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DRUGS
DR MARIA KHALIQ
HOUSE OFFICER MU1
HFH
STEROIDS
1.

GLUCOCORTICOID
MODE OF ACTION
Mediated by glucocorticoid receptors
Regulates the transcription of terget gene...
INDICATIONS
Allergic reactions:
Angioneurotic edema,asthma,bee stings,
allergic rhinitis
Collagen vascular disorer:
Rheuma...
Infections:
gram negativwe septicemia
Neurological disorders;
Cerebral edema , multiple sclerosis
Pulmonary disease:
Aspir...
SIDE EFFECTS
Iatrogenic cushing syndrome:
weight gain, muscle wasting, thining
of skin, skin striae, bruising,
osteoprosis...
ulceration,heart disease,hypertention,diabetes,
osteoprosis,glaucoma,herpes simplex infection

2. MINRELOCORTICOIDS:
Aldos...
DIURETICS
1.

CARBONIC ANHYDRASE
INHIBITORS
INDICATIONS:
1. Glaucoma
2. Urinary alkalinization
3. Metabolic Alkalosis
4.Ac...
SIDE EFFECTS:
Hyperchloremic metabolic acidosis
Renal stones
Renal potassium wasting
Hypersensitivity reactions:
Fever, ra...
2.

LOOP OF HENLE:
INDICATIONS
Hyperkalemia
Acute renal failure
Anion overdose
TOXICITY
Hypokalemic Metabolic Alkalosis
Ot...
Allergic Reactions:
Skin rashes, eosinophilia, interstitial
nephritis
CONTRAINDICATIONS:
Used with caution in hepatic cirr...
3. POTASSIUM SPARING
DIURETICS
INDICATIONS:
Useful in state of mineralocorticoid excess:
Conns syndrome, ectopic ACTH
prod...
SIDE EFFECTS:
Hypertkalemia
Hyperchloremic Metabolic Acidosis
Gynecomastia
Acute renal failure
Kidney stones
CONTRAINDICAT...
4. OSMOTIC DIURETICS
INDICATIONS:
To increase volume of urine volume
Reduction of intracranial pressure
Reduction of intra...
HEPARIN
TYPES:
Unfractioned Heparin{Standard}
Low molecular weight Heparin
MODE OF ACTION:
Activates prothrombin to inhibi...
INDICATIONS
ANTICOAGULATION:
Treatment and prevention of DVT
Pulmonary Embolism
Unstable angina
Acute periphral arterial o...
SIDE EFFECTS:
Bleeding
Transient reversible alopecia
Osteoprosis
Spontaneous fractures
Transient thrombocytopenia
CONTRAIN...
Purpura
Severe hypertension
Intracranial hemorrhage
Infective endocarditis
Active tuberculosis
Ulcerative lesions of GIT
T...
ATROPINE
Atropine is a an Anticholinergic and
Antispasmodic
INDICATIONS:
Mydriasis and cycloplegia for examination of
reti...
As pre anesthetic medication to reduce
secretions in upper and lower respiratory tract
Prophylaxis of motion sickness
Urin...
ADVERSE EFFECT
Dry mouth
Xerostomia
Nausea, vomitng, constipation
Urinary retention
Blurred vision
Photophobia
Nervousness...
ADRENALINE
Adrenaline is a sympathomimmetic drug
INDICATIONS
Emergency management of complete heart
block and cardiac arre...
Hypotension:
Due to hypovolemic shock
Cardiac arrythmia
Neurogenic disease
Adverse effects of antihypertensives
Cardiogeni...
Tremors
Palpitations
Headache and restlessness
Pulmonary edema
CONTRAINDICATIONS:
Hypertension
Hyperthyroidism
Ischemic he...
LIGNOCAIN
It is a local anesthetic
MODE OF ACTION:
Blocks activated and inactivated Na channels
INDICATIONS:
Local anesthe...
ADVERSE EFFECTS;
Allergic reactions
Hearing disturbances
Slurred speech
Paresthesia
Convulsions
Sleepiness
Light headednes...
ACE INHIBITOR
ANGIOTENSIN
CONVERTING ENZYME
INHIBITOR





