Katzung & Trevor's Pharmacology Examination and Board Review, 9th Edition

The most trusted and efficient pharmacology review – complete with 1000+ Q&As — and now in full color

5 STAR DOODY’S REVIEW!
“The authors have designed this book to foster the mastery of pharmacology for students who have to pass course, module, or certification examinations….This is one of the best review books in pharmacology. The latest version is far superior, both in content and presentation, to previous versions. I give it my highest recommendation.”–Doody’s Review Service

From the authors of Basic and Clinical Pharmacology, the leading pharmacology textbook, here is the newest edition of the best review book available for medical pharmacology course exams and board examinations. This skill-building guide comes with over 1000 review questions and answers –- far more than most other pharmacology reviews –- and a chapter-based approach that facilitates use with course notes or larger texts.

Features:
* A new full-color presentation

* Organized to reflect course syllabi, focusing on the clinical use and pharmacology of drug categories, rather than individual drugs

* Two complete practice exams

* A valuable appendix of test-taking strategies

* Chapters that include valuable learning aids such as:

–Short discussion of the major concepts that underlie basic principles or drug groups

–Explanatory figures and tables

–Review questions followed by answers and explanations

–Drug Trees in drug-oriented chapters that visually organize drug groups

–A list of high-yield terms and definitions you need to know

* Skill Keeper questions that prompt you to review previous material to understand links between related topics

* A checklist of tasks you should be able to do, once you have finished the chapter

* Summary Tables that list the important drugs and include key information about their mechanisms of action, effects, clinical uses, pharmacokinetics, drug interactions, and toxicities.

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Bleomycin-Induced Flagellate Hyperpigmentation

A 39-year-old woman with a long-standing vascular malformation of the posterior tongue underwent intralesional sclerotherapy with a single dose of bleomycin. Within 1 week after treatment, painless, nonpruritic, flagellate hyperpigmentation developed on her trunk. She had no alopecia and no changes in the appearance of nails or mucosa. She reported having no dyspnea or pulmonary symptoms.
Bleomycin is a glycopeptide antibiotic commonly used for chemical pleurodesis, the treatment of cutaneous warts, and the treatment of a variety of cancers. The rate of flagellate hyperpigmentation in patients who are treated with bleomycin may be as high as 20%. Most tissues contain a cysteine proteinase capable of hydrolyzing and inactivating bleomycin. The reduced concentration of bleomycin hydrolase in the skin and lung, as compared with other tissues, may explain the medication's adverse reaction profile.

The patient was counseled that the flagellate hyperpigmentation usually fades over a period of several months after the cessation of the medication. During the past year, the hyperpigmentation in this patient has faded but not yet resolved.

Beta2 Adrenergic Receptor Mnemonic

Beta2 Adrenergic Autonomic Receptor of the Sympathetic Nervous System presented in a pictorial mnemonic format . Key Point: Beta2 expands. For Medical learning.

Angioedema caused by angiotensin-converting enzyme (ACE) inhibitor

Swollen tongue caused by angiotensin-converting enzyme (ACE) inhibitor-associated

angioedema.

Diagnosis:

Angioedema is a clinical diagnosis. If the patient presents with the characteristic swelling of the
mouth, lips, tongue, or pharynx and is also taking an ACE inhibitor, the diagnosis should be highly suspected.

Clinical Complication:
Airway compromise secondary to swelling of the tongue, uvula, soft palate, and larynx is a common and potentially life-threatening complication of ACE inhibitor-associated angioedema.

Management : Patients with impending airway compromise require the immediate establishment of a definitive airway. Those with less severe findings need early medical management with intravenous (IV) antihistamines, steroids, and subcutaneous epinephrine. After discontinuation of the ACE inhibitor and administration of the appropriate medications, most cases of ACE inhibitor-induced angioedema resolve within 12 to 48 hours.2 However, this angioedema can proceed rapidly to life-threatening airway closure and must be treated as a serious emergency.

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Handbook of Drugs in Intensive Care: An A - Z Guide - 2010 Edition

The fourth edition of this compact, practical pocketbook provides easy access for the reader with an A-Z listing of every drug and accompanying advice on its correct administration and potential adverse effects. It is an invaluable resource for all healthcare professionals working in the intensive care setting.

Numerous treatment options are available to intensive care staff; this requires detailed knowledge of routes of administration and contra-indications to use in certain clinical conditions. Now in its fourth edition, this concise, practical handbook to drugs and prescribing for intensive care gives up-to-date advice on established drugs as well as providing advice on those recently approved. The book is divided into two sections: an A-Z guide to many of the drugs available, with concise information on each drug, including uses, limitations, administration directions and adverse effects. The second section contains topics relevant to the critically ill patients, including factors that may affect drug prescribing and management of medical emergencies. There is also a key data section showing weight conversions, BMI and corresponding dosage calculations, and an invaluable chart indicating drug compatibility for IV administration. This is an invaluable resource for doctors, nurses, and pharmacists caring for critically ill patients.

Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice

Written by experts at the forefront of current research and clinical practice, this volume provides evidence-based guidelines for safe, effective, and rational drug therapy in newborns, children, and adolescents. Coverage includes specific recommendations for all major drug classes and diseases, a detailed section on drugs and the newborn, and chapters on specific treatment settings such as the pediatric intensive care unit and emergency room. Also included are chapters on adverse effects and interactions and state-of-the-art discussions on pharmacokinetics, pharmacodynamics, pharmacogenetics, drug development, and clinical drug trials in infants and children. Appendices include a neonatal formulary and a pediatric formulary.

Side effects of Prostaglandin E1 on neonates

Prostaglandin E1 used in:
 Maintain patency or reopen ductus arteriosus in case of
1. Cyanotic Congenital Heart Disease

• Transposition of the Great Vessels
• Tricuspid atresia

2. Aortic Coarctation

# Side effects are common and potentially lethal

1. Flushing
2. peripheral edema
3. Hypotension
4. Apnea
5. Hyperpyrexia
6. Jitteriness
7. Diarrhea
8. Hypoglycemia
9. Hypocalcemia
10. Renal Failure
11. Rhythm disturbance
12. Coagulopathies

Note that : Start with "x" mg of Prostaglandin E1( Where "x" = 0.3 x WeightKg )
-Add enough D5W or NS to Prostaglandin for 50 ml total
At this dilution: Infusion rate of 0.5 ml/min provides 0.05 ug/kg

SLUG BAM: Muscarinic effects of Acetylcholine

Acetylcholine acts on two vastly different classes of receptors - nicotinic receptors (with two subtypes, one at the neuromuscular junction of skeletal muscle, the other within ganglia and the CNS), and muscarinic receptors (widely distributed within both peripheral and central nervous systems).

**Muscarinic effects SLUG BAM:

• Salivation/ Secretions/ Sweating
• Lacrimation
• Urination
• Gastrointestinal upset
• Bradycardia/ Bronchoconstriction/ Bowel movement
• Abdominal cramps/ Anorexia
• Miosis

propofol infusion syndrome: a simple name for a complex syndrome.

It was revealed just recently that Propofol, a short-acting, intravenously administered sedative agent is what might have caused the cardiac arrest of the King of Pop, Michael Jackson.

Propofol infusion syndrome (PRIS) is a rare and often fatal syndrome described in critically ill children undergoing long-term propofol infusion at high doses. Recently several cases have been reported in adults, too.

The main features of the syndrome consist of cardiac failure, rhabdomyolysis, severe metabolic acidosis and renal failure.
To date 21 paediatric cases and 14 adult cases have been described. These latter were mostly patients with acute neurological illnesses or acute inflammatory diseases complicated by severe infections or even sepsis, and receiving catecholamines and/or steroids in addition to propofol.............

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Drugs administered in Status Epilepticus

A 21 year old is brought to your clinic in status epilepticus. What drug should be administered initially?

• A) Lorazepam
• B) Phenytoin
• C) Phenobarbital
• D) Pentobarbital
• E) Fosphenytoin

Answer and Discussion
The answer is A. Lorazepam should be administered intravenously and approximately 1 minute allowed to assess its effect. Diazepam or midazolam may be substituted if lorazepam is not available. If seizures continue at this point, additional doses of lorazepam should be infused and a second intravenous catheter placed in order to begin a concomitant phenytoin (or fosphenytoin) loading infusion. Even if seizures terminate after the initial lorazepam dose, therapy with phenytoin or fosphenytoin is generally indicated to prevent the recurrence of seizures.

Major non-antibiotics Teratogenic drugs

Before that we will talk about some principles, first adapted by James Wilson, highlight the nature of teratogens:

Principle 1: Susceptibility to teratogenesis depends on the genotype of the embryo

Principle 2: Susceptibility to a teratogenic agent depends on the developmental stage when the exposure occurs

Principle 3: Different teratogenic agents effect developing cells and tissues in various ways

Principle 4: The final manifestations of abnormal development are death, malformation, growth retardation, and functional disorder

Principle 5: The nature of the detrimental environmental agent impacts its access to the fetus.

