Showing posts with label Essential drugs. Show all posts
Showing posts with label Essential drugs. Show all posts

Antihypertensives, immunosuppressants and medications used in palliative care. Cyclosporine. Dexamethasone. Hydrocortisone. Prednisolone. Tamoxifen

Immunosuppressive drugs:

- Azathioprine, cyclosporine

Cytotoxic drugs:

  • Asparagine, Blyomycin, Calcium Folate, Chloramposyl, Clormethine, Cisplatin, Cyclophosphamide, Cetarapine, Dakarpazine, Dactinomycin, Downorubicin, Doxorubicin, Etoposide, Fluorouracil, Levamisol, Merkaptopurine, Methotrexate, Procarbazine, Phenplastin, Fincristine.
  • Hormones and Antihypertensives:
  • Dexamethasone, hydrocortisone, prednisolone, tamoxifen

Palliative care medications:

The World Health Organization (WHO) Expert Committee on the Use of Essential Medicines recommended that all medicines listed in the Bulletin of the World Health Organization "Eradication of Cancer Pain" with the "Guide to Opium Availability", second edition, are essential. The drugs are listed in the relevant sections of the Model List, according to their therapeutic uses, such as analgesics.

Antihypertensive drugs

1- Therapeutic strategy:

It depends on the intensity of the blood pressure, its repercussions and the overall cardiovascular risk.

2- Choice of antihypertensive classes:

The five classes of antihypertensives that have been shown to be effective in cardiovascular prevention may be offered as first-line therapy for uncomplicated essential hypertension.
The five classes of antihypertensives that have been shown to be effective in cardiovascular prevention are:
  • diuretics;
  • beta-blockers;
  • Calcium channel inhibitors, especially dihydropyridines;
  • the converting enzyme inhibitors (IEC);
  • Angiotensin II receptor antagonists (ARAII).
  • When initiating treatment with ACE inhibitors or ARAII, it is recommended to monitor serum potassium and serum creatinine within 7 to 15 days of starting treatment.
  • Daily monoprice should be favored to promote adherence.
  • It is recommended to start with monotherapy, but a fixed combination with first-line AMM may also be offered.
  • In second intention, a dual therapy will be introduced in a period of at least four weeks in case of insufficient tension response.
  • The treatment is set up from the outset in a situation of secondary prevention.
  • There is no convincing demonstration of efficacy in cardiovascular prevention for the following molecules:
  • alphablockers, with a less preventive effect than thiazide diuretics;
  • Central antihypertensives (no large-scale intervention trial).

3- Voltage objectives:

- According to AFSSAPS-HAS recommendations
For all hypertensives, TA <140 mmhg.="" p="">For all elderly subjects (systolic BP), TA <150 mmhg.="" p="">In case of renal insufficiency, proteinuria> 0.5 g / d, TA <130 125="" case="" diabetes="" even="" feasibility="" in="" mmhg="" of="" p="" random="">- Management strategy based on comorbidities.
The factors taken into account are: aging, LVH, coronary insufficiency, arterial disease of the lower limbs (see corresponding specific lessons).

Antihypertensive drugs, anti-giardic and leishmaniacs. Metronidazole. Miglomin Antimonials. Amphotericin b. Bentamidine

Antipyretic and antirheumatic drugs:
- diloxanide
- metronidazole
Drugs acting on adrenoreceptors
- meglumine antimoniate
Supplementary list:
- amphotericin B, pentamidine.

Antipyretics are active ingredients used to fight against feverish conditions and certain acute inflammatory syndromes. Their main indication is the fight against hyperthermia of the feverish state.

Indication:
The treatment of fever can be based on two main criteria:
- tolerance, which is subjective;
- the value of the temperature, which is objective (generally from 38.5 ° C).
In adults, the goal of prescribing an antipyretic may be based on tolerance to treat discomfort; but it is better to stick to the temperature in the young child and the infant, especially the severe increase in temperature can be accompanied by:
- of hidrorrhea.
- an increase in the mix.
- vomiting.
can cause rapid dehydration if the temperature does not drop rapidly.
The preferred medications are paracetamol and ibuprofen. Simple measures are usually associated, such as hydration and undressing, depending on their tolerance.

Examples of antipyretics:
- paracetamol.
- class of nonsteroidal anti-inflammatory drugs:
+ acetylsalicylic acid (aspirin).
+ ibuprofen.
+ ketoprofen.
+ quinine.