CAPTOPRIL
ENALAPRIL
LISINOPRIL
RAMIPRIL
MODE OF ACTION:
Prevent salt and water retention
Inhibit periphral arterial and venous
vasoconstriction
Inhibit activation...
ADVERSE EFFECTS
Dry cough
Skin rashes
Neutropenia
Hyperkalemia
Postural hypertension
Angioedema
DIGOXIN
MECHANISM OF ACTION:
Inhibits Na_K ATPase resulting in intracellular
Na accumulation resulting in activation of
Na...
INDICATION
Congestive cardiac failure
Atrial fibrillation
Atrial flutter
Paroxysmal atrial tachycardia
AV nodal tachycardi...
ADVERSE EFFECT
Premature ventricular beats
Ventricular tachycardia
Ventricular fibrillation
A V block
Sinus arrythmia
Paro...
CALCIUM GLUCONATE
INDICATIONS:
Hypocalcemia
Chronic calcium defeciency
Rickets
Osteomalacia
Osteoporosis
CONTRAINDICATIONS...
Hypercalciuria
Renal failure
Renal calculi
Galactosemia
ADVERSE EFFECTS
Nausea
Diarrhea
Hypotension
H2 BLOCKER
H2 RECEPTOR
ANTAGONIST





Cimetidine
Ranitidine
Famotidine
Nizatidine
INDICATION
Duodenal ulcer
Benign gastric ulcer
Reflux esophagitis
Zollinger _ Ellison syndrome
prophylaxis of stess ulcer
...
INSULIN
INDICATION
Type 1 diabetes
Type 11 diabetes when hyperglycemia is not
controlled with diet therapy or oral drugs
1...
In emergencies e.g ketoacidosis or surgical
operations
In all IDDM in combinition of intermediate or
long acting insulin
3...
COMPLICATIONS OF INSULIN:
Lipoatrophy or Lipohypertrophy
Insulin resistance
Weight gain
Local allergy
Hypoglycemia
Periphr...
ORAL HYPOGLYCEMIC
DRUGS







SULPHOYLUREAS
BIGUINIDE
ALPHA GLUCOSIDASE INHIBITOR
NON SULPHONYLUREAS INSULIN
STIMUL...
SULPHONYLUREAS
Glibenclamide
Gliclazide
Glimepride
Glipizide
These agents are used in non obese patients of
diabetes
MECHA...
ADVERSE EFFECTS
Hypoglycemia
Hypersensitivity
GIT disturbances
Obesity
Water intoxication and hyponatremia
 BIGUINIDE
Met...
ADVERSE EFFECT
Nausea , vomiting, diarrhea
Lactic acidosis
CONTRAINDICATION
Renal failure
Hepatic insufficiency
Alcoholism...
ALPHA GLUCOSIDASE INHIBITORS
Acarboes
Miglitol
MECHANISM OF ACTION
Inhibits glucose absorption from intestine
Lowers the p...
BRONCHODILATORS
SALBUTAMOL
SALBUTAMOL is a selective Beta 2 agonist
INDICATIONS
Bronchospasm
Status asthmaticus
Uncomplica...
Feeling of tension
Headache
Tachycardia
Periphral vasodilatations
USED WITH PRECAUTION IN:
Hyperthyroidism
Myocardial insu...
BETA BLOCKERS
INDICATIONS
Hypertension
Angina
Arrythmia
Atrial fibrillation
Atrial flutter
Myocardial Infarction
Anxiety a...
NITRATES
ISOSORBIDE DINITRATE
INDICATIONS
Angina prophylaxis
Acute myocardial infarction
Hypertension
CONTRAINDICATION
Hyp...
ADVERSE EFFECTS
Headache
Dizziness
Cerebral ischemia
Weakness
Orthostatic hypotension
Reflex tachycardia
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Drugs 2

