The document discusses drug interactions of the anticoagulant argatroban. It notes that argatroban can interact with other anticoagulants, antiplatelets, NSAIDs, SSRIs, SNRIs, St. John's Wort, herbal supplements like ginkgo and garlic, and foods like papaya - increasing the risk of bleeding. It advises close monitoring when argatroban is taken with these substances. The document also provides tips for patients taking anticoagulants and references additional sources on drug interactions.
Drug interactions of Low Molecular weight Heparins (LMWHs)Naina Mohamed, PhD
Low Molecular weight Heparins (LMWHs) may interact majorly with drugs such as Warfarin, Heparin and Other Anticoagulants like Danaparoid, Bivalirudin, Rivaroxaban, Apixaban, Dabigatran and Antiplatelet agents such as Aspirin, Clopidogrel, Ticagrelor, etc.
• Concomitant use of Dabigatran and Itraconazole or Ketoconazole is contraindicated.
• Drugs such as Heparin, Enoxaparin, Dalteparin, Tinzaparin, Bivalirudin, Lepirudin, Fondaparinux, Phenindione, Danaparoid, Rivaroxaban, Apixaban, Verapamil, Quinidine, Amiodarone, Ketoconazole, Itraconazole, Ritonavir, Saquinavir, Nelfinavir, Tacrolimus and Cyclosporine increase the risk of Dabigatran induced bleeding.
• Coadministration of Dabigatran with P-Glycoprotein Inducers like Carbamazepine, Rifampin or St. John's wort elevate the risk of Thrombosis.
Concomitant use of Heparin and Telavancin or Oritavancin is contraindicated. Heparin may also interact majorly with other Anticoagulants such as Enoxaparin, Dalteparin, Bivalirudin, Danaparoid, Rivaroxaban, Apixaban and Dabigatran.
Hirudins such as Bivalirudin, Desirudin, Lepirudin can interact majorly with drugs such as Warfarin, Heparin, Enoxaparin, Dalteparin, Tinzaparin, Fondaparinux, Phenindione, Argatroban, Rivaroxaban, Apixaban and Dabigatran.
Danaparoid can interact majorly with drugs such as Warfarin, Hirudins (Bivalirudin, Lepirudin) and Other Anticoagulants like Heparin, Enoxaparin, Dalteparin, Tinzaparin, Fondaparinux, Phenindione, Argatroban, Rivaroxaban, Apixaban and Dabigatran.
Warfarin interacts majorly with drugs such as Tamoxifen, Simvastatin, Penicillins, cephalosporins, Macrolide antibiotics, Fluoroquinolones, Sulphonamides, Azole antifungals, Amiodarone, Enoxaparin, Danaparoid, Antiplatelets, Fish oil, Vitamin K rich foods, Green tea, Pomegranate etc.
Clinically Important Drug Interactions of FibrinolyticsNaina Mohamed, PhD
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
Drug interactions of Low Molecular weight Heparins (LMWHs)Naina Mohamed, PhD
Low Molecular weight Heparins (LMWHs) may interact majorly with drugs such as Warfarin, Heparin and Other Anticoagulants like Danaparoid, Bivalirudin, Rivaroxaban, Apixaban, Dabigatran and Antiplatelet agents such as Aspirin, Clopidogrel, Ticagrelor, etc.
• Concomitant use of Dabigatran and Itraconazole or Ketoconazole is contraindicated.
• Drugs such as Heparin, Enoxaparin, Dalteparin, Tinzaparin, Bivalirudin, Lepirudin, Fondaparinux, Phenindione, Danaparoid, Rivaroxaban, Apixaban, Verapamil, Quinidine, Amiodarone, Ketoconazole, Itraconazole, Ritonavir, Saquinavir, Nelfinavir, Tacrolimus and Cyclosporine increase the risk of Dabigatran induced bleeding.
• Coadministration of Dabigatran with P-Glycoprotein Inducers like Carbamazepine, Rifampin or St. John's wort elevate the risk of Thrombosis.
