1. The document discusses the pharmacology of drugs used to treat Parkinson's disease. It describes the mechanisms and side effects of various dopaminergic medications like levodopa, dopamine receptor agonists, MAO-B inhibitors, and COMT inhibitors.
2. Anticholinergic drugs are also covered, which are used to treat tremor and rigidity but not bradykinesia. Other drugs mentioned include amantadine and apomorphine.
3. The document concludes with a section on review questions related to the pharmacology of Parkinson's disease treatments.
the presentation on anti parkinson drug contain their classification of drugs, mechanism of action. uses of drugs, side effect, causes, symptoms, additional symptoms, physiology, pathophysiology
Drugs used in Parkinsons Disease ( anti- Parkinson drugs) Ravish Yadav
detail and complete study on the topic of anti parkinson drug. the study is done under the guidance of faculty member. the learning content complete information of the topic
the presentation on anti parkinson drug contain their classification of drugs, mechanism of action. uses of drugs, side effect, causes, symptoms, additional symptoms, physiology, pathophysiology
Drugs used in Parkinsons Disease ( anti- Parkinson drugs) Ravish Yadav
detail and complete study on the topic of anti parkinson drug. the study is done under the guidance of faculty member. the learning content complete information of the topic
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
3. PARKINSONISM DISEASE II
• Dopaminergic neurons are in substantia niagra (midbrain)
• D-2 receptors are putative mediator of PD drugs.
• D-2 receptors are located postsynaptically on striatal neurones.
• D-2 receptors are located presynaptically on substantia Niagara.
3
8. Dopamine is a derivatives of
tyrosine that is broken down to
adrenaline.
9. GOAL OF TREATMENT
• Enhance availability of dopamine in BBB=↓ Breakdown of Dopamine,
↑ D2 agonists.
• Reduce cholinergic activity in BBB= ↑ anticholinergic drugs.
10.
11. 1. DOPAMINE PRECUSSOR: LEVODOPA -PK
• Rapidly absorbed in small intestines.
• Food delays plasma availability
• Compete with dietary amino acid for absorption
• Peak in plasma 1-2 hours after oral dose
• Plasma t1/2 = 1-3 hours
• 2/3rd appear in urine as metabolite within 8 hours of oral dose.
• Two metabolites= 3-methoxy-4-phenylacetic acid & dihydroxyphenylacetic
acid (DOPAC)
• Only 1-3% of oral Levodopa enters BBB (∴ need of decarboxylase inhibitor
!!!)
12. LEVODOPA-PK
Decarboxylase inhibitor (Carbidopa):-
• Reduce peripheral metabolism to dopamine
• Plasma concentration
• Elongate plasma t1/2
• Improve entry of Levodopa in brain
• Dopamine does not penetrate BBB
• Reduces daily need of LEVODOPA by 75%
14. LEVODOPA-PD
• It is precursor of dopamine
• Therapeutic effect ↓ with time
• Loss of nigrostriatal nerves = ↓ response to levodopa
• Benefits diminish after 3 years
• Levodopa does not lower progression of disease
• Given in combination with CARBIDOPA i.e. 25 mg Cabidopa + 100 mg
Levodopa= ↓ peripheral metabolism, ↑striatal distribution
• Dopamin agonist such as bromocriptine reduce response fluctuations
• Levodopa reduces Bradykinesia
15. LEVODOPA- S/E
• GIT=Anorexia, nausea, vomiting (dopamine stimulate chemoreceptor
trigger zone outside BBB in brain stem)= N/V reduces when carbidopa
is added.
• CVS= arrhythmias (HR) due to increased catecholamine. Postural
hypotension, HTN.
• Behavioral Effects= depression, agitation, insomnia, somnolence,
euphoria (common in Levodopa+Cabidopa due to high CNS levels)
• Behavioral effect treated with atypical antipsychotic (clozapine,
olanzapine, risperidone)=Low affinity on D2 receptors
16. LEVODOPA-SE
• Dopamine dysregulation syndrome –compulsive overuse of levodopa
• Punding –repetitive complex and purposeful motor activity i.e. grooming.
Rx=↓dose
• Dyskinesia (chreoatherosis most common) due to uneven distribution of
striatal dopamine = Rx=↓ Levodopa dose, give Amantadine or clozapine
• Mydriasis, Glaucoma
• Gout, BUN, bilirubin
• Drug holidays(stopping levodopa 3-21 days) may be used to S/E and
improve response.
• Drawback of Drug holiday = immobility which increases risk of aspiration
pneumonia
17. LEVODOPA: DRUG INTERACTIONS
• Pyridoxine (vitamin B6) ↓ therapeutic effect= ↑ extracerebral
metabolism.
• Levodopa+ Monoamine oxidase A inhibitor = Hypertensive crisis
(200/100mmHg)- such combo should be avoided, even 2 weeks of
discontinuance.
18. LEVODOPA: CONTRAINDICATIONS
• Psychotic patients = ↑ mental disturbance
• Angle closure glaucoma
• GIT bleeding may worsen
• History of melanoma= dopamine is precursor of melanin
19.
20. 2. DOPAMINE RECEPTOR AGONIST (DRA)
• Bromocriptine = Selective D2 agonist, enhances levodopa effect,
reduce fluctuation, reduce S/E, reduce dose of levodopa.
• Pergolide= D1 and D2 agonist = causes valvuler heart diseases
• Pramipexole = Preferential D3 receptors, effective for mild
parkinsonism, rapid absorption, adjustment to doses in renal
insufficiency.
• Ropinirole- selective D2 agonist, monotherapy in mild PD, CYP1A2
metabolized
• Rotigotine=skin patch delivery, early PD, has continuous dopaminergic
stimulation than oral drugs, may cause reaction at application site
21. DRA: S/E
Gastrointestinal Effects
• Anorexia and nausea and vomiting – Take with meals to ↓.
• Constipation
• Dyspepsia
• reflux esophagitis.
• Bleeding from peptic ulceration.
22. DRA: S/E II
Cardiovascular Effects
• Postural hypotension @ the initiation.
• Painless digital vasospasm- ergot derivatives (bromocriptine or
pergolide).
• Cardiac arrhythmias with discontinuing treatment.
• Peripheral edema.
• Cardiac valvulopathy with pergolide
23. DRA: S/E III
Mental Disturbances
• Confusion, Hallucinations, Delusions.
• DRA MAY CAUSE Disorders of impulse control:
1. Compulsive gambling, shopping, betting, sexual activity.
2. Due to activation of D2 or D3 receptors in Limbic system.
3. It is dose-dependent. Impulse control.
24. DRA: S/E III
Dyskinesia
• Abnormal movements- Rx: ↓total dose of dopaminergic drugs.
Severity of Complications of DRA RX > levodopa.
• Complications with DRA common with geriatric.
• Complication ↑ as disease advance
26. 3. MONOAMINE OXIDASE INHIBITORS
Two Isoforms of monoamine oxidase in CNS:-
1. MAO-A metabolizes: norepinephrine, 5HT, and dopamine.
2. MAO B metabolizes dopamine selectively.
• MAO Prolong t1/2 of levodopa
27. MAO-B INHIBITORS: Selegiline (Deprenyl)
• Selective irreversible inhibitor MAO B at normal doses
• Inhibit MAO A at ↑ doses
• Retards dopamine breakdown↑ antiparkinsonism effect of levodopa.
• Levodopa dose is ↓ when taken with
• Good adjunctive therapy for declining response to levodopa.
• Standard dose = 5 mg with Breakfast, 5 mg with Lunch.
• S/E: insomnia
• No therapeutic effect on parkinsonism when taken alone.
28. MAO-B INHIBITORS: Rasagiline
• Selective irreversible inhibitor of MAO B.
• Rasagiline potency > Selegiline in ↓ MPTP-induced parkinsonism
• It is an adjunctive therapy to ↑se carbidopa-levodopa t1/2 in:-
1. Advanced disease
2. Response fluctuations.
• Read the ADAGIO trial for more!!
29. MAO-B INHIBITORS: Safinamide
• Rx of response fluctuations in patients taking carbidopa levodopa
• Not effective as monotherapy for Parkinson’s disease.
• Starting dose is 50 mg OD then titrated to 100mg After 2 weeks.
30. MAO-INHIBITORS CONSIDERATIONS
• Patients on meperidine, tramadol, methadone, propoxyphene,
cyclobenzaprine.
• Avoid dextromethorphan while on MAO-B inhibitors
• Avoid other MAO inhibitors while on Rasagiline, selegiline &
safinamide.
• Avoid MAO-B inhibitor while TCI or SSRI causes serotonin syndrome
• Increases the S/E of Levodopa + Carbidopa
• Nonselective MAO inhibitor + Levodopa = Hypertensive Crises due to
accumulation of NE
31. CATECHOL-O-METHYLTRANSFERASE INHIBITORS
(COMTI)
• Decarboxylase inhibitor (Carbidopa) causes compensatory ↑COMT in
plasma.
• This causes ↓response to Levodopa & brain bioavailability.
• Selective COMT inhibitors ↑ t1/2 of levodopa thus brain
bioavailability↑.
32. COMTI: Tolcapone and Entacapone
• MOA: inhibit COMT
• ↑ t1/2 of Levodopa by ↓ peripheral metabolism.
• Levodopa clearance is ↓
• Brain bioavailability of levodopa ↑
• Used in Rx of response fluctuation.
• Entacapone is less hepatotoxic.
33. COMTI: Tolcapone and Entacapone-PK
• Both are rapidly absorbed
• Bound to plasma proteins
• Metabolized before excretion.
• Tolcapone has both central and peripheral effect.
• Entacapone has peripheral effect only.
• Half-life of both drugs i= 2 hours,
• Potency: tolcapone > entacapone.
