: ) .. ( ... ... ... m-172@hotmail.

com
... ...

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Chemotherapy

Anti-Biotic

 : ) .. ( ... ... ... m-172@hotmail.com

Chemotherapy
... ...

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Anti-Biotic

Special Antibiotic

General Antibiotic

) (

) (

1.
2.
3.
4.
5.
6.
7.
8.

Sulfonamides
Penicillins

Antifungal
Antiviral
) ) Anti T.B.
Anti Maralial
Anti Leprosy

Anti Amoedbiasis
anti hilminthiasis
Anti U.T.I

) ) Cephalosporins
) Erythromycins ( Macrolids
) )
Aminoglycosides

Quinolones
Tetracyclines
Chloramphenicol
Lincosamines

1.
2.
)
3.
4.
5.
6.
7.
8.
9.

Classification

According to their Affects

Accrding to their Spectrum

According Mechansim of Action

Bactericidal

Narrow Spectrum
) (
G+ve OR G-ve
----------------------------------------------Broad Spectrum

G+ve AND G-ve
-----------------------------------------------

) Inhibit Cell Wall Synthesis ( B-Lactam

) )
a. penicillins
) )
) ) b. Cephalosporins
----------------------------------------------Nucleic Acid Synthesis

a. Sulfonamides

b. Quinolones
----------------------------------------------Protein Synthesis

a. Tetracyclines
b. Chloramphenicol
c. Aminoglycosides

) D. Erythromycins ( Macrolids
) )

----------------------------------------------Bacteriostatic

-----------------------------------------------

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B-Lactam Antibiotic
... ...

Pencililns

( )

( )
1. Benzyl penicillin :
( Penicillin G ) > I.M & I.V ( not orally )
) ( < ) ( :

( )

smanepabraC

2. Long Acting :
( Penicillin V ) > Durapen & Penadur L.A
) ( < :

3. Broad Spectrum Penicillins :

Effective agenst Gm+ve and Gm-ve

e.g. : Amoxicillin Ampicillin
- :

4. B-Lactamase :
a. Penicillinase Resistant

1. Methicillin
2. Cloxacillin
3. Fluxacillin better absorbed than CLoxacillin

snirposolahpeC

Imipenam ( IPM )

It is B-Lactam

Imipenam + Cilastatin =
( Tienam )
= + :

Use in hospital infection

Frist Generation Cephalosoprins

Cepha + L , D , Z , R
L , D , Z , R + Cepha
1. Cehpalexin ( Keflex )
2. Cephadroxil ( Duricef )
3. Cepharadin
4. Cephalothin
5. Cephazolin

Second Generation Cephalosoprins

Cef + A , U , i , O
A , U , i , O + Cef
1. Cefaclor ( Ceclor )
2. Cefuroxime ( Zinnat )
3. Cefixim ( Suprax )

Third Generation Cephalosoprins

Cef + T
T + Cef
1. Cefotaxime ( Claforan )
2. Ceftriaxone ( Rocephin )

5. B-Lactamase :
a. Penicillinase Inhibitors

+
1. Clavulanic acid + Amoxicillin = Augmentin

Third Generation Cephalosoprins

1. Cefopim ( Maxipim )

2. Sulbactam + Ampicillin = Unasyn

Uses :
1. Respiratory Tract Infection (R.T.I )
2. Urinary Tract Infection ( U.T.I. )
3. Meningitis
) )

Uses :
1. Respiratory Tract Infection (R.T.I )
2. Urinary Tract Infection ( U.T.I. )
3. Antharax

4. Anti Tetanus
5. Gonorrhea

6. Gas Gangrene

 ... m-172@hotmail.com ... ... ( ) .. :

AminoGlycosides
Chloramphenicol
... ...

1431
Macrolids
Antibiotic
( )

- Replace for pencillin

- good for pregnancy

End with ( thromycin )

1.
2.
3.
4.
5.

( thromycin )
Erethromycin
Azithromyci ( Zithromax )
Calrithromycin
roxithromycin
Spiramycin ( Rovamycin )

Uses :
1. Drug choice in Diphtheria

2. Drug choice in Chlamydia ( Neonates &
Pregnancy )

3. Drug choice in Pneumonia

----------------------------------------------------------------------------Adverse effect :
1. Cholestatic Jaundice

( )

End with ( mycin )

1.
2.
3.
4.
5.
6.
7.

Drugs :
( mycin )

Streptomycin
Gentamycin
Kanamycin
Neomycin ( the only Oral )
Netilmycin
Tobramycin
Amikacin

N.B. :
It is not good Oral Bioavailability exept
Neomycin
) )
----------------------------------------------------------------------------Toxicity of AminoGlycosides :
1. Nephrotoxicity
2. Ototoxivity

( )

1. Chloramphenicol
2. Thiaphenicol
Uses :
1. drug choice for Typhoid Fever

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Tetralcycline
Sulfonamides
Trimethprim

1431

( )
End with ( cycline )

start with ( sulpha )

( cycline )

1.
2.
3.
4.
5.

tetracycline
oxytetracycline
chlortetracycline
doxycycline
minocycline

Uses :
1. treatment of Acne
----------------------------------------------------------------------------Adverse effect :

1.

