This document discusses drugs used to treat mania. It begins by defining mania as a state of abnormally elevated mood and energy. Lithium carbonate is described as the first drug found to effectively treat mania through suppressing manic episodes and preventing mood cycling. The mechanisms of lithium's action and its use, efficacy, adverse effects, and interactions are explained in detail. Alternatives to lithium that are commonly used include sodium valproate, carbamazepine, lamotrigine, and atypical antipsychotics either alone or in combination with other drugs. These alternatives are described as having comparable efficacy to lithium in treating acute mania and maintaining remission of bipolar disorder.
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
Anxiety is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat. It has several types. the presentation includes pharmacologic approach of anxiety disorder.
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
Bipolar disorder is a mood disorder with alternate episodes of mania and depression. the symptoms includes hyperexcitability, mood changes, psychological and behavioural affect, weight gain or weight loss, sleep disturbances, fatigue etc. Mania is a state with periods of great excitement or euphoria, delusions, and over activity. The presentation includes points about mania and treatment strategies of mania
Anxiety is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat. It has several types. the presentation includes pharmacologic approach of anxiety disorder.
In this slideshare we gonna discuss about Mania Disorder, a key component of Bipolar Disorder, is a mental health condition characterized by extreme mood swings, with episodes of mania at one end and depressive states on the other. This comprehensive presentation delves into the complexities of Mania Disorder, shedding light on its symptoms, underlying causes, and the range of treatment options available.
Hello friends. In this PPT I am talking about CNS 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.
Need for Therapeutic Drug Monitoring, Factors to be considered during the Therapeutic Drug Monitoring, and Indian scenario for Therapeutic Drug Monitoring.
Drug distribution system in a hospital.pptxMangeshBansod2
Drug distribution system in a hospital
Dispensing of drugs to inpatients, types of drug distribution systems, charging policy and labelling, Dispensing of drugs to ambulatory patients, and Dispensing of controlled drugs.
Community Pharmacy
Organization and structure of retail and wholesale drug store, types and design, Legal requirements for establishment and maintenance of a drug store, Dispensing of proprietary products, maintenance of records of retail
and wholesale drug store
Adverse drug reaction- Drug Interaction .pptxMangeshBansod2
Classifications - Excessive pharmacological effects, secondary pharmacological effects, idiosyncrasy, allergic drug reactions, genetically determined toxicity, toxicity following sudden withdrawal of drugs, Drug interaction- beneficial interactions, adverse interactions, and pharmacokinetic drug interactions, Methods for detecting drug interactions,
spontaneous case reports and record linkage studies, and Adverse drug reaction reporting and management.
2. Hospital Pharmacy and its Organisation.pptxMangeshBansod2
Hospital pharmacy and its organization
Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and
functions of hospital pharmacists.
Hospital and it’s organization
Definition, Classification of hospital- Primary, Secondary and Tertiary hospitals, Classification based on clinical and non- clinical basis, Organization Structure of a Hospital, and Medical staffs involved in the
hospital and their functions.
The increased availability of biomedical data, particularly in the public domain, offers the opportunity to better understand human health and to develop effective therapeutics for a wide range of unmet medical needs. However, data scientists remain stymied by the fact that data remain hard to find and to productively reuse because data and their metadata i) are wholly inaccessible, ii) are in non-standard or incompatible representations, iii) do not conform to community standards, and iv) have unclear or highly restricted terms and conditions that preclude legitimate reuse. These limitations require a rethink on data can be made machine and AI-ready - the key motivation behind the FAIR Guiding Principles. Concurrently, while recent efforts have explored the use of deep learning to fuse disparate data into predictive models for a wide range of biomedical applications, these models often fail even when the correct answer is already known, and fail to explain individual predictions in terms that data scientists can appreciate. These limitations suggest that new methods to produce practical artificial intelligence are still needed.
In this talk, I will discuss our work in (1) building an integrative knowledge infrastructure to prepare FAIR and "AI-ready" data and services along with (2) neurosymbolic AI methods to improve the quality of predictions and to generate plausible explanations. Attention is given to standards, platforms, and methods to wrangle knowledge into simple, but effective semantic and latent representations, and to make these available into standards-compliant and discoverable interfaces that can be used in model building, validation, and explanation. Our work, and those of others in the field, creates a baseline for building trustworthy and easy to deploy AI models in biomedicine.
