NEET MDS Lessons
Pharmacology
Ketorolac
Mechanism of action
primary action responsible for its anti-inflammatory/antipyretic/analgesic effects is inhibition of prostaglandin synthesis through inhibition of the enzyme cyclooxygenase (COX). Ketorolac is not a selective inhibitor of COX enzymes
Indications: short-term management of pain
Contraindications
hypersensitivity to ketorolac, and against patients with the complete or partial syndrome of nasal polyps, angioedema, bronchospastic reactivity or other allergic manifestations to aspirin or other non-steroidal anti-inflammatory drugs (due to possibility of severe anaphylaxis).
Kinins
Peptide that are mediated in the inflammation.
Action of kinin:
On CVS: vasodilatation in the kidneys, heart, intestine, skin, and liver. It is 10 times active than histamine as vasodilator.
On exocrine and endocrine glands: kinin modulate the tone of pancreas and salivery glands and help regulate GIT motility, also affect the transport of water and electrolytes, glucose and amino acids through epithelial cell transport.
Neurolept Anesthesia
An antipsychotic agent such as droperidol plus an opiate analgesic agent such as fentanyl or sufentanil. This latter agent is approximately eight to ten times more potent than fentanyl.
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.
ANTIBIOTICS
Chemotherapy: Drugs which inhibit or kill the infecting organism and have no/minimum effect on the recipient.
Antibiotic these are substances produced by microorganisms which suppress the growth of or kill other micro-organisms at very low concentrations.
Anti-microbial Agents: synthetic as well as naturally obtained drugs that attenuate micro-organism.
SYNTHETIC ORGANIC ANTIMICROBIAL DRUGS
Sulfonamides
Trimethoprim-sulfamethoxazole
Quinolones – Ciprofloxacin
ANTIBIOTICS THAT ACT ON THE BACTERIAL CELL WALL
Penicillins
Cephalosporins
Vancomycin
INHIBITORS OF BACTERIAL PROTEIN SYNTHESIS
Aminoglycosides - Gentamicin
Antitubercular Drugs: Isoniazid & Rifampin
Tetracyclines
Chloramphenicol
Macrolides – Erythromycin, Azithromycin
Clindamycin
Mupirocin
Linezolid
ANTIFUNGAL DRUGS
Polyene Antibiotics (Amphotericin B, Nystatin and Candicidin)
Imidazole and Triazole Antifungal Drugs
Flucytosine
Griseofulvin
ANTIPROTOZOAL DRUGS
Antimalarial Drugs – Quinine, Chloroquine, Primaquine
Other Antiprotozoal Drugs – Metronidazole, Diloxanide, Iodoquinol
ANTIHELMINTHIC DRUGS
Praziquantel
Mebendazole
Ivermectin
ANTIVIRAL DRUGS
Acyclovir
Ribavirin
Dideoxynucleosides
Protease inhibitors
Tetracycline
Tetracycline is an antibiotic produced by the streptomyces bacterium
Mechanism and Resistance Tetracycline inhibits cell growth by inhibiting translation. It binds to the 30S ribosomal subunit and prevents the amino-acyl tRNA from binding to the A site of the ribosome. This prevents the addition of amino acids to the elongating peptide chain, preventing synthesis of proteins. The binding is reversible in nature.
Example: Chlortetracycline, oxytetracycline, demethylchlortetracycline, rolitetracycline, limecycline, clomocycline, methacycline, doxycycline, minocycline
Source: Streptomyces spp.; some are also semi-synthetic
Spectrum of activity: Broad-spectrum. Exhibits activity against a wide range of Gram-positive, Gram-negative bacteria, atypical organisms such as chlamydiae, mycoplasmas, rickettsiae and protozoan parasites.
Effect on bacteria: Bacteriostatic
Cells become resistant to tetracyline by at least two mechanisms: efflux and ribosomal protection.
Contraindications Tetracycline use should be avoided during pregnancy and in the very young (less than 6 years) because it will result in permanent staining of teeth causing an unsightly cosmetic result.
Tetracyclines also become dangerous past their expiration dates. While most prescription drugs lose potency after their expiration dates, tetracyclines are known to become toxic over time; expired tetracyclines can cause serious damage to the kidneys.
Miscellaneous: Tetracyclines have also been used for non-antibacterial purposes, having shown properties such as anti-inflammatory activity, immunosuppresion, inhibition of lipase and collagenase activity, and wound healing.
Neomycin
used as a topical preparation
Neomycin is not absorbed from the gastrointestinal tract, and has been used as a preventative measure for hepatic encephalopathy and hypercholesterolemia. By killing bacteria in the intestinal tract, it keeps ammonia levels low and prevents hepatic encephalopathy, especially prior to GI surgery. It is not given intravenously, as neomycin is extremely nephrotoxic (it causes kidney damage), especially compared to other aminoglycosides.