PharmaPHILIA - Extracting Concepts Of Medical With Rph FIA

  Different seizure types & syndromes originating from several mechanism that have in common sudden, excessive & synchronous discharge of cerebral neurons 3rd most common disease after CVS & Alzheimer Idiopathic Epilepsy when no specific anatomic cause for the seizure such as Trauma or Neoplasm, patient may be diagnosed with Idiopathic/Cryptogenic/Primary Epilepsy Symptomatic Epilepsy  Ano. Of cause such as Illicit drug use,tumor, head injury, hypoglycemia, meningeal infection, rapid withdrawl from Alchol can precipitate seizure Classification of Seizure 1) Partial seizure:  involve only a portion of brain,part of one lobe of one Hemisphere... I. Simple Partial: these seizures are caused by a group of hyperactive neuron exhibiting abnormal electrical activity which confined to single locus in the brain ll. Complex Partial: These seizures exhibit complex sensory hallucination & mental distortion. Motor dysfunction involves Chewing movement, Diarrhea, Urina...

Drugs used to treat Erectile Dysfunction Erectile Dysfunction= inability to maintain Penile erection for successful performance of Sexual activity ED has physical & psychological causes including vascular disease, diabetes, medications, depression, prostatic surgery Classification Drugs for Erectile Dysfunction (PhosphoDiEstrase-5 inhibitor) Sildenafil Tadalafil Vardenafil Previous therapies include intrapenile inj of Alprostadil, penile implant Phosphodiestrase-5 inhibitor PDE-5 MOA NO activate Guanylyl cyclase... form cGMP... ↓ intracellular Ca++.....relaxation  of smooth muscles...PDE-5 responsible degradation of cGMP... PDE-5 inhibitors Θ  PDE-5.... Increase blood flow into Corpus Cavernosum at any level of sexual stimulation No effect in the absence of sexual stimulation P.K  should be taken 1hr prior to sexual activity... Erectile enhancement upto 4hr.. Abs.   delayed by high fat meal... Disintegrating tab of Vardenafil not affected by fat meal ... S.E ...

Classification Anti-Microbial Agents Optimal therapy for Patients with Peptic Ulcer disease who infected with Helicobacter Pylori.... Urea Breath Test: Exhaled 13CO2 analyzed...presence of H.Pylori increase ratio of 13CO2-12CO2 in Expired breath...H.pylori release UREASE hydrolyzes labeled Urea into 13CO2 Triple therapy consist of PPI, Metronidazole/Amoxicillin, Clarithromycin Quadruple therapy PPI, Metronidazole, Tetracycline, Bismuth subsalicylate GERD not associated with H.pylori H2-Receptor Antagonists Gastric acid secretion by parietal cells of mucosa stimulated by ; Histamine, Ach, Gastrin. Receptor binding results in activation of Protein Kinase....stimulate H+/K+- ATPase proton pump ...secrete H+ in exchange for K+ into lumen of Stomach.....Gastric acid production MOA= H2-receptor anatagonists block action of Histamine at all H2-receptor ... Competetively bind to H2-Receptor----- reduce intracellular conc. ATP....inhbit gastric acid secretion Potently inhibit 90% Basal, Food-...

  Immune activation 3 signal model Signal 1 =Antigen at APC(Antigen presenting Surface) react with T-Cell at CD3 receptor Signal 2 =CD80 & CD86 at APC engage with CD28 at T-Cell Signal 1 & Signal 2 activate Calcium-Calcineurin Pathway, production of Cytokine i.e IL-2, IL-15, CD154, CD25. Signal 3 =IL-2 bind with CD25 at T-Cell activate mTOR (Mammalian Target of Rapamycin) , stimulate T-Cell proliferation Selective Inhibitor of Cytokine

 TOXICOLOGY Toxicity = Inherent capacity of chemical to cause injur...dose & duration dependent Acute toxicity: conversion of Xenobiotics into Nucleophilic specie Chronic toxicity: conversion of Xenobiotics into Electrophilic specie Warfarin is Rodenticide...Malathion Θ AcetylCholinEsterase, Ach toxicity Asbestos is Carcinogenic CCL4: from consumption of Contaminated water...cause Irritation of Eyes & Respiratory Chloroform: Hepaatotoxic, Nephrotoxic Benzene: Hematopoietic toxicity...Agranulocytosis, Leukopenia Toluene: CNS impair Speech, hearing, vision Methanol (Wood Alchol) & Ethylene Glycol: Methanol oxidizes into Formic acid... Ethylene Glycol oxidized into Glycolic, Oxalic, and Glyxolic acid Isopropnol: metabolize into Acetone, then COOH, cause Acedemia Organophosphate & Carbmate= Inseecticides....ΘAcetylCholinesterase Pyrethroids: Insecticide...↑Na+...Convulsion, itching...S.E; Contact Dermatitis, Asthma Rotenone: Insectiside... ΘNAD+ by ↓O2 Lead: C...

