50 Pharmacology Facts That Every Student Should Know

Pharmacology Facts

Pharmacology is a very vast Subject Thats why  Its very difficult to summarise every Pharmacology Facts in one article,this list goes some way toward that goal.We Have Made a list of Very important Pharmacology Facts These facts are listed on the basis of mechanisms of action,Drugs Interaction,Uses,Side Effects and Other clinical factors.Hope These Pharmacology Facts will Help Every Student In Medical exams.

Pharmacology Facts

(1)Aspirin Increase the risk of bleeding in olders,those who drink alcohol and those who take NSAIDs and other blood thinning agents.

(2)First Generation Antihistamine Such as chlorphenramine,Diphenhydramine,Dimenhydrinate-cause more sedation than their second generation equivalents such as acrivastine,cetrizine,loratidine and fexofenadine .These second generation has less penetration through the blood brain barrier.These medicine are used in the treatment of hay fever and Allergy.

(3)ACE Inhibitors are known to cause Continous Dry cough-Because of the accumulation of Kinins in the lungs.Patient are sometimes then switched to ARBs (Anhiotensin receptor blockers)-Though Cough May persist.

(4)Amoxicillin is typically the first choice drug in the treatment of otitis media (Inflammation of the middle ear).

(5)Clavulanic Acid Is A beta -Lactamse inhibitor,Meaning it inhibit the enzyme i.e Beta lactamases this enzyme is responsible for the breakdown of antibiotics that contain beta lactam ring.

(6)Paracetamol Overdose causes depletion of glutathione,the compound responsible for ejecting toxic NAPQI(N.acetyl-p-benzoquinone imine) .Acetylcysteine can be administered to fill/restore glutathione levels.

(7)Statins drugs are associated with an increased risk of muscle damage/pain (myopathies)and in some cases can lead to the potentially fatal rhabdomyolysis.

(8)Proton Pump inhibitors like esomeprazole,lansoprazole and pantoprazole inhibit the final step production of acid in the stomach by irreversibly blocking the H+/K+ Atipase of gastric parietal cells.

(9)H2 Receptor Blockers also inhibit or block the production of acid but not in the final phase.Ranitidine and Famotidine are longer acting than cimetidine,With fewer drug reactions and fewer adverse effects.

(10)Tetracycline causes tooth discolouration and phototoxicity.Tetracycline absorption is impaired by drugs or foods containing calcium,magnesium,iron or aluminium iron.

(11)Flouroquinolones like ciprofloxacin and moxifloxacin are associated with an increased risk of tendon damage.

(12)Beta Blockers should be avoided in asthamtic patients because of their potential to precipitate acute asthamtic attacks.

(13)Protamine sulfate is used as antidote to heparin toxicity.

(14)Methyldopa ,Labetalol and Nifedipine are the drugs of choice for hypertension in pregnant womens.

(15)Aminoglycosides like Gentamicin and tobramycin are associated with nephrotoxcity and ototoxicity.

(16)Salbutamol is a short acting beta 2 agonist and is a bronchodilator.its side effects include headache,tachycardia(fast heart rate) tremors,anxiety and dizziness.

(17)Opioids such as morphine,heroin,oxycodone,and fantanyl stimulate the parasympathetic nervous system,causing constricted pupil.This is a common identifier of opioid toxicity.

(18)Calcitonin is used to treat osteoporosis in womens who are atleast 5 years past menopause.

(19)Pramipexole is a dopamine agonist which is used to treat Parkinson disease and restless legs syndrome.

(20)Methotrexate is an antifolate,immunosuppressant drug used to treat various types of cancer and autoimmune diseases.side effects include fatigue,hair loss,nausea,ulcerative stomatitis,leukopenia and hepatoxicity and is teratogenic.This drug cause folate deficiency.

(21)Narrow therapeutic window drugs like Digoxin,lithium and warfarin need close monitoring because very small changes in dose can have very serious clinical consequences.

(22)There are two types of Insulin analogue i.e short and long acting analogues.Short acting analogues includes insulin glulisine,insulin aspart,and insulin lispro.
Long acting include insulin detemir and insulin glargine.insulin degludec is an ultra long acting insulin analogue.

(23)Naproxen is an NSAID Used to treat pain and inflammation and is associated with an intermediate risk of stomach ulceration,compared to low risk ibuprofen,and high risk indomethacin.

(24)isoniazid in combination with other drugs used for the treatment of TB (Tuberculosis).Side effect includes elevated liver enzymes ,reduced blood count,peripheral neuropathy and pyridoxine dificieny.

(25)Acetylsalicylic acid or ASA toxicity can cause ringing of the ear (Tinnitus)

(26)Don’t Use Narcotics in patient with head trauma.

(27)Don’t Give antacids with food because it delay gastric emptying.

(28)Avoid Warfarin with acetaminophen and acetylsalicylic acid because it increase bleeding and increased INR.

(29)Hydroxycholoroquine is an antimalarial drug also used to treat rheumatoid arthritis.its chronic use is associated with eye toxicity.That is why patient should be monitored for the presence of any ocular damage.

(30)Senna is used in the treatment of constipation.it is recommended to be taken at bedtime because it takes 6-12 hours to show effect.

(31)Furosemide is used to treat edema in CHF (Congestive cardiac failure),Kidney disease and liver diseases.Side effects includes ototoxicity ,increased urination,hyperglycemia,hyperuricemia,,hypokalemia and hypotension.

(32)Fusidic acid is used to treat skin infections of gram positive organism.

(33)Warfarin is an anticoagulant that works by inhibting the vitamin k dependent synthesis clotting factors 2,7,9 and 10.Risk increase in the first phase of therapy.

(34)Antitussive drugs like codeine,pholcodine,and dextromethorphan are used to suppress cough.

(35)Antifungal Drugs work by inhibiting the enzyme,lanosterol-14alpha-demethylase,this enzyme responsible for converting lanosterol into ergosterol.

(36)Domperidone is a Selective D2 receptor antagonist.its used as an antemetic and gastroprokinetic agent.

(37)Global Pharmaceutical Market is more than $300 Billion.

