Diuretics are substances that promote urine formation and loss of salt from the body. They are prescribed to treat high blood pressure, fluid retention due to conditions like heart failure or kidney disease, and edema. There are three types of diuretic medications that work by lowering salt and water levels in the body. Diuretics can interact with other medications a person is taking, so patients should inform their doctor about all medicines and supplements. Common side effects include weakness, cramps, rashes, and gastrointestinal issues.
Diuretics
Pharmacology
Katzung
Abnormalities in fluid volume and electrolyte composition are common and important clinical disorders. Drugs that block specific transport functions of the renal tubules are valuable clinical tools in the treatment of these disorders. Although various agents that increase urine volume (diuretics) have been described since antiquity, it was not until 1937 that carbonic anhydrase inhibitors were first described and not until 1957 that a much more useful and powerful diuretic agent (chlorothiazide) became available. Technically, a “diuretic” is an agent that increases urine volume, whereas a “natriuretic” causes an increase in renal sodium excretion and an “aquaretic” increases excretion of solute-free water. Because natriuretics almost always also increase water excretion, they are usually called diuretics. Osmotic diuretics and antidiuretic hormone antagonists (see Agents That Alter Water Excretion) are aquaretics that are not directly natriuretic.
Diuretics
Pharmacology
Katzung
Abnormalities in fluid volume and electrolyte composition are common and important clinical disorders. Drugs that block specific transport functions of the renal tubules are valuable clinical tools in the treatment of these disorders. Although various agents that increase urine volume (diuretics) have been described since antiquity, it was not until 1937 that carbonic anhydrase inhibitors were first described and not until 1957 that a much more useful and powerful diuretic agent (chlorothiazide) became available. Technically, a “diuretic” is an agent that increases urine volume, whereas a “natriuretic” causes an increase in renal sodium excretion and an “aquaretic” increases excretion of solute-free water. Because natriuretics almost always also increase water excretion, they are usually called diuretics. Osmotic diuretics and antidiuretic hormone antagonists (see Agents That Alter Water Excretion) are aquaretics that are not directly natriuretic.
Tannins
Tannins are complex substances that usually occur as mixtures of polyphenols that are very difficult to separate since they do not crystallize.
OR
Tannins are polyhydroxy
phenolic compounds.
Tannins are found commonly
in the bark of trees, wood,
leaves, buds, stems, fruits,
seeds, roots and plant galls.
Tannins are complex chemical substances derived from phenolic acids (sometimes called tannic acid). They are classified as phenolic compounds, which are found in many species of plants.
Tannins are high molecular weight phenolic compounds commonly found in plants with molecular weights ranging from 500 to over 3000 Dalton and up to 20,000 Dalton.
Examples of plant species used to obtain tannins for tanning purposes are wattle (Acacia sp.), oak (Quercus sp.), eucalyptus (Eucalyptus sp.), birch (Betula sp.), willow (Salix caprea), pine (Pinus sp.), quebracho (Scinopsis balansae) .
The herbal drugs are divided into groups according to their medicinal action: demulcent, expectorant, antitussive, spasmolytic, anticatarrhals and immunostimulant.
Demulcents
- The major respiratory demulcent herbs are Althaea officinalis root or leaves, mallows flowers, Ulmus spp., licorice and comfrey.
- Respiratory demulcents are herbs contain mucilage and have a soothing and antiinflammatory action on the lower respiratory tract. Indications for respiratory demulcents:
Dry, non-productive, irritable cough
Application:
Best taken before meals.
Adulteration it is a practice of substituting the original crude drug partially or fully with other substances which is either free from or inferior in therapeutic and chemical properties or addition of low grade or spoiled drugs or entirely different drug similar to that of original drug substituted with an intention of enhancement of profits.
adulteration may be defined as mixing or substituting the original drug material with other spurious, inferior, defective, spoiled, useless other parts of same or different plant or harmful substances or drug which do not confirm with the official standards
Introduction to diuretics.
Therapeutic approaches.
Normal physiology of urine formation.
Classification of drugs .
Mechanism of action of Acetazolamide.
Mechanism of action of Thiazides.
Mechanism of action of Loop diuretics.
Mechanism of action of potassium sparing diuretics &aldosterone antagonists.
Tannins
Tannins are complex substances that usually occur as mixtures of polyphenols that are very difficult to separate since they do not crystallize.
OR
Tannins are polyhydroxy
phenolic compounds.
Tannins are found commonly
in the bark of trees, wood,
leaves, buds, stems, fruits,
seeds, roots and plant galls.
Tannins are complex chemical substances derived from phenolic acids (sometimes called tannic acid). They are classified as phenolic compounds, which are found in many species of plants.
Tannins are high molecular weight phenolic compounds commonly found in plants with molecular weights ranging from 500 to over 3000 Dalton and up to 20,000 Dalton.
Examples of plant species used to obtain tannins for tanning purposes are wattle (Acacia sp.), oak (Quercus sp.), eucalyptus (Eucalyptus sp.), birch (Betula sp.), willow (Salix caprea), pine (Pinus sp.), quebracho (Scinopsis balansae) .
The herbal drugs are divided into groups according to their medicinal action: demulcent, expectorant, antitussive, spasmolytic, anticatarrhals and immunostimulant.
Demulcents
- The major respiratory demulcent herbs are Althaea officinalis root or leaves, mallows flowers, Ulmus spp., licorice and comfrey.
- Respiratory demulcents are herbs contain mucilage and have a soothing and antiinflammatory action on the lower respiratory tract. Indications for respiratory demulcents:
Dry, non-productive, irritable cough
Application:
Best taken before meals.
Adulteration it is a practice of substituting the original crude drug partially or fully with other substances which is either free from or inferior in therapeutic and chemical properties or addition of low grade or spoiled drugs or entirely different drug similar to that of original drug substituted with an intention of enhancement of profits.
adulteration may be defined as mixing or substituting the original drug material with other spurious, inferior, defective, spoiled, useless other parts of same or different plant or harmful substances or drug which do not confirm with the official standards
Introduction to diuretics.
Therapeutic approaches.
Normal physiology of urine formation.
Classification of drugs .
Mechanism of action of Acetazolamide.
Mechanism of action of Thiazides.
Mechanism of action of Loop diuretics.
Mechanism of action of potassium sparing diuretics &aldosterone antagonists.
End-stage renal disease is a condition in which the kidneys no longer function normally and required excellent medical and nursing care for the managing this condition.
The definition of constipation can vary from person to person. That being said, most people describe it as having infrequent stools. Some folks may also define it as having hard stools or difficulty completely emptying the bowel.
Medicinal plants and anasarca ( sweellimg) A series of LecturesByMr. All...Mr.Allah Dad Khan
A series of LecturesByMr. Allah Dad Khan former DG Agriculture Extension KP Province and Visiting Professor the University of Agriculture Peshawar allahdad52@gmail.com
Pharmacology - 10 Nursing Mnemonics and TricksKelghe D'cruz
Pharmacology isn’t the easiest to study and master. Apart from drug names, you also have to know what they do, how they interact with each other, and who they are for.
A pair of kidneys are the organs which filter toxic wastes and removes excess fluids from our body. With the current lifestyle, non-communicable diseases are on the rise. Due to which almost one in every ten individuals suffer from kidney disease. Global burden of diseases ranks kidney disease as one of the leading causes of disability, morbidity and mortality in India.
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
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
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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.
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
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
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
2. A diuretic is a substance that removes water fromA diuretic is a substance that removes water from
the body by promoting urine formation and thethe body by promoting urine formation and the
loss of salt (sodium).loss of salt (sodium).
And it is considered as a drug used to increaseAnd it is considered as a drug used to increase
urine output. Diuretics are prescribed for theurine output. Diuretics are prescribed for the
treatment of edema (the accumulation of excesstreatment of edema (the accumulation of excess
fluids in the tissues of the body), which oftenfluids in the tissues of the body), which often
occurs as the result of disease of the kidneys,occurs as the result of disease of the kidneys,
liver, lungs, or heart. Diuretics are also used toliver, lungs, or heart. Diuretics are also used to
treat hypertension (high blood pressure).treat hypertension (high blood pressure).
3. USES OF DIURETICSUSES OF DIURETICS
TREATMENT OF HIGH BLOOD PRESSURETREATMENT OF HIGH BLOOD PRESSURE
TREATMENT OF FLUID RETENTION (including heart failure,TREATMENT OF FLUID RETENTION (including heart failure,
kidney failure, cirrhosis)kidney failure, cirrhosis)
TREATMENT OF HEART FAILURE (Spironolactone andTREATMENT OF HEART FAILURE (Spironolactone and
Eplerenone)Eplerenone)
PREVENTION OF CALCIUM KIDNEY STONESPREVENTION OF CALCIUM KIDNEY STONES
TREATMENT OF NEPHROGENIC DIABETES INSIPIDUSTREATMENT OF NEPHROGENIC DIABETES INSIPIDUS
TREATMENT OF RENAL TUBULAR ACIDOSISTREATMENT OF RENAL TUBULAR ACIDOSIS
TREATMENT OF MENIERE'S DISEASETREATMENT OF MENIERE'S DISEASE
4. Why do I need to take a diuretic?Why do I need to take a diuretic?
Diuretics are sometimes calledDiuretics are sometimes called
"water pills." They are used to treat"water pills." They are used to treat
congestive heart failure (CHF), highcongestive heart failure (CHF), high
blood pressure (hypertension), orblood pressure (hypertension), or
edema (water retention). Diureticsedema (water retention). Diuretics
are also prescribed for certain kindsare also prescribed for certain kinds
of kidney or liver diseases.of kidney or liver diseases.
5. How do diuretics work?How do diuretics work?
There are 3 types of diuretic medicines. EachThere are 3 types of diuretic medicines. Each
type works a little differently, but they all lowertype works a little differently, but they all lower
the amount of salt and water in your body, whichthe amount of salt and water in your body, which
helps to lower your blood pressure.helps to lower your blood pressure.
1. Thiazide diuretics1. Thiazide diuretics
2. Potassium-sparing diuretics2. Potassium-sparing diuretics
3. Loop-acting diuretics3. Loop-acting diuretics
6.
7. What if I am taking otherWhat if I am taking other
medicines?medicines?
Other medicines that you may beOther medicines that you may be
taking can increase or decrease thetaking can increase or decrease the
effect of diuretics. These effects areeffect of diuretics. These effects are
called an interaction. Be sure to tellcalled an interaction. Be sure to tell
your doctor about every medicineyour doctor about every medicine
and vitamin or herbal supplementand vitamin or herbal supplement
that you are taking, so he or she canthat you are taking, so he or she can
make you aware of any interactions.make you aware of any interactions.
8. Common side effects:Common side effects:
WeaknessWeakness
Muscle crampsMuscle cramps
Skin rashSkin rash
Increased sensitivity to sunlight (withIncreased sensitivity to sunlight (with
thiazide diuretics)thiazide diuretics)
Throwing upThrowing up
DiarrheaDiarrhea
CrampsCramps
Dizziness or lightheadednessDizziness or lightheadedness
Joint painJoint pain