Adrenal gland consist of cortex & medulla.... Medulla secrete Epinephrine... Cortex secrete Adrenal Corticoids & Adrenal Androgens

“There is no friend as loyal as a book.”                                                                           ― Ernest Hemingway My Drive:  https://drive.google.com/drive/folders/1FQE34jeKeozJ2G6sFcwyJVszoBlqbAXy?usp=sharing  Pharmaceutical Analysis:  https://drive.google.com/drive/folders/12XPMn1GlyoiActJ0mc9JFEDrtf4zJWlJ?usp=sharing Pharmaceutical Biochemistry:  https://drive.google.com/drive/folders/1y4IY0V4Y0j2Cf2J0IvRI_jpjHJ5An3R1?usp=sharing BNF: https://drive.google.com/drive/folders/1X5VeiXULULKxr6b8MOK0Kw92re2GXuzx?usp=sharing British pharmacopoeia: https://drive.google.com/drive/folders/1xfwrsvgSL6WjmV0LJoB2hAyQ2VybsvOu?usp=sharing Clinical pharmacy: https://drive.google.com/drive/folders/1Rqp4C46Fo_qObg1m8IiJMtEAAW9dzXpV?usp=sharing Forensic pharmacy:  https://driv...

 Asthma= chronic disease characterized by Hyperresponsive airway, characterized by Bronchoconstriction, shortness of breath, cough, chest tightness, wheezing, rapid respiration COPD= Irreversible obstruction of airway include Emphysema and chronic Bronchitis Allergic Rhinitis Inflammation of mucous memb. Of nose characterized by itchy, watery eyes, runny nose, unproductive cough, nasal congestion Cough defensive respiratory response to irritants Meterd –dose inhaler= contain Ozone-depleting Chlorofluorocarbons...SLOWLY & DEEPLY technique ….Nedocromil, Metaproterenol, Cromolyn, Flunisolide, Albuterol/Ipratropium, Pirbuterol New formulations are environment friendly include HydrofuoroAlkanes & Dry powder inhaler (DPIs) ….DPI technique QUICKLY, DEEPLY Drugs for Asthma Epinephrine DOC in Acute Anaphylaxis & Status Asthmaticus Quick relief= by Short-acting β2- Agonists e.g ALBUTEROL 5-30min onset, 6-4hr t1/2 not catecholamine , not hydrolyzed by COMT… S.E; Hypokalemia, Hyp...

 Thiazide Diuretics Sulphonamide derivative..related in structure to Carbonic Anhydrase….partly depend on renal PG synthesis Act on DISTAL CONVULATED TUBULE….called Ceiling Diuretics b/c increase in dose above normal dose not increase Diuretic response MOA= Act on distal tubules...inhibit Na+/CI- Cotransporter…decrease Reabsorption of Na+….increased Excretion of Na+ & CI-..Loss of K+..Loss of Mg++..decreased excretion of Ca++…reduced peripheral Vascular Resistance T.E= used in Hypertension, HF (decrease extracellular volume), Hypercalciuria,Diabetes Insipidus…… excreted thhroughorganic acid secretary sys of kidney S.E= Hypokalemia, Hyonatremia, HyperUricemia (by decreasing excretion of uricacid from organic acid secretary sys), Volume depletion, Hypercalcemia, Hyperglycemia,Hyperlipidemia, Hypersensitivity Loop Diuretics Act on ASCENDING LOOP OF HENLE….high Efficacy…Ethacrynic acid has Steeper Dose Response Curve….Bumetanide more potent MOA= inhbit Na+/K+/2CI-Cotransport in ...

 HMG CoA Reductase Inhibitors (Statins)  3-Hydroxy-3-MethylGlutryl-Coenzyme A reductase inhibitors lower LDL Cholesterol level..Rate limiting step Cholesterol synthesis MOA =Statin inhibit HMG Co A reductase ...which convert HMG CoA into Mevalonic Acid which convert into Cholesterol…decrease conc. Of Cholesterol within cell Low intracellular Cholesterol stimulate synthesis of LDL receptor…Increased LDL receptor promote uptake of LDL from blood Low intracellular Cholesterol decrease Secretion of VLDL Increase plasma HDL level T.E= All types of Hyperlipidemia…..Familial Hypercholeserolemia lack LDL receptor so benefit less S.E= myopathies, rhabdomylysis, increase LFT, t1/2 1.5-2hr...Lova & Simva prodrug Contraindicated in pregnancy & lactation, teenage & children… Niacin (Nicotinic acid)  reduce LDL(Bad cholesterol), increase HDL(good  cholesterol ) MOA =inhibit Lipolysis in Adipose tissue…decrease level of Free Fatty Acids..liver use these Free Fatty A...

