This document summarizes different types of anti-epileptic drugs. It defines epilepsy as a group of convulsive disorders caused by disturbed nerve cell activity in the brain, causing seizures characterized by loss of consciousness and body movements. It describes several first-line drugs including phenytoin, phenobarbital, primidone, carbamazepine, ethosuximide, sodium valproate, and benzodiazepines. It provides details on their mechanisms of action, dosages, effectiveness for different seizure types, and common adverse effects. The document also discusses newer antileptic drugs including lamotrigine, gabapentin, vigabatrin, and their uses, mechanisms, and side effects
complete explanation with amicable pictures regarding CNS stimulants and cognitive enhancers.useful for both UG and PG students.references from different books and authors
complete explanation with amicable pictures regarding CNS stimulants and cognitive enhancers.useful for both UG and PG students.references from different books and authors
TCAs increase neurotransmitter levels by preventing nerve endings — called synapses — from drawing these chemicals back into their tissues, which is normally how the body reduces their concentrations. They increase levels of norepinephrine and serotonin, two neurotransmitters, and block the action of acetylcholine, another neurotransmitter, this helps nerve signalling in the brain, which can help relieve depression. Tricyclic antidepressants are most effective for people with severe depression compared with those with mild to moderate depression, but they are also given as alternatives to SSRIs (selective serotonin re-uptake inhibitors) and are sometimes used in panic disorder, obsessive compulsive disorder and the treatment of chronic pain.
Sedatives and Hypnotics
Pharmacology
Clinical uses
Sedation
Coping with stress and anxiety
Smoothing effects of stimulants
Potentiation of narcotics
Treatment of serious mental disorders
Pleasurable sensations, including intoxication
Classifications
Benzodiazepines
Diazepam, Clonazepam, Oxazepam, Clobazam, Clordiazepoxide, Midazolam
Barbiturates
Phenobarbitone, Amobarbital, Thiopental-Na
Newer drugs
Zolpidem, Zaleplon, Buspirone
Chloral hydrate
Paraldehyde
Diphenhydramine
Benzodiazepines
Properties
High therapeutic index (high LD50)
Relatively safe in overdose
Develop tolerance slowly
Less addiction liability
Benzodiazepines
Benzodiazepines
Most commonly prescribed Benzodiazepines
All Benzodiazepines are classified as Controlled Drugs in some countries.
Most are CD Schedule 4
Diazepam (Valium,Anxicalm)
Alprazolam (Xanax)
Bromazepam (Lexotan)
Clobazam (Frisium)
Lormetazepam (Noctamid)
Nitrazepam (Mogadon)
Clonazepam
Two are CD Schedule 3
Flurazepam (Rohypnol)
Temazepam (Nortem)
Structure Activity Relationship
In ring A an electron – withdrawing group such as Cl, Br, NO2 or CN at position 7.
A methyl Group is attached to the nitrogen atom in position 1 in ring B. However, substituents at position 1 that are metabolically are still clinically useful e.g. Flurazepam.
Replacement of the carbonyl function with two hydrogens in position 2 gives medazepam, less potent than diazepam.
Replacement of one of the hydrogen with a OH group on position 3 lower the activity on the one hand and aids elimination on the other.
Introduction of a carbonyl function in the 3 position increases the duration of action and also favours formation of water soluble salts.
e) α-pyridyl derivative and cycloalkyl substituent at 5 position give potent compounds.
f) Electronegative substituents such as Cl or F at the ortho and disubstituted in both ortho positions in ring C.
g) Derivatives with additional rings joining the diazepine nucleus at the 1 and 2 positions are generally more active than the corresponding 1-methylbenzodiazepines.
h) Replacement of the benzene ring by heteroaromatic (e.g. pyrazole) resulted in compounds with interesting anxiolytic properties ( e.g. ripazepam).
i) Saturation of the 4,5- double bond reduces potency, as does a shift of the unsaturation into the 3,4-position.