Principle 6: As dosage increases the manifestations of abnormal development increase in degree from the no-effect to the lethal level

TAP CAP : Is the word that collct some of the most Major non-antibiotics Teratogenic drugs

Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin

Meyler's Side Effects of Analgesics and Anti-inflammatory Drugs (Meylers Side Effects)

Meyler's Side Effects of Analgesics and Anti-inflammatory Drugs (Meylers Side Effects)
Elsevier Science; 1 edition (December 30, 2009) | ISBN: 0444532730 | 702 pages | PDF | 6 MB

Elsevier now offers a series of derivative works based on the acclaimed Meyler's Side Effect of Drugs, 15th Edition. These individual volumes are grouped by specialty to benefit the practicing biomedical researcher and/or clinician.

Opioids and analgesics are members of a diverse group of drugs used to relieve pain. They are frequently used in combination with prescription and nonprescription pain relievers, and misuse is prevalent. Pain medicine specialists and most physicians or surgeons will find this volume useful in prescribing the appropriate drugs for pain therapy and for preventing misuse of the medication.

* The only drug guide that includes clinical case studies and expert analysis
* Features not only analgesics and anti-inflammatory drugs, but also all other drugs that act in an analgesic or anti-inflammatory manner
* Most complete cross referencing of drug-drug interactions available
* Latest content from the most highly-regarded compilation of drug side effects: Side Effects of Drugs Annual serial

Melatonin and it`s uses

Melatonin is a hormone secreted by the pineal gland in the brain. It helps regulate other hormones and maintains the body's circadian rhythm. The circadian rhythm is .................

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Beta Receptor: Mechanism of Activation in Cardiac Muscle

1.The agonist binds to the myocardial beta1-adrenergic receptor. which is a typical G-protein coupled receptor.

2.In the unstimulated state the G-protein is complexed with GDP..............

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Drugs in Allergic Rhinitis

Drugs in Allergic Rhinitis :
#H1 antihistamines are effective for treating nasopharyngeal itching, sneezing, watery rhinorrhea, and ocular itching, tearing, erythema.

*Side effects associated with older H1 antihistamines include sedation, visual disturbance, urinary retention, and arrhythmias

#Newer H1 antihistamines:( terfenadine (Seldane) astemizole (Hismanal))

*These agents exhibit less sedation associated with .......

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Challenges for Drug Discovery in a Postgenomic World

Jeffrey Conn, Ph.D.

Professor of Pharmacology and Director of the Vanderbilt Institute for Chemical Biology Program in Drug Discovery, Vanderbilt University School of Medicine

The lecture was part of Vanderbilt Medical's Discovery Lecture Series, featuring the nation's most eminent scientists, speaking on the highest-impact research and policy issues in science and medicine today.

Alpha1 Autonomic Receptor Mnemonic

Alpha 1 Adrenergic Autonomic Receptor of the Sympathetic Nervous System presented in a pictorial mnemonic format. Key Point: Alpha1 Constricts. For Medical learning.

The Washington Manual of Medical Therapeutics– April 2010 Edition

Established for over 40 years as the “bible” of the medical ward. The Washington Manual of Medical Therapeutics is now in its Thirty-Third Edition and builds upon that proud tradition–with even more of the current information you need delivered in a time-saving, quick-reference style. Its portability, comprehensiveness, and ease of access makes it a favorite on-call resource for housestaff and faculty around the world. In this edition, color has been added for better navigation, new decision support algorithms have been added, and an improved templated and bulleted format facilitates a quicker answer. With this edition you now have the capability to upload this content to your handheld device and receive updates to the information throughout the activation period. Plus, you have access to eight medical calculators that include: GFR – Cockcroft-Gault Method (Adult); Urea Reduction % (Hemodialysis); Transtubular Potassium Gradient; Osmolal Gap; Anion Gap; Serum Osmolality; Reticulocyte Index; and Body Mass Index (BMI).



http://hotfile.com/dl/59386771/68a336c/washington_manual.chm.html

When man becomes Reddish !!

What is Red man syndrome??
It is an infusion-related reaction peculiar to vancomycin.Typically it consists of pruritus, an erythematous rash that involves the face, neck, and upper torso...............

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Chloroquine-Induced Hair Hypopigmentation

A 16-year-old, blonde-haired patient was evaluated for a new band of lighter-colored hair located approximately 3 cm from the scalp. The patient first noted the change in hair color 1 week after returning from a 2-week vacation in Costa Rica, during which she took chloroquine phosphate for malaria prophylaxis.

Instead of taking 500 mg weekly, the recommended dose for prophylaxis, the patient took 500 mg of chloroquine phosphate daily, starting 1 week before the trip, during the 2 weeks in Costa Rica, and for 1 week after returning home. She had taken the first dose 3.5 months before presentation. Hair hypopigmentation is a rare but reversible side effect of chloroquine.
Although most cases occur after 3 consecutive months of treatment with daily doses of more than 500 mg of the drug, rapid onset is also possible.