1. Metronidazole is the most commonly used drug for both intestinal and extra-intestinal amebiasis as it is effective against trophozoites.
2. Other drugs include luminal amebicides like diloxanide furoate, iodoquinol, and paromomycin which are only effective in the lumen.
3. For severe or resistant cases, tissue amebicides like chloroquine or emetine may be used in combination with metronidazole and a luminal drug.
Antiprotozoal agents is a class of pharmaceuticals used in treatment of protozoan infection. Protozoans have little in common with each other and so agents effective against one pathogen may not be effective against another
These are antibiotics having a macrocyclic
lactone ring with attached sugars. Erythromycin
is the first member discovered in the 1950s,
Roxithromycin, Clarithromycin and Azithromycin
are the later additions. Antimicrobial spectrum is narrow,
includes mostly gram-positive and a few gramnegative
bacteria, and overlaps considerably with
that of penicillin G. Erythromycin is highly active
against Str. pyogenes and Str. pneumoniae, N.
gonorrhoeae, Clostridia, C. diphtheriae and
Listeria, but penicillin-resistant Staphylococci
and Streptococci are now resistant to erythromycin
also.
All cocci readily develop resistance
to erythromycin, mostly by acquiring the
capacity to pump it out. Resistant Enterobacteriaceae
have been found to produce an erythromycin
esterase. Alteration in the ribosomal binding
site for erythromycin by a plasmid encoded
methylase enzyme is an important mechanism of
resistance in gram-positive bacteria. All the above
types of resistance are plasmid mediated. Change
in the 50S ribosome by chromosomal mutation
reducing macrolide binding a
Pharmacology of Penicllins (Beta lactam antibiotics), description of their mechanism of action, mechanism of resistance, classification, indications and adverse effects
Antiprotozoal agents is a class of pharmaceuticals used in treatment of protozoan infection. Protozoans have little in common with each other and so agents effective against one pathogen may not be effective against another
These are antibiotics having a macrocyclic
lactone ring with attached sugars. Erythromycin
is the first member discovered in the 1950s,
Roxithromycin, Clarithromycin and Azithromycin
are the later additions. Antimicrobial spectrum is narrow,
includes mostly gram-positive and a few gramnegative
bacteria, and overlaps considerably with
that of penicillin G. Erythromycin is highly active
against Str. pyogenes and Str. pneumoniae, N.
gonorrhoeae, Clostridia, C. diphtheriae and
Listeria, but penicillin-resistant Staphylococci
and Streptococci are now resistant to erythromycin
also.
All cocci readily develop resistance
to erythromycin, mostly by acquiring the
capacity to pump it out. Resistant Enterobacteriaceae
have been found to produce an erythromycin
esterase. Alteration in the ribosomal binding
site for erythromycin by a plasmid encoded
methylase enzyme is an important mechanism of
resistance in gram-positive bacteria. All the above
types of resistance are plasmid mediated. Change
in the 50S ribosome by chromosomal mutation
reducing macrolide binding a
Pharmacology of Penicllins (Beta lactam antibiotics), description of their mechanism of action, mechanism of resistance, classification, indications and adverse effects
This PPT covers drug therapy for tuberculosis. It includes classification of antitubercular drugs, chemotherapy for tuberculosis, strategies for addressing resistance and pharmacotherapy of antitubercular drugs
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
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.
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!
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.
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.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
5. Therapeutic Classification of Anti-Amebic Drugs
I. Luminal Amebicides (Drugs effective in Luminal Infection only)
1. Dichloroacetamides
Diloxanide Furoate
2. Halogenated Hydroxyquinolines
Idoquinol (Diiodohydroxyquine)
3. Antibiotics: Tetracyclines, Paromomycin
4. Oral Bismuth Salt : Emetine Bismuth Iodide
6. II. Extra-Luminal Amebicides
A: Systemic or Tissue Amebicides
1. Chloroquine
2. Emetines : Emetine, Dehydroemetine
B: Mixed Amebicides /Drugs effective in systemic & Intestinal
Amebiasis . (Not reliably effective against luminal infections as
luminal concentrations are too low for single drug treatment)
Nitroimidazoles
Metronidazole
Tinidazole
Secnidazole.
7. Metronidazole (Flagyl)
Most commonly used
Mixed tissue amebicide (Intestinal & extra Intestinal) not reliably
effective against amebae in the lumen as luminal concentrations are
too low for single drug treatment.
