Diazepam is a benzodiazepine used to treat status epilepticus and convulsive disorders by increasing the inhibitory neurotransmitter GABA. It is metabolized in the liver and has a high oral bioavailability. Common side effects include sedation, drowsiness, and respiratory depression. Diazepam levels can be affected by interactions with other CNS depressants, antidepressants, anticonvulsants, and CYP3A4 inhibitors. Improving communication between healthcare professionals through team-based rounding and establishing treatment plans can help ensure patient safety.
It is a anti- hypertensive drug. It is non-selective beta blocker drug. Hence it is beta blocker drug so it has many side effect.Not only Propranolol but also Timolol,Atenolol are beta blocker drugs.
It is a anti- hypertensive drug. It is non-selective beta blocker drug. Hence it is beta blocker drug so it has many side effect.Not only Propranolol but also Timolol,Atenolol are beta blocker drugs.
Before prescribing any pharmaceutical medicine, the physician should consider certain factors that can modify the effect of the drug. The same dose of a drug can produce different degrees of response in different patients and even in the same patient under different situations. The Important factors modify the effect of a drug are subdivided into two groups: patient related factors and drug related factors.
• Patient related factors: age, gender, body weight, presence of food, drug allergy, genetic variation, environmental state, pathological state, psychological state, etc.
• Drug related factors: physical state of a drug, route of drug administration, time of drug administration, drug cumulation, drug combination, drug tolerance, drug dependence, etc.
Interaction between the food and drugs have a high effect on the success of treatment patients and on the side effects of drugs . the interaction not in all cases is bad but sometimes can improve the absorption and decrease the side effect. grapefruits interaction has received very high attention recently. Consequently, the presence of food in the digestive tract may reduce absorption of a drug. Often, such interactions can be avoided by taking the drug 1 hour before or 2 hours after eating. Like drugs, foods are not tested as comprehensively so they may interact with prescription or over the-counter drugs. therefor it is advisable for patients to follow the doctor and specialists’ guidelines to acquire greatest advantages with least food tranquilize cooperation.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2. Diazepam
Diazepam is used to treat status epilepticus and as an adjunct in convulsive
disorders
Diazepam depresses all levels of the Central Nervous System through the
increased action of gamma-aminobutyric acid (GABA)
Diazepam is a benzodiazepine that treats unbalanced chemicals in the brain
Diazepam is generally given in the rectal form for the pediatric population in
treatment of status epilepticus
3. Epilepsy
Epilepsy, also known as seizure disorder is excessive and abnormal brain cell
activity that can occur at any age and vary in etiology
Seizures can be hereditary or congenital or acquired
There are two classifications of seizures: Partial or generalized
Partial consists of simple and complex
Generalized consists of absence, tonic-clonic, clonic, atonic, myoclonic,
and tonic seizures
Status epilepticus is another category of seizure activity that is life-threatening
and is defined as activity lasting greater than 30 minutes or two or more
consecutive seizures without recovery between them
4. Intended Drug Response
The primary goals of treating acute repetitive seizures are prompt cessation of
the seizure and prevention of recurrence
Diazepam exerts its anticonvulsant effect by interacting with receptor
molecules, the benzodiazepine receptor, to regulate the efficiency of the
inhibitory neurotransmitter GABA at the GABA (A) receptor
The GABA (A) complex is a receptor-gated chloride channel that contains the
benzodiazepine as an allosteric modulatory unit
Equilibration speed between plasma and the effect site is described by the
equilibration half-life measured by elimination of the drug from the effect
site. The determining factor for onset of action in the CNS is the equilibration
of the half-life.
Diazepam crosses the blood brain barrier to elicit its pharmacological effect
5. Potential Drug Interactions
Other CNS depressants (e.g. alcohol, barbiturates, and opioids) that may
cause increased toxicity, sedation, and respiratory depression.
Tagamet may decrease the metabolism of Diazepam resulting in an
increased half-life and a decrease in clearance of the drug.
Selective serotonin reuptake inhibitors (e.g. Prozac, Zoloft, Paxil) increase
diazepam levels and alter its clearance.
Valproic acid may also result in an increase in sedative effects of
Diazepam by displacing it from its binding sites
Strong CYP3A4 inhibitors (Doxylamine, Hydroxyzine, Fosaprepitant,
Minocycline & Olanzapine) also cause potential interactions with
6. Adverse Drug Reactions/Side Effects
Drowsiness, amnesia, vertigo, hypotension, and slowed
respiratory rate. Other possible adverse reactions noted are
tachycardia, chest pain, confusion, ataxia, slurred speech, and
headache.
Common side effects may include lightheadedness, rash,
constipation, nausea, vomiting, menstrual irregularities, and
blurred vision
Sedation is a commonly reported adverse event associated with
Diazepam in any route that is administered. This must be
monitored in comparison to the normal post-ictal sedation of
7. Pharmacokinetics
Volume distribution equals 0.8 - 1.9 L/kg
The percent bound to plasma protein equals 98 where T1/2 equals
44 - 48 hrs. Though it accumulates over time and can take longer
with prolonged use.
Oral bioavailability is greater than 90% and time to peak ranges
from 15 minutes to 2.5 hours. If fasting peak time is 1.5 hours
and with food 2.5 hours.
Metabolism of Diazepam occurs in the liver via oxidation catalysed
by cytochrome P450 (CYP) isoenzymes 3A4 and 2C19
Diazepam shows to have adverse effects that affect more of the
8. Binding Issues
Due to Diazepam being highly bound to plasma proteins,
the binding interactions with other drugs arise.
Free fatty acids are an example of a class of drugs that
displace Diazepam binding in vitro and in vivo.
Valproic acid is a drug that is a two chain fatty acid and
and displaces Diazepam with its ability to bind fatty acid
binding sites on albumin.
The inhibition of Diazepam binding by Valproic acid is
competitive due to the number of binding sites for
Diazepam.
9. Pharmacogenomics
Drug treatment of epilepsy is characterized by the unpredictably of efficacy, drug
reactions, and optimal doses in individualized patients.
The unpredictability of antiepileptics results from individual genes whose
variations exert a measurable influence on the effect of the drug given for
treatment.
Environmental and genetic factors play a role in regulation of basal expression
and function of the CYP3A4 receptors.
The current best strategy to avoid genetically dose-related adverse reactions is
used of single-dose modern day treatment of antiepileptics which are not
metabolized by the liver nor involved in idiosyncratic reactions.
10. Improving Communication
Rounding with all of the different professions (in a hospital) seems to work really well as
everyone can share their knowledge in real time
Improving communication would be face-to-face conversation or meetings consisting with the
specialist, primary care physician, charge nurse, treating nurse, nurse assistant, social
worker, dietician/nutritionist, therapists, and case manager
The treatment plan established will be a team approach and provide a solid foundation of
communication between all professions resulting in a more established means of patient
safety
In other clinical settings, the nurse or caregiver will play a vital role to ensure any medication
adjustments, frequency or intensity in seizures, seizure pattern, adverse effects, etc. are
communicated with the prescribing doctor along with the primary care physician
11. Application to Practice
Patients and caregivers must understand the different
types of seizures and understand when they should be
prompted to seek medical emergency.
Overuse and abuse must be avoided and adverse
reactions must fully be understood
Collaboration with the provider or private duty nurse,
other in-home resources, and all doctors associated
with the child’s care is imperative.
The nurse plays the most important role in this process
and must be accountable for the education provided
and assessed