Concomitant use of Heparin and Telavancin or Oritavancin is contraindicated. Heparin may also interact majorly with other Anticoagulants such as Enoxaparin, Dalteparin, Bivalirudin, Danaparoid, Rivaroxaban, Apixaban and Dabigatran.
Hirudins such as Bivalirudin, Desirudin, Lepirudin can interact majorly with drugs such as Warfarin, Heparin, Enoxaparin, Dalteparin, Tinzaparin, Fondaparinux, Phenindione, Argatroban, Rivaroxaban, Apixaban and Dabigatran.
Danaparoid can interact majorly with drugs such as Warfarin, Hirudins (Bivalirudin, Lepirudin) and Other Anticoagulants like Heparin, Enoxaparin, Dalteparin, Tinzaparin, Fondaparinux, Phenindione, Argatroban, Rivaroxaban, Apixaban and Dabigatran.
Warfarin interacts majorly with drugs such as Tamoxifen, Simvastatin, Penicillins, cephalosporins, Macrolide antibiotics, Fluoroquinolones, Sulphonamides, Azole antifungals, Amiodarone, Enoxaparin, Danaparoid, Antiplatelets, Fish oil, Vitamin K rich foods, Green tea, Pomegranate etc.
Clinically Important Drug Interactions of FibrinolyticsNaina Mohamed, PhD
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
These are some drug interactions Of warfarin.
Drug interactions with different classes.
There are larges number of interactions of warfarin I have mentioned some of these.
Drug Interactions of Recombinant Tissue Plasminogen Activators (rtPA)Naina Mohamed, PhD
Drug Interactions of Recombinant Tissue Plasminogen Activators (rtPA):
• The risk of Orolingual Angioedema is increased by the concomitant use of Alteplase and ACE inhibitors (Captopril, Lisinopril, Perindopril, etc).
• Concurrent use of Alteplase and Nitroglycerin (GTN) results in Less coronary artery reperfusion, Longer time to reperfusion, and more coronary artery Reocclusion
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
Aspirin is an antiplatelet drug and it produces antiplatelet activity in lower doses (75-100 mg daily), while Higher dose of Aspirin (Up to 3600 mg daily in divided doses) is required for it’s analgesic effects.
Author: Danielle Cassidy, Pharm.D., BCPS
Description: Educational handout created for families and young adults discharged from the hospital on warfarin therapy.
Warfarin. Most used oral anticoagulant in the world. In some cases it has no alternative. Has many side effects. Careful monitoring and judicious titration of dose can make it best. Live long Warfarin.
Warfarin and newer oral anticoagulants e.g. debigatran, rivaroxaban, apixaban were presented in cardiology morning session in Bangabandhu Sheikh Mujib Medical University.
These are some drug interactions Of warfarin.
Drug interactions with different classes.
There are larges number of interactions of warfarin I have mentioned some of these.
Drug Interactions of Recombinant Tissue Plasminogen Activators (rtPA)Naina Mohamed, PhD
Drug Interactions of Recombinant Tissue Plasminogen Activators (rtPA):
• The risk of Orolingual Angioedema is increased by the concomitant use of Alteplase and ACE inhibitors (Captopril, Lisinopril, Perindopril, etc).
• Concurrent use of Alteplase and Nitroglycerin (GTN) results in Less coronary artery reperfusion, Longer time to reperfusion, and more coronary artery Reocclusion
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
Aspirin is an antiplatelet drug and it produces antiplatelet activity in lower doses (75-100 mg daily), while Higher dose of Aspirin (Up to 3600 mg daily in divided doses) is required for it’s analgesic effects.
Author: Danielle Cassidy, Pharm.D., BCPS
Description: Educational handout created for families and young adults discharged from the hospital on warfarin therapy.
Warfarin. Most used oral anticoagulant in the world. In some cases it has no alternative. Has many side effects. Careful monitoring and judicious titration of dose can make it best. Live long Warfarin.