Kills only trophozoits in intestinal wall but not the cysts of E.
histolytica.
9. Pharmacokinetics:
Prep: Oral, I/V infusion, topical gel, cream.
Abs. well & almost complete from GIT, some unabsorbed drug reaches
colon.
PPL:1- 3 hrs
Dist Rapid & wide. Distributed to all tissues & high concentrations in
body fluids– CSF & brain. Also in Vaginal secretions ,saliva.
t ½: 7.5 hrs
Met: in the liver; may accumulate in hepatic insufficiency
Excretion: urine.
10. MOA
Metronidazole kills protozoa & is bactericidal for anaerobic bacteria.
• Metronidazole is a pro drug.
It requires reductive activation of the NITRO group.
This occurs in sensitive anaerobic protozoa & anaerobic
bacteria by Ferredoxins; which are electron transport
proteins.
• These proteins can donate electrons to Metronidazole ,which serves
as electron acceptor.
• The reduced product is cytotoxic, it targets DNA & other
biomolecules / proteins, resulting in cell death.
Hence it kills the micro-organisms .
11. Resistance:
Not a therapeutic problem.
Some strains of T. vaginalis are becoming resistance.
12. Antimicrobial Spectrum
Kills anaerobic protozoa & bacteria
• Entameba Histolytica (Trophozoits only)
Trichomona Vaginalis
Giardia Lamblia
Clostridia – C . difficile
B. fragilis
Helicobacter pylori.
Also toxic to hypoxic / anoxic cells
13. Therapeutic Uses
Versatile drug
1. Amebiasis: DOC in all tissue infections
Acute intestinal Amebiasis / Amebic colitis with
dysentery. 10 d course with a luminal amebicide
Not reliably effective against parasites in lumen,
Hepatic Amebiasis :10 d course cures 95 % cases
For cases in which initial therapy fails –
Aspiration of abscess & addition of Chloroquine /
Dehydroemetine or Emetine--- toxic
14. 2. Trichomoniasis : Treatment of choice single dose of 2g.
Vaginal & urethral Trichomoniasis. Can be used topically.
3. Giardiasis Treatment of choice--- single dose 90 % efficacy.
4. Bacterial vaginosis: Can be used topically as a gel.
5. Eradication of H. Pylori in Peptic ulcer--a component of 14
days triple therapy regimen. Metronidazole 500mg BD along
with a proton pump inhibitor BD, Clarithromycin 500mg BD
6. Pseudomembranous enterocolitis by Clostridium difficile.
DOC. (Vancomycin is the drug of second choice)
15. 1. Anaerobic/ mixed intra abdominal infections.
2. Component of prophylaxis specially for colorectal
surgery.
3. Brain abscess.
4. Acute Ulcerative Gingivitis.
5. Facilitates extraction of adult guinea worm in
Dranculosis
6. Acne rosacae.
17. III. OTHER A/E:
2. Disulfiram like action with alcohol.
3. Dysuria ,Dark urine.
4. Mutagenic in bacteria.
5. Carcinogenic in Rodents.
6. Hypersensitivity reactions--- rash, neutropenia
IV. Drug interactions
- Potentiate Anticoagulant effect of Warfarin.
- Metabolism of Metronidazole induced by Phenytoin &
Phenobarbitone & Cimetidine may inhibit it.
- Metronidazole increases Lithium toxicity.
18.
19. Contraindications
Patient with active disease of the CNS.
Hepatic Disease/Renal disease, dose adjustment should
be done.
Pregnancy/ Nursing Mothers.
20. Tinidazole :
• It is a second- generation Nitroimidazole.
• Congener of Metronidazole
• It is similar to Metronidazole in spectrum of activity, MOA ,
absorption , A/E & D/I.
• It is also effective against cysts of E.histolytica.
• It is longer acting –once daily dose.
• Short course– 2gm daily, single dose-- for 3 days.
Secnidazole: Longer acting
Single 2gm dose is given
21. Emetines
Source: Emetine --- Alkaloid of Ipecacuanna (Ipecac)
Dehydroemetine---Synthetic analog
Effective against the trophozoits of Entameba histolytica.
22. Therapeutic Uses :Limited use: Only when Metronidazole can not be
used in :
Severe Amoebic dysentry
Hepatic Amebiasis
Dehydroemetine is preferrd– better toxic profile
Drug should be used S/C or I/M injection in a supervised setting
Never given I/V
Used only for minimum period to relieve severe symptoms. Usually 3-5
days.
