This document discusses drug therapy for cough. It classifies drugs as acting peripherally, centrally, or both. Peripherally acting drugs include demulcents, expectorants, and mucolytics. Demulcents coat receptors in the throat to reduce cough. Expectorants increase bronchial secretions making them easier to cough up. Mucolytics thin mucus. Centrally acting drugs raise the cough center threshold, mainly for dry cough. Codeine is the standard antitussive but others include pholcodeine and dextromethorphan. Benzonatate acts both centrally and peripherally to suppress cough.
this presentation gives the knowledge about the decongestants are a type of medication that can provide short relief for a blocked nose ................
this presentation gives the knowledge about the decongestants are a type of medication that can provide short relief for a blocked nose ................
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.
Asthma is a chronic inflammatory disorder of the airways that is characterized by increased responsiveness of the tracheobranchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages which may be relieved spontaneously or by therapy.
Cough is a protective reflex, its purpose being expulsion of respiratory secretions or foreign particles from air passages.
It occurs due to stimulation of mechano or chemoreceptors in throat,
respiratory passages or stretch receptors in the lungs.
Act peripherally in the respiratory tract to reduce tussal impulses.
They aim to control rather than eliminate cough.
Many H-1 anti histamines have been conventionally added to antitussive /expectorant formulations.
Antihistamines afford relief in cough due to their sedative and Anticholinergic actions but lack selectivity for cough centre.
Analeptics stimulate respiration and can have resuscitative value in
Coma or fainting.
They stimulate respiration in sub convulsive doses,
but margin of safety is narrow.
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.
Asthma is a chronic inflammatory disorder of the airways that is characterized by increased responsiveness of the tracheobranchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages which may be relieved spontaneously or by therapy.
Cough is a protective reflex, its purpose being expulsion of respiratory secretions or foreign particles from air passages.
It occurs due to stimulation of mechano or chemoreceptors in throat,
respiratory passages or stretch receptors in the lungs.
Act peripherally in the respiratory tract to reduce tussal impulses.
They aim to control rather than eliminate cough.
Many H-1 anti histamines have been conventionally added to antitussive /expectorant formulations.
Antihistamines afford relief in cough due to their sedative and Anticholinergic actions but lack selectivity for cough centre.
Analeptics stimulate respiration and can have resuscitative value in
Coma or fainting.
They stimulate respiration in sub convulsive doses,
but margin of safety is narrow.
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.
Follow us on: Pinterest
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
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.
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
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.
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!
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
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.
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
2. Cough
is
physiologically
useful
protective reflex that clears the
respiratory tract of the accumulated
mucus and foreign substances.
It occurs due to stimulation of mechano /
chemo receptors in throat, respiratory
passage or stretch receptors in the
lung.
3. Types of cough
• Cough is two types
COUGH
Non Productive (Dry)
Productive (Tenacious)
4. • Non productive:- cough is considered as
serving no useful purpose., rather it
increased discomfort to the patient.
• For treatment antitussive agents are
useful.
• Productive cough:-It is characterized by
presence of excessive sputum and may be
associated with conditions such as chronic
bronchitis and bronchiectasis.
• In this condition expectorants are useful.
5. • Ideal antitussive should suppress the
frequency as well as intensity of coughing
with out affecting the normal elimination of
excessive secretions from the respiratory
tract.
• Expectorants:- Increase
decrease the viscosity
enhance the propulsion
upward and outward by
and coughing.
the volume and
of secretions to
of the secretion
ciliary movement
6. Classification of drugs
Peripherally acting
Pharyngeal
demulcents
Peripherally& centrally
Centrally acting
Opioids
Expectorants
Mucokinetics
Mucolytic
Non Opioids
9. Demulcents:- Indirect peripherally acting
cough suppressants.
• They provide a protective coat over
sensory receptors on pharynx and reduce
afferent impulses from the inflamed /
irritated mucosa.
• They provide relief in dry cough arising
from throat.
• Ex:- Honey, liquorice
10. Expectorants
• Mucokinetics:These
expectorants
stimulate the flow of respiratory tract
secretions
by
stimulating
bronchial
secretory cells( to inc. volume) and the
ciliary movement (to facilitate their
removal)
Ex:- Volatile oils, certain emetics in sub
emetic doses, ammonium chloride, Na
citrate, guaiacol and guaifenesin.
11. Essential oils:- Provide only mild expectoration by
directly stimulating the bronchial secretory cells.
• know its use has declined.
Sodium and potassium citrate:- (0.3-1g) After
absorption citrates get
converted to
bicarbonates in vivo and mucus becomes less
viscous in alkaline pH.
Ammonium chloride:- It is a gastric irritant which
reflexly enhances bronchial secretions.
