This document provides an overview of mycology and fungal identification techniques. It discusses the characteristics of yeasts and molds, as well as various culture media used for fungal growth. Identification methods for yeast and molds are outlined, including MALDI-TOF, rRNA sequencing, lactophenol cotton blue preps, and stains. Specimen collection, transport, and laboratory safety are also covered. Dimorphic fungi such as Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis/posadasii are described in detail, including their morphology in both mycelial and yeast phases, pathogenicity, diagnosis, and histopathology.
- Vibrio are Gram-negative, curved rods or comma-shaped bacteria that are highly motile due to single polar flagella. They are found worldwide in marine and coastal environments.
- The most important species is Vibrio cholerae, which causes the disease cholera. Other medically important species include V. paraheamolyticus and V. vulnificus.
- V. cholerae produces a heat-labile enterotoxin that causes a massive loss of water and electrolytes from the intestines, leading to dehydration and cholera's severe diarrhea symptoms.
Heartworm is a parasitic roundworm spread through mosquito bites between hosts. It infects dogs, cats, wolves and other animals. Early infection may show no symptoms, but later symptoms can include coughing, fatigue after exercise, weight loss, and fainting as the worms accumulate in the heart and lungs, eventually causing heart failure if left untreated. Diagnosis involves blood tests to detect microfilariae or antigens or chest x-rays to assess lung damage. Treatment requires a drug to kill adult worms along with restricted exercise for several weeks to prevent further damage. Monthly preventative medications including ivermectin, milbemycin or selamectin can reduce the risk of infection.
This document discusses methods for detecting Methicillin-Resistant Staphylococcus aureus (MRSA). MRSA is any strain of S. aureus that is resistant to beta-lactam antibiotics due to the mecA gene. Rapid detection of MRSA is important for optimal treatment and reducing costs. The document describes several screening methods, focusing on the oxacillin salt agar screening test which involves growing bacterial samples on agar containing oxacillin and 4% NaCl. Growth of more than one colony indicates oxacillin resistance and identifies the strain as MRSA.
This document discusses the laboratory diagnosis of Salmonella species. It begins by describing Salmonella bacteria and the diseases they can cause in humans, including typhoid fever, paratyphoid fever, and gastroenteritis. It then discusses the habitats of different Salmonella serotypes and outlines several methods for laboratory diagnosis, including culture-based isolation and identification using biochemical tests and serological or molecular techniques. The document provides details on the morphology, cultural characteristics, enrichment and selective media used for Salmonella as well as their typical biochemical reactions that are used for identification.
This document provides an overview of bacteriology concepts including definitions of aerobic and anaerobic bacteria. It discusses specimen collection and transport for aerobic cultures. Key details are provided about gram staining including common gram positive and negative morphologies. Common agar media used in the field like blood, chocolate, and MacConkey agars are described. Details are given about identifying and testing common gram positive cocci like Staphylococcus, Streptococcus, and Enterococcus. Specific pathogenic species and their identification are covered including Staphylococcus aureus, coagulase-negative Staphylococci, and Streptococcus pyogenes.
This document provides an overview of mycology and fungal identification techniques. It discusses the characteristics of yeasts and molds, as well as various culture media used for fungal growth. Identification methods for yeast and molds are outlined, including MALDI-TOF, rRNA sequencing, lactophenol cotton blue preps, and stains. Specimen collection, transport, and laboratory safety are also covered. Dimorphic fungi such as Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis/posadasii are described in detail, including their morphology in both mycelial and yeast phases, pathogenicity, diagnosis, and histopathology.
- Vibrio are Gram-negative, curved rods or comma-shaped bacteria that are highly motile due to single polar flagella. They are found worldwide in marine and coastal environments.
- The most important species is Vibrio cholerae, which causes the disease cholera. Other medically important species include V. paraheamolyticus and V. vulnificus.
- V. cholerae produces a heat-labile enterotoxin that causes a massive loss of water and electrolytes from the intestines, leading to dehydration and cholera's severe diarrhea symptoms.
Heartworm is a parasitic roundworm spread through mosquito bites between hosts. It infects dogs, cats, wolves and other animals. Early infection may show no symptoms, but later symptoms can include coughing, fatigue after exercise, weight loss, and fainting as the worms accumulate in the heart and lungs, eventually causing heart failure if left untreated. Diagnosis involves blood tests to detect microfilariae or antigens or chest x-rays to assess lung damage. Treatment requires a drug to kill adult worms along with restricted exercise for several weeks to prevent further damage. Monthly preventative medications including ivermectin, milbemycin or selamectin can reduce the risk of infection.
This document discusses methods for detecting Methicillin-Resistant Staphylococcus aureus (MRSA). MRSA is any strain of S. aureus that is resistant to beta-lactam antibiotics due to the mecA gene. Rapid detection of MRSA is important for optimal treatment and reducing costs. The document describes several screening methods, focusing on the oxacillin salt agar screening test which involves growing bacterial samples on agar containing oxacillin and 4% NaCl. Growth of more than one colony indicates oxacillin resistance and identifies the strain as MRSA.
This document discusses the laboratory diagnosis of Salmonella species. It begins by describing Salmonella bacteria and the diseases they can cause in humans, including typhoid fever, paratyphoid fever, and gastroenteritis. It then discusses the habitats of different Salmonella serotypes and outlines several methods for laboratory diagnosis, including culture-based isolation and identification using biochemical tests and serological or molecular techniques. The document provides details on the morphology, cultural characteristics, enrichment and selective media used for Salmonella as well as their typical biochemical reactions that are used for identification.
This document provides an overview of bacteriology concepts including definitions of aerobic and anaerobic bacteria. It discusses specimen collection and transport for aerobic cultures. Key details are provided about gram staining including common gram positive and negative morphologies. Common agar media used in the field like blood, chocolate, and MacConkey agars are described. Details are given about identifying and testing common gram positive cocci like Staphylococcus, Streptococcus, and Enterococcus. Specific pathogenic species and their identification are covered including Staphylococcus aureus, coagulase-negative Staphylococci, and Streptococcus pyogenes.
This document provides information about histoplasmosis, including its characteristics, pathogenesis, types, clinical presentation, and laboratory diagnosis. It can be summarized as follows:
1. Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum, which exists in both a mycelial and yeast form. It is found worldwide in soil contaminated with bird or bat droppings.
2. Infection typically occurs via inhalation of yeast cells into the lungs. It can cause pulmonary or disseminated disease, spreading to organs in immunocompromised individuals.
