1. The document discusses various classes of antihypertensive drugs and their mechanisms of action in lowering blood pressure.
2. The classes covered include diuretics, peripheral alpha-1 blockers, central sympatholytics, beta-blockers, ACE inhibitors, calcium channel blockers, and vasodilators. Each works by a specific mechanism to reduce cardiac output and/or total peripheral resistance.
3. The key targets of antihypertensive therapy are the organ systems and mechanisms that control the physical factors influencing cardiac output and total peripheral resistance, such as the kidneys, blood vessels, heart, and brain centers. Properly matching a drug's mechanism to a patient's needs can optimize treatment
A condition in which the heart is unable to pump sufficient blood
to meet the metabolic demand of the body and also unable to receive it back because every time after a systole.
Drugs used in Parkinsons Disease ( anti- Parkinson drugs) Ravish Yadav
detail and complete study on the topic of anti parkinson drug. the study is done under the guidance of faculty member. the learning content complete information of the topic
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...Dr Pankaj Kumar Gupta
PH1.28 Describe the mechanisms of action, types, doses, side effects, indications and contraindications of the drugs used in ischemic heart disease (stable, unstable angina and myocardial infarction), peripheral vascular disease
Autacoids - pharmacological actions and drugs related to them. SIVASWAROOP YARASI
Autacoids or "autocoids" are biological factors which act like local hormones, have a brief duration, and act near the site of synthesis. The word autacoids comes from the Greek "autos" (self) and "acos" (relief, i.e. drug).
A soape note on uncontrolled hypertensionRomit Subba
This was our SOAPE note on Uncontrolled HTN. SOAPE S Stands for Subjective O stands for Objective A for Assessment P for Plan and E for Education . Patient have Uncontrolled HTN for which we being a pharmacist giving our rationale depending upon his/her SOAPE. Suggestions and comments are appreciated.
Hello friends. In this PPT I am talking about Cardiovascular system 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.
A condition in which the heart is unable to pump sufficient blood
to meet the metabolic demand of the body and also unable to receive it back because every time after a systole.
Drugs used in Parkinsons Disease ( anti- Parkinson drugs) Ravish Yadav
detail and complete study on the topic of anti parkinson drug. the study is done under the guidance of faculty member. the learning content complete information of the topic
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
PH1.28 Describe the mechanisms of action, types, doses, side effects, indicat...Dr Pankaj Kumar Gupta
PH1.28 Describe the mechanisms of action, types, doses, side effects, indications and contraindications of the drugs used in ischemic heart disease (stable, unstable angina and myocardial infarction), peripheral vascular disease
Autacoids - pharmacological actions and drugs related to them. SIVASWAROOP YARASI
Autacoids or "autocoids" are biological factors which act like local hormones, have a brief duration, and act near the site of synthesis. The word autacoids comes from the Greek "autos" (self) and "acos" (relief, i.e. drug).
A soape note on uncontrolled hypertensionRomit Subba
This was our SOAPE note on Uncontrolled HTN. SOAPE S Stands for Subjective O stands for Objective A for Assessment P for Plan and E for Education . Patient have Uncontrolled HTN for which we being a pharmacist giving our rationale depending upon his/her SOAPE. Suggestions and comments are appreciated.
Hello friends. In this PPT I am talking about Cardiovascular system 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.
Losocor co training south africa Dr Saurav dekaassam1
Losacar co contain losartan and hydrochlorothiazide . This presentation give you brief about basics of hypertension and its treatment with losartan hydrochlorothiazide .
This presentation deals with the most common antihypertensive drugs used in our day-to-day practice. The common 4 ABCDs (Angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, diuretics)
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
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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
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2. Hypertension – silent killer
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Heart Attack Stroke Kidney Failure
Hypertension- asymptomatic
Morbidity and mortality due to end organ
damage
3. Anti hypertensive drugs
• Patients with primary hypertension are
generally treated with drugs that 1) reduce
blood volume (which reduces central
venous pressure and cardiac output).
• Reduce systemic vascular resistance.
• Reduce cardiac output by depressing heart
rate and stroke volume.
