Pharmacology. 48

#Endocrine_Pharma ■ E/W Hypoglycemia occurs in pts with renal and liver diseases = - b/c no insulinase enzymes in these pts = insulin not degraded = ⬆️ half life

#Endocrine_Pharma ■ E/W long acting insulin is not preferred = - due to delayed onset and no control of postprandial hyperglycemia and causes long duration hypoglycemia

#Endocrine_Pharma ■ E/W insulin is mainly given Subcutaneously = - b/c it replicate normal insulin secretion and replace Basal and Prandial secretion

#Endocrine_Pharma ■ E/W insulin used to treat Hyperkalemia = - b/c it increases the cellular uptake of potassium

#Endocrine_Pharma ■ E/W Glucosidase inhibitors (Acarbose & Meglitol ) are contraindicated in pt with inflammatory bowel disease = - b/c they cause ⬇️ CHO absorption and accumulation in colon which cause flatulence, GIT upset and worsing the disease

للتوضيح: المريض هنا عنده نقص ف توصيل الأكسجين للانسجة يعني الlactic acidosis تصيرلهم بسهولة والدواء يسبب في lactic acidosis عشان هكي Contraindicated

#Endocrine_Pharma ■ E/W Metfomin is contraindicated in pt with Pulmonary disease and heart failure = - b/c these pts are predisposed to lactic acidosis

#Endocrine_Pharma ■ E/W Sulfonylurea causes 2ndry pancreatic failure = - b/c it increases insulin secretion from pancreatic cells leads to exhaustaion of insulin stores

#Endocrine_Pharma ■ E/W Sulfonylurea not used in Type I DM = - b/c its mechanism of action depends on presence of functioning Beta cells

#Blood_Pharma ■ E/W Fibrinolytics should be followed by anti coagulants and anti Plt = - b/c when clot dissolves, local thrombin increases lead to plt aggregation and thrombosis

#Blood_Pharma ■ E/W Warfarin is not preferred for using ? - Narrow TI - Delayed onset of action - Requires routine monitoring - Drug-drug interactions

#Blood_Pharma ■ E/W Warfarin has delayed onset of action = - Due to its mechanism of action that inhibit Vit k epoxide reductase required for synthesis of factor 10. 9. 7. 2 شغله ع مستوى تصنيع بروتينات، مفعوله يطول ما يبدا

#Blood_Pharma ■ E/W hydroxycobalamin is preferred in ttt = ((2 slowly and 2 more )) - slowly absorbed - more bound to plasma proteins - slowly excreted - more sustained rise in serum cobalamin

#GIT_Pharma ■ E/W PPIs are 1st choice but they have short t1/2 = - b/c they irreversibly inhibit proton pump and at least 18hrs required for synthesis of new pump

#CVS_Pharma Explain why we use Na nitroprusside only in severe cases of Hypertension??? Because it has short duration of action and it will lead to Cyanide toxicity

#CVS_Pharma Explain why we prefer low dose thiazide over high dose??? Because it will lead to metabolic side effects

Because They reduce intraglomerular pressure by inhibiting AgII mediated efferent arteriolar vasoconstriction and reduce proteinuria

#CVS_Pharma Explain Why ACEIs & ARBs are Preferred in Diabetics and in patients with Nephropathy???

#Autacoids ● E/W ACE inhibitors are contraindicated in pts with Bilateral renal aretery stenosis ? - b/c in this condition angio II constrict eff arteriole more than aff to maintain GFR, ACE inhibitors remove this effect result in fall in GFR

#Lab_of_Pharma Drug interactions experiment = مهم - study effects of enzyme inducers & inhibitors on Hexobarbitone action (sedative) - animal used = Female Rat - the effect to be studied = sleeping time ● Hexo + Cimetidine = potentiation reaction (⬆️ sleeping time) ● Hexo + Phenobarbitone = antagonism (⬇️ sleeping time) ● Phenobarbitone then immediately Hexo = additive (⬆️⬆️ sleeping time)