Drugs used in git system (GIT - Laxatives /purgatives , drugs used to treat p...Vinitkumar MJ
CLASS FOR OPHTHALMIC ASSISTANT STUDENTS ( O.A. STUDENTS 2nd year .
educational purpose
short description regarding GIT SYSTEM & drugs used to treat diarrhoea , peptic ulcer diseases , irritable bowel syndrome , IBS, antimotility drugs & laxatives /purgatives etc..
Drugs used in git system (GIT - Laxatives /purgatives , drugs used to treat p...Vinitkumar MJ
CLASS FOR OPHTHALMIC ASSISTANT STUDENTS ( O.A. STUDENTS 2nd year .
educational purpose
short description regarding GIT SYSTEM & drugs used to treat diarrhoea , peptic ulcer diseases , irritable bowel syndrome , IBS, antimotility drugs & laxatives /purgatives etc..
Peptic Ulcer Disease Affects All Age Groups. Can occur in children, although rare. Duodenal ulcers tends to occur first at around the age 25 and continue until the age of 75. Gastric ulcers peak in people between the ages of 55 and 65. Men Have Twice The Risk as Women Do
Acidity is said to have occurred when a person suffers from heartburn, and also when formation of gas takes place in the stomach. It is a common problem which many suffer from, and occurs mainly due to excess secretion of hydrochloric acid in the stomach. To know more about Acidity visit here: www.lazoi.com
Top homeopathic medicines for IndigestionHomeo Mart
we present the top 5 homeopathic medicines for Indigestion, Acidity, Gas in Single remedies and Specialties
Buy Top Homeopathic medicines for Indigestion online - http://bit.ly/hmmrt_acidity
Top 5 Single Remedies in Homeopathy for Indigestion
# 1 Carbo Vegetabilis
For Indigestion with Marked Upper Abdominal Discomfort
Abdominal discomfort, pain, and burning tend to worsen from eating. Belching that is empty, of gas, bitter, sour. Nausea and aversion to food
#2 Cinchona Officinalis (China)
For Indigestion with Gas and Highly Distended Abdomen
indigestion with gas and highly distended abdomen. Motion brings relief in the abdominal bloating. suitable in cases where consumption of excessive tea, fruits, and milk causes Indigestion
#3 Lycopodium Clavatum
For Indigestion with Abdominal Fullness After Eating. SYmptoms: formation of gas with bloating of the abdomen immediately after Vomiting of food, bile or sour substances may be present Rubbing the abdomen may relieve the pain
#4 Ipecac
For Indigestion and Nausea, indigestion attended with marked
Vomiting of watery fluid, white mucus or ingesta. Symptoms: excessive accumulation of saliva along with empty belching.
Distress or cutting pain in the stomach
#5 Iris Versicolor
For Indigestion with Burning in Stomach, burning may extend to the food pipe and the throat. Vomiting may be sour or of food.
Top medicine for migraine/headache with gastric issues, indigestion, acidity, nausea, sour vomiting.
Peptic Ulcer Disease Affects All Age Groups. Can occur in children, although rare. Duodenal ulcers tends to occur first at around the age 25 and continue until the age of 75. Gastric ulcers peak in people between the ages of 55 and 65. Men Have Twice The Risk as Women Do
Acidity is said to have occurred when a person suffers from heartburn, and also when formation of gas takes place in the stomach. It is a common problem which many suffer from, and occurs mainly due to excess secretion of hydrochloric acid in the stomach. To know more about Acidity visit here: www.lazoi.com
Top homeopathic medicines for IndigestionHomeo Mart
we present the top 5 homeopathic medicines for Indigestion, Acidity, Gas in Single remedies and Specialties
Buy Top Homeopathic medicines for Indigestion online - http://bit.ly/hmmrt_acidity
Top 5 Single Remedies in Homeopathy for Indigestion
# 1 Carbo Vegetabilis
For Indigestion with Marked Upper Abdominal Discomfort
Abdominal discomfort, pain, and burning tend to worsen from eating. Belching that is empty, of gas, bitter, sour. Nausea and aversion to food
#2 Cinchona Officinalis (China)
For Indigestion with Gas and Highly Distended Abdomen
indigestion with gas and highly distended abdomen. Motion brings relief in the abdominal bloating. suitable in cases where consumption of excessive tea, fruits, and milk causes Indigestion
#3 Lycopodium Clavatum
For Indigestion with Abdominal Fullness After Eating. SYmptoms: formation of gas with bloating of the abdomen immediately after Vomiting of food, bile or sour substances may be present Rubbing the abdomen may relieve the pain
#4 Ipecac
For Indigestion and Nausea, indigestion attended with marked
Vomiting of watery fluid, white mucus or ingesta. Symptoms: excessive accumulation of saliva along with empty belching.
