1. This document discusses various ionotropic drugs including epinephrine, norepinephrine, dopamine, isoproterenol, dobutamine, ephedrine, and phenylephrine. It details their receptor activity, uses, dosages, and mechanisms of action in increasing cardiac contractility and blood pressure.
2. The document also covers digoxin, a cardiac glycoside that increases intracellular calcium levels to have an ionotropic effect. It is extracted from foxglove and has a narrow therapeutic index. Signs of digoxin toxicity and treatment options are provided.
3. In summary, the document reviews adrenergic receptor agonists and digoxin, describing their clinical uses, dos
Scope: This subject is intended to impart the fundamental knowledge on various aspects
(classification, mechanism of action, therapeutic effects, clinical uses, side effects and
contraindications) of drugs acting on different systems of body and in addition,emphasis
on the basic concepts of bioassay. Objectives: Upon completion of this course the student should be able to
1. Understand the mechanism of drug action and its relevance in the treatment of
different diseases
2. Demonstrate isolation of different organs/tissues from the laboratory animals by
simulated experiments
3. Demonstrate the various receptor actions using isolated tissue preparation
4. Appreciate correlation of pharmacology with related medical sciences
Non-steroidal anti-inflammatory drugs is a class of analgesic medication that reduces pain, fever and inflammation. Since most episodes of back pain involve inflammation, NSAIDs such as ibuprofen and naproxen are often an effective treatment option.
Scope: This subject is intended to impart the fundamental knowledge on various aspects
(classification, mechanism of action, therapeutic effects, clinical uses, side effects and
contraindications) of drugs acting on different systems of body and in addition,emphasis
on the basic concepts of bioassay. Objectives: Upon completion of this course the student should be able to
1. Understand the mechanism of drug action and its relevance in the treatment of
different diseases
2. Demonstrate isolation of different organs/tissues from the laboratory animals by
simulated experiments
3. Demonstrate the various receptor actions using isolated tissue preparation
4. Appreciate correlation of pharmacology with related medical sciences
Non-steroidal anti-inflammatory drugs is a class of analgesic medication that reduces pain, fever and inflammation. Since most episodes of back pain involve inflammation, NSAIDs such as ibuprofen and naproxen are often an effective treatment option.
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
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.
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
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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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.
12. EPINEPHRINE
Prototype sympathomimetic
synthesized stored andreleased from adrenal medulla
oral administration not effective- rapid metabolism in GI mucosaand liver
RECEPTORS STIMULATED-Beta 1-myocardium-raises BP, cardiac
output,myocardial oxygen demand by increasing contractility
Alpha 1- decreases splanchnic and renal blood flow but increases cpp by
increasing aortic diastolic bp
Beta 2- vasodilation in sk. muscle
13. ROUTES- SC/IV/IM
DOSE- to improve myocardial contractility 2-20 Mic/min(0.04-0.4
mic/kg/min)-4mic/ml dilution
Available preparation-1:1000(1mg/ml)
prefilled syringe 1:10000
1 in 1 lakh for paediatric use(10 mic/ml)
USES
1. Life threatening anaphylaxis-100-500 mcg
2. Severe asthma and bronchospasm- nebulization -5ml of 1:1000 (max 5 mg)
3. Cardiac arrest- 1mg every 3-5 mins
14. NOREPINEPHRINE
Precursor of epinephrine
Direct alpa 1 , beta 1 with little beta 2 activity
Beta 1 – myocardial contractility- inc BP
infusion- 2-20 mic/min(0.01-0.4mic/kg/min
should be infused in 5 D ( acidity-prevent oxidation of catecholamine)
DOC in septic shock-inc MAP,PVR
15. DOPAMINE
Precursor of norepinephrine
direct and indirect adrenergic and dopaminergic agonist
renal dose-0.5-3 mic/kg/min-DA1
3-10 mic/kg/min-beta 1
>10 mic/kg/min-PVR inc- alpha 1
used to improve cardiac output, maintain renal function
16. ISOPROTERENOL
Pure beta agonist
Beta 1-inc HR,CO,CONTRACTILITY,SBP
Beta 2-dec PVR,DBP
Dose- 1-5 mic/min
Metabolism-COMT in liver
Effective in patient with heart block
18. EPHEDRINE
Indirect acting synthetic sympathomimetic- alpha and beta
5-10 mg IV
Tachyphylaxis can occur
IV – inc HR,SBP
Hypotension due to Regional blockade and GA induction
Oral- treat bronchial asthma
IM-0.5 mg/kg- antiemetic
20. DIGOXIN
Cardiac glycoside
Extracted from foxglove plant
60-80% oral bioavailability
Peak plasma conc- 1-3 hours following oral administration
100% iv bioavailability-attain peak plasma conc immediately
Excreted entirely by kidneys
Half life -1-2 days- inversely proportional to GFR(inc with age and renal
disease.
21. ORAL IV
ONSET OF ACTION 0.5-2hrs 10-30mins
PEAK EFFECT 6hrs 2-4hrs
Mechanism of action-selective and reversible cardiac sarcolemmal Na+_K+ ATPase
inhibitor
Increases intracellular calcium –responsible for ionotropic action
• Other benefits-
1. No change in heart rate
2. Decrease in LV preload and afterload
3. Decrease in wall tension
4. Decrease in oxygen consumption in failing heart
22.
23. ECG findings obtained at therapeutic plasma concentrations include
Prolonged PR interval-delayed Av nodal conduction
Shortened QTc intervals-rapid ventricular repolarization
ST depression-scaphoid/scooped out-decreased phase 3 depolarization of
cardiac action potentials.
Diminished /inverted T wave
NARROW THERAPEUTIC RANGE
24. Digoxin toxicity
20% of patients treated with cardiac glycosides –report digitalis toxicity
AT RISK INDIVIDUALS:
-Renal dysfunction
-Diuretics-potassium depletion-arrhythmia
-Hyperventilation-decrease potassium 0.5mEq/L for 10mmHg decrease in
PaCO2
-Electrolyte imbalance –Hypokalemia,Hypercalcemia,Hypomagnesemia
-Hypoxemia induced sympathetic nervous system activity
25. Plasma conc < 0.5ng/ml-no toxicity
Therapeutic range-0.5-2.5ng/ml
Toxic range>3.0ng/ml
Treatment
- treat the underlying cause
-treat cardiac dysrhythmias
Phenytoin-0.5-1.5mg/kg IV over 5 mins
Lidocaine-1-2mg/kg IV
Atropine-35-70mic/kg IV
K+ supplementation-0.025-0.050 mEq/L
-Life threatening toxicity- digoxin antibodies
-Temporary artificial transvenous cardiac pacemaker-if complete heart
block is present.