antiepileptic drugs classification
revision notes based on lecture notes
high yield topic
glutaminergic transmission
ethosuximide
revision notes based on lecture notes
high yield topic
Serotonin is major neurotransmitter and affects the physiology of our body. Serotonin antagonists are used in various pathological conditions of body. This is a small presentation showing feature of serotonin.
Serotonin is major neurotransmitter and affects the physiology of our body. Serotonin antagonists are used in various pathological conditions of body. This is a small presentation showing feature of serotonin.
anti epileptics drugs is a part of pharmacology. the topic contain information regarding epilepsy and their drug. ppt is short and simple and have correct information
The parasympathetic division typically acts in opposition to the sympathetic autonomic nervous system through negative feedback control.
This action is a complementary response, causing a balance of sympathetic and parasympathetic responses.
Overall, the parasympathetic outflow results in the conservation and restoration of energy, reduction in heart rate and blood pressure, facilitation of digestion and absorption of nutrients, and excretion of waste products.
These are drugs that produce actions similar to that of Acetylcholine hence known as parasympathomimetics.
They act either by directly interacting with cholinergic receptors or by increasing the availability of Acetylcholine at these sites.
Sympatholytic drugs (Adrenergic blockers) bind to the adrenergic receptors and prevent the action of adrenergic drugs.
These are drugs which block the actions of sympathetic division or catecholamines (adrenaline and noradrenaline).
They are competitive antagonists at both α and β adrenergic receptors.
anti epileptics drugs is a part of pharmacology. the topic contain information regarding epilepsy and their drug. ppt is short and simple and have correct information
The parasympathetic division typically acts in opposition to the sympathetic autonomic nervous system through negative feedback control.
This action is a complementary response, causing a balance of sympathetic and parasympathetic responses.
Overall, the parasympathetic outflow results in the conservation and restoration of energy, reduction in heart rate and blood pressure, facilitation of digestion and absorption of nutrients, and excretion of waste products.
These are drugs that produce actions similar to that of Acetylcholine hence known as parasympathomimetics.
They act either by directly interacting with cholinergic receptors or by increasing the availability of Acetylcholine at these sites.
Sympatholytic drugs (Adrenergic blockers) bind to the adrenergic receptors and prevent the action of adrenergic drugs.
These are drugs which block the actions of sympathetic division or catecholamines (adrenaline and noradrenaline).
They are competitive antagonists at both α and β adrenergic receptors.
HYPERPARATHYROIDISM
PRIMARY
BROWN TUMOUR
SALT AND PEPPER APPEARANCE OF SKULL
COD FISH SPINE
,
normal calicum metabolism
,
secondary hyperparathyroidism
,
albert hereditary osteodystrophy
,
pseudopseudohypoparathyroidism
,
hypocalcemia
HIGH YIELD
PSYCHIATRY REVISION NOTES REVISION NOTES BASED ON LECTURE NOTES WITH PREVIOUS YEAR QUESTIONS
WITH HIGH YIELD TOPICS
ALCOHOL
CAFFEINE
NICOTINE
COCAINE
SUBSTANCE ABUSE DISORDERS
NEET AIIMS PG PREPARATION
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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!
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
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
29. Barbiturates
• Phenobarbitone & primidone
• MOA
• GABAagonist increased chloride conductance
• Reduces Ca2+ dependant release of NT
• Uses
• GTCS & partial seizure
• GTCS in infants (DOC)
TONY SCARIA 2010 KMC
30. Phenytoin
• Nonsedative oral
• Antiarrythmic class Ib (digitalis induced arrhythmia)
• MOA preferential binding to and prolongation of the inactivated
