This document summarizes various drugs acting on the gastrointestinal tract. It discusses emetics and their mechanisms of action including apomorphine and cephaeline. It also discusses various classes of antiemetics like anticholinergics, H1 antihistamines, neuroleptics, prokinetic drugs, and 5HT3 antagonists. Specific antiemetics discussed include hyoscine, promethazine, ondansetron, and granisetron. It also summarizes causes and treatment of diarrhea, including specific antimicrobial drugs and nonspecific antidiarrheal drugs like adsorbents, anti-secretory drugs, and antimotility drugs.
short and simple study on the topic of laxative and purgatives which is very usefull for the student , teachers, as well as health cares peoples. this study is done by the student with the help of teachers
Anthelmintics | B.Pharm 3rd year 2nd Sem | Medicinal Chemistry-III | History, Classification, Structures & Synthesis of anthelmintics, Synthesis of Diethylcarbamazine citrate, Synthesis of Mebendazole
Sulphonamides Pharmacology For Pharmacy studentsMalay Pandya
This is the PowerPoint presentation of the Antimicrobial drug - SULPHOANMIDE.
Sulphonamide is the first antimicrobial agent
It Can be employed for suppressive therapy of chronic urinary tract infection, streptococcal pharyngitis and gum infection.
Combined with trimethoprim (cotrimoxazole) sulfamethoxazole is used for many bacterial infections.
This will be useful to all Pharmacy Student ...
short and simple study on the topic of laxative and purgatives which is very usefull for the student , teachers, as well as health cares peoples. this study is done by the student with the help of teachers
Anthelmintics | B.Pharm 3rd year 2nd Sem | Medicinal Chemistry-III | History, Classification, Structures & Synthesis of anthelmintics, Synthesis of Diethylcarbamazine citrate, Synthesis of Mebendazole
Sulphonamides Pharmacology For Pharmacy studentsMalay Pandya
This is the PowerPoint presentation of the Antimicrobial drug - SULPHOANMIDE.
Sulphonamide is the first antimicrobial agent
It Can be employed for suppressive therapy of chronic urinary tract infection, streptococcal pharyngitis and gum infection.
Combined with trimethoprim (cotrimoxazole) sulfamethoxazole is used for many bacterial infections.
This will be useful to all Pharmacy Student ...
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.
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.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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.
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
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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.
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.
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.
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
6. * EMETICS
Emetics drugs used to evoke vomiting.
Vomiting undesirable substances are ingested.
At emergency powdered mustard suspension or strong salt
solution may be used.
CLASSIFICATION.
Act on Chemoreceptor Trigger Zone(CTZ).
eg: Apomorphine.
Act reflexly and on CTZ.
eg: Cephaeline.
7.
8. * APOMORPHINE.
Mechanism of action(MOA)
Acts centrally by stimulating the
medullary CTZ connected with
vomiting centre
Uses
As emetic.
HO OH
N
H
H3C
9. * CEPHAELINE
MOA.
Locally by irritating the gastric mucosa & centrally by
stimulating the medullary CTZ to induce
vomiting.
Uses – as emetic.
H3C
O
Chemically it is an alkaloid found in ipecac.
CH3
H
H
H3C
O
N
HN
O CH3
OH
10. * ANTIEMETICS
Anti emetics drugs used to prevent or suppress
vomiting.
CLASSIFICATION OF ANTI EMETICS
Anticholinergics
eg: Hyoscine,Dicyclomine.
H1 antihistamines.
eg: Promethazine, Diphenhydramine, Dimenhydrinate,
Doxylamine, Cyclizine, Meclizine, Cinnarizine.
12. *ANTICHOLINERGICS
HYOSCINE
MOA
Blocks conduction of
nerve impulses across a
cholinergic link in the pathway
leading from the vestibular
apparatus to the vomiting centre.
Uses
For motion sickness.
CH3
O
O
O
N OH
9-methyl-3-oxa-9-azatri
cyclo[3.3.1.02,4]non-7-yl
(2S)-3-hydroxy-2-phenyl
propanoate
13. * DICYCLOMINE
MOA
Same as that of hyoscine.
2-(diethyl amino)ethyl(bicyclohexane)-
1- carboxylate.
Uses
As antiemetic, spasmolytic, in motion sickness, morning
sickness.
O
O N
CH3
CH3
14. *H1 ANTIHISTAMINES.
