- The document provides an overview of how to approach and manage a poisoned patient. It discusses toxicology, common reasons for overdoses, assessing risk, supportive care including monitoring and investigations, gastrointestinal decontamination, enhanced elimination, antidotes, potential complications, and disposition.
- Key aspects of the approach and management include the RRISDEAD method of resuscitation, risk assessment, supportive care, investigations, decontamination, enhanced elimination, antidotes, and disposition. Supportive care involves airway, breathing, circulation support as well as monitoring, fluid management, and treating secondary issues like seizures.
- Specific toxic syndromes discussed include anticholinergic syndrome, serotonin syndrome, and
This presentation deals with buprenorphine drug profile, from a clinical pharmacist perspective.
Summarized version of drug, including chief ADRs, interactions, and patient and health-care professional counselling tips have been mentioned.
Antipsychotics, antipsychotic drugs, major tranquilizers, tranquilizersMuthu Venkatachalam
introduction, indication, contraindications and side effects of antipsychotic drugs are explained.
Antipsychotic drugs used in the treatment of schizophrenia including psychosis is described.
Chlorpromazine, Clozapine
This presentation deals with buprenorphine drug profile, from a clinical pharmacist perspective.
Summarized version of drug, including chief ADRs, interactions, and patient and health-care professional counselling tips have been mentioned.
Antipsychotics, antipsychotic drugs, major tranquilizers, tranquilizersMuthu Venkatachalam
introduction, indication, contraindications and side effects of antipsychotic drugs are explained.
Antipsychotic drugs used in the treatment of schizophrenia including psychosis is described.
Chlorpromazine, Clozapine
Principles and Practice of Sedation in Intensive Care Unit (ICU)Apollo Hospitals
Distress is common amongst critically ill patients in ICU, especially those who are intubated or have difficulty communicating with their caregivers [1]. Distress in ICU generally presents as agitation. It needs to be treated for patient comfort & if left untreated increases sympathetic tone with untoward physiologic effects [2].
Before a sedative agent is initiated to manage agitation, the cause of distress should be identified & treated. Common causes of distress in critically ill patients include:-anxiety, pain, delirium, dyspnoea and neuromuscular paralysis. These etiologies may occur separately or in combination.
Organophosphate poisoning is poisoning due to organophosphates (OPs). Organophosphates are used as insecticides, medications, and nerve agents.
Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.
Other names: Organophosphate toxicity
Causes: organophosphates
This interesting ppt is the continuation of the Pharmacology of Opioid analgesics I... This impressive ppt highlight the pharmacology, advantages and disadvantages of opioid analgesics other than morphine with illustrations....!!
Principles and Practice of Sedation in Intensive Care Unit (ICU)Apollo Hospitals
Distress is common amongst critically ill patients in ICU, especially those who are intubated or have difficulty communicating with their caregivers [1]. Distress in ICU generally presents as agitation. It needs to be treated for patient comfort & if left untreated increases sympathetic tone with untoward physiologic effects [2].
Before a sedative agent is initiated to manage agitation, the cause of distress should be identified & treated. Common causes of distress in critically ill patients include:-anxiety, pain, delirium, dyspnoea and neuromuscular paralysis. These etiologies may occur separately or in combination.
Organophosphate poisoning is poisoning due to organophosphates (OPs). Organophosphates are used as insecticides, medications, and nerve agents.
Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.
Other names: Organophosphate toxicity
Causes: organophosphates
This interesting ppt is the continuation of the Pharmacology of Opioid analgesics I... This impressive ppt highlight the pharmacology, advantages and disadvantages of opioid analgesics other than morphine with illustrations....!!
Poisoning and Overdose have increased in recent times at exponential ratio, and most cases are with the initial attempt to harm oneself. this is very unfortunate. This presentation will help doctors and other health workers to be able to determine how to assist a patients who had overdosed on dangerous substances.
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
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
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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
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.