7.
)

8.

Uses :

Sulfacetamid : eye drops

1.

prostatitis

Adverse effect :

N.B. :
It is not good Oral Bioavailability exept
Neomycin
) )

Megaloplastic Anemia
Treatment by : folic acid

----------------------------------------------------------------------------Toxicity of AminoGlycosides :

inhibition growth of bone

1. Nephrotoxicity
2. Ototoxivity

( )

( sulpha )
Sulphamethoxazole ( Bactrin

teeth bone abnormalities

2.

( )

3.
teratogenecity
-----------------------------------------------------------------------------

QUINOLONES &
FLUOROQINOLONES
( )

end with ( floxacin )

3.
4.
5.

6.

( floxacin )
Nalidixic acid ( Nalidram )
Norfloxacin
Ofloxacin

Ciprofloxacin ( not in
pregnancy )

Lincosamines
( )

: Drugs
1.
2.

Lincomycin ( Lincocin )
Clindamycin ( Dalacin c )

Uses :
1. in teeth one infectios

1431
Anti T.B.

... m-172@hotmail.com ... ... ( ) .. :

... ...

Leprosy

( Tuber Celosis )

- Duration treatment from 6-9 months
9 6
- we use 3 4 drugs together
4 3
- First line drugs :

Rifampicin

Isoniazid ( INH )

Pyrazinamide

Treatment of Leprosy ?

- Uses :

Bactericidal

ttt of T.B. with Isoniazid

( I.N.H )

leprosy

- Side Effects :

Orange red discoloration of

all secretions ( urine , sweet ,
saliva )
) )

Neurological symptoms :
headache

Hepatic Microsomal enzyme

inducer
) )
-------------------------------------------------------2. Isoniazid ( I.N.H ) isonicotinci acid

-A:

1.

- Drugs :

3.
4.
5.
6.

Sulphons ( Dapson )
Rifampicin
Clofazimine
Ethionamide

Ethambutol

Cycloserine
- Second line drugs :

Para-amino Salicylic asic

( P.A.S )

Ethionamide
----------------------------------------------------1. Rifampicin :

AntiFungal

2.
3.

- B : End with ( conazole )

1.

2.

Malaria

Nystatin ( Mycostatin )
Amphotericen
Griseofulavin ( oral )

3.
4.
5.

( conazole )
Ketoconazole ( Nizoral )
Fluconazole ( Diflucan )
Itraconazole ( Sporanox )
Clotramazole ( Candestan )
Miconazole

- Transfer by bite ( Female Anopheles )

Treatment of Malaria ?
- Drugs :

Helminthes

Chloroquine first choice in

Acute Attack

Pyrimethamine first choice in

Prophylaxis in endemic area

Quinine
N.B. :
Quinine NOT Quinidine ( anti arrhythmic )

Anti-Amoebiasis

Treatment of Amoebiasis ?
- Drugs :

1.
2.
3.

Metronidazole ( Flagyl )
Tinidazole
Emetine HCL

- Ascaris (round worm ) )

)
End with ( bendazole )
1.
2.

( bendazole)
Mebendazole ( Vermox )
Flubendazole ( Fluvermal )

- Tape worm
6.
Niclosemide ( Yomesan )
7.
Praziqunatel

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... ...

AntiViral

AntiCancer

Gamma Globulin * ( inj )

B-

Amantadine ( Symmetrel ) *
ttt influenza A + Parkinsonism

A anti metabolites :

Methotrexate

Fluorouracil ( 5 Fl.u )

Mercaptopurine

Cytabrin

Cyclophoshamide

Acyclovir ( Zovirax ) ttt

Herpes

Ribavirin ( Virazole )

Zidovudine * ttt HIV

Anti Urinary Tract

Infection (U.T.I )

AntiLesishmania

Sodium Stiboglyconate

Nitrofurantoin

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1431

Respiration

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Respiration
... ...

Bronchial Asthma

Pathology :

Definition :
Allergic chest disase

1. Bronchoconstriction

2. Inflammation > Congestion

3. Thick viscid secretion

Treatment of Bronchial Asthma

Bronchodilators :
1. Selective B2 agonist :

- Salbutamol ( Ventoline )
- Terbutaline
- Hexoprenaline
- Salmetrol
- Formetrol
----------------------------------------2. Anti-Cholinergics :

- Ipratropium Bromid ( Atrovent )
----------------------------------------3. Methyl Xanthine :
- Aminophylline :
slow I.V. injection ( oral , supp )

----------------------------------------Side effect :
Hypotension Rapid

Corticosteroid :
---------------------------------------------------1. Hydrocortisone Sodium Succinate
---------------------------------------------------2. Steroid Aerosols for Inhalation :

