مذكرة علم أدوية 2010

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Chemotherapy

Anti-Biotic

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Anti-Biotic

General Antibiotic ) (.1 .2 ) .3 .4 .5 .6 .7 .8 .9 Sulfonamides Penicillins )

Special Antibiotic ) (.1 .2 .3 .4 .5 .6 .7 .8 Antifungal Antiviral ) ) .Anti T.B Anti Maralial Anti Leprosy Anti Amoedbiasis anti hilminthiasis Anti U.T.I

) ) Cephalosporins ) Erythromycins ( Macrolids ) ) Aminoglycosides Quinolones Tetracyclines Chloramphenicol Lincosamines

Classification

According Mechansim of Action ) Inhibit Cell Wall Synthesis ( B-Lactam ) ) a. penicillins ) ) ) ) b. Cephalosporins ----------------------------------------------Nucleic Acid Synthesis a. Sulfonamides b. Quinolones ----------------------------------------------Protein Synthesis a. Tetracyclines b. Chloramphenicol c. Aminoglycosides ) D. Erythromycins ( Macrolids ) )

Accrding to their Spectrum Narrow Spectrum ) ( G+ve OR G-ve ----------------------------------------------Broad Spectrum G+ve AND G-ve -----------------------------------------------

According to their Affects Bactericidal ----------------------------------------------Bacteriostatic -----------------------------------------------

1431Pencililns

... [email protected] : .. ) ( ... ... B-Lactam Antibiotic ... ... ( )

( ) 1. Benzyl penicillin : ( Penicillin G ) > I.M & I.V ( not orally ) : ) ( < ) (

snirposolahpeC( )

smanepabraC Imipenam ( IPM )

2. Long Acting : ( Penicillin V ) > Durapen & Penadur L.A : ) ( <

3. Broad Spectrum Penicillins : Effective agenst Gm+ve and Gm-ve e.g. : Amoxicillin Ampicillin : -

It is B-Lactam

Frist Generation Cephalosoprins Cepha + L , D , Z , R L , D , Z , R + Cepha 1. Cehpalexin ( Keflex ) 2. Cephadroxil ( Duricef ) 3. Cepharadin 4. Cephalothin 5. Cephazolin

Imipenam + Cilastatin = ( Tienam ) : + = Use in hospital infection

Second Generation Cephalosoprins Cef + A , U , i , O A , U , i , O + Cef 1. Cefaclor ( Ceclor ) 2. Cefuroxime ( Zinnat ) 3. Cefixim ( Suprax )

4. B-Lactamase : a. Penicillinase Resistant 1. Methicillin 2. Cloxacillin 3. Fluxacillin better absorbed than CLoxacillin

Third Generation Cephalosoprins Cef + T T + Cef 1. Cefotaxime ( Claforan ) 2. Ceftriaxone ( Rocephin )

5. B-Lactamase : a. Penicillinase Inhibitors + 1. Clavulanic acid + Amoxicillin = Augmentin 2. Sulbactam + Ampicillin = Unasyn

Third Generation Cephalosoprins 1. Cefopim ( Maxipim )

Uses : 1. Respiratory Tract Infection (R.T.I ) 2. Urinary Tract Infection ( U.T.I. ) 3. Antharax 4. Anti Tetanus 5. Gonorrhea 6. Gas Gangrene

Uses : 1. Respiratory Tract Infection (R.T.I ) 2. Urinary Tract Infection ( U.T.I. ) 3. Meningitis ) )

1431 Macrolids Antibiotic( ) - Replace for pencillin - good for pregnancy

... [email protected] : .. ) ( ... ... AminoGlycosides Chloramphenicol ... ... ( ) ( ) End with ( mycin ) 1. 2. 3. 4. 5. 6. 7. Streptomycin Gentamycin Kanamycin Neomycin ( the only Oral ) Netilmycin Tobramycin Amikacin ( mycin ) Drugs : 1. Chloramphenicol 2. Thiaphenicol Uses : 1. drug choice for Typhoid Fever

End with ( thromycin ) 1. 2. 3. 4. 5. ( thromycin ) Erethromycin Azithromyci ( Zithromax ) Calrithromycin roxithromycin Spiramycin ( Rovamycin )

Uses : 1. Drug choice in Diphtheria 2. Drug choice in Chlamydia ( Neonates & Pregnancy ) 3. Drug choice in Pneumonia ----------------------------------------------------------------------------Adverse effect : 1. Cholestatic Jaundice

N.B. : It is not good Oral Bioavailability exept Neomycin ) ) ----------------------------------------------------------------------------Toxicity of AminoGlycosides : 1. Nephrotoxicity 2. Ototoxivity

... [email protected] : .. ) ( ... ... ... Tetralcycline Sulfonamides Trimethprim...