Warfarin and newer oral anticoagulants e.g. debigatran, rivaroxaban, apixaban were presented in cardiology morning session in Bangabandhu Sheikh Mujib Medical University.
Complementary and alternative therapies for hyperlipidemiaNaina Mohamed, PhD
CAM for Hyperlipidemia includes Dietary Supplements (Omega-3 Fatty Acids, Plant sterols and stanols, Soy protein, Flax seed, Red yeast rice), Herbal Supplements (Ginger, Garlic, Ginseng) and Mind – Body Practices (Transcendental Meditation and Yoga).
Complementary and alternative therapies for Coronary Heart Disease (CHD)Naina Mohamed, PhD
Dietary supplements used to treat Coronary Heart Disease (CHD) include Omega 3 fatty acids, Vitamin C, Vitamin E, Fiber and Coenzyme Q10. And the Mind-Body approaches to treat CHD include Chelation therapy, Meditation, Acupuncture, Reflexology and Tai chi.
Complementary and alternative therapies for hypertensionNaina Mohamed, PhD
To treat hypertension many CAM approaches are useful including Mind and Body Practices such as Dynamic Aerobic (Endurance) Exercise, Dynamic Resistance Exercise, Device-Guided Slow Breathing, Transcendental Meditation (TM), Biofeedback Techniques and Acupuncture, Herbal Supplements such as Garlic, Black cumin, Cinnamon, Flaxseed, Sour Tea, Ginger, Cardamom, Green Tea, Sweet basil, Celery, Ginseng, Saffron, Goldthread, Oats, Chinese hawthorn, Carrot, Tomato, Pomegranate, Radish and Sesame and Dietary Supplements like Coenzyme Q10, Omega 3 FAs, Melatonin and Vitamin D.
The health benefits of Smoking Cessation such as Better sex, Improved fertility, Younger looking skin, Whiter teeth, Better breathing, Longer life, Less stress, Improved smell and taste, More energy and Healthier loved ones are discussed in this presentation.
Huy Tran is a lab and clinical haematologist at Peninsula Health. He has research interests in haemostasis and thrombosis and is a member of the Australasian committee for anticoagulation reversal. Here he presents on the new oral anticoagulants and what can be done when they cause critical bleeding
In the NOACs era , how to deal with liver cirrhosis needing anticoagulation?magdy elmasry
Is My Cirrhotic Patient Auto-anticoagulated?
Does "Auto-anticoagulation" Protect Against thrombosis in Patients with Liver Disease?
The normal balance of hemostasis and rebalanced hemostasis in liver disease.Should we anti-coagulate patients with cirrhosis?How safe is anticoagulation therapy to use in those with chronic liver disease?
Anticoagulants, commonly referred to as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time.
Oral Surgery in Patients on Anticoagulant TherapyVarun Mittal
Management of patients on Anticoagulant Therapy in Surgical Practice with special emphasis on Oral Surgical Procedures; along with Guidelines drawn from various Text Books and Journals
What are anti-coagulants?
What are the difference between antiplatelet, anticoagulants and thrombolytics?
Coagulation cascade
Virchows Triad
Classification of anti-coagulants?
Indications of anti-coagulants?
Mechanism and site of action of different anti-coagulants?
Aceclofenac Tablets 100mg Taj Pharma PILTajPharmaQC
Aceclofenac Tablets 100mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Aceclofenac Dosage & Rx Info | Aceclofenac Uses, Side Effects Vecuronium bromide: Indications, Side Effects, Warnings, Aceclofenac-Drug Information –Taj Pharma, Aceclofenac dose Taj pharmaceuticals Aceclofenac interactions, Taj Pharmaceutical Aceclofenac contraindications, Aceclofenac price, Aceclofenac Taj Pharma Aceclofenac SmPC-Taj Pharma Stay connected to all updated on Aceclofenac Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
• Vorapoxar may interact with CYP3A4 enzyme inhibitors such as Ketoconazole, Itraconazole, Posaconazole, Clarithromycin, Nefazodone, Ritonavir, etc.
