Introduction
Generic Name: Atorvastatin
Brand Names: Lipitor,Atorvast,Divastin,Lipicut
Atorvastatin a group of drugs called HMG CoA reductase inhibitors, or "statins."
Atorvastatin reduces levels of "bad" cholesterol or LDL and triglycerides in the blood, and also increasing levels of "good" cholesterol or HDL.
4Mechanism of action
Statin drugs competitively inhibit HMG-CoA, which is an enzyme that catalyzes the synthesis of HMG-CoA in to cholesterol. Therefore, it effectively the synthesis of new cholesterol. It leads to an increase in LDL receptor on Liver cells to take in more LDL, effectively decreasing LDL in the body
5Pharmacokinetics
Absorption
Atorvastatin undergoes rapid absorption when taken orally, with an approximate time to maximum plasma concentration of 1–2 h
Distribution
The mean volume of distribution of atorvastatin is approximately 381 L. It is highly protein bound (=98%), and likely secreted into human breast milk.
8Metabolism
Atorvastatin metabolism is primarily through cytochrome P450 3A4 hydroxylation to form active ortho-and parahydroxylatedmetabolites. The ortho-and parahydroxylatedmetabolites are responsible for 70% of systemic HMG-CoA reductase activity. The ortho-hydroxymetabolite undergoes further metabolism via glucuronidation.
9ExcretionAtorvastatin is primarily eliminated via hepatic biliary excretion, with less than 2% recovered in the urine. Bile elimination follows hepatic and/or extrahepaticmetabolism. Atorvastatin has an approximate elimination half-life of 14 h.
10Medical Uses
Hypercholesterolemia to reduce total cholesterol, LDL-C, apo-B, as well as increase HDL levels.
Hypertriglyceridemia
Primary prevention of heart attack, stroke.
Secondary prevention of myocardial infarction, stroke, unstable angina.
Myocardial infarction and stroke prophylaxis in patients with type II diabetesInteractions
Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage.
Interactions with clofibrate, fenofibrate, gemfibrozil, usually in combination with statins, increase the risk of myopathy.
Barbiturates, carbamazepine, oxcarbazepine, rifampin, and rifamycin, which are CYP3A4 inducers, can decrease the plasma concentrations of atorvastatin.
12Precautions to be taken Before taking this medicine
Liver disease
Muscle pain or weakness
History of liver disease
History of kidney disease
History of stroke
If you are pregnant or breast-feeding
A thyroid disorder
If you drink more than 2 alcoholic beverages daily.
Side Effects
Cough
Difficulty with swallowing
Fast heartbeat
Fever and dizziness
Itching
Muscle cramps, pain, stiffness, swelling, or weakness
Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Skin rash
Tightness in the chest
Unusual tiredness or weakness
Introduction
Generic Name: Atorvastatin
Brand Names: Lipitor,Atorvast,Divastin,Lipicut
Atorvastatin a group of drugs called HMG CoA reductase inhibitors, or "statins."
Atorvastatin reduces levels of "bad" cholesterol or LDL and triglycerides in the blood, and also increasing levels of "good" cholesterol or HDL.
4Mechanism of action
Statin drugs competitively inhibit HMG-CoA, which is an enzyme that catalyzes the synthesis of HMG-CoA in to cholesterol. Therefore, it effectively the synthesis of new cholesterol. It leads to an increase in LDL receptor on Liver cells to take in more LDL, effectively decreasing LDL in the body
5Pharmacokinetics
Absorption
Atorvastatin undergoes rapid absorption when taken orally, with an approximate time to maximum plasma concentration of 1–2 h
Distribution
The mean volume of distribution of atorvastatin is approximately 381 L. It is highly protein bound (=98%), and likely secreted into human breast milk.
8Metabolism
Atorvastatin metabolism is primarily through cytochrome P450 3A4 hydroxylation to form active ortho-and parahydroxylatedmetabolites. The ortho-and parahydroxylatedmetabolites are responsible for 70% of systemic HMG-CoA reductase activity. The ortho-hydroxymetabolite undergoes further metabolism via glucuronidation.
9ExcretionAtorvastatin is primarily eliminated via hepatic biliary excretion, with less than 2% recovered in the urine. Bile elimination follows hepatic and/or extrahepaticmetabolism. Atorvastatin has an approximate elimination half-life of 14 h.
10Medical Uses
Hypercholesterolemia to reduce total cholesterol, LDL-C, apo-B, as well as increase HDL levels.