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( ) End with ( cycline ) ( cycline )

( ) start with ( sulpha ) 7. ) ( sulpha ) Sulphamethoxazole ( Bactrin Sulfacetamid : eye drops

( ) Uses :

1.2. 3. 4. 5.

tetracycline oxytetracycline chlortetracycline doxycycline minocycline

1.

prostatitis

8.

Adverse effect : Megaloplastic Anemia Treatment by : folic acid

Uses : 1. treatment of Acne ----------------------------------------------------------------------------Adverse effect :

N.B. : It is not good Oral Bioavailability exept Neomycin ) ) ----------------------------------------------------------------------------Toxicity of AminoGlycosides : 1. Nephrotoxicity 2. Ototoxivity

1.

teeth bone abnormalities inhibition growth of bone

2.

3. teratogenecity -----------------------------------------------------------------------------

QUINOLONES & FLUOROQINOLONES( )

Lincosamines( )

end with ( floxacin ) 3. 4. 5.

( floxacin ) Nalidixic acid ( Nalidram ) Norfloxacin Ofloxacin

: Drugs 1. 2. Lincomycin ( Lincocin ) Clindamycin ( Dalacin c )

6.

Ciprofloxacin ( not in pregnancy )

Uses : 1. in teeth one infectios

1431Anti T.B.

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( Tuber Celosis )

Leprosy Treatment of Leprosy ? - Drugs : -A:

AntiFungal

- Duration treatment from 6-9 months 6 9 - we use 3 4 drugs together 3 4 - First line drugs : Rifampicin Isoniazid ( INH ) Pyrazinamide Ethambutol Cycloserine - Second line drugs : Para-amino Salicylic asic ( P.A.S ) Ethionamide ----------------------------------------------------1. Rifampicin : - Uses :

1. 3.4. 5. 6. Sulphons ( Dapson ) Rifampicin Clofazimine Ethionamide 2. 3.

Nystatin ( Mycostatin ) Amphotericen Griseofulavin ( oral ) ( conazole ) Ketoconazole ( Nizoral ) Fluconazole ( Diflucan ) Itraconazole ( Sporanox ) Clotramazole ( Candestan ) Miconazole

- B : End with ( conazole ) 1.

2.

Malaria - Transfer by bite ( Female Anopheles ) Treatment of Malaria ? - Drugs :

3. 4. 5.

Bactericidal

ttt of T.B. with Isoniazid ( I.N.H ) leprosy

Helminthes - Ascaris (round worm ) ) ) End with ( bendazole ) 1. 2. ( bendazole) Mebendazole ( Vermox ) Flubendazole ( Fluvermal )

Chloroquine first choice in Acute Attack Pyrimethamine first choice in Prophylaxis in endemic area Quinine N.B. : Quinine NOT Quinidine ( anti arrhythmic )

- Side Effects : Orange red discoloration of all secretions ( urine , sweet , saliva ) ) ) Neurological symptoms : headache Hepatic Microsomal enzyme inducer ) ) -------------------------------------------------------2. Isoniazid ( I.N.H ) isonicotinci acid

Anti-Amoebiasis Treatment of Amoebiasis ? - Drugs :

- Tape worm 6. Niclosemide ( Yomesan ) 7. Praziqunatel

1.2. 3.

