This document discusses various types of antidepressant medications. It describes tricyclic antidepressants (TCAs) such as amitriptyline and selective serotonin reuptake inhibitors (SSRIs) like fluoxetine. Side effects of TCAs include sedation, weight gain, and anticholinergic effects. SSRIs have fewer interactions and side effects than TCAs. Serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine and duloxetine are preferred over TCAs. Monoamine oxidase inhibitors (MAOs) such as moclobemide are reversible and selective, lacking many side effects of other antidepressants. Atypical antidepressants including
ANTIDEPRESSANTS: All you need to know...by RxVichu! :)RxVichuZ
This is my 50th powerpoint.......
Deals with Important tips while using ANTIDEPRESSANTS, their special precautions, ADRs and differential mechanisms.
Will be worthwhile for a precise insight!!
Thanking all viewers who have supported me all my ways to reach this 50th milestone!!
Regards,
Vishnu. :)
Local anaesthetics – a brief outlook by Rxvichu!!RxVichuZ
This is my 24th ppt!
Its on LOCAL ANESTHETICS.............It comprises varying drugs, their potencies, and other details....
Useful for 2nd year students.....and for reference!
Do check...n send ur reviews!
Thank you!
@rxvichualwz4uh!
:) :)
ANTIDEPRESSANTS: All you need to know...by RxVichu! :)RxVichuZ
This is my 50th powerpoint.......
Deals with Important tips while using ANTIDEPRESSANTS, their special precautions, ADRs and differential mechanisms.
Will be worthwhile for a precise insight!!
Thanking all viewers who have supported me all my ways to reach this 50th milestone!!
Regards,
Vishnu. :)
Local anaesthetics – a brief outlook by Rxvichu!!RxVichuZ
This is my 24th ppt!
Its on LOCAL ANESTHETICS.............It comprises varying drugs, their potencies, and other details....
Useful for 2nd year students.....and for reference!
Do check...n send ur reviews!
Thank you!
@rxvichualwz4uh!
:) :)
Dr rowan molnar anaesthetics study guide part ivDr. Rowan Molnar
Dr rowan molnar anaesthetics study guide part iv
Identifies (hopefully confirms!) anaesthetic agent being used
Measures inspiratory & expiratory concentrations
Expiratory (alveolar) concentration enables calculation of MAC fraction or multiple – i.e. estimation of anaesthetic depth.
Now mandatory when inhalational anaesthetic agents are used.
Dr Rowan Molnar,
Dr Rowan Molnar Anaesthetics,
Dr Rowan
Depression is a mental health disorder.
Characterized by symptoms like sad mood, loss of interest and pleasure, low energy, worthlessness, guilt, psychomotor retardation or agitation, change in appetite and/ or sleep, melancholia, suicidal thoughts, etc.
It may be unipolar (only depression) or bipolar (cycle of mood swings from mania to depression).
It is the leading psychiatric disorder.
The mood change may have a psychotic basis with delusional thinking or occur in isolation.
Antidepresants are the drugs which can elevate mood in depressive illness.
Major depression and mania are two extremes of affective disorders which refer to a pathological change in mood state
Major depressions characterized by symptoms like sad mood, loss of interest and pleasure, low energy, worthlessness, guilt, psychomotor retardation or agitation, change in appetite and/or sleep, melancholia, suicidal thoughts, etc
3. The mood change may have a psychotic basis with delusional thinking or occur in isolation and induce anxiety. On the other hand, pathological anxiety may lead to depression.
This presentation describes various movement disorders and its management strategies with particular focus of management of parkinson's disease. It gives basic overview of the drugs also.
Unlock your potential with the ultimate NAPLEX study guide, meticulously designed to ensure you pass your pharmacy licensing exam with flying colors. This guide offers a thorough exploration of all the essential topics covered in the NAPLEX, including pharmacotherapy, pharmacy law, and medication management. Each chapter is structured to enhance your understanding, complete with clear explanations, practical examples, and review questions to test your knowledge.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
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
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. Dr. RAGHU PRASADA M S
MBBS,MD
ASSISTANT PROFESSOR
DEPT. OF PHARMACOLOGY
SSIMS & RC.
1
2. They are among the most commonly prescribed drugs .
Depression: It is a the most commonly serious disorder of
mood, ranges from mild to very serious condition
Types of Depression - Two types
Unipolar Exogenous / Reactive Depression
Endogenous/Major Depression (MDD)
Bipolar
5. Depression is due to deficiency of nor-epinephrine &
serotonin
Normally action of released NE & serotonin is terminated
by active reuptake into the nerve terminal from the
synapse via specific transporters.
TCAs block the amine transporters (uptake pumps) for
nor-epinephrine (NET) & serotonin (SERT) in brain.
