Pharmacology. 48

#CNS_Pharma Explain why Tolcapone is replaced by Entacapone??? Because Tolcapone cause hepatotoxicity

#CNS_Pharma E/W low protein diet is advised in Parkinson disease patient؟؟ _Because high protein diet decreases absorption of L-dopa .

#CNS_Pharma E/w we use non ergot preferred than ergot ؟؟ _Because ergot alkaloid causes vasoconstriction , urine retraction and stimulate of central dopamine receptor

#CNS_Pharma E/W used Rsagline better than Selegiline ؟ _Rsagline is not metabolized to amphetamine like substances = not cause sleep disturbances and hallucinations

#CNS_Pharma E/W D-D interaction L-dopa and vit.B6 (Pyridoxine) ؟؟ Enhances the activity of the dopa-decarboxylase and increase the peripheral metabolism of L-dopa this may prevent the therapeutic effect of L-dopa.

#Endocrine_Pharma ■ E/W Antibiotics causes failure of Contraception = - b\c contraceptive estrogen needs enzymes of intestinal bacteria to convert it to parent drug, and antibiotics kill bacteria

#Endocrine_Pharma ■ E/W rifampicin is contraindicated during oral contraception = - b/c it's enzyme inducer and decrease the contraception efficacy

#Endocrine_Pharma ■ E/W natural sex hormones are not used clinically = - b/c they undergo extensive first pass metabolism

#Endocrine_Pharma ■ E/W Progestins used in threatened abortion = - b/c of their effect to induce uterine relaxation that delay labor

#Endocrine_Pharma ■ E/W Calcifediol (inactive vit D) is Contraindicated in pt with renal disease = - b/c it requires activation by kidney Hydroxylase

#Endocrine_Pharma ■ E/W Cinacalcet is contraindicated in pt with Ca less than 8.4mg/dl = - b/c this drug ⬆️ sensitivity of parathyroid Ca-sensing receptor to decrease PTH secretion and bone resorption

#Endocrine_Pharma ■ E/W Alendronate is taken while sitting & with full glass of water = - b/c Gastric and esophageal irritaion are common side effects

#Endocrine_Pharma سؤال مميز ■ E/W Ketoconazole (antifungal) used in management of Cushing syndrome = - b/c of its effect to decrease adrenal and gonadal steroid synthesis

#Endocrine_Pharma ■ E/W steroids used in Hypercalcemia = - b/c they ⬇️ activation of Vit D leads to ⬇️ Ca absorption in GIT

#Endocrine_Pharma ■ E/W steroids are used in Cerebral edema = - b/c they prevent passage of fluid and cells out of capillaries

#Endocrine_Pharma ■ E/W IM Betamethasone used for pregnant suspect premature delivery = - b/c induce lung maturity in fetus by acting as a surfacant

#Endocrine_Pharma ■ E/W IV Hydrocortisone used in thyroid storm = هنا تذكر الBenefits - Protect from shock - Prevent conversion of T4 to T3 - Rapidly reduce thyroactive material levels

#Endocrine_Pharma ■ E/W Propylthiouracil preferred in pregnancy = - b/c it's strongly protein bound so less crosses the placenta

■ E/W Methimazole preferred over Propythiouracil = - b/c it has lower risk of serios liver injury and can be given daily

#Endocrine_Pharma ■ E/W IV T3 not preferred in ttt of myxodema coma = - b/c can be cardiotoxic and more difficult to monitor