3. Laboratory diagnosis involves direct examination of samples for yeast cells, culture of the fungus, and serological tests like complement fixation
The document describes procedures for the haemagglutination (HA) test and haemagglutination inhibition (HI) test. The HA test detects viruses that can agglutinate or clump red blood cells by binding viral proteins to receptors on RBCs. It is used to measure virus titers. The HI test detects antibodies that inhibit HA by binding to viral antigens and blocking receptor binding. It is used to measure antibody titers and evaluate vaccines. Both tests involve making serial dilutions of virus or serum samples in microtiter plates, then adding RBCs to detect agglutination or its inhibition.
This document provides information about gram positive bacilli (rods), including Bacillus species. It discusses their characteristics such as being aerobic or facultatively anaerobic, producing endospores, and being catalase-positive. Key pathogens mentioned are B. anthracis which causes anthrax, and B. cereus which can cause food poisoning. The document then focuses on B. anthracis and B. cereus, describing their microscopy, culture characteristics, biochemical tests for identification, and advanced detection techniques for B. anthracis.
Direct microscopic examination of clinical specimens can provide a presumptive diagnosis of fungal infection by revealing the presence of fungal elements. Different stains and techniques are used to visualize fungi depending on the suspected infection. KOH wet mounts are useful for superficial mycoses while GMS, H&E and fluorescent antibody stains aid in diagnosis of deep mycoses from tissue biopsies and body fluids. Proper specimen collection and rapid microscopic evaluation can help initiate appropriate antifungal treatment.
This document outlines objectives and information about Haemophilus species. It discusses their microscopic characteristics, normal habitats, diseases caused, optimal growth conditions, and methods for identifying and differentiating species. Key points include that most species normally inhabit the respiratory tract but can cause systemic infections; they require factors like hemin and NAD for growth; and species are differentiated based on tests like hemolysis, ALA, and growth factor requirements. Important pathogenic species covered are H. influenzae, H. ducreyi, H. aegypticus, H. parainfluenzae, and H. haemolyticus.
This topic is highly useful for MBBS students.
Strongyloides is a Nematode. Causes Strongyloidiasis.
This topic briefly describes about the mode of transmission, life cycle, clinical features ,complications ,diagnosis, treatment and its prevention.
Medical Microbiology Laboratory (Enterobacteriaceae - III)Hussein Al-tameemi
This document provides information about Enterobacteriaceae and Salmonella species. It discusses the taxonomy and classification of Enterobacteriaceae, describing their characteristics. Salmonella is highlighted as an important genus. The document outlines methods for culturing and identifying Salmonella from clinical specimens such as blood and stool. Biochemical tests and serological identification methods like the Widal test are also summarized.
Medical Microbiology Laboratory (Enterobacteriaceae - II)Hussein Al-tameemi
This document provides information about Gram-negative bacilli in the Enterobacteriaceae family, focusing on Klebsiella species and Proteus species. It discusses their taxonomy, morphology, culture characteristics, and biochemical tests used to identify them. Klebsiella are normal gut flora that can cause UTIs, sepsis, and pneumonia. They are lactose fermenters that form mucoid colonies on MacConkey agar. Proteus species like P. mirabilis and P. vulgaris cause similar infections and have characteristics like swarming colonies, a fishy odor, and being urease and motile but non-lactose fermenting. Biochemical tests can differentiate Klebsiel
E. coli O157:H7 is a pathogenic strain of the bacteria Escherichia coli that was first recognized in 1982 during an outbreak linked to contaminated hamburgers. It produces Shiga toxin which can cause bloody diarrhea and potentially fatal complications like hemolytic-uremic syndrome. Common modes of transmission include ingesting contaminated food, water, or contact with ruminant animal feces. Prevention focuses on proper hygiene like handwashing and thoroughly cooking foods. Between 1982-2002 in the US, outbreaks remained common with over half being foodborne, highlighting the ongoing need for food safety regulations and precautions.
This document provides an introduction to the topic of mycology. It discusses the key characteristics of fungi, including their eukaryotic nature and cell wall composition of chitin and glucan. Fungi can exist in either yeast or mold forms and many medically important fungi are dimorphic, being able to live in both forms. The document outlines different types of fungal infections and methods for diagnosis, including microscopic examination, serology, culture and nucleic acid probes.
Acinetobacter is a genus of gram-negative bacteria that includes opportunistic pathogens. The most clinically important species are A. baumannii and A. lwoffii. A. baumannii is commonly found in hospitals and can cause infections in immunocompromised patients. It is able to survive on surfaces and in the environment. Treatment is challenging due to high levels of antibiotic resistance, though carbapenems and polymyxins may be used. Proper hygiene and cleaning can reduce transmission in clinical settings.
The document discusses hemoflagellates, single-celled flagellated parasites that infect the blood and tissues of humans and animals. It describes the structure, life cycles, transmission, geographic distribution, pathogenesis, diagnosis, treatment, and prevention of two important genera of hemoflagellates: Trypanosoma brucei, which causes African sleeping sickness, and Trypanosoma cruzi, which causes Chagas disease in South and Central America. Key aspects of the parasites, diseases they cause, and approaches to control are summarized.
Medical Microbiology Laboratory (biochemical tests - ii)Hussein Al-tameemi
1. The document discusses various biochemical tests used to identify bacteria, including enzymatic tests, metabolic pathway tests, and specific tests.
2. Metabolic pathway tests include carbohydrate oxidation/fermentation tests like the oxidative fermentation test, carbohydrate fermentation in TSI agar, and methyl red and Voges-Proskauer tests. They also include amino acid degradation tests and single substrate utilization tests.
3. Examples of specific tests discussed are the citrate utilization test and acetate utilization test to determine if bacteria can use certain compounds as the sole carbon source.
This document discusses ESBL (Extended Spectrum Beta Lactamases) which confer bacterial resistance to several classes of beta-lactam antibiotics. Early diagnosis of ESBL-producing pathogens is important to reduce mortality and morbidity. The document then describes several confirmatory tests for ESBL production, focusing on the double disk synergy test. This test involves placing disks containing beta-lactam antibiotics and amoxicillin-clavulanic acid on an inoculated agar plate. A positive result is indicated by a clear extension of the inhibition zone between the antibiotic and amoxicillin-clavulanic acid disks.