Hypertriglyceridemia
Primary prevention of heart attack, stroke.
Secondary prevention of myocardial infarction, stroke, unstable angina.
Myocardial infarction and stroke prophylaxis in patients with type II diabetesInteractions
Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side effects such as liver damage.
Interactions with clofibrate, fenofibrate, gemfibrozil, usually in combination with statins, increase the risk of myopathy.
Barbiturates, carbamazepine, oxcarbazepine, rifampin, and rifamycin, which are CYP3A4 inducers, can decrease the plasma concentrations of atorvastatin.
12Precautions to be taken Before taking this medicine
Liver disease
Muscle pain or weakness
History of liver disease
History of kidney disease
History of stroke
If you are pregnant or breast-feeding
A thyroid disorder
If you drink more than 2 alcoholic beverages daily.
Side Effects
Cough
Difficulty with swallowing
Fast heartbeat
Fever and dizziness
Itching
Muscle cramps, pain, stiffness, swelling, or weakness
Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Skin rash
Tightness in the chest
Unusual tiredness or weakness
Atorvastatin Impurity | Atorvastatin Epoxy Tetrahydrofuran Analog Hemarsh Technologies
Atorvastatin is used to reduce the levels of bad cholesterol and triglycerides in the blood. Here are some of the products of Atorvastatin which are widely used in the pharma industry like Atorvastatin Epoxy Tetrahydrofuran Analog, Atorvastatin FX1 Impurity, Atorvastatin FXA Impurity, & Atorvastatin Pyrrolidone Phenanthrene Calcium.
Hypolipidemic agents, also known as cholesterol-lowering drugs or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are also called lipid-lowering drugs.
Atorvastatin Impurity | Atorvastatin Epoxy Tetrahydrofuran Analog Hemarsh Technologies
Atorvastatin is used to reduce the levels of bad cholesterol and triglycerides in the blood. Here are some of the products of Atorvastatin which are widely used in the pharma industry like Atorvastatin Epoxy Tetrahydrofuran Analog, Atorvastatin FX1 Impurity, Atorvastatin FXA Impurity, & Atorvastatin Pyrrolidone Phenanthrene Calcium.
Hypolipidemic agents, also known as cholesterol-lowering drugs or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are also called lipid-lowering drugs.
Job of a Medical Representative is very challenging. They have to achieve their sales target by generating prescriptions in favor of their products.Here is the list of traits which are needed to become a successful Medical Representative is given below.
A detailed information about the cholesterol types, its absorption, conversion and drugs used to lower the levels of LDL, VLDL and Triglycerides - classification, mechanism of action, side effects, dosage and indications.
Drugs for Gout ( Acute and Chronic gout)ANUSHA SHAJI
The current presentation include the pharmacotherapy of drugs for acute and chronic gout. Details include definition, classification of drugs, mechanism, pharmacokinetics, adverse effects, uses and contraindications.
Anticoagulants, commonly referred to as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time.
Mechanism of drug action (pharmacokinetic and pharmacodynamic )Ravish Yadav
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
lecture presented at 5th. March 2024 as part of the newly pharmacist training course about patient safety program
high alert medications
look alike sound alike medication
lecture presented at 3rd. March 2024 about the Iraqi pharmacovigilance system as part of the newly appointed pharmacist training course (2024),
Update was performed depending on the latest version of the (Iraqi Pharmacovigilance Guidelines for Healthcare Professionals) 2024
IPhVC recommendations & monitoring requirement of biosimilars, Worldwide & Iraq control of Bioproducts & biosimiliars, as well as references enlisted adverse reactions to common products used in our hospital
Lecture presented at the 31st Jan 2024 in our hospital
Systemic & inhaled Quinolone antibiotic EMA/MAHRA update considering when not to administr this groups of antibiotics
According to the Iraqi Pharmacovigilance Centre instructions
Benzyl alcohol as parenteral drugs additives
Their effects on specialist populations like pediatrics, pregnant and lactating females
With possible prepartaions were they are added
According to the Iraqi Pharmacovigilance Centre instructions
Antibiotic stewardship, Clinical pharmacyDrug information Centre, Medication...Alaa Fadhel Hassan Alwazni
Training workshop held at Al-Mahmoudiya General Hospital in 18/10/2023
about work & duties of different comittes & units realted to the clinical pharmacy & pharmacovigilance
lecture presented at Al-Mahmoudiya General hospital in the 30th Aug 2023
based upon recent governmental protocols of antibiotic selection, dosage forms conversion by MOH 2023
IV drug additives
Updated on 1st Aug 2023
Refrences:
British National Formulary, (Sep. 2022) v3.1.6 android application
* Medscape, (July, 2023) v1131.0 & v181.0 android application
**Others: Elsevier’s Intravenous Medications: A Handbook for Nurses and Health Professionals,
Mosby’s Drug Reference for Health Professions,
Drugs.com website, Professionals, AFHS Monographs,
Electronic Medicines Compendium (emc) website,
& MMS home website, Drugs, Info.