The use of antipyretics dates back to ancient times. Thus the Egyptians successfully used the decoctions of willow leaves to fight fever and pain. Later, around 400 BC J. - C., Hippocrates, according to which "the nature is the doctor of the patients", recommends, with a view to relieve the pains of the delivery and to lower the fever, a tea of ​​leaves of willow. Following the Greeks, the Romans resorted to the same remedy (the Latin name of the willow is salix). This use continued empirically until the eighteenth century.
The antipyretics used at that time were preparations from either natural compounds of cinchona bark (from which quinine is derived) or salicylate contained in the bark of willow. The cinchona bark became scarce and expensive, and the need to find substitutes appeared. Harmon Northrop Morse synthesized as early as 1878 a substance called acetylaminophenol, without however attributing any medical property to it: it was only fifty years later that it was marketed as a medicine under the name of paracetamol. At that time, other products were used as a cure for pain and fever: in 1882, Hoechst commercialized the Kairin discovered by Otto Fisher; in 1897, aspirin is synthesized by Felix Hoffmann and is a great success. BASF does not develop its antipyretic Thallin, developed around 188. Acetanilide (1886) and phenacetin (1887) are also used before the serious side effects of their administration are noted, while the disadvantages of aspirin are starting to be known. Paracetamol then reappears and the first studies on the antipyretic and analgesic properties of paracetamol are conducted at the end of the nineteenth century.

Medications for the prevention of malaria .. Chloroquine. Myfluquin. Doxycycline. Proguanil

Medicines for malaria prevention:
- chloroquine.
- mefloquine.
- doxycycline.
- proguanil.

Malaria is a treatable and preventable disease, which has led to a reduction in deaths from malaria.
To prevent malaria, follow these steps:
- Avoid traveling to a country where malaria is prevalent, especially in African countries.
- Take the necessary protective medicine if you want to go to a country where the disease is spread.
- After you have left a country where malaria is prevalent, you should take the protective medicine again.
- Spray your home with insecticides to eliminate malaria-transmitting mosquitoes.
- Sleep under a transparent cloth network containing an insecticide, to prevent the arrival of mosquitoes.
- Wear long clothing and cover the body, to prevent mosquitoes from sucking blood.
- Spray the skin and clothes with special sprays containing mosquito repellent.
- Protect children from exposure to mosquitoes, to prevent them from becoming potentially fatal in children.
Malaria treatment is very easy if the infection is mild. The patient gets rid of malaria within 3-4 days of starting treatment. Serious malaria infections are difficult to treat and often result in death.

Malaria can be prevented by certain precautions and precautions, especially if the person is living in a country where malaria is frequent or frequent. For example, mosquito bites that spread and be more active between dusk and dawn should be avoided. Wear long-sleeved clothing, use an insect repellent on the skin and clothing, put mosquito nets during sleep to avoid mosquito bites, and if a person travels to a place where malaria is prevalent, talk to the doctor a few months before the date of travel. Anti-malarial medicines, and after returning from travel also, in general, the drugs used for malaria prevention are the same drugs used to treat the disease.

Medications for the treatment of malaria .. Amodiazine. Chloroquine. Kenin. Artemether. Primakin. Lomifantrine. Artemether. Artesons. Doxycycline. Myfluquin. Sulfadoxine. Pyrimethamine

Medicines for the treatment of malaria:
- amodiaquine
- chloroquine
- quinine
- Artemether
- primaquine
- lumefantrine
Supplementary list:
Artemether, Artesonate, Doxycycline, Myfluocine, sulfadoxine + pyrimethamine.

Diagnosis of Malaria:
Malaria treatment depends on the correct diagnosis. In order for the doctor to diagnose malaria, he or she checks the health history of the person, including any modern travel to tropical climates, which can cause a great deal of transmission. A physical examination is also performed, Determine if a person's spleen or liver is puffy. If the patient has symptoms of malaria, the doctor may ask for more blood tests to confirm the diagnosis. In these tests, the doctor can know if:
- The person has malaria or not.
- Any type of malaria in the patient.
- The cause of infection is caused by a parasite resistant to certain types of drugs or not.
- If the disease has caused anemia.
- If the disease has affected vital organs.

Treatment of Malaria:
The treatment of malaria, the type of medication, and the length of treatment of malaria vary from person to person. There are several grounds for treatment. These are: the type of malaria parasite, the severity of symptoms, age and general health.
The history of drugs used to treat malaria is a constant struggle between parasite resistance to advanced drugs and the search for new pharmaceutical combinations in large parts of the world. For example, chloroquine resistance has made the drug ineffective, and antimalarial drugs used to treat malaria Come:
- Chloroquine.
- Quinine sulfate.
- Hydroxychloroquine.
- Mefloquine.
- Malarone.

NSAID inhibitors of the reverse transcriptase inhibitor and protease inhibitors. Nevirapen. Endenavir. Lubinavir. Nelfinavir. Ritonavir. Sakuenavir

Non-nucleoside inhibitors of reverse transcriptase enzyme:
- efavirenz (EFV or EFZ)
- nevirapine (NVP)

Protease inhibitors:
- indinavir (IDV)
- lopinavir
- nelfinavir (NFV)
- ritonavir
- (saquinavir (SQV).