Metronidazole ( Flagyl ) Tinidazole Emetine HCL

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AntiViral A Gamma Globulin * ( inj )

AntiCancer A anti metabolites : Methotrexate Fluorouracil ( 5 Fl.u ) Mercaptopurine Cytabrin Cyclophoshamide

B-

Amantadine ( Symmetrel ) * ttt influenza A + Parkinsonism Acyclovir ( Zovirax ) ttt Herpes Ribavirin ( Virazole )

Zidovudine * ttt HIV

Anti Urinary Tract Infection (U.T.I )

AntiLesishmania Sodium Stiboglyconate

Nitrofurantoin

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Respiration

Bronchial Asthma

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Definition : Allergic chest disase

Pathology : 1. Bronchoconstriction 2. Inflammation > Congestion 3. Thick viscid secretion

:

Cough Therapy Non-productive ( Dry ) ) ) Productive Cough

Treatment of Bronchial Asthma Bronchodilators : 1. Selective B2 agonist : - Salbutamol ( Ventoline ) - Terbutaline - Hexoprenaline - Salmetrol - Formetrol ----------------------------------------2. Anti-Cholinergics : - Ipratropium Bromid ( Atrovent ) ----------------------------------------3. Methyl Xanthine : - Aminophylline : slow I.V. injection ( oral , supp ) ----------------------------------------Side effect : Hypotension Rapid Corticosteroid : ---------------------------------------------------1. Hydrocortisone Sodium Succinate ---------------------------------------------------2. Steroid Aerosols for Inhalation : End with ( sone ) ( sone ) 1. Beclomethasone Di Propionate ( Becotid ) 2. Budesonide ( Pulmicort ) 3. Betamethasone Valerate ( Clenil ) ---------------------------------------------------3. Prednisolon ---------------------------------------------------N.B : Newly Treatment of Bronchila Asthma is : B2 agonist + Inhalation of Cortisone +

Anti-tussives Drugs : 1. Morphine 2. Codeine 3. Dextromethorphan

- Expectorants Drugs : 1. Tincture of Ipecacuanha ( Emetine ) ) ) -----------------------------Mucolytic agent : 1. Bromhexine 2. Acetylcysteine 3. Carbocistene 4. Ambroxol 5. Guaphenesin

Mast cell stabilizers : 1. Di Sodium Cromoglycate 2. Ketotifen ( Zaditen )

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Central Nervous System

C.N.S ) (

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... [email protected] : .. ) ( ... ... Sedatives : ttt Anxiety : ... ...

Hypnotics : ttt Wakefulness : Classification of Hypnotics

1. Barbiturate End with : barbitone barbitone : 1. long Acting :

2. Benzodiazepine ( BDZ ) End with : Zepam - ZolamZepam - Zolam1. long Acting :

1. Barbiturate 2. Benzodiazepine 3. Chlora Hydrate 4. Paraldehyde 5. Thalidomide 6. Glutethemide

:

Phenobarbitone ( Phenobarbital )

2. Intermediate Acting :

Flurazepam Nitrazepam

Amobarbitone ( Amylobarbital )

3. Short Acting :Bentobarbitone Secobarbitone

2. Intermediate Acting : Temazepam

3. Short Acting : 4. Ultra Short Acting :Thiopentone ( Thiopental ) Hexobarbitone

Triazolam

N.B. :

Diazepam

Antidote specific

Flumazenil

BDZ

Treatment of Parkinsonism

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... [email protected] : .. ) ( ... ... Anti Depressant drug ... ...

: : nor arenaline Dopamin A.Ch : ( ) ) ( noisserpeD fo gurD

Drug of Parkinsonism 1. Tri cyclic antidepressant ( TCA ) ) ) - Imipramine ( Tofranil ) - Clomipramine ( Anafranil ) - Amitriptyline 2. MAOI : - Phenelzine ( Nordil ) - Nialamide ( Niamide ) - Moclobemide N. B. : MAOI not use with milk 3. Atypical ( second generation ) ) ) A Selective Serotonin Reuptake Inhibitors ( SSRI ) : - Fluoxetine ( Prozac ) - Citalopram ( Cipram ) - Sertraline ( Lustral ) - Fluvoxamine ( Faverin ) - MANIA : : : nor arenaline Dopamin A.Ch - ttt Lithium Carbonate ( Prianil )

1. Levodopa ( L dopa ) 2. Carbidopa ( Sinemet ) 3. Selegiline( Deprenyl ) ( Jumex )

4. Bromocriptine ( Parlodel ) 5. Amantadine ( Symmetrel ) AntiViral 6. Benzotropine ( Cogentin )

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Anti - Epilepsy

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A Generalized Seizures B Partial ( Focal ) Seizures

Major Tranquillizers ( Anti Schizophrenic ) ( )