The medical ethics lecture was presented online as part of the newly - employed pharmacists training course on 23/5/2023
Al-Mahmoudiya General Hospital
High alert medications (HAM)
Lecture presented in the unit of clinical pharmacy, Al-Mahmoudiya General Hospital
As part of the training course for clinical pharmacy 22/5/2023
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
Intravenous dextrose (glucose water) available conc., doses, side effects, precautions & direction for adm.
presented at Al-Mahmoudiya General Hospital on 20/12/2022
Resistant culture for the bacterial isolate of Al-Mahmoudiya G.Hospital as part of antibiotic stewardship mission
presented on 23/11/2022 at our hospital
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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!
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
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.
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).
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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
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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. By: Ala’a F. Hassan/Clinical pharmacy unit
Action: all are HMG CoA reductase inhibitors that prevents
the 1st enzymatic step of de-novo cholesterol synthesis as
well as increase LDL catabolism(increase surface LDL
receptors on cells)
Absorption: pravastatin & fluvastatin are completely
absorbed following oral intake while only 30-50%
absorbance reported with lovastatin & Simvastatin
food intake was found to increase lovastatin absorption
while decrease (fluvastatin, atrovastatin & pravastatin)
bioavailablities still rosuvastatin & simvastatin absorption
is unaffected by food
Undergo marked hepatic 1st pass extraction (lovastatin &
simvastatin are prodrugs) with t1l2 ranges from 1-3 hr
(fluvastatin ,pravastatin & simvastatin) up to 19 hr with
rosuvastatin; peak plasma concentration achieved within
4hrs mostly
Elimination: principally excretion via bile & feces despite
urinary elimination also occurs(with pravastatin &
rosuvastatin mostly as unchanged drugs)
2. Statins dosing chart & potency
So pitavastain was found to be highly potent for lowering LDLc
followed by rosuvastatin, atrovastatin, simvastatin &
pravastatin though the lest potent agent were lovastatin &
fluvastatin
Adverse effects & Interactions
i. Cholesterol is an essential structural component of cells, a
precursor for steroid hormones, vitamin D metabolites and
bile acids, and an important factor in neural myelinization
and brain growth so possible side effects of statins on
growth, pubertal development and endocrinologic functions
have restricted their use in children during the prepubertal
stage, Furthermore since fat-soluble vitamins are
transported by lipoproteins, their reduction by statins has
been suspected to lead to vitamin deficiencies.
ii. The most serious adverse effect associated with statins
therapy is myopathy, which may progress to fatal or
nonfatal rhabdomyolysis which is increased with renal
insufficiency & intake of drugs as cyclosporine, antifungals,
3. erythromycin, clarithromycin, fucidic acid, gemfibrozil,
niacin, colchicin, nicotinic acid & anti arrythmics
iii. Statins found to enhance coumarins anticoagulant effect
while dcrease warfarin effect
iv. Other interaction reported with antacid(reduces
rosuvastatin absorption) ,ethnylestradiol as well as
glibinclamide & digoxin (plasma concentration Increased
by fluvastatin & atorvastain respectively), bosentan
(increases statin plasma concentration
v. Effects of statins on urinary protein excretion and kidney
function found atrovastatin to be protective and
Rosuvastatin was unprotective and possibly harmful, in
diabetic and nondiabetic patients[Allegations were made
that patients taking low doses of rosuvastatin were at
greater risk of developing serious kidney damage specially
with fibrates as fenofibrate, and rhabdomyolysis than those
taking other statins]
vi. There are few reports of statins induced thrombocytopenia
with pathophysiologic mechanisms of two major categories:
decreased platelet production via marrow suppression and
peripheral platelet clearance, usually by one of several
possible immune mechanisms
vii. Other studies report pancreatitis induced by atrovastatin,
rosuvastatin, simvastatin, pravastatin, fluvastatin and
lovastatin.