MOA OF ANTIHISTAMINES
Act by both relaxing the smooth muscles and also act
centrally to depress vomiting centres.
They diminish vestibular stimulation & depress labyrinthine
function.
H1 antagonism.
15. * PROMETHAZINE
Uses
Antihistaminic
Antiemetic
sedative
S
N
H3C
10-(2-(dimethylamino)propyl)
phenothiazine.
CH3
N
CH3
16. S
N
H
PHENOTHAIZINE
S
N
NaNH2
ClCH2CHN(CH3)2
S
N
CH3
N
H3C
H3C
+
17. * DIPHENHYDRAMINE
Uses
Antihistaminic
Antiemetic
Antitussive
2-(diphenylmethoxy)
Sedative N,N-dimethylethanamine.
CH3
O
N
CH3
18. * MECLIZINE
Uses
Antihistaminic
Antiemetic
1-(p-chlorophenylbenzyl)-4-
(m-methylbenzyl)piperazine.
Cl
N N
CH3
19. * CYCLIZINE
H
N N CH3
1-(diphenylmethyl)-4-methyl piperazine.
Uses
In postoperative and drug induced vomiting.
In motion sickness.
C
C6H5
20. *
HN NH + CH3COCl N NH
H3C
O
CH3I
-HI
N N CH3
H3C
O
HCl
HN N CH3 +
Cl
N N CH3
-HCl
21. *NEUROLEPTICS
MOA – They block D2 receptors in the CTZ.
CHLORPROMAZINE.
Uses
Antipsychotic
Antiemetic
Antitussive
H3C
N CH3
N
2-chloro-10-(3-(dimethylamino)
propyl)phenothiazine.
S
Cl
22. * HALOPERIDOL
O
F N
4-(4-(p-chlorophenyl)-4-hydroxy
piperidone)-4-N-fluorobutyrophenone
Uses
Antipsychotic
antiemetic
CCH 2CH2CH2
Cl
OH
24. + H3C N N Cl
*
S
N
H
Cl
2 CHLORO PHENOTHAIZINE
-HCl
NaNH2/TOLUENE
H3C N N
S
N Cl
25. *PROKINETIC DRUGS
METOCLOPRAMIDE
MOA
D2 antagonism,
5HT3 antagonism,
5HT4 agonism in CTZ
or NTS.
Uses
Cl
Antiemetic 4-amino-5-chloro-N-(2-(diethyl-aminoethyl)-
2-methoxy benzamide
H2N
O
NH
N
CH3
CH3
O
CH3
26. * DOMPERIDONE
H
5-chloro-1-(1-(3-(2-oxo2,3-dihydro-1H-benzo
imidazol-1-yl)propyl)piperidin-4-yl)-1H-benzo
imidazol-2(3H)-one.
MOA – D2 antagonism in CTZ.
Uses
Antiemetic
O
N
N
O
N
N
H
N
Cl
27. *5HT3 ANTAGONISTS
ONDANSETRON
Act via CTZ or NTS
Uses
In chemotherapy induced vomiting.
In post operative vomiting.
CH O 3
N
N N
H3C
9-methyl-3-[(2-methyl-1H-imidazol-1-yl)
methyl]-1,2,3,9-tetrahydro-4H-carbazol-
4-one
28. * GRANISETRON
Has long half life compared to
ondansetron.
Uses
In chemotherapy induced vomiting
In post operative vomiting
H3C
O
N
H3C
NH
N
N
1-methyl-N-(9-methyl-9-azabicyclo
[3.3.1]non-3-yl)-1H-indazole-3-carb
oxamide
29. DIARRHOEA
Loose bowel movements resulting into the frequent
passage of watery,uniformed stools with or without
mucous and blood.
Classification
Osmotic diarrhoea
Something in the bowel draws water from the body into the
bowel.
Eg;Sorbitol is not absorbed by the body but draws water from
the body into the bowel, resulting in diarrhoea.
30. Secretory diarrhoea
Occurs when the body is releasing water into the bowel,
many infections, drugs causes secretory diarrhoea.
Exudative diarrhoea
Diarrhoea with the presence of blood and pus in the stool.
This occurs with inflammatory bowels disease (IBD), such as
Crohn’s disease or ulcerative colitis etc.
31. Acute diarrhoea
Sudden onset in a previously healthy person
Lasts from 3 days to 2 weeks
Self-limiting
Resolves without sequels
Chronic diarrhoea
Lasts for more than 3 weeks.
