1. NSAIDs work by inhibiting prostaglandin synthesis via blocking cyclooxygenase (COX) enzymes. They are classified based on selectivity for COX-1 vs COX-2.
2. Aspirin is a non-selective, irreversible COX inhibitor. It provides analgesic, antipyretic and anti-inflammatory effects. Common adverse effects include gastric irritation and bleeding risks.
3. Paracetamol is considered a COX-3 inhibitor. It has analgesic properties but does not cause gastric irritation or bleeding like other NSAIDs. Acute overdose can cause liver damage.
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
this presentation gives the knowledge about the decongestants are a type of medication that can provide short relief for a blocked nose ................
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
NSAIDs are the chemically diverse class of drugs that have anti-inflammatory, analgesic & antipyretic properties.
They are also called as Non Narcotic, Non Opioid, Aspirin like analgesics.
They are among the widely used therapeutic agents world wide and often taken without prescription for minor aches and pain.
They are used to suppress the symptoms of inflammation associated with rheumatic disease.
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
this presentation gives the knowledge about the decongestants are a type of medication that can provide short relief for a blocked nose ................
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
NSAIDs are the chemically diverse class of drugs that have anti-inflammatory, analgesic & antipyretic properties.
They are also called as Non Narcotic, Non Opioid, Aspirin like analgesics.
They are among the widely used therapeutic agents world wide and often taken without prescription for minor aches and pain.
They are used to suppress the symptoms of inflammation associated with rheumatic disease.
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones
Analgesic is a drug that relieves pain by acting on the CNS or on the peripheral pain mechanism without altering consciousness
Opioid analgesics
Non Opioid analgesics (NSAIDs)
NSAIDs are non-steroidal anti-inflammatory drugs. These are not only pain killers but also are anti-inflammatory drugs that are widely used in dentistry. These are weaker analgesics, also called nonnarcotic or aspirin-like or antipyretic analgesics. They do not depress CNS, do not produce physical dependence, and have no abuse liability. They act primarily on peripheral pain mechanisms.
Liraglutide is GLP-1 Receptor agonist, approved for use in Diabetes. this slideshow describes clinical researches on Liraglutide, especially LEAD and LEADER trials, as well as the recommendations of use of LIraglutide in diabetes.
recent advances in pharmacotherapy of Glaucoma DrShrey Bhatia
new drugs, potential targets, recent trends for glaucoma treatment. important new target have been discussed along with current therapies. good enough for post graduate teaching and undergraduate classes.
discussing all aspects of evidence based medicine, Introduction
History of EBM
Need of EBM
Steps to practice
Discussion - advantages/disadvantages/critical analysis
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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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.
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
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
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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2. introduction
• None of them are steroids
• All are analgesic, anti-pyretic and anti-inflammatory ( paracetamol is not
anti-inflammatory)
• Do not produce CNS depression, respiratory depression and don’t cause
drug dependence
• Act by inhibiting prostaglandin synthesis (except nefopam and diacerein)
7. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
ANALGESIA
• Relieves integumental pain associated with inflammation/tissue injury
• Not effective in visceral pain and ischemic pain
• Uses: headache, backache, toothache, myalgia, neuralgia,
dysmenorrhoea, rheumatoid arthritis, cancer pain
8. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
ANTI-PYRETIC
• Reduces raised body temperature, does not effect normal body
temperature
• Resets hypothalamic thermostat
• Uses: reducing fever of any origin
9. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
ANTI-INFLAMMATORY
• Decreases vasodilatory PGs( PGE2, PGI2) less edema
• Increases resistance of connective tissue mucopolysaccarides to
prevent spread of inflammation
• Uses: osteoarthritis, rheumatoid arthritis, rheumatic fever
10. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
INHIBITION OF PLATELET AGGREGATION
Mechanism:
• Thromboxane A2 ( TXA2) – platelet aggregation,
• PGI2– decreases platelet aggregation
• By irreversibely inhibiting COX -1, should decreases both TXA2 and PGI2
• Platelets have no nucleus, life span – 7 days, cannot synthesize COX after
inhibition by aspirin
• Vascular endothelium can regenerate COX after inhibition
• Uses: Aspirin is used at low doses ( 75-100mg) to decrease TXA2
production and inhibition of platelet aggretation; lower risk of re-infaction
