Self-medication is a global phenomenon and potential contributor to human pathogen resistance to antibiotics. The adverse consequences of such practices should always be emphasized to the community and steps to curb it.
Pharmacodynamics and kinetics during pregnancyReem Alyahya
This presentation discuss the following objectives:
-Drug therapy during pregnancy, childbirth, and lactation.
-Physiological changes of drugs in pregnant women.
-Drug toxicity
-Cross-placental transfer of drugs
-Exertion of drugs in breast milk
-Drug safety + ABCDX
Drug therapy in pregnancy and lactationVishnupriya K
This slide share will provide drugs which are used and which are contraindicated during pregnancy and lactation, also give information about side effects and malformations if pregnant women's used some drugs.
Self-medication is a global phenomenon and potential contributor to human pathogen resistance to antibiotics. The adverse consequences of such practices should always be emphasized to the community and steps to curb it.
Pharmacodynamics and kinetics during pregnancyReem Alyahya
This presentation discuss the following objectives:
-Drug therapy during pregnancy, childbirth, and lactation.
-Physiological changes of drugs in pregnant women.
-Drug toxicity
-Cross-placental transfer of drugs
-Exertion of drugs in breast milk
-Drug safety + ABCDX
Drug therapy in pregnancy and lactationVishnupriya K
This slide share will provide drugs which are used and which are contraindicated during pregnancy and lactation, also give information about side effects and malformations if pregnant women's used some drugs.
Priciples of therapeutics, Dosage Indiviualization, Herbal SupplimentsFarazaJaved
This presentation briefly covers the general aspect of therapeutics and drug development then its dose adjustment according to the pt. need and checking either patient comply to that therapy or not. last portion based on herbal supplements and its use.
Pharmaceutical care concepts - clinical pharmacy ShaistaSumayya
The pharmaceutical care is defined as “the direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.”
Pharmaceutical care involves the process through which a pharmacist cooperates with a patient and other professional in designing , implementation, and monitoring a therapeutic plan that will produce specific therapeutic outcomes for the patient
medication Adherence defined as the act of filling a new prescription for the first time.
The extent to which the patients take medications as prescribed by the prescriber.
Self-Medication is dangerous. Self-Medication may lead to Misdiagnosis of an illness, Drug interactions, Insufficient dosage, Habituation, Allergic reactions, etc. Patients should should not Self-Medicate and consult a doctor to avoid these hazards. Asking doctor a medical query has never been so easy! Lybrate has a pool of doctors available online to offer you credible medical advice. To avail an easy access to doctors across the country, anytime, anywhere download Lybrate apps and get going.
Podkayne, "visiting a friend"? Pshaw, who believes that? ;) The events of this installment detail what Podkayne Cummings was up to during the Teaser Trailer.
Priciples of therapeutics, Dosage Indiviualization, Herbal SupplimentsFarazaJaved
This presentation briefly covers the general aspect of therapeutics and drug development then its dose adjustment according to the pt. need and checking either patient comply to that therapy or not. last portion based on herbal supplements and its use.
Pharmaceutical care concepts - clinical pharmacy ShaistaSumayya
The pharmaceutical care is defined as “the direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.”
Pharmaceutical care involves the process through which a pharmacist cooperates with a patient and other professional in designing , implementation, and monitoring a therapeutic plan that will produce specific therapeutic outcomes for the patient
medication Adherence defined as the act of filling a new prescription for the first time.
The extent to which the patients take medications as prescribed by the prescriber.
Self-Medication is dangerous. Self-Medication may lead to Misdiagnosis of an illness, Drug interactions, Insufficient dosage, Habituation, Allergic reactions, etc. Patients should should not Self-Medicate and consult a doctor to avoid these hazards. Asking doctor a medical query has never been so easy! Lybrate has a pool of doctors available online to offer you credible medical advice. To avail an easy access to doctors across the country, anytime, anywhere download Lybrate apps and get going.
Podkayne, "visiting a friend"? Pshaw, who believes that? ;) The events of this installment detail what Podkayne Cummings was up to during the Teaser Trailer.
Computer insecurity is inevitable, and technology alone cannot save us. Here are 10 essential processes every organization should follow to help stay secure.
FDA Pregnancy, Lactation, and Reproductive Potential Labeling RuleChi Lan Trinh
As part of our Women's Health course, we were required to choose a topic related to women's health, and to research and formally present that topic to the MCPHS University community. For our project, we chose to research the changes in the pregnancy categories for drug labeling, set to take effect on June 30, 2015. This is the poster that we used during our presentation.