Inhibit the co-agulation by inhibiting Thrombin or Vit K anatagonists Heparin =Glycosaminoglycan…have negative charge…Acidic due to Sulphate & Carboxylicacid group….high moleculat weight…extracted from Porcine Intestinal Mucosa Complexed with Histamine in Mast cells…Low molecular weigh heparin(LMWH)<6000 MOA =interact with AntiThrombin lll…speed up process of anti-coagulant ofn Antithrombin LMWH complex with Antithrombin & Inactivate Factor Xa…Prothrombin not convert into Thrombin…no formation of fibrin T.E= used in Deep Vein Thrombosis…pulmonary embolism...Prophylactically in Pt. to avoid Postoperative thrombus during Elective surgery Do not cross placenta...used in Pregnant women with Prosthetic heart valve P.K =i.v administer...I/M inj leads to Hematoma formation…1-2hr t1/2…4hr of LMWH.. Titrate the infusion forr7-10 days so aPTT (activated Partial Thromboplastin time) b/w 1.5-2.5…. .taken up by Monocyte/Macrophage Sys for metabolismS.E= Hemorrhage...used Protamine sulph...

  Thrombus= A clot that adheres to vessel wall Embolus= intravascular clot that floats in the blood Platelet aggregation inhibitor Platelet Aggregation =Stimulation of Platelets by Thrombin, Collagen and ADP… Activation of Phospholipase..liberate Arachidonic acid..Arachidonic acid convert into Prostaglandin H2(PG) by COX-1….PG H2 convert into TX A2 ..cause aggregation Fibrinogen attach GP IIb/IIIa receptor..cross-linking..aggregation of platelets Aspirin= inhibit COX1 by irreversible Acetylation of Serine…Arachidonic acid not convert into TX A2…..inhibit aggregation Also inhibit TX A2 Synthetase…activate Prostacyclin...furthur inhibition of aggregation… Ibuprofen anatagonize platelet inhibition by Aspirin Aspirin is only NSAID that irreversibly exhibit antithrombotic property…81mg of Aspirin known as “Baby Aspirin”….S.E; bleeding time prolong Clopidogrel, Ticlopidine, Prasugrul= MOA= irreversibly inhibit binding of ADP to GP IIb/IIIa…inhibit activation of receptor…inhibit...

  Hypertension= sustained systolic B.P of >140mmHg or a sustained Diastolic B.P of >90mmHg  DASH= Dietary Approach to Stop Hypertension…include fruit, vegetables, low fat dairy products, low in fat cholesterol & sodium Renin inhibitors Aliskerin= directly inhibit RENIN….contraindicated in Pregnancy…cause cough, angioedema, hyperkalemia, diarrhea   Centrally acting adrenergic drugs Clonidine=α2-agonist...Centrally decrease Adrenergic outflow …decrease sympathetic firing rate &noeepinephrine release….  Useful in Hypertension complicated by renal  disease…..cause Na+ water retention... rebound hypertension occur     α 2-Methyldopa = converted into MethylNorepinephrine….. Centrally decrease Adrenergic outflow ….decrease total peripheral resistance& B.P … treat Hypertenson   with Renal Impairment……cause sedation, dizziness...can be used in pregnancy Vasodilators MOA=direct smooth muscle relaxant…vasodilation....

  Angina Pectoris =Sudden, severe pressing chest pain radiating to the Neck, Jaw, Back,Arms Due to decrease Coronory blood flow, insufficient O2 to meet the demands of Myocardium, leading to ISCHEMIA . Types of Angina 1) Effort-Induced Angina ,Classic/Stable Angina/Typical/Atherosclerotic Angina Short-lasting, heavy or Squeezing feeling in the chest…due to reduction of coronary perfusion due to obstruction of Coronory Artery by Atherosclerosis.. Nitroglycerin used  Developed during work i.e Exercise, physical activity, emotional excitement  2) Unstable Angina  Chest pain occur with increased frequency, duration, intensity by less effort… lasts for 20 minutes… 3) Prinzmetal/Variant/Vasospastic/Rest Angina  Due to coronary artery spasm 4) Mixed form Angina  5) Acute Coronory Syndrome Organic Nitrates Nitroglycerine & Nitrites= Isosorbide Mononitrate & dinitrate are solid at room temp… Nitroglycerine volatile at room temp….Amylnitrate extrem...

 Class l Na+ Channel Blocker  Block voltage gated Na+ channel like local anesthetics..slow the rate of rise of Phase 0.  High affinity for Active & Inactive channels..little effect on resting..decrease excitability & conduction velocity..  Cause Pro-Arrhthymic effects…… QT interval prolongation. Use- Dependance Class l bind to open or inactivated sodium channel than are fully repolarized…show great degree of blockade during depolarizing stage  Block the cell discharging at high frequency without interfering normal  mal one S.E=anticholinergic side effects like dry mouth, urinary retention,constipation etc Class lB = decrease Duration of Action Potential…rapidly interact with Na+ channel..little effect on Rate of Depolarization Lidocaine= Class lB drug...Local Anesthetic..Shorten Phase 3 repolarization.. T.E=used in Ventrical Arrhythmia in Myocardial Infarction(M.I)… S.E=Slurred speech, Paresthesia, Convulsion, Cradiac Arrhythmia Mexiletine ...