• Vorapoxar may also interact with CYP3A4 enzyme inducers like Rifampin.
• Cilostazol is a selective inhibitor of phosphodiesterase 3 (PDE3) and it is an antiplatelet drug and a vasodilator.
• Cilostazol can interact with Omeprazole, Fluoxetine, Fluvoxamine, Aspirin, Ticlopidine, Ticagrelor, Nefazodone, Azole antifungals, Idelalisib, Amiodarone, Cobicistat, Piperaquine and Ginkgo.
Glycoprotein IIB/IIIA inhibitors interact with Other Antiplatelets (Aspirin, Ticlopidine, Dipyridamole, etc.) and Ginkgo and increase the risk of bleeding.
Drug Interactions of Dipyridamole (Antiplatelt - Adenosine reuptake inhibitor)Naina Mohamed, PhD
Dipyridamole is used as an Antiplatelet drug by inhibiting the reuptake of adenosine. Dipyridamole can interact with many drugs including ADP blockers (Clopidogrel, Prasugrel, Ticlopidine, Ticagrelor, etc), Glycoprotein IIB/IIIA inhibitors (Abciximab, Tirofiban, etc.), Fibrinolytics (Reteplase, Tenecteplase, Streptokinase, etc.), Adenosine, Treprostinil, Sulfinpyrazone, Regadenoson, Distigmine and Ginkgo.
Drug Interactions of ADP receptor Blockers (Antiplatelets)Naina Mohamed, PhD
· ADP receptor Blockers (Antiplatelets) include Thienopyridines (Clopidogrel, Prasugrel, Ticlopidine) and Non-Thienopyridines (Ticagrelor, Cangrelor, Elinogrel ).
· The risk of adverse effects could be reduced by healthcare professionals through the screening, education, and follow up on suspected drug interactions.
§ Islamic fasting is similar to Alternate Day Fasting (ADF), since the feast and fast periods of Islamic fasting lasts 12 hours in average.
§ Though Islamic fasting is associated with some adverse effects, there was no detrimental effects on health attributed directly to them, in health individuals. And the adverse effects of fasting could be minimized very easily by following the preventive measures.
§ The chronic patients with Diabetes, Coronary Artery Disease (CAD), Cancer, Ulcer, Urolithiasis, Chronic Kidney Disease (CKD), etc. should consult the healthcare professionals before observing Fasting.
§ Moreover, Islam exempts the Sick, Travelers and Pregnant, Breast Feeding and Menstruating women from fasting.
§ Islamic Fasting can be good for health if it's done correctly.
• Concurrent use of Streptokinase and Antiplatelet agents such as Aspirin, Dipyridamole and Clopidogrel results in elevated risk of Bleeding.
• It is Contraindicated to use Fibrinolytics and Defibrotide concomitantly.
• Drugs increasing the risk of Fibrinolytics associated Bleeding include…
o Anticoagulants (Warfarin, Heparin, Enoxaparin, Dabigatran, etc)
o Antiplatelet agents (Aspirin, Clopidogrel, etc)
o Pentosan Polysulfate Sodium
• Herbs increasing the risk of Fibrinolytics associated Bleeding include…
o Fenugreek
o Garlic
o Ginkgo
o Evening Primrose Oil
o Clove Oil
o Anise
o Turmeric (Curcumin)
o Licorice
o Asafetida
o Capsicum (Capsaicin)
o Celery
o Kava
o Cat's claw
o Medowsweet
o Feverfew
o Tan-shen
¢ The imbalance between caloric intake and expenditure might result in to Overweight or Obesity.
¢ An US study reported that the Complementary and Alternative Medicine (CAM) use is high and continues to increase.
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
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.
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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5cl-adba precursor (semi finished )
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Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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2. Introduction
Anticoagulants are the drugs used to prevent harmful blood clots which
can cause serious conditions like Deep Vein Thrombosis (DVT), Pulmonary
Embolism (PE), or a Stroke, by affecting blood coagulation factors.
