The document summarizes various toxicities caused by anticancer drugs and their management. It discusses acute and delayed toxicities affecting organs like bone marrow, gastrointestinal tract, liver, kidney, lung and heart. It provides examples of drugs causing specific toxicities like neutropenia, anemia, thrombocytopenia and strategies to ameliorate them, including hematopoietic growth factors, cytoprotective agents, dose adjustments and supportive care. The summary highlights management of common toxicities like nausea, diarrhea, stomatitis and alopecia through symptomatic measures and agents.
CANCER: A group of disease involving abnormal cell growth with the potential to invade or spread to other part of the body.
CHEMOTHERAPY: the term chemotherapy is describe as the use of chemicals or drugs to treat cancer.
CYTOTOXIC DRUG: lysis both normal and cancer cells
Anticancer drugs: Classification , general toxicity and Alkylating agents.Ameena Kadar
Neoplasm or cancer is one of the dangerous condition. Here we discuss about cancer and it's drug classification, general toxicity and brief description about Alkylating agents.
CANCER: A group of disease involving abnormal cell growth with the potential to invade or spread to other part of the body.
CHEMOTHERAPY: the term chemotherapy is describe as the use of chemicals or drugs to treat cancer.
CYTOTOXIC DRUG: lysis both normal and cancer cells
Anticancer drugs: Classification , general toxicity and Alkylating agents.Ameena Kadar
Neoplasm or cancer is one of the dangerous condition. Here we discuss about cancer and it's drug classification, general toxicity and brief description about Alkylating agents.
Basic principles of chemotherapy/ AMAs covers definition, history of AMAs development, principles of AMAs, problems associated with AMAs, failure of therapy with examples.
Tetracyclines slide contains full information about uses, adverse effect, marketed preparation, precaution, route of drug administration, antimicrobial spectrum, mechanism of action, pharmacokineticks and pharmacodynamics of tetracyclines. This slide is very helpful for pharmacy and pharmacology student for the study about tetracyclines.
Lecture covers the pharmacology of anticholinergic drugs. Includes classification, therapeutic uses, adverse effects of anticholinergics. Atropine has been described as prototype drug.
Chemotherapy drugs are managed by the trained healthcare professional with many standard precautions. Most of the cancer patients must gone through the chemotherapy treatment
Basic principles of chemotherapy/ AMAs covers definition, history of AMAs development, principles of AMAs, problems associated with AMAs, failure of therapy with examples.
Tetracyclines slide contains full information about uses, adverse effect, marketed preparation, precaution, route of drug administration, antimicrobial spectrum, mechanism of action, pharmacokineticks and pharmacodynamics of tetracyclines. This slide is very helpful for pharmacy and pharmacology student for the study about tetracyclines.
Lecture covers the pharmacology of anticholinergic drugs. Includes classification, therapeutic uses, adverse effects of anticholinergics. Atropine has been described as prototype drug.
Chemotherapy drugs are managed by the trained healthcare professional with many standard precautions. Most of the cancer patients must gone through the chemotherapy treatment
This presentation comprises of various chemotherapeutic agents used in ENT malignancies and other conditions. Its classifies the agents and briefly discusses the dosage and their common side effects.
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
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.
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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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
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
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
1. TOXICITY OF ANTI CANCER
DRUGS AND ITS AMELIORATION
Dr. Jaya Dadhich
Resident, Department of Pharmacology
SMS medical college, Jaipur
2. Overview
• Anticancer drug target
• Toxicities caused by anticancer drugs
• Management of individual toxicity
• Generalised approach
• pharmacological intervention
• Summary
3.
4.
5. Toxicity of anticancer drugs
Acute or in short term
1. Nausea and vomiting=
CTZ or from upper GIT impulses
By cisplatin, decarbazine, lomustine,
actinomycin D, all the alkylating agents
2.Local toxicity
6. 3. Toxicity due to effect on normal rapidly
multiplying cells
Bone marrow depression
Lymphoreticular tissue-immunosuppression
Platelets- thrombocytopenia
GIT-diarrhoea and ulcers
Skin and hair follicles- alopecia
Wound healing-delayed
Gonads-oligozoospermia
7. DELAYED OR LONG TERM TOXICITY
Carcinogenecity and mutagenecity
Secondary hyperuricemia
Effect on foetus
Effect on children
10. Measures to reduce the toxicity
1. Pulse therapy
Interval of some time eg 2 week
2. Selective drug administration
3.Bone marrow transplantation
4. Supportive measures
12. Bone marrow suppression
• Peripheral cytopenia from bone marrow
suppression is a frequent dose limiting side
effect of chemotherapy and can manifest
as acute and chronic marrow damage.
• Destruction of activity of proliferating
haematopoietic precursor cells
• Deprivation of formed elements, and
incidence of life threatening haemorrhage
and infection.
13.
14. Approach
• Management varies from dose reduction to
treatment for neutropenic,sepsis.
• Patient who develop grade 4 toxicity require
hospitalisation, treatment of infection or bleeding
• Colony stimulating factors like erythropoietin,
Darbopoietin alpha, G-CSF, GM-CSF, various
cytokines, platelet transfusion is given
• Bone marrow transplantation
15. Anemia
The symptoms associated with mild to
moderate anaemia can negatively affect the
person’s normal functional ability and quality
of life.