(38)Lipitor is the best selling drug of all time.

(39)Insulin is one of the most commonly used drugs that cause adverse effects.

(40)Antihypertensive drugs like ganglion blocker drugs are not used these days because of serious adverse effects.

(41)Atomoxetine is used to treat attention deficit hyperactivity disorder (ADHD)it inhibit norepinephrine and serotinine transporters.side effects include dry mouth,nausea,decreased appetite,trouble in sleep,drowsiness and dizziness.

(42)Ziprasidone should be taken with food to enhance bioavailibility.it is a typical antipsychotic drug.

(43)Metformin is the first line drugs in the treatment of type 2 diabetes and long term use and high doses could lead to vitamin B12 malabsorption and its subsequent dificiency.

(44)Antidote is a greek word used to “give against”are those agents used to oppose the effects of poison with out causing damage to the normal cells.

(45)Maximum dose of paracetamol is 4 grams per day other wise will cause hepatotixcity.

(46)MRSA(Methicillin resistant staphylococus aureus) Super bug is a bacterium responsible for various difficult to treat infection in humans .

(47)Benzodiazepine are classified in term of their elimination half life .short acting benzodiazepine includes trizolam,alprazolam,midazolam and oxazepam while intermediate acting drugs include lorazepam,clonazepam,temazepam, and long acting benzodiazepines include diazepam,flurazepam,cholrdiazepoxide.

(48)Drug of choice in hypertensive emergencies is sodium nitroprusside.

(49)5-HT3 antgonist drugs like,ondansetron,palonosetron and granisetron are used to treat nausea and vomiting,especially effective in treating nausea and vomiting caused by chemotherapy.

(50)Drugs of choice in Congestive cardiac failure are ACE inhibtors like enalapril,lisinopril .

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Important Antidotes List

Antidotes

What are Antidotes ? 

The Word Antidote Derived From A Greek Word “antididonai”  Which Means Give Against So ” Antidotes are Any Substance  which Are Used To oppose the effects of poisons without causing any damage to The body” .

How The Poison Enter Into The Body ?

The Poison In Any Form may be  taken in by the breath Or swallowed, Absorbed Through the thinner and more delicate mucous membranes, Or absorbed through the skin, or implanted by stings, bites, or other wounds.

There Are A lot Of Antidotes In The Medical Field Today But Some Antidotes Are Very Important And Need To Be Remembered Because Of Their Frequent Use In The Emergency Situations.  Knowledge About Antidotes Is Very Important For All Medical Professionals Especially Those Who Are Working In Health Care Settings.Here Are Some Of The Types And List Of Very Important And Frequently Used Antidotes ;

Types of Antidotes

1:Universal Antidotes :This type of antidote is Given when unknown poison is ingested

Composition:
(1):powdered charcoal 2 parts
(2):Magnesium oxide 1 part
(3):Tannic Acid 1 Part

2:Chemical Antidotes :These substances neutrilize the chemical action or oxidize the poison into nontoxic or insolouble form
eg:

Dilute alkali(milk of magnesia)

Dilute acetic acid,

Potassium permangante

Tannin(strong tea).

3:Physiological or pharmacological Antidotes
These produce effects opposite to that of poison
eg:

Naloxone for morphine,

Atropine and oxime for organophosphorous poison,

N-acetylcysteine for acetaminophen

4:Mechanical or physical Antidotes :
These substances prevents the absorption of poison by their presence
eg:Activated charcoal is used for strychinine,emulcents(fats,oils,milk,eggalbumin) are used for corrosive and irritant poisoning,Bulky food used for glass poisoning ,And mineral poisoning(dose 30-60 gms for childreb and 60-100gms ofr adults)

5:Chelating agents:
These are substances which form chelates(non ionized complexes) with cations.These are mostly used in heavy metal poisoning
eg:

N-pencillamine for mercury,lead,copper

BAL(dimercepol) is used in heavy metal poisons

EDTA is used in Arsenic,mercury,lead
versenate is used in Arsenic,mercury and lead
Desferoxamine is used for iron.

Important Antidotes List :

Antidotes For

Non-specific poisons except cyanide, iron, lithium, caustics and alcohol = Activated charcoal

Cobra bite = Snake Anti-Venin.

Heparin = Protamine Sulfate

GAS=Use artificial respiration,Remove patient to air, apply heat to extremities; send for doctor.

ABSINTHE = Give an active emetic; then flaxseed tea freely; stimulate

Insulin reaction = Glucose (Dextrose 50%)

ALKALI, VOLATILE = Drink freely of water with vinegar or lemon juice in it.

ANTIMONIAL WINE = Give warm water freely to encourage vomiting.

AQUA FORTIS = Magnesia or soap dissolved in water, every two minutes.

BED BUG POISON = Give milk or white of eggs in large quantities.

BELLADONNA = Active emetic; stimulate.

Acetaminophen/Paracetamol  = N-Acetylcysteine or Mucomyst

Anticholinergics, diphenhydramine, dimenhydrinate =Physostigmine

BenzodiazepinesZaleplonZolpidem = Flumazenil (Romazicon)

Calcium Channel Blockers = Calcium Chloride, Glucagon

Cyanide = Amyl nitrite, sodium nitrite, sodium thiosulfate

Iron  = Deferoxamine

For Chemicals causing methemoglobinemia in patients with G6PD deficiency = Vitamin C
For Lead = EDTA, dimercaprol, succimer

Methanol = Folic acid

AMMONIA = Lemon juice, diluted vinegar or acetic acid.

Methotrexate = Leucovorin calcium

Potassium = Insulin + Glucose, Kayexalate

MERCURY = White of eggs freely; afterwards evacuate; mild drinks

Valproic acid  = L-Carnitine

Isoniazid, ethylene glycol = Pyridoxine HCl (Vitamin B6)

Tricyclic antidepressants = phyostigmine or NaHCO3

Sulfonylureas = Octreotide (Sandostatin )

Alpha  agonists (e.g., clonidine), Opioids (e.g., codeine, diphenoxylate, fentanyl, heroin, meperidine, morphine and propoxyphene = Naloxone

Arsenic,  Copper,  Lead,  Mercury = D-Penicillamine (Cuprimine )

Neuromuscular blockade = anticholinesterase agents.

