NEET MDS Lessons
Pharmacology
PHARYNGEAL DEMULCENTS
Administered in the form of lozenges, cough drops and cough linctus.
Produce soothing action on throat directly and by increasing the flow of saliva and provide symptomatic relief from dry cough.
EXPECTORANT
Expectorants are the drugs which increase the production of bronchial secretion and reduce its viscosity to facilitate its removal by coughing.
ANTITUSSIVES
They are central cough suppressants and act centrally to raise the threshold of cough centre and inhibit the cough reflex by suppressing the coordinating cough centre in the medulla oblongata.
Codeine - it depresses cough centre but is less constipating and abuse liability is low.
Pholcodeine is similar to codeine in efficacy and is longer acting. It has no analgesic or addicting property.
Noscapine is another opium alkaloid of benzylisoquinoline group. It is used as antitussive with no analgesic and drug abuse or drug dependence property.
Dextromethorphan is a synthetic compound and its dextroisomer is used as antitussive and is as effective as codeine
Pipazethate is another synthetic compound of phenothiazine category used as antitussive with little analgesic and sedative properties.
ANTIHISTAMINICS
They do not act on cough centre but provide relief due to their sedative and anticholinergic action.
BRONCHODILATORS
Bronchodilators are helpful in individuals with cough and bronchoconstriction due to bronchial hyperreactivity. They help by improving the effectiveness of cough in clearing secretions.
Isoflurane (Forane) MAC 1.3%, Blood/gas solubility ratio 1.4
- Better muscle relaxation than with the other halogenated anesthetic agents.
- Isoflurane markedly potentiates the action of the neuromuscular blocking agents.
- Produces rapid onset and recovery of anesthesia.
- Does not sensitize the heart to catecholamines.
- Produces respiratory depression, but produces less cardiovascular depression
- than does halothane.
- It has an extremely low degree of metabolism and is apparently relatively
- nontoxic.
Carbapenems: Broadest spectrum of beta-lactam antibiotics.
imipenem with cilastatin
meropenem
ertapenem
Monobactams: Unlike other beta-lactams, there is no fused ring attached to beta-lactam nucleus. Thus, there is less probability of cross-sensitivity reactions.
aztreonam
Beta-lactamase Inhibitors No antimicrobial activity. Their sole purpose is to prevent the inactivation of beta-lactam antibiotics by beta-lactamases, and as such, they are co-administered with beta-lactam antibiotics.
clavulanic acid
tazobactam
sulbactam
Classification
I) Esters
1. Formed from an aromatic acid and an amino alcohol.
2. Examples of ester type local anesthetics:
Procaine
Chloroprocaine
Tetracaine
Cocaine
Benzocaine- topical applications only
2) Amides
1. Formed from an aromatic amine and an amino acid.
2. Examples of amide type local anesthetics:
Articaine
Mepivacaine
Bupivacaine
Prilocaine
Etidocaine
Ropivacaine
Lidocaine
Agonist, Antagonist, and Partial Agonists
Agonists: molecules that activate receptors. A drug that mimics the body's own regulatory processes.
Antagonists: produce their effects by preventing receptors activation by endogenous regulatory molecules and drugs. Block activation of receptors by agonists.
Noncompetive Antagonist: Bind irreversibly to receptors, and reduce the maximal response that an agonist can elicit.
Competitive Antagonist: Bind reversibly to receptors, competing with agonists for binding sites.
Partial Agonists: Have moderate intrinsic activity, the maximal effect that a partial agonist can produce is lower than that of a full agonist. Act as antagonists as well as agonists.
Chloramphenicol
derived from the bacterium Streptomyces venezuelae
Chloramphenicol is effective against a wide variety of microorganisms, but due to serious side-effects (e.g., damage to the bone marrow, including aplastic anemia) in humans, it is usually reserved for the treatment of serious and life-threatening infections (e.g., typhoid fever). It is used in treatment of cholera, as it destroys the
vibrios and decreases the diarrhoea. It is effective against tetracycline-resistant vibrios.It is also used in eye drops or ointment to treat bacterial conjunctivitis.
Mechanism and Resistance Chloramphenicol stops bacterial growth by binding to the bacterial ribosome (blocking peptidyl transferase) and inhibiting protein synthesis.
Chloramphenicol irreversibly binds to a receptor site on the 50S subunit of the bacterial ribosome, inhibiting peptidyl transferase. This inhibition consequently results in the prevention of amino acid transfer to growing peptide chains, ultimately leading to inhibition of protein formation.
Spectrum of activity: Broad-spectrum
Effect on bacteria: Bacteriostatic
TRIMETHOPRIM
It is a diaminopyrimidine. It inhibits bacterial dihydrofolate reductase( DHFRase).
In combination with sulphamethoxzole it is called Co-trimoxazole.
Spectrum of action
S. Typhi. Serratia. Klebsiela and many sulphonamide resistant strains of Staph.aureus. Strep pyogens
Adverse effects
Megaloblastic anemia. i.e.. due to folate defeciency.
Contraindicated in pregnancy.
Diuretics if given with co-trimoxazole cause thrombocytopenia.
Uses
I. UTI. 2. RTI. 3. Typhoid. 5. Septicemias. 5. Whooping cough