Facilitation of NE & serotonin transmission ---- improves
symptoms of depression .
6. Amitryptyline
Potent sedative
Weight gain ++
Anticholinergic ++
Most researched
150mg / day
(Therapeutic in 95% of
adults)
Clomipramine
Similar side effects to
amitryptyline.
Said to be best for
obsessional
symptoms.
150mg / day
7. Dothiepin
Sedative
Same side effects as
amitryptyline.
By far and away the
most toxic
antidepressant.
150 mg / day
Imipramine
Stimulant
Anticholinergic ++
150 mg/ day
8. Antimuscarinic effects
Postural hypotension
Tachycardia, arrhythmias-TCAs potentiate the effect of
directly acting sympathomimetics but inhibit the effect of
indirectly acting sympathomimetics
Sedation
Weight gain
Jittery feeling
Sexual dysfunction (ejaculatory)
Demerits-anticholinergic, cardiovascular and neurological
side effects
Relatively low safety margin, lag time of 2-4wks before
action
9. Anticholinergic drugs aggravative the toxicity of TCAs
T3 and T4 potentiate CNS stimulant effects of TCAs
Phenytoin, chlorpromazine and aspirin displace TCAs
From lprotein binding sites
MOAs and TCAs show synergistic action leading to
serious toxicities
TCAs reverse the antihypertensive effect of alfa2
receptor agonist clonidine
11. First choice in elderly.
First choice if heart
disease.
First choice if suicide
risk.
More expensive.
Side effects
Like TCA reduce with
time.
Gut problems
predominate.
Flat dose response
curve – so no need to
titrate dose upwards.
12. MOA: Inhibit Serotonin & NE reuptake at all doses by
binding to NET & SERT
Venlafaxine: Weak Dopamine re-uptake inhibitor at higher
doses. No effect on muscarinic, adrenergic or histaminic
receptors. They are preferred over TCAs for MDD & pain
syndromes
ADR-sweating, anxiety, dizziness, impotence
Duloxetine-used fro panic attacks, diabetic neuropathic pain,
fibromyalgia and stress urinary incontinence in women
ADR-agitation, insomnia and rise in BP
13. MAO –mono amino oxide is a mitochondrial enzyme
involved in oxidative deamination of biological amines
(Adr, NA, DA, 5-HT)
MAO-A inhibitor posses antidepressant acitvity
Moclobemide-Reversible and selective MAO-A inhibitor
Because of competitive enzyme inhibition, tyramine is
able to displace it from the enzyme
It lacks anticholinergic, sedative, cognitive, psychomotar
and cardiovascular side effects
Well tolerated alternative to TCAs
150mg BD max-600mg / day.
ADR- dizziness, insomnia, headache
14. With non-selective MAO inhibitors
cheese wine, pickled meat, fish, yeast extract
Contain large quantities of tyramine, dopa
Indirectly acting sympathomimetics escape
degradation in gut reach systemic circulation and
displace large amount of NA hypertensive crisis,
cerebrovascular accidents
Treatment-phentolamine, chlorpromazine, prazocin
15. MOIs +TCAs- hypertension, arrhythmias and seizures
MOIs inhibit degradation of dopamineNE
hypertension
MOIs are enzyme inhibitors
MOIs+morphine severe respiratory depression
MOIs+sulfonylureas hypoglycemic coma
MOIs+ chloroquine increased toxicity
16. Trazodone-first atypical antidepressant, blocks
5-HT uptake and has prominent α adrenergic and
weak 5HT2 antagonistic property
Beneficial to OCD (Obsessive Compulsive Disorder)
Low cardiotoxicity, few anticholinergic side effects.
Drowsiness, Nausea.
150 mg /day.
17. BUPROPION -The inhibitor of DA and NA uptake has
excitant property
Its metabolite is amphetamine like presynaptic
release of DA and NA
Used as an aid for smoking cessation
May be acting by augmenting the dopamine reward
pathway
Adverse effects- insomnia, agitation, dry mouth
C/I- bipolar disorders
18. Mirtazapine : Blocks 5HT2 , & presynaptic α2 receptors.
Enhances release of Serotonin & NE
Amoxapine: Potent Nor-Epinephrine uptake inhibitor but
mild inhibition of Serotonin reuptake. Blocks D2
receptors so has neuroleptic property also
Maprotiline: Potent Nor-Epinephrine uptake inhibitor.
19.
20. All are useful in Major depression, in combination with
other drugs.
Bupropion is useful in ADHD
Bupropion also helps in reducing craving & attenuating
the withdrawal symptoms for Nicotine in tobacco users
trying to quit smoking.
Panic attacks, post traumatic stress disorder
Obsessive compulsive disorder
Nocturnal enuresis
Premenstrual syndrome
Chronic alcoholism