23. Adverse Effects
Mild when used for 3-5 days, increase with time
Diarrhea .
Central nausea & vomiting
Pain & tenderness at site of injection/ sterile abscess.
Muscle weakness & discomfort.
Minor ECG changes
Serious toxicity:
Hypotension, Cardiac arrhythmias, Cardiac failure.
Contraindications:
Cardiac /renal disease
Young children , pregnancy.
24. Chloroquine
Antimalarial drug –already discussed.
Tissue Amebicide specially against Amoebic Hepatitis &
Liver Abscess.
Concentrated in liver; kills trophozoits of E. histolytica
Not effective for amebic colitis or luminal amebae
because absorbed in upper intestine.
TH.use: Hepatic amebiasis / abscess; not responding to
Metronidazole
25. Diloxanide Furoate (Luminal amebicide)
Dichloroacetamide derivative
Pharmacokinetics: Given orally, in gut splits into Diloxanoid
& furoic acid. 90% Diloxanoid is absorbed & conjugated
to form glucuronide -- excreted in urine
MOA: Not understood.
Unabsorbed Diloxanoid is directly amebicidal
against amebea in lumen but not those in intestinal wall.
26. Therapeutic uses:
Drug of choice for Asymptomatic Luminal Amoebiasis
(cyst passers)
Alongwith tissue amebicide in severe intestinal & extra
intestinal amebiasis.
Adverse effects
Flatulence
Nausea, abdominal cramps
Skin rashes rarely.
Precautions: Pregnancy
27. IODOQUINOL
Iodoquinol (Diiodohydroxyquine) is a halogenated hydroxyquinoline.
An effective luminal amobecide used with metronidazole to treat
amebic infections.
Only effective against trophozoits in lumen.
Pharmacokinetics :-Poorly understood
90% unabsorbed → amebicide.
10% absorbed →Metabolized to Glucronides ,excreted in urine. Half
life 11-14 hrs.
28. ADVERSE EFFECTS
Diarrhoea, anorexia, nausea, vomiting, abdominal pain.
Headache
Iodism: Dermatitis, urticaria , pruritis ,fever.
Increased in protein bound iodine --- decreased 131I measurement.
Some idoquinol can produce severe neurotoxicity on prolonged use
& high doses--- so used with caution
CAUTIONS
Taken with meals.
With caution in: optic neuropathy , Non-amebic Hepatic disease ,
Renal or Thyroid disease.
C/I in intolerance to Iodine.
29. ANTIBIOTICS
.
Paromomycin
Tetracyclines
Uses: Luminal amebicides
5. Asymptomatic infection (Carriers).
6. Along with extra luminal amebicides in serious
infections.
30. Paromomycin sulphate:
An aminoglycoside antibiotic.
Not significantly absorbed from the gut.
Used as Luminal amebicide.
Less toxic than other agents.
Superior to Diloxanide furoate in clearing asyptomatic
infections.
No effect on extra-intestinal amebic infections.
Also used in visceral leishmeniasis paenterally.
A/E: Abd. Distress & diarrhea.
31. Tetracyclines:
Used as Luminal amebicide.
Does not kill bacteria directly but disturbs the symbiosis
between normal intestinal flora & E .histolytica . The
amebae grow at expense of normal intestinal flora .
Tetracyclines are broad spectrum antibiotics & kill these
flora leading to death of E .histolytica also.
Used in resistant cases.
32. Treatment of specific forms of Amebiasis:
Asymptomatic intestinal infection.
Generally not treated in endemic area.
In non-endemic area treated with luminal amebicide.
– Dolixanide furoate
– Iodoquinol
– Paromomycin.
May be combined with tetracyclines.
33. Amebic Colitis with dysentery:
Mild to moderate intestinal infection:
DOC ---- Metronidazole & Luminal agent.
Alternative ---- Dolixanide furoate, Iodoquinol,
Paromomycin + Tetracycline / Erythromycin.
Severe intestinal infection
DOC ---- Metronidazole & Luminal agent
Alternative ---- Dolixanide furoate, Iodoquinol,
Paromomycin + Tetracycline / dehydroemetine or
emetine.
34. Hepatic abscess, ameboma & other Extra intestinal
Infections:
DOC ---- Metronidazole & luminal agent.
For unusual cases--- not responding to Metronidazole
– Chloroquine + Luminal agent.
– Dehydroemetine or emetine.