This document describes the liver fluke Fasciola hepatica and Fasciola gigantica. It details their taxonomy, life cycle, transmission, symptoms, diagnosis and treatment. Fasciola species have a complex life cycle involving an aquatic snail as the first intermediate host and water plants as the second intermediate host. Humans and ruminants can become infected by ingesting metacercariae on contaminated water plants or water. Infection causes fascioliasis and symptoms range from asymptomatic to abdominal pain. Diagnosis involves finding eggs in stool or through serology. Treatment includes drugs like bithionol and triclabendazole.
This particular presentation includes slide on basic virology about rabies virus, pathogenesis of rabies and it's management specially emphasized on guide of pre and post exposure vaccination.
The document describes and classifies various medically important trematode parasites. It discusses their general characteristics, classification, life cycles, and morphology of adults and eggs. Key points include: trematodes are flatworms with oral and ventral suckers, require two intermediate hosts, and eggs are operculated; major groups discussed are blood flukes (Schistosoma), liver flukes (Fasciola, Clonorchis, Opisthorchis), intestinal flukes (Fasciolopsis, Heterophyids, Echinostoma), and lung flukes (Paragonimus). Adult and egg morphology and sizes are provided for identification purposes.
A 41-year-old woman with aplastic anemia was admitted with fever. Blood cultures grew E. coli resistant to ampicillin and narrow-spectrum cephalosporins. Despite treatment with multiple antimicrobials over 4 weeks, the patient's fever and bacteremia persisted. The microbiology lab was contacted to help determine why standard therapies were failing to clear the infection.
Doxophylline is a methylxanthine derivative that acts as a bronchodilator by increasing diaphragm contractility, relaxing bronchial musculature, and decreasing inflammation. It has potential advantages over theophylline as it has a wider therapeutic window and causes fewer side effects. Doxophylline may be useful for treating conditions like COPD, asthma, chronic bronchitis, and emphysema by reducing bronchoconstriction, mucus production, and edema in the airways. Further studies on doxophylline are needed to fully understand its efficacy and safety profile.
Amphetamine, also known by many street names, is a stimulant drug that can be injected, snorted, smoked, or taken orally in pill form. It is classified as an "upper" that causes both short term effects like increased heart rate and energy, as well as long term risks like heart and brain damage. While amphetamine was first produced in 1887 and found medical uses, it is now illegal without a prescription due to its high potential for abuse and health risks.
This document provides information about histoplasmosis, including its characteristics, pathogenesis, types, clinical presentation, and laboratory diagnosis. It can be summarized as follows:
1. Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum, which exists in both a mycelial and yeast form. It is found worldwide in soil contaminated with bird or bat droppings.
2. Infection typically occurs via inhalation of yeast cells into the lungs. It can cause pulmonary or disseminated disease, spreading to organs in immunocompromised individuals.
3. Laboratory diagnosis involves direct examination of samples for yeast cells, culture of the fungus, and serological tests like complement fixation
The document describes procedures for the haemagglutination (HA) test and haemagglutination inhibition (HI) test. The HA test detects viruses that can agglutinate or clump red blood cells by binding viral proteins to receptors on RBCs. It is used to measure virus titers. The HI test detects antibodies that inhibit HA by binding to viral antigens and blocking receptor binding. It is used to measure antibody titers and evaluate vaccines. Both tests involve making serial dilutions of virus or serum samples in microtiter plates, then adding RBCs to detect agglutination or its inhibition.
This document provides information about gram positive bacilli (rods), including Bacillus species. It discusses their characteristics such as being aerobic or facultatively anaerobic, producing endospores, and being catalase-positive. Key pathogens mentioned are B. anthracis which causes anthrax, and B. cereus which can cause food poisoning. The document then focuses on B. anthracis and B. cereus, describing their microscopy, culture characteristics, biochemical tests for identification, and advanced detection techniques for B. anthracis.
Direct microscopic examination of clinical specimens can provide a presumptive diagnosis of fungal infection by revealing the presence of fungal elements. Different stains and techniques are used to visualize fungi depending on the suspected infection. KOH wet mounts are useful for superficial mycoses while GMS, H&E and fluorescent antibody stains aid in diagnosis of deep mycoses from tissue biopsies and body fluids. Proper specimen collection and rapid microscopic evaluation can help initiate appropriate antifungal treatment.
This document outlines objectives and information about Haemophilus species. It discusses their microscopic characteristics, normal habitats, diseases caused, optimal growth conditions, and methods for identifying and differentiating species. Key points include that most species normally inhabit the respiratory tract but can cause systemic infections; they require factors like hemin and NAD for growth; and species are differentiated based on tests like hemolysis, ALA, and growth factor requirements. Important pathogenic species covered are H. influenzae, H. ducreyi, H. aegypticus, H. parainfluenzae, and H. haemolyticus.
This topic is highly useful for MBBS students.
Strongyloides is a Nematode. Causes Strongyloidiasis.
This topic briefly describes about the mode of transmission, life cycle, clinical features ,complications ,diagnosis, treatment and its prevention.
Medical Microbiology Laboratory (Enterobacteriaceae - III)Hussein Al-tameemi
This document provides information about Enterobacteriaceae and Salmonella species. It discusses the taxonomy and classification of Enterobacteriaceae, describing their characteristics. Salmonella is highlighted as an important genus. The document outlines methods for culturing and identifying Salmonella from clinical specimens such as blood and stool. Biochemical tests and serological identification methods like the Widal test are also summarized.
Medical Microbiology Laboratory (Enterobacteriaceae - II)Hussein Al-tameemi
This document provides information about Gram-negative bacilli in the Enterobacteriaceae family, focusing on Klebsiella species and Proteus species. It discusses their taxonomy, morphology, culture characteristics, and biochemical tests used to identify them. Klebsiella are normal gut flora that can cause UTIs, sepsis, and pneumonia. They are lactose fermenters that form mucoid colonies on MacConkey agar. Proteus species like P. mirabilis and P. vulgaris cause similar infections and have characteristics like swarming colonies, a fishy odor, and being urease and motile but non-lactose fermenting. Biochemical tests can differentiate Klebsiel
E. coli O157:H7 is a pathogenic strain of the bacteria Escherichia coli that was first recognized in 1982 during an outbreak linked to contaminated hamburgers. It produces Shiga toxin which can cause bloody diarrhea and potentially fatal complications like hemolytic-uremic syndrome. Common modes of transmission include ingesting contaminated food, water, or contact with ruminant animal feces. Prevention focuses on proper hygiene like handwashing and thoroughly cooking foods. Between 1982-2002 in the US, outbreaks remained common with over half being foodborne, highlighting the ongoing need for food safety regulations and precautions.