4. Secondary hypertension
• Patients with Secondary hypertension are
best treated by controlling or removing the
underlying disease or pathology, although
they may still require antihypertensive
drugs.
5. Cardiac output
• Each time the heart beats, a volume of
blood is ejected from one ventricle .
This stroke volume (SV), times the number
of beats per minute (Heart rate HR), equals
the cardiac output (CO).
CO = SV × HR
6. Systemic vascular resistance
• Systemic vascular resistance (SVR) refers to the resistance to blood
flow offered by all of the systemic vasculature, excluding the
pulmonary vasculature.
• This is sometimes referred as total peripheral resistance (TPR).
SVR is therefore determined by factors that influence vascular
resistance in individual vascular beds.
• Mechanisms that cause vasoconstriction increase SVR, and those
mechanisms that cause vasodilation decrease SVR.
• Although SVR is primarily determined by changes in blood
vessel diameters, changes in blood viscosity also affect SVR.
7. Central venous pressure
• Venous pressure is a term that represents
the average blood pressure within the
venous compartment. The term "central
venous pressure" (CVP) describes the
pressure in the thoracic vena cava near the
right atrium
8. Determinants of Arterial Pressure
Mean Arterial
Pressure = X Arteriolar
Diameter
Blood
Volume
Stroke
Volume
Heart
Rate
Filling Pressure
Contractility
Blood Volume Venous Tone
CRITICAL POINT!
Change any physical factors
controlling CO and/or
TPR and MAP can be
altered.
9. Mechanisms Controlling CO and TPR
Artery Vein
2. Hormonal
Renal
Ang II
Adrenal
Catecholamines
Aldosterone
3. Local Factors
1. Neural
SymNS
PSNS
CRITICAL POINTS!
1. These organ systems and mechanisms control physical factors of CO and TPR
2. Therefore, they are the targets of antihypertensive therapy.
10. 2. Secondary hypertension- due to specific organ pathology
1. renal artery stenosis
2. pheochromocytoma
3. aortic coarctation
4. adrenal tumor
Summary-Types and Etiology of Hypertension
1. White coat hypertension
office or environmental
3. Essential Hypertension
No known cause.
CRITICAL POINT!
Pharmacological Therapy used
primarily for essential hypertension.
11. Summary
General Treatment Strategy of Hypertension
1. Diagnosis- 3- 6 independent measurements.
2. Determination of primary vs. secondary hypertension.
3. If secondary, treat underlying pathology.
5. Pharmacological treatment.
4. If primary, initiate lifestyle changes
smoking cessation
weight loss
diet
stress reduction
less alcohol
etc.
CRITICAL POINTS!
Goal- normalize pressure- decrease CO and/or TPR
12. Classes of Antihypertensive Agents
1. Diuretics
2. Peripheral a-1 Adrenergic Antagonists
4. b-Adrenergic Antagonists
3. Central Sympatholytics (a-2 agonists)
5. Anti-angiotensin II Drugs
6. Ca++ Channel Blockers
7. Vasodilators
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Pharmacological Treatment
CRITICAL POINTS!
1. Each designed for specific control system
2. Often used in combination
14. Diuretics (cont)
2. Mechanism of Action
Urinary Na+ excretion
Urinary water excretion
Extracellular Fluid
and/or Plasma Volume
3. Effect on Cardiovascular System
Acute decrease in CO
Chronic decrease in TPR, normal CO
Mechanism(s) unknown
1. Site of Action
Renal Nephron
15. Diuretics (cont)
4. Adverse Reactions
dizziness,
electrolyte imbalance/depletion,
hypokalemia,
hyperlipidemia,
hyperglycemia (Thiazides)
gout
5. Contraindications
hypersensitivity,
compromised kidney function
cardiac glycosides (K+ effects)
hypovolemia,
hyponatremia
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16. Peripheral a-1 Adrenergic Antagonists
Drugs: prazosin (Minipres); terazosin (Hytrin)
1. Site of Action- peripheral arterioles, smooth muscle
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CRITICAL POINT!
Major mechanism/site of SymNS control of blood pressure.
17. 2. Mechanism of Action
Competitive antagonist at a-1 receptors on vascular
smooth muscle.
