Cardiac glycosides like digoxin are derived from plants like Digitalis lanata and act on the heart by increasing the force of contraction. They work by increasing intracellular calcium levels in heart muscle cells through multiple mechanisms - increasing calcium influx, releasing calcium from intracellular stores, and blocking calcium efflux from cells. This makes the heart muscle contract with more force, increasing cardiac output which benefits patients with heart failure. Digoxin is commonly used for heart failure, atrial fibrillation, and other arrhythmias but has a narrow therapeutic window. Its toxicity can be managed with electrolyte supplementation, drugs to control arrhythmias, and antibodies in severe cases. Drug interactions and dose adjustments based on kidney function are important considerations with
Hypolipidemic agents, also known as cholesterol-lowering drugs or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are also called lipid-lowering drugs.
Chemistry of Anti Anginal Drugs by Professor BeubenzProfessor Beubenz
This presentation will give you an idea about the chemistry of Anti-anginal drugs along with its classification, mechanism of action & Structural Activity Relationship.
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https://www.youtube.com/watch?v=-7yjQm4zzX8&t=1183s
Hypolipidemic agents, also known as cholesterol-lowering drugs or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are also called lipid-lowering drugs.
Chemistry of Anti Anginal Drugs by Professor BeubenzProfessor Beubenz
This presentation will give you an idea about the chemistry of Anti-anginal drugs along with its classification, mechanism of action & Structural Activity Relationship.
#Professor_Beubenz
For more such videos do
#Subscribe
#Share
#Like
to the Channel Professor Beubenz
Thank You.
https://www.youtube.com/watch?v=-7yjQm4zzX8&t=1183s
3rd unit drugs used in congestive heart faliureNikithaGopalpet
Introduction.
Signs and Symptoms.
Types of CHF.
Classification .
Drugs used in CHF.
Mechanism of action.
Structure.
Adverse Drug Reactions and
Uses.
Reference
Introduction.
Classification .
Drugs used in Coagulant and Anticoagulant Agents
Mechanism of action .
Structure
Synthesis
Adverse Drug Reactions .
Uses.
Reference
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.
3rd unit drugs used in congestive heart faliureNikithaGopalpet
Introduction.
Signs and Symptoms.
Types of CHF.
Classification .
Drugs used in CHF.
Mechanism of action.
Structure.
Adverse Drug Reactions and
Uses.
Reference
Introduction.
Classification .
Drugs used in Coagulant and Anticoagulant Agents
Mechanism of action .
Structure
Synthesis
Adverse Drug Reactions .
Uses.
Reference
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.
Cardiotonics (Greek Kardia-heart) are the drugs which give strength or energy to the activity of the heart.
The cardiotonics increase the force of contraction of cardiac muscles and stimulate the overall activity of the heart
Examples- digitalis, squill, thevetia, strophantus, arjuna bark
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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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!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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.
2. Learning objectives
• What are cardiac glycosides and from which sources are they derived?
• What are their actions inside the body?
• How do they provide beneficial effects?
• How are they useful in therapeutics and how do we administer them?
• What are the adverse effects we should look out for during treatment
with these drugs?
• How will you manage a patient of digitalis toxicity?
• What precautions should we take while prescribing them?
4. Introduction:
• Inotropic property
• Cause increase in myocardial contraction and output
• How are they different from sympathomimetics?
• No increase in O2 consumption
5. Introduction: Chemistry
• Non-sugar molecule (Aglycone/genin) ----- Ether linkage ----- Sugar moiety =
Glycoside
• Non-sugar part (PD activity) = Cyclopentanoperhydrophenanthrene ring
(steroid) + 5-6 unsaturated
lactone rings
• Sugar part (PK property) =
1-4 molecules of digitoxose
6.
7. Digoxin
• Prototype drug
• From Digitalis lanata
• Positive inotropy: Cardiotonic action in failing heart
8.
9. MOA
• End result sought in heart failure = Increased CO, resulting from:
Increased force of contraction of heart muscle (myocardium)
• Excitation - contraction coupling = Muscle contraction
• Which ion primarily drives muscle contraction?
• What are the ways in which concentration of this ion can be increased
in the myocardial cell cytosol? (1 minute Buzz)
11. The Ca++ bank
• Entry of Ca++
• Release more Ca++
• Block exit of Ca++
12. MOA
• Entry through voltage sensitive L-type Ca++ channels during action
potential
• Trigger Ca++ = Increases >> Ca++ release from Sarcoplasmic reticulum
(SR) by activating Ryanodine receptor (SR-Ca++ release channel)
• Blockade of Ca++ exit
(What is the mechanism of this blockade?)
13. MOA
• During restorative phase of contraction, Ca++ ions are removed by:
- Reuptake into SR
- Expulsion from cell by 3 Na+/1 Ca++ exchange pump (NCX) which
brings in Na+ ions in exchange for Ca++ extruded
- Na+ ion excess in the cell is normally removed by Na+ K+ ATPase
• DIGOXIN binds to and blocks Na+K+ ATPase on myocardial cell
membrane
17. Therapeutic uses
• CCF: Low output failure especially with atrial fibrillation
• Atrial Fibrillation
• Atrial flutter
• PSVT if there is associated heart failure
HEART FAILURE = ABCDEFG
18. PK
• A – good orally (75-90%)
• Loading dose when acute digitalisation is necessary
0.5 – 0.75 mg 8h X 3 doses orally (Digitalising dose)
0.25 – 0.5 mg/day (Maintenance dose)
• Onset of action - 30 min
• Half life 36 - 40h
• D - >> aVd (6-7 L/kg), cumulative effect, may need Drug holiday
• M – Liver <<
• E - Renal (unchanged), needs dose adjustment based on creatinine
clearance
19. ADRs
• Narrow safety margin (TDM, electrolyte and ECG monitoring)
• Extra-cardiac:
GIT effects: Anorexia, nausea, vomiting
CNS effects: Headache, confusion, restlessness, disorientation,
weakness, xanthopsia (yellow vision), hallucinations, altered mood
Skin rashes, gynaecomastia (rare)
• Cardiac: All types of arrhythmias
Ventricular ectopics, pulsus bigeminy, VT
AF, Afl, AT, severe bradycardia, AV block
20. Treatment of digoxin toxicity
• CCU care
• Stop digoxin and K+ depleting drugs, like thiazide and loop diuretics
• IV KCl (even when serum K+ is normal) especially for
tachyarrhythmias
• Oral or IV Propranolol for SVT
• IV lignocaine for ventricular arrhythmias
• Atropine and cardiac pacemaker for AV block and bradyarrhythmias
• Digoxin antibodies (DIGIBIND)
22. Precautions and contraindications
• Factors predisposing to digoxin toxicity:
Elderly age group (decreased renal and hepatic elimination)
IV route>oral
Renal failure
Hypokalemia (Increases binding of digoxin to Na+K+ATPase)
Hypomagnesemia
Hypercalcemia
24. Current therapeutic status of digitalis in
HF
• Most effective drug to restore cardiac compensation especially in
patients with dilated heart and low ejection fraction
• All patients not responding to ACEI/ARB/BB/Diuretics
• Continued digitalis therapy is the best course in CHF patients with
AF
Limitations:
Low safety margin
Cannot reverse/retard the cause
26. Important Questions
• Classify the drugs used in heart failure. Describe the pharmacological
actions and explain the MOA of digoxin. (10)
• Compare and contrast digoxin and digitoxin (4)
• Describe the toxicities of digoxin. (4)
• How will you treat a patient of digitalis toxicity/poisoning? (4)
• Explain four drug interactions of digoxin. (4)
• What is the source of digoxin and digitoxin? (2)
• What is the role of KCl administration in digoxin poisoning? (2)