  1. 1. DRUGS DR MARIA KHALIQ HOUSE OFFICER MU1 HFH
  2. 2. STEROIDS 1. GLUCOCORTICOID MODE OF ACTION Mediated by glucocorticoid receptors Regulates the transcription of terget genes EXAMPLES Hydro cortisone Cortisone Dexamethasone
  3. 3. INDICATIONS Allergic reactions: Angioneurotic edema,asthma,bee stings, allergic rhinitis Collagen vascular disorer: Rheumatoid arthritis,Temporal arthritis lupus erythemetosis Eye disorders: Acute uveitis,allergic conjunctivitis Gastrointestinal disease: IBD, nontropical sprue
  4. 4. Infections: gram negativwe septicemia Neurological disorders; Cerebral edema , multiple sclerosis Pulmonary disease: Aspiration pneumonia,bronchial asthma sarcoidosis Renal disorders: Nephrotic syndrome Skin diseases: Atrophic dermatitis, dermatosis , xerosis
  5. 5. SIDE EFFECTS Iatrogenic cushing syndrome: weight gain, muscle wasting, thining of skin, skin striae, bruising, osteoprosis, hyperglycemia, diabetes Increased risk of infections Peptic ulceration Psychosis Depression CONTRAINDICATIONS Given with great caution in patients with peptic
  6. 6. ulceration,heart disease,hypertention,diabetes, osteoprosis,glaucoma,herpes simplex infection 2. MINRELOCORTICOIDS: Aldosterone Deoxycorticosterone Fludrocortisone
  7. 7. DIURETICS 1. CARBONIC ANHYDRASE INHIBITORS INDICATIONS: 1. Glaucoma 2. Urinary alkalinization 3. Metabolic Alkalosis 4.Acute mountain sickness
  8. 8. SIDE EFFECTS: Hyperchloremic metabolic acidosis Renal stones Renal potassium wasting Hypersensitivity reactions: Fever, rash, bone marrow suppression, interstitial nephritis.
  9. 9. 2. LOOP OF HENLE: INDICATIONS Hyperkalemia Acute renal failure Anion overdose TOXICITY Hypokalemic Metabolic Alkalosis Ototoxicity Hyperuricemia Hypomagnesemia
  10. 10. Allergic Reactions: Skin rashes, eosinophilia, interstitial nephritis CONTRAINDICATIONS: Used with caution in hepatic cirrhosis , renal failure and congestive heart failure.
  11. 11. 3. POTASSIUM SPARING DIURETICS INDICATIONS: Useful in state of mineralocorticoid excess: Conns syndrome, ectopic ACTH production Useful in Secondary aldosteronism: CCF , hepatic cirrhosis, nephrotic syndrome
  12. 12. SIDE EFFECTS: Hypertkalemia Hyperchloremic Metabolic Acidosis Gynecomastia Acute renal failure Kidney stones CONTRAINDICATIONS: Used with caution with Chronic renal failure and liver disease
  13. 13. 4. OSMOTIC DIURETICS INDICATIONS: To increase volume of urine volume Reduction of intracranial pressure Reduction of intraocular pressure SIDE EFFECTS: Extracellular volume expansion that may complicate CCF, pulmory edema Dehydration and Hypernatremia
  14. 14. HEPARIN TYPES: Unfractioned Heparin{Standard} Low molecular weight Heparin MODE OF ACTION: Activates prothrombin to inhibit procoagulant 11a, V11, 1X, X, X1.
  15. 15. INDICATIONS ANTICOAGULATION: Treatment and prevention of DVT Pulmonary Embolism Unstable angina Acute periphral arterial occlusion In patients of MI to prevent: Coronary reocclusion after thrombolysis Mural thrombosis
  16. 16. SIDE EFFECTS: Bleeding Transient reversible alopecia Osteoprosis Spontaneous fractures Transient thrombocytopenia CONTRAINDICATIONS: Hypersensitivity to heparin Active bleeding Hemophilia Thrombocytopenia