Anticholinesterase = atropine sulfate or pralidoxime.

Fluoride ingestion = Calcium salts

Digoxin = digibind digoxine immune fab

Beta blockers and calciumchannel blockers = glucagon

Ergotamine = Heparin

Dopamine = Phentolamine.

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Scientists Develop Artificial Womb To Help Premature Babies

Artificial Womb

Scientists Develop Artificial Womb To Help Premature Babies:
Scientists in the United States have developed a womb-like bag called an extra-uterine support device that would transform care for extremely premature babies, considerably rising probabilities of survival.While the new development isn’t specifically a synthetic uterus tank, physicians have created a uterus-like “biobag” that’s capable of sustaining premature foetal lambs very shortly when they start development.
Doctors said that the pioneering approach may radically improve outcomes for babies born so early that they can not breathe, feed or fight infection without medical help.

The team spent three years evolving their system through a series of four prototypes – starting with a glass incubator tank and reaching to the present fluid-filled bag.

Six preterm lambs tested within the most up-to-date prototype were physiologically similar to a 23- or 24-week-gestation human baby and were ready to grow during a temperature-controlled, near-sterile surroundings

In pre-clinical studies with lambs, the researchers were ready to mimic the uterus surroundings and therefore the functions of the placenta, giving premature offspring a vital chance to develop their lungs and other organs.
The lambs were kept within the biobags for four weeks. throughout this time, they grew hair; their lungs developed; and that they reached the point where they might survive on their own.

Remarkably, the eight lambs within the trial developed commonly within the artificial womb and every survived, proving that the biobag with success mimicked the natural conditions found within the uterus—and paving the means for a brand new life-saving device for humans.

At that age, a human baby weighs very little quite 500 grams, its lungs don’t seem to be ready to deal with air and its probabilities of survival are low. Death rates are up to 70 % and people who do survive face life-long disability.

The scientists created amniotic fluid in their science lab and originated the system so that this flowed into and out of the bag.
The team is in discussions with the United States of America Food and Drug Administration (FDA) and predicts that babies might be incubated within the system within three years in the 1st clinical test.
In light of this progress, specialists assert that artificial wombs could also be a reality within the next 10-20 Years.

Drugs Used In Pregnancy

Drugs Used In Pregnancy

 

Drugs Can Have Harmful Effects On The Fetus At any Time In Pregnany.Its Very Important To Keep In Mind When Prescribing For A Pregnant Women.In The First Trimester Of Pregnany Drugs Can Produce Malformation (Teratogenesis).Third And eleventh Week Of Pregnany Is more Critical Time For Teratogenesity.

The Second And Third Trimester Can Effect The Growth And Functional development Of The Fetus. And Drugs Given Just Before Term Or During Labour Can Have Adverse Effects On The Neonates Or On The Labour.

According To FDA There Are Five Categories Of Drugs ,A,B,C,D or X

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the foetus within the first trimester of pregnancy (and there’s no evidence of risk in later trimesters).

Category B

Animal studies have failed to demonstrate a risk to the foetus and there are not any satisfactory and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse impact on the foetus and there are not any adequate and well-controlled studies in humans, however potential advantages might warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction information from investigational or marketing experience or studies in humans, however potential advantages might warrant use of the drug in pregnant girls despite potential risks.

Category X

Studies in animals or humans have demonstrated foetal abnormalities and/or there’s positive proof of human fetal risk based on adverse reaction information from investigational or marketing expertise, and therefore the risks concerned in use of the drug in pregnant girls clearly outweigh potential advantages.

 

In This Article We Will Talk About The Drugs Safely Used During Pregnancy In general, it’s best to avoid any unnecessary Use Of Drugs early in your pregnancy. During the first trimester, fetal organs develop rapidly, making them extremely vulnerable to the potential risks of drugs.

Prescription Drugs Used In Pregnancy

  • Folic Acid and Vitamin B6
  • Levothyroxine
  • Insulin
  • During 18 and 32 weeks of pregnancy may increase the risk of hyperactivity and behavioral problems in children according to a study published in JAMA Pediatrics.)
  • Methyl dopa, and hydralazine
  • Heparin
  • Some antibiotics namely Amoxycillin, Ampicillin, Cephalosporins, Erythromycin (not estolate)

Drugs Used In Pregnancy For Pain Relief

A cold compress and rest will help alleviate headaches and muscle pain throughout pregnancy, however if you wish further relief, your doctor might recommend acetaminophen. once this drug is used as directed, it is a safe choice. However, it is best to avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen . Some studies recommend that taking these medications close to conception or in early pregnancy might increase the chance of miscarriage and birth defects.

Drugs Used In Pregnancy For Colds & Allergies

Few women get through 9 months without cold or hypersensitivity reaction symptoms. The safest way to go is to try nondrug remedies: Rest, drink a lot of fluids -particularly warm ones — and use a saline nasal spray to assist relieve stuffiness. the great news is that while a cold will make you miserable, it poses no special risks throughout pregnancy. The flu, however, are often more serious in pregnant ladies, and typically leads to pneumonia. Since influenza shots are safe for both you and baby, it’s knowing get one throughout flu season if you are in your second or third trimester.

If cold or hypersensitivity reaction symptoms interfere together with your ability to eat or sleep, your health care provider could suggest medication, especially if you are past the first trimester. several doctors believe the antihistamine chlorpheniramine  is that the safest choice, because it has been used for several years by pregnant ladies and is not better-known to cause birth defects. unfortunately, very little is known regarding newer medication like loratadine therefore it’s wise to avoid them.

To relieve a cough, doctors usually recommend a drug known as dextromethorphan  However, you should avoid cough product that contain iodine, which might cause doubtless life-threatening thyroid problems within the fetus, still as those that contain high levels of alcohol.

If you need a decongestant, your doctor could recommend a nasal spray that contains oxymetazoline, as a result of only alittle quantity of the drug is absorbed into your system.