End with ( sone )
( sone )
1. Beclomethasone Di Propionate ( Becotid )
2. Budesonide ( Pulmicort )
3. Betamethasone Valerate ( Clenil )
---------------------------------------------------3. Prednisolon
---------------------------------------------------N.B :
Newly Treatment of Bronchila Asthma is :

B2 agonist
+ Inhalation of Cortisone
+

Mast cell stabilizers :

1. Di Sodium Cromoglycate
2. Ketotifen ( Zaditen )

Cough Therapy

Non-productive ( Dry )
) )

Productive Cough

Anti-tussives Drugs :

- Expectorants Drugs :

1. Tincture of
Ipecacuanha ( Emetine )
) )
-----------------------------Mucolytic agent :

1. Bromhexine
2. Acetylcysteine
3. Carbocistene
4. Ambroxol
5. Guaphenesin

1. Morphine
2. Codeine
3. Dextromethorphan

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1431

Central Nervous System

C.N.S

) (

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Sedatives : ttt Anxiety :
... ...

Hypnotics : ttt Wakefulness :

Classification of Hypnotics

1. Barbiturate

1. Barbiturate

End with : barbitone

barbitone :

2. Benzodiazepine

1. long Acting :

2. Benzodiazepine
( BDZ )

End with :
Zepam - Zolam
Zepam - Zolam

Phenobarbitone ( Phenobarbital )

1. long Acting :

3. Chlora Hydrate

4. Paraldehyde

2. Intermediate Acting :

Amobarbitone ( Amylobarbital )

3. Short Acting :

Bentobarbitone
Secobarbitone

2. Intermediate Acting :

Temazepam

3. Short Acting :

5. Thalidomide

Flurazepam
Nitrazepam

4. Ultra Short Acting :

Thiopentone ( Thiopental )
Hexobarbitone

Triazolam

N.B. :

6. Glutethemide

Diazepam

Antidote specific

Flumazenil

BDZ

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Anti Depressant drug... ...

Treatment of Parkinsonism

:
:
nor arenaline Dopamin A.Ch :
( )
) (
noisserpeD fo gurD

Drug of Parkinsonism

1. Levodopa
( L dopa )
2. Carbidopa
( Sinemet )
3. Selegiline

( Deprenyl ) ( Jumex )

4. Bromocriptine
( Parlodel )
5. Amantadine
( Symmetrel ) AntiViral
6. Benzotropine
( Cogentin )

1. Tri cyclic antidepressant ( TCA )

) )
- Imipramine ( Tofranil )
- Clomipramine ( Anafranil )
- Amitriptyline
2. MAOI :
- Phenelzine ( Nordil )
- Nialamide ( Niamide )
- Moclobemide
N. B. :
MAOI not use with milk

3. Atypical ( second generation )
) )
A Selective Serotonin Reuptake
Inhibitors ( SSRI ) :

- Fluoxetine ( Prozac )
- Citalopram ( Cipram )
- Sertraline ( Lustral )
- Fluvoxamine ( Faverin )

- MANIA :
:
:
nor arenaline Dopamin A.Ch
- ttt
Lithium Carbonate ( Prianil )

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Anti - Epilepsy

A Generalized Seizures

B Partial ( Focal ) Seizures

Drug of Anti - Ebilepsy

1. Barbiturate
2. Phenytoin
3. Carbamazepine
( Tereatol )

4. Sodium Valproate
( Depakene )
5. Benzodiazepine
( BDZ )
- Diazepam :
choice in Status epilepticus
- Clonazepam ( Revotril ) :
Choice in Pettmal epilepticus

6. Ethosuximide

Major Tranquillizers
( Anti Schizophrenic )

C.N.S Stimulants

( )
Drug of Parkinsonism
stnalumitS S.N.C fo gurD

1. Thioridazine
( Melleril )

1. Xanthenes
( Caffeine )

2. Haloperidol
( Safenace )

2. Cocaine

3. Clozapine

3. Amphetamine

4. Resperidone
( Respirdal )

4. Lobeline

5. Sulpride

5. Strychnine

( Zyprxia )

Antidote is

I.V.(Mephenesine)

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General & Local

Anesthesia

) (

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General Anesthesia

General Anesthesia

Drug of Inhalation anesthesia

Drug of I.V anesthesia

) )

1. Ethers

1. Ultra Short Acting :

Thiopentone ( Thiopental )
Hexobarbitone

2. Halothane
( Fluothan )

2. Benzodiazepine

3. Isoflourane

3. Ketamine
( ketalar )

(Diazepam )( Lorazepam )

4. Nitrous Oxide
( N2O )

4. Morphine

5. Cyclopropane

5. Fetanly

( Opioid analgesics )

( Opioid analgesics )

End with : Caine

Caine :

1. Cocaine

2. Procaine

3. Lidocaine

Mechanism of Action :
They block Na+ channels

Side effect :
Malignant Hypothermia

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Thyroid Gland

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... ...
Thyroid Gland
Calcitonin Hormone

1431

Thyroxine Hormone

Function :

Function :

1. Control Ca+ Level

1. Metabolism
2. Control Temperature

Disease :

Disease :

1. HypoCalcemia

)1. Myxoedema (Hypo )(Hypothyrodism

: ttt :
) 1. Alendronate ( Fosamax
Also ttt Osteoprosis

: ttt :
) 1. Thyronine Sod ( Etroxin

Disease :
)2. Goiter (Hyper ) (Hyperthyrodism

: ttt :
) 1. Thioamides ( Thiouracils
) 2. Cabemazole ( Neomarcazol

1431

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Diabetes Mellitus
... ...