Bio
Dr. Michel Dumontier is the Distinguished Professor of Data Science at Maastricht University, founder and executive director of the Institute of Data Science, and co-founder of the FAIR (Findable, Accessible, Interoperable and Reusable) data principles. His research explores socio-technological approaches for responsible discovery science, which includes collaborative multi-modal knowledge graphs, privacy-preserving distributed data mining, and AI methods for drug discovery and personalized medicine. His work is supported through the Dutch National Research Agenda, the Netherlands Organisation for Scientific Research, Horizon Europe, the European Open Science Cloud, the US National Institutes of Health, and a Marie-Curie Innovative Training Network. He is the editor-in-chief for the journal Data Science and is internationally recognized for his contributions in bioinformatics, biomedical informatics, and semantic technologies including ontologies and linked data.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
2. MANIA
Mania, also known as manic syndrome, is a
state of abnormally elevated arousal, affect,
and energy level, or "a state of heightened
overall activation with enhanced affective
expression together with lability of affect.”
Mania—elation or irritable mood, reduced
sleep, hyperactivity, uncontrollable thought
and speech, may be associated with reckless
or violent behaviour.
3. Mania is characterized by excessive desire &
too much of euphoria
Majority of the patients of mania also
experience cyclic episodes of maniafollowed
by depression
Bipolar manic depressive psychosis
6. ANTIMANIC AND MOOD STABILIZING DRUGS (Drugs
for bipolar disorder)
LITHIUM CARBONATE –
In 1949, it was found to be sedative in animals and
to exert beneficial effects in manic patients.
Lithium is a drug of its own kind to suppress mania
and to exert a prophylactic effect in bipolar (manic
depressive) disorder at doses which have no overt
CNS effects.
several anticonvulsants and atypical antipsychotics
have emerged as alternatives to lithium with
comparable efficacy.
Actions and mechanism-
7. Given to patients in acute mania, it gradually
suppresses the episode taking 1–2 weeks;
continued treatment prevents cyclic mood changes.
The markedly reduced sleep time.
mechanisms have been proposed-
(a) Li+ partly replaces body Na+ and is nearly equally
distributed inside and outside the cells; this may
affect ionic fluxes across brain cells or modify the
property of cellular membranes.
(b) Lithium decreases the presynaptic release of NA
and DA in the brain of treated animals without
affecting 5-HT release. This may correct any
imbalance in the turnover of brain monoamines.
8. 3.Lithium in therapeutic concentration
range inhibits hydrolysis of inositol-1-
phosphate by inositol monophosphatase.
As a result, the supply of free inositol for
regeneration of membrane
phosphatidylinositides, which are the
source of IP3 and DAG, is reduced.
9. The hyperactive neurones involved in the manic state may be
preferentially affected, because supply of inositol from
extracellular sources is less. Thus, lithium may ignore normally
operating receptors, but ‘search out’ and selectively, though
indirectly, dampen signal transduction in the overactive
10. 2. Other actions- Lithium inhibits the action of ADH
on distal tubules in the kidney and causes a
diabetes insipidus like state.
An insulin-like action on glucose metabolism is
exerted.
Leukocyte count is increased by lithium therapy.
Lithium inhibits release of thyroid hormones
resulting in feedback stimulation of thyroid through
pituitary.
Pharmacokinetics- Lithium is slowly but well
absorbed orally and is neither protein bound nor
metabolized.
It first distributes in extracellular water, then
gradually enters cells and penetrates into brain.
11. Adverse effects-
1. Nausea, vomiting and mild diarrhoea occur initially,
can be minimized by starting at lower doses.
2. Thirst and polyuria are experienced by most, some
fluid retention may occur initially, but clears later.
3. Fine tremors are noted even at therapeutic
concentrations.
4. CNS toxicity manifests as plasma concentration
rises producing tremors, motor incoordination, mental
confusion, slurred speech.