Drugs Used In Pregnancy For Digestive Discomforts

Heartburn, constipation, and hemorrhoids are among the foremost common complaints of pregnancy. Luckily, there are many drug-free solutions you’ll use to stop these problems. to move off heartburn, avoid consumption large meals, particularly in the evening, and select smaller, more frequent ones instead. you should additionally steer clear of rich, fried, or spicy foods, which frequently trigger stomach irritation. Sleeping on an incline may stop the contents of your stomach from splashing into your esophagus, causing symptom.

If symptoms persist, your doctor could suggest a safe antacid, like calcium carbonate (Tums). however if additional relief is required, your doctor could recommend sucralfate, usually called carafate, a drug that coats and protects the abdomen lining.

To prevent constipation and also the hemorrhoids that usually follow, drink lots of water and eat fiber-rich foods. Exercise, along with your doctor’s approval, may facilitate to keep constipation unfree. If issues persist, your doctor could recommend a bulk-fiber laxative, like Metamucil or Fiberall. However, you should avoid stimulant laxatives, like castor oil, which may trigger labor. once treating hemorrhoids, use product that contain glycerine or witch hazel, however avoid hydrocortisone, that hasn’t verified to be entirely safe and might be absorbed into your system.

 

Top 100 Drugs Of Choice For Different Diseases

Drugs Of Choice

Drugs Of Choice For Different Diseases are categorized on the basis of diseases .Following are the most important classes of drugs used as a first choice in the treatment of different diseases .

Drugs Of Choice List in infections

(1)Penicillin G
Streptococcus pneumoniae, S.Viridans,Hemolytic Streptococci group A,B,C,G,Staphylococcus (Non-Penicillinase producing)
Neisseria Meningitidis,Clostridium(ABC)Bacillus Cereus,Actinomyces.Treponema Pallidum, T.Pertene
(2)Ampicillin
Listeria,Enterococcus faecalis.
(3)Vancomycin
MRSA,Coagulase negative staphylococcus,Enterococcus faecium.
(4)Erythromycin
Corynebacterium
(5)Doxycycline
Bacillus anthracis,
Borelia burgdorferi, B.Recurrentis.
Chalmydia & Rickettsiae.
(6) Cotrimoxazole
Nocardia
(7) Azithromycin
Hemophilus ducreyi & Mycoplasma .
(8) Ceftriaxone
Proteus,E.coli,Salmonella
(9)Carbapenems
Serratia,Enterobacter,Acinetobacter
(10)(Metronidazole
Bacteriocides
(11)Ceftazidime
Burkholderia pseudomallei

Drugs Of Choice List in pregnancy (12)Choloroquine
Drug of choice for malaria in pregnancy
(13) Alpha-Methyldopa
DoC for hypertension in pregnancy
(14)Heparin
DOC for anticoagulation in pregnancy.
(15)Labetalol
DOC for hypertensive crisis in pregnant women.
(16)Acetaminophen
Analgesic DOC
(17)Phenobarbitone
DoC for epilepsy in pregnant women.
(18)Doxylamine & Pyridoxine
DoC for nausea in pregnancy.

Drugs Of Choice List for various types of seizures: (19)Valproate
Tonic seizures
Absence seizures
Grand mal (GTCS)
Clonic seizures
Atonic seizures
Myoclonic seizures
(20)Carbamazepine
Partial seizures
(21)Vigabatrin
Infantile spasm with tuberous sclerosis
(22)ACTH
Infantile spasm
(23)Lorazepam (IV)
Status epilepticus
(24)Diazepam
Febrile seizures
(25)Magnesium Sulphate
Seizure in eclampsia

Drugs Of Choice List in poisoning  (26)Physostigmine
Atropine, Belladona  & Dhatura poisoning
(27)Atropine
Carbamate,Early mushroom poisoning,Organophosphate poisoning.
(28)Flumazenil
Benzodiazepine poisoning
(29)Acetylcystine
Acetaminophen poisoning
(30)Nalaxone
Opoid poisoning
(31)Deferiprone
Chronic iron poisoning
(32)Desferrioxamine
Acute iron poisoning
(33)Glucagon
Beta blockers poisoning
(34)Amyl nitrate
Cyanide poisoning

Drugs Of Choice List in bronchial asthma (35)Salbutamol
Acute attack of bronchial ashtma in normal patient and pregnant women.
Exercise & Aspirin-induced acute attack of bronchial asthma.
(36)Ipratropium
Acute attack of bronchial asthma during labour.
Acute attack of bronchial ashtma on beta-blockers therapy.
(37)Corticosteroids
Prophylaxis of bronchial asthma ,exercise induced and aspirin-induced asthma.

Drugs Of Choice List In Antimicrobials Prophylaxis (38)Ampicillin
Group B streptococcus infection
(39)Amoxicillin
Endocarditis and Otitis media
(40)Azithromycin
Mycobacterium avium complex (MAC) Pertussis
(41)Benzathine penicillin
Rheumatic fever
(42)Procaine Penicillin
Gonorrhea and syphilis
(43)Tetracycline
Rickettsial infection and plague.
(44)Cefazoline
Surgical Prophylaxis
(45)Doxycycline
Anthrax
(46)Trimethoprim and sulphamethoxazole
Toxoplasmosis , Pneumocystis jerveci UTI
(47)Rifampicin
Hemophilus influenza type B.
(48)Oseltamivir
Influenza Type A & B.

