This document discusses drug interactions, including definitions, types, mechanisms, examples, and management. It defines a drug interaction as when two drugs administered together cause a modification in one drug's effects. Interactions can occur through pharmacokinetic mechanisms like absorption, distribution, metabolism, and excretion, or pharmacodynamic mechanisms like receptor interactions. Common interacting drug classes and examples of specific interactions are provided. Management involves identifying risk factors, monitoring for potential interactions, and considering alternative treatments if serious interactions could occur.
Drug interaction - Potential antimicrobial drug interaction in a hospital set...Dr. Jibin Mathew
A drug interaction is a situation in which a substance affects the activity of a drug when both are administered together. This action can be synergistic or antagonistic or a new effect can be produced that neither produces on its own
Drug interaction is defined as the pharmacological activity of one drug is altered by the concomitant use of another drug or by the presence of some other substance
The Drug whose Activity is effected by such an Interaction is called as a “Object drug.”
The agent which precipitates such an interaction is referred as the “Precipitant”.
Drug interaction - Potential antimicrobial drug interaction in a hospital set...Dr. Jibin Mathew
A drug interaction is a situation in which a substance affects the activity of a drug when both are administered together. This action can be synergistic or antagonistic or a new effect can be produced that neither produces on its own
Drug interaction is defined as the pharmacological activity of one drug is altered by the concomitant use of another drug or by the presence of some other substance
The Drug whose Activity is effected by such an Interaction is called as a “Object drug.”
The agent which precipitates such an interaction is referred as the “Precipitant”.
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.
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.
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Stay informed, stay safe, and get your flu shot today!
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
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.
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
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. DRUG INTERACTIONS
Dr. K.Vinay Kumar
Assistant Professor
Department of Pharmacology
RVM Institute of Medical Sciences & Research
Center
2. DRUG INTERACTIONS:LEARNING
OBJECTIVES
1. Definition of Drug interactions
2. Types of Drug interactions
3. Pharmacokinetic Interactions with examples
4. Pharmacodynamic Interactions with examples
5. Food drug interaction with examples.
6. Drug disease interactions
7. Selection of drug to avoid drug interactions.
8. Management of drug interactions
3. DRUG INTERACTION DEFINITION
When two drugs are administered simultaneously
or quick succession they causes the modification
of response of one drug is called drug
interactions.
DRUG
A
DRUGB
OBJECT
DRUG
PRECIPITANT
DRUG
5. They are several mechanism that can involved to
cause drug interaction
6. Regular Medications During Likely To Be Involved
In Drug Interactions.
Antidiabetic drugs Oral contraceptives
Antihypertensive drugs Antiasthmatic drugs
Antianginal drugs Antipeptic ulcer drugs
Antiarthritic drugs Corticosteroids
Antiepileptic drugs Antitubercular drugs
Antiparkinsonian drugs Anti-HIV drugs.
7. DOES DRUG INTERACTIONS ARE SEEN IN
ALL THE PATIENTS TAKING SAME DRUG
Patients Factors Drug Specific Factors
Genetics Dose
Gender Route of administration
Concurrent disease Drug formulation
Diet Sequence of drug
administration.
YES NO
8. WHAT IS THE MAIN CAUSES OF DRUG
INTERACTIONS
1. Due multiple drug therapy
2. Due to multiple prescriptions
3. Due to multiple pharmacological effect of drugs
4. Due to Multiple diseases
5. Poor patients compliance
6. Advancing age of the patients
9. PHARMACOKINETIC DRUG-INTERACTION
Drug A (orally administered) + Drug B (orally
administered) Drug A interfere with Absorption
of drug B due to insolubility and poorly
absorbed complex in the gut lumen
Example: Tetracycline's, Calcium/Iron, Salts,
Antacids or Sucralfate. Such interactions can be
minimized by administering the two drugs with a
gap of 2-3 hrs.
10. DRUG INTERACTION AT ABSORPTION.
1. Complexation and absorption
2. Alternation in GIT pH.
3. Alternation in gut motility
4. Alternation of GI microflora
11. 1. ALTERNATION IN GIT PH.
Drugs are absorbed from stomach (acidic media),
so when this media become neutral or alkaline,
this will affect the absorption of drug
Example
Ketoconazole +H2 blockers + PPIs
Ketoconazole absorption is reduced by H2
blockers and PPIs because they decreases gastric
acidity which promotes dissolution and
absorption of ketoconazole.
12. 2. ALTERNATION OF GI MICROFLORA
Antibiotics (Ampicillin + Tetracycline +
Clotrimazole) + Oral Contraceptive.
Were antibiotics reduces the gut flora, gut flora is
required to normalize the deconjugation of oral
contraceptive pills (in bile as glucuronides)
Contraceptive failure.
13. 3. ALTERNATION IN GUT MOTILITY
Accelerated gastric emptying increases drug
absorption
Atropine and Opiates delay gastric emptying
Metaclopramide induces gastric emptying.
Example: Digoxin and Riboflavin, increased
gastrointestinal motility is associated with a
decrease in the rate of absorption.
16. Quinidine + Digoxin
Quinidine Decreases
tissue plasma protein
binding of Digoxin
Quinidine competitively
inhibit P – glycoprotein
transport
Reduces distribution of
Digoxin
Reduces renal and biliary
excretion of Digoxin
Inc plasma conc. of Digoxin (2 folds)
Digoxin Toxicity
19. Examples : 01 – Enzyme Inhibitors
Statins + Fibrates, Niacin, Erythromycin, Azole and
HIV Protease.
Inhibits the metabolism of statins.
Induced myopathy of statins .
20. MICROSOMAL ENZYME INDUCTION
Drug that increases the activity of microsomal
enzymes and increases the metabolism of several
drugs is called microsomal enzyme induction
(gene mediated increase synthesis of CYP450).
1 – 2 weeks produce maximal effects.
1 – 3 weeks regresses gradually after
discontinuation of inducer.
21. Rifampin induces CYP-2C-9 & CYP-2C-19 which
metabolizes phenytoin
Decrease plasma levels of phenytoin
Therapeutic failure
Poor control of Seizures
RIFAMPIN + PHENYTOIN
22. DRUG INTERACTION AT EXCRETION OF
DRUGS.
Drug interaction takes place in excretion mostly
by inhibiting tubular transport mechanism.
Weak acidic drugs like penicillin's,
phenobarbitone, Acetazolamide, nitrofurantoin,
will get eliminated in alkaline medium.
Basic drugs like Chloroquine will get eliminated
with acidic urine.
23. EXAMPLE 01: PENICILLIN + PROBENECID
Probenecid and penicillin both excrete by renal
tubular secretion
Both competes with each other for excretion
Probenecid inhibits excretion of penicillin
Probenecid prolongs the half-life of penicillin,
allowing single dose therapy
24. Example 02 : -
Aspirin + Probenecid Aspirin blocks the
uricosuric action of probenecid.
Example 03 : -
Aspirin + Methotrexate Aspirin decreases
tubular secretion of Methotrexate.
25. PHARMACODYNAMIC DRUG-INTERACTION
Modification of one drug at the target site by
another drug.
1. Pharmacological antagonism
2. Interfere with neuronal uptake or
neurotransmitter release.
3. Additive or summative action
4. Changes in ionic balance.
26. COMPETITIVE VS NON COMPETITVE
ANTAGONISM
Warfarin – Vitamin K Diazepam - Bicuulline
28. AMPICILLIN & TETRACYCLINE
Ampicillin (Penicillin's) usually more effective
against rapidly multiplying bacteria as being a
cell-wall synthesis inhibitor.
Tetracycline (protein
synthesis inhibitor) is
Bacteriostatic inhibits
multiplication
Tetracycline Antagonize the effect of Ampicillin
30. LEVODOPA + CARBIDOPA
Carbidopa is peripheral dopa-decarboxylase
inhibitor which inhibit peripheral conversion of
levodopa in Dopamine.
Levodopa
X
Increased levels of levodopa in brain
increase efficacy Decrease peripheral side effects
Dopamine
Dopa-decarboxylase
Carbidopa
31. DRUG INTERACTION WITH DIAGNOSTIC
TESTS
Nalidixic acid, Salicylates and Vitamin C
Provides false positive test of urine sugar in
Benedicts solution
32. FOOD -DRUG INTERACTION
Food effects the rate and extend of absorption of
drug from GIT
Herbal Metabolic ‘s Drugs
Avocado Enzymatic
inductor
Warfarin
Soya
Enzymatic
inhibition
Clozapine, haloperidol,
Olanzapine, caffeine,
NSAIDs, phenytoin, za
firlukast, warfarin
33. Example
Statins (treatment for high cholesterol) + Grape
juice.
.
decreases the
absorption of
statins
Increases the risk
of liver or kidney
damage
Rhabdomyolysis
(skeletal muscle breaks
down, releasing a protein
called myoglobin into the
blood)
Kidney damage
34. DRUG DISEASE INTERACTIONS
The use of a drug alters or worsens a condition or
disease.
Example : Metformin in kidney disease patients
In kidney disease patients use metformin in low
dose if not, not to continue.
Because metformin get accumulated in kidney
causing for other kidney damage
35. SELECTION OF DRUG TO AVOID DI
The drug compound in combination should be
selected in such a way that it should not cause any
side effects and it should be complemented.
Example :- Antibiotics is used along with an
analgesic to treat an painful infectious condition.
In some cases multiple drugs are used to treat a
patients suffering from two or more diseases at
same time. Examples :– Patients suffering from
hypertension and diabetes
36. In such cases adverse drug interaction may seen
in later situation, because of some other drugs
may be administered to patients depending on
his/her disease/symptoms.
37. MANAGEMENT OF DRUG INTERACTIONS
1. Identify the patients risk factors.
2. Take history of the patients
3. Be knowledge about the action of the drug being
used.
4. Patient must be monitored if the drug is
prescribed for the first time
5. If the interaction is potentially serious , seek for
alternative drugs.
38. 4. High risk drugs must be checked for probable
drug interactions.
5. Drug interactions must be predicted while
prescribing the drugs.
6. Interaction can occur with OCT drugs which the
patients might not tell about.
7. Educate the patients.
8. Monitoring of drugs should be done.
39. The elderly are at great risk of drug interaction
because of polypharmacy, age related impairment
of metabolism and excretion.
Complementary and alternative medicine (
dietary supplements, herbal or homeopathic
medicines) as well as recreational drugs,
including alcohol, tobacco should be kept in mind
which considering drug interactions.
Editor's Notes
The drug whose activity is affected in drug interaction such drug is called as object drugs.
The agents with precipitate in drug interaction is called as “precipitant drugs”