The document summarizes the key differences and treatment approaches for delirium and dementia. Delirium is characterized by a rapid onset, fluctuating course, and primary defect in attention, while dementia has a more insidious onset and primary defect in memory. Treatment for delirium focuses on treating the underlying cause, while treatment for dementia aims to manage cognitive and behavioral symptoms through acetylcholinesterase inhibitors or other medications depending on the symptom.
Lecture slides for Medical Undergraduate teaching in Pharmacology. Study material is based on Essentials of medical pharmacology by KD tripathi and Katzung. Figures are obtained from google image search and above mentioned textbooks.
Second generation atypical anti-psychotic used for mental disorders more extensively for bipolar disorder. have very low side effects than other SGA Medications
Lecture slides for Medical Undergraduate teaching in Pharmacology. Study material is based on Essentials of medical pharmacology by KD tripathi and Katzung. Figures are obtained from google image search and above mentioned textbooks.
Second generation atypical anti-psychotic used for mental disorders more extensively for bipolar disorder. have very low side effects than other SGA Medications
This presentation consisits about antimanic agents, its mode of action, indication, contraindication, side-effects and nursing management. It also has details of Carbamazepine and Valporate.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
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
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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.
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
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Cognitivedisorders unit 9 2
1.
2. Delirium vs. Dementia
Delirium Dementia
Rapid onset Insidious onset
Primary defect in attention Primary defect in short term
Fluctuates during the course memory
of a day Attention often normal
Visual hallucinations Does not fluctuate during
common day
Often cannot attend to Visual hallucinations less
MMSE or clock draw common
Can attend to MMSE or clock
draw, but cannot perform
well
3. Delirium vs. Dementia
Delirium
4 causal subcategories
General medical condition
Substance induced
Cocaine, opioids, PCP
Multiple causes
Trauma, Kidney disease
Other
Lack of sleep
4. Cognitive DIsorders
Delirium
Fluctuating cognitive impairment and disturbance
of consciousness
Psychosis and Insomnia
5. Treating Delirium
Primary goal -treat underlying cause
Cause: Anticholinergic toxicity
Physiostigmine salicylate 1 to 2 mg IV or IM with
repeated doses in 15 to 30 minutes may be indicated
6. Treatment
Psychosis
Haloperidol
2 to 6 mg IM, repeated in an hour if necessary
Depending on patient’s age, weight and physical
condition.
Once patient is calm begin oral medication
Liquid concentrate or tablet
2 daily oral doses, 2/3 of the dose at bedtime
Effective daily dose of Haloperidol 5 to 40 mg for most
patients
7. Treatment
Atypical antipsychotics
Risperidone: for those with side effects from
haloperidol or contraindications
Starting dose: .5mg HS or BID
Olanzapine: agent of choice for patients with PD
with hallucinations/delirium
Starting dose 2.5mg PO HS or BID
Clozapine, quetiapine, aripiprazole may also be
considered although clinical trial experience is
limited.
8. Treatment
Insomnia
Best treated with benzodiazepines with short or
intermediate half-lives
Lorazepam (Ativan) 1 to 2 mg at bedtime
10. Dementia
The treatment for dementia is aimed at :
Symptomatic treatment of memory disturbance
Symptomatic treatment of memory disturbance
11. What are the common forms of
dementia?
There are four main types of dementia:
Alzheimer’s disease (60%; of cases)
Vascular dementia (30–40%; including about
20% where dual pathology exists)
Dementia with Lewy bodies (15% of cases)
Fronto-temporal dementia (5%)
Percentages total more than 100 because of
variability in studies
12. How is Alzheimer’s disease
Alzheimer’s disease may be characterized by a diffuse
characterised?
pattern of cortical deficits including: Aphasia – loss or
impairment of language caused by brain dysfunction
Apraxia – inability to execute learned movements on
command
Agnosia – inability to recognize or associate meaning to
a sensory perception
Acalculia – inability to perform arithmetical calculations
Agraphia – inability to write
Alexia – inability to read
13. Vascular dementia
Vascular dementia is the second most common
cause of dementia. It results from vascular or
circulatory lesions or from diseases of the
cerebral vasculature leading to ischaemia or
infarction.