34. COMTI : Tolcapone and Entacapone-S/E
• Dyskinesia
• Nausea, Diarrhea, Abdominal pain
• Confusion.
• Orthostatic hypotension
• Sleep disturbances
• Orange discoloration of the urine.
• Tolcapone is Hepatotoxic=Liver enzyme levels ↓( avoid in Liver
disease)
• Monitor LFT every 2-4 weeks while on Tolcapone.
38. S/E OF ANTIMUSCARINIC AGENTS
• Cognitive impairment.
• Dyskinesia.
• Acute suppurative parotitis due to dryness of the mouth.
• Constipation.
• Increased heart rate
• HTN
• Insomnia
39. Others Drugs Parkinson's: AMANTADINE
• An antiviral agent
• Weak antiparkinsonism properties.
• Potentiate dopaminergic function.
• Influencing the synthesis, release, or reuptake of dopamine.
• Antagonize the effects of adenosine at A2A receptors=Adenosine
inhibit D2 receptor function.
• Amantadine is an antagonist of the NMDA thus antidyskinetic effect.
40. Others Drugs Parkinson's: APOMORPHINE
• A potent nonergoline dopamine agonist.
• Binds onto D2 receptors in the caudate nucleus and putamen
• Given S/C
• Effective for the temporary relief of akinesia due to dopamine RX
• Rapidly taken blood and then the brain within 10 minutes of SC
• T1/2 persists for up to 2 hours.
• Nausea common and antiemetic
41. APOMOPHINE S/E
• Nausea common and antiemetic.
• Dyskinesia
• Drowsiness, insomnia, chest pain,
• Sweating, Hypotension, syncope
• Constipation, diarrhea,
• mental or behavioral disturbances
• Drug interaction with 5-HT3 antagonists= +++ hypotension
42. REVIEW QUESTIONS
Dopamine agonist ergot derivative that stimulates D1 & D2 receptors
A) levodopa
B) Amantadine
C) pergolide
D) selegiline
E) trihexyphenidyl
43. REVIEW QUESTION
Reason that dopamine itself is not used to treat in Parkinson's disease:
A) It is derivative of amino acid
B) the problem is cholinergic in nature
C) dopamine does not cross the blood-brain barrier
D) levodopa has a higher affinity for the D2 receptor
44. REVIEW QUESTION
Antiviral drug found to have anti-Parkinson's properties:
A) procyclidine
B) pergolide
C) amantadine
D) levodopa
E) reserpine
46. REVIEW QUESTION
Effective in managing essential tremor
A) propranolol
B) metoprolol
C) primidone
D) diazepam
E) chlordiazepoxide
47. REVIEW QUESTION
Which one of the following combinations of antiparkinsonian
drugs is an appropriate treatment plan?
A. Amantadine, carbidopa, and entacapone.
B. Levodopa, carbidopa, and entacapone.
C. Pramipexole, carbidopa, and entacapone.
D. Ropinirole, selegiline, and entacapone.
E. Ropinirole, carbidopa, and selegiline.
48. REVIEW QUESTION
Peripheral adverse effects of levodopa, including
nausea, hypotension, and cardiac arrhythmias, can be
diminished by including which of the following drugs in
the therapy?
A. Amantadine.
B. Ropinirole.
C. Carbidopa.
D. Tolcapone.
E. Pramipexole.
49. REVIEW QUESTION
Which of the following antiparkinsonian drugs may cause
vasospasm?
A. Amantadine.
B. Bromocriptine.
C. Carbidopa.
D. Entacapone.
E. Ropinirole.
50. REVIEW QUESTION
Modest improvement in the memory of patients with
Alzheimer’s disease may occur with drugs that increase
transmission at which of the following receptors?
A. Adrenergic.
B. Cholinergic.
C. Dopaminergic.
D. GABAergic.
E. Serotonergic.
51. REVIEW QUESTION
First-line anti-Parkinson drug; also used to treat hyperprolactinemia at
lower doses
A) amantadine
B) levodopa
C) bromocriptine
D) selegiline
E) benztropine mesylate
52. REVIEW QUESTION
Carbidopa is useful in the management of Parkinson's disease because
it is an:
A) effective D2 agonist
B) effective D2 antagonist
C) effective peripheral decarboxylase inhibitor
D) effective central decarboxylase inhibitor
E) effective competitor at the GABA receptor
53. REVIEW QUESTION
One is a catechol-o-methyltransferase inhibitor available for managing
Parkinson's disease:
A. Tolcapone
B. Mepenem
C. Cabidopa
D. Selegiline
54. REVIEW QUESTION
This dopamine receptor tied is localized in the substantia nigra zona
compacta and presynaptically on striatal axons from dopaminergic
substantia nigral cells.
A. D1
B. D2
C. D3
D. D4
E. D5
55. REVIEW QUESTION
A dopamine receptor type probably most important in mediating
benefits of dopaminergic anti-Parkinsonian drugs.
A. D1
B. D2
C. D3
D. D4