NEET MDS Lessons
Pharmacology
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
Opiate Antagonists
Opiate antagonists have no agonist properties. They are utilized to reverse opiate induced respiratory depression and to prevent drug abuse.
A. Naloxone
Pure opiate antagonist , Short duration of action, Only 1/50th as potent orally as parenterally
B. Naltrexone
Pure opiate antagonist, Long duration of action, Better oral efficacy
Anesthesia agents
1. Inhalation anesthetics (volatile anesthetics)
- gases : N2O, xenon
- Fluids (vaporisers)
2. Intravenous anesthetics
- Barbiturans : thiopental
- Others : propofol, etomidat
3. Pain killers
- Opioids: fentanyl, sufentanil, alfentanil, remifentanil, morphine
- Non Steroid Anti Inflamatory Drugs: ketonal, paracetamol
4. Relaxants
- Depolarising : succinilcholine
- Non depolarising : atracurium, cisatracurium, vecuronium, rocuronium
5. adiuvants
-benzodiazepins: midasolam, diazepam
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
Carbonic anhydrase inhibitors
Acetazolamide, Dichlorphenamide, Methazolamide, Ethoxzolamide
Mechanism of Action
1. Carbonic anhydrase (CA) facilitates excretion of H+ and recovery of bicarbonate by the proximal renal tubule and ciliary epithelium of the eye. Sodium is recovered in exchange for H+.
2. Inhibitors block CA block sodium recovery. A very mild diuresis is produced (this is really a side effect of their use in glaucoma) because relatively unimportant mechanism for Na recovery and because proximal tubule site means that other sodium recovery mechansims continue to process their normal fraction of the sodium load.
Antihypertensives Drugs
CATEGORIES
I. Diuretics to reduce blood volume
Chlorothiazide (Diuril)
II. Drugs that interfere with the Renin-Angiotensin System
A. Converting enzyme inhibitors Captopril , enalapril, Lisinopril
B. Angiotensin receptor antagonists Saralasin Losartan
III. Decrease peripheral vascular resistance and/or cardiac output
A. Directly acting vasodilators
1. calcium channel blockers Nifedipine , Diltiazem, amlodipine
2. potassium channel activators Minoxidil
3. elevation of cGMP Nitroprusside
4. others Hydralazin e
B. Sympathetic nervous system depressants
1. α-blockers Prazosin, phentolamine, phenoxybenzamine
2. β-blockers Propranolol ,Metoprolol, atenolol
3. norepinephrine synthesis inhibitors Metyrosine
4. norepinephrine storage inhibitors Reserpine
5. transmitter release inhibitors Guanethidine
6. centrally acting: decrease
sympathetic outflow Clonidine , methyldopa
Ofloxacin : It is a quinolone antibiotic and similar in structure to levofloxacin. It is an alternative treatment to ciprofloxacin for anthrax.