Doctors Network: Pharmacology

Showing posts with label Pharmacology. Show all posts

Teratogenic drugs and their effects

Teratogenic drugs and their effects

Alcohol in pregnancy -- Fetal Alcohol Syndrome (FAH) - Midfacial hypoplasia and Long philtrum

Using DES in pregnancy - New born with T shaped Uterus

Dilantin/Phenytoin -- Craniofacial dysmorphism (5-10%) and also nail hypoplasia

Isotretinoin (Accutane) - Microtia -small ear - severe birth defects also heart problem

Lithium - Ebstein anomaly - large Right arium

Tetracyclin - Deciduous teeth discoloration (after 4 month)

Thalidomide - Phocomelia (Limb reduction defects exposure from Day 42-48)

Valproic Acid (Depakote) - Neural Tube Defects like Spina bifida , Congenital Heart disease

Coumadin - Chondrodysplasia punctata also optic atrophy

Urinary Incontinence and its types (Stress , Urge , Overflow , Bypass & Irritative)

EPS and Treatment

Factors Causing Hyperkalemia and Hypokalemia

Factors Causing Hyperkalemia

Acidosis
ACEI
Beta-Blockers (Propanolol)
Digitalis toxicity
Succinylcholine
Renal Failure
Mineralocorticoid deficiency (Hypoaldosteronism)
Potassium-Sparing Diuretics (Spironolactone,Triamterene,Amiloride)
Rhabdomyolysis

Factors Causing Hypokalemia

Loop and Thiazide Diuretics
Osmotic Diuretics
Mineralocorticoid (Hyperaldosteronism)
Alkalosis
Insulin
Beta-2 agonists(Albuterol)
Eating disorder
Diarrhea, Vomiting
Laxatives
ATN - recovery phase
Elderly patients.

Insulin therapy and its types

Insulin types depicted on the graph below : Regular insulin is preferred in the initial treatment of Diabetic ketoacidosis(DKA). Recognize the different types insulins and their durations of action.

Line A- rapid-acting (e.g., lispro)

Line B-regular

Line C-NPH

Line D-Lente

Line E-Ultralente

Line F-Glargine

Diabetic patients need two types of insulin: both a basal long-acting insulin and a short acting insulin.
The latter covers post-meal hyperglycemia. The best basal, long-acting insulin is glargine insulin(Lantus), which is supplemented by at least 3 shots of short-acting insulin at mealtimes. Before the advent of glargine, NPH was the best long-acting basal insulin.
Since NPH is only good for 12-18 hours, patients need two shots per day, plus the short-acting mealtime shots. Glargine allows only four shots per day, while the use of NPH requires five shots.

The best short-acting insulins are aspart and lispro. Before the advent of these two drugs, regular insulin was the best option for postmeal hyperglycemia. Insulin aspart and insulin lispro have a very rapid onset of action.

Common Drugs (toxicity/poisoning) & Their Antidotes (DOC)

DRUGS OF CHOICE

1. Acetaminophen /Paracetamol poisoning :- acetyl cysteine
2. acute bronchial- asthma :- salbutamol
3. acute gout :- NSAIDS
4. acute hyperkalemia:- calcium gluconate
5. severe DIGITALIS toxicity:-DIGIBIND
6. acute migraine :- sumatriptan
7. cheese reaction :- phentolamine
8. atropine poisoning :- physostigmine
9. cyanide poisoning :- amyl nitrite
10. benzodiazepine poisoning:- flumazenil
11. cholera :- tetracycline
12. KALA-AZAR :- lipozomal amphotericin- B
13. iron poisoning :- desferrioxamine
14. MRSA :- vancomycin
15. VRSA :- LINEZOLID
16. warfarin overdose :- vitamin-K
17. OCD :- fluoxetine
18. alcohol poisoning :- fomepizole
19. epilepsy in pregnancy :- phenobarbitone
20. anaphylactic shock :- adrenaline