This document discusses the pharmacotherapy of glaucoma. It begins by defining the different types of glaucoma including primary, secondary, congenital, and several subtypes. It then outlines the major goals of glaucoma therapy which are to maintain a safe intraocular pressure level to prevent nerve damage, minimize side effects, and improve patient compliance through education.
The document reviews the various classes of glaucoma medications including cholinergic agonists, prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors. It provides examples of drugs in each class and describes their mechanisms of action and common side effects. Combination therapies are also mentioned. Treatment approaches for acute angle
Medicines Used for Glaucoma Management _Optom LectureGauriSShrestha
the most commonly prescribe treatment for glucoma is eye drops. These medicine decreases IOP to the level that prevents damage to the optic nerve by either decrease acqueous secretion from the ciliary body or facilitating acqueous drainage through the trabecular or uveoscleral outflow systems. This presentation outlines the principal eye medicine currently used in ophthalmic practice.
Medicines Used for Glaucoma Management _Optom LectureGauriSShrestha
the most commonly prescribe treatment for glucoma is eye drops. These medicine decreases IOP to the level that prevents damage to the optic nerve by either decrease acqueous secretion from the ciliary body or facilitating acqueous drainage through the trabecular or uveoscleral outflow systems. This presentation outlines the principal eye medicine currently used in ophthalmic practice.
miotics and mydriatics presentation m&mmparthsaraf55
Optometrists are well-acquainted with the two opposing muscles in the iris, the sphincter and the dilator, as we witness their effects daily in clinical practice. Pupil constriction (miosis) can either be stimulated by contraction of the iris sphincter or by relaxation of the iris dilator. On the other hand, pupil dilation (mydriasis) can either be stimulated by contraction of the iris dilator or by relaxation of the iris sphincter.
Miotic and mydriatic drops work by acting on these different muscles of the iris. The drops are able to control pupil size by targeting two parts of the autonomic nervous system: the sympathetic and parasympathetic systems. Let’s review their function and clinical role to better understand their present uses and why some of these agents are undergoing re-evaulation for potential new ones.
Behind the Scenes
The sympathetic pathway, mainly responsible for pupil mydriasis, involves a three-neuron pathway.1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. This synapse is located between the C8 and T2 vertebrae. The second neuron, which is the preganglionic neuron, exits the spinal cord, ascends through the thorax and synapses near the apex of the lung into the superior cervical ganglion. The third postganglionic neuron travels to the cavernous sinus and enters the orbit through the short and long ciliary nerves, synapsing to the iris dilator.1,2
Contrarily, the parasympathetic pathway is mainly responsible for pupil miosis.1,3 Pupil constriction starts when light enters the retina and activates the retinal ganglion cells—the beginning of the afferent arm—which then transmit their impulses into the optic nerve. This stimulus travels to the optic chiasm, through the optic tract and eventually reaches the pretectal nucleus. The impulses from the pretectal nucleus begin the efferent arm, which projects to the Edinger-Westphal nucleus. The Edinger-Westphal nucleus gives rise to preganglionic fibers, which then synapse with postganglionic neurons in the ciliary ganglion. Postganglionic neurons leave the ciliary ganglion to innervate the iris sphincter.1,3
Tropicamide has a strong mydriatic effect.
Tropicamide has a strong mydriatic effect. Click image to enlarge.
Behind the Scenes
The sympathetic pathway, mainly responsible for pupil mydriasis, involves a three-neuron pathway.1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. This synapse is located between the C8 and T2 vertebrae. The second neuron, which is the preganglionic neuron, exits the spinal cord, ascends through the thorax and synapses near the apex of the lung into the superior cervical ganglion. The third postganglionic neuron travels to the cavernous sinus and enters the orbit through the short and long ciliary n
GLAUCOMA
,dignosis , types of glaucoma , risk factors oo glaucoma and treatment , the clasis of drugs that use in treatment of glaucoma.
prepared by : Hardi Sdiq
university of sullaimani
collage of pharmacy
miotics and mydriatics presentation m&mmparthsaraf55
Optometrists are well-acquainted with the two opposing muscles in the iris, the sphincter and the dilator, as we witness their effects daily in clinical practice. Pupil constriction (miosis) can either be stimulated by contraction of the iris sphincter or by relaxation of the iris dilator. On the other hand, pupil dilation (mydriasis) can either be stimulated by contraction of the iris dilator or by relaxation of the iris sphincter.
Miotic and mydriatic drops work by acting on these different muscles of the iris. The drops are able to control pupil size by targeting two parts of the autonomic nervous system: the sympathetic and parasympathetic systems. Let’s review their function and clinical role to better understand their present uses and why some of these agents are undergoing re-evaulation for potential new ones.
Behind the Scenes
The sympathetic pathway, mainly responsible for pupil mydriasis, involves a three-neuron pathway.1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. This synapse is located between the C8 and T2 vertebrae. The second neuron, which is the preganglionic neuron, exits the spinal cord, ascends through the thorax and synapses near the apex of the lung into the superior cervical ganglion. The third postganglionic neuron travels to the cavernous sinus and enters the orbit through the short and long ciliary nerves, synapsing to the iris dilator.1,2
Contrarily, the parasympathetic pathway is mainly responsible for pupil miosis.1,3 Pupil constriction starts when light enters the retina and activates the retinal ganglion cells—the beginning of the afferent arm—which then transmit their impulses into the optic nerve. This stimulus travels to the optic chiasm, through the optic tract and eventually reaches the pretectal nucleus. The impulses from the pretectal nucleus begin the efferent arm, which projects to the Edinger-Westphal nucleus. The Edinger-Westphal nucleus gives rise to preganglionic fibers, which then synapse with postganglionic neurons in the ciliary ganglion. Postganglionic neurons leave the ciliary ganglion to innervate the iris sphincter.1,3
Tropicamide has a strong mydriatic effect.
Tropicamide has a strong mydriatic effect. Click image to enlarge.
Behind the Scenes
The sympathetic pathway, mainly responsible for pupil mydriasis, involves a three-neuron pathway.1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. This synapse is located between the C8 and T2 vertebrae. The second neuron, which is the preganglionic neuron, exits the spinal cord, ascends through the thorax and synapses near the apex of the lung into the superior cervical ganglion. The third postganglionic neuron travels to the cavernous sinus and enters the orbit through the short and long ciliary n
GLAUCOMA
,dignosis , types of glaucoma , risk factors oo glaucoma and treatment , the clasis of drugs that use in treatment of glaucoma.
prepared by : Hardi Sdiq
university of sullaimani
collage of pharmacy
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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
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Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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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.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
1. Pharmacotherapy of Glaucoma
Moderated by:
Dr. Pinaki Chakravarty,
Prof. & HOD,
Dept. of Pharmacology,
TMCH
Presented by:
Dr. Karabi Adak
3rd yr PGT,
Dept. of Pharmacology,
TMCH
7. Elevated IOP can be reduced by
outflow through:
• the trabecular meshwork
• the uveoscleral pathway
• a surgically created pathway
production of aqueous
humor by ciliary body
8. Maintain IOP –
nerve damage
unlikely to happen
Reset IOP to lower
level
Minimise local and
systemic S/E-
improve quality of
life
Patient
education-
Improved
compliance
Major goals
of therapy
14. 3. Prostaglandin analogs
• Latanoprost 0.005%
• Bimatoprost 0.01% drops
• Unoprostone 0.15%
• Travoprost 0.004%
• Tafluprost 0.0015%
Systemic side effects minimal (cold hands and feet)
• Local reactions : iris pigmentation; eyelid skin darkening;
eyelash lengthening, thickening, pigmentation, and
misdirected growth; conjunctival hyperemia; ocular
irritation; superficial punctate keratitis
• Latanoprost brown pigmentation in iris
onset of increased iris pigmentation; first
year of treatment and
can be permanent
*The nature and severity of adverse events are not affected
by the increased pigmentation of the iris
15. 4. Rho kinase inhibitor
• Netarsudil
• Inhibits NA transport decreased aq.
humor production
• Expensive
• S/E: Tearing,Redness, blurred vision,
corneal staining
17. 1. Non- selective beta blockers
• Timolol 0.25%
• modest reduction of resting pulse rate
worsening of heart failure
• adverse pulmonary effects (dyspnea,
airway obstruction, pulmonary failure)
• chronic administration corneal
anesthesia
• care should be taken with sinus
bradycardia, heart failure
• systemic side effects could be exaggerated
in elderly patients
18. 2. Beta 1 blocker
• Betaxolol 0.5% drops
• Carteolol 1%
• Levobunolol 0.5%
• Metipranolol 0.3%
• Betaxolol- can be used in
pts. With HF and
pulmonary disease
• Rest should be used
cautiously
19. 4. Selective alpha 2 agonists
• Apraclonidine 0.5%-1% drops
• Brimonidine 0.2%drops
• Used preoperatively and
• Postoperatively for the prevention of ↑ IOP
• Does not penetrate BBB
negligible systemic hypotension
• Local adverse effects common
• Tachyphylaxis may be observed
• Effective long-term monotherapy or adjunctive
• therapy
• Penetrates the BBB mild systemic
hypotension and lethargy
• Local ADR < with apraclonidine
20. 5.CAI
• Topical: Brinzolamide 1%, dorzolamide 2%
• Systemic: Acetazolamide 250 mg qid
• Topical CAIs: well tolerated
• ADRs-ocular burning, stinging, discomfort
and allergic reactions, bitter taste, and
superficial punctate keratitis.
• Dorzolamide, brinzolamide are
sulfonamides attributable to
sulfonamide S/Es
• Should not be used in patients with renal
or hepatic impairment
• Acetazolamide : Headache, metabolic
acidosis
22. Acute Angle Closure Glaucoma
Diagnosis- measuring IOP during an acute attack/ performing gonioscopy
Acetazolamide (PO or IV): 500mg iv stat/ 250mg tablet
topical beta blockers, prostaglandin analogues, α2-adrenergic agonists and
pilocarpine miosis
If above measures fail- iridotomy using laser
*a single attack of angle closure after pharmacologic dilatation rarely cause
permanent damage to the eye
24. Chronic Open Angle Glaucoma
Life long therapy
DOC- Latanoprost very expensive; OD regime better compliance
Alternative- Timolol
Dorzolamide, brinzolamide- less systemic toxicity than oral acetazolamide
Absorption minimized by digital compression of eye canthus