This document provides an introduction to the topic of mycology. It discusses the key characteristics of fungi, including their eukaryotic nature and cell wall composition of chitin and glucan. Fungi can exist in either yeast or mold forms and many medically important fungi are dimorphic, being able to live in both forms. The document outlines different types of fungal infections and methods for diagnosis, including microscopic examination, serology, culture and nucleic acid probes.
Acinetobacter is a genus of gram-negative bacteria that includes opportunistic pathogens. The most clinically important species are A. baumannii and A. lwoffii. A. baumannii is commonly found in hospitals and can cause infections in immunocompromised patients. It is able to survive on surfaces and in the environment. Treatment is challenging due to high levels of antibiotic resistance, though carbapenems and polymyxins may be used. Proper hygiene and cleaning can reduce transmission in clinical settings.
The document discusses hemoflagellates, single-celled flagellated parasites that infect the blood and tissues of humans and animals. It describes the structure, life cycles, transmission, geographic distribution, pathogenesis, diagnosis, treatment, and prevention of two important genera of hemoflagellates: Trypanosoma brucei, which causes African sleeping sickness, and Trypanosoma cruzi, which causes Chagas disease in South and Central America. Key aspects of the parasites, diseases they cause, and approaches to control are summarized.
Medical Microbiology Laboratory (biochemical tests - ii)Hussein Al-tameemi
1. The document discusses various biochemical tests used to identify bacteria, including enzymatic tests, metabolic pathway tests, and specific tests.
2. Metabolic pathway tests include carbohydrate oxidation/fermentation tests like the oxidative fermentation test, carbohydrate fermentation in TSI agar, and methyl red and Voges-Proskauer tests. They also include amino acid degradation tests and single substrate utilization tests.
3. Examples of specific tests discussed are the citrate utilization test and acetate utilization test to determine if bacteria can use certain compounds as the sole carbon source.
This document discusses ESBL (Extended Spectrum Beta Lactamases) which confer bacterial resistance to several classes of beta-lactam antibiotics. Early diagnosis of ESBL-producing pathogens is important to reduce mortality and morbidity. The document then describes several confirmatory tests for ESBL production, focusing on the double disk synergy test. This test involves placing disks containing beta-lactam antibiotics and amoxicillin-clavulanic acid on an inoculated agar plate. A positive result is indicated by a clear extension of the inhibition zone between the antibiotic and amoxicillin-clavulanic acid disks.
This document describes the liver fluke Fasciola hepatica and Fasciola gigantica. It details their taxonomy, life cycle, transmission, symptoms, diagnosis and treatment. Fasciola species have a complex life cycle involving an aquatic snail as the first intermediate host and water plants as the second intermediate host. Humans and ruminants can become infected by ingesting metacercariae on contaminated water plants or water. Infection causes fascioliasis and symptoms range from asymptomatic to abdominal pain. Diagnosis involves finding eggs in stool or through serology. Treatment includes drugs like bithionol and triclabendazole.
This particular presentation includes slide on basic virology about rabies virus, pathogenesis of rabies and it's management specially emphasized on guide of pre and post exposure vaccination.
The document describes and classifies various medically important trematode parasites. It discusses their general characteristics, classification, life cycles, and morphology of adults and eggs. Key points include: trematodes are flatworms with oral and ventral suckers, require two intermediate hosts, and eggs are operculated; major groups discussed are blood flukes (Schistosoma), liver flukes (Fasciola, Clonorchis, Opisthorchis), intestinal flukes (Fasciolopsis, Heterophyids, Echinostoma), and lung flukes (Paragonimus). Adult and egg morphology and sizes are provided for identification purposes.
A 41-year-old woman with aplastic anemia was admitted with fever. Blood cultures grew E. coli resistant to ampicillin and narrow-spectrum cephalosporins. Despite treatment with multiple antimicrobials over 4 weeks, the patient's fever and bacteremia persisted. The microbiology lab was contacted to help determine why standard therapies were failing to clear the infection.
Doxophylline is a methylxanthine derivative that acts as a bronchodilator by increasing diaphragm contractility, relaxing bronchial musculature, and decreasing inflammation. It has potential advantages over theophylline as it has a wider therapeutic window and causes fewer side effects. Doxophylline may be useful for treating conditions like COPD, asthma, chronic bronchitis, and emphysema by reducing bronchoconstriction, mucus production, and edema in the airways. Further studies on doxophylline are needed to fully understand its efficacy and safety profile.
Amphetamine, also known by many street names, is a stimulant drug that can be injected, snorted, smoked, or taken orally in pill form. It is classified as an "upper" that causes both short term effects like increased heart rate and energy, as well as long term risks like heart and brain damage. While amphetamine was first produced in 1887 and found medical uses, it is now illegal without a prescription due to its high potential for abuse and health risks.
This document discusses how various drugs can alter the electrocardiogram (ECG) by affecting cardiac conduction pathways and electrolyte levels. It outlines the systematic steps for ECG interpretation and describes the mechanisms and ECG changes caused by sodium channel blockers, calcium channel blockers, potassium channel blockers, drugs acting on the autonomic nervous system, drugs of abuse, and electrolyte disturbances. Understanding how drugs can impact the ECG is important for diagnosing cardiac toxicity during drug overdose.
1) The document discusses various toxidromes including anticholinergic, cholinergic, sympathomimetic, narcotic, and serotonergic toxidromes.
2) It outlines the essential investigations for potential drug overdoses including calculating the anion gap, serum osmolality, and osmolar gap.
3) The management of common overdoses is discussed, including toxic alcohols, acetaminophen, TCAs, and serotonin syndrome. Some overdoses may require dialysis.
This document provides an overview of poisonings and toxicology for primary care providers. It discusses the basics of assessing and stabilizing a poisoned patient, including determining if they are stable or unstable based on vital signs and mental status. It covers various toxin categories like anticholinergics, cholinergics, opioids, sedatives, sympathomimetics, carbon monoxide, and toxic alcohols. For each category it describes signs and symptoms, mechanisms, and treatment approaches like supportive care, activated charcoal, antidotes, and specific reversal agents. The goal is to help primary care recognize poisoning presentations and provide initial stabilization before transfer if needed.
Amphetamine is a strong drug that can have both positive and negative effects. It increases alertness, confidence, talkativeness and concentration but reduces fatigue, appetite and anxiety while also potentially causing irritability, convulsions, brain damage, hallucinations and increasing risks of alcoholism when abused long term. Overdose can kill.