Distress or cutting pain in the stomach
#5 Iris Versicolor
For Indigestion with Burning in Stomach, burning may extend to the food pipe and the throat. Vomiting may be sour or of food.
Top medicine for migraine/headache with gastric issues, indigestion, acidity, nausea, sour vomiting.
Stomach pain is typical for those suffering from an insufficiency stomach. It is possible to take regular painkillers to lessen the discomfort. If someone experiences an unexpected stomach ache, they must consult a physician to determine the cause and prescribe medication.
Nausea and vomiting are the most common manifestations of gastrointestinal (GI) diseases. Although nausea and vomiting can occur independently, they are usually closely related and treated as one problem.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Abortion and other Causes of Early Pregnancy Bleeding.pdfChantal Settley
Describe common causes of bleeding in early pregnancy.
Describe the clinical classifications of abortion, the legal aspects of abortion in Ethiopia, and the safe methods used in health facilities.
Identify the warning signs and the emergency treatment required before referral for early pregnancy bleeding.
Describe the features of woman-friendly comprehensive post-abortion care, including the post-abortion family planning service
List the advantages of regionalised perinatal care.
Describe the functioning of a perinatal-care clinic.
Communicate better with patients and colleagues.
Safely transfer a patient to hospital.
Determine the maternal mortality rate.
Medical problems during pregnancy, labour and the puerperium.pdfChantal Settley
Diagnose and manage cystitis.
Reduce the incidence of acute pyelonephritis in pregnancy.
Diagnose and manage acute pyelonephritis in pregnancy.
Diagnose and manage anaemia during pregnancy.
Identify patients who may possibly have heart valve disease.
Manage a patient with heart valve disease during labour and the puerperium.
Manage a patient with diabetes mellitus.
Explain the wider meaning of family planning.
Give contraceptive counselling.
List the efficiency, contraindications and side effects of the various contraceptive methods.
List the important health benefits of contraception.
Advise a postpartum patient on the most appropriate method of contraception.
Define the puerperium.
List the physical changes which occur during the puerperium.
Manage the normal puerperium.
Assess a patient at the 6-week postnatal visit.
Diagnose and manage the various causes of puerperal pyrexia.
Recognise the puerperal psychiatric disorders.
Diagnose and manage secondary postpartum haemorrhage.
Teach the patient the concept of ‘the mother as a monitor’.
Uterine contractions continue, although less frequently than in the second stage.
The uterus contracts and becomes smaller and, as a result, the placenta separates.
The placenta is squeezed out of the upper uterine segment into the lower uterine segment and vagina. The placenta is then delivered.
The contraction of the uterine muscle compresses the uterine blood vessels and this prevents bleeding. Thereafter, clotting (coagulation) takes place in the uterine blood vessels due to the normal clotting mechanism.
Identify the onset of the second stage of labour.
Decide when the patient should start to bear down.
Communicate effectively with the patient during labour.
Use the maternal effort to the best advantage when the patient bears down.
Make careful observations during the second stage of labour.
Assess the fetal condition during the time the patient bears down.
Accurately evaluate progress in the second stage of labour.
Manage a patient with a prolonged second stage of labour.
Diagnose and manage impacted shoulders.
Monitoring the condition of the fetus during the first stage of labour.pdfChantal Settley
Monitor the condition of the fetus during labour.
Record the findings on the partogram.
Understand the significance of the findings.
Understand the causes and signs of fetal distress.
Interpret the significance of different fetal heart rate patterns and meconium-stained liquor.
Manage any abnormalities which are detected.
1.1 Define and use correctly all of the key terms
1.2 Describe the signs of true labour and distinguish between true and false labour
1.3 Explain to the mother how to recognise the onset of true labour
1.4 Describe the characteristic features and mechanisms of the four stages of labour
1.5 Describe the seven cardinal movements made by the baby as it descends the birth canal in a normal labour
10.2 Preterm labour and preterm rupture of the membranes.pdfChantal Settley
Define preterm labour and preterm rupture of the membranes.
Understand why these conditions are very important.
Understand the role of infection in causing preterm labour and preterm rupture of the membranes.
List which patients are at increased risk of these conditions.
Understand what preventive measures should be taken.
Diagnose preterm labour and preterm rupture of the membranes.
Manage these conditions.
Understand why an antepartum haemorrhage should always be regarded as serious.
Provide the initial management of a patient presenting with an antepartum haemorrhage.
Understand that it is sometimes necessary to deliver the fetus as soon as possible, in order to save the life of the mother or infant.
Diagnose the cause of the bleeding from the history and examination of the patient.
Correctly manage each of the causes of antepartum haemorrhage.
Diagnose the cause of a blood-stained vaginal discharge and administer appropriate treatment.
Define hypertension in pregnancy.
Give a simple classification of the hypertensive disorders of pregnancy.
Diagnose pre-eclampsia and chronic hypertension.
Explain why the hypertensive disorders of pregnancy must always be regarded as serious.
List which patients are at risk of developing pre-eclampsia.
List the complications of pre-eclampsia.
Differentiate pre-eclampsia from pre-eclampsia with severe features.
Give a practical guide to the management of pre-eclampsia.
Provide emergency management for eclampsia.
Manage gestational hypertension and chronic hypertension during pregnancy.
7.2 New Microsoft PowerPoint Presentation (2).pdfChantal Settley
Welcome the woman and ask her to sit near you and facing you.
Smile and make good eye contact with her.
Reassure her that you will always maintain her privacy and confidentiality
Without her permission, do not include a third person in the meeting.
Use simple non-medical language and terminologies throughout that she can understand, and check frequently that she has really understood.
Actively listen to her, using gestures and verbal communication to show her that you are paying attention to what she says.
Encourage her to ask questions, express her needs and concerns, and seek clarification of any information that she does not understand.
6.4 Assessment of fetal growth and condition during pregnancy.pdfChantal Settley
When you have completed this unit you should be able to:
• Assess normal fetal growth.
• List the causes of intra-uterine growth restriction.
• Understand the importance of measuring the symphysis-fundus height.
• Understand the clinical significance of fetal movements.
• Use a fetal-movement chart.
• Manage a patient with decreased fetal movements.
• Understand the value of antenatal fetal heart rate monitoring.
What possible complications to look for:
Antepartum haemorrhage
Pre-eclampsia
proteinuria and a rise in the blood pressure.
Cervical changes
Symphysis-fundus height measurement
below the 10th centile?
above the 90th centile?
To review and act on the results of the screening or special investigations done at the booking visit.
2. To perform the second assessment for risk factors.
If possible, all the results of the screening tests should be obtained at the first visit.
Assess normal fetal growth.
List the causes of intra-uterine growth restriction.
Understand the importance of measuring the symphysis-fundus height.
Understand the clinical significance of fetal movements.
Use a fetal-movement chart.
Manage a patient with decreased fetal movements.
Understand the value of antenatal fetal heart rate monitoring.
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
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
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
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.
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
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.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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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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.
2. Drugs and the
gastrointestinal system
• Drugs can be used to influence the GIT
to:
– Increase gastric emptying & gastric motility
– Balance the ratio of acid-to-mucus secretion
in the stomach and neutralising gastric acid
– Relieving diarrhoea & intestinal colic
– Relieving constipation
Compiled by C Settley
3. Dyspepsia, pg 152
• Dyspepsia : heartburn
• Heartburn, also called acid indigestion, is
a symptom of gastro esophageal reflux
(GERD). It can occur when acid or other
contents from your stomach "back up" into
the esophagus. That's the tube food
passes through going from your mouth to
your stomach.
Compiled by C Settley
5. Dyspepsia, pg 152
• Dyspepsia : heartburn
– Simple antacids neutralise stomach acid &
relieve pain
– E.g. Magnesium containing antacids (causes
diarrhoea) and aluminium containing antacids
(causes constipation).
– Combination of these is indicated
– NB drug interactions
Compiled by C Settley
6. Dyspepsia, pg 152
• Calcium carbonate and sodium
bicarbonate may be used as simple
antacids.
• However care should be taken as
Calcium carbonate may interfere with
normal acid base balance while sodium
bicarbonate should be used with caution in
patients who require a restricted sodium
intake (eg ?)
Compiled by C Settley
7. Peptic ulcer, pg 153
• Peptic ulcers are sores that develop in the
lining of the stomach, lower esophagus, or
small intestine (the duodenum), usually as
a result of inflammation caused by the
bacteria H. pylori, as well as from erosion
from stomach acids.
Compiled by C Settley
9. Peptic ulcer
• Aim of treatment is to lower gastric acidity
to allow ulcer to heal.
• Simple antacids may be used.
• Antibiotics for ulcers? Recurrent ulcers
may be due to Helicobacter pylori
infection. Treated with a combination of
antibiotics.