C.N.S Stimulants

Drug of Anti - Ebilepsy

Drug of Parkinsonism stnalumitS S.N.C fo gurD

1. Barbiturate 2. Phenytoin 3. Carbamazepine( Tereatol )

1. Thioridazine ( Melleril ) 2. Haloperidol ( Safenace ) 3. Clozapine( Zyprxia )

1. Xanthenes ( Caffeine ) 2. Cocaine

4. Sodium Valproate ( Depakene ) 5. Benzodiazepine ( BDZ )- Diazepam : choice in Status epilepticus - Clonazepam ( Revotril ) : Choice in Pettmal epilepticus

3. Amphetamine

4. Resperidone ( Respirdal ) 5. Sulpride

4. Lobeline 5. Strychnine

6. Ethosuximide

Antidote is

I.V.(Mephenesine)

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General & Local

Anesthesia ) (

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General Anesthesia Drug of Inhalation anesthesia ) )

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General Anesthesia

Drug of I.V anesthesia 1. Ultra Short Acting :Thiopentone ( Thiopental ) Hexobarbitone

End with : Caine Caine :

1. Ethers 2. Halothane ( Fluothan ) 3. Isoflourane 4. Nitrous Oxide ( N2O ) 5. Cyclopropane

1. Cocaine 2. Procaine 3. Lidocaine Mechanism of Action : They block Na+ channels Side effect : Malignant Hypothermia

2. Benzodiazepine 3. Ketamine ( ketalar ) 4. Morphine 5. Fetanly( Opioid analgesics )

(Diazepam )( Lorazepam )

( Opioid analgesics )

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Thyroid Gland

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Thyroxine Hormone : Function 1. Metabolism 2. Control Temperature

Calcitonin Hormone : Function 1. Control Ca+ Level

: Disease )1. Myxoedema (Hypo )(Hypothyrodism : : ttt ) 1. Thyronine Sod ( Etroxin : Disease )2. Goiter (Hyper ) (Hyperthyrodism : : ttt ) 1. Thioamides ( Thiouracils ) 2. Cabemazole ( Neomarcazol

: Disease 1. HypoCalcemia : : ttt ) 1. Alendronate ( Fosamax Also ttt Osteoprosis

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... [email protected] : .. ) ( ... ... Diabetes Mellitus ... ...

Type ( I ) : IDDM Insulin Dependant Diabetes Mellitus :

Insulin Preparation

Oral Hypoglycemic ( NIDDM )

- Keep in Refrigators : ( 2 8 ) C ) 2 - 8 ( - S.C. ( Sub-Cutaneous ) - Regular Insulin Is : S.C. & I.V.

( )

- Age < 30 years 03 - Causes : 1. Genetic Factors

1. Sulphonylureas - Frist Generation : End with : amide amide : Tolbutamide Acetohexamide Chlorpropamide - Second Generation : Start with : Gil Gil : Gilbenclamide ( Daonil ) Glipizide ( Minidiab )

Type ( II ) : NIDDM Non Insulin Dependant Diabetes Mellitus :

1. Natural Insulin : - Regular - It is : - Clear - Colorless - Watary - Actrapid

2. Modified Insulin : - Fast Acting : duration ( 12 16 ) hours : ) 21 61 ( * drug : Semilente : - Intermediate Acting : duration ( 24 ) hours : ) 42 ( Onec Daily * drug : Isophan Insulin ( NPH ) : - Long Acting : duration ( 20 36 ) hours : ) 02 63 ( * drug : - Ultralente - Protamin Zinc Insulin ( PZI )

- Age > 40 years 04 - Causes : 1. Obsity 2. Stress 3. Smoking

2. Biguanides - METFORMIN ( Glucophage ) - Appetite

- Anti dot of insulin is Glucose or Glucaon Hormone

Female Sex Hormone Estrogen & Progesterone

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... [email protected] : .. ) ( ... ... Male Sex Hormone Adrenocortial Hormone ... ... Androgens ( Testosterone ) ( Corticosteroids ) - its Secreted from Suprarenal Cortex - its used as Anti-Inflammatory & Anti-Rheumatic - used of Cortisol : 1. ddison's Disease A 2. Anti-inflammatory in Rheumatic 3. Allergic Disease as ( Bronchial Asthma ) Adverse Effect of Corticosteroids :