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
2. Objectives Provide a general overview of toxicology How to approach the poisoned patient Understanding common toxidromes
3. What is Toxicology What is it not a poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not a poison. -Paracelsus (1943-1541), the Renaissance Father of Toxicology, in his Third defence
4. Why do people OD? Significant portion intend to die at time of overdose Most want to escape an intolerable situation or state of mind Small minority of patients want to punish someone or make someone feel guilty Mental health difficulties particularly, depression, ETOH or substance misuse, and personality disorders are frequently seen Inability to tolerate life stressor or events, relationship breakdowns, anniversaries of bereavement, ect. Mitchell, A. Dennis, M. Self harm and attempted suicide in adults: 10 practical questions and answers for emergency department staff. Emerg Med J, 2006: 26, 251-255
5. What Drugs do they OD on? ETOH Paracetamol Benzo’s Antipsychotics Antidepressants Antiepileptic Opiods And many many more!!!
14. The ECG in TOX Valuable inexpensive screening tool QRS widening R/T sodium channel blockade, common with TCA overdose QT prolongation is a potassium channel effect associated with TDP, common in some antidepressant, antiarrythmics, & antipsychotic overdoses.
15. Urine Drug Screen Why don’t we do it? In general it rarely if ever changes management. Expensive Takes 1-2 days to get back When would we consider it?
19. Whole Bowel IrrigationActivated charcoal has most benefits in a limited number of poisoning, other methods have limited if any evidence to support their use.
21. Antidotes Limited number of antidotes available for limited number of poisonings. Common Antidotes: NAC Naloxone Sodium Bicarb Digoxin Immune Fab 5. Octreotide
22. Common Complications in the Critically Poisoned Patient Aspiration Pneumonia ARDS ARF DVT/PE Rhabdomyolysis Compartment Syndrome Hepatotoxicity
23. Disposition The patients journey can be: RESUS ICU Assessment Obs ward Psych Or patients with DSP need Pysch R/V
24. Poisoning in Children Most paediatric poisoning are benign, as children generally ingest small quantities. Always base your assessment on worse case scenario: The time of ingestion is assumed to be the latest possible time Assume all missing or unaccounted for agent(s) have been ingested Do not attempt to account for spillage, which is difficult to estimate If more than child involved, it is assumed that each child ingested all the missing or unaccounted for agent(s)
26. Management of child who ingest unidentified poison Admit for minimum of 12-hour observation Ensure health care facility can cope Defer IV access until evidence of toxicity Check BSL at presentation and on D/C Monitor GCS & vital signs Cardiac monitor if decreased GCS or abnormal vital signs D/C during daylight hours
27.
28. Common poisoning in the Elderly Digoxin Metformin Lithium Disposition= Generally elderly patients end up in Gen Med units for prolonged periods of care
30. Coma Patients presenting with coma have generally overdosed on a drug with CNS depressant effects. Can be caused by secondary effects: Hypoxaemia Hypoglcaemia Hyponatraemia Hypotension Seizures Cerebral oedema
31. Coma Management RRSIDEAD Good supportive care & airway management Treat secondary effects Look at what else can cause coma Neurotrauma Metabolic encepathopathy Menigioencephalopathy Space occupying lesion Patients generally go to ICU, till conscious states improve Look for complication’s (Asp Pneumonia)
32. Why do we use Diazepam so much in TOX? Good safety profile Long half life Controls agitation well Used to treat toxic seizures Generally drug of choice in managing withdrawals Dose adult 5-10mg, child 0.1-0.3mg/kg/dose every 3-5mins
33. Anticholinergic Syndrome Results from the competitive, reversible blockade of central & peripheral cholinergic blockade. Is potentially life threatening Diagnosed clinically by agitated delirium and peripheral muscarinic blockade History of ingestion of known anticholinergic agent
36. Remember the saying!!! Hyperthermia (HOT as a hare) Flushed (RED as a beet) Dry Skin (DRY as a bone) Dilated pupils (Blind as a bat) Delirium, hallucinations (Mad as a hatter) Tachycardia Urinary Retention
46. Managing Serotonin Syndrome RRSIDEAD Check BSL Check temp >38.5 continuous core monitoring, temp > 39.5 paralysis and intubate Give benzo’s to achieve gentle sedation HT & tachycardia generally respond to benzo’s, if refractory trial of GTN infusion Antidote: Cyproheptadine, given orally or via NG