This document summarizes the effects of cannabis and amphetamine abuse. It discusses how cannabis affects the brain through cannabinoid receptors, particularly CB1 receptors which are abundant in areas involved in reward and movement. Prolonged cannabis use can cause impaired coordination, difficulty thinking, and increased risk of lung cancer. Amphetamines are stimulants that cause the release of dopamine and norepinephrine. They are prescribed medically for conditions like ADHD and obesity but recreational use can lead to increased heart rate, euphoria, and risks of overdose with effects on heart, breathing and mental state. Both drugs are addictive and long term abuse can damage physical and mental health.
Toxidromes poisoning in emergency medicineshama101p
This document discusses different types of toxidromes, which are groupings of drugs that cause similar signs and symptoms. The four main toxidromes covered are: 1) anticholinergics, which cause symptoms like dilated pupils, dry skin, and tachycardia; 2) sympathomimetics, which cause symptoms like tachycardia, hypertension, and dilated pupils; 3) opioids, which cause pinpoint pupils, respiratory depression, and sedation; and 4) cholinergics, which cause symptoms like increased salivation, tearing, and bronchospasm. For each toxidrome, example drugs are provided and treatment approaches for overdose are outlined. The document also discusses approaches for diagn
This document discusses toxicologic emergencies. It provides statistics on poisonings in the US and outlines the evaluation and management of poisoned patients. Key aspects of the history and physical exam are reviewed. Common toxidromes such as anticholinergic, opioid, and serotonin syndrome are described. Methods of decontamination, enhanced elimination, and use of antidotes are also outlined. Two case examples involving acetaminophen toxicity and carbon monoxide poisoning are then presented and discussed.
The document discusses adrenoceptor agonists and antagonists. It begins by providing an overview of the sympathetic nervous system and drugs that act on it. It then describes direct-acting sympathomimetic drugs that mimic norepinephrine and epinephrine by acting on alpha and beta receptors. Various agonists are discussed in depth, including their mechanisms of action, effects, uses, and adverse reactions. The document also covers adrenoceptor antagonists that block alpha and beta receptors, describing examples like prazosin and propranolol along with their clinical applications.
Amphetamine related presentations to the EDSCGH ED CME
Amphetamine use is common in Australia, second only to cannabis. This presentation reviewed the history, epidemiology, and complications of amphetamine use and provided a case study. Acute complications include increased heart rate, blood pressure, arrhythmias, chest pain, agitation, psychosis, seizures, and hyperthermia. Chronic complications include increased risk of infections, stroke, heart disease, and mental health issues. Management involves monitoring vitals and giving benzodiazepines to treat agitation, seizures, and other complications.
This document discusses alkyl benzene sulfonates (ABS), which are major components of anionic detergents. It describes the chemistry and manufacturing of ABS and linear alkylbenzene sulfonates (LAS). ABS can be branched or linear, while LAS is comprised of linear alkyl chains. The document also discusses the environmental impacts and biodegradability of ABS and LAS, noting LAS biodegrades more readily. It assessed the toxicity of LAS to aquatic organisms and sediments, and the microbial consortia involved in LAS biodegradation.
This document provides a summary of a teaching session on toxidromes. It discusses several case presentations and the key features of different toxidromes including: sympathomimetic toxicity, serotonin syndrome, opioid overdose, anticholinergic syndrome, neuroleptic malignant syndrome, and malignant hyperthermia. For each case, the document outlines vital signs, physical exam findings, differential diagnoses, management considerations, and important complications.
Industrial toxicology deals with the toxic properties of substances that people are exposed to in occupational and non-occupational settings. Toxicity is the study of how the body responds to toxic substances. Toxic effects can be acute or chronic and result from inhalation, ingestion, skin/eye contact, or other routes of exposure. Setting workplace standards involves understanding chemical toxicity through methods like chemical analogy, animal experimentation, and establishing exposure limits based on a substance's toxic properties.
Diagnosis and treatment of amphetamine abuseAsra Hameed
Amphetamine is a stimulant and an appetite suppressant. It stimulates the central nervous system (nerves and brain) by increasing the amount of certain chemicals in the body. This increases heart rate and blood pressure and decreases appetite, among other effects.
Amphetamine is used to treat narcolepsy and attention deficit disorder with hyperactivity (ADHD).
Amphetamine may also be used for purposes other than those listed in this medication guide.
This document discusses caffeine, including its history, sources, mechanism of action, metabolism, extraction processes, health benefits, risks, and decaffeination. Caffeine is a natural stimulant found in coffee, tea, soft drinks and energy drinks. It acts as an antagonist to adenosine receptors in the brain, increasing neuronal activity. While caffeine has potential benefits like reducing Alzheimer's risk, it can also increase heart rate and blood pressure. The document examines studies on both the positive and negative health effects of caffeine consumption.
Poisoning can occur through ingestion, inhalation, injection, or skin absorption of toxic substances. Poisonings are classified as intentional, unintentional, or undetermined. Common causes of poisoning include pharmaceuticals, household products, pesticides, and plants/mushrooms. Initial medical care focuses on life support and stabilizing the patient. Preventing further absorption and administering antidotes specific to the toxin are also important treatment steps. Proper storage and disposal of toxic substances can help prevent accidental poisoning.
Local & systemic Complications of Local AnesthesiaIAU Dent
This document discusses local anesthesia (LA), including its mechanism of action, factors influencing injection discomfort and techniques to reduce discomfort, testing the success of LA, causes and management of failed LA, complications of LA including local and systemic complications, and management of specific complications like needle breakage, pain/burning on injection, persistent anesthesia, and trismus. It provides anatomical and technical details related to achieving successful LA and avoiding complications.
This document discusses grape and raisin toxicity in dogs. It provides information on:
- The toxic doses of grapes and raisins for dogs are 0.7 oz/kg for grapes and 0.1 oz/kg for raisins.
- Clinical signs of toxicity include lethargy, vomiting, diarrhea, and acute renal failure.
- The mechanism is unknown but may involve mycotoxins, pesticides, or an inability to metabolize components of the fruits.
- Diagnostics show elevated BUN and creatinine levels and urinalysis abnormalities. Treatment focuses on decontamination, supportive care like IV fluids, and monitoring for renal recovery.