Type ( I ) : IDDM
Insulin Dependant Diabetes Mellitus
:

- Age < 30 years

30
- Causes :
1. Genetic Factors

Type ( II ) : NIDDM
Non Insulin Dependant Diabetes Mellitus
:

- Age > 40 years

40
- Causes :
1. Obsity
2. Stress
3. Smoking

Insulin Preparation

Oral Hypoglycemic ( NIDDM )

( )

- Keep in Refrigators : ( 2 8 ) C
( 8 - 2 )
- S.C. ( Sub-Cutaneous )

- Regular Insulin Is : S.C. & I.V.

1. Natural Insulin :
- Regular
- It is :
- Clear
- Colorless
- Watary
- Actrapid

2. Modified Insulin :
- Fast Acting : duration ( 12 16 ) hours
( 16 12 ) :
* drug : Semilente :
- Intermediate Acting : duration ( 24 ) hours
( 24 ) : Onec Daily
* drug : Isophan Insulin ( NPH ) :
- Long Acting : duration ( 20 36 ) hours
( 36 20 ) :
* drug :
- Ultralente
- Protamin Zinc Insulin ( PZI )

- Anti dot of insulin is Glucose

or Glucaon Hormone

1. Sulphonylureas

- Frist Generation :
End with : amide
amide :
Tolbutamide
Acetohexamide
Chlorpropamide
- Second Generation :
Start with : Gil
Gil :
Gilbenclamide
( Daonil )
Glipizide ( Minidiab
)

2. Biguanides

- METFORMIN ( Glucophage )
- Appetite

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Male Sex Hormone
Adrenocortial Hormone
... ...
Androgens ( Testosterone )
( Corticosteroids )

Female Sex Hormone

Estrogen & Progesterone

1. Estrogen

- Therapeutic :
1. Development Female
Secondary Sex Charaters

2. Amenorrhea

3. Oral Contraceptive
- Natural Estadiol ( Steroid ) :

Start with : Estr Oestr
Estr Oestr :
Estradiol
monobebzoate
Estriol Valerate
Esterone
- Semisynthetic Estrogen
( Steroidal ) :
Ethinyl Estradiol
Meseranol ( oral
contraception )
- synthetic Non- Steroidal
Estrogen
Dithyl Stilbesterol
Hexoesterol
- Anti Estrogens :
1. Tamoxifen ( Nolvadex ) :
- ttt Estrogen-dependent Cancer

2. Clomiphen Citrate ( Clomid ) :
- ttt Infertility

1. Androgens

- Therapeutic :
1. Male Hypogonadism
( Delayed Puberty )

2. Infertility

- its Secreted from Suprarenal Cortex

- its used as Anti-Inflammatory & Anti-Rheumatic

- used of Cortisol :
1. Addison's Disease

2. Anti-inflammatory in Rheumatic
3. Allergic Disease as ( Bronchial Asthma )
Adverse Effect of Corticosteroids :

- Anti androgens :
- Cyproterone ( Androcur )
Uses :
1. Increase Sexual Ability

2. Hirsutism

Hyperglycemia ( D.M )
Osteoporosis
Retardation of Growth in Children
Oedema
Hypertension
Hypokalemia ( Potassium Loss )
Peptic Ulcer
Glaucoma
Cushing Syndrome

Contraindications of Corticosteroids :

Pituitary Hormone
Oxytocin

1. Oxytocin

- Used for Induction of Labour &

Abortion

- Therapeutic :
1. Uterine Stimulation
) )
2. Labour Induction
3. Mammalian Gland
Stimulation

Diabetes Mellitus

Osteoporosis
Pregnancy
Hypertension
Peptic Ulcer
Digitalis Toxicity
Cushing Syndrome

- Prepeation :
End with : sone , solone
-

sone , solone :
Cortisone
Prednisone
Beclomethasone
Dexamethasone

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Autonomic
Nervous Ssystem
) )

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Sympathetic
... ...

1431

Adrenergic Receptor Stimulation

- 2

) -Pancreas ( Decreas Insuline secretion

) )

- 1
- Vasoconstriction ( V.C. ) to blood
)Vessels (B.V.

