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  1. #1

    عضو فعال


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    مراجعة فارماكولوجى للخريجين

    السلام عليكم ورحمة الله وبركاته
    إن شاء الله سوف أنقل لكم بعض تلخيصات الفارما لخريجى صيدلة والموضوع منقول للأمانة من مواقع أخرى نبدأ الآن باسم الله:



    The autonomic nervous sysyem
    Anatomy
    I-Efferent neurons
    Carries nerve impulses from the CNS to the effector organs by way
    of 2 types of efferent neurons

    a) a preganglionic neuron
    Its cell body located within the CNS
    Emerge from the brain stem or the spinal cord
    Make a synaptic connection in ganglia which act as arelay station between the preganglionic neuron and the postganglonic neuron

    b) a postganglionic neuron
    Its cell body originating in the ganglia
    Terminates on effector organ such as
    Smooth muscle of the viscera
    Cardiac muscle
    Exocrine glands

    II- Afferent neurons
    are important in the reflex regulation of this system
    ex: sensing pressure in the carotid sinus and aortic arch and signaling the CNS to influence the efferent branch of the system to respond
    Sympathetuc neurons

    The preganglionic neurons of sympathetic system
    Come from thoracic and lumber regions of the spinal cord
    Synapse in 2 cord-like chains of ganglia that run parallel on each side of the spinal cord
    Axons of the postganglionic neurons extend from these ganglia to glands & viscera

    Special case : (The adrenal medulla) : acts like the sympathetic ganglia
    a)receives preganglionic fibers
    b)lacking axons
    c) if stimulated,it secretes the hormone(epinephrine= adrenaline) + less amount of norepinephrine which influence other organs
    Parasympathetic neurons

    The preganglionic fibers
    arise from the cranial and sacral areas of the spinal cord
    synapse in ganglia near the effector organs
    In both : postganglionic fibers extend from the ganglia to the effector organs

    Function of the sympathetic system
    Not essential for life
    Has the property of adjusting in response to stressful situations such as
    trauma - fear - hypoglycemia - cold - exercise

    Effects of stimulation of the sympathetic devision
    increase heart rate
    increase blood pressure
    mobilize energy stores in the body
    increase blood flow from the skin to skeletal muscles and heart
    diverting flow from the skin and internal organs
    stimulation of the pupils and bronchioles
    i.e : Fight &Flight response due to
    Direct sympathetic response
    Stimulation of adrenal medulla to release epinephrine and norepinephrine

    Functions of the parasympathetic system
    Essential for life
    Maintain essential body functions
    Usually acts to oppose or balance the actions of the sympathetic division
    It is a dominant over the sympathetic division in rest & digest stimulation
    Affect specific organs such as stomach and eye

    Innervation by the autonomic nervous system

    I- dual innervation

    Most organs in the body are innervated by both divisions
    'ex : the heart has
    a) vagal parasympathetic innervation which slows the rate of contraction
    b) sympathetic innervation speeds contraction
    c)the vagus is the predominant controlling factor for rate

    II- Organs receiving only sympathetic
    examples
    Adrena medulla
    Kidney
    Pilomotor muscle
    Sweat glands
    N.B :the control of blood pressure is also mainly a sympathetic activity
    Neurotransmitters

    Cholinergic and adrenergic neurotransmitters are the primarily chemical signals in the autonomic nervous system
    The autonomic nerve fibers can be classified into 2 groups based on the chemical nature of the neurotransmitter released

    Acetyl choline
    Released from the preganglionic neurons in
    both parasympathetic and sympathetic
    in adrenal medulla
    in neuromuscular junction

    Norepinephrine & epinephrine
    In sympathetic.it is released from the postganglionic neurons to the
    effector organs

    يتبع إن شاء الله



  2. #2

    مشرفة سابقة


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    رد: مراجعة فارماكولوجى للخريجين

    أميرة بدينها

    جزيتِ خيرا أخيتي
    ونفع الله بكِ
    هذا لا ينفع الخريجين فقط
    بل ايضا يقدم المادة للطلبة بصورة عامةحتى يسهل عليهم
    ننتظر جديدكِ ونورتِ قسمنا