Interaction between one or more coadministered medications leading to
change in their effectiveness or toxicity, is termed as “Adverse drug
interaction”.
Anticoagulants can interact with prescription drugs, Over-the-counter
(OTC) medications, Herbal products, Dietary supplements, Vitamins,
Foods, Diseases, and Genetics (family history).
4. Defibrotide &
Antithrombotics
Concomitant use of defibrotide and a systemic antithrombotic agent is
contraindicated.
http://www.bloodjournal.org/content/120/21/3411?sso-checked=true
Antithrombotics
+ Defibrotide
Additive
antithrombotic
effects
Increased risk
bleeding
Contraindicated
5. Argatroban & Heparin
If coadministration is required, closely monitor the patient for signs and
symptoms of bleeding.
Argatroban +
Heparin
Additive
anticoagulation
Increased risk of
bleeding
6. Argatroban &
Other Anticoagulants
Use caution and monitor closely for bleeding when Argatroban is used
concomitantly with other Anticoagulants.
Argatroban + Other Anticoagulants
(Heparin, Enoxaparin, Dalteparin,
Tinzaparin, Bivalirudin, Lepirudin,
Fondaparinux, Phenindione,
Danaparoid, Rivaroxaban, Apixaban,
Dabigatran)
Additive anticoagulation Increased risk of bleeding
7. Anticoagulants &
Fibrinolytics
Observe patients for external bleeding and be alert for signs and symptoms of
internal bleeding, if concomitant use of an anticoagulant and a fibrinolytic agent
is required.
https://www.ncbi.nlm.nih.gov/pubmed/11085346
Anticoagulants +
Fibrinolytics (Alteplase,
Retaplase, Tenecteplase,
Streptokinase, Urokinase)
Additive
anticoagulation
Increased risk of
bleeding
8. Anticoagulants &
Antiplatelet agents
Concomitant use warrants close monitoring.
http://circ.ahajournals.org/content/116/3/305
Anticoagulants +
Antiplatelet agents (Aspirin,
Clopidogrel, Ticagrelor, etc)
Additive anticoagulation Increased risk of bleeding
9. Anticoagulants &
Fenofibrate
Reduce the dose of the anticoagulant by about one-third at the start of
treatment, if concomitant use is required.
Then gradually adjust the dose based on the results of INR monitoring.
https://www.ncbi.nlm.nih.gov/pubmed/12549950
Anticoagulants +
Fenofibrate
Additive effects on
anticoagulation
Enhanced bleeding
risk
10. Anticoagulants &
Orlistat
Caution should be exercised when Anticoagulants and Orlistat are used
concurrently.
https://www.ncbi.nlm.nih.gov/pubmed/12659605
Anticoagulants + Orlistat
Orlistat may reduce the
absorption of fat-soluble
vitamins, including vitamin
K
Increased risk of bleeding
11. Anticoagulants &
NSAIDs
If used concomitantly, monitor for signs of bleeding.
http://www.aafp.org/afp/2009/1215/p1371.html
Anticoagulants + NSAIDs
(Ibuprofen, Diclofenac,
Naproxen, etc)
NSAIDs possess antiplatelet
effects
Increased risk of bleeding
12. Anticoagulants & SSRIs
Serotonin is essential in initiating the hemostatic response of platelets to vascular injury.
Monitor patient for signs of increased bleeding When SSRIs and an anticoagulant are given
concurrently.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728939/
Anticoagulants + Selective serotonin
reuptake inhibitors (SSRIs)
(Fluvoxamine, Paroxetine,
Vortioxetine, Escitalopram,
Sertraline, Nefazodone, vilazodone)
SSRIs block the uptake of
serotonin by platelets
Decreased function of plateletsIncreased risk of Bleeding
13. Anticoagulants & SNRIs
Serotonin is essential in initiating the hemostatic response of platelets to vascular injury.