- Dopamine

- Vasoconstriction (V.C.) to mucous

)memberane (m.m

) - Active Mydriases ( eye pupil

- 2
2
- Bronchodilatation

- 1
1
) ) - C.N.S.
- Cardiac

:
Stimulation
Agonist
Memetic
Inducer

:
Blocking
Antagonist
lytic
Inhibiton

 ... m-172@hotmail.com ... ... ( ) .. :

1 Stimulation
Blocking
...
...

1431
1 Stimulation
1

1. Nasal Decongestant :
-

Naphazoline
Tetrahydrozoline
Xylometazoline
Phenylephrine
Methoxamine

2. Mydriatic :
- Ephedrine
- Phenylephrine

1. Cadiac Stimulation :
-

1. Hyepertension :

Adrenaline
Isoprenaline
Dopamine
Dobutamine

Selective

2. C.N.S. Stimulation :

- Dphedrine
- Amphetamine
- Methamphetamine

Atenolol
Esmolol
Metoprolol
Acebutolol
Practolol

Non Selective

- Propranolol ( Inderal )
- Nadolol ( Corgard )

NB.

1 Blocking
1

2 Stimulation
2

1. Hyepertension :

- Prazosin ( Minipress )
- terazosin
- Doxazosin

2. Migraine Headache :
- Ergotamine

2. Partum Hemorrhage :
- Ergometrine

- Labetalol and Cavidilol is

Blocers

and

2. Eye ( Glaucoma )

) )

1. Bronchodilators :

- Selective
-

2 agonist :

Salbutamol ( Ventoline )
erbutaline ( Bricanyl )
Salmetrol ( Servent )
Formetrol ( Foradil )

Timolol ( Timoptic )
Betoxolol ( Betoptic )

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:
Parasympatholytics
... ...

1431
ParaSympathetic

Muscarinic ( m )

Nicotinic ( n )

Parasympathomimetics

1. Natural :
* Atropine :

:
2. InDirect parasympathomimetics
Physostigamine
Neostigamine
Pyridostigmine
- end with : stigmine
stigmine :

Uses :

o
o
o
o
o

:
Cholinomimetics
Muscarinic
agonist
Colinoceptive
agonist
:
1. Direct parasympathomimetics
A. Ch
Metacholine
Cabachol
Bethanecol
Pilocarpine ( ttt
Glacoma )
Muscarine

Mechanisum of action : Muscarinic Agonist

Peptic Ulcer
Intestinal Colic
Parkinsonism
Nocturnal enuresis
Pre aneshetic medication to no complications :

Increase respiratory center (R.C) of Morphine

Dicrease Slaivary, Bronchila secretion

Toxicity :

Dry mouth
Tachycardia
Urin retention

1. Synthetic :
* Mydriatics atropine substitute :
Atropien

- End with :

Homatropine
Tropicamide
Eucatropine
tropine

* Anti-Spasmodic :

Hoyscine ( Buscupan )
* Anti-Ashmatics atropine substitute :

Ipratropium ( Atrovent )
* Anti-Parkinsonian atropine substiutue :

Benztropine ( Cogentin )

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Vitamins

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Vitamins

Water soluble Vitamin

Fat or Lipid soluble Vitamin

- its is ( B-complex , C ) :

* Vitamin B-complex :

- its is ( K , E , D , A ) :
- Vit A ( Retinol )

VA daily dose 30.000-50.000 IU

50.000-30.000 :

- Vit B1 ( Thiamine ) 1
ttt of : Beri Beri
- Vit B2 ( Ribo Fluvin )

Correction of Deficiency 100.000200.000IU

200.000-100.000 :

ttt of : Night blindness

- Vit B6 ( Pyridoxine )

ttt of : vomiting of
Pregnancy
) (
- Vit B7 ( Biotin )

- Vit E ( Tocopherols )

it is Antioxidant

- Vit B12 ( Cyanocobalamine )

ttt ot : Anaemia

- Vit D3 ( Cholecalciferol )

osteoprosis

* Vit C ( ascorbic acid )

ttt of :
o
Scurvy
o
Bleeding swollen gums

- Vit K ( Phytomenadion )

ttt of : Bleeding

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C.V.S.
Cardio Vascular System

 ... m-172@hotmail.com ... ... ( ) .. :

gurD evitceleS
General
Drug ...
...

Hypertension

1431

Definition

1. Selective 1 Blockers : 1
- Prazosin ( Minipress )
- terazosin
- Doxazosin
2. Central 2 Agonist : 2
- methyl dopa ( Aldomet )
- Clonidine
* safly Antyhpertension in pregnancy

- Arterial Blood Presure > 140/90

140/90 >

Causes

Salt

Smoking
Stress

3. Vasodilators :
- Hydralazine
- Minodixil
- Na,nitro prussede
4. Angiotensin Converting Enzyme
Inhibitor ( ACEI ) :
* Drugs : end with ( pril )
- Captopril ( Capoten )
- Lisinopril ( Zestril )
- Enalapril
- Perindopril
- Benzapril
* Angiotensin Receptor Blocker :
End with ( sartan )
- Losartan
- Valsartan
- Candesartan
- Telmisartan
* Side effect of ACEI :
Dry irritant
First dose Hypotension

Hyperkalaemia

1. blockers :