  17. 17. Purpura Severe hypertension Intracranial hemorrhage Infective endocarditis Active tuberculosis Ulcerative lesions of GIT Threatened abortion Visceral carcinoma Advanced hepatic or renal disease
  18. 18. ATROPINE Atropine is a an Anticholinergic and Antispasmodic INDICATIONS: Mydriasis and cycloplegia for examination of retina. Prophylaxis of motion sickness Antidoote in OPC poisoning Parkinsonism Antidote in mushroom poisoning
  19. 19. As pre anesthetic medication to reduce secretions in upper and lower respiratory tract Prophylaxis of motion sickness Urinary urgency caused by minor inflammatory bladder disorder Pain due to spasm of smooth muscles as in biliary colic, intestinal colic, renal colic and peptic ulcer
  20. 20. ADVERSE EFFECT Dry mouth Xerostomia Nausea, vomitng, constipation Urinary retention Blurred vision Photophobia Nervousness CONTRAINDICATION Angle closure glaucoma Urinary retention Paralytic ileus
  21. 21. ADRENALINE Adrenaline is a sympathomimmetic drug INDICATIONS Emergency management of complete heart block and cardiac arrest Anaphylaxis Bronchospasm Chronic orthostatic hypotension
  22. 22. Hypotension: Due to hypovolemic shock Cardiac arrythmia Neurogenic disease Adverse effects of antihypertensives Cardiogenic shock Combined with local anesthesia to prolong duration of infiltration of nerve block ADVERSE EFFECT: Anxiety
  23. 23. Tremors Palpitations Headache and restlessness Pulmonary edema CONTRAINDICATIONS: Hypertension Hyperthyroidism Ischemic heart disease Cardiac arrythmias
  24. 24. LIGNOCAIN It is a local anesthetic MODE OF ACTION: Blocks activated and inactivated Na channels INDICATIONS: Local anesthetics Antiarrythmic in Ventricular fibrillation and tachycardia
  25. 25. ADVERSE EFFECTS; Allergic reactions Hearing disturbances Slurred speech Paresthesia Convulsions Sleepiness Light headedness
  26. 26. ACE INHIBITOR ANGIOTENSIN CONVERTING ENZYME INHIBITOR     CAPTOPRIL ENALAPRIL LISINOPRIL RAMIPRIL
  27. 27. MODE OF ACTION: Prevent salt and water retention Inhibit periphral arterial and venous vasoconstriction Inhibit activation of sympthatic system INDICATIONS: Congestive cardiac failure Hypertension
  28. 28. ADVERSE EFFECTS Dry cough Skin rashes Neutropenia Hyperkalemia Postural hypertension Angioedema
  29. 29. DIGOXIN MECHANISM OF ACTION: Inhibits Na_K ATPase resulting in intracellular Na accumulation resulting in activation of Na_Ca channels causing increase in intracellular Ca increasing force of contraction Positive ionotropic effect Increases refractory period of AV node
  30. 30. INDICATION Congestive cardiac failure Atrial fibrillation Atrial flutter Paroxysmal atrial tachycardia AV nodal tachycardia CONTRAINDICATIONS Cardiac temponade Constrictive pericarditis Hypertrophic obstructive cardiomyopathy Ventricular fibrillation Ventricular tachycardia
  31. 31. ADVERSE EFFECT Premature ventricular beats Ventricular tachycardia Ventricular fibrillation A V block Sinus arrythmia Paroxysmal and non paroxysmal atrial tachycardia Anorexia,nausea,vomiting and diarrhea Headache, fatigue, malaise, hallusinations