In acute intoxication these symptoms progress to muscle
twitchings, drowsiness, delirium, coma and
convulsions. Vomiting, severe diarrhoea, albuminuria,
hypotension and cardiac arrhythmias are the other
features.
12. 5. On long-term use, some patients develop renal
diabetes insipidus. Most patients gain some body
weight.
Goiter has been reported in about 4%. This is due
to interference with release of thyroid hormone →
fall in circulating T3, T4 levels → TSH secretion
from pituitary → enlargement and stimulation of
thyroid.
6. Lithium is contraindicated during pregnancy:
foetal goiter and other congenital abnormalities.
Lithium can cause dermatitis and worsen acne.
13. Interaction
Diuretics (Thiazide, Furosemide) promote proximal
tubular reabsorption of Na + as well as Li
plasma level of Li rises.
Li tends to enhance insulin / sulfonylurea induced
hypoglycemia.
Neuroleptics , Phenothiazines & Butyrophenone
combination produces marked tremor & rigidity.
Except Paracetamol or Aspirin otherNSAID’S
reduces renal clearance of Li+
Li+ potentiates succinylcholine or d-tubocurarine
induced muscle relaxation
14. Use
Lithium is used as its carbonate salt because this is
less hygroscopic and less gastric irritant than LiCl. It
is converted into chloride in the stomach.
1. Acute mania (inappropriate cheerfullness or
irritability, motor restlessness, high energy level,
nonstop talking, flight of ideas, little need for sleep
and progressive loss of contact with reality;
sometimes violent behaviour). Though lithium is
effective in controlling acute mania.
2. Prophylaxis in bipolar disorder Lithium has proven
efficacy in bipolar disorder.
3. Lithium is being sporadically in many other
recurrent neuropsychiatric illness, cluster headache
15. Use
4. Cancer chemotherapy induced leukopenia
and agranulocytosis: Lithium may hasten
the recovery of leukocyte count.
5. Inappropriate ADH secretion syndrome:
Lithium tends to counteract water retention,
but is not dependable.
16. ALTERNATIVES TO LITHIUM
Approximately 30% patients of mania and bipolar
disorder (especially rapidly cycling cases) show
incomplete or poor response to lithium.
several anticonvulsants and atypical antipsychotics
have been extensively evaluated as alternatives to
lithium.
1. Sodium valproate - A reduction in manic relapses is
noted when valproate is used in bipolar disorder.
It is now a first line treatment of acute mania in which
high dose valproate acts faster than lithium and is an
alternative to antipsychotic ± benzodiazepine..
It can be useful in those not responding to lithium or not
tolerating it.
Combination of valproate with an atypical antipsychotic
has high efficacy in acute mania.
17. 2. Carbamazepine- Soon after its introduction as
antiepileptic, carbamazepine (CBZ) was found to
prolong remission in bipolar disorder.
It is less popular than valproate as an alternative
to lithium.
Initiation of therapy with high doses needed for
efficacy produce neurotoxicity and are poorly
tolerated.
Compared to lithium and valproate, efficacy of
carbamazepine for long-term prophylaxis of bipolar
disorder.
18. ALTERNATIVES TO LITHIUM
3. Lamotrigine - There is now strong evidence
of efficacy of this newer anticonvulsant for
prophylaxis of depression in bipolar disorder.
It is now extensively used in the maintenance
therapy of type II bipolar disorder, because in
this condition risk of inducing mania is
minimal.
20. 4. Atypical antipsychotics – Olanzapine, risperidone,
aripiprazole, quetiapine, with or without a BZD, are now
the first line drugs for control of acute mania.
Aripiprazole has recently emerged as the favoured drug
for treatment of mania in bipolar I disorder, both as
monotherapy as well as adjuvant to lithium or
valproate.
Maintenance therapy with aripiprazole prevents mania.
Olanzapine is also approved for maintenance therapy
of bipolar disorder.
Though both manic and depressive phases are
suppressed, it is not considered suitable for long-term
therapy due to higher risk of weight gain,
hyperglycaemia, etc.
Combination of an atypical antipsychotic with valproate
or lithium has demonstrated high efficacy in acute
phases as well as for maintenance therapy of bipolar