post MI, deep vein thrombosis, pulmonary embolism
11. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
RELIEF IN DYSMENORRHOEA
• PGE and PGF2α are increased in dysmenorrhoea menstrual cramps
• Aspirin reduces uterine PG levels
12. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Pharmacological actions
CLOSURE OF DUCTUS ARTERIOSUS
• Ductus arteriosus is kept patent by PGE2 and PGI2
• This synthesis is switched off at birth closure of ductus
• Uses: low dose aspirin brings about closure of ductus arteriosus (by
inhibiting PGE2 and PGI2 ) if fails to close at birth
14. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Adverse effects
GASTRIC MUCOSAL DAMAGE:
• PGE2 and PGI2 inhibit gastric acid secretion, stimulate mucus and
bicarbonate production
• Aspirin decreases PGE2 and PGI2 gastric acid release, no protective
mucus layer gastric mucosal damage
15. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Adverse effects
DISTURB ACID BASE BALANCE
• At 400 ug/ml -500ug/ml : Respiration is stimulated by direct action on
respiratory centre washout CO2 respiratory alkalosis
• At 500 ug/ml -1mg/ml: depression of respiratory center pCO2
increase respiratory acidosis
• at > 1mg/ml: aspirin hydrolized to salicyclic acid, depression of renal
function to remove metabolic acids, derangement of carbohydrate
metabolism metabolic acidosis
16. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Adverse effects
BLEEDING TENDENCIES
• Decrease prothrombin levels by decreasing proconvertin ( factor V)
HYPERSENSITIVITY
• Diversion of arachidonic acid to lipoxygenase pathway increase
leukotrienes bronchoconstriction, skin rash, rhinitis, angioneurotic
edema
17. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Adverse effects
EFFECT OF URIC ACID
• < 2g/day: decrease uric acid excretion
• >5g/day: increase uric acid excretion ( not used in gout because high
doses are not tolerated)
RENAL EFFECTS
• Patients with CHF, cirrhosis, renal disease analgesic nephropathy
18. Non selective IRREVERSIBLE COX- inhibitors
ASPIRIN
Adverse effects
REYS’S SYNDROME
• Aspirin intake when children are recovering from febrile viral fever
reys’s syndrome: liver damage, encephalopathy
19. Non selective IRREVERSIBLE COX- inhibitors
• METHYL SALICYCLATE : used in balms, aka “ oil of wintergreen”
• SALICYLIC ACID: keratolytic agent, treatment of corns and warts
• SULFASALAZINE: treatment of ulcerative colitis, rheumatoid fever
Non selective REVERSIBLE COX- inhibitors
INDOMETHACIN
• immunosuppressive actions
• Use: ankylosing spondylitis, closure of ductus arteriosus
• ADR: more potent GI upset, hallucination, vertigo, confusion ( C/I in
epilepsy and psychiatric cases
20. Non selective REVERSIBLE COX- inhibitors
• IBUPROFEN: ADRs less than aspirin ( 400mg TDS)
• DICLOFENAC: 99% protein bound, moderate potency, moderate GI
upset ( 50mg TDS)
• ACECLOFENAC : same as diclofenac, longer acting ( 100mg BD)
• MEFENAMIC ACID: also PG receptor antagonist action, inhibits
leucoterine, used in dysmenorrhoea ( 250-500mg TDS)
• KETOROLAC: eye drops for seasonal allergic conjunctivitis
21. Weak inh of COX 1 and 2, other mode of anti-
inflammatory actions
NIMESULIDE
• Reduce superoxide generation, free radicals, PAF, metalloproteinase
activity in connective tissues
Preferential COX-2 inh
MELOXICAM, ETODOLAC, NABUMETONE
Longer action, less gi toxicity, no superiority over other NSAID
22. Selective COX-2 inh
CELECOXIB, VALDECOXIB, ETROCOXIB, ROFECOXIB,
PARECOXIB
• COX-2 is induced at the site of inflammation
• Inhibits COX-2 without affecting COX-1 present in GIT and platelet
no GI upset
ADR
• Reduce whole body PGI without affecting TXA2 platelet aggregation
enhanced
• Renal toxicity
USES
• Osteoarthritis, rheumatoid arthritis, dysmenorrhoea, gouty arthritis,
musculoskeletal pain
23. COX-3 inh
PARACETAMOL( acetaminophen)
• COX-3 is involved in pain perception and fever, not in inflammation
• Does affect acid-base balance
• Does not produce gastric mucosal damage
• Does not affect platelet aggregation
USES: mild-mod pain, in patients with peptic ulcer, hemophilila,
bronchial asthma, children with viral fever; dose- 500mg TDS
ADRs
Nausea, skin rash, mild increase in hepatic enzymes
24. Acute PARACETAMOL poisoning
• Children, adults with compromised hepatic function, chornic
alcoholics lower glucuronide conjugation ability
• Major pathway of PCM metabolism: Glucuronide conjugation
• Minor pathway : cyt P450 form toxic metabolite N-acetyl-p-
benzoquinone imine metabolized by glutathione conjugation
• At toxic doses ( 4-5g/day), large amount of toxic metabolite formed
glutathione cannot handle metabolism hepatic and renal cell
necrosis
25.
26. Acute PARACETAMOL poisoning
treatment
• Start within 16 hrs of PCM ingection
• Vomiting induced
• Gastric lavage done
• Activated charcoal given
• Administration of N-acetycysteine ( IV) and methionine : have SH
group like glutathione replenish glutathione
27. DONOT inhibit PGs
NEFOPAM, DIACEREIN
• Used for short lasting musculoskeletal pain not responding to other
NSAID
• Post op pain, cancer , dental pain
• ADR: atropine like ( dry mouth, urinary retention, blurred vision)
• Diacerein- discoloration of urine