Anesthetic Drugs Of Choice List (49)Propofol
Day care
(50)Sevoflurane
Congenital heart disease,ASD,VSD,PDA
(51)Etomidate
Ischemic heart disease
(52)Ketamine
Asthma and COPD
Shock
CHF, and congenital heart disease (Right to left shunt)
(53)Thiopentone
Epilepsy
Thyrotoxicosis
(54)Methohexitone
Electroconvulsion therapy
(55)Isoflurane
Cardiac surgery
Neurosurgery
For producing deliberate hypotension

Drugs Of Choice List in Endocrinological Disorders (56)Insulin
Type 1 DM
Diabetes Mellitus in pregnancy.
Diabetic Ketoacidosis.
Uncontrolled DM.
(57)Metformin
Type 2 DM
Diabetes mellitus in obesity
(58)Sildenafil
Erectile Dysfunction
(59)Hydrocortisone
Acute and chronic adrenal insufficiency.
(60)Nateglinide
Post prandial hyperglycemia.
(61)Methotrexate
Ectopic pregnancy
(62)Oxytocin
Post partum hemorrhage
Induction of labour
(63)Cabergoline
Acromegaly
Hyperprolactinemia.
(64)Finasteride
Andogenital alopecia.
(65)Alendronate
Osteoporosis

Drugs of choice in fungal infections(66)Amphotericin B
Meningeal histoplasmosis
Endocarditis by candida
Sever or CNS blastomycosis
Induction i cryptococcal meningitis(For 2 weeks)
Exserohium
(67)Fluconazole
Candida albicans
Maintainance in cryptococcal meningitis
(68)itraconazole
Non meningeal histoplasmosis
Sporotrichosis
Para Coccidiodomycosis
Mild or non CNS blastomycosis
Chromoblastomycosis
Penicillium mameffei
(69)Prednisolone+itraconazole/Voriconazole
Allergic bronchopulmonary aspergillosis.
(70)Capsofungin
Candida glabarata,and candida krusei .

Drugs of choice in gastrointestinal disorders(71)PPIs
Gastric ulcer ,Duodenal ulcer ,stress ulcer,NSAIDs-induced ulcer.
GERD,& Zolinger elison syndrome.
(72)Metoclopramide
Migraine associated or drug or disease associated vomiting
(73)Domperidone
Levodopa induced vomiting
(74)Ondansetron
Post operative or radiation induced vomiting
(75)5HT3 antagonist
Cisplatin induced early vomiting
(76)Lactulose
Hepatic encephalopathy
(77)Methyl naltrexone
Opioid induced constipation
(78)Octreotide
Diarhea in carcinoid syndrome

Drugs of choice in Hematological Disorders (79)Warfarin
DVT prophylaxis
Chronic atrial fibrillation in mitral stenosis, advanced kidney disease and mechanical prosthetic heart valves
(80)Heparin+Warfarin
Initiation of therapy in DVT.
(81)Vitamin K
Warfarin overdose
(82)Protamine
Heparin overdose

Drugs of Choice in Hypertension (83)Thiazide diuretics
Hypertension
(84)Prazosin
Hypertension With BPH
(85)Beta Blockers
Hypertension with ischemic heart disease.(Angina)
(86)ACE inhibitors
Hypertension with chronic kidney diseases.
(87)Alpha methylDopa
Hypertension in pregnancy
(88)Phentolamine
Hypertensive emergencies with cheese reaction
(89)Nitroprusside+Esmolol
Hypertensive emergencies in aortic dissection.
(90)Labetalol
Hypertensive emergencies in pregnancy .

Drugs of choice in shock(91)Adrenaline
Anaphylactic shock
(92)Dopamine or nor adrenaline
Cardiogenic shock
(93)Phenylephrine
Distributive shock
(94)Prazosin
Secondary shock
(95)Dopamine
Shock with oliguria
(96)Corticosteroids
Shock due to adrenal insufficiency

Drugs of choice For viral diseases(97)Ribavirin
Viral hemorrhagic fever
Measles
Respiratory syncytial virus(in high-risk patient
(98)Zanamivir
Oseltamivir-resistant influenza
Oseltamivir
Seasonal influenza and avian influenza (bird flu)
(99)Acyclovir
Herpes simplex and varicella.
Valacyclovir
Acute herpes zoster.
(100)Gancyclovir
Cytomegalovirus retinitis.

Important Drugs and Their Side Effects

drugs and their side effects
Nearly All Drugs Both OTC And Prescription Drugs Have Some Kind Of Undesirable Side effects From simple Muscle Pain to Death .Whether they are the simple drug like aspirin to the most sophisticated drugs In the Market , All Drugs Come With Some Minor Or serious Side Effects.Nearly All Drugs Can cause Nausea,Vomiting And For Drugs Used On Skin Will Cause Irritation.

Following Are Some Of The Most Commonly Used Drugs And Their Side Effects .

1.Ampicillin- Hypersensitivity
2. Amphotericin.B- Nephrotoxicity
3. Androgen- Virilization
4. Antipsychotics- Sedation, Orthostatic hypotension, Tardive dyskinesia
5. Anti- TB- Hepatotoxicity
6. Aspirin (cox-I Inhibitors)- Hepatotoxicity
7. ACE Inhibitors- Dry Cough
8. Atropine – Dryness of mouth, Blurred vision, Constipation
9. Chlorambucil- Alopecia
10.Celecoxib,Valdecoxib (cox-II Inhibitors)-cardio and Hepatotoxicity
11.Chloroquine – Phototoxicity
12.Chloramphenicol- Grey baby syndrome, Bone   marrow depression
13. Ciprofloxacin – Phototoxicity
14. Clofazimine- Pigmentation of skin, Discoloration of Urine
15. Clozapine – Agranulocytosis
16. Erythromyicin- Cholestatic Juandice
17. Ethambutol – Optic Neuritis, Retrobulbular Neuritis
18. Hydrochlorthiazide- Hypokalamia
19. Isoniazid – Peripheral Neurtis
20. Metronidazole- Disulfiram like reaction
21. Minoxidil- Hirsutism
22. Morphine- Constipation
23. Nimesulide – Hepatotoxicity
24. Nitrogen Mustard- Bone marrow depression
25. Nitroglycerin- Palpitation
26. Penicillin. G- Jarisch Heximer Reaction
27. Phenformin- Lactic acidosis, GI disturbance, Metalic taste
28. Phenytoin- Hirsutism
29. Quinidine- Cinchonism
30. Quinine Sulphate- Black Water Fever
31. Repaglinide- Althralgia
32. Rosaglitazone- Anemia,Weight gain
33. Sitagliptin- Coldness
34. Spironolactone- Hyperkalamia
35. Cimetidine- Gynacomastia
37. Sulfonyl Ureas derivatives- Bone marrow depression
38. Terfenadine- Type-I arrhythmia
39. Tetracyclines- Discoloration of teeth
40. Thalidomide- Phocomelia

41.Impotericin B – injection site reactions (pain, swelling, irritation),fever,shaking,chills,flushing, shortness of breat.