1. Estrogen

1. Androgens

- Therapeutic : 1. Development Female Secondary Sex Charaters 2. Amenorrhea 3. Oral Contraceptive - Natural Estadiol ( Steroid ) : Start with : Estr Oestr Estr Oestr : Estradiol monobebzoate Estriol Valerate Esterone - Semisynthetic Estrogen ( Steroidal ) : Ethinyl Estradiol Meseranol ( oral contraception ) - synthetic Non- Steroidal Estrogen Dithyl Stilbesterol Hexoesterol - Anti Estrogens : 1. Tamoxifen ( Nolvadex ) : - ttt Estrogen-dependent Cancer 2. Clomiphen Citrate ( Clomid ) : - ttt Infertility

- Therapeutic : 1. Male Hypogonadism ( Delayed Puberty ) 2. Infertility - Anti androgens : - Cyproterone ( Androcur ) Uses : 1. Increase Sexual Ability 2. Hirsutism

-

Hyperglycemia ( D.M ) Osteoporosis Retardation of Growth in Children Oedema Hypertension Hypokalemia ( Potassium Loss ) Peptic Ulcer Glaucoma Cushing Syndrome

Contraindications of Corticosteroids :

Pituitary Hormone Oxytocin

Diabetes Mellitus Osteoporosis Pregnancy Hypertension Peptic Ulcer Digitalis Toxicity Cushing Syndrome

1. Oxytocin

- Used for Induction of Labour & Abortion

- Therapeutic : 1. Uterine Stimulation ) ) 2. Labour Induction 3. Mammalian Gland Stimulation

- Prepeation : End with : sone , solone sone , solone : Cortisone Prednisone Beclomethasone Dexamethasone

-

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Autonomic Nervous Ssystem) )

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: Adrenergic Receptor Stimulation

- - Dopamine

: Stimulation Agonist Memetic Inducer

1- - Vasoconstriction ( V.C. ) to blood ).Vessels (B.V

1

2-

2

) -Pancreas ( Decreas Insuline secretion ) )

- Vasoconstriction (V.C.) to mucous )memberane (m.m ) - Active Mydriases ( eye pupil

-

-

: Blocking Antagonist lytic Inhibiton

1- 1) ) .- C.N.S - Cardiac

2- 2 - Bronchodilatation

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1 1 1. Cadiac Stimulation :Adrenaline Isoprenaline Dopamine Dobutamine

1. Hyepertension :

1 1. Nasal Decongestant :Naphazoline Tetrahydrozoline Xylometazoline Phenylephrine Methoxamine

Selective-

1

2. Mydriatic : - Ephedrine - Phenylephrine

2. C.N.S. Stimulation :- Dphedrine - Amphetamine - Methamphetamine

Atenolol Esmolol Metoprolol Acebutolol Practolol

Non Selective

- Propranolol ( Inderal ) - Nadolol ( Corgard )

NB.

1 Blocking 1 1 1. Hyepertension : - Prazosin ( Minipress ) - terazosin - Doxazosin

2 Stimulation 2 2 1. Bronchodilators :

- Labetalol and Cavidilol is

and

Blocers:

2. Eye ( Glaucoma )

) ) Timolol ( Timoptic ) Betoxolol ( Betoptic )

- Selective-

2. Migraine Headache :- Ergotamine

Salbutamol ( Ventoline ) erbutaline ( Bricanyl ) Salmetrol ( Servent ) Formetrol ( Foradil )

2 agonist :

2. Partum Hemorrhage :- Ergometrine

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... [email protected] : .. ) ( ... ... : Parasympatholytics ... ... Muscarinic ( m ) Nicotinic ( n )

:

Parasympathomimetics

1. Natural : * Atropine :

: Cholinomimetics Muscarinic agonist Colinoceptive agonist : 1. Direct parasympathomimetics A. Ch Metacholine Cabachol Bethanecol Pilocarpine ( ttt Glacoma ) Muscarine : 2. InDirect parasympathomimetics Physostigamine Neostigamine Pyridostigmine - end with : stigmine stigmine :

-

Mechanisum of action : Muscarinic Agonist : Uses :

o o o o o

Peptic Ulcer Intestinal Colic Parkinsonism Nocturnal enuresis Pre aneshetic medication to no complications :

Toxicity :

Increase respiratory center (R.C) of Morphine Dicrease Slaivary, Bronchila secretion

-

Dry mouth Tachycardia Urin retention

1. Synthetic : * Mydriatics atropine substitute : Atropien

:

- End with :

Homatropine Tropicamide Eucatropine tropine

* Anti-Spasmodic : Hoyscine ( Buscupan ) * Anti-Ashmatics atropine substitute : Ipratropium ( Atrovent ) * Anti-Parkinsonian atropine substiutue : Benztropine ( Cogentin )

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Vitamins

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Vitamins

Water soluble Vitamin - its is ( B-complex , C ) : * Vitamin B-complex : - Vit B1 ( Thiamine ) 1 ttt of : Beri Beri - Vit B2 ( Ribo Fluvin ) - Vit B6 ( Pyridoxine ) ttt of : vomiting of Pregnancy ) ( - Vit B7 ( Biotin ) - Vit B12 ( Cyanocobalamine ) ttt ot : Anaemia * Vit C ( ascorbic acid ) ttt of : o Scurvy o Bleeding swollen gums

Fat or Lipid soluble Vitamin

- its is ( K , E , D , A ) : - Vit A ( Retinol ) VA daily dose 30.000-50.000 IU : 000.03-000.05 Correction of Deficiency 100.000200.000IU : 000.001-000.002 ttt of : Night blindness

- Vit E ( Tocopherols ) it is Antioxidant

- Vit D3 ( Cholecalciferol ) osteoprosis - Vit K ( Phytomenadion ) ttt of : Bleeding

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.C.V.SCardio Vascular System

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... [email protected] : .. ) ( ... ... gurD evitceleS General Drug ... ... Hypertension 1. Selective 1 Blockers : 1 - Prazosin ( Minipress ) - terazosin - Doxazosin 2. Central 2 Agonist : 2 - methyl dopa ( Aldomet ) - Clonidine * safly Antyhpertension in pregnancy 3. Vasodilators : - Hydralazine - Minodixil - Na,nitro prussede 4. Angiotensin Converting Enzyme Inhibitor ( ACEI ) : * Drugs : end with ( pril ) - Captopril ( Capoten ) - Lisinopril ( Zestril ) - Enalapril - Perindopril - Benzapril * Angiotensin Receptor Blocker : End with ( sartan ) - Losartan - Valsartan - Candesartan - Telmisartan * Side effect of ACEI : Dry irritant First dose Hypotension Hyperkalaemia 1. blockers : Selective 1 - Atenolol - Esmolol - Metoprolol - Acebutolol - Practolol Non Selective - Propranolol ( Inderal ) - Nadolol ( Corgard ) NB. - Labetalol and Cavidilol is and Blocers

Definition

- Arterial Blood Presure > 140/90 140/90 >

2. Ca chaneel Blocker : * Verapamil group : - Verapamil ( Isoptin ) - Diltiazem ( Altiazem ) * Dihydropyridin group : End with ( dipine ) - Nifedipine ( Epilat ) - Amlodipin ( Norvasc ) - Nicardipine - Isradipine - Nimodipine

Causes

3. Diuretics : * Thiazide Diuretics: - Chlorothiazide - Hydrochlorothiazide * Loop diuretics : - Frusemide ( Lasix ) - Ethacrynic acid - Bumetadine * Carbonic anhydrase inhibitors : - Acetazolamide ( Diamox ) * K-sparing diuretics : - Spironolactone ( Aldoactone ) - Triamterene - Amiloride

-

Salt Smoking Stress

Side effects , contraindication : 1. Hypokalmia : decrease K avoid in Digitalis Toxicity and Hepatic Disease 2. Hyponatremia : decrease Na 3. Hypercalcemia : increase Ca 4. Hyperuticemia : avoid in Gout 5. Hyperglyceamia : avoid in Diabetes Mellitus 6. Hyperlipidemia 7. Fetotoxic : avoid in pregnancy 8. Hypersensitivity reaction : avoid in Renal Disease and Antibiotic

... [email protected] : .. ) ( ... ... Selective Drug gurD lareneG ... ... Congestive Heart Failure

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Definition

The fris choice : ACEI

1. blockers : Selective 1 - Atenolol - Esmolol - Metoprolol - Acebutolol - Practolol Non Selective - Propranolol ( Inderal ) - Nadolol ( Corgard ) NB. - Labetalol and Cavidilol is and Blocers

