NEET MDS Lessons
Pharmacology
Biguanides
metformin
Mechanism
↓ gluconeogenesis
appears to inhibit complex 1 of respiratory chain
↑ insulin sensitivity
↑ glycolysis
↓ serum glucose levels
↓ postprandial glucose levels
Clinical use
first-line therapy in type II DM
Toxicity
no hypoglycemia
no weight gain
lactic acidosis is most serious side effect
contraindicated in renal failure
Different Systems of the CNS & their functions
These systems are pathways formed of specific parts of the brain and the neurons connecting them.
They include:
1.The pyramidal system
2.The extrapyramidal system
3.The limbic system
4.The reticular formation
5.The tuberohypophyseal system
The pyramidal system:
It originates from the motor area of the cerebral cortex and passes through the spinal cord, therefore it is also known as the “corticospinaltract”.
It is responsible for the regulation of the fine voluntary movements.
The extrapyramidal system:
It also controls the motor functionbut involves areas other than the corticospinal tract.
It is involved in the regulation of gross voluntary movements, thus it complements the function of the pyramidal system.
The “basal ganglia” constitute an essential part of this system.
Degenerative changes in the pathway running from the “substantianigra”to the “corpus striatum”(or nigrostriatal pathway) may cause tremors and muscle rigidity characteristic of “Parkinson’s disease”.
The limbic system:
The major parts of this system are: the hypothalamus, the basal ganglia, the hippocampus(responsible for short term memory), and some cortical areas.
The limbic system is involved in the control of “behavior”& “emotions”.
The reticular formation:
It is composed of interlacing fibers and nerve cells that run in all directions beginning from the upper part of the spinal cord and extending upwards.
It is important in the control of “consciousness” and “wakefulness”.
The tuberohypophyseal system:
It is a group of short neurons running from the hypothalamusto the hypophysis(pituitary gland) regulating its secretions.
Methyl salicylate
also known as oil of wintergreen, betula oil, methyl ester) is a natural product of many species of plants Structurally, it is methylated salicylic acid It is used as an ingredient in deep heating rubs
CNS acting drugs are of major therapeutic and clinical importance.
They can produce diverse physiologicaland psychologicaleffects such as:
•Induction of Anesthesia
•Relief of Pain
•Prevention of Epileptic seizures
•Reduction of Anxiety
•Treatment of Parkinsonism
•Treatment of Alzheimer's disease
•Treatment of Depression
•Centrally acting drugs also include drugs that are administered without medical intervention like tea, coffee, nicotine, and opiates.
Neurotransmitters can be classified into:
1. Biogenic amines:
ACh, NA, DA, 5-HT, Histamine
2. Amino acids:
Excitatory (glutamate & asparate)
Inhibitory (GABA& glycine)
3. Others:
Adenosine, melatonin
VITAMIN -K
- Group of lipophilic, hydrophobic vitamins.
- Needed for the post-translational modification of coagulation proteins.
- Phylloquinone (vitamin K1) is the major dietary form of vitamin K.
- Vitamin K2 (menaquinone, menatetrenone) is produced by bacteria in the intestines.
Hydromorphone
- About 8-10 times more potent than morphine when given intravenously.
- Slightly shorter duration of action.
- More soluble than morphine, thus higher concentrations may be injected if necessary.
- Better oral/parenteral absorption ratio than morphine, but not as good as codeine or oxycodone.
- It is used for the treatment of moderate to severe pain