42.Lipitor-Joint Pain

43.Benzodiazepines – Drowsiness.,Confusion.,Dizziness.,Blurred vision.

44.Beta Blockers – Shortness of breath,Stomach Upset, Fatigue .Erectile Dysfunction.

45.Paracetamol-Liver Toxicity

46.Glucophage (Metformin)-Megaloblastic Anemia and Acute Respiratory Distress Syndrome.

47.Albuterol-Tremors,Chest Pain ,Bronchospasm.

48.Clonidine -Drowsiness.

49.Rosuvastatin- confusion, memory problems

50.Esomeprazole-Stomach Cramps, Gas, Diarrhea.

51.Insulin Glargin-Low Blood Sugar

52.Pregabalin-Blurred Vision,Drowsiness, Fluid Retention in the Legs, Feet, Arms or Hands, Weight Gain.

53.Tiotropium-Chest Pain,urinary tract infection,Nose Bleed,Rashes.

54.AdalimumabAcute Infection of the Nose, Throat or Sinus, Extreme Loss of Body Water.

55.Prednisone –infection, Nervous.

56.Viagra-flushing,Headache,Blurred Vision,stuffy nose.etc

 

Drugs To avoid when pregnant

Drugs To avoid when pregnant

Drugs That Cause Problems During Pregnancy

These Are The Drugs To avoid when pregnant because these drugs Cause Problems During Pregnancy.

1)Antibiotics

  • Fluoroquinolones (such as ciprofloxacin, ofloxacin, levofloxacin, and norfloxacin)
  • Nitrofurantoin
  • Streptomycin
  • Sulfonamides (such as sulfasalazine and trimethoprim- sulfamethoxazole)
  • Tetracycline

Abnormalities Caused By These Drugs

Possibility of bone and joint abnormalities (seen only in animals)

2) Anticonvulsants

  • Carbamazepine
  • Phenobarbital
  • Phenytoin
  • Valproate

Abnormalities Caused By These Drugs

  • Bleeding problems in the newborn. This Problem Can be prevented by Taking Vitamin K Orally 30 Days Before Delivery
  • Cause Risk of birth defects, including neural tube defects (such as spina bifida)
  • Volproate Cause Some (1%) risk of birth defects, including a neural tube defects (such as a meningomyelocele), cleft palate, and defects of face,  the heart, skull, limbs , and  spine

3) Antihypertensives

a)Angiotensin-converting enzyme (ACE) inhibitors

  • Captopril
  • Benazepril
  • Fosinopril
  • Enalapril
  • Lisinopril
  • Quinapril
  • Ramipril
  • Trandolapril
  • Perindopril

Abnormalities Caused By These Drugs :Serious Injury To The Fetus ,May Cause Kidney Damage In The Fetus ,Reduce Amniotic Fluid,Also Cause Defects Of Lungs ,Face And Limbs

b)Calcium Channel Blockers:

  • Isradipine
  • Nisoldipine
  • Amlodipine
  • Verapamil
  • Nifedipine (sustained-release only)
  • Diltiazem(sustained-release only)
  • Nicardipine
  • Felodipine

Abnormalities Caused By CCB:

Fluid retention in the ankles ,Dizziness, headache,  flushing, heartburn,an abnormally fast heart rate (tachycardia)  And enlarged gums.

Verapamil also caused Constipation.

c)Beta Blockers Drugs :

  • Atenolol
  • Bisoprolol
  • Metoprolol
  • Acebutolol
  • Nadolol
  • Penbutolol
  • Propranolol
  • Betaxolol
  • Carteolol
  • Timolol
  • Nebivolol
  • Pindolol

Problems Caused By Beta Blockers:

Beta Blockers Caused Slow Growth Rate In The Fetus And Also Cause Low Level Of Blood Sugar And Low Heart Rate .

d)Thiazide Diuretics:

  • Chlorothiazide
  • Bendroflumethiazide
  • Hydroflumethiazide
  • Chlorthalidone
  • Hydrochlorothiazide
  • Methyclothiazide
  • Metolazone
  • Indapamide

Problems Caused By Diuretics:

Taking Thiazide Diuretics During Pregnancy Will Cause Decrease In The Level Of oxygen,Potasium Sodium.Also Decrease In  Number Of  Platelets  In The Fetus. Inadequate Growth Before Birth.

4) Antianxiety drug:

  • Diazepam

Abnormalities Caused By Diazepam :

When This Drug Is Taken In The Third Trimester Of Pregnancy It cause irritability, exaggerated reflexes in the newborn depression, and shaking.

5) Mood-stabilizing drug:

  • Lithium

Abnormalities:

Poor feeding, Lethargy, reduced muscle tone, nephrogenic diabetes insipidus in the newborn And underactivity of the thyroid gland.

6) Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Naproxen
  • Ibuprofen
  • Aspirin and other salicylates

 

Problems Or Abnormalities :

When the medication are taken in large doses, probably miscarriages during the first trimester, a delay within thebegin of labor, premature closing of the connection between the aorta and artery to the lungs (ductus arteriosus), jaundice, necrotizing enterocolitis (damage to the liner of the intestine), and (occasionally) brain injury within thefoetus and bleeding issues within the woman throughout and after delivery and/or within the newborn

When the medication are taken late in pregnancy, a discount in the amount of fluid round the developing foetus.

 

7)Sex Hormones:

  • Synthetic progestins (but not the low doses used in oral contraceptives)
  • Danazol

(When Synthetic Progestin And Danazol  are taken In The early stages Of pregnancy, masculinization of a female fetus’s genitals, sometimes requiring surgery for correction)

  • Diethylstilbestrol (DES)

(Abnormalities of the penis in sons.Abnormalities of the uterus, an increased risk of vaginal cancer ,menstrual problems, and complications during pregnancy in daughters)

8)Vaccines:

Vaccines for polio, measles, mumps or yellow fever

This Vaccine cause Potential infection of the placenta and developing fetus.

Vaccine for  chickenpox (varicella) and rubella.

This Is Associated With Unknow Risks.

9)Drugs Used In Skin Treatment:

Isotretinoin

Etretinate

Problems:

Both Of these Drugs Cause Birth defects, such as small ears,  heart defects, and hydrocephalus .

While Isotretinoin Also Cause  Intellectual disability And Risk of miscarriage.

10) Oral ant diabetic drugs:

  • Metformin
  • Glyburide
  • Tolbutamide
  • Chlorpropamide

Problems/Abnormalities Caused By These Drugs :

Inadequate control of diabetes in the pregnant woman

When a Pregnant woman with type 2 diabetes Takle The Drugs, possibility of increased risk of miscarriage Are More .

Also Cause a  very low blood sugar level in the newborn.

 

 

DRUGS USED IN EMERGENCY SITUATIONS

 Emergency Drugs

1)COMMONLY USED DRUGS IN ICU AND CCU

The main groups of drugs used in ICU are as follows:

OPOIDS: • Fentanyl • Naloxone • Morphine • Pethidine

Non Opoids:  Analog of phencyclidine,And  Ketamine

BENZODIAZEPINES: • Midazolam • Diazepam• Flumazenil • Lorazepam

SEDATIVES: Propofol.

The main groups of drugs used in CCU are as follows:

Digoxin ,Propanolol ,Lignocaine, Adenosine, Amiodarone Verapamil Aspirin, Sodium bicarbonate, GTN Streptokinase Isosorbide di-nitrate ,Nicorandil, Atrovastin.

2)Common Emergency Drugs

Life Saving Drugs: • Atropine• Sodabicarbonate • Adrenaline• Calcium Gluconate • Xylocard

Other Emergency Drugs are:

  • Atropine •Midazolam Common drugs used for OP poisoning •Diazepam

3)Drugs used in Congestive Cardiac Failure:

  • ACE inhibitors: captopril, enalapril
  • ARBS: losartan. Candesartan
  • Beta blockers
  • Diuretics
  • vasodilators
  • Digoxin

4) Most Common drugs used for cardiac arrest:

  • Antiarrythmic- amiodarone, lidocaine.
  • Epinephrine
  • Vasopressors dopamine, dobutamine
  • Other drugs-, sodium bicarbonate atropine, , thrombolytic Agents(STK, tPA) ,calcium

 5) Drugs used in Angina

  • Isosrbide dinitrate
  • Amlodipine
  • Glyceryl trinitrate(GTN)
  • Propanolol • Verapamil

6) Common drugs used in Myocardial Infarction:

  • Vasodilators: Nitroglycerine
  • Antiplatelet: aspirin
  • Anticoagulant: heparin
  • Pain relief : Morphine
  • Vasopressor: dopamine, dobutamine
  • Stool softner: cremaffin .

7) Commonly Used Drugs In Operation Theater:

  • Local Anesthetics:

This Includes Lignocaine/Lidocaine HCL,And Bupivacaine HCL

  • General anesthetics:This Group Inclides

Ether,Isoflurane,halothane,nitrous oxide,thiopentone sodium,Sevoflurane,Propofol.

10) MUSCLE RELAXANT:

  • Vecuronium
  • Mivacurium
  • Succinyl choline
  • Atracurium

A new drug Xadago approves By FDA to treat Parkinson’s disease

Fda approves new drug for parkinson disease

US FDA approves A new Drug i.e Xadago (safinamide) For the treatment of Parkinson Disease A Disease In Which Cells In The Brain Which Produce Dopamine Become Impaired Or Die. Dopamine Is A chemical That helps transmit signals between the areas of the brain that produce smooth, purposeful movement  such as eating, shaving and writing.According To Report Of National Institute Of Health More Then 1 Million Americans Have Parkinson Disease And  Approximately 50,000 US Citizens Are Diagnosed With Parkinson Disease Each Year.

The New Drug Is A Great Plus To The Treatment Of Parkinson Patients Who are Currently Using Levodopa or carbidopa For OFF Episodes.

According To FDA press Release The effectiveness of Xadago in treating Parkinson’s sickness was shown In Two Clinical Trials.In First clinical test of 645 participants who were additionally taking levodopa and were experiencing “off” time. Those receiving Xadago experienced a lot of useful “on” time, a time when Parkinson’s symptoms are reduced, without difficult uncontrolled involuntary movement (dyskinesia), compared to those receiving a placebo. the rise in “on” time was among a reduction in “off” time and better scores on a measure of motor function assessed throughout “on” time than before treatment.

In The Second Clinical Trial of 549 participants, the participants adding Xadago to their L-dopa treatment had additional “on” time without difficult  uncontrolled involuntary movement compared to those taking a placebo, and additionally had better scores on a measure of motor function assessed throughout “on” time than before treatment.

Some Very Common Adverse reactions Were Seen With The Use Of Xadago Like Trouble In Sleeping (Insomnia), Falls ,Nausea ,And uncontrolled involuntary movement,hallucinations and psychotic behavior; withdrawal-emergent hyperpyrexia (fever) problems with impulse control/compulsive behaviors; retinal pathology and confusion.

According To FDA The Drug Is Contraindicated In Severe Liver Problems And Those Who Are already TaKing Drugs For Cold And Flu Like dextromethorphan.It Is also Contraindicated in Patients Who Are Taking Mono amine Oxidase Inhibitors (MAOI) Because This May Cause Sudden Increase In BP.(Blood Pressure)Some Antidepressants Drugs Like Tricyclic , serotonin-norepinephrine reuptake inhibitors (SNRIs),Tetracyclic,  triazolopyridines and  cyclobenzaprine Can Also Cause Life threatening Conditions Know As Serotonins Syndrome.

 

How To Treat Depression ?

How To Treat Depression

Depression Also Called  major depressive disorder ; could be a common and serious medical health problem that negatively affects how you’re feeling, the way you think that and the way you act. luckily, it’s treatable. Depression causes feelings of unhappiness and/or a loss of interest in activities once enjoyed. It will cause a range of emotional and physical issues and may decrease a person’s ability to perform at work and at home.