A thorough laboratory investigation is
necessary to assess the cause of anaemia.
The decision for transfusion should be based
on the patient’s symptom in concert with
laboratory data.
20. Neutropenia
• Definition: Absolute neutrophil count <
500cell/mm3 and count <1000cell/mm3 with a
predicted decrease to 500cell/mm
Four general principles to minimise the risk of
infection in patients with cancer.
a) Augment the host defence mechanism
b) Preserving the natural barrier of defence
c) Reducing the environmental organisms
d) Minimising endogenous micro flora.
21. Infections and neutropenia
• Prompt intervention of empirical
chemotherapy is essential in the management
of neutropenia.
• The choice of antibiotics is influenced by the
ever-changing environment, individual
susceptibility, pattern and emergence of
resistant strains.
22. Interventions to promote mechanical
barrier integrity include
1. Avoidance of injections whenever possible
2. Strategies to prevent skin breakdown
3. Avoidance of bladder catheterisation
4. Daily baths , Perineal and rectal hygiene
5. Oral care after meals
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33. Thrombocytopenia
• A moderate risk of bleeding exists when the
platelet count falls to less than
50,000cells/mm3 and major risk is associated
with the platelet count falls to less than
10,000cells/mm3.
• Clinical manifestations include increased
bruising, purpura, petechiae, oozing from
mucosal surface.
34.
35.
36.
37. Gastrointestinal toxicity
• Anorexia, nausea and vomiting are frequently
observed after chemotherapy.
• It is not a pathological process but rather a
physiological process in which the body
attempts to rid itself of toxic substances
38. Emetic potential
Level 1
Frequency of
emesis <10%
Level 2
Frequency of
emesis
10-30%
Level 3
Frequency of emesis 30-
60%
Level 4
Frequency of emesis 60-
90%
Carboplatin Carmustine
<250mg/m2
Level 5
Frequency of emesis
>90%
Carmustine>250mg/m2
Cisplatine>59mg/m2
Bleomycin Docetaxel Cyclophosphamide
<750mg/m2
Busulfan Etoposide Doxorubicin 20-60mg/m2
Hydroxyurea Gemcitabine Epirubicin Cisplatine Cyclophosphamide
<90mg/m2
<50mg/m2
>1500mg/m2
Vinblastine
Vincristine
Methotrexate
>50mg/m2
<250mg/m2
Idarubicin Cyclophosphamide
>750mg/m2
< 1500mg/m2
Dacarbazine
39. Class of antiemetics Drug
Antihistamines Cinnarizine
Benzodiazepines Lorazepeam
Anticholinergic drugs Hyoscine
Dopamine inhibitors Phenothiazines
Corticosteroids Dexamethasone
5-HT3antagonists Ondansetron
Prokinetic drugs Metoclopramide
NK1 receptor
antagonists
Substance P antagonists
43. Management
• Management of treatment related diarrhoea
is symptomatic and requires little or no
alteration in cancer therapy.
• Pharmacological management is given 12 to
24 hours later if inadequate response or
immediately if grade 3 or 4 diarrhoea begin.
• It includes agents like kaolin, pectin,
loperamide, diphenoxylate hydrochloride,
Octreotide
45. Management
• Interventions start with informing and preparing
the patient for the possibility of alopecia.
• Because of the concern for scalp metastasis and
sanctuary sites, scalp hypothermia is no longer
recommended.
• Studies have shown that the use of Imuvert – a
membrane vesicle ribosome preparation from a
bacterium either partially or completely reverse
the alopecia caused by the chemotherapeutic
agents
47. • Early detection and treatment of neurotoxicity by
reduction of drug dose or discontinuation
prevents permanent neurological damage
• Assessment of symptoms of neurotoxicity should
be documented on a routine basis.
• Tricyclic antidepressant, anticonvulsant, high
dose vitamins are used in drug therapy.
• Management by a cytoprotectant like Amifostine
is promising
49. • Depending on the condition of patient
discontinuation of drugs,
• reduction in dose or
• intermittent therapy is done other than
supportive management.
• Defibrotide can reverse the venoocclusive
disease of liver caused by all drugs at high
doses except cisplatin.
51. Renal toxicity
• Assess the renal function and evaluate the risk
factors before initiating therapy. Plasma
concentration of blood urea nitrogen and
creatinine are common assessment parameters.
24 hour collection of urine for creatinine
clearance is recommended to monitor patients
and alter drug doses to prevent or minimize renal
toxicity.34 Thiophosphate Cytoprotectants like
Amifostine can counteract cisplatin induced
nephrotoxicit
53. Management
• It includes discontinuation of the drug and
administration of corticosteroids and
supportive care.
54. Cardiac toxicity
• Cardiomyopathy is the most common
chemotherapy associated cardiac toxicity and is
thought to be due to free radical mediated injury
• The anthracyclines have the highest risk for
cardiomyopathy which is cumulative dose
response related.
• The primary management strategy of
Anthracycline cardiac toxicity is prevention and
early detection. Use of cardioprotectant iron
chelator, Dexrazoxane represents the primary
prevention approach