Associated with recurring passage of diarrhoeal stools, fever,
loss of appetite, nausea, vomiting, weight loss, and chronic
weakness
32. CAUSES OF DIARRHOEA
Acute Diarrhoea
Microbes
Drug induced
Nutritional
Chronic Diarrhoea
Tumours
Diabetes
Addison’s disease
Hyperthyroidism
Irritable bowel syndrome
E. Coli bacteria Rotavirus
33. DRUG THERAPY
i. Specific antimicrobial drugs
ii. Non specific antidiarrhoeal drugs
ORAL REHYDRATION
THERAPY
34. Specific anti microbial drugs
A. Antimicrobials are of no value
Due to non infective causes such as
Irritable bowel syndrome
Colic disease
Pancreatic enzyme deficiency etc
Rota virus causes acute diarrhoea, specially in children
35. B. Antimicrobials are regularly useful
cholera
Tetracyclines,
chloramphenicol
etc
Clostridium
difficile
Vancomycin,
metronidazole etc
amoebiasis
Metronidazole,
dioxonid
furoate
36. NON SPECIFIC ANTIDIARROEALS
1.Adsorbents
Eg; kaolin, pectin, calcium carbonate. Etc
2. Anti secretory drugs
Eg; sulphasalazine, bismuth sub salicylate,
atropine etc.
3.Antimotility drugs
Eg: codeine, loperamide, diphenoxylate etc
37. Functions of Antidiarrhoeal Drugs
Decrease irritation to the intestinal wall
Block GI muscle activity to decrease movement
Affect CNS activity that cause GI spasm and stop
movement
Relief of symptoms and compensation of fluid &
electrolyte loss
38. Non Specific Antidiarrhoeal Drugs
Adsorbents
Coat the walls of the GI tract
Bind to the causative bacteria or toxin, which is then
eliminated through the stool
Examples: bismuth subsalicylate, kaolin-pectin, activated
charcoal.
39. Side Effects
Increased bleeding time
Constipation, dark stools
Confusion
Hearing loss, metallic taste, blue gums
40. Anti secretory drugs
Agents which reduce the secretion
Decrease intestinal muscle tone and peristalsis of GI tract
Result: slowing the movement of faecal matter through the
GI tract
Examples: belladonna alkaloids, atropine, sulphasalazine,
hyoscyamine
42. Antimotility drugs
Decrease bowel motility and relieve rectal spasms
Decrease transit time through the bowel, allowing more
time for water and electrolytes to be absorbed
Examples: codeine, loperamide, diphenoxylate
44. O
N
N
CH2
C
C CH2
C
O
CH2
H3C
Diphenoxylate HCl
45. SYNTHESIS OF DIPHENOXYLATE HCL
CH3
H2C
NH
O
O
H2C
H2C
+ O
CH3
H2C
N
O
O
CH2
CH2
OH
ethyl 4-phenylpiperidine-4-carboxylate ethyl 1-(2-hydroxyethyl)-4-phenylpiperidine-4-carboxylate
CH3
H2C
N
O
O
CH2
CH2
Cl
H3C C
H +
N
CH2 N
O
C CH2
O
CH2
H3C
C
ethylene oxide
48. Synthesis of Sulphasalazine
O
OH
OH
H2N
Cl
N O
OH
OH
N
+
H
S
O
N N
O
H2N
H
N
N
O
S
N
N
HO
O
HO
O
5-amino-2-hydroxybenzoic acid
NaNO2/HCl
5-[(Z)-chlorodiazenyl]-2-hydroxybenzoic acid
4-amino-N-(pyridin-2-yl)benzenesulfonamide
2-hydroxy-5-{(E)-[4-(pyridin-2-ylsulfamoyl)phenyl]diazenyl}benzoic acid
49. Metabolism of Sulphasalazine
Sulphasalazine
[H]
Gut
H2N
O
OH
OH
5- Amino salicylic acid
+
H
O
S
N
O N
N-(pyridin-2-yl)benzenesulfonamide
Prodrug, having low solubility and poorly absorbed from
ileum.
The azo bond split by colon bacteria into Sulfapyridine and
5-amino salicylic acid.
Blocks cyclooxgenase and lipooxygenase pathway and
reduce mucosal secretion.
51. CONSTIPATION
Constipation is the infrequent and/or unsatisfactory
defecation fewer than 3 times per week.