The document provides an overview of the preanesthetic period for surgical nursing and anesthesia. It discusses obtaining patient information through history and physical examination, performing diagnostic tests, selecting an anesthetic protocol based on factors like the procedure and patient status, providing preanesthetic patient care like fasting, and commonly used preanesthetic agents including atropine, glycopyrrolate, benzodiazepines, phenothiazines, and alpha-2 agonists.
The document describes a 65-year-old male patient with acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), and peripheral vascular disease who was admitted to the hospital. He was initially treated with a ventilator and tube feedings, but developed high gastric residuals and worsening respiratory status. His nutrition was modified by discontinuing enteral and parenteral feeds due to excessive calorie intake, as indicated by elevated CO2 levels and increased respiratory quotient. His respiratory status and nutrition were closely monitored until he was successfully weaned from the ventilator and discharged.
This document describes the case of 65-year-old Daishi Hayato who was admitted to the hospital with acute respiratory distress, COPD, and peripheral vascular disease. He had a history of smoking 2 packs per day for 50 years. He developed respiratory failure and required intubation and ventilation. Enteral and parenteral nutrition were started but caused excessive calorie intake, as shown by elevated CO2 levels and increased RQ. Nutrition was modified to prevent further complications.
The document provides an overview of endocrine emergencies including adrenal crisis, diabetic ketoacidosis, and hypoglycemia. It describes the endocrine system and its functions. Adrenal crisis occurs when the adrenal glands cannot produce adequate hormones in response to stress. Diabetic ketoacidosis results from insulin deficiency and excess stress hormones, causing a buildup of ketones in the blood. Assessment, diagnostic testing, nursing diagnoses, and treatment approaches are outlined for these conditions. The goal is to stabilize vital signs and correct fluid, electrolyte, acid-base, and blood glucose imbalances.
This document discusses nausea and vomiting, including its definition, causes, pathophysiology, clinical presentation, and treatment. It describes the epidemiology of nausea and vomiting, noting it is most common in those aged 15-24 and less common in other ages. Treatment involves both non-pharmacological approaches like rest and rehydration as well as a variety of antiemetic drugs depending on the underlying cause, including 5-HT3 antagonists, D2 antagonists, antihistamines, and corticosteroids. The choice of antiemetic considers factors like the situation of motion sickness, pregnancy, postoperative nausea and vomiting, and cytotoxic chemotherapy.
Hypothyroidism is caused by an abnormality in the thyroid gland that prevents the release or production of thyroid hormones. Symptoms include decreased metabolism, goiter, hair loss, and constipation. Levothyroxine is used to treat hypothyroidism but can cause cardiac issues or palpitations if not taken properly. A thyroidectomy can potentially cause complications from an overdose of thyroid replacement drugs.
Medications can be administered by different routes that affect their absorption rate and extent. Oral medications pass through the stomach and liver first, while sublingual and parenteral routes provide faster absorption. The major organ systems involved in drug excretion are the liver, kidneys, intestines
This document provides an overview of pharmacology basics including definitions of key terms, drug categories, pharmacodynamics, pharmacokinetics, drug computations, and examples of nursing teachings related to over-the-counter medications and sample patient cases. Key concepts covered include drug absorption, distribution, metabolism, excretion, factors influencing drug effects, allergic reactions, and conversions between units of measurement for drug dosages.
This document provides an overview of treating sepsis in 8 steps:
1) Rapidly assess for critical instability and signs of organ dysfunction
2) Administer empiric fluids and perform ultrasound exams to identify potential infection sources
3) Administer early, broad-spectrum antibiotics within 1 hour
4) Identify and control infection sources
5) Understand appropriate vasoactive medications
6) Recognize patients that deteriorate rapidly
7) Use lactate levels to guide resuscitation but recognize limitations
8) Optimize hemodynamics prior to intubation for shock patients
Two case studies are then presented and managed using the stepwise approach.
1. The child has relapsed acute lymphoblastic leukemia (ALL) and underwent reinduction chemotherapy.
2. Following the first cycle of reinduction therapy, laboratory tests show: a white blood cell count of 21,900, uric acid level of 9, and LDH level elevated.
3. These laboratory abnormalities indicate tumor lysis syndrome, a potential complication of effective chemotherapy in patients with high tumor burden. Urgent intervention is needed to prevent renal failure and other complications.
This document provides information about homocystinuria, an inborn error of metabolism caused by cystathionine β-synthase deficiency. It leads to increased levels of homocysteine and methionine. Symptoms include ectopia lentis, skeletal abnormalities, intellectual disability, and blood clots. Treatment involves a low-protein, methionine-restricted diet and supplementation with vitamins B6, folate, betaine to convert homocysteine to cystathionine. Early diagnosis and treatment can prevent complications and allow for normal growth.
This document provides a case study on a 75-year old woman admitted with abdominal pain who was diagnosed with acute gallstone pancreatitis. The summary is:
1) The patient presented with intermittent right upper quadrant abdominal pain for 6 weeks along with nausea and vomiting in the past 24 hours. Laboratory tests revealed elevated pancreatic enzymes and ultrasound showed gallstones.
2) The case was identified as acute gallstone pancreatitis, which occurs when a gallstone lodges in the pancreatic duct, causing the pancreatic juices to become trapped and inflamed.
3) The anatomy of the gallbladder and pancreas was described, noting their roles in bile and enzyme production and drainage into the small intestine.
Clinical Toxicology by dr.tayyaba rphpptBIANOOR123
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants.
Mesenteric torsion pathology and managementGalinaHayes
Lennox, a 5-year-old boxer, collapsed and was brought to the veterinary emergency department with rectal bleeding and shock. Initial treatment stabilized the dog, but it remained unresponsive. Surgery revealed an intestinal torsion, which was repaired. Post-operatively, the dog developed facial swelling and a drop in red blood cell count, indicating a delayed transfusion reaction from previous blood products. Supportive care was provided and the dog was eventually discharged.
Background: Body of literature are becoming pronounced that pathological condition in one organ of the body might have an effect on other distal organs owing to the fact, that the entire body metabolism is orchestrated centrally.
Pathological events occurring in an organ are likely to be extended to other organs. Pretreatment that minimize these events are presumed to be beneficial to the extended organs.
Methods: Following 30 min of ischemia and 48 h of reperfusion in the kidney, rats under anesthesia were sacrificed and blood sample collected through cardiac puncture. Serum level of troponin I, and activities of total creatine kinase (CK), mass creatine kinase (CK-MB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma –glutamyl transferase (GGT) were estimated spectrophotometrically.