  3. #3

    عضو فعال


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    جزاك الله خيرا أختى الكريمة ونفع الله بك وسدد خطاك على هدى النبى صلى الله عليه وسلم

  4. #4

    عضو فعال


    تاريخ التسجيل : Mar 2009
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    رد: مراجعة فارماكولوجى للخريجين

    Introduction to pharmacology

    I- Routes of drug administration : 2 major routes
    A- Enteral
    Oral
    the most common route
    the most variable mode in amount of drugs reach the target tissues
    some drugs are absorbed from the stomach
    most drugs are absorbed from the duodenum
    most drugs absorbed from GIT enter the portal circulation and encounter the liver before they are distributed in the general circulation
    first pass ****bolism by intestine or liver limits the efficacy of many drugs when taken orally

    Sublingual
    the drug diffuses to the systemic circulation directly

    Rectal
    fifty percntage of the drug bypass the portal circulation
    Useful if the drug
    destructed by the intestinal enzymes
    destructed by the low pH of the stomach
    induce vomitting or the patient himself is vomitting
    B- Parenteral
    I.V
    the most common parenteral route
    drugs avoid first pass ****bolism
    permit a rapid effect
    permit the maximal degree of control over the circulating levels of drug
    the rate of infusion must be carefully controlled

    I.M
    main route used for depot preparations which dissolves slowly providing a sustained dose over an extended period of time
    used also for many aquous solutions of drugs

    S.C
    as I.M it requires absorbtion
    slower than I.V
    minimizes the risks associated with I.V injections
    Others
    Inhalation
    provides rapid delivery of drug producing rapid effect almost as that of I.V
    Intranasal e.g salmon calcitonin used in osteoporosis
    Intrathecal e.g methotrexate in leukemia
    Intraventricular
    Topical when local effect of the drug is required
    Transdermal e.g nitroglycerine when used as antianginal




    II- Absorbtion of drugs

    the transfer of a drug from its site of administration to
    blood streem
    the rate and the efficiency of absorbtion depend on the route of administration so in

    I.V : Complete absorbtion
    Other routes : partial absorbtion which lowers the bioavailability

    A- Transport of drugs from GIT

    depending on their chemical properities drugs may be absorbed from GIT by


    Passive diffusion
    Active transport


    B- physical factors influencing absorbtion

    blood flow to the absorbtion site
    total surface area available for absorbtion
    contact time at the absorbtion surface


    III-Bioavailability

    the fraction of administerd drug that reaches the systemic circulation in a chemically unchanged form

    ex : if 100 mg of the drug is administrated orally and 70 mg of this drug is absorbed unchanged ..the bioavailability is 70%

    Factors that influence bioavailability

    first pass hepatic ****bolism
    solubility of the drug
    chemical instability
    the nature of the drug formulation


    IV-Drug distribution

    the process by which a drug reversibly leaves the blood stream and enters the interstitium (extracellular fluid) and/or the cells of tissues

    Factors affect drug distribution

    A- blood flow

    B- capillary permeability which determined by

    Capillary structure
    ex : blood brain barrier : lipid soluble drugs readily penetrate to the CNS since they can dissolve in the membrane of its endothelial cells but ionized or polar drugs generally fail to enter the CNS

    Drug structure

    Binding of drugs to proteins

    reversible binding to plasma proteins sequesters drugs in a non diffusible form and slows their transfer out of the vascular compartment



    V-Binding of drugs to plasma proteins

    Usually albumin

    bound drugs are pharmacologically inactive ...only the free unbound drug can act on target sites in the tissues and elicit a biological response
    so hypoalbunemia may alter the level of free drug

    A- Binding capacity of albumin

    binding of drugs to albumin is reversible
    albumin may show

    Low capacity : one drug molecule per albumin molecule
    High capacity : a number of drug molecules per single albumin molecule

    albumin has the strongest affinity for anionic drugs(weak acids) and hydrophobic drugs

    most hydrophilic drugs and neutral drugs do not bind to albumin

    many of drugs are hydrophobic by design since this property permits absorbtion after oral administration

    B- Competition for binding between drugs & clinical imprtance of drug displacement

    ex : Tolbutamide is normally 95% bound and only 5% free so 95% is inert in its pharmacological action

    sulfonamid with higher affinity for albumin if adminiserd it displaces tolbutamide and now 100% of tolbutamide become free in plasma

    but note that.... the tolbutamide concentration does not remain elevated since the drug moves out of the plasma into the interstitial fluid and avhievs new equilibrium


    VI- Drug ****bolism

    drugs are most often eleminated by biotransformation and/or excretion into the urine or bile

    The liver is the major site for drug ****bolism

    Specific drugs may undergo biotransformation in other tissues

    some agents are initially administerd as inactive compounds(prodrugs) and must be ****bolized to thir active forms


  5. #5

    مشرفة عامة سابقا


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    جزاكم الله خيرا ً

    هل ستتناولي أهم الأدوية المتداولة ؟؟؟؟

    اليوزيز والمود اوف اكشن والسايد افيكت ؟؟؟

  6. #6

    عضو فعال


    تاريخ التسجيل : Mar 2009
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    رد: مراجعة فارماكولوجى للخريجين

    السلام عليكم ورحمة الله وبركاته
    إن شاء الله هيكون الكلام عن مرض معين مثلا ال بيصيب الجهاز التنفسى والادوية المستخدمة وإن شاء الله أحاول أجيبلك
    mode of action
    side effect
    وإن شاء الله يعيننى الله على ذلك

  7. #7

    مشرفة سابقة


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    moslma lillah غير متواجد حالياً

    رد: مراجعة فارماكولوجى للخريجين

    وعليكم السلام ورحمة الله وبركاته
    بارك الله فيكِ اختنا
    هل انتي دكتورة ؟

  8. #8

    عضو فعال


    تاريخ التسجيل : Mar 2009
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    رد: مراجعة فارماكولوجى للخريجين

    السلام عليكم ورحمة الله وبركاته
    دى محاضرات فارما شرح جزء AUTONOMIC إن شاء الله تستفيدوا منها
    ويا رب تكون الروابط صحيحة

    http://hotfile.com/dl/103493045/3038c46/Autonomic.1.Dr.Said.Abd.Elhady.mp3.html
    http://hotfile.com/dl/103493655/0654856/Autonomic.2.Dr.Said.Abd.Elhady.mp3.html
    http://hotfile.com/dl/103494362/d622a0e/Autonomic.3.Dr.Siad.Abd.Elhady.mp3.html

    http://hotfile.com/dl/103501147/a967b7b/Autonomic.4.Dr.Said.Abd.Elhady.mp3.html

  9. #9

    عضو فعال


    تاريخ التسجيل : Mar 2009
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    رد: مراجعة فارماكولوجى للخريجين

    Drugs affecting the cardiovascular system
    Treatment of congestive heart failure CHF

    I- Overview of congestive heart failure CHF

    it is a condition in which the heart is unable to pump sufficient blood to meet the needs of the body
    it can be caused by
    impaired ability of the cardiac muscle to contract
    an increesed work load imposed on the heart

    CHF is accompanied by abnormal increase in blood volume and interstitial fluid
    the heart,veins,and capillaries therefore generally dilated with blood.Hence,the term (Congestive) heart failure

    Underlying causes of CHF

    arteriosclerotic heart disease
    dilated cardiomyopathy
    congential heart disease
    valvular heart disease
    left systolic dysfunction secondary to coronary artery disease is the most common cause of CHF

    The therapeutic goal for CHF is to increase cardiac output

    Three classes of drugs have been shown to be clinically effective in reducing symptoms and prolonging life
    Vasodilators: reduce the load on the myocardium
    Diuretic agents : decease extracellular fluid volume
    Inotropic agents : increase the strength of contraction of
    cardiac muscle

    these agents
    relieve the symptomps of cardiac insufficiency
    do not reverse the underlying pathologic condition

    Drugs that may preciptate or exacerbate CHF so should be
    avoided as possble

    non steroidal antiinflammatory drugs
    alcohol
    B blockers
    calcium ghannel blockers
    some antiarrythmic drugs


    II- Vasodilators
    In CHF,the impaired contractile function of the heart is exacerbated by compensatory increase in preload and afterload

    Preload
    the volume of blood that fills the ventricle during diastole
    elevated preload causes overfilling of the heart which increases the work load
    Afterload
    the pressure that must overcome for the heart to pump blood into the arterial system
    elevated afterload cause the heart to work harder to pump
    blood into the arterial system

    Vasodilators are useful in reducing excessive preload and afterload as follow
    dilation of veinous blood vessels increases the venous capacitance by which a decrease in preload occurs
    arterial dilators reduce systemic arteriolar resistance by which a decrease in afterload occurs

    Classes of vasodilators

    A- Angiotensin convertizing enzyme (ACE) inhibitors
    ex : captopril - lisinopril - enalapril

    Adverse effects

    postural hypotension
    renal insuffeciency
    persistant dry cough
    should not be used in pregnant women

    B - Direct smooth muscle relaxants
    ex: hydrazaline - isosorbide - sodium nitroprusside

    III - Diuretics
    ex : bu****nide - furosemide - hydrochlorothiazide

    relieve pulmonary congestion and peripheral edema
    useful in reducing the symptoms of volume overload
    Thiazide diuretics are relatively mild diuretics and lose efficacy if patient creatinine clearance is less than 50 ml/min
    Loop diuretics are used in patients with renal insuffiency
    Overdoses of loop diuretics can lead to profound hypovolemia

    IV- Inotropic agents

    positive inotropic agents enhance cardiac muscle contractility
    and increase cardiac output

    although these drugs act by different mechanisms ,in each case the inotropic action is the result of an increased cytoplasmic calcium concentration that enhances the contractility of the cardiac muscle

    A-Cardiac glycosides(Digitalis)=digoxin &digitoxin

    digoxin(lanoxin) is the most widely used agent

    Therapeutic uses

    digoxin is indicated in patients with severe left ventricular systolic dysfunction after initiation of diuretic and vasodilation therapy
    not indicated in patient with diastolic or right sided heart failure
    patients with mild to moderate heart failure will often respond to treatment with ACE inhibitors and diuretics and do not require digoxin

    N.B. The digitalis glycosides show only a small difference between a therapeutically effective dose and doses that are toxic or even fatal i.e. have low therapeutic index

    Factors predisposing to digitalis toxicity

    a) Electrolytic disturbances

    hypokalemia can preciptate serious arrythmia
    reduction of serum K levels is most frequently observed in patients receiving thiazide or loop diuretics
    hypokalemia can be usually prevented by use of a K sparing diuretics or supplementation with potassium chloride
    hypercalcemia and hypomagnesemia also predispose to digitalis toxicity

    b)Drugs

    Quinidine : can cause digitalis toxicity by
    displacing digitalis from plasma protein binding sites
    competing with digitalis for renal excretion
    Verpamil(isoptin) : displace digitalis from( PPBS) and can increase digoxin levels by 50 to 75% which may require a reduction in the dose of digoxin

    c)Others

    potassium depleting diuretics
    corticosteroids
    hypothyrodism
    hypoxia
    renal failure
    myocarditis

    B- B adrenergic agonists
    ex : dobutamine

    improves cardiac performance by both
    positive inotropic effects

    vasodilation
    must be given by I.V. infusion and is primarily used in the
    treatment of acute heart failure in hospital setting

    C- Phosphodiesterase inhibitors : not used clinically
    thanks






    منقول لأمانة
    وياريت لو فيه أى خطأ يتم تصحيحه
    ول عنده معلومة ياريت يضيفها

  10. #10

    عضو مجتهد


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    ربنا يبارك في حضرتك
    اشكرك جدا واقول جزاكي الله خيرا لحاجتي لهذا الجهد اسال الله ان يكون مباركا
    بوركتي

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