Strategies for Long-term Management of Recurrent Ovarian Cancerbkling
A panel of doctors and patients will discuss decision-making in the recurrent setting of ovarian cancer, including how to understand and consider options like chemotherapy, surgery, and clinical trials. Panelists include Dr. Jason Wright and Dr. June Hou from Columbia University College of Physicians and Surgeons, survivor/research advocate Annie Ellis, and others living with recurrence.
En esta infografía podras dar respuesta a las interrogantes: ¿Qué es la violencia contra la mujer?, ¿Cuáles son los derechos de las mujeres en la ley 1257?, ¿Cuáles son los alcances de las medidas de protección que pueden solicitar las mujeres?, ¿Cuáles son las medidas de atención ante los casos de violencias?, ¿Cuáles son las sanciones que puede imponer la ley? Además los decretos reglamentarios que amplían la aplicación de la ley 1257 de 2008 y que fueron expedido en diciembre de 2011.
Medidas de atención a mujeres víctimas de violencia, situaciones especiales de riesgo, servicios del sistema general de seguridad social en salud a las mujeres victimas de violencias.
Alcaldía de Santiago de Cali. - Aecid Colombia.
Proyecto "Apoyo a la institucionalización de la política pública de lucha para erradicar las violencias contra las mujeres."
drugs safety in pregnancy medications medication in pregnancy treatment during pregnancy healthy pregnancy teratogen teratogenecity teratogenic drugs in pregnancy drugs and congenital malformation
Oral surgery during pregnancy
Dr. Ahmed M. Adawy
Professor Emeritus, Dep. Oral & Maxillofacial Surg.
Former Dean, Faculty of Dental Medicine
Al-Azhar University
Pregnancy, also known as gestation, is the time during which a fetus develops inside a woman's uterus. Pregnancy is typically divided into three trimesters. The common belief has been that, if an oral surgery procedure is recommended, but it’s not an emergency, the second trimester is the ideal time. Pregnancy however, is not a disease and pregnant woman should not be treated differently than the general population. In short, it could be concluded that:
• Dental care is safe and essential during pregnancy
• Pregnancy is not a reason to defer routine dental care or treatment
• Diagnostic measures, including needed dental x-rays, can be undertaken safely
• Emergency care should be provided at any time during pregnancy
challenges in obstetric prescription
Beautiful Slide Show By Editor Dr. Ragini Agrawal And Dr. Tamkeen khan
Dr. Ragini Agrawal, Chairperson Food , Drug & medico surgical Equipment Committee 2009-2011
This topic includes Introduction, common side effects from maternal medications on infants, guidelines for medication during lactation, effects of various medications on lactation and neonates
Treatment of many dermatologic conditions is elective. Some drugs which used by the dermatologist for the patient who is pregnant or lactating may have potentially harmful effects on the mother and fetus or nursing infant. Likewise, not every pregnancy (in the absence of drug therapy) results
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
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.
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
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Issues to consider while prescribing for pregnant and lactating patients
1. Some issues to consider
while prescribing
medications for…
Pregnant and Lactating
Patients
2. Physiological changes in pregnancy
Total body water is increased by approximately 8 litres, leading
to altered drug distribution.
Pregnancy also increases cardiac output, the rate of liver
metabolism, plasma volume, glomerular filtration and fat
stores.
These physiological changes cause plasma drug
concentrations to be reduced in pregnancy.
It is important to carefully monitor medications and their effects
during pregnancy to ensure that the doses used are as low as
possible but provide an adequate therapeutic response.
3. Placental transfer
Factors affecting the rate of drug transfer through placenta:
Metabolic status
Gestational age of the fetus
Drug’s protein binding, ionisation, lipid solubility and MW.
Misconception: placental barrier provides protection to the
fetus;
However, almost all drugs are able to pass freely through the
placenta, with only those with a MW >1000 Da being unable to
do so, e.g., insulin and heparin.
• Da stands for Dalton
4. Teratogenicity
Teratogen: A drug which when exposed in utero, directly or
indirectly causes structural or functional abnormalities in the
fetus or in the child after birth.
Structural malformations: the effects of thalidomide, which were
first recognised in the 1960s.
Intrauterine growth retardation: beta-blockers (most notably
atenolol), have been associated with intrauterine growth
retardation (IUGR) probably due to increased fetal and utero-
placental peripheral vascular resistance and reduced placental
blood flow.
Diethylstilbestrol, which was used to prevent recurrent
miscarriages, is now known to cause transplacental
carcinogenicity; in-utero exposure is associated with problems
in later life such as infertility in both male and female offspring
and a rare form of vaginal cancer.
5. Neuropsychological and behavioural abnormalities may also
occur after drug exposure. Some antiepileptic drugs and drugs
of abuse have been associated with learning and behavioural
problems (in the child) following in-utero exposure.
Timing of exposure
During the preimplantation stage, in very early pregnancy,
exposure to a drug is unlikely to produce a teratogenic effect
due to an inbuilt ‘recovery process’ in the concept us.
If a ‘teratogenic insult’ occurs and there is damage to only a
small number of cells then ‘compensation’ occurs whereby the
remaining viable cells continue to divide to replace any
damaged cell(s).
However, if a large number of cells are damaged then
implantation will not occur and the pregnancy will be lost. This
is known as the ‘all or nothing’ or totipotent period.
6. The 10 weeks following implantation are the most sensitive as
this is the time during which major structural changes and
organogenesis are taking place (major organs and limbs
develop).
Teratogenic effects resulting in fetal malformations are:
dose related (how much drug)
time related (when, and for how long the drug exposure occurs)
While the first trimester is the most sensitive period to structural
malformations, some drugs may affect the fetus in the later
stages of pregnancy, so care should be taken when prescribing
throughout pregnancy.
E.g.,: exposure to ACE inhibitors in the second and third
trimesters can cause serious adverse effects such as
oligohydramnios; growth retardation; lung and kidney hypoplasia;
and hypocalvaria.
8. Drugs which are fetotoxic when taken in the 2nd
& 3rd
trimester
9. Important to carry out an individual risk assessment when
considering prescription of a drug in pregnancy.
Not practically possible to produce lists of ‘safe’ drugs and
drugs that must always be avoided.
In certain cases it may be necessary to prescribe a suspected
teratogen, as the benefit may outweigh the risk due to the
severity of the maternal condition, or stage of pregnancy.
Expert advice should be sought whenever there is any doubt
about drug safety in pregnancy.
10. General considerations when prescribing in pregnancy
The risk posed by drug use in pregnancy can be minimized
through pre-pregnancy counselling.
Folic acid supplementation can be initiated and treatment
optimized to ensure that the safest medications are used.
When prescribing for a pregnant patient, consideration should
be given to whether medication is absolutely necessary.
Often non-drug measures may be sufficient. E.g.,:
• dietary measures may alleviate common conditions such as
nausea and constipation;
• behavioural therapy and counselling may be adequate in the
management of anxiety and mild depression.
It is important to balance the risk of drug treatment (to the
fetus) against the risks (to both mother and fetus) from
failing to treat the maternal condition.
11. All drugs in pregnancy should be prescribed in the lowest dose
for the shortest possible time.
Drugs may act synergistically in terms of teratogenic potential
and for this reason monotherapy is desirable when possible.
E.g.,: Polytherapy with antiepileptic drugs poses a higher risk to
the fetus than monotherapy.
The case for each drug should be assessed on an
individual patient basis.
12. Factors contributing to drug concentrations in the fetus
Major factor is the concentration of drug present in the
mother.
Other contributing factors include:
gestational age of the fetus
the degree of placental development (placental blood flow
volume and surface area)
drug’s profile (molecular size; lipid solubility; protein binding
characteristics)
degree of drug ionization in the physiologic pH
13. FDA PREGNANCY RISK FACTOR CATEGORIES
Based on submitted clinical study information reviewed as part
of the drug approval process, the Food and Drug Administration
(FDA) assigns one of five pregnancy risk factors based on the
degree of risk that use of the drug would potentially cause to
the fetus.
Category A: Controlled studies in pregnant women…
fail to demonstrate a risk to the fetus in the 1st trimester
no evidence of a risk in later trimesters
possibility of fetal harm appears remote.
14. Category B: Either…
a) animal-reproduction studies have not demonstrated fetal risk
but there are no controlled studies in pregnant women,
OR
b) animal-reproduction studies have shown adverse effect (other
than a decrease in fertility) that was not confirmed in
controlled studies in women in the first trimester (and there is
no evidence of a risk in later trimesters.)
15. Category C: Either…
a) pre-clinical studies have revealed adverse effects on the fetus
(teratogenic or embryocidal) but there are no controlled
studies performed in pregnant women,
OR
b) pre-clinical and clinical study data are not available.