state of the Na+ channel
TONY SCARIA 2010 KMC
32. PK
• 80 -90 % protein bound low Vd
• Enzyme inducer
• Metabolised by hydroxylation of CYP 2C19 & 2C9 & as well as by
glucuronide conjugation
• Excreted in urine as glucocoronide conjugate
• Saturation kinetics
• Zero order kinetics at higher dose
• Narrow TI 10 -20 ug/ml
TONY SCARIA 2010 KMC
34. S/E of phenytoin
• Hyperplasia of gums
• Hirsutism
• Hypersensitivity reaction
• Hyperglycemia
• Hypersensitivity
• Hydantoin syndrome
• d/t toxic epoxide metabolism
• Impaired DNA synthesis d/t FA deficeicny
• Cleft palate hypoplastic phalanges microcepahly
• Lymphadenopathy Pseudolymphoma
TONY SCARIA 2010 KMC
35. Gingival hyperplasia d/t phenytoin
• Mc manifestation in
children & adults
• d/t inhibition of
collagenase enzyme
responsible for
breakdown of
collagen
TONY SCARIA 2010 KMC
36. Other drugs causing gingival hyperplasia
• Phenytoin
• CCB
• Sirolimus
• Cyclosporine
• Lamotrigine
TONY SCARIA 2010 KMC
37. Drug interactions of phenytoin
• Induces enzymes
• OCP digitoxin doxycycline theophylline rifampicin levodopa
• carbamazepine & phenytoin
• Increase each others metabolism
• Displacement from PPB of valproate
• Sucralfate binds to phenytoin in GIT decrease its absorption
TONY SCARIA 2010 KMC
40. Uses of phenytoin
• In all types of seizures
• Except absence seizure & myoclonic seizure
• Trigeminal neuralgia
• 2nd choice
• Cardiac arrhythmia
• d/t digitalis toxicity
TONY SCARIA 2010 KMC
41. Fosphenytoin
• Water soluble
• IV/IM
• Given as slow infusion to Px arrhythmia / CV collapse & coma
• Used in emergency
• Increased risk of hyperphosphatemia
TONY SCARIA 2010 KMC
44. Carbamazepine PHARmacokinetics
• Oral form only
• Well absorbed
• 80 % protein bound
• Enzyme inducer
• Induces its own metabolism
TONY SCARIA 2010 KMC
46. S/e of carbamazepine
• Hypersensitivity reactions
• Rashes photosensitivity hepatitis
• Lupus like syndrome
• Agranulocytosis
• Aplastic anemia
• Water retention & hyponatremia (SIADH)can occur in elderly
TONY SCARIA 2010 KMC
47. Risk of carbamazepine induced in SJS is
increased in presence of
• HLA B 1502
• May also be allergic to phenytoin lamotrigine & oxcarbazepine
TONY SCARIA 2010 KMC
48. Uses of carbamazepine
• GTCS
• Simple & complex partial seizure
• Trigeminal neuralgia
• Glossopharygengeal neuralgia
• Post herpetic neuralgia
• In Diabetis insipidus
TONY SCARIA 2010 KMC
49. Oxcarbazepine
• Analog of carbamazepine
• Converted to licarbazepine
• No autoinduction
• Enzyme inducer (less than carbamazepine)
• Higher risk of hyponatremia & hepatotoxicity
TONY SCARIA 2010 KMC
50. Drug Moa ADR Use
Lamotrigine Block Na+ & Ca2+ channel Sedation / skin rases / SJS
/ataxia
Partial seizure
Safe drug in pregnancy
Gabapentin Increase release &
inhibits uptake of GABA
(inhibit presynaptiv N
type ca2+ channels)
Sedation ataxia Partial & grandmal
seizure
Neuropathic pain
Vigabatrin inhibits GABA – T Psychosis
Permanent & progressive
painless loss of vision
Partial seizure
LGS (add on)
Infantile spasm with
tuberous sclerosis
Tiagabine Inhibits glial & neuronal
uptake of GABA
Tremors ataxia mental
confusion
Refractory partial seizure
TONY SCARIA 2010 KMC
51. Drug MOA ADR Use
Levitiracetam SV2A protein inhibitor Associated with anger &
aggression
Refractory partial seizure
Felabamate NMDA blocker Hepatotoxicity
Aplastic anemia
Weight loss
Resistant epilepsies
LGS
Zonisamide (sulphonamide derivative)
Voltage gated Na+ & ca2+
channel inhibitor
Renal stone Refractory partial seizure
Topiramate (weak
carbonic anhydrase
activity)
Blocks Na + channel
Increase GABA activity
Decrease glutamate
action
AMPA blocker
Renal stone
Weight loss
Drowsiness dizziness
Partial seizure
Grandmal seizure
Migraine prophylaxis
Alcohol dependence
TONY SCARIA 2010 KMC
52. Drug MOA ADR Use
MgSO4 Toxicity is monitored by
patellar reflex
Eclampsia
Lacosamide Blocks Na channel &
CRMP2
Partial onset seizures
Ganaxolone Neurosteroid • Absence seizure
• Infantile spasm
• Catamenial epilepsy
Rufinamide Block Na+ channel • LGS
Retigabine Block K channel • Add on in partial
seizure
Perampanel
Telampanel
AMPA antagonist • Partial seizure
Pregabalin Inhibit N type Ca2+
channel in presynaptic
neuron
Sedation • Fibromyalgia
TONY SCARIA 2010 KMC
61. Valproate
• Blocks voltage gated Na+ channel
• Blocks T type Ca2+ channels
• facilitate glutamic acid decarboxylase (GAD) increase GABA
• inhibitory effect on the GABA transporter GAT-1
• inhibits GABA transaminase in the brain
• Decrease release of aspartate (excitatory NT) in brain
TONY SCARIA 2010 KMC
62. PK of valproate
• Available as capsule syrup IV capsule
• High oral bioavailability
• Enzyme inhibitor
• All others are inducers
TONY SCARIA 2010 KMC
63. S/E of valproate
• Increased appetite & weight gain
• PCOD
• Acute pancreatitis
• Hepatotoxicity in children <2 yrs
• Therefore in children < 2years DOC In absence seizure is ethosuximide
• Alopecia
• Teratogenic NT defect
TONY SCARIA 2010 KMC
64. Valproate can cause hyperammonemia
• d/t blockage of ura
cycle
• Carnitine deficiency
TONY SCARIA 2010 KMC
65. Uses of valproate
DOC in seizure disorder Also used in
• GTCS
• Myoclonic
• Atonic
• Clonic
• Atypical absence
• LGS
• Partial
• Infantile spasm
• Absence
Valproate is also used in
• Bipolar disorder with rapid cycling
• Migraine headache prophylaxis
• Neuropathic pain
TONY SCARIA 2010 KMC
72. S/E of AED
Antiepileptic causing weight loss TOFE Antiepileptic causing renal stone TOPAZ
• Topiramate
• Felbamate
• Topiramate
• Zonismaide
TONY SCARIA 2010 KMC
73. S/E of AED
Lymphadenopathy Phenytoin
Hairloss Valproate
Permanent visual field loss Vigabatrin
Anemia Carbamazeoine
Felbamate (bonemarrow suppression)
Hepatotoxicity Valproate
Carbamazepine
SJS Carbamazepine
Lamotrigine
Weight gain Valproate
TONY SCARIA 2010 KMC
74. First line Second line
Partial seizure with or
with out GTCS
Carbamazepine
valproate
Lamotrigine
Phenobarbital
Lamotrigine
Gabapentin
GTCS Valproate
Lamotrigine
Phenytoin
Topiramate
Absence seizures Valproate
Ethosuximide
Lamotrigine
Clonazepam
Zonisamide
Myoclonic jerks Valproate Lamotigine
Felbamate ]
TONY SCARIA 2010 KMC
75. Infantile spasm
• DOC is ACTH
• Incase of infantile spasm with tuberous sclerosis vigabatrin is used
TONY SCARIA 2010 KMC
76. Lennox gestaut syndrome
• First line
• Valproate (DOC)
• BZD (clonazepam clobazam)
• Rufinamide
• Second line
• Felbamate
• Topiramate
TONY SCARIA 2010 KMC
77. Treatment of seizures in pregnancy
• Preconception counselling
• To be stabilised under minimum effective dose with same drug
• If new drug has to be started LAMOTRIGINE DOC
• Folic acid (0.4mg/day) & vitamin K supplementation
• Periodic screening for teratogenicity
TONY SCARIA 2010 KMC
78. Teratogenic effects of AED
Valproate NT defects spina bifida
Phenytoin Fetal hydantoin syndrome (microcephaly short
phalanges cleft lip)
Carabamazepine Cleft lip & palate
Topiramate Limb agenesis in rodents
Hypospadiasis in males
Zonismaide Teratogenic
TONY SCARIA 2010 KMC
79. • Absence seizures (>2 years)
• GTCS
• Tonic seizure
• Clonic seizure
• Myoclonic seizure
• Atonic
Valproate
• Absence seizure (<2 years) Ethosuximide (d/t hepatotoxicity valproate is not used
)
• Febrile seizure Rectal diazepam
Partial seizure Carbamazepine
Infantile spasm ACTH
Infantile spasm with tuberous sclerosis Vigabatrin
Lennox gastaut syndrome Valproate
Febrile seizure Diazepam (per rectal)
Status epilepticus Lorazepam
Seizure in eclampsia MgSO4
Mesial temporal sclerosis Surgery
TONY SCARIA 2010 KMC
82. Drugs causing seizures
Drug of abuse Anesthetic & analgesic Psychotropics Sedative hypnotic drug
withdrawal
• Amphetamine
• Cocaine
• Phencyclidine
• Methylphenidate
• Meperidine
• Tramadol
• Local anesthetic
• Antidepressants
• Antipsychotics
• Lithium
• Alcohol
• Barbiturate
• BZD
TONY SCARIA 2010 KMC
83. Types of ca2+ channel Drugs acting on them
N type of ca2+ channel • pregabalin
• Gabapentin
T type of Ca2+ channel • Ethosuximide
• Valproate
L type Ca2+ • CCB
TONY SCARIA 2010 KMC