Abnormally infrequent and difficult passage of faeces through
the lower GI tract
Symptom, not a disease
Disorder of movement through the colon and/or rectum
52. CAUSES OF CONSTIPATION
Diet
Lack of exercise
Irregular bowel habits
Drug induced
Disease States/Conditions
Spasm of colon
Dysfunction of myenteric plexus
53. SYMPTOMS OF CONSTIPATION
Infrequent defecation
Nausea
Vomiting
Anorexia
Feeling full quickly
Stools that are small, hard, and/or difficult
to evacuate
Rectal bleeding
Weight loss (in chronic constipation)
54. • Mild action,
elimination of soft
stools but formed
stools.
Laxative or
aperients
• Stronger action
resulting in more
fluid evacuation.
Purgative or
cathartic
LAXATIVES
Drugs that promote evacuation of bowels.
Based on intensity of action
57. 4. Osmotic purgative
Magnesium salts, lactulose
etc
Bulk Forming Laxatives
Improve stool consistency and frequency with regular use
Ensure good fluid intake to prevent faecal impaction
Onset of action 2-3 days
Side Effects may include bloating, flatulence, distension
58. Stool Softeners
May be useful with anal fissures of haemorrhoids
Liquid paraffin is not recommended for treatment of
constipation
- risk of aspiration and lipoid pneumonia
- long term use may result in depletion of Vitamins
A, D, E and K
59. Stimulant Laxatives
Increase intestinal motility by stimulating colonic nerves
Useful with opioids
Onset of action 8-12 hours
May develop tolerance
2nd line therapy in elderly due to risk of electrolyte
disturbances
Cramping, diarrhoea, dehydration
60. Osmotic Laxatives
Increase fecal water content
Result: bowel distention, increased peristalsis, and
evacuation
Improving stool frequency
Onset of action – up to 48 hours
Metabolized by bacteria flatulence
61. O
O
N
H O 3 C O
CH3
Bisacodyl
Synthesis of Bisacodyl
N O
CH + 2C6H5OH
H2SO4
(CH3CO)2O
N
O
O
O
C
CH3
CH3
C
O
pyridine-2-carbaldehyde
(pyridin-2-ylmethanediyl)dibenzene-3,1-diyl diacetate
62. O
O
OH
OH
Phenolphthalein
O
O
O
+
OH
OH
H2SO4
O
O
OH
OH
phathalic anhydride
phenol
3,3-bis(4-hydroxyphenyl)-2-benzofuran-1(3H)-one
phenolphthalein
Synthesis of phenolphthalein
63. N
-
-
Na S S
Na
O O
O
O
O
O O
O
sodium picosulphate
-{(pyridin-2-ylmethanediyl)dibenzene-4,1-diyl bis[hydrogenato(2-)-O sulfate]}disodate(2-)
64. OH
NH
N NH
NH
Tegaserod CH3
3-[(E)-{2-[(pentylamino)methyl]hydrazinylidene}methyl]-1H-indol-5-ol
It is 5HT4 agonist used for the management of
irritable bowel syndrome and constipation
65. *Contract stomach muscles and stimulate hunger
N
N
3-phenyl-3,4-dihydroquinazoline( Orexin)
Bitters – secretion of gastric juice
Eg: Quassins
66. *
*Disturbance of appestat – weight regulating
mechanism in hypothalamus
Eg: Dextro amphetamine
NH2
CH3
NH2
CH3
H3C
Aptrol
67. *
*HCl
*Pepsin
O
O
CH3
CH3
O
O
OH
CH3
Florantyrone
Si O
CH3
O
CH3
CH3
Si CH3
CH3
CH3
Si
CH3
H3C
n
Simethicone
68. *
*Protect sensitive surface from irritation
*Lozenges or gargles
*Cohesive substances like colloids, dextrins, sugar,
starches
*Eg: Acacia
Tragacanth
Liquorice
76. REFERENCE
1.Text Book of Medicinal Chemistry by V. Alagarsamy,
1st edition volume-II, page no:1137
2.Bently and Driver’s Text book of Pharmaceutical Chemistry
8th edition, page No. 724, 625.
3.Essentials of Medicinal Pharmacology by K D TRIPATHI,
6th edition page No. 651
4.Clinical Pharmacy and Therapeutics, by Roger Walker,
Cate Whitelsia, 4th edition, Page No: 824- 832
5. Foye’s principles of Medicinal Chemistry, 5th edition,
page No: 474-475