Results: Serum troponin I increased to 0.031 ± 0.001 ng/ml in the ischemic group, and following pretreatment with Lmm (600mg/kg), serum level of troponin I decreased significantly to 0.021 ± 0.001 ng/ml (P<.05).><.05),><.05)><.05).
The document summarizes presentations from a symposium on canine and feline health. It includes an article on challenging feline endocrine cases that outlines diagnostic approaches for polydipsia/polyuria, weight gain, and insulin resistance in cats. The article provides diagnostic flowcharts and lists common endocrine and non-endocrine differentials for each presentation. It also discusses history questions and testing to differentiate causes like diabetes, hyperthyroidism, and dietary issues.
Phaeochromocytoma is a rare tumor that develops in the chromaffin cells of the adrenal medulla. It causes the overproduction of catecholamines which can increase blood pressure and heart rate. Diagnosis involves testing urine or plasma for elevated catecholamines/metanephrines. Treatment is usually laparoscopic surgery to remove the tumor followed by monitoring as blood pressure normalizes. Aggressive blood pressure control pre- and post-operatively is needed to prevent hypertensive crises from the sudden removal of excess catecholamines.
George, a 40-year-old male with a history of chronic alcoholism and gallstones, presented with severe abdominal pain after starting sulfasalazine for ulcerative colitis. Lab results showed elevated amylase, lipase, and white blood cell count. The physician's diagnosis was acute pancreatitis, likely caused by sulfasalazine triggering the condition. Due to the severity of symptoms and lab abnormalities, the patient should be admitted to the ICU and given IV fluids, analgesics, and monitored closely for complications of acute pancreatitis.
A 27-year-old male presented to the emergency department with vomiting, abdominal pain, altered mental status, and malaise. Many empty drug bottles were found in his bedroom. Toxicology testing did not find an overdose but acetaminophen toxicity was suspected due to the patient's recent depression and use of over-the-counter drugs. Acetaminophen toxicity can cause liver damage and is a common cause of acute liver failure in both the US and Saudi Arabia. Early identification and treatment with N-acetylcysteine can prevent liver injury if started soon after overdose.
Dr. Swamy Venuturupalli Presents “Alternative Treatments for Lupus: Do They W...LupusNY
This document discusses complementary and alternative therapies for arthritis, specifically for systemic lupus erythematosus (SLE). It defines complementary and alternative medicine and classifies different modalities. It then reviews studies on the use of various CAM therapies in SLE patients, including relaxation techniques, herbal medicine, nutritional supplements like fish oils, DHEA, and acupuncture. It discusses challenges in evaluating CAM and provides resources for more information.
Similar to Methylzanthine Toxicities Er Rotation Presentation 9 17 09 (20)
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Methylzanthine Toxicities Er Rotation Presentation 9 17 09
1. Katie Krimetz Western University, College of Veterinary Medicine 4th Year E.R. and Critical Care Rotation VCA EAH&RC, San Diego 9/17/09 Methylxanthine Toxicities
2. OverviewMethylxanthine Toxicities Synonyms and Sources Toxicokinetics Mechanism of Action Toxicities/Risk Factors Clinical Signs and Differentials Clinical Pathology Diagnosis Treatment Prognosis
5. Sources Image: http://www.css.cornell.edu/ecf3/Web/new/AF/pics/CacaoTree1.jpg Theobromine Cacao beans (seeds of Theobroma cacao) Hulls/mulch often used in landscaping Chocolate candy Concentration is 3-10x greater than caffeine7 Both play a part in toxicities Cola soft drinks Tea Image: http://www.montosogardens.com/theobroma_cacao_4_small.JPG
6. Sources of Theobromine Quick Tip: 1 oz milk chocolate/lb body weight potentially lethal7 Table 59-2 – 3) Carson reference, unless otherwise noted
7. Sources Theophylline Tea Human asthma medications bronchodilator May present risk, but toxicities rare3 Image: http://1.bp.blogspot.com/_8bMLJ1CEHMw/R9QPsXLpZzI/AAAAAAAAADg/62HWPcF5z0s/s400/tea-in-hands.jpg
8. Toxicokinetics Caffeine Absorption: Quick Peak serum levels @ 30-60 min3 Food does not affect 1 Distribution: Proportionate to body water Readily absorbed from GI track7 Passes into all body compartments Metabolism: Hepatic Ɲ-demethylation2,3 CO2 Phase II conjugation reactions2,3 hydrophilic Subsequent enterohepatic recycling7 elimination +/- absorption Excretion Half-life: (dogs) 4.5 hours 1,3,7 Bile Caution: enterohepatic recirculation1,3 10% unchanged in urine3 Image: From Reference 2
9. Toxicokinetics Theobromine Absorption: Slow Peak serum levels @ 10 hours3 Increases pyloric sphincter tone stays in the stomach longer8 Distribution: Readily absorbed from GI tract Passes into all body compartments1 Metabolism: Hepatic Ɲ-demethylation2,3 Phase II conjugation reactions2,3 Enterohepatic recycling1,7 Excretion: slow Half-life: (dogs) 17.5 hours1,3,7 Urine, and some through bile Image: From Reference 2
10. Toxicokinetics Theophylline Absorption: Quick Peak serum levels @ 1.5 hours3 Depends on preparation (ex: sustained-release tabs)1 Food slows rate of absorption1 But can increase or decrease bioavailability1 Distribution: Readily absorbed from GI track Passes into all body compartments1 Metabolism: Hepatic No significant first pass effect1 Ɲ-demethylation2,3 Phase II conjugation reactions2,3 Excretion Half-life: 5.7 hours (dog), 7.8 hours (cat)1,3 10% unchanged in urine3, some through bile Image: From Reference 2