Compiled by C Settley
10. Peptic ulcers: Causes
• Helicobacter pylori (H. pylori): a bacteria that can cause a
stomach infection and inflammation
• Frequent use of aspirin, ibuprofen, and other anti-inflammatory
drugs (risk associated with this behavior increases in women and
people over the age of 60)
• Smoking
• Drinking too much alcohol
• Radiation therapy
• Stomach cancer
Compiled by C Settley
11. Peptic ulcers: Symptoms
• The most common symptom of a peptic ulcer is burning abdominal
pain that extends from the navel to the chest, which can range from
mild to severe. In some cases, the pain may wake you up at night.
Small peptic ulcers may not produce any symptoms in the early
phases.
• Other common signs of a peptic ulcer include:
• changes in appetite
• nausea
• bloody or dark stools (melena)
• unexplained weight loss
• indigestion
• vomiting
• chest pain
Compiled by C Settley
12. Peptic ulcer: treatment-
Pro-kinetic drugs
• Used to treat and prevent nausea &
vomiting.
• Metoclopramide increases the rate of
gastric emptying and peristalsis.
Compiled by C Settley
13. Peptic ulcer: treatment-
Drugs that increase gastric pH
• Proton pump inhibitors
– Effect: prevents secretion of HCl (gastric acid)
– Increasing pH in stomach
– E.g. Omeprazole
Compiled by C Settley
14. Peptic ulcer: treatment-
Drugs that reduce gastric pH
• H2 receptor antagonists
– Blocks gastric H2 receptors
– Reduces gastric acid secretion
– Not as effective as proton pump inhibitors
– More possible drug interactions
– E.g. cimetidine
Compiled by C Settley
15. Peptic ulcer: treatment-
Cytoprotective drugs
• Protect sells of stomach lining against
corrosive effects of gastric acid
• By forming a protective layer
• Very good success rate in healing of
ulcers
• E.g. sucralfate
• Take one hour before meals
Compiled by C Settley
16. Treatment for diarrhoea
anti-motility agents
• First find cause of diarrhoea, not all
diarrhoea must be stopped
• E.g. loperamide
• Non-analgesic opioid
• Stimulate opioid receptors in enteric
nervous system
• To inhibit release of acetylcholine
• Decreases peristalsis
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17. • A COMBINATION OF THESE DRUGS
ARE PRESCRIBED IN THE TREATMENT
OF PEPTIC ULCERS!!!
Compiled by C Settley
18. Intestinal colic (cramps)
• E.g. Hyoscine butylbromide (Buscopan)
• Has an anti-spasmodic action
Compiled by C Settley
19. Relieving constipation
• Laxatives should only be used to:
• Treat acute episodes of constipation
• To clean out the bowel
• To assist in elimination of drugs (overdose
or poisoning) e.g. kexelate,
organophosphates
Compiled by C Settley
20. Bulk-forming laxatives
• Only bulk-forming agents for chronic use
• Indigestible substances
• Help to retain water in bowel
• Stimulates peristalsis
• Take with large glass of water
• E.g. bran
Compiled by C Settley
21. Osmotic laxatives
• Action:
– Increase osmotic pressure in bowel
– Water retained
• Mainly indicated for short term use or rapid
evacuation of bowel e.g. magnesium sulphate
• Lactulose can be used for longer periods
• Preparation for bowel surgery? Eg …
Compiled by C Settley
22. Irritants / contact laxatives
• Action:
• These agents stimulate / irritate the colon
directly
• Increases peristalsis
• E.g. bisacodyl, senna
• Not for chronic use, easily abused
Compiled by C Settley
23. Other
• Stool softeners: moisten the stool by
drawing water from the intestines
• Liquid paraffin: acts as intestinal lubricant
Compiled by C Settley
24. Drug action within the central
nervous system
• Opioid analgesics
• Action of OA’s:
– Suppress neurotransmission of pain sensations
– Main action in brain & spinal cord (opioid receptors)
• Analgesics of choice for severe pain (examples). Please go
through drug action, indication, side effects etc
• Morphine
• Pethidine
• Tramadol
Compiled by C Settley
25. Pethidine
• Has a rapid onset
• Its analgesic effects are limited to a few
hours in duration
• It has a toxic metabolite that accumulates
with repeated administration iow not suited
for the treatment of chronic pain
• Suited for post operative setting
• Obstetrics, ureter colic and biliary
obstruction
Compiled by C Settley
26. The difference between
Analgesics and NSAID’S
• An anti-inflammatory drug is one that
reduces inflammation or swelling.
• A pain killer, more properly called an
analgesic, is a drug that stops you from
feeling pain.
• Some drugs do both, such as ibuprofen.
But most drugs only do one or the other.
Compiled by C Settley
27. NSAID’S
• Anti inflammatory effects
• Antipyretic effects
• Constriction of blood vessels
• Examples: aspirin, diclofenac, paracetamol
• Read through clinical application- pg 144-145
Compiled by C Settley