14. Clinical features of vascular
dementia
problems concentrating and communicating
depression accompanying the dementia
symptoms of stroke, such as physical weakness or
paralysis
memory problems (although this may not be the
first symptom)
a 'stepped' progression, with symptoms remaining
at a constant level and then suddenly deteriorating
epileptic seizures
periods of acute confusion.
15. Clinical features of vascular
dementia
Other symptoms may include:
hallucinations (seeing things that do not exist)
delusions (believing things that are not true)
walking about and getting lost
physical or verbal aggression
restlessness
incontinence.
16. Clinical features of Dementia with
Lewy Bodies
Dementia of six months’ duration with: Periods of
confusion
Fluctuations in cognition (especially attention and
alertness)
Visual hallucinations
Spontaneous extrapyramidal signs such as rigidity or
slowing (mild parkinsonism)
Bradykinesia (paucity of movement)
20. Acetylcholinesterase
Inhibitors
Donezepil
Adminestered once daily
Generally well tolerated
Dose: 5mg oral/ day for 4 weeks then
increase dose to 10mg/day
Effective in Parkinsonian cognitive impairment
21. Acetylcholinesterase
Inhibitors
Donezepil
PHARMACODYNAMICS / KINETICS
Absorption: Well absorbed
Protein binding: 96%, primarily to albumin (75%)
&
alpha1-acid glycoprotein (21%)
Metabolism: Extensively to four major
metabolites
(two are active) via CYP2D6 and 3A4; undergoes
glucuronidation
35. Acetylcholinesterase
Inhibitors
Galantamine
Newer agent
Galantamine has shown modest benefit
in patients with a clinical diagnosis of either
vascular dementia or combination of AD and CVA
Dose: Initial: 4 mg twice a day for 4 weeks
I f 8 mg per day tolerated, increase to 8 mg twice
daily for > or =4 weeks
I f 16 mg per day tolerated, increase to 12 mg
twice daily; range: 16-24 mg/day in 2 divided
doses
37. Acetylcholinesterase
Inhibitors
Galantamine
PHARMACODYNAMICS / KINETICS
Metabolism: Hepatic; linear, CYP2D6 and
3A4;
metabolized to epigalanthaminone and
galanthaminone both of which have
acetylcholinesterase inhibitory activity 130
times less than galantamine
38. Acetylcholinesterase
Inhibitors
Galantamine
PHARMACODYNAMICS / KINETICS
Bioavailability: 80% to 100%
Half-life elimination: 6-8 hours
Time to peak: 1 hour
Excretion: Urine (25%)
39. Acetylcholinesterase
Inhibitors
Galantamine
Significant Adverse Reactions in>10%
Gastrointestinal: Nausea (6% to 24%)
vomiting (4% to 13%), diarrhea (6% to 12%)
Significant Adverse reactions in 1-10%
Cardiovascular: Bradycardia (2% to 3%),
syncope (0.4% to 2.2%: dose-related), chest pain
(> or =1%)
Central nervous system: Dizziness (9%),
headache (8%), depression (7%), fatigue (5%),
insomnia (5%), somnolence (4%), tremor (3%)
40. Acetylcholinesterase
Inhibitors
Galantamine
A D V E R S E R E A C T IO N S S IG N IF IC A N T
<1%
Aggression, alkaline phosphatase increased,
aphasia, apraxia, ataxia, atrial fibrillation, AV block,
bundle branch block, convulsions, dehydration,
delirium, diverticulitis, dysphagia, epistaxis,
esophageal perforation, gastrointestinal bleeding,
heart failure, hypokalemia, hypokinesia, hypotension,
melena, palpitations, paranoid reaction, paresthesia,
vertigo
41. Symptomatic Treatment of Behavioral
Disturbance in Dementia Patients
Delusions and hallucinations:
rivastigmine, risperidol, quetiapine
Depression: citalopram, fluoxetine>> TCA
Agression and anxiety: trazodone,
carbamazepine, valproate, gabapentin