Cyclosporine-A is a cyclic non-ribosomal peptide composed of 11 amino acids that was discovered in 1970 from the fungus Tolypocladium inflatum. It is an immunosuppressant drug used to prevent rejection in organ transplant recipients and for certain autoimmune and inflammatory diseases. It works by inhibiting T-cell activation. Cyclosporine-A is metabolized by the CYP3A4 enzyme system and primarily excreted in the bile. It has a half-life of 5-18 hours and peak levels occur 2-4 hours after administration. Common side effects include renal dysfunction, hypertension, hyperlipidemia and hirsutism. It requires careful monitoring due to its
A complete drug profile of Tacrolimus an immunosuppressant used for organ transplant. It consist of PK/PD, MOA, Indication & Uses, Contraindications, Warnings & Precautions, Drug-interaction, Doses & Administration, Dosage forms, Chemical Formula, Side-Effects, Adverse Drug Reactions, Therapeutic Drug Monitoring (TDM).
An antifungal medication is a pharmaceutical fungicide used to treat and prevent mycoses such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. Such drugs are usually obtained by a doctor's prescription, but a few are available OTC (over-the-counter).
Antifungals work by exploiting differences between mammalian and fungal cells to kill the fungal organism with fewer adverse effects to the host. Unlike bacteria, both fungi and humans are eukaryotes. Thus, fungal and human cells are similar at the biological level. This makes it more difficult to discover drugs that target fungi without affecting human cells. As a consequence, many antifungal drugs cause side-effects. Some of these side-effects can be life-threatening if the drugs are not used properly.
Antileprosy drugs have been described with their pharmacology also this topic covers Multidrug treatment for leprosy including paucibacillary and multibacillary leprosy and lepra reactions
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
learning objectives : Pathophysiology of Psoriasis
Common sites with pictures
Pharmacotherapy of Psoriasis
Local Drug therapy
Systemic Drug therapy
Biological therapy
Phototherapy
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
A complete drug profile of Tacrolimus an immunosuppressant used for organ transplant. It consist of PK/PD, MOA, Indication & Uses, Contraindications, Warnings & Precautions, Drug-interaction, Doses & Administration, Dosage forms, Chemical Formula, Side-Effects, Adverse Drug Reactions, Therapeutic Drug Monitoring (TDM).
An antifungal medication is a pharmaceutical fungicide used to treat and prevent mycoses such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. Such drugs are usually obtained by a doctor's prescription, but a few are available OTC (over-the-counter).
Antifungals work by exploiting differences between mammalian and fungal cells to kill the fungal organism with fewer adverse effects to the host. Unlike bacteria, both fungi and humans are eukaryotes. Thus, fungal and human cells are similar at the biological level. This makes it more difficult to discover drugs that target fungi without affecting human cells. As a consequence, many antifungal drugs cause side-effects. Some of these side-effects can be life-threatening if the drugs are not used properly.
Antileprosy drugs have been described with their pharmacology also this topic covers Multidrug treatment for leprosy including paucibacillary and multibacillary leprosy and lepra reactions
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
learning objectives : Pathophysiology of Psoriasis
Common sites with pictures
Pharmacotherapy of Psoriasis
Local Drug therapy
Systemic Drug therapy
Biological therapy
Phototherapy
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
OLD and NEW definition of Hepatorenal syndrome , EASL 2018 +AASLD 2012 guidelines , pathophysiology mechanisms , Precipitants of HRS , prevention and treatment of HRS , new drugs for HRS on lane , few evidences .
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Author: Danielle Cassidy, PharmD, BCPS
Audience: Third year pharmacy students at University of Colorado School of Pharmacy & Oregon State University College of Pharmacy.
Background: Provides overview of common causes of pediatric venous thromboembolism & treatment management.
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Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
4.
Neoral has 10-54% Bioavailability
Sandimmune
(‘Pre-digested, Modified’ form by ME)
than
Metab by CY P450 3A4 enzyme system in liver
Excreted by the way of bile through faeces (90%),
with only 6 % excreted in urine
5.
Hepatic dysfunction / CYP3A4 Inhibitors may
prolong the half life and requires dose adjustment
Renal Disease does not alter Clearance
Peak Levels in 02 – 04 hrs
t1/2 = 05-18 hrs
Clearance Rate : 05-07 mL/min/kg
6.
