Pharmacotherapy of congestive heart faliure Rahulvaish13
This PPT covers the pathophysiology, treatment protocol and details of individual drugs used and those drugs failed in clinical trials; taken from standard text books and articles as reference. This will be extremely useful for undergraduates ( MBBS, BDS,) and postgraduates (MD,MDS ,Phd).
Pharmacotherapy of congestive heart faliure Rahulvaish13
This PPT covers the pathophysiology, treatment protocol and details of individual drugs used and those drugs failed in clinical trials; taken from standard text books and articles as reference. This will be extremely useful for undergraduates ( MBBS, BDS,) and postgraduates (MD,MDS ,Phd).
Hypolipidemic agents, also known as cholesterol-lowering drugs or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are also called lipid-lowering drugs.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2. ANTILIPEMIC DRUGS
(ANTIHYPERLIPIDEMIC AGENTS)
Used for patients/clients with elevated blood
lipids, such as cholesterol, triglycerides, and
phospholipids.
Drugs are used in combination with lifestyle
changes (such as proper diet, weight loss, and
exercise) to decrease the risk of CAD.
3. THE CLASSES OF ANTILIPEMIC
DRUGS INCLUDE:
BILE-SEQUESTERING DRUGS- The bile-
sequestering drugs are cholestyramine,
colestipol, and colesevelam.
Bile Sequestering drug bind with bile acids,
leading to their excretion in the feces.
5. Pharmacodynamics-The bile-sequestering
drugs lower blood levels of low-density
lipoproteins (LDLs). These drugs combine
with bile acids in the intestines to form an
insoluble compound that’s then excreted in
stool. The decreasing level of bile acid in
the gallbladder triggers the liver to
synthesize more bile acids.
6. Pharmacotherapeutics- Bile-sequestering
drugs are the drugs of choice for treating type
ii hyperlipoproteinemia (familial
hypercholesterolemia) when the patient can’t
lower his LDL levels through diet alone.
7. Drug interactions- They may bind with
acidic drugs in the GI tract, decreasing their
absorption and effectiveness. Bile-sequestering
drugs may reduce absorption of lipid-soluble
vitamins, such as vitamins A, D, E and K.
Poor absorption of vitamin K can affect
prothrombin times significantly, increasing the
risk of bleeding.
8. ADVERSE REACTIONS TO BILESEQUESTERING DRUGS
Short-term adverse reactions to these drugs are
relatively mild.
More severe reactions can result from long-term
use. Adverse GI effects with long-term therapy
include severe fecal impaction, vomiting,
diarrhea, and hemorrhoid irritation.
9. FIBRIC ACID DERIVATIVES
Fibric acid is produced by several fungi. Two
derivatives of this acid are Fenofibrate and
gemfibrozil.
These drugs are used to reduce high
triglyceride levels, and to a lesser extent, high
LDL levels.
10. Pharmacokinetics- Fenofibrate and
gemfibrozil are absorbed readily from the
GI tract and are highly protein-bound.
Fenofibrate is hydrolyzed while
gemfibrozil undergoes extensive
metabolism in the liver. Both drugs are
excreted in the urine.
11. Pharmacodynamics- Although the exact
mechanism of action for these drugs isn’t known,
researchers believe that fibric acid derivatives may:
•Reduce cholesterol production early in its
formation
•Mobilize cholesterol from the tissues
•Increase cholesterol excretion
•Decrease synthesis and secretion of lipoproteins
•Decrease synthesis of triglycerides.
12. Pharmacotherapeutics- Fibric acid drugs
are used primarily to reduce triglyceride
levels, especially very-low-density
triglycerides, and secondarily to reduce blood
cholesterol levels. They’re typically used to
treat patients with types ii, iii, iv, and mild
type v hyperlipoproteinemia.
13. Drug interactions- Fibric acid drugs may
displace acidic drugs, such as barbiturates,
phenytoin, thyroid derivatives, and cardiac
glycosides. The risk of bleeding increases
when fibric acid derivatives are taken with
oral anticoagulants.
14. HMG-COA REDUCTASE (OR 3HYDROXY-3-METHYL-GLUTARYL-COA
REDUCTASE OR HMGCR)
is the rate-controlling enzyme of the
mevalonate pathway, the metabolic pathway that
produces cholesterol and other isoprenoids.