Selective 1
- Atenolol
- Esmolol
- Metoprolol
- Acebutolol
- Practolol
Non Selective
- Propranolol ( Inderal )
- Nadolol ( Corgard )

NB.
- Labetalol and Cavidilol is
and Blocers

2. Ca chaneel Blocker :
* Verapamil group :
- Verapamil ( Isoptin )
- Diltiazem ( Altiazem )
* Dihydropyridin group :
End with ( dipine )
- Nifedipine ( Epilat )
- Amlodipin ( Norvasc )
- Nicardipine
- Isradipine
- Nimodipine

3. Diuretics :
* Thiazide Diuretics:
- Chlorothiazide
- Hydrochlorothiazide
* Loop diuretics :
- Frusemide ( Lasix )
- Ethacrynic acid
- Bumetadine
* Carbonic anhydrase inhibitors :
- Acetazolamide ( Diamox )
* K-sparing diuretics :

- Spironolactone ( Aldoactone )
- Triamterene
- Amiloride

Side effects , contraindication :

1. Hypokalmia : decrease K avoid in Digitalis
Toxicity and Hepatic Disease
2. Hyponatremia : decrease Na
3. Hypercalcemia : increase Ca
4. Hyperuticemia : avoid in Gout
5. Hyperglyceamia : avoid in Diabetes Mellitus

6. Hyperlipidemia
7. Fetotoxic : avoid in pregnancy
8. Hypersensitivity reaction : avoid in Renal
Disease and Antibiotic

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Selective Drug
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Congestive Heart Failure

1431

Definition

The fris choice : ACEI

1. blockers :

Selective 1
- Atenolol
- Esmolol
- Metoprolol
- Acebutolol
- Practolol
Non Selective
- Propranolol ( Inderal )
- Nadolol ( Corgard )

NB.
- Labetalol and Cavidilol is
and Blocers

- Cardic Blood out put < Body need

<

2. Inotropic agents :
* Drugs :
- Diogxin
- Digitoxin
- Ouabin
* Toxicities of Digitalis :
1. Nausea
2. vomiting

3. headache

4. Hallucination

5. Bradycardia
< 60 beats/minute 60
72
6. Heart Block

7. Arrhythmias

8. Visual Disturbance

N.B. :
1. Antidote of Digitoxin is Digibind

2. Elimination of Digoxin mainly Kidney

3. Elimination of Digitoxin mainly Liver

2. Ca chaneel Blocker :
* Verapamil group :
- Verapamil ( Isoptin )
- Diltiazem ( Altiazem )
* Dihydropyridin group :
End with ( dipine )
- Nifedipine ( Epilat )
- Amlodipin ( Norvasc )
- Nicardipine
- Isradipine
- Nimodipine

3. Diuretics :
* Thiazide Diuretics:
- Chlorothiazide
- Hydrochlorothiazide
* Loop diuretics :
- Frusemide ( Lasix )
- Ethacrynic acid
- Bumetadine
* Carbonic anhydrase inhibitors :
- Acetazolamide ( Diamox )
* K-sparing diuretics :

- Spironolactone ( Aldoactone )
- Triamterene
- Amiloride

Side effects , contraindication :

1. Hypokalmia : decrease K avoid in Digitalis
Toxicity and Hepatic Disease
2. Hyponatremia : decrease Na
3. Hypercalcemia : increase Ca
4. Hyperuticemia : avoid in Gout
5. Hyperglyceamia : avoid in Diabetes Mellitus

6. Hyperlipidemia
7. Fetotoxic : avoid in pregnancy
8. Hypersensitivity reaction : avoid in Renal
Disease and Antibiotic

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Selective Drug
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Angina Pectoris

1431

1. blockers :

1. Nitrites & Nitrates :

Definition

- Oxygen supply < Cardiac need

<

* Glyceryl Trinitrate ( Nitroglycerin )

( Nitromack )
- The drug Choice for Angina
- its is S.L
* Isosorbide Dinitrate :
- ( Dinitra ) ( Isordil ) ( Effox ) (Isomack)
* Isosorbid Nononitrite :
- ( Monocard )
* Transdermal patches ( Nitroderm TTS )
) )
- its release 5ml / 24h 24 5
N.B. :
Viagra ( Sildenafil citrate ) is
contraindicated with Nitroglycerin

Selective 1
- Atenolol
- Esmolol
- Metoprolol
- Acebutolol
- Practolol
Non Selective
- Propranolol ( Inderal )
- Nadolol ( Corgard )

NB.
- Labetalol and Cavidilol is
and Blocers

2. Ca chaneel Blocker :
* Verapamil group :
- Verapamil ( Isoptin )
- Diltiazem ( Altiazem )
* Dihydropyridin group :
End with ( dipine )
- Nifedipine ( Epilat )
- Amlodipin ( Norvasc )
- Nicardipine
- Isradipine
- Nimodipine