Monitor patient for signs of increased bleeding When SNRIs and an anticoagulant are given
concurrently.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728939/
Anticoagulants + Selective Serotonin and
Norepinephrine Reuptake Inhibitors
(SNRIs)
(Venlafaxine, Desvenlafaxine, Duloxetine,
Milnacipran, Levomilnacipran,
Sibutramine)
SNRIs block uptake of
by platelets
Decreased function of
platelets
Increased risk of Bleeding
14. Anticoagulants &
St. John's Wort
Prothrombin time should be monitored closely.
Patients should not discontinue St. John's Wort without notifying their health
care provider.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917631/
Anticoagulants + St.John's Wort
St. John's Wort induce CYP3A4 and
CYP1A2 mediated metabolism of R-
warfarin and CYP2C9 mediated S-
warfarin metabolism
Decreased warfarin plasma
concentrations leading to Reduced
anticoagulant effectiveness
15. Anticoagulants &
Ginkgo
Extreme caution is advised, due to the severity of the bleeding cases reported.
http://onlinelibrary.wiley.com/doi/10.1002/mnfr.200700098/epdf
Anticoagulants + Ginkgo
Ginkgolide B of Ginkgo may
inhibit Platelet Activating
Factor (PAF) induced
aggregation
Increased risk of bleeding
16. Anticoagulants & Garlic
Monitor bleeding time and signs and symptoms of excessive bleeding, if
garlic is taken with an anticoagulant.
http://onlinelibrary.wiley.com/doi/10.1002/mnfr.200700072/epdf
Anticoagulants + Garlic
Garlic has Anti-platelet,
Antithrombotic and
Fibrinolytic activities
Increased risk of bleeding
17. Anticoagulants +
Papaya
The patient should be monitored closely for symptoms of bleeding and
the INR should be closely monitored, if taken concomitantly.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025393/
Anticoagulants + Papaya
Papain of Papaya may
damage the mucous
membranes of the
gastrointestinal tract
Increased bleeding risk
18. Anticoagulants &
Chamomile
Patients should be educated about the potential risk of using chamomile
products, while being treated with warfarin.
Monitor the patient for signs and symptoms of excessive bleeding.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1435958/
Anticoagulants +
Chamomile (Matricaria
chamomilla)
Coumarins present in
chamomile may potentiate
the effect of anticoagulants
Increased risk of bleeding
19. Anticoagulants &
Coenzyme Q10
Caution is advised if coenzyme Q10 and Anticoagulants are taken together.
Monitor the INR to determine continued therapeutic effect.
https://www.ncbi.nlm.nih.gov/pubmed/9621803
Anticoagulants +
Coenzyme Q10
Coenzyme Q10 is
chemically similar to
Vitamin K2
Reduced
anticoagulant
effectiveness
20. Anticoagulants &
Ginger
Caution is advised if ginger and an anticoagulant are taken concomitantly.
https://www.ncbi.nlm.nih.gov/pubmed/11144706
Anticoagulants + Ginger
Ginger may inhibit
thromboxane B2 formation
& may increase
levels
Increased risk of bleeding
21. Anticoagulants &
Fenugreek
Monitor bleeding time and signs and symptoms of excessive bleeding, if
fenugreek and anticoagulants are used concomitantly.
http://onlinelibrary.wiley.com/doi/10.1592/phco.21.5.509.34492/epdf
Anticoagulants +
Fenugreek
Coumarin content
of fenugreek may
add to the effect of
anticoagulants
Increased risk of
bleeding
22. Anticoagulants & Anise
Caution is advised if anise is taken with an anticoagulant. Monitor for signs and
symptoms of increased excessive bleeding.
http://www.ajhp.org/content/57/13/1221.long
Anticoagulants +
Anise
Coumarin content of
Anise may add to
the effect of
anticoagulants
Increased risk of
bleeding
23. Anticoagulants & Clove
Oil
Monitor the patient closely for signs and symptoms of bleeding, if both are
taken together.
http://www.ajhp.org/content/57/13/1221.long
Anticoagulants + Clove Oil
Eugenol and Acetyl
in clove oil inhibit platelet
aggregation
Increased risk of bleeding
24. Anticoagulants &
Asafetida
Monitor the patient closely for signs and symptoms of bleeding.
http://www.ajhp.org/content/57/13/1221.long
Anticoagulants +
Asafetida
Asafetida contains
free ferulic acid and
coumarin
Increased risk of
bleeding
25. Anticoagulants &
Capsaicin
Signs and symptoms of excessive bleeding should be monitored closely if
capsaicin (or large amounts of red pepper) and anticoagulants are taken
concomitantly.
http://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140305.17.pdf
Anticoagulants + Capsaicin
Capsaicin may inhibit
platelet aggregation and
enhance fibrinolytic activity
Increased risk of bleeding
26. Anticoagulants &
Evening primrose oil
Monitor for signs and symptoms of excessive bleeding.
https://www.ncbi.nlm.nih.gov/pubmed/19783511
Anticoagulants + Evening primrose
oil
Gamma-linolenic acid from
primrose oil may inhibit
thromboxane B2 production and
increase prostacyclin production
Increased risk of bleeding
27. Anticoagulants &
Licorice
Monitor for signs and symptoms of excessive bleeding, if licorice is taken with an
anticoagulant.
https://www.ncbi.nlm.nih.gov/pubmed/23671711
Anticoagulant
+ Licorice
Inhibition of thrombin and
platelet aggregation by
licorice
Increased risk
of bleeding
28. Anticoagulants & Celery
Monitor the patient closely for signs and symptoms of bleeding, if both are taken
together.
http://naturaldatabase.therapeuticresearch.com/nd/PrintVersion.aspx?id=882&AspxAuto
DetectCookieSupport=1
Anticoagulants +
Celery
Apigenin content of Celery, may inhibit
thromboxane A2 formation leading to
reduced platelet aggregation & Celery
contains coumarin derivatives, which
may produce additional anticoagulant
effects
Increased risk of
bleeding
29. TIPS for Patients on
Anticoagulants
Do not double the dose to compensate a missed one.
Do not forget to discuss with your surgeon or dentist about the regular use of
Anticoagulant prior to any surgery.
Talk to your Physician or Pharmacist before taking any other medications, including
prescription and OTC (Over-The-Counter) medicines.
Contact your doctor if you develop severe diarrhea, an infection or a fever.
Seek immediate medical advice if there is signs of bleeding such as blood in your stools
or urine, nose-bleeds, bleeding gums, excessive menstrual bleeding or excessive
bruising.
Be careful with knives and try to minimize the risk of falling.
Always adhere to the prescribed dosage schedule.
Wear or carry an identification stating that You are on Anticoagulant.
30. Conclusion
Drug interactions can result in significant morbidity and mortality and thus
minimizing the risk for drug interactions should be a goal in drug therapy.
The patients with clotting disorders should bring a list of all of the drugs they
are taking including prescription drugs, over-the-counter drugs, and any
supplements, herbal or otherwise, during their visit to the doctor or
pharmacist.
The risk of adverse effects could be reduced by healthcare professionals
through the screening, education, and follow up on suspected drug
interactions.
If possible, the patients are recommended to fill all their prescriptions at one
pharmacy.
Pharmacists can play a crucial role in identifying possible drug interactions by
asking patients on Anticoagulants about their herbal and other alternative
medicine product use.
31. References
Stockley’s Drug Interactions, 9e
Karen Baxter
Goodman & Gilman's: The Pharmacological Basis of Therapeutics,
12e
Laurence L. Brunton, Bruce A. Chabner, Björn C. Knollmann
Basic & Clinical Pharmacology, 12e
Bertram G. Katzung, Susan B. Masters, Anthony J. Trevor
A Manual of Adverse Drug Interactions
J.P. Griffin, P.F. D'Arcy
Clinical Manual of Drug Interaction Principles for Medical Practice
Gary H. Wynn, Jessica R. Oesterheld, Kelly L. Cozza, Scott C.
Armstrong