• Large doses it can produce metabolic acidosis.
12. • KI:- (0.2-0.3g) It is secreted by bronchial
glands and in this process irritates them,
increasing the volume of secretions.
• It also gastric irritant acts reflexly as well.
ADE:-It is dangerous in patients sensitive to
iodine and interfere with thyroid function.
• Prolong use can induce goiter and
hypothyroidism
• Less popular now because of hazards
13. • Guaiacol and Guaifenesin are obtained from
creosote wood but nowadays are prepared
synthetically.
• These safe expectorants with proven efficacy.
• Guaifenesin is less irritating derivate of guaiacol.
• After absorption, guaifenesin
is secreted
through bronchial glands to increase airway
secretion and mucosal ciliary activity.
• It is administered orally 100-200mg BD
14. Mucolytic
Mucolytics alter the chemical characteristics
of mucus to decrease its viscosity and
facilitate its removal by ciliary action
Commonly used mucolytics include acetyl
cysteine,
carbocysteine,
bromhexine,
ambroxol and dornase-alfa.
15. Bromhexine:- It is an alkaloid from vaska
plant .
• It depolymerises mucopolysaccharides of
mucus
and also increase lysosomal
enzyme activity that break the fiber
network of tenacious sputum .
• Oral dose is 8-16mg TDS
• Side effects:- GIT upset and rhinorrhoea
(Water release from nose).
17. Acetylcyseteine :- It is a mucolytic that
decrease the viscosity of mucus by
splitting the disulfide –S -- S- bonds of
mucoproteins.
• Action facilitated by alkaline pH(7-9)
• Administratation is done by nebulisation
(3-5ml of 20%solution),also oral 200mg
TDS but efficacy is much less.
• Side effects :- Nausea, vomiting, stomatitis
and bronchospasam
18. • Dornase-alfa:- It is highly purified solution
of recombinant human deoxyribonuclease
(DNase). These enzyme that selectively
cleaves DNA.
• Purulent (Pus) pulmonary secretions in
cystic fibrosis contain very high amounts
of extra cellular DNA.
• Dornase alfa inhalation (2.5mg once daily)
hydrolysis this accumulated DNA in the
sputum of the patients of cystic fibrosis
19. Other
Drinking warm water, inhaling warm moist air
or menthol vapours, surfactants such as
tyloxapol,
proteolytic
enzymes
such
as
chymotrypsin or trypsin are also used
for
their hydrating and mucolytic action.
20. Centrally acting
• Drugs that act in the CNS to raise the
threshold of cough centre to reduce tussal
impulses
• Main aim to control rather then eliminate
cough
• These are mainly useful for dry unproductive
cough or if cough is disturbs sleep or is
hazardous.
21. Codeine:- An opium alkaloid (Semi synthetic
opioid), qualitatively similar to but less
potent then morphine.
• It is more selective for cough centre and it
is treated as standard antitussive.
• It suppress cough center for 6hr.
• Administered orally (10mg BD or TDS)
• Abuse liability is low at these dose.
• Side effects:- High dose cause respiratory
depression,
convulsions,
postural
hypotension, constipation.
22. Pholcodeine:- It is structurally related to
codeine but it is slightly more potent,
longer acting and better tolerated than
codeine.
• It
cause
lesser
constipation
drowsiness than codeine.
• More suited for long term use
• Orally 10-15mg BD
and
23. Dextromethorphan:-It is methyl
dextroisomer of levorphanol.
ester
of
the
• It has less addition liability, no analgesic action,
least constipating effect and minimal drowsiness
• It is as potent as codeine and given orally 10mg
TDS
• Most popular cough suppressant
• Combination available with antihistamines and
bronchodilators in cough mixtures.
24. Noscapine:- It is naturally occurring opium
alkaloid belonging to benzylisoquinoline
group.
• Popular cough suppressant
• Given orally 15mg TDS.
• Less addiction liability, drowsiness,
analgesic activity
• Side effect: At high doses may produce
nausea, headache and tremors.
25. Pipazethate:- Phenothiazine group
antitussive. Occasionally used.
• Given by orally 40mg TDS
Chlophedianol:- It is less effective
• Rarely used
• Dose 20mg BD orally
• High doses cause excitatory
tremors.
of
effects,
26. Centrally & peripherally acting antitussives
Benzonatate:- It is structurally related to
local anesthetic tetracaine.
• It not only inhibits the afferent cough
impulses to suppress the central cough
center, but also inhibits the pulmonary
stretch receptors and also posses local
anaesthetic action
• Administered orally 100-200mg Orally
Side effects: Drowsiness, nausea, headache
• High doses cause vertigo.