Drugs should be given only if the potential benefit
justifies the potential risk to the fetus.
16. Category D:
Positive evidence of human fetal risk, BUT
the benefits from use in pregnant women may be acceptable
despite the risk.
e.g. if the drug is needed in a life-threatening situation or for a
serious disease for which safer drugs cannot be used or are
ineffective.
17. Category X:
Pre-clinical and clinical studies have demonstrated fetal
abnormalities
OR
There is evidence of fetal risk, and the risk of the use of the
drug in pregnant women clearly outweighs any possible
benefit(s).
The drug is contraindicated in women who are or may
become pregnant.
18. Prescribing Considerations for Women Who Are
Breastfeeding
Clinical information concerning the safety of drug use while
breast-feeding an infant is often more limited than information
regarding the safe use of drugs during pregnancy.
Almost all drugs transfer into breast milk and this may carry a
risk to a breastfed infant.
Factors to consider:
• drug characteristics (including lipid solubility, protein binding
ability, degree of ionization, and ADME);
• dose received by the infant via breast milk,
• effect of the drug in the infant.
19. Drug transfer from maternal plasma to milk is mostly by
passive diffusion across biological membranes.
Transfer is greatest in the presence of low maternal plasma
protein binding and high lipid solubility.
Drugs that are poorly absorbed or have high first-pass
metabolism are less likely to cause adverse effects to the
breast-fed child.
E.g.,: Gentamicin is highly hydrophilic and is very poorly
absorbed when administered orally. If gentamicin is ingested
via breast milk, it is unlikely to be absorbed in the infant.
20. Milk is slightly more acidic than plasma (pH of milk is
approximately 7.2 and plasma is 7.4) allowing weakly basic
drugs to transfer more readily into breast milk.
Milk composition varies within and between feeds and this may
also affect transfer of drugs into breast milk. E.g.,: milk at the
end of a feed (hindmilk) contains considerably more fat than
foremilk and may concentrate fat-soluble drugs.
Milk to plasma (M/P) concentration ratio: Drugs transfer into
breast milk is most commonly described quantitatively using the
M/P concentration ratio.
21. The accuracy of this value is improved if it is based on AUC
curves of the drug in maternal milk and plasma (M/P AUC).
Dose received by the infant via breast milk can be calculated
by:
D(infant) = C(maternal) x M/P(AUC) x V(infant)
Units: D(infant)in mg/kg/day; C(maternal) in (mg/L); V(infant) in (L/kg/day)
The volume of milk ingested by infants is commonly estimated
as 0.15L/kg/day.
The infant dose (mg/kg) can then be expressed as percentage
of the maternal dose (mg/kg).
22. An arbitrary cut-off of 10% has been selected as a guide to the
safe use of drugs during lactation.
Drugs such as lithium (infant dose as high as 80% of the
weight-adjusted maternal dose) and amiodarone (infant dose
up to 50%) should be avoided due to high infant exposure and
potential for significant toxicity.
For drugs with greater inherent toxicity (cytotoxic agents,
ergotamine, gold salts, immunosuppressives), the cut-off of
10% is too high and breastfeeding is contraindicated.
23. TOPICAL PREPARATIONS
Maternal use of topical preparations (creams, nasal sprays or
inhalers) would be expected to carry less risk to a breastfed
infant than systemically administered drugs.
This is due to relatively lower maternal drug plasma
concentrations and therefore, lower transfer into breast milk.
However, the risk to the infant must be considered in relation to
the toxicity of the drug used, the dosage regimen and the area
of application.
E.g.,: use of corticosteroids nasal sprays or inhalers in standard
doses would be considered compatible with breastfeeding.
24. ISSUES
1) Infants have lower drug clearance, impaired metabolic
processes (phase1 oxidation and phase 2 glucuronidation)
than adults.
• Drugs subject to high first-pass metabolism may have higher oral
availability in premature or term infants due to impaired ability to
metabolise on first-pass.
2) Minimise risk to the breastfed infant by reducing drug
exposure
• The overall risk of a drug to a breastfed infant depends on the
concentration in the infant's blood and the effects of the drug in the
infant.
• If, after assessment of the risks and benefits, the decision is made to
breastfeed while the mother is using a drug, the infant should be
monitored for adverse effects such as failure to thrive, irritability
and sedation.
• However, it is difficult to identify adverse reactions occurring in
neonates.
• Feeding immediately prior to a dose may help to minimise infant
exposure as concentrations in milk are likely to be lowest towards
the end of a dosing interval.