  32. 32. CALCIUM GLUCONATE INDICATIONS: Hypocalcemia Chronic calcium defeciency Rickets Osteomalacia Osteoporosis CONTRAINDICATIONS: Hypercalcemia
  33. 33. Hypercalciuria Renal failure Renal calculi Galactosemia ADVERSE EFFECTS Nausea Diarrhea Hypotension
  34. 34. H2 BLOCKER H2 RECEPTOR ANTAGONIST     Cimetidine Ranitidine Famotidine Nizatidine
  35. 35. INDICATION Duodenal ulcer Benign gastric ulcer Reflux esophagitis Zollinger _ Ellison syndrome prophylaxis of stess ulcer ADVERSE EFFECTS Drug interactions Skin rashes Headache
  36. 36. INSULIN INDICATION Type 1 diabetes Type 11 diabetes when hyperglycemia is not controlled with diet therapy or oral drugs 1. ULTRASHORT ACTING INSULIN 2. SHORT ACTING OR REGULAR INSULIN Indications: New cases of diabetes with dehydration and or ketoacidoses
  37. 37. In emergencies e.g ketoacidosis or surgical operations In all IDDM in combinition of intermediate or long acting insulin 3. INTERMEDIATE ACTING INSULIN Indicated in stable patients usually mixed with regular insulin 4. LONG ACTING INSULIN
  38. 38. COMPLICATIONS OF INSULIN: Lipoatrophy or Lipohypertrophy Insulin resistance Weight gain Local allergy Hypoglycemia Periphral edema
  39. 39. ORAL HYPOGLYCEMIC DRUGS       SULPHOYLUREAS BIGUINIDE ALPHA GLUCOSIDASE INHIBITOR NON SULPHONYLUREAS INSULIN STIMULATION PHENYLALANINE DERIVATIVE THIAZOLIDINEDIONS
  40. 40. SULPHONYLUREAS Glibenclamide Gliclazide Glimepride Glipizide These agents are used in non obese patients of diabetes MECHANISM OF ACTION Improves early phase of insulin release Reduce periphral resistence to insulin actions Reducing hepatic release of glucose 
  41. 41. ADVERSE EFFECTS Hypoglycemia Hypersensitivity GIT disturbances Obesity Water intoxication and hyponatremia  BIGUINIDE Metformin MECHANISM OF ACTION Reduces hepatic gluconeogenesis Slows down glucose absorption from GIT
  42. 42. ADVERSE EFFECT Nausea , vomiting, diarrhea Lactic acidosis CONTRAINDICATION Renal failure Hepatic insufficiency Alcoholism Cardiac failure Respiratory Insufficiency
  43. 43. ALPHA GLUCOSIDASE INHIBITORS Acarboes Miglitol MECHANISM OF ACTION Inhibits glucose absorption from intestine Lowers the postprandial hyperglycemia ADVERSE EFFECTS Flatulence, abdominal bloating and diarrhea 
  44. 44. BRONCHODILATORS SALBUTAMOL SALBUTAMOL is a selective Beta 2 agonist INDICATIONS Bronchospasm Status asthmaticus Uncomplicated premature labour ADVERSE EFFECTS Fine tremors
  45. 45. Feeling of tension Headache Tachycardia Periphral vasodilatations USED WITH PRECAUTION IN: Hyperthyroidism Myocardial insuffeciency Angina Hypertension
  46. 46. BETA BLOCKERS INDICATIONS Hypertension Angina Arrythmia Atrial fibrillation Atrial flutter Myocardial Infarction Anxiety and tremor Obstructive cardiomyopathy
  47. 47. NITRATES ISOSORBIDE DINITRATE INDICATIONS Angina prophylaxis Acute myocardial infarction Hypertension CONTRAINDICATION Hypotension Marked anemia Cerebral haemorrhage
  48. 48. ADVERSE EFFECTS Headache Dizziness Cerebral ischemia Weakness Orthostatic hypotension Reflex tachycardia

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