- Cardic Blood out put < Body need <

2. Inotropic agents : * Drugs : - Diogxin - Digitoxin - Ouabin * Toxicities of Digitalis : 1. Nausea 2. vomiting 3. headache 4. Hallucination 5. Bradycardia < 60 beats/minute 60 72 6. Heart Block 7. Arrhythmias 8. Visual Disturbance N.B. : 1. Antidote of Digitoxin is Digibind 2. Elimination of Digoxin mainly Kidney 3. Elimination of Digitoxin mainly Liver




... [email protected] : .. ) ( ... ... Selective Drug gurD lareneG ... ... Angina Pectoris

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1. Nitrites & Nitrates : Definition * Glyceryl Trinitrate ( Nitroglycerin ) ( Nitromack ) - The drug Choice for Angina - its is S.L * Isosorbide Dinitrate : - ( Dinitra ) ( Isordil ) ( Effox ) (Isomack) * Isosorbid Nononitrite : - ( Monocard ) * Transdermal patches ( Nitroderm TTS ) ) ) - its release 5ml / 24h 5 42 N.B. : Viagra ( Sildenafil citrate ) is contraindicated with Nitroglycerin


- Oxygen supply < Cardiac need <



2. Dipyridamol : - ( Persantin )


... [email protected] : .. ) ( ... ... Selective Drug gurD lareneG... ... Anti-Arrhythmic drug

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1. Na channel blockers : Definition Quinidine Procainamide Lidocaine Flecainide


- abnormality in origin or conduction of impulses from brain 1. K channel blockers : - Amiodarone - Bretylium - Sotalol




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ANALGESICS

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... [email protected] : .. ) ( ... ... Non Narcotic Analgesics Analgesics ... ...

Narcotic Analgesics - Produce stupor, drowsiness and onlonge use they may cause dependence . * Classification of Narcotic Analgesics : : 1. Opium alkaloids : Morphine, Codeine ) ( : 2. Semi Synthetic Morphine : Di acetyle Morphine ( Heroin ) 3. Synthetic Morphine Substitutes : - Meperidine - Methadone - Fentanyl

Antipyretic Analgesics Non steroid anti-inflammatory ( NSAIDs )

* Mechanism of action of NSAIDs : - inhibit COX synthesis of Prostaglandins ( PGs ) * Classification of antipyretic analgesics : - Acetyl Salicylic acid ( Aspirin ) - Paracetamol - Dipyrone ( Novalgin ) - Ibuprofen , Ketoprofen , Naproxen - Indol derivatives : Indomethacin , Sulindac , Tolmetin - Fenamates : Mefenamic acid ( Ponestan ) - Diclofenac : Voltaren , Cataflam - Piroxicams : Feldene

Morphine * uses of Morphine : - Pain relieve ( in sever cardiac pain, cancer and colic ) ) ) - Pre anesthetic medication to proveid Analgesis, Sedation and Decrease Saliva . * Side effect Toxicity of Morphine : - Over dose make ( Respiratory depression ) - Urine retention - Bronchospasme - Tolerance * Morphine Antiedote : Start with : Nal - Naloxone ( Narcan ) - Naltrexone ( Trexane ) 50mg oral tablets - Nalorphine

Salicylates * uses of Salicylates : - Antipyritc - Analgesic - Common Cold - Rheumatic fever - Rheumatiod arthritis - Chronic gout - Prophlaxis : ( SD 75-100 mg / day ) 100-75 ) ) * Contraidications of Salicylates : - Favism - Bleeding tendency : Hemophilia - Bronchial asthma - Peptic ulcer N.B. : NSAIDs taken after meal :

Paracetamol Side effect and toxicity : - Hepatotoxic - ttt by oral ( N-Acetylcysteine ) ) ( : N.B. : Parafoen = Paracetamol + Chlordoxazone : = +

N.B. - Maximum Dose of : Ibuproven ( 400 , 600 ) = 3200 mg/day ( 8 Tab ) 8 - Maximum Dose of : Paracetamol = 4 g/day = 4000mg/day ( 8 Tab ) 8 - Maximum Dose of : Diclofenac (50,75,100) = 150 mg/day - Sumatriptan : used in ttt Migraine headache

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Treatment of Gout - Excess Depostion of Uric acid in Joints * Acute Attack : a. Colchicine : Specific drug of frist choice b. if Failed Colchicine give NSADs : - Indomethacin - Naproxen - Sulindac c. Steroidal anti-inflammatorys drugs : - ACTH - Prednisolone * Prophylaxis : - Allopurinol ( Zyloric ) [

Antihistamine H1 blockers ) ) - Non Sedating antihistamine : 1. 2. 3. 4. Astemizole Cetrazine Loratidine ( Claritine ) Terfenadine )

- Sedating antihistamine : 1. 2. 3. 4. Chlorpheneramine Dimenhydrinate ( Dramamine ) Diphenhydramine Cyproheptadine ( Periactine )

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G.I.T

Treatment of

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... [email protected] : .. ) ( ... ... ... Anti-Emetics Drug Peptic Ulcers Anti- Constipation Drug...

