Presentation for Medical undergraduates for teaching pharmacology. It deals with Physiology of steroid hormones and their action along with agents which are used therapeutically with their action, adverse effects and therapeutic uses.
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
Presentation for Medical undergraduates for teaching pharmacology. It deals with Physiology of steroid hormones and their action along with agents which are used therapeutically with their action, adverse effects and therapeutic uses.
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
Summary of thyroid and antithyroid drugs
-Introduction
-Synthesis
-Pharmacological Action
-Mechanism of action
-Drugs in Hypothyroidism
-Thyroid Inhibitors
-Drugs in Hyperthyroidism
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Seretonin (5HT) and Its Antagonists PharmacologyPranatiChavan
Serotonin is a chemical that has a wide variety of functions in the human body. It is sometimes called the happy chemical, because it contributes to wellbeing and happiness.
The scientific name for serotonin is 5-hydroxytryptamine, or 5-HT. It is mainly found in the brain, bowels, and blood platelets.
Serotonin is used to transmit messages between nerve cells, it is thought to be active in constricting smooth muscles, and it contributes to wellbeing and happiness, among other things. As the precursor for melatonin, it helps regulate the body’s sleep-wake cycles and the internal clock.
It is thought to play a role in appetite, the emotions, and motor, cognitive, and autonomic functions. However, it is not known exactly if serotonin affects these directly, or if it has an overall role in co-ordinating the nervous system.
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
an overall overview in corticosteroids and its application in oral and maxillofacial diagnostic medicine and pathology drawing to the conclusions of the limitations and drawbacks of these medicines. i have also included the precautions to be taken in dental therapeutic procedures fo
The current presentation include the pharmacotherapy for rheumatoid arthritis. The definition, classification, mechanism of action of drugs, pharmacokinetics, adverse effects, contraindications and uses.
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
Summary of thyroid and antithyroid drugs
-Introduction
-Synthesis
-Pharmacological Action
-Mechanism of action
-Drugs in Hypothyroidism
-Thyroid Inhibitors
-Drugs in Hyperthyroidism
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Seretonin (5HT) and Its Antagonists PharmacologyPranatiChavan
Serotonin is a chemical that has a wide variety of functions in the human body. It is sometimes called the happy chemical, because it contributes to wellbeing and happiness.
The scientific name for serotonin is 5-hydroxytryptamine, or 5-HT. It is mainly found in the brain, bowels, and blood platelets.
Serotonin is used to transmit messages between nerve cells, it is thought to be active in constricting smooth muscles, and it contributes to wellbeing and happiness, among other things. As the precursor for melatonin, it helps regulate the body’s sleep-wake cycles and the internal clock.
It is thought to play a role in appetite, the emotions, and motor, cognitive, and autonomic functions. However, it is not known exactly if serotonin affects these directly, or if it has an overall role in co-ordinating the nervous system.
This ppt discusses pharmacological actions, toxic effects and clinical applications of corticosteroids. It also mentions precations to be taken while using steroids
an overall overview in corticosteroids and its application in oral and maxillofacial diagnostic medicine and pathology drawing to the conclusions of the limitations and drawbacks of these medicines. i have also included the precautions to be taken in dental therapeutic procedures fo
The current presentation include the pharmacotherapy for rheumatoid arthritis. The definition, classification, mechanism of action of drugs, pharmacokinetics, adverse effects, contraindications and uses.
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
The ppt is made for undergraduate students to have a basic understanding on Corticosteroids and its role in all feilds of medicine. This is also useful to Postgraduate students
Corticosteroids in Dentistry| Application and Adverse Effect of CorticosteroidDr. Rajat Sachdeva
Corticosteroids are very similar to Steroid hormones produced naturally in Adrenal Cortex of humans.
Protein, Carbohydrates and Fat metabolism, maintenance of fluid electrolytes and adapting the body to stress.
Corticosteroids are antinflammatory, analgesics, effective on ulceration promotes the healing of nerve injuries.
Oral Sub-mucus Fibrosis, Central Giant Cell Granuloma, Lichen Planus (for 5 min, 0.5% application of Clobetasol Propionates with Nystatin) in a Gingival Tray.
Bullous and Mucous Pemphigoid, Melkerson Rosenthal syndrome, Bell's Palsy, Post-Herpetic neuralgia.
General Pharmacology Lecture Slides on Essential Drugs and Rational use of Medicines by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Dental Pharmacology Lecture Slides on Sialogogues and Antisialogogues by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Pharmacology Lecture Slides on Autonomic Nervous System Introduction by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
2. Corticosteroids
• Corticosteroids are a class of steroidal
hormones released by the adrenal cortex,
which includes
– Glucocorticoids, &
– Mineralocorticoids.
• However, the term “corticosteroids” is
generally used to refer to glucocorticoids.
3. Glucocorticoids
• Glucocorticoids are primary stress hormones that regulate a
variety of physiologic processes and are essential for life.
• The actions of glucocorticoids are predominantly mediated
through glucocorticoid receptor (GR).
• A diverse collection of receptor isoforms have been identified.
• Glucocorticoids regulate diverse cellular functions:
– development,
– homeostasis,
– metabolism,
– cognition and
– Inflammation.
4. Glucocorticoids
• Glucocorticoids (cortisol in man and corticosterone in rodents)
are steroid hormones synthesized and released by the adrenal
glands in a circadian manner, in response to physiological cues
and stress.
* Cortisol when used as medication is k/a Hydrocortisone.
• Due to its lipophilic nature, glucocorticoids cannot be pre-
synthesized and stored in adrenal glands, but have to be rapidly
synthesized (using a number of enzymatic reactions) upon ACTH
stimulation.
• Biologically active glucocorticoids are synthesized from cholesterol
through a multienzyme process termed steroidogenesis.
5. Steroids
• Steroid: A group of compound, having a
common structure based on the steroid
nucleus.
• For examples:
– Sex hormones [androgen and estrogens],
– Hormones of the adrenal cortex [cortisone].
6. Corticosteroids
• ACTH is secreted by anterior pituitary under the
influence of CRH on hypothalamus
• The adrenal cortex secretes several hormones:
• Zona glomerulosa -Mineralocorticoids - Aldosterone
• Zona fasciculata -Glucocorticoids - Cortisol
• Zona reticularis -Androgens
8. -Steroids-
Normal rates of secretion of
two principal corticoids in
man:
Cortisol
10-20 mg daily
(almost half in few morning
hours)
Aldosterone
0.125mg/day
• Corticosteroids
• Hydrocortisone
• Prednisolone
• Dexamethasone
• Beclomethasone
• Budesonide
• Fluticasone
9. Basal secretions
Group Hormone Daily
secretions
Glucocorticoids • Cortisol
• Corticosterone
5 – 30 mg
2 – 5 mg
Mineralocorticoid
s
• Aldosterone
• 11- Deoxycorticosterone
5 – 150 mcg
Trace
Sex Hormones
•Androgen
•Progestogen
•Oestrogen
• DHEA
• Progesterone
• Oestradiol
15 – 30 mg
0.4 – 0.8 mg
Trace
From Essential of Pharmacotherapeutics, ed. FSK Barar. P
.351
11. Steroids-MOA
• Corticosteroids penetrate cells and bind to a high affinity cytoplasmic
receptor protein (large multi-protein complex ).
• On binding ligand GR undergoes a conformational change, resulting in
the dissociation of the multi-protein complex.
• The ligand bound GR is rapidly translocated into the nucleus through
nuclear pores.
• Then there is binding to glucocorticoid response elements (GRE)
on the chromatin.
• Transcription of specific m-RNA & Regulation of protein synthesis
• Onset of action takes at least 30-60 min: effects persist much longer
than the steroid itself.
• In many tissues, the overall effect is catabolic, i.e. inhibition of
protein synthesis. This may be a consequence of steroid directed
synthesis of an inhibitory protein.
13. Pharmacological Actions
• The corticoids have widespread actions.
• They maintain fluid-electrolyte, cardiovascular
and energy substrate homeostasis and
functional status of skeletal muscles and nervous
system.
• They prepare the body to withstand effects of all
kinds of noxious stimuli and stress.
15. Carbohydrate, protein & lipid metabolism
• Wasting of muscles
• Increased Gluconeogenesis
• Decreased Peripheral utilization of glucose
• Increased Glycogen deposition in liver
• Redistribution of Fat
• Buffalo hump
• Moon face
• Promote adipokinetic agents activity
(glucagon, growth hormone, adrenaline, thyroxine)
Negative nitrogen balance & hyper-
glycemia
16. Electrolyte and water balance
• Aldosterone is more important
• Act on D.T. & C.D. of kidney
– Increased Na+
re-absorption
– Increased Urinary excretion of K+
and H+
• Addison’s disease (Decreased Aldosterone Levels)
– Na+
loss
– Shrinkage of ECF
– Cellular hydration
– Hypodynamic state of CVS
– Circulatory collapse,
– Renal failure, death
18. • Decreased Recruitment of WBC & monocyte-
macrophage into affected area & increase of
chemotactic substances
• Decreased TNF from phagocytic cells
• Decreased IL1 from monocyte-macrophage
• Decreased Formation of Plasminogen Activator
• Decreased Action of MIF (Migration Inhibiting factor) &
decreased fibroblastic activity
• Decreased Expression of cyclooxygenase II
Actions: Anti-inflammatory
19. Immunosuppressive & anti-allergic actions
• Suppresses all types of hypersensitivity &
allergic phenomenon
• At High dose: Interfere with all steps of
immunological response
• Causes greater suppression of CMI (graft
rejection & delayed hypersensitivity)
• Transplant rejection: Decreased antigen expression
from grafted tissues, delay revascularization,
decreased sensitization of T lymphocytes etc.
20. • Inhibit cell division or synthesis of DNA
• Delay the process of healing
• Retard the growth of children
• Cause peptic ulcerations on prolonged exposure
Actions: Growth & Cell divi-
sion
21. Pharmacological Actions
• For most clinical purposes, synthetic
glucocorticoids are used because they have a
higher affinity for the receptor, are less
activated and have little or no salt-retaining
properties.
• Hydrocortisone orally for replacement
therapy, i.v. for shock and asthma, topically for
eczema (ointment) and enemas (ulcerative
colitis).
• Prednisolone the most widely used drug given
orally in inflammation and allergic diseases.
22. Pharmacological Actions
• Betamethasone and dexamethasone: very
potent, w/o salt-retaining properties; thus,
very useful for high-dose therapies (e.g.,
cerebral edemas).
• Beclometasone diproprionate, budesonide:
pass membranes poorly; more active when
applied topically (severe eczema for local anti-
inflammatory effects) than orally; used in
asthma, (aerosol).
• Triamcinolone: used for severe asthma and for
local joint inflammation (intra-articular inj.).
23. Uses
• Corticosteroids are used:
· To reduce inflammation (asthma, arthritis) and swelling
(cerebral oedema)
· To suppress the immune response SLE (systemic lupus
erythematosus)
· To reduce nausea and vomiting (as in cancer chemo-
therapy)
· To reduce terminal pain (associated with cancer)
· As replacement therapy (in Addison’s disease)
26. Avoiding unwanted effects
of corticosteroids
• Modification of dose/dose regimen
· Use short courses/low doses if possible
· Use steroid sparing drugs
· Withdraw chronic’ steroids slowly
· Give dose once daily and in morning
· Give on alternate days if possible
· Give prophylactics if possible
· Give product locally
· Remember contraindications
27. Giving products locally can
still cause problems!
• systemic dosing can occur
• local toxicity can develop -
–skin: infection, thinning, bruising.
–eye: viral infection, cataract, glaucoma.
–inhalation: fungal infection, hoarseness
–joints: infection, necrosis
28. Tapering of Corticosteroid Therapy
It is extremely important that these drugs not be
omitted or discontinued suddenly, the dose is slowly
reduced to a minimal dose and then it is stopped.