3. Effects on Cardiovascular System
Vasodilation, reduces peripheral resistance
Peripheral a-1 Adrenergic Antagonists, cont.
CRITICAL POINT!
Blocking a-receptors on vascular smooth muscle allows
muscle relaxation, dilation of vessel, and reduced resistance.
18. 5. Contraindications
Hypersensitivity
Peripheral a-1 Adrenergic Antagonists, cont.
4. Adverse effects
nausea; drowsiness; postural hypotenstion;
1st dose syncope
6. Therapeutic Considerations
no reflex tachycardia; small 1st dose;
does not impair exercise tolerance
useful with diabetes, asthma, and/or
hypercholesterolemia
use in mild to moderate hypertension
often used with diuretic, b antagonist
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19. Central Sympatholytics (a-2 Agonists)
Drugs: clonidine (Catapres), methyldopa (Aldomet)
1. Site of Action
CNS medullary
cardiovascular centers
CNS a-2 adrenergic stimulation
Peripheral sympathoinhibition
Decreased norepinephrine release
2. Mechanism of Action
3. Effects on Cardiovascular System
Decreased NE-->vasodilation--> Decreased TPR
CRITICAL POINT!
Stimulation of a-2 receptors in the medulla decreases peripheral
sympathetic activity( arterial contraction), reduces tone, vasodilation
and decreases TPR.
20. 5. Contraindications
4. Adverse Effects
dry mouth; sedation; impotence;
Central Sympatholytics (a-2 Agonists); cont.
s
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21. b Adrenergic Antagonists
Drugs: propranolol (Inderal); metoprolol (Lopressor)
atenolol (Tenormin); nadolol (Corgard);
pindolol (Visken)
1. Sites of Action
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b-1 b-1
2. Mechanism of Action
competitive antagonist at b- adrenergic receptors
22. b Adrenergic Antagonists, cont.
3. Effects on Cardiovascular System
a. Cardiac-- HR, SV CO
b. Renal-- Renin Angiotensin II TPR
5. Contraindications
asthma; diabetes; bradycardia;
hypersensitivity
4. Adverse Effects
impotence; bradycardia;
fatigue; exercise intolerance;
23. Anti-Angiotensin II Drugs
Angiotensin II Formation
2. Ang II Receptor Antagonists
losartan (Cozaar);
candesartan (Atacand);
valsartan (Diovan)
1. Angiotensin Converting Enzyme-
Inhibitors
enalopril (Vasotec);
quinapril (Accupril);
fosinopril (Monopril);
moexipril (Univasc);
lisinopril (Zestril, Prinivil);
benazepril (Lotensin);
captopril (Capoten)
Ang I
Ang II
ACE
ACE
Ang II
Renin
Angiotensinogen
Ang I
AT1
AT2
Lung
VSM
Brain
Kidney
Adr Gland
24. 3. Effect on Cardiovascular System
Anti-Angiotensin II Drugs, cont
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Volume
Aldosterone
Vasopressin
CO
Angiotensin II
Vasoconstriction
TPR
SymNS
HR/SV
Angiotensin II
Norepinephrine
CO
SymNS
29. Summary
Sites and Mechanisms of Action
1. Can alter CO/TPR at number of sites and/or mechanisms.
2. Antihypertensives mechanistically specific, and alter blood
pressure through physiologically diverse effects on CO/TPR.
3. All organ systems and/or effector mechanisms are p’col targets.
3. a-2 agonists
4. b-blockers
Receptor antag.
2. a-antag.
5. ang II antag.
7. Vasodilators
6. Ca++ antag.
1. Diuretics
4. b-blockers
Other- 5. ACE inhibitors
Lung, VSM, Kidney, CNS
CRITICAL POINTS!
30. Summary Important Points
Hypertensive Agents
Each class of antihypertensive agent:
1. has as specific mechanism of action,
2. acts at one or more major organ systems,
3. on a major physiological regulator of blood pressure,
4. reduces CO and/or TPR to lower blood pressure,
5. has specific indications, contraindications, and
therapeutic advantages and disadvantages associated
with the mechanism of action.