Barbiturates
Barbiturates
Barbiturates
Barbiturate poisoning
Treatment of Barbiturate poisoning
Buspirone
TCAs increase neurotransmitter levels by preventing nerve endings — called synapses — from drawing these chemicals back into their tissues, which is normally how the body reduces their concentrations. They increase levels of norepinephrine and serotonin, two neurotransmitters, and block the action of acetylcholine, another neurotransmitter, this helps nerve signalling in the brain, which can help relieve depression. Tricyclic antidepressants are most effective for people with severe depression compared with those with mild to moderate depression, but they are also given as alternatives to SSRIs (selective serotonin re-uptake inhibitors) and are sometimes used in panic disorder, obsessive compulsive disorder and the treatment of chronic pain.
Sedatives and Hypnotics
Pharmacology
Clinical uses
Sedation
Coping with stress and anxiety
Smoothing effects of stimulants
Potentiation of narcotics
Treatment of serious mental disorders
Pleasurable sensations, including intoxication
Classifications
Benzodiazepines
Diazepam, Clonazepam, Oxazepam, Clobazam, Clordiazepoxide, Midazolam
Barbiturates
Phenobarbitone, Amobarbital, Thiopental-Na
Newer drugs
Zolpidem, Zaleplon, Buspirone
Chloral hydrate
Paraldehyde
Diphenhydramine
Benzodiazepines
Properties
High therapeutic index (high LD50)
Relatively safe in overdose
Develop tolerance slowly
Less addiction liability
Benzodiazepines
Benzodiazepines
Most commonly prescribed Benzodiazepines
All Benzodiazepines are classified as Controlled Drugs in some countries.
Most are CD Schedule 4
Diazepam (Valium,Anxicalm)
Alprazolam (Xanax)
Bromazepam (Lexotan)
Clobazam (Frisium)
Lormetazepam (Noctamid)
Nitrazepam (Mogadon)
Clonazepam
Two are CD Schedule 3
Flurazepam (Rohypnol)
Temazepam (Nortem)
Structure Activity Relationship
In ring A an electron – withdrawing group such as Cl, Br, NO2 or CN at position 7.
A methyl Group is attached to the nitrogen atom in position 1 in ring B. However, substituents at position 1 that are metabolically are still clinically useful e.g. Flurazepam.
Replacement of the carbonyl function with two hydrogens in position 2 gives medazepam, less potent than diazepam.
Replacement of one of the hydrogen with a OH group on position 3 lower the activity on the one hand and aids elimination on the other.
Introduction of a carbonyl function in the 3 position increases the duration of action and also favours formation of water soluble salts.
e) α-pyridyl derivative and cycloalkyl substituent at 5 position give potent compounds.
f) Electronegative substituents such as Cl or F at the ortho and disubstituted in both ortho positions in ring C.
g) Derivatives with additional rings joining the diazepine nucleus at the 1 and 2 positions are generally more active than the corresponding 1-methylbenzodiazepines.
h) Replacement of the benzene ring by heteroaromatic (e.g. pyrazole) resulted in compounds with interesting anxiolytic properties ( e.g. ripazepam).
i) Saturation of the 4,5- double bond reduces potency, as does a shift of the unsaturation into the 3,4-position.
Barbiturates
Barbiturates
Barbiturates
Barbiturate poisoning
Treatment of Barbiturate poisoning
Buspirone
Anti Parkinson Disease | PDF | Pharmacology | Assignment MrHotmaster1
An anti-parkinson is a type of drug which is intended to treat and relieve the symptoms of parkinson’s disease.
Most of these agents act by either increasing dopamine activity or reducing acetylcholine activity in the central nervous system.
In clinical practice, anti-cholinergic drugs, amantadine, and the anti-histamines have their primary use of treatment for medication induced parkinsonism, acute dystonia, and medication induced tremor.
