📖 Pharmacology
Antidiarrheal
PharmacologyAntidiarrheal
Antidiarrheal drugs may be given to relieve the symptom (non-specific therapy) or may be given to treat the underlying cause of the symptom (specific therapy).
Ι. Drugs used for the symptomatic (non-specific) treatment of diarrhoea include:
• Opiates and opiate derivatives are the most effective (such as morphine), but it is not used because of potentially serious adverse effects. Other agents, such as diphenoxylate and loperamide, are commonly used.
• Adsorbent – demulcent products such as kaolin – pectin preparation may be included in antidiarrheal preparations. Unfortunately, they may adsorb nutrients and other drugs, including the antidiarrheal agents if given concurrently.
• Anticholinergic agents e.g. atropine is occasionally used to decrease abdominal cramping and pain associated with diarrhoea.
ΙΙ. Specific therapy may include the use of antibacterial agents that are recommended for use in carefully selected cases of bacterial enteritis. For example, severe diarrhoea by salmonella, shigella, campylobacter and clostridia species can be treated by antibiotics (ampicillin, chloramphenicol, co-trimoxazole).
Thrombolytic Agents
PharmacologyThrombolytic Agents:
Tissue Plasminogen Activator (t-PA, Activase)
t-PA is a serine protease. It is a poor plasminogen activator in the absence of fibrin. t-PA binds to fibrin and activates bound plasminogen several hundred-fold more rapidly than it activates plasminogen in the circulation.
Streptokinase (Streptase)
Streptokinase is a protein produced by β-hemolytic streptococci. It has no intrinsic enzymatic activity, but forms a stable noncovalent 1:1 complex with plasminogen. This produces a conformational change that exposes the active site on plasminogen that cleaves a peptide bond on free plasminogen molecules to form free plasmin.
Urokinase (Abbokinase)
Urokinase is isolated from cultured human cells.Like streptokinase, it lacks fibrin specificity and therefore readily induces a systemic lytic state. Like t-PA, Urokinase is very expensive.
Contraindications to Thrombolytic Therapy:
• Surgery within 10 days, including organ biopsy, puncture of noncompressible vessels, serious trauma, cardiopulmonary resuscitation.
• Serious gastrointestinal bleeding within 3 months.
• History of hypertension (diastolic pressure >110 mm Hg).
• Active bleeding or hemorrhagic disorder.
• Previous cerebrovascular accident or active intracranial bleeding.
Aminocaproic acid:
Aminocaproic acid prevents the binding or plasminogen and plasmin to fibrin. It is a potent inhibitor for fibrinolysis and can reverse states that are associated with excessive fibrinolysis.
Stages of anesthesia
PharmacologyStages of anesthesia
Stage I
Analgesia
Still conscious but drowsy
Stage II
Excitement stage
Loss of consciousness, however, irregular ventilation may be present which affects absorption of inhalation agents.
Reflexes may be exaggerated.
This is a very dangerous stage
Stage III
Surgical anesthesia
Loss of spontaneous movement
Regular, shallow respiration
Relaxation of muscles
Stage IV
Medullary paralysis
Death
Classification of Local anesthetics
PharmacologyClassification
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