Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
This slide have the information about chemotherapy:- the treatment of disease by means of chemicals that have a specific toxic effect upon the disease-producing microorganisms or that selectively destroy cancerous tissue.Also include the drug resistance:-Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial.
Pharmacology of Penicllins (Beta lactam antibiotics), description of their mechanism of action, mechanism of resistance, classification, indications and adverse effects
This slide have the information about chemotherapy:- the treatment of disease by means of chemicals that have a specific toxic effect upon the disease-producing microorganisms or that selectively destroy cancerous tissue.Also include the drug resistance:-Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial.
Pharmacology of Penicllins (Beta lactam antibiotics), description of their mechanism of action, mechanism of resistance, classification, indications and adverse effects
Rational Use of Antibiotics. Infection was a major cause of morbidity and mortality, before the development of antibiotics.
The treatment of infections faced a great challenge during those periods.
Later in 1928, the discovery of Penicillin, a beta-lactam antibiotic, by Alexander Fleming opened up the golden era of antibiotics.
It marked a revolution in the treatment of infectious diseases and stimulated new efforts to synthesize newer antibiotics.
The period between the 1950s and 1970s is considered the golden era of discovery of novel antibiotic classes, with very few classes discovered since then.
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Anti-microbials therapy and complications.pptxsushma kaphle
Antimicrobial drugs
Selection of microbial agents
Selection of routes
Determinants of rational dosing
Chemotherapeutic spectra
Combinations of Antimicrobials
Drug resistance
Prophylactic antibiotics
Complications
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Definition of Osteoporosis - Prevalence - Risk factors for Osteoporosis - Diagnosis of Osteoporosis - Clinical manifestations- Laboratory investigations - DEXA - T and Z score - Management of Osteoporosis - Prevention
Definition and introduction to bronchial asthma - classification of bronchial asthma - pathophysiology and risk factors for bronchial asthma - diagnosis of bronchial asthma - clinical manifestations - investigations - management of bronchial asthma
Definition of diabetes - introduction - classification of diabetes - etiology of diabetes type 1 and type 2- risk factors for diabetes - diagnosis of diabetes - clinical manifestations of diabetes type 1 and type 2- investigations for diabetes - treatment of diabetes - non-pharmacological treatment and pharmacological treatment - pharmacotherapy of type 1 and type 2 - acute complications of diabetes and treatment
Definition of arrhythmia - background on cardiac physiology including conduction in heart - action potential - pathogensis of arrhythmia - causes and risk factors for arrhythmia- diagnosis of arrhythmia - symptoms of tachyarrhythmias and bradyarrhythmias - investigations for arrhythmia - treatment of arrhythmia - pharmacological and other modalities of therapy for arrhythmia - managment of different types of arrhythmias
Definition of heart failure - causes and types of heart failure - pathophysiology and risky factors for heart failure - Diagnosis clinical manifestations and investigations and classification of heart failure- treatment of chronic heart failure
Also Acute heart failure causes - clinical picture and treatment
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
definition of pain - classification - categories and different clinical types of pain - assessment of pain and how to manage using pharmacological and non-pharmacological intervention
- Introduction to multimedia and different types and categories of multimedia
-use of multimedia in education with special consideration to medicine
-Future of multimedia
Introduction to Sexually transmitted diseases with a concentration on certain diseases like syphilis - herpes - chancroid- gonorrhoea - chamydia - bacteria vaginosis- trichomoniasis-candidiasis- human papilloma virus
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
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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.
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).
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.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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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ASA GUIDELINE
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
3. Objectives
1)Review the classification of antimicrobials
2)Define pharmacodynamic principles and their relationship to
effective antimicrobial therapy
3)Discuss patient and drug related factors that influence the
selection of the appropriate antimicrobial agent
4)Identify monitoring parameters to evaluate antimicrobial
therapy
4. What are Antimicrobials?
Antimicrobials are drugs that destroy microbes, prevent their
multiplication or growth, or prevent their pathogenic action
Differ in their physical, chemical, and pharmacological
properties
Differ in antibacterial spectrum of activity
Differ in their mechanism of action
5. Classification of Antimicrobials
A. According to source:
1.Natural compounds: e.g.penicillin, chloramphenicol.
2.Synthetic compounds: e.g.sulfonamides, quinolones.
3.Semisynthetic compounds: e.g.ampicillin.
6. B. Accordingto the effect on microorganisms:
1.Bactericidal agents: that kills the microorganism e.g.
penicillin.
2.Bacteriostatic agents: arrest growth of the microorganism
e.g. sulfonamides.
9. D. According to antimicrobial spectrum:
1. Narrow spectrum drugs:
Drugs affect mainly Gram +ve bacteria e.g. benzyl penicillin.
Drugs affect mainly Gram –ve bacteria e.g. aminoglycosides.
2. Extended spectrum drugs:
agents that affect Gram +ve & Gram –ve bacteria.