If these enzyme is blocked, serum cholesterol and
LDL levels decrease, because more LDLs are
absorbed by the cells for processing into
cholesterol. HDL levels increase slightly with this
alteration in fat metabolism.
15. Therapeutic Action and Indications- HMGcoA Reductase inhibitors block the formation of
cellular cholesterol, leading to decrease in serum
LDLs, with a slight increase or no change in the
levels of HDLs. Because these drugs undergo a
marked first-pass effect in the liver, most of their
effects on the process that generates atheromas in
vessel walls. That exact mechanism of action is not
understood.
16. These drugs are indicated as adjuncts with
diet and exercise for the treatment of
increased cholesterol and LDL levels that are
unresponsive to dietary restrictions alone; to
slow the progression of CAD in patients
with documented CAD; and to prevent first
MI in patient who are at risk for MI.
17. Pharmacokinetics-the statins are all
absorbed from the GI tract and undergo the
first- pass metabolism in the liver. They are
excreted in the feces and urine. The peak
effect of this drug is usually seen within 2-4
weeks. These drugs cross the placenta and
have been associated with skeletal
malformations of he fetus.
18. Contraindications and action- These
drugs are contraindicated in the presence
of allergy to any of the statins or to fungal
byproducts or compounds. They are also
contraindicated with active liver disease or
a history of alcoholic liver disease, w/c
could exacerbate, leading to severe liver
failure.
19. Adverse Effect- The most common adverse
effects associated with these drugs reflect
their effects on the GI system: flatulence,
abdominal pain, nausea, vomiting, and
constipation. CNS effects can include
headache, dizziness, blurred vision, fatigue,
and cataract development and may effect
changes in the cell membrane and synthesis
of cholesterol.
20. Cholesterol Absorption Inhibitors- are a
class of compounds that prevents the uptake of
cholesterol from the small intestine into the
circulatory system.
Lower the amount of cholesterol that your
body absorbs. So your blood has lower
total cholesterol and lower LDL (bad)
cholesterol
21. Therapeutic action and indicationsEzetimibe works in the brush border of the
small intestine to decrease the absorption of
dietary cholesterol, leading to drop in serum
cholesterol levels. It is indicated as an adjunct to
diet and exercise to lower cholesterol levels as
monotherapy or as part of combination therapy
with an HMG-CoA inhibitors or a bile acid
sequesterant.
22. Pharmacokinetics- Ezetimibe is
absorbed well after oral administration,
reaching peak levels in 4-6 hours. It is
metabolized in the liver and the small
intestine, with a 22 hours half- life.
Excretion in the feces and urine.
23. Contraindications and CautionsEzetimibe is contraindicated with allergy
to any component of the drug. If it is used
in combination with a statin, it should not
be used during pregnancy or lactation or
with severe liver disease because of the
known effects of statins, including
possible liver problems and renal failure.
24. Adverse Effect- The most common adverse
effect associated with ezetimibe are mild
abdominal pain and diarrhea. It is not
associated with the bloating and flatulence
that occurs with the bile acid sequestrants and
fibrates, other adverse effect have been
reported include headache, dizziness, fatigue,
URI, back pain, muscle aches and pain.
25. NICOTINIC ACID- Lowers total cholesterol,
LDL-cholesterol, and triglyceride levels, while
raising HDL-cholesterol levels.
Vitamin B (Niacin) or Nicotinic Acid, inhibits
release of free fatty acids in the adipose tissue,
increases the rate of triglyceride removal form
plasma, and generally reduces LDL and
triglycerides level and increases HDL levels.
26. The initial effect on lipid levels is usually
seen within 5 to 7 days, with the maximum
effect occurring 3 to 5 weeks. Niacin is
associated with intense cutaneous flushing,
nausea, and abdominal pain, making its use
somewhat limited.
27. It also increases serum levels of uric acid
and may predispose patients to the
development of gout. Niacin is often
combined with bile acid sequestrants fro
increased effect. It is given at bedtime to
make maximum use of nighttime cholesterol
synthesis, and it must be given 4 to 6 hours
after bile sequestrant to ensure absorption.