NEET MDS Lessons
Pharmacology
Nalidixic acid:
Nalidixic acid is the basis for quinolone antibiotics. It acts bacteriostatically (that is, it inhibits growth and reproduction) or bactericidally (it kills them) on both Gram positive and Gram negative bacteria, depending on the concentration. It is especially used in treating urinary tract infections, caused for example by Escherichia coli, Proteus, Enterobacter and Klebsiella.
Halothane (Fluothane) MAC 0.76%, Blood/gas solubility ratio 2.3
- Nonflammable.
- Any depth of anesthesia can be obtained in the absence of hypoxia.
- Halothane produces a marked hypotensive effect
- accompanies hypotension.
- Halothane “sensitizes” the ventricular conduction system in the heart to the action of catecholamines. However, ventricular arrhythmias are rare if
- respiratory acidosis, hypoxia and other causes of sympathetic stimulation are avoided.
- Respiration is depressed by all anesthetic concentrations.
- Halothane is metabolized to a significant extent and some of its metabolic produces have been shown to be hepatotoxic.
- Can produce a malignant hyperpyrexia due to an uncontrolled hypermetabolic reaction in skeletal muscle.
Halothane is generally used with nitrous oxide, an opiate and a neuromuscular blocking drug.
OXYMETAZOLINE
It is a directly acting sympathomimetic amine used in symptomatic relief in nasal congestion which increases mucosal secretion.
It is used:
- As a nasal decongestant in allergic rhinitis, with or without the addition of antazoline or sodium chromoglycate.
- As an ocular decongestant in allergic conjunctivitis.
Compounds like naphazoline and xylometazoline are relatively selective α2 agonists, which on topical application produce local vasoconstriction.
Fluconazole: an antifungal used orally, intravenously or vaginally to treat yeast and fungal infections. Side-effects of systemic administration include hepatotoxicity (liver damage).
- For vaginal candidiasis (vaginal thrush), a once-only oral dose is often sufficient.
Prostaglandines:
Every cell in the body is capable of synthesizing one or more types of PGS. The four major group of PGs are E, F, A, and B.
Pharmacological actions:
stimulation of cyclicAMP production and calcium use by various cells
CVS
PGE2 acts as vasodilator; it is more potent hypotensive than Ach and histamine
Uterous
PGE2 and PGF2α Contract human uterus
Bronchial muscle
PGF2α and thromboxan A2 cause bronchial muscle contraction.
PGE2 & PGI2 cause bronchial muscle dilatation
GIT: PGE2 and PGF2α cause colic and watery diarrhoea
Platelets
Thromboxan A2 is potent induce of platelets aggregation
Kidney
PGE2 and PGI2 increase water, Na ion and K ion excretion (act as diuresis) that cause renal vasodilatation and inhibit
tubular reabsorption
USE
PGI2: Epoprostenol (inhibits platelets aggregation)
PGE1: Alprostadil (used to maintain the potency of arterioles in neonates with congenital heart defects).
PGE2: Dinoproste (used as pessaries to induce labor)
Synthetic analogue of PGE1: Misoprostol (inhibit the secretion of HCl).
ANTICHOLINERGIC DRUGS
Blocks the action of Ach on autonomic effectors.
Classification
Natural Alkaloids - Atropine. Hyoscine
Semi-synthetic deriuvatives:- Homatropine, Homatropine methylbromide, Atropine methonitrate.
Synthetic compounds
(a) Mydriatics - Cyclopentolate. Tropicamide.
(b) Antisecretory - Antispasmodics - Propantha1ine. Oxy-phenonium, Pirenzipine.
c) Antiparkinsonism- Benzotopine, Ethopropazine, Trihexyphenidyl, Procyclidine, Biperiden
Other drugs with anticholinergic properties • Tricyclic Antidepressants • Phenothiazines • Antihistaminics • Disopyramide
MUSCARINIC RECEPTORS SUBTYPES & ANTAGONISTS
• M 1 Antagonists – Pirenzepine, Telenzepine, dicyclomine, trihexyphenidyl
• M 2 Antagonists – Gallamine, methoctramine
• M 3 Antagonists – Darifenacin, solifenacin, oxybutynin, tolterodine
Pharmacological Actions
CNS - stimulation of medullary centres like vagal. respiratory. vasomotor and inhibition of vestibular excitation and has anti-motion sickness properties.
CVS - tachycardia.
Eye - mydriasis
Smooth muscles - relaxation of the muscles receiving parnsympathetic motor innervation.
Glands - decreased secretion of sweat and salivary glands
Body Temperature - is increased as there is stimulation of temperature regulating centre.
Respiratory System- Bronchodilatation & decrease in secretions. For COPD or Asthma - antimuscarinic drugs are effective
GIT - Pirenzepine & Telenzepine - decrease gastric secretion with lesser side effects.
Phenoxymethylpenicillin (penicillin V) Phenoxymethylpenicillin, commonly known as penicillin V, is the orally-active form of penicillin. It is less active than benzylpenicillin
Indications:
infections caused by Streptococcus pyogenes, tonsillitis, pharyngitis, skin infections, prophylaxis of rheumatic fever, moderate-to-severe gingivitis (with metronidazole)