11. Mechanism of Action Theory 1 Antagonize cellular adenosine receptors1,7 CNS stimulation, diuresis, tachycardia Suspected to be blocked at therapeutic and toxic doses1 Theory 2 Increase cellular calcium entry1,7 Inhibits muscle uptake and sequestration of calcium1,7 Through sarcoplasmic reticulum of striated muscle Increases strength and contractility1 since no re-sequestration Theory 3 Competes for CNS benzodiazepine receptors, inhibit phosphodiesterase1,7 Increases cAMP levels Regulates potassium channels hypokalemia Theory 4 Sympathetic stimulation1,7 Increases circulating levels of epinephrine and norepinephrine catecholamines Hypokalemia, metabolic acidosis, cardiac disturbances1
12. Toxicity/Risk Factors Caffeine – usually by ingesting chocolate Mean Lethal Dose/LD50 DOG – 110-200 mg/kg1 CAT – 80-150 mg/kg1 Mild signs 20 mg/kg7 Cardiotoxic 40-50 mg/kg7 Seizures >60 mg/kg7 Image: http://www.midwayanimalhosp.com/dogchocyWEB0912_468x303.jpg
13. Toxicity/Risk Factors Theobromine Mean Lethal Dose/LD50 DOG – 250-500 mg/kg1 CAT – 200 mg/kg1 Therapeutic level (diuresis and cardiac stimulation) 20 mg/kg Theophylline Mean Lethal Dose/LD50 DOG – 290 mg/kg1 CAT – 800 mg/kg1 Image: http://itchmo.com/wp-content/uploads/2007/06/thirsty_puppy0b7cb7.jpg
14. Clinical Signs Signs within 6-12 hours7 Often more than one methylxanthine has been ingested Renal diuresis3 Mild signs:7 Vomiting, diarrhea, abdominal distension, polydipsia, restlessness Moderate/Progressive signs:7 Hyperactivity, polyuria, ataxia, tremors, seizures Severe Signs:7 Tachycardia, PVCs, tachypnea, cyanosis, hyper-/hypotension, hyperthermia, bradycardia, coma Hypokalemia cardiac dysfunction High fat content of chocolate pancreatitis Death d/t cardiac arrhythmias, hyperthermia, or respiratory failure
16. Clinical Signs and Differentials CNS, cardiac muscle stimulation3 Most likely signs in acute toxicosis3 Smooth muscle relaxation/weakness Especially bronchial muscle3 Differentials7 Amphetamine toxicity Pseudoephedrine toxicity Cocaine toxicity Antihistamine ingestion Other CNS Stimulants
17. Clinical Pathology Rare to see lesions7 Diagnostic findings in GI tract at necropsy Hemorrhage, hyperemia, or congestion7 Agonal changes Pulmonary edema or congestion7 Severe arrhythmias
19. Treatment Stabilize patient first – Basic life support Tremors/seizures: methocarbamol, diazepam, acepromazine Ace lasts longer, some alpha-blocking effects (help to lower blood pressure)4 Start low (0.025-0.05 mg/kg) then in small incremental doses Severe seizures: barbiturates ECG Arrhythmias1,7 Tachyarrhythmias: Beta-blockers propanolol or metoprolol Metoprolol preferred1,5 Other medications to avoid: enrofloxacin, corticosteroids, cimetidine1 Bradyarrhythmias: atropine Ventricular tachyarrhythmias: lidocaine for dogs Fluid diuresis: stabilize cardiac function and quicken urinary excretion1
20. Treatment Within 2 hours of ingestion…1 Decontamination Inducing emesis (OH, syrup of ipecac, apomorphine, xylazine) Gastric lavage Especially for patients that needed sedation for stabilization ALWAYS USE ENDOTRACHEAL TUBE Adsorbent Activated charcoal 1-4 g/kg1,7 Repeat dose every 3-8 hours in symptomatic patients Reduces enterohepatic recirculation and reduces exposure to lower GI bacteria1 Mix with cathartic to ensure charcoal excretion Sorbitol, magnesium, NaSO4 Image: http://gal-lori.com/wp-content/uploads/2008/06/g080123a1kittylitter.jpg
21. Treatment Don’t forget... Thermoregulation Correcting acid/base abnormalities Consider… Urinary catheter Methylxanthines and metabolites can be reabsorbed through bladder wall1,7
22. Prognosis Excellent with timely treatment and control Guarded to Poor without treatment or control Most patients recover within 24-48 hours1 Clinical signs can last up to 72 hours7 Image: http://pixdaus.com/pics/1210617619u5cfEhB.jpg
23. References Albretsen, Jay C. Mehtylxanthines. In: Plumlee, Konnie H. Clinical Veterinary Toxicology. St. Louis, Missouri: Mosby; 2004: 322-326 Beasley, V. “Toxicants Associated with Stimulation or Seizures.” Veterinary Toxicology, IVIS. IVIS Veterinary Toxicology Editor. Last updated: 8/9/1999 Carson, Thomas L. Methylxanthines. In: Peterson M, Talcott P. Small Animal Toxicology. St. Louis, Missouri: Elsevier Saunders; 2006: 845-851 Dunayer, Eric, MS, VMD, DABT, DABVT. VIN consultant: Toxicology. ASPCA Animal Poison Control Center, 10/15/08 Grossman, Mark, DVM MS. VIN consultant: Toxicology, Associate Editor: Dermatology. Coordinator: Georgia Animal Poison Information Center. Co-Owner: Roanoke Island Animal Clinic, Manteo, NC 27954, 1/20/09 Gwaltney-Brant, Sharon, DVM, PhD, DABVT, DABT. ASPCA Animal Poison Control Center, Allied Agency of the University of Illinois. VIN Discussion: 5/23/08 The Merck Veterinary Manual: Merck & Co., Inc.; 2009. http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/211104.htm Wismer, Tina, DVM, DABVT, DABT. ASPCA Animal Poison Control Center, Allied Agency of the University of Illinois. VIN Dicussion: 10/1/08.
24. Questions and Discussion Image: http://www.spudart.org/blog/images/2003/207-0799_IMG_400.jpg Image: http://blogs.nashvillescene.com/bites/trufflesbig.jpg
Passes into BBB, placenta, and mammary glandsN-demethylation – releases carbon dioxide into liverphase II -conjugation reactions- creates a more hydrophyllic molecule for easier excretion/absorption (Carson, Beasley)
no first pass effect = little to no change when it first goes through liver still available after liver metabolism
Adenosine – normally inhibitis neurotransmission, slows down cell activity, adenosine binding also causes blood vessels to dilate antagnoized = neurotransmission allowedCa+2 – normal: Ca stored in SR of striated muscle, Ca binds to muscle fibers to allow contraction. Re-sequestration must occur for relaxationBenzodiazepine – sedative, anticonvulsant, myorelaxantPhosphodiesterase – inhibition = increased cAMP levelsK channels = normal cell depolarization
Propanolol reduces theopylline clearance in humans – reduces diuresis – urine is how it is excreted, NEED diuresisAvoid other meds for same reason
Cathartic increases GI motility
Methylxanthines = diuresis no renal toxicity with raisins?Or toxic compound in raisins does not survive candy processing/heat?Mixed box of chocolates w/ nuts/fruits, etc – Assume ½ is chocolate (Grossman)