Postoperative nausea and vomiting (PONV) is a common complication following surgery. It can increase patient discomfort, medical costs, and length of hospital stay. Multiple factors contribute to PONV risk, including patient characteristics like female gender or prior history of nausea, as well as anesthetic and surgical factors. A variety of drug classes have been used to prevent and treat PONV, including antihistamines, anticholinergics, dopamine antagonists, corticosteroids, and newer 5-HT3 receptor antagonists and neurokinin-1 receptor antagonists. Non-drug approaches such as acupuncture, aromatherapy, and supplemental oxygen may also help reduce PONV. Hospitals have developed
Neuromuscular monitoring, also known as train of four monitoring, is a technique used during recovery from the application of general anesthesia to objectively determine how well a patient's muscles are able to function. It involves the application of electrical stimulation to nerves and recording of muscle response using, for example, an acceleromyograph. Neuromuscular monitoring is typically used when neuromuscular-blocking drugs have been part of the general anesthesia and the doctor wishes to avoid postoperative residual curarization (PORC) in the patient, that is, the residual paralysis of muscles stemming from these drugs.
A basic overview on the management of intra-operative bronchospasm: the risk factors, triggers, diagnosis, prevention and management. Includes a case scenario – discussion.
Neuromuscular monitoring, also known as train of four monitoring, is a technique used during recovery from the application of general anesthesia to objectively determine how well a patient's muscles are able to function. It involves the application of electrical stimulation to nerves and recording of muscle response using, for example, an acceleromyograph. Neuromuscular monitoring is typically used when neuromuscular-blocking drugs have been part of the general anesthesia and the doctor wishes to avoid postoperative residual curarization (PORC) in the patient, that is, the residual paralysis of muscles stemming from these drugs.
A basic overview on the management of intra-operative bronchospasm: the risk factors, triggers, diagnosis, prevention and management. Includes a case scenario – discussion.
This is an overview of drugs used to control nausea and vomiting. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
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.
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!
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
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
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
23. Impact of Multiple Patient-Related Risk Factors* Risk of PONV Increased Based on Number of Primary Risk Factors Present * Validated in 2,722 adult patients receiving inhalational anesthesia. Apfel CC et al. Anesthesiology . 1999;91:693–700. Primary Risk Factors: History of PONV or motion sickness ■ Female sex ■ Nonsmoking ■ Use of postoperative opioids Patients With PONV, %
35. EMEND ® (aprepitant) Blocks Substance P From Binding to NK 1 Receptors EMEND Substance P NK 1 receptor 1. Keller M et al. Biol Psychiatry . 2006;59:216–223. 2. Hargreaves R. J Clin Psychiatry . 2002;63(suppl 11):18–24. Binding of EMEND at the NK 1 Receptor Site 1,2
A study conducted at Stanford University Medical Center was designed to quantify patients’ preferences regarding common, low-morbidity anesthesia postoperative outcomes, such as incisional pain, nausea, or shivering. The survey instrument developed by researchers allowed patients to rank possible outcomes from 1 to 10 (1=most undesirable and 10=most desirable). One hundred one adult patients (aged ≥18 years) who were scheduled to undergo surgery in either the outpatient surgery center or main tertiary hospital surgery suite completed and returned the survey instrument to the preoperative evaluation anesthesia clinic. 1 As shown in this table, patients ranked vomiting as the least preferred outcome ( F -test <0.01), viewing postoperative vomiting as even less preferred than pain. Nausea also ranked among the 5 least preferred postoperative anesthesia outcomes. 1 In order from the least preferred to the most preferred, the other outcomes were ranked: 5) recall without pain (ie, patient remembers being awake during surgery, unable to move or talk); 6) residual weakness; 7) shivering; 8) sore throat; and 9) somnolence. 1 These results are consistent with other research involving patient preferences for symptoms during the immediate postoperative recovery period. A study involving 200 women who underwent elective gynecologic surgery showed that the relative importance to patients of not experiencing symptoms of PONV, pain, and sedation was 74%, 23%, and 3%, respectively. 2 References: 1. Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg . 1999;89:652–658. 2. Lee A, Gin T, Lau ASC, Ng FF. A comparison of patients’ and health care professionals’ preferences for symptoms during immediate postoperative recovery and the management of postoperative nausea and vomiting. Anesth Analg . 2005;100:87–93.
This slide depicts key neurotransmitters involved with emesis. The brainstem vomiting center contains high concentrations of several neurotransmitter receptors, including receptors for acetylcholine, histamine, dopamine, opioid, and serotonin. 1 This anatomic region is also rich in neurokinin 1 (NK 1 ) receptors, which have a high affinity for the recently identified emetic neurotransmitter, substance P. 2,3 By serving as sensors that can be stimulated by drugs, electrolytes, and metabolic chemicals, these receptors relay impulses to the vomiting center and initiate the vomiting reflex. 4 Blockade, or antagonism, of these receptor sites is the mechanism of action of many of the pharmacologic antiemetic agents commonly used for PONV. 1,4 Many currently available antiemetic medications for use in PONV were first developed to treat motion sickness as well as nausea and vomiting induced by chemotherapy and radiation therapy. 4 However, because afferent systems trigger the release of various neurotransmitters, an antiemetic that is effective against one type of vomiting can be ineffective against emesis induced by other stimuli. For example, serotonin 5-HT 3 receptor antagonists exhibit potent antiemetic activity against acute chemotherapy-induced nausea and vomiting but do not inhibit response to other emetogens, such as motion or opioid and dopaminergic agonists. 5 Some receptors, such as 5-HT 3 and NK 1 , are found both peripherally and in the CNS. 3,6 Whereas 5-HT 3 receptor antagonists exert their antiemetic activity primarily on abdominal vagal afferents, it appears that the substance P/NK 1 emetic pathway is primarily centrally mediated. 6 References: 1. Nelson TP. Postoperative nausea and vomiting: understanding the enigma. J Perianesth Nurs . 2002;17:178–189. 2. Cameron D, Gan TJ. Management of postoperative nausea and vomiting in ambulatory surgery. Anesthesiol Clin North America . 2003;21:347–365. 3. Harrison S, Geppetti P. Substance P. Int J Biochem Cell Biol . 2001;33:555–576. 4. Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs . 2000;59:213–243. 5. Diemunsch P, Grélot L. Potential of substance P antagonists as antiemetics. Drugs . 2000;60:533–546. 6. Saito R, Takano Y, Kamiya H. Roles of substance P and NK 1 receptor in the brainstem in the development of emesis. J Pharmacol Sci . 2003;91:87–94. Nelson p. 180/A; p. 182/A Cameron p. 348/A; p. 349/A Nelson p. 180/A; p. 182/A Kovac p. 220/A Cameron p. 348/A; p. 349/A Harrison p. 558/A; p. 559/A Diemunsch p. 534/A; p. 535/A Harrison p. 556/B Saito p. 91/A Kovac p. 216/A,B Nelson p. 182/A Apfel 1999 p. 693/B Cameron p. 348/A; p. 352/A Kovac p. 220/B Harrison p. 558/A; p. 559/A Nelson p. 180/A; p. 182/A Kovac p. 216/A
A simplified risk model developed by Apfel and colleagues was validated in 2 medical centers, involving a total of 2,722 adult patients. All patients received inhalational anesthesia, without antiemetic prophylaxis, for various types of surgery. If needed, nonsteroidal analgesic drugs or opioids (eg, oxycodone or tramadol) were used to treat postoperative pain. Statistical analyses identified 4 predictors of PONV: history of PONV or motion sickness, female sex, nonsmoking, and the use of postoperative opioids. 1 In addition, researchers correlated the incidence of PONV with the number of risk factors present. The risk of PONV increased with the presence of each additional primary risk factor, representing a 30% to 110% relative increase with each additional risk factor 1 : 0 risk factors present : Associated with 10% incidence of PONV 1 risk factor present : Associated with 21% incidence of PONV 2 risk factors present : Associated with 39% incidence of PONV 3 risk factors present : Associated with 61% incidence of PONV 4 risk factors present : Associated with 79% incidence of PONV Based on this approach to risk modeling, a prophylactic antiemetic strategy is recommended for patients with 2 or more of these identified risk factors. 1 Reference: 1. Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting. Anesthesiology . 1999;91:693–700.
For more than 50 years, scientists have studied different classes of agents and their effectiveness in preventing PONV. Phenothiazines and antihistamines were developed in the 1950s. Butyropherones, substituted benzamides, and anticholinergics were introduced in the 1970s. In 1991, there was a significant breakthrough in emetic prevention with the development of 5-HT 3 receptor antagonists. These agents introduced substantial protection from PONV that previous classes did not offer. However, as shown previously, PONV remains a problem in up to 30% of all surgeries and patient populations despite current therapies. 1–3 Therefore, it was important to further the treatment paradigm to augment prevention of PONV. In 2006, more than 10 years after 5-HT 3 receptor antagonists were approved, the FDA approved EMEND ® (aprepitant)—the first and only substance P/NK 1 receptor antagonist for prevention of PONV. References: 1. Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs . 2000;59:213–243. 2. Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting: a review. Can J Anesth . 2004;51:326–341. 3. Apfel CC, Korttila K, Abdalla M, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med . 2004;350:2441–2451.
As a selective substance P/NK 1 receptor antagonist, EMEND ® (aprepitant) has a high affinity for NK 1 receptors located throughout the body. 2,3 In the illustration on this slide, the large multicolored structure represents the NK 1 receptor site. EMEND (the yellow chemical structure) is seen preventing substance P from binding to the site. The NK 1 receptor is a member of the pGPCR (peptidergic G-protein coupled receptor) family of receptors. Its principal signal transduction mechanism is Gq/11. This protein is linked to activation of phospholipase, which mediates an increase in intracellular calcium. 1 The NK 1 receptor is sometimes referred to as the substance P receptor because substance P is its preferred ligand. EMEND is a selective substance P/NK 1 receptor antagonist with a high affinity for NK 1 receptors located throughout the body. 2,3 Substance P can be thought of as a neuromodulator that amplifies the effects of other transmitters acting on the same cells. Therefore, blockade of substance P can have both direct and indirect effects on signaling because the actions of other transmitters are not amplified or exaggerated. As an NK 1 receptor antagonist, EMEND prevents the binding of substance P to the NK 1 receptor, preventing the activation of the signal transduction pathways and subsequent effects on cell physiology and signaling. References: 1. Alexander SPH, Mathie A, Peters JA. Guide to receptors and channels, 2nd edition. Br J Pharmacol . 2006;147(suppl 3):S1–S180. 2. Keller M, Montgomery S, Ball W, et al. Lack of efficacy of the substance P (neurokinin 1 receptor) antagonist aprepitant in the treatment of major depressive disorder. Biol Psychiatry . 2006;59:216–223. 3. Hargreaves R. Imaging of substance P receptors (NK 1 ) in the living human brain using positron emission tomography. J Clin Psychiatry . 2002;63(suppl 11):18–24.