NEET MDS Lessons
Pharmacology
A. Sympathetic Nervous System Depressants
1. Antagonists
Both α-adrenoceptor antagonists and β-adrenoceptor antagonists are useful antihypertensives.
- α-blocker Prazosin, phentolamine, phenoxybenzamine
- β-blocker Propranolol ,Metoprolol, atenolol
- α/β-blocker labetalol
2. Sympathetic depressants
a. Examples of peripherally acting agents include
- reserpine This agent interferes with the storage of norepinephrine
- quanethidine This agent interferes with the release of norepinephrine
- trimethaphan This agent blocks transmission through autonomic ganglia.
b. Examples of Centrally acting agents include
- alphamethyldopa
- clonidine. These agents act by decreasing the number of impresses along sympathetic nerves.
Adverse Effect
include nasal congestion, postural hypotension, diarrhea, sexual dysfunction, dry mouth. sedation and drowsiness.
B. Directly Acting Vasodilators
Act on vascular smooth muscle cells independently of adrenergic nerves and adrenergic receptors.
Relaxation of vascular smooth muscle which leads to a decrease in peripheral vascular resistance.
Sites of action of vasodilators are many. For example
Calcium Channel Blocker’s MOA
. Decrease automaticity & conduction thru SA & AV nodes
. Decreased myocardial contractility
. Decreased peripheral & coronary
smooth muscle tone = decrease SVR
Potassium channels activators
minoxidil, cause vasodilation by activating potassium channels in vascular smooth muscle.
An increase in potassium conductance results in hyperpolarization of the cell membrane which is associated with relaxation of smooth muscle.
Nitrovasodilators, such as sodium nitroprusside,
Increase in intracellular cGMP. cGMP in turn activates a protein kinase. Directly-Acting Vasodilators are on occasion used alone but more frequently are used in combination with antihypertensive agents from other classes (esp. a β-blocker and a diuretic.)
Chloral hydrate
1. Short-acting sleep inducer—less risk of “hangover” effect the next day.
2. Little change on REM sleep.
3. Metabolized to trichloroethanol, an active metabolite; further metabolism inactivates the drug.
4. Used for conscious sedation in dentistry.
5. Can result in serious toxicity if the dose is not controlled.
Griseofulvin
- Griseofulvin is an antifungal drug. It is used both in animals and in humans, to treat ringworm infections of the skin and nails. It is derived from the mold Penicillium griseofulvum.
- It is administered orally.
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.
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
Barbiturates
1. Long-acting. Phenobarbital is used to treat certain types of seizures (see section on antiepileptic drugs).
2. Intermediate-acting. Amobarbital, pentobarbital (occasionally used for sleep), secobarbital.
3. Short-acting. Hexobarbital, methohexital, thiopental—rarely used as IV anesthetics.
Methods of general anesthesia
CIRCLE SYSTEM
*HIGH-FLOW
FRESH GAS FLOW > 3 l/min.
*LOW-FLOW
FGF ok. 1l/min.
*MINIMAL-FLOW
FGF ok. 0,5 l/min.