Final handout, pharmacology of drugs used for calcium disorders .docxAhmed Ali
Calcium, Vitamin D, and Bone Health Essentials for Undergrads
This is a non-exhaustive overview of key players in bone health, aimed at undergraduate students. Please note:
This information is for educational purposes only and does not constitute medical advice.
The authors do not guarantee the accuracy or suitability of this information for clinical use.
Always consult a healthcare professional for personalized guidance.
Calcium:
Crucial mineral for building and maintaining strong bones.
Primary source: Diet (dairy, leafy greens, fortified foods).
Deficiencies: Rickets in children, osteoporosis in adults.
Supplements: Used to address deficiencies, but overuse can be harmful.
Vitamin D:
Fat-soluble vitamin crucial for calcium absorption.
Synthesized in skin via sun exposure, obtained from diet (oily fish, eggs).
Deficiencies: Rickets, osteomalacia, osteoporosis.
Supplements: Often recommended, especially in low sun exposure conditions.
Bone Resorption and Formation:
Constant process of bone breakdown (osteoclasts) and rebuilding (osteoblasts).
Calcium and vitamin D play key roles in supporting this process.
Medications for Bone Health (brief mention):
Bisphosphonates: Inhibit bone resorption, first-line for osteoporosis.
Teriparatide: Stimulates bone formation, used for severe cases.
Denosumab: Targets bone resorption, alternative for postmenopausal osteoporosis.
Calcitonin: Lowers blood calcium in emergencies, not for long-term use.
Raloxifene: Protects bone and reduces fracture risk in women, similar to estrogen.
Scope: This subject is intended to impart the fundamental knowledge on various aspects
(classification, mechanism of action, therapeutic effects, clinical uses, side effects and
contraindications) of drugs acting on different systems of body and in addition,emphasis
on the basic concepts of bioassay. Objectives: Upon completion of this course the student should be able to
1. Understand the mechanism of drug action and its relevance in the treatment of
different diseases
2. Demonstrate isolation of different organs/tissues from the laboratory animals by
simulated experiments
3. Demonstrate the various receptor actions using isolated tissue preparation
Mechanism of urine formation
Definition and classification of diuretics
MOA and SAR of each class
Their dose and adverse effects
Pharmacologicaol uses
all about diuretics
hypertensive drugs in various conditions.pptxSunandaMohan
Electrolyte imbalance
Metabolic: hyperglycemia, hyperlipidemia, hyperuricemia.
Erectile dysfunction
Not effective in chronic renal disease.
More effective in elderly: also in patients with isolated systolic hypertension.
Long acting, used once a day
No tolerance and no fluid retention
Reduce calcium excretion, preferred in osteoporosis (especially older women).
Hydrochlorothiazide is one commonly used thiazide and consider as 1st choice.
the main problem with thiazide is hypokalemia and this can be avoided by K+ supplementation or using K+ sparing diuretics.
However, ACEI/ARBs should not combined with K+ sparing diuretics which cause dangerous hyperkaliemia in some pt.
Indications: HT, especially co-existing with:-
DM,
Nephropathy,
Left Ventricular Hypertrophy (LVF),
Chronic Heart Failure (CHF),
Angina,
Post Myocardial Infarction (MI) cases.
ADRs: Dry persistent cough, Fetal malformations, granulocytopenia, proteinuria (Rare).
Efficacy as monotherapy ~30-40%. Always combined with other drugs
Slow onset (1-3 weeks), well sustained action
Gradual in BP in hypertensives only.
Mech : Initially, TPR increases due to -blockade
Later TPR decreases – resistance vessels adapt to chronically decreased CO
Both systolic & diastolic BP reduced.
Also, ↓ release of NA from sympathetic nerve endings, ↓ Renin release from kidney (1).
Contraindicated in CHF, Pulmonary diseases (Bronchial asthma/COPD), Peripheral vascular disease and Variant angina.
Cardioprotective – especially helpful to prevent sudden cardiac death if given Post MI, along with ACEIs.
Hypoglycemic episodes – (1 selective less risky)
Absence of SEs like Postural Hypotension, GIT effects etc
Efficacy as monotherapy ~30-40%. Always combined with other drugs
Slow onset (1-3 weeks), well sustained action
Gradual in BP in hypertensives only.
Mech : Initially, TPR increases due to -blockade
Later TPR decreases – resistance vessels adapt to chronically decreased CO
Both systolic & diastolic BP reduced.
Also, ↓ release of NA from sympathetic nerve endings, ↓ Renin release from kidney (1).
Almost obsolete drugs
Reserpine – R.serpentina roots. Indigenous. Inhibits tpt of NA into storage granules depletion. Slow onset (2-3 wks). Also CA & 5HT depletion in brain depression, antipsychotic effect & Parkinsonism like symptoms. Not preferred as anti-HT drug now.
Guanethidine – Displaces NA from storage granules, release of NA from nerve terminals & NA reuptake inhibited depletion. Obsolete drug.
Latest guidelines (JNC8, NICE 2011): Consider:-
Age / Race: Younger patients (↑ renin) respond better to ACEIs/ARBs. Blacks & aged respond better to CCBs. Diuretics alternatives to CCBs.
If monotherapy ineffective – ACEIs/ARBs + CCBs/Diuretics.
ACEIs/ARBs + CCBs + Diuretics – 3rd step
If all fails – resistant HT – add a aldosterone antagonist or beta-blocker with vasodilator action.
BP > 140/90 in pregnancy can be risky
CKD, Diabetes & Chronic HT are risk factors for Pre-eclampsia
Aspirin
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.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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.
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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
2. · Diuretics fluid loss via urine output
· Major uses of diuretics include prevention of renal failure and
management of hypertension.
· Most diuretics work by blocking reabsorption of Na+ and Cl-; the more
ion absorption blocked, the more fluid that is lost.
· Potassium is necessary for nerve impulse conduction and regulation of
acid-base balance.
· Calcium is critical to normal metabolic processes of the heart, nerves,
muscles, bones, and coagulation.
· Mineral supplements tend to cause GI distress and should be administered
with a full glass of water or with meals.
3. High Ceiling Loop Diuretics
N203
ATI (Unit 9)
Fluids/Lytes/Minerals/Renal -
12. Expected Action:
Proto: aluminum hydroxide gel (Amphojel) — Others: calcium
carbonate (Tums, OsCal), aluminum carbonate gel (Basaljel)
· Bind intestinal phosphate that is excreted in the feces
Therapeutic Uses: · Antacid
· hyperphosphatemia (>4.5mg/dL) in end-stage renal disease
Adverse Effects: · Constipation · Hypophosphatemia (<3mg/dL)
Contraindications/Precautions: ♀ (_) ·
· CI: hypophosphatemia / bowel obstruction / pregnant or breastfeeding
Interactions: · Alter absorption of many medications. Do not administer other
medications concurrently with Amphojel.
Education: · Give with first bite of food to absorb phosphate in food
· Avoid PO4 foods: (dairy, fish, pork, nuts, whole-grains)
16. Expected Action:
Proto: Potassium Chloride (K-Dur) — Others:
K+ gluconate, K+ phosphate, K+ bicarbonate
· K+ is essential for nerve conduction, muscle excitability, and acid/base balance
Therapeutic Uses: · Hypokalemia · K+-sparing diuretics
· K+ loss d/t excessive/prolonged diarrhea, vomiting, GI fistulas, drainage
Adverse Effects: · GI distress (take with water or meals)
· GI ulceration (do not dissolve / take with water or meals)
· Hyperkalemia (rare ĉ oral) – signs = bradycardia, hypotension, ECG Δ
Contraindications/Precautions: ♀ (_) · Severe renal disease
· Hypoaldosteronism creates risk for hyperkalemia
Interactions: ·
· Concurrent use of K+-sparing diuretics (spironolactone) or ACE inhibitors
(lisinopril) increases risk of hyperkalemia.
Education: · Never give IV push · Use infusion pump
· Assess site for irritation, phlebitis, infiltration – d/c immediately if present
· Dilute to no more than 40 mEq/L || give no faster than 10 mEq/hr.
24. Expected Action: Proto: raloxifene (Evista)— Others: tamoxifen citrate (Nolvadex)
· Endogenous estrogen in bone, lipid metabolism, and blood coagulation
· osteoclast activity bone
· resorption.
plasma cholesterol
· Antagonist to estrogen on breast and endometrial tissue
Therapeutic Uses: · Postmenopausal osteoporosis · risk of breast cancer
Adverse Effects: · Hot flashes · risk of PE and DVT Keep active
Contraindications/Precautions: ♀ (X) · CI: Hx of venous thromboses
Interactions: · None
Education:
· Sufficient calcium / vitamin D to PTH
release and Ca2+ release from bones
Ca2+ WNL
9-10.5 mg/dL
26. Expected Action:
Proto: alendronate (Fosamax)
Others: ibandronate (Boniva), risedronate (Actonel)
· number and action of osteoclasts bone resorption
Therapeutic Uses: · ♂/♀ osteoporosis ·
· Paget’s disease and hypercalcemia of malignancy
Adverse Effects: · Esophagitis full glass of H2O and upright for 30 min
· risk for hyperparathyroidism @ doses in Paget’s disease
Contraindications/Precautions: ♀ (C) · CI: Esophageal disorders, GERD
Interactions: ·
· Ca2+supplements, antacids, OJ, & caffeine all alendronate absorption
Education: · Take first thing in AM, with H2O
· Sufficient Ca2+ / vitamin D to PTH release and Ca2+ release from bones
· Encourage weight-bearing exercise (30-40 min/day)