reports of hypotension during general
anaesthesia and cardiac arrest,
• Dysrhythmias, and hypertension in patients with phaeochromocytoma
following the administration of metoclopramide.
• Cns
• Metoclopramide raises the threshold for vomiting at the chemoreceptor
trigger zone and prevents apomorphine-induced vomiting in man.
• The drug has neuroleptic effects (including an antipsychotic action),
• As would be expected of a centrally acting dopamine antagonist
• GU the drug may increase ureteric peristaltic activit
15. Cyclizine
Uses
• Cyclizine is used in the treatment of nausea and vomiting due to:
1. opioid or general anaesthetic agents
2. motion sickness
3. radiation sickness, and
4. Ménière’s disease
Main action Antiemetic.
16. Presentation
• As tablets containing 50 mg of cyclizine hydrochloride and as a clear,
• colourless solution for injection containing 50 mg/ml of cyclizine lactate
which should be protected from light.
• Fixed-dose combinations with morphine, caffeine, ergotamine, and
dipipanone are available. It has a pH of 3.2.
Mode of action
• Cyclizine is a competitive antagonist of histamine at H1 receptors and has
anticholinergic activity at the muscarinic M1, M2, and M3 receptors.
• The antiemetic effect is mediated via blockade of central histamine and
muscarinic receptors within the vomiting area of the chemoreceptor
trigger zone.
• Cyclizine produces its antiemetic effect within 2 hours and lasts
approximately 4 hours.
17. Route of administration/doses
• Cyclizine may be given orally or by intramuscular or intravenous injection.
• Given the low pH of the parenteral preparation, injection by either route
may be painful.
• The maximum daily dose is 150 mg.The paediatric dose is 1 mg/kg.
Effects
• CVS The drug has mild anticholinergic action and can produce tachycardia
and hypotension due to alpha-blockade.
• RS Cyclizine, although it has antihistaminergic properties, does not
completely reverse anaphylactic bronchospasm,
• CNS The principal effect of the drug is antiemetic, with a slight degree of
sedation.