This interesting ppt deals with the Pharmacology of Antiepileptic drugs and the treatment of different types of seizures with beautiful illustrations....
This presentation consisits about antimanic agents, its mode of action, indication, contraindication, side-effects and nursing management. It also has details of Carbamazepine and Valporate.
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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.
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
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
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.
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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
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.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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.
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.
2. Epilepsy is collective term applied for
group of convulsive disorder.
It is disorder in which the nerve cell
activity in the brain is disturbed ,
causing seizures
3. 1. Loss or disturbance of consiousness
2. Characterised body movements
3. Autonomic hyperactivity
5. PHENYTOIN is imp derivative
It acts by
normalizing seizures
reducing sodium conc in brain cell which leads to
decrease in post tetanus potentiation
Absorbtion :well on oral
Onset of action slow , duration of action long
Metabolism through enterohepatic circulation
Excretion :urine within 48hours
6. CNS: giddiness,tremors,headache,insomnia, drowsiness
GIT: nausea ,vomiting, anorexia
RASHES: urticaria(hives), scarlantiform, measles like rashes
GUMS: swelling, bleeding and gingivitis
FOETAL HYDANTOIN SYNDROME: cleft palate , hair lip
and microcephaly in the foetus
OTHERS : hepatitis, jaundice, megaloblastic anemia ,
lymphadenopathy
7.
8.
9.
10.
11. Dose : 100mg TID by oral and gradually
increase to 500mg
Use
grand mal, psychomotor epilepsy and
cardiac arrhythmias
12.
13. PHENOBARBITONE
Use
grand mal, focal cortical and psychomotor epilepsy
not use in petitmal epilepsy
Sudden withdrawal increases the frequency of
convulsions..gradually substituted by phenytoin
DOSE : 60-80mg divided doses
ADR: drowsiness, depression , lethargy
14. Tricyclic compound
Structural similar imipramine(anti depressant drug)
More effective in temporal epilepsy and grand mal
epilepsy
Remarkably effective in trigeminal neuralgia and
glossopharyngeal neuralgia
Absorbtion : slow
Bioavailibility : 90%
Dose :100mg BD tablet ..gradually increase upto
600-1200mg per day for temporal epilepsy
18. Ethosuximide
Use: petitmal epilepsy
Orally effective
ADR :anorexia, nausea , vomiting , drowziness
Dose: initial 250mg per day gradually increase by
250mg each week to 750-1000mg
19. Highly effective in petitmal
Ineffective in focal cortical and temporal epilepsy
Mechanism
inhibition of gamma aminobutyrate transaminase
potentiation of post synaptic GABA activity
Absorbtion: complete after oral
Metabolised : liver 90%
ADR: nausea , vomit, hepatic damage, sedation, ataxia,
spina bifida
Dose ;600mg to 1600mg per day orally
20.
21. It is benzodiazepine compound
Effective in petitmal and myoclonic seizures
It acts by increasing effect of GABA in CNS
Treating grandmal –can be used with
phenytoin or phenobarbitone.
ADR: drowsiness, ataxia, personality changes,
tremor, vertigo ,confusion
22. Emergency drug for status epilepticus and
tetanus
Used i.v
LAMOTRIGINE
It is phenyltriazine compound
It acts by blocking Na+ and preventing
release of glutamate
Used in add on drug in resistant patient
ADR : sleepiness, dizziness, diplopia, ataxia
and vomit
23. It is an GABA agonist
Highly lipid soluble
Does not act on GABA receptors but acts on releasing GABA
Well absorb orally
Excret unchanged in urine
Adr : mid sedation, tiredness , dizziness
Use: partial seizure resistant to other drugs
24. It is GABA transaminase inhibitor which acts
by increasing synaptic GABA concentration
Well absorb orally , excrete unchanged in
urine
Use : refractory epilepsy
Adr : weight gain, drowsiness , depression ,
diplopia