Enzyme inhibitors are molecules that bind to enzymes and reduce their activity temporarily or permanently.
The inhibitor link can stop the substrate material from entering the active enzyme site and / or preventing the enzyme from stimulating its reaction. There are two types of inhibitors, either reflective or non-reflective. Non-reflective inhibitors typically interact with the enzyme and change it chemically (by forming covalent bonds).
These inhibitors are found to modify the residues of essential amino acids necessary for enzymatic activity. In contrast, there are reflective inhibitors that are linked to non-covalent bonds and different types of inhibitors are produced depending on whether these inhibitors bind to the enzyme, or synthesized enzyme and substrate material, or both. Many drug molecules are inhibitory to the enzyme, so their detection and improvement is a very active area in Research in biochemistry and pharmacy.
The enzyme inhibitor is often judged by its class (lack of binding to other proteins) and its efficacy (its dissociation constant, indicating the concentration needed to inhibit the enzyme).
When the variety is high, we ensure that the drug will have few side effects and therefore low toxicity.
The enzyme inhibitors also occur naturally and are involved in the regulation of metabolism.
For example, enzymes in the metabolic pathway can be inhibited by products produced during the chain reaction and discouraged.
This type of negative feedback slows down the production line when products begin to build and is an important way to maintain balance in the cell.
Other cellular enzyme inhibitors are proteins that are specifically linked to the enzyme and inhibit its action.
This can help control the enzymes that may be harmful to the cell, such as proteases or nucleases. Natural enzyme inhibitors can be used as a protection against any foreign or harmful body.
The most common uses of enzyme inhibitors are drugs to treat diseases.
Many of these inhibitors target an enzyme in the human body and aim to correct its pathological condition.
However, not all drugs are enzyme inhibitors.
Some, such as antiepileptic drugs, alter the activity of the enzyme by causing an increase in its productivity or reduction, which are unrelated to the above types.
An example of a medical enzyme inhibitor is Viagra, a common treatment for males with erectile dysfunction.
This molecule works to increase body signals, which relax the smooth muscles in the body and increase the flow of blood and expansion of the arteries, causing erection.
Since the drugs reduce the activity of the enzyme that stops these signals, it makes these signals last longer than the time.
Another example of the structural similarity of some enzyme inhibitors that are targeted is similar to the form that compares methotrexate and folic acid.
Folic acid is the substrate of dehydrolyte reduction, an enzyme involved in the manufacture of nucleotides that are strongly inhibited by methotrexate. Methotrexate performs the same action as the enzyme dehydrolyte reductase, thus stopping the production of nucleotides.
This biomass of nucleotide is more toxic to cells of rapid growth than non-dividing cells, because the fast-growing cell has the ability to replicate nucleic acids, so methotrexate is often used in chemotherapy for cancer.
Drugs are also used to inhibit enzymes needed to survive pathogens.
For example, bacteria surround a thick cell wall made of polymer such as peptidoglycans.
Many antibiotics such as penicillin and vancomycin inhibit the enzymes that then produce and bind the polymer filaments together.
This causes to decrease the cell wall strength and the bursting of bacteria.
The design of antibiotics is facilitated when the enzyme necessary to survive the disease is absent or very different in humans.
In the example above, humans do not produce peptidoglycans, hence the inhibitors of this process are toxic to bacteria.
It also produces toxicity in antibiotics by exploiting differences in the structure of ribosomes in bacteria, or how they are made for fatty acids.
Enzyme inhibitors are also important in controlling metabolic processes.
Many metabolic pathways in the cell are inhibited by metabolites that control enzyme activity through the tibial ligaments or inhibition of substrate material.
A good example is the diaphragmatic controls of diabetic biodegradation. This pathway consumes glucose and produces energy.
A major step to the regulation of diabetic glycolysis is an early reaction in the pathway stimulated by phosphofructokinase.
When energy levels rise, the energy molecule connects the alosteric site in PFK1 to reduce the rate of enzyme reaction.
Sugar dissolving is inhibited and production of ATP decreases.
This control helps the negative feedback maintain a constant concentration of the epithelium in the cell. However, metabolic pathways are not only regulated by inhibition since activation of the enzyme is equally important.
With respect to PFK1, 2,6-bisphosphate and literature are examples of metabolism that are arostric doping.
Inhibitory physiological enzymes can also be inhibited by specific protein inhibitors.
This process occurs in the pancreas, which inhibits many enzymes that activate enzymes of the digestive system known as Zemogens.
Many of these inhibitors are activated by the terpsin protein, so it is important to block the activity of trypsin propane in the pancreas to prevent the organ from digesting itself.
One way to control trypsin activity is to produce a protein that inhibits trypsin and is specific and strong in the pancreas.
This inhibitor is tightly bound with trypsin, inhibits its activity and protects the pancreas.
Although trypsin inhibitor is a protein, it avoids degradation as a substrate of protease by excluding water from the active site of the toxin and disrupting the transition state.
Many pesticides are enzyme inhibitors. Acetylcholinesterase (ASH) is an enzyme found in animals from insects to humans.
It is essential that the function of neurons through its mechanism to break down acetylcholine nervous in their components, acetate and choline.
This is fairly unusual among neurotransmitters as most are absorbed, including serotonin, dopamine, and noradrenaline, from the synaptic cleft rather than cleft. A large number of ASH inhibitors are used in both medicine and agriculture.
Adverse competitive inhibitors, such as erydomonium, fisostigmine, and neostigmine, are used in the treatment of myasthenia gravis and anesthesia.
Carbamide pesticides are also examples of reversible AS inhibitors.
Organic phosphate pesticides such as malathion, parathion, and chlorpyrifos irreversibly inhibit acetylcholinesterase. Many pesticides are inhibitory enzymes.
Such as sulfonyl urea inhibiting acetolactate synthase. All of these enzymes are required for plants to make amino acids branching chain.
Many other enzymes are inhibited by herbicides, including enzymes needed for the bio-synthesis of lipids, carotenoids, oxidative photosynthesis and phosphorus processes.