3. Diuretics :
* Thiazide Diuretics:
- Chlorothiazide
- Hydrochlorothiazide
* Loop diuretics :
- Frusemide ( Lasix )
- Ethacrynic acid
- Bumetadine
* Carbonic anhydrase inhibitors :
- Acetazolamide ( Diamox )
* K-sparing diuretics :

- Spironolactone ( Aldoactone )
- Triamterene
- Amiloride

2. Dipyridamol :
- ( Persantin )

Side effects , contraindication :

1. Hypokalmia : decrease K avoid in Digitalis
Toxicity and Hepatic Disease
2. Hyponatremia : decrease Na
3. Hypercalcemia : increase Ca
4. Hyperuticemia : avoid in Gout
5. Hyperglyceamia : avoid in Diabetes Mellitus

6. Hyperlipidemia
7. Fetotoxic : avoid in pregnancy
8. Hypersensitivity reaction : avoid in Renal
Disease and Antibiotic

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Selective Drug
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Anti-Arrhythmic drug

1431

1. blockers :

1. Na channel blockers :
Definition

Quinidine
Procainamide
Lidocaine
Flecainide

NB.
- Labetalol and Cavidilol is
and Blocers

- abnormality in origin or
conduction of impulses from brain

Selective 1
- Atenolol
- Esmolol
- Metoprolol
- Acebutolol
- Practolol
Non Selective
- Propranolol ( Inderal )
- Nadolol ( Corgard )

2. Ca chaneel Blocker :
* Verapamil group :
- Verapamil ( Isoptin )
- Diltiazem ( Altiazem )

1. K channel blockers :
- Amiodarone
- Bretylium
- Sotalol

* Dihydropyridin group :
End with ( dipine )
- Nifedipine ( Epilat )
- Amlodipin ( Norvasc )
- Nicardipine
- Isradipine
- Nimodipine

3. Diuretics :
* Thiazide Diuretics:
- Chlorothiazide
- Hydrochlorothiazide
* Loop diuretics :
- Frusemide ( Lasix )
- Ethacrynic acid
- Bumetadine
* Carbonic anhydrase inhibitors :
- Acetazolamide ( Diamox )
* K-sparing diuretics :

- Spironolactone ( Aldoactone )
- Triamterene
- Amiloride

Side effects , contraindication :

1. Hypokalmia : decrease K avoid in Digitalis
Toxicity and Hepatic Disease
2. Hyponatremia : decrease Na
3. Hypercalcemia : increase Ca
4. Hyperuticemia : avoid in Gout
5. Hyperglyceamia : avoid in Diabetes Mellitus

6. Hyperlipidemia
7. Fetotoxic : avoid in pregnancy
8. Hypersensitivity reaction : avoid in Renal
Disease and Antibiotic

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1431

ANALGESICS

1431

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Non Narcotic Analgesics
Analgesics
... ...

Narcotic Analgesics

Antipyretic Analgesics
Non steroid anti-inflammatory ( NSAIDs )

- Produce stupor, drowsiness and onlonge use they may
cause dependence .

* Classification of Narcotic Analgesics :
:
1. Opium alkaloids : Morphine, Codeine
: ) (
2. Semi Synthetic Morphine :
Di acetyle Morphine ( Heroin )
3. Synthetic Morphine Substitutes :
- Meperidine
- Methadone
- Fentanyl

Morphine

* uses of Morphine :
- Pain relieve ( in sever cardiac pain, cancer and colic )
) )
- Pre anesthetic medication to proveid Analgesis, Sedation
and Decrease Saliva .
* Side effect Toxicity of Morphine :
- Over dose make ( Respiratory depression )
- Urine retention
- Bronchospasme
- Tolerance
* Morphine Antiedote :
Start with : Nal
- Naloxone ( Narcan )
- Naltrexone ( Trexane ) 50mg oral tablets
- Nalorphine

* Mechanism of action of NSAIDs :

- inhibit COX synthesis of Prostaglandins ( PGs )
* Classification of antipyretic analgesics :
- Acetyl Salicylic acid ( Aspirin )
- Paracetamol
- Dipyrone ( Novalgin )
- Ibuprofen , Ketoprofen , Naproxen
- Indol derivatives : Indomethacin , Sulindac , Tolmetin
- Fenamates : Mefenamic acid ( Ponestan )
- Diclofenac : Voltaren , Cataflam
- Piroxicams : Feldene

Salicylates
* uses of Salicylates :
- Antipyritc
- Analgesic
- Common Cold
- Rheumatic fever
- Rheumatiod arthritis
- Chronic gout
- Prophlaxis : ( SD 75-100 mg / day )
100-75 ) )
* Contraidications of Salicylates :

- Favism
- Bleeding tendency : Hemophilia
- Bronchial asthma
- Peptic ulcer

Paracetamol
Side effect and toxicity :
- Hepatotoxic
- ttt by oral ( N-Acetylcysteine )
: ) (
N.B. : Parafoen = Paracetamol + Chlordoxazone
+ = :

N.B. : NSAIDs taken after meal

:
N.B.
- Maximum Dose of : Ibuproven ( 400 , 600 ) = 3200 mg/day ( 8 Tab )
8
- Maximum Dose of : Paracetamol = 4 g/day = 4000mg/day ( 8 Tab )
8
- Maximum Dose of : Diclofenac (50,75,100) = 150 mg/day
- Sumatriptan : used in ttt Migraine headache

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Treatment of Gout

Antihistamine H1 blockers

) )

- Excess Depostion of Uric acid in Joints

- Non Sedating antihistamine :

* Acute Attack :

1.