2.Broad spectrum drugs:
agents act on wide range of Gram +ve & Gram –ve bacteria
and others (protozoa) e.g. tetracyclines.
10. Antimicrobial therapy
Empiric
Infecting organism(s) not yet identified
More “broad spectrum”
Definitive
Organism(s) identified and specific therapy chosen
More “narrow” spectrum
Prophylactic or preventative
Prevent an initial infection or its recurrence after infection
12. I. Confirm the presence of an infection
CAREFUL history and physical exam including
relevant laboratory data and signs and symptoms
1) Fever:
o Is considered a hallmark of most infectious diseases.
o defined as elevated temperature >37.2◦C.
o May be present in absence of infection e.g. in
autoimmune disorders and several malignancies.
o May be absent in presence of infection if the immune
system is depressed.
13. 2) White blood cell count:
Normal WBC is 4000-10,000 cells/mm3.
Bacterial infections are associated with elevated granulocyte
counts (neutrophils, basophils, and eosinophils).
Viral, TB and fungal infections are associated with elevated
lymphocytic count.
Parasitic infections and allergic reactions are associated with
increased eosinophilic count.
3) Any swelling or erythema at a particular site
4) Purulent drainage from a visible site
5) Patient complaints
14. II. Selection of antimicrobial agents
1) Identification of the infecting organism:
Infected body materials (e.g., blood, sputum, urine, wound
drainage, etc.) must be sampled and cultured before initiating
treatment.
Empirical therapy before identification of the organism is
necessary in the following conditions:
o In all acutely ill patients with infections of unknown origin.
o Infection in a neutropenic patient, or a patient with meningitis.
15. Culture Results
Minimum inhibitory concentration (MIC)
o The lowest concentration of drug that prevents visible bacterial growth
after 24 hours of incubation in a specified growth medium
o Organism and antimicrobial specific
Report organism(s) and susceptibilities to antimicrobials
o Susceptible (S)
o Intermediate (I)
o Resistant (R)
17. 2) Patient factors:
In neonates
- The use of chloramphenicol can lead to shock and
cardiovascular collapse(gray baby syndrome).
- The use of sulfonamides may lead to kernicterus (brain
damage)
In growing children:
- the use of fluoiroquinolones can lead to arthropathy
- the use of tetracyclines can bind to growing bones and teeth
resulting in abnormal teeth and bone formation.
18. In old age(>65years)
- The incidence of renal toxicity with aminoglycosides is
greater than in younger patients.
In immunocompromised patients
- The use of bactericidal agents is necessary , as the host’s
immune system is not capable of final elimination of the
bacteria.
Pregnancy:
- Many antibiotics cross the placenta and cause adverse
effects to the fetus e.g. aminoglycosides and tetracyclines.
19. Genetic or metabolic abnormalities
o Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Renal and hepatic function
o Accumulation of drug metabolized and/or excreted by these
routes with impaired function
o risk of drug toxicity unless doses adjusted accordingly
o Renal excretion is the most important route of elimination
for the majority of antimicrobials
20. 3) Tissue penetration:
The capillary lining in some tissues e.g. brain form natural barriers to
drug delivery due to presence of tight junctions of the capillary wall.
Lipid soluble antibiotics e.g. chloramphenicol and metronidazole can
cross these barriers in normal conditions. Penicillin is ionized at
physiologic pH and cannot cross these barriers unless inflammation
is present.
Poor perfusion of some area
- e.g. diabetic foot, reduces the amount of antibiotic reaching this area,
making treatment is difficult.
21. III. Determinants of the rational dosing
Minimum inhibitory concentration (MIC):
o The MIC is the lowest concentration of antibiotic in body tissues
and fluids that inhibits bacterial growth.
Concentration-dependent killing:
o Certain antibiotics(e.g.aminoglycosides) show enhanced bacterial
killing in concentration above the MIC.
o Giving these antibiotics by a single large dose per day achieves
high peak levels and cause rapid killing of bacteria.
22. Time-dependent killing:
o depends on the time of the drug concentration to remain above
the MIC. So, preparations with long duration kill more bacteria.
o e.g.β-lactam antibiotics, macrolides, clindamycin, and linezolid
Post-antibiotic effect (PAE):
o The PAE is a persistent bacterial suppression after levels of
antibiotic fall below the MIC.
o Antimicrobials with long PAE(e.g. aminoglycosides and
fluoroquinolones) usually require one dose per day.
23. IV. Monitoring
Efficacy and toxicity of antimicrobials
Clinical assessment
o Improvement in signs and symptoms
• Fever curve, WBC
• erythema, pain, cough, drainage, etc.