- Drug therapy : 1. Antacids : - Sodium bicarbonate ( NaHCO3 ) - Calcium carbonate ( CaCO3 ) - MgO & MgOH ( Milk Magnesia ) - Best combination : Mg(OH)2 & Al(OH)3 2. Antisecretory Drugs : - Inhibit the secretion of HCL : a. H2blockers : - end with : tidine 1. Cimetidine 2. Ranitidine ( Zantac ) 3. Famotidine 4. Nizatidine b. Proton Pump inhibitors : - end with : prozole 1. Omeprazole 2. Lansoprazole 3. Pantoprazole 3. Mucosal protections : - Sucralfate - Pgs : Misoprostol ( Cytotec ) - Colloidal bismuth

- Centrally acting anti-ematics : 1. Hyoscine ( Buscopan ) 2. Anti-Histaminics : Diphenhydramine 3. Phenothiazines : Chlorpromazine 4. Metoclopramide ( Primpran , Plasil ) 5. Oudanstreon ( Zofran ) 6. Domperidone ( Domipi )

- Purgatives as : ) ) 1. Bisacodyl ( Dulcolax ) 2. Lactulose ( Ezilax ) 3. Emodine N.B. : Glycerin suppositories in treatment of constipation

Anti- Diarrhea Drug 1. Kaolin ( Kaptin ) 2. Pectin 3. Lopermide ( Imodium ) * Oral Rehydrate Solution ( ORS ) Not cure diarrhea Correct and balance dehydration, acid, base, electrolyte ( NaCL + KCL + Na Citrate + Glucose ) 3 + ( ) + + +

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Blood Drugs

Blood

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Fibrinolytics ) ) - end with : kinase

Vitamin K 1. Phytomendaion = VK1 ( Konakion ) 2. Menaquinone = VK2 3. Menadione = VK3

) ) Iron Deficiency Anima ( Microcytic Hypochromic ) 1. Ferrous sulfare ( Ferrogard ) - antidote : Desferoxamine - Ferrous Glauconate suitable for Children * General Side effects of Iron : 1. Nausea 2. Vomiting : 3. Constipation : 4. Oral Solution : - washable black discoloration of teeth ) )

1.

Streptokinase Urikinase

2.

Antiplatelet agent ) ) 1. 2. Aspirin in small dose ( 75/100mg ) Ticklopidine Dipyridamol ( Presantin )+

3.

Pernicious & Megaloplastic AnimaB12

Anti Coagulants 1. Ancord Heparin ( antidot is Protamine sulfate ) ( use in Pregnanacy ) + Warfarin ( antidot is VK1 ) 1 Dicoumarol Enoxaprine ( Clexan ) inj

2. 3.4.

1. Pernicious Anima : VB 12 + Folic Acid = 21 Never Folic Acid alone Cynocobalamine VB12 ( Cyanocobalamine ) Folic Acid ( Vifolin , Folvite )N.B. : Normal Hb in Males = 13.5 15.5 ( 13-16 ) ( 1417 ) 16-13) ) = 5.31 5.51 Normal Hb in Females = 12.5 15.5 15.5 12.5 =

-

5.

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Hyperlipoprateinemia

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Hydroxy-Methyl-Glutaryl (HMG) CO-A Rdeuctase Inhibitor

... [email protected] : .. ) ( ... ... ... ... Fibric Acid derivatives ( Fibrates )

- end with : vastatin 1. 2. 3. Lovastatin Pravastatin Servastatin

- with : fibr 1. 2. 3. Colifibrate Fenofibrate Gemfibrozil

4. Simvastatin ( Zocor ) not use for Pregnancy

Not use in Pregnancy and Lactation

مذكرة علم أدوية 2010

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