Inhibits production of Pro-inflammatory IL-2 by inhibiting
calcineurin thus decreases T cell proliferation
Calcineurin inhibition leads to reduced activity of the
transcription factor NFAT-1 (Nuclear Factor Activated T
cells)
Inhibits INF-gamma production by T lymphocytes and
thus reduces keratinocyte proliferation by
downregulating ICAMs-1
7.
8. US FDA approved :
1.Psoriasis
2.Severe psoriasis
3.Recalcitrant, treatment resistant psoriasis
IN EU / AUSTRALIA :
1. Atopic dermatitis
2. Psoriasis
13. 1.
Age < 18 or > 64 (CsA has been used in AD in Children
> 01 year @ 5mg/kg/day with high efficacy, less side
effects (Dec BA, better Clearance) but RCTs not
performed)
2.
Controlled HT
1.
On medications that interfere with CsA metabolism
2.
On medications that potentiate renal dysfunction
3.
Pregnancy, lactation – Cat C
14. DOSE RELATED :
•Renal
Dysfunction – dose related toxicity. To avoid
it, the dose of CsA < 5 mg/kd/day
•HTN
– mean diastolic BP > 90 mmHg – direct
vasoconstrictor effect of CsA on vascular smooth
muscles in kidneys but it could also be secondary to
renal dysfunction. (Reversible)
25. •
For patients with Severe, inflammatory flares of
Psoriasis or Recalcitrant psoriasis :Start with max dermatological dose of 5mg/kg/day
administered over 2 doses (Rapid Onset of Action)
•
As soon as the patient is no longer in distress, the
dose of CsA can be decreased in decrements of
1mg/kg daily every 02 weeks until the minimum
effective dosage for maintenance therapy.
26. •
For patient with Chronic Plaque type Psoriasis :Start with 2.5 to 3 mg/kg/day
If improvement has not occurred by 1 month
increase the CsA dose by 0.5 to 1
mg/kg
daily every 2 weeks as necessary
but not to
exceed maximum dose of 5
mg/kg
•
If there is insufficient response to 5mg/kg for 3
continuous months, CsA should be discontinued.
27. •
•
•
•
While stopping CsA, it should be gradually tapered as
Rebound is possible after sudden discontinuation.
US FDA : CsA can be used continuously for 01 year
Worldwide Consensus Guidelines : upto 02 years can
be used.
Recommended is short term use of CsA for 3 to 6
months ideally, especially for Psoriasis (Intermittent,
Short Term, RESCUE therapy)
28.
Open-label trials in PsA with 6mg/kg/day X 08
weeks with significant efficacy noted; Relapse in
02 weeks.
Rotational therapy (06 months CsA followed by
MTX upto 15mg/wk) caused significant (>50%)
reduction in Joint tenderness and Swelling)
29.
Non-Bioequivalence between Sandimmune /
Gengraf-Neoral
Before Meals / After Meals due to fatty food
interaction
Dose-calculation based on IBW > ABW due to
lean body fat
30. BASELINE :
Clinical :
1.Complete history and physical examination (to rule out active
infection, tumours)
2.Baseline BP
Lab inv :
1.Baseline Serum Urea / Creatinine levels
2.Other baseline renal evaluation : Urine RE/ME
3.CBC / LFT with Enzymes
4.Serum Lipid Prolfile
5.Mg2+, K+, Serum Uric Acid
32. FOLLOW UP :
•Examination :
1.Re-evaluate every 2 weeks X 02 months
then monthly
1.BP on each visit
•Lab
inv.
1.Urea, Creatinine, Urinanalysis, Se Electrolytes, Uric acid,
Lipid profile
2.Lab surveillance every 2 weeks X 02 months
then Monthly till on CsA
33. Serum creatinine rises >30% above patient’s baseline
Repeat measurement within 2 weeks
Creatinine is sustained at >30% above patients baseline
Reduce CsA dose by at least 1 mg/kg/day (for at least 1
month)
34. •
Reduce CsA dose by at least 1 mg/kg/day (for at least 1 month)
•
Creatinine decreases
to <30% of baseline
Creat. remains >30%
•
CsA can be continued
at new dosage
stop CsA treatment
Creat returns to within 10%
of baseline
CsA treatment can be
resumed at lower dosage
35.
Serum Creatinine rises by at least 50% above the
baseline value, CsA should be discontinued until
serum Creatinine returns to baseline.