Antimicrobial regimen
o Serum levels
o Renal and/or hepatic function
o Other lab tests as needed
o Consider IV to PO switch
Microbiology reports
o Modify antimicrobial regimen to susceptibility results if necessary
o “Narrow” spectrum of antimicrobial if appropriate
24. Other Drug Factors
Adverse effect profile and potential toxicity
Cost
Acquisition cost + storage + preparation + distribution + administration
Monitoring
Length of hospitalization + readmissions
Patient quality of life
Resistance
Effects of the drug on the potential for the development of resistant
bacteria in the patient, on the ward, and throughout the institution
Drug – Drug interactions
26. I. General adverse effects:
Hypersensitivity or allergic reactions: In form of fever, skin
rash, arthralgia, cholestatic jaundice or hemolysis. More
serious reactions are agranulocytosis, bone marrow aplasia or
anaphylactic reaction.
Reactions related to alterations in normal body flora,
superinfection or vitamin B deficiency may follow the use of
broad-spectrum antimicrobials. It is due to inhibition of
bacterial flora that suppresses commensal micro-organisms
which present in gut or that forms these vitamins, respectively.
Resistance
27. II. Direct toxic reactions:
resulting from high doses or drug interactions, on liver,
kidney, GIT, nervous system or CVS.
29. Administration of antimicrobials usually alter bacterial flora but with no
ill effect in most cases however, broad-spectrum antibiotics if used for
long time may alter or kill bacterial flora. So, the bacteria and fungi that
are normally inhibited by bacterial flora will multiply leading to
superinfection (its early manifestation may by diarrhea).
caused by staphylococci, Pseudomonas, proteus, Candida albicans or
Clostridia difficile.
30. Cont..
Superinfection may be vaginal, oral, pharyngeal or even systemic
infection e.g. staphylococcal enterocolitis, candidiasis or
Pseudomembranous colitis(=antibiotic-associated diarrhea).
Treatment:
Stop the causative agent and give drug, which kill the organisms
responsible for super infection e.g. staphylococcal enterocolitis,
which is treated by metronidazole or vancomycin orally, antifungal
nystatin for candidiasis.
32. I. Innate resistance:
Is a feature of a particular species of bacteria e.g Pseudomonas.
The gene(s)of resistance can be transferred between bacteria by
transfer of naked DNA(transformation),by conjugation with direct
cell-to-cellt transfer of extrachromosomal DNA(plasmids), or
through bacteriophage(transduction)..
33. II. Acquired resistance:
Occurs when bacteria that were sensitive to certain antibiotic
become resistant with time.
Mechanisms responsible :
i. Production of enzymes that inactivate the drug.
ii. Alteration of drug binding site.
iii. Reduction in drug uptake by the organism.
iv. Development of altered metabolic pathways.
35. Drug-Drug interactions
Influences the selection of appropriate drug therapy, the dosage, and
necessary monitoring
Drug interactions
risk of toxicity or potential for efficacy of antimicrobial
May affect the patient and/or the organisms
Pharmacokinetic interactions
o Alter drug absorption, distribution, metabolism, or excretion
Pharmacodynamic interactions
o Alter pharmacologic response of a drug
o Selection of combination antimicrobial therapy ( 2 agents) requires
understanding of the interaction potential
36. COMBINATION OF ANTIBIOTICS
Indications:
1. To obtain broader spectrum e.g. amoxicillin+clavulanic acid→ co-
amoxiclav.
2. To obtain synergism e.g. sulfonamides + trimethoprim → co-
trimoxazole.
3. In mixed bacterial infections e.g. diabetic foot or peritonitis.
4. In serious bacterial infections e.g. bacterial meningitis or septicemia.
5. To overcome bacterial resistance e.g.TB and pseudomonas infection.
6. To reduce toxicity of one drug by using smaller doses of two drugs.
37. Cont.
Results:
i. Bactericidal+bactericidal → synergism :
e.g. penicillin with aminoglycosides.
ii. Bacteriostatic+bacteriostatic → addition:
e.g. tetracyclines with sulfonamides.
iii. Bactericidal+bacteriostatic →
a. Antagonism: e.g. penicillin with erythromycin
b. Synergism: e.g. sulfadiazine with penicillin
39. 1. Antimicrobials should only be given when necessary and after antimicrobials
susceptibility test whenever possible.
2. The pharmacokinetics of the drug should be taken into consideration e.g.
the state of hepatic and renal functions of the patient.
3. In serious infection it is better to start with a parenteral loading of a
bactericidal agent to avoid emergence of resistant strains by giving
adequate dosage for sufficient duration and adapting proper combination
regimens.
4. Antimicrobials should be continued for 3 days after apparent cure is
40. Summary
Antimicrobials are essential components to treating infections
Appropriate selection of antimicrobials is more complicated than matching a drug to a
bug
While a number of antimicrobials potentially can be considered, clinical efficacy, adverse
effect profile, pharmacokinetic disposition, and cost ultimately guide therapy
Once an agent has been chosen, the dosage must be based upon the size of the patient,
site of infection, route of elimination, and other factors
Optimize therapy for each patient and try to avoid patient harm
Use antimicrobials only when needed for as short a time period as needed to treat the
infection in order to limit the emergence of bacterial resistance