Astemizole

2.

Cetrazine

a. Colchicine : Specific drug of frist choice

3.

Loratidine ( Claritine )

4.

Terfenadine )

b. if Failed Colchicine give NSADs :

- Indomethacin
- Naproxen
- Sulindac
c. Steroidal anti-inflammatorys drugs :

- ACTH
- Prednisolone
* Prophylaxis :
- Allopurinol ( Zyloric )
[

- Sedating antihistamine :

1.

Chlorpheneramine

2.

Dimenhydrinate ( Dramamine )

3.

Diphenhydramine

4.

Cyproheptadine ( Periactine )

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G.I.T

1431

1431

Treatment of

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... Drug
...
Anti-Emetics Drug
Peptic Ulcers
Anti- Constipation

- Drug therapy :
1. Antacids :
- Sodium bicarbonate ( NaHCO3 )
- Calcium carbonate ( CaCO3 )
- MgO & MgOH ( Milk Magnesia )
- Best combination : Mg(OH)2 & Al(OH)3
2. Antisecretory Drugs :
- Inhibit the secretion of HCL :
a. H2blockers :

- Centrally acting anti-ematics :

- Purgatives as : ) )

1. Hyoscine ( Buscopan )

1. Bisacodyl ( Dulcolax )

2. Anti-Histaminics : Diphenhydramine

2. Lactulose ( Ezilax )

3. Phenothiazines : Chlorpromazine

3. Emodine

4. Metoclopramide ( Primpran , Plasil )

N.B. : Glycerin suppositories in treatment of

constipation

5. Oudanstreon ( Zofran )

3. Mucosal protections :

- Sucralfate
- Pgs : Misoprostol ( Cytotec )
- Colloidal bismuth

6. Domperidone ( Domipi )

- end with : tidine

1. Cimetidine
2. Ranitidine ( Zantac )
3. Famotidine
4. Nizatidine
b. Proton Pump inhibitors :
- end with : prozole
1. Omeprazole
2. Lansoprazole
3. Pantoprazole

Anti- Diarrhea Drug

1. Kaolin ( Kaptin )
2. Pectin
3. Lopermide ( Imodium )
* Oral Rehydrate Solution ( ORS )
Not cure diarrhea
Correct and balance dehydration, acid, base, electrolyte
( NaCL + KCL + Na Citrate + Glucose )

+ 3
( + + + )

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1431

Blood Drugs

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Coagulation
Anti-Bleeding
Anti-Anemic

1431

Blood

Fibrinolytics
) )
- end with : kinase

1.

Streptokinase

2.

Urikinase

Antiplatelet agent
)
)

Vitamin K

1. Phytomendaion = VK1
( Konakion )
2. Menaquinone = VK2
3. Menadione = VK3

) )
Iron Deficiency Anima
( Microcytic Hypochromic )

1. Ferrous sulfare ( Ferrogard )
- antidote : Desferoxamine
- Ferrous Glauconate suitable for Children
* General Side effects of Iron :

1. Nausea
2. Vomiting :
3. Constipation :
4. Oral Solution :
- washable black discoloration of teeth
) )

1.

Aspirin in small dose ( 75/100mg )

2.

Ticklopidine

3.

Dipyridamol ( Presantin )+

Pernicious & Megaloplastic Anima

B12

Anti Coagulants

1.

Ancord

2.

Heparin ( antidot is Protamine sulfate )

( use in Pregnanacy ) +

3.

Warfarin ( antidot is VK1 ) 1

4.

Dicoumarol

5.

Enoxaprine ( Clexan ) inj

1.
Pernicious Anima :
VB 12 + Folic Acid = 12

Never Folic Acid alone
Cynocobalamine VB12
( Cyanocobalamine )
Folic Acid ( Vifolin , Folvite )
N.B. :

Normal Hb in Males = 13.5 15.5 ( 13-16 ) ( 1417 )

16-13) 15.5 13.5 = )
Normal Hb in Females = 12.5 15.5
15.5 12.5 =

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1431

Hyperlipoprateinemia

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Hydroxy-Methyl-Glutaryl
(HMG) CO-A Rdeuctase Inhibitor

Fibric Acid derivatives ( Fibrates )

- end with : vastatin

- with : fibr

1.

Lovastatin

1.

Colifibrate

2.

Pravastatin

2.

Fenofibrate

3.

Servastatin

3.

Gemfibrozil

4.
Simvastatin
( Zocor ) not use for
Pregnancy

Not use in Pregnancy and

Lactation