Cyclosporine is an immunosuppressive complementary medicine. Rejection in kidney, liver, heart or bone marrow transplantation. Taste disease against the host

Ciclosporin
Cyclosporine is a complementary immunosuppressive drug
Capsules, cyclosporine 25 mg
Center for infusion (center for infusion solution), cyclosporine 50 mg / ml, ampoule 1 ml
Uses: rejection in kidney transplantation, liver, heart or bone marrow;
Precautions: Monitor renal function (increase in serum creatinine and serum polynesia in the first few weeks may require dose reduction, exclude rejection of kidney taste, see also; monitor liver function (adjust dose according to bilirubin and liver enzymes; monitor blood pressure) Control of serum magnesium; hyperuricemia; blood lipid measurement before and during treatment; avoidance of hypercalcemia; Pregnancy; breast-feeding.
Dosage:
Note. Low doses are required when cyclosporine is used with other immunosuppressants
Transplantation, by mouth, ADULT and CHILD over 3 months 10-15 mg / kg 4-12 hours before surgery, then 10-15 mg / kg daily for 1-2 weeks, reduced to 2-6 mg / Kg per day for maintenance (adjust dose according to blood concentrations and kidney function).
Transplantation, intravenous infusion over 2-6 hours, ADULT and CHILD and give one-third oral dose
Bone marrow transplants, bait disease against host, by mouth, ADULT and CHILD over 3 months 12.5-15 mg / kg daily for 2 weeks, starting the day before surgery, followed by 12.5 mg / kg daily for 3-6 months, then reduced Gradually (may last for one year after implantation).
Bone marrow transplant, bait disease against host, intravenous infusion over 2-6 hours, ADULT and CHILD over 3 months 3-5 mg / kg daily for 2 weeks, starting the day before surgery, followed by oral maintenance.
the shift. Any shift between trade names must be done with caution, with the manufacturer consulting for more information
Mitigation and giving. As directed by the manufacturer.
Note. The infusion center contains polycyclic polycyclic oil, which is linked to the intestine; monitor the patient for 30 minutes after initiating the infusion, and then at frequent intervals.
Hypercalcemia, hypercalcemia, hypercalcemia, hyperholesterolemia, hypercalcemia, hypercalcemia, hypercalcemia, hypercalcemia, hypercalcemia, hypercalcemia; Hyperthyroidism, hyperthyroidism, hyperthyroidism, hypercalcemia, hypercalcemia (especially in patients with heart transplantation); increased incidence of malignant tumors and reproductive lymphoma; increased exposure to infections as a result of immunosuppression; Hyperurmia syndrome Blood hemolytic); and poverty is also a mild blood, tremors, Takgat, neuropathy; indigestion menstruation or menopause; inflammation of the pancreas, muscle inflammation or muscle weakness; cramps; gout; edema; headache.

Azathioprine .. To prevent rejection in the recipients of taste. Rheumatoid Arthritis. Inflammatory bowel disease

Azathioprine
Azathioprine is a complementary immunosuppressive drug
Tablets, azathioprine 50 mg
Injection, (powder for injection solution) Azathioprine (as sodium salt), 100 mg Vial
Uses: to prevent rejection in bait recipients; rheumatoid arthritis; inflammatory bowel disease.
Contraindications: hypersensitivity to azathioprine and mercaptopurine; breