This document discusses bronchial asthma, including its pathophysiology, clinical presentation, types, diagnosis and treatment. Asthma is a chronic inflammatory disease of the airways characterized by reversible airflow obstruction. It involves bronchial smooth muscle spasm and excessive mucus secretion. Treatment includes short-acting bronchodilators for acute symptoms and long-term controllers like corticosteroids and leukotriene modifiers for inflammation.
The main focus of this presentation is to discuss all the drugs used nowadays in clinical practice to treat/ manage bronchial asthma. Along with the mechanism of action, use and adverse effects of anti-asthma drugs, we have given a highlight of the pathophysiology of asthma and how the drugs individually act at individual set point(s) to bring the clinical outcome.
Bronchial Asthma - Epidemiology, Pathogenesis and ManagementShashikiran Umakanth
Bronchial asthma is a chronic disease with airway inflammation as a central theme in its pathogenesis. Prevalence of this condition is gradually increasing, especially in developed countries and in countries that are getting "westernized". With early diagnosis, regular monitoring and prompt and rational treatment, most patients with asthma can lead a symptom-free life.
we are going to discuss asthma and COPD in the pharmacologicl perspective.
this presentation is done by :
Fatimah Fathi - Noura Bandar - Ahad Fahid - Shuruq Fahad
The main focus of this presentation is to discuss all the drugs used nowadays in clinical practice to treat/ manage bronchial asthma. Along with the mechanism of action, use and adverse effects of anti-asthma drugs, we have given a highlight of the pathophysiology of asthma and how the drugs individually act at individual set point(s) to bring the clinical outcome.
Bronchial Asthma - Epidemiology, Pathogenesis and ManagementShashikiran Umakanth
Bronchial asthma is a chronic disease with airway inflammation as a central theme in its pathogenesis. Prevalence of this condition is gradually increasing, especially in developed countries and in countries that are getting "westernized". With early diagnosis, regular monitoring and prompt and rational treatment, most patients with asthma can lead a symptom-free life.
we are going to discuss asthma and COPD in the pharmacologicl perspective.
this presentation is done by :
Fatimah Fathi - Noura Bandar - Ahad Fahid - Shuruq Fahad
DRUGS USED IN THE TREATMENT OF BRONCHIAL ASTHMA AND COPD
Characterized by hyper responsiveness of bronchial smooth muscle to a variety of stimuli”
Resulting in:
Narrowing of air ways
Increased secretion
Mucosal edema
Mucus plugging
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
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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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.
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.
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.
3. Asthma is a chronic inflammatory
disease in which patient suffers with
reversible episodes of airway
obstruction due to bronchial hyper
responsiveness.
4. Early phase
(Acute)
-Due to bronchial
smooth muscle
spasm.
- Excessive
secretion of
mucus.
Chronic phase
Continuous
Inflammation,
fibrosis, oedma,
necrosis of
bronchial
epithelial cells.
It has 2phases
5. Clinical hallmarks
Recurrent episodic coughing
Shortness of breathing
Chest tightness
Wheezing
Symptoms are worsening at night
6. Asthma described as two type
Extrinsic
(Atopic extrinsic asthma)
It is associated with
exposure of specific
allergen
Ex:- House dust, pollen
It is episodic and less
prone to develop to
status asthmaticus.
Intrinsic
(Non atopic extrinsic asthma)
It is associated with
some non specific
stimulants
Ex:- chemical irritants
It is perenial and prone
to develop to status
asthmaticus.
7. Pathophysiology
Allergen enter (Foreign body)
Immunological reaction (AG:AB Complex formation)
Circulation in blood
Basophiles, Neutrophilis engulf
Cause neutralization
contd..,
8. Whenever same allergen re exposed
Activation of AG:AB complex
Reacts with lung mast cells
(Degranulation of mast cells)
Spasmogens release
(Like Histamine,5HT,PGs,LT4, Cytokines)
9. Bronchial Tone
IgE-Antigen Complex
Basophil
Activation
Eosinophil
Activation
Chemical mediators
Histamine, LTC4, LTD4, LTB4,
Cytokines, Adenosine, PGD2, PAF,
ECP and Neuropeptides
Cause inflammation, oedema,
bronchospasm, muscus secretion,
epithelial damage
Mast Cell
Degranulation
In early phase these
mediators leads to
bronchoconstriction
In late phase
inflammation,
pulmonary oedema,
mucous secretion
bronchial
hypersensivity and
epithelial damage
10. It divided into two categories
1. Short term relievers.( Bronchodilators)
2. Long term controllers.
Asthma therapy
16. Sympathomimetic agents
ß2 receptors are present in the airway
smooth muscle. cause Bronchodilatation
These are only provide relief
M.O.A:
cAMP
Bronchodilatation
Release of broncho constricting mediators
from mast cells
Inhibit macrovascular leakage
Mucociliary clearance
17. Epinephrine:
Rapid bronchodilator when SC/inhaled(320µg/puff)
Onset of action 15min after inhalation
Duration of action:60-90min.
ADR:- Acts on β1 receptor cause
Tachycardia
Arrhythmias
Worsening angi
So rarely prescribed.
18. Ephedrine: α,β1, β2
Ephedrine has a longer action
Oral activity
Lower potency
Pronounced central effects.
19. β2 Selective
Short acting : Terbutaline, Salnutamol
On inhalation they have rapid onset(1-5Min)
Short duration of action preferred for acute attack
Route: Inhalation 100-200µg/6hourly
Other MDI, Oral, IM, IV
Terbutaline is the only one drug safely used during
the pregnancy.
20. Long acting: Salmeterol, bambutarol
Long acting but slow onset of action
Preferred for maintenance therapy
Not useful in acute attack due to slow onset of
action
Route: Inhalation 50µg twice daily.
Formoterol:
Long acting
Rapid onset
Preferred for prophylaxis due to long acting
Route: Inhalation 12-24µg twice daily
21. ADR of Sympathomimetics
By oral route stimulate β2 receptors in skeletal
muscle cause tremors, Orthostatic hypotension.
Tachycardia (High dos also stimulate β1
receptors in heart)
Restlessness
Tolarance occurs.
22. Antimuscurnic agent
Less effective then β agonists
MOA: By blocking M3 receptors on air way smooth
muscle and prevents Ach action.
-They acts by cGMP levels in bronchial smooth
muscle.
Ipatropium:-
-Poor absorption from bronchi into systemic
circulation
-Do not cross BBB.
-Also mucus secretion
Ipatropium + β2 (Salbutamol) work better in serve
asthma and long duration of action
23. Methyl Xanthenes
MOA:
i) Inhibition of PDE 3,4. These enzyme are responsible
for metabolism of cAMP.
ii) Blockade of Adenosine receptors.
Actions:
Theophyline exhibits bronchodilatory action
Anti Inflammatory
Immunomodulator
Respiratory stimulation
Diaphragmatic contractility
Mucociliary clearance
24. Pharmaco Kinetics:
Oral/Parental
Food delay the rate of absorption
Well distributed
Cross placental & BBB
Metabolized in Liver
Excreted in urine
26. Corticosteroids (Controllers)
Glucocorticosteriods induce synthesis of lipocotrin
which inhibits pholipaseA2 there by preventing
formation of mediators such as PGs,TAX2, LTand
other mediators.
Actions: Anti allergic, anti inflammatory,
immunosuppressant ( AG:AB reactions ), Mucosal
oedema, bronchial hyperactivity, Enhance β
adrenergic action by up regulation of β2 receptors in
lung.
27. Inhalator glucocorticosteriods such as
beclomethasone, budesonide and fluticasone are
used as prophylactic agents in asthma.
PK:
Well tolerated
less systemic side effects.
Common side effects:
Dryness of mouth
Voice change
Oropharangeal candidiats.
Systemic are used in acute severe and chronic severe
asthma.
28. Mast cell stabilizers
Non bronchodilating, Non steroid drugs, used for prophylactic
treat.
MOA:
Prevent degranulation and release of chemical mediators from
the mast cells.
They stabilize the mast cells by preventing transmembarane
influx of Ca ions.
PK:
Highly ionized
Least systemic absorption
well tolerated.
Uses: Allergic asthma, allergic conjunctivitis, allergic rhinitis,
allergic dermatitis.
Ketotifen (Mast stab.+ Antihistamincs)
29. LT Modulators
LT are powerful bronchoconstrictors.
Action by preventing their synthesis or blocking
effect on cys LT receptors
Synthesis inhibitors (Lipooxygenase)
Zafirlukast,Montelukast
PK:
Well absorbed after oral administration
Highly bound to plasma protein
Metabolized by liver
Effective for prophylactic treat of mild asthma.
30. ADR:
Head ache
skin rashes
rarely eosinophilia
Zileuton cause hepatic toxicity.
31. Monoclonal anti IgE antibody
MOA:- AG:Ab complex formation by AB action
Omalizumab: Recombinant humanized
monoclonal antibody.
Inhibit the binding site of IgE to mast cells and
basophils
PK: administered parentarally
Uses: Moderate to severe asthma and allergic
disorders.
Indicated for asthmatic patients who are not
adequately controlled by inhalational
corticosteroids.
ADR: Inj site redness, itching, stinging.
32. Miscellaneous
NO: It dilate pulmonary blood vessels and
relax airway smooth muscle.
Uses: For acute severe asthma and
management of pulmonary hypertension.
Ca channel blockers:
Broncho constriction ultimately involves
some degree of ca into cells Nefedpine /
Verapamil should provide relief in asthma.
33. RX Status asthmatics (Acute severe asthma)
Status asthmatics a severe acute
asthma, which is a life threatening
condition involving exhaustion,
cyanosis, bradicardia,hypotension,
dehydration and metabolic
acidosis.
34. Humidified O2 inhalation
Neubulized β2 adrenergic agonist + anti
cholinergic agent
Systemic glucocorticosteroids IV
(Hydrocortisone 200mgIV)
IV fluids to correct dehydration.
K supplements: To correct hypokalemia
produced by repeated administration of
salbutamol.
NaHCo3 (Sodium bicarbonate) to treat
acidosis.
Antibiotics to treat infection
35. DRUGS TO BE AVOIDED IN ASTHMA
β adrenergic blockers
Cholinergic agents
NSAIDS ( cause hyperapoenia) except
paraceatamol.