Research tells us that different factors contribute to the onset of depression, including genetics, grief or difficult life circumstances certain medical conditions, changes in hormone levels,stress,. Any of those factors alone or together will precipitate changes in brain chemistry that cause depression’s several symptoms.

According To WHO depression is one of the foremost disabling disorders in the world, affecting roughly one in 5 ladies and one in 10 men at some point in their life.

 

Symptoms  Of Depression:

Depression symptoms can vary from mild to severe and can include:

  • Thoughts of death or suicide
  • Difficulty thinking, concentrating or making decisions
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Feeling sad or having a depressed mood
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Feeling worthless or guilty
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)

 

Types Of Depression And  How To Treat Depression  :

There Are Three Types of Depression,

1)Mild Depression

2)Moderate Depression

3)Sever Depression .

 

1)Mild Depression :

If Your Depression Is Mild One You Should  Wait And See For Atleast 2 Weeks That Whether Your Depression May Subside By Itself Or Not.

Take Help Of Exercise Some Studies Have Shown That Exercise Is One of The Main Treatment For Depression . Antidepressant Drugs Should not be use routinely in mild depression.

2)Moderate Depression :

If You Have Been Diagnosed With Mild Or Moderate Depression Your Strategies Should Be Talking Therapy There are differing kinds of talking medical care for depression, as well as cognitive behavioral therapy (CBT) and guidance. Your general practitioner will refer you for talking treatment, or in some elements of the country you would possibly be able to refer yourself.

3)Severe Depression:

If Your Depression Is Sever One The Controlling Strategies Should Be Antidepressant Drugs .There are approximately 30 type of Antidepressant drugs. Keep In Mind That These Drugs Should be Prescribed By A License Physician Or A Team Of Psychologists.

 

How To Treat Depression Naturally  ?

1)Be Socially Active:

keep in regular contact with friends and family, or consider joining a class or group. Strong social networks cut back isolation, a key risk factor for depression. Volunteering may be a marvelous way to get social support and facilitate others while additionally helping yourself.

2) Exercise:

Exercise Is The Best Natural Remedy For Reducing Your Depression Daily About 30-60 Minutes Of Exercise will Be A Great Plus for Your Health Because Due To Exercise Your Body Release Different Hormones Like Serotonin And Endorphins, It Also Increase The Growth Of New Brain Cells .

3)Sleep Well:

Depression will build it exhausting to induce enough shut-eye, and insufficient  sleep will make depression worse.

4)Try To Be Happy:

According To Some Studies Feeling Happy May Increase Your Serotonins Level Which Will Make You Happy Low serotonin receptor function is related to poor mood, and high 5-hydroxytryptamine (serotonin) levels are related to better mood. Basically, whereas low 5-hydroxytryptamine (serotonin) could cause you to feel unhappy, feeling happy may additionally increase your 5-hydroxytryptamine (serotonin ) levels. It’s not clear that is more powerful, however a technique to extend 5-hydroxytryptamine (serotonin )may be through  psychotherapy strategies like cognitive behavioral medical care, meditation

5)Avoid Caffeine Which Decrease Level Of 5 hydroxytryptamine (Serotonin)

6)Never Avoid Meal Because This Will Stable Your Blood Sugar Which Reduce Mood Swing.

Drugs That Are Used In Depression :

1.Selective Serotonin Reuptake Inhibitors: (SSRI)

fluoxetine (Prozac, Sarafem)

escitalopram (Lexapro)

paroxetine (Paxil, Pexeva, Brisdelle)

sertraline (Zoloft)

trazodone (Oleptro)

citalopram (Celexa)

fluvoxamine (Luvox)

2.Serotonin & Nor epinephrine  Reuptake Inhibitors: (SNRI)

These drugs include:

duloxetine (Cymbalta)

desvenlafaxine (Pristiq, Khedezla)

venlafaxine (Effexor XR)

levomilnacipran (Fetzima)

 

3)Tricyclic antidepressants (TCAs)

TCAs include:

desipramine (Norpramin)

imipramine (Tofranil)

amoxapine

trimipramine (Surmontil)

clomipramine (Anafranil)

amitriptyline

doxepin

nortriptyline (Pamelor)

protriptyline

4)Mono Amine Oxidase Inhibitors (MAOIs) :

Phenelzine (Nardil)

Selegiline (Smsam)

Isocarboxazid (Marplan)

Tranylcyromine (Parnate)

 

Treatment Strategies :

There’s very little to decide on among the various classes of antidepressant medication in terms of efficaciousness, therefore selection should be based on the person patient’s needs, together with the presence of concomitant illness, current clinical aid, suicide risk, and previous reaction to antidepressant therapy. because there may be an interval of 2 weeks before the antidepressant action takes place, electroconvulsive treatment can be required in extreme depression whilst delay is unsafe or intolerable. at some stage in the first few weeks of treatment, there’s an accelerated potential for agitation, anxiety, and suicidal ideation.

SSRIs are higher tolerated and are safer in overdose than other classes of antidepressants and need to be considered first-line for treating depression. In patients with unstable angina or who have had a recent myocardial infarction, sertraline has been proven to be safe.

Tricyclic antidepressants have comparable efficacy to SSRIs however are much more likely to be discontinued due to side- effects; toxicity in overdosage is likewise a problem. SSRIs are less sedating and have fewer antimuscarinic and cardiotoxic results than tricyclic antidepressants.

MAOIs have dangerous interactions with some foods and drugs, and need to be reserved to be used by experts. although anxiety is frequently present in depressive illness (and can be the presenting symptom), the usage of an antipsychotic or an anxiolytic might also mask the genuine diagnosis. Anxiolytics or antipsychotic drugs have to consequently be used with warning in depression but they’re useful adjuncts in agitated patients. Augmenting antidepressants with antipsychotics under professional superintendence may additionally be important in patients who’ve depression with psychotic signs.

Sources : BNF

Lippincott Pharmacology

Note:Treatment And Drugs Therapy Are Only For Medical Students And Professionals.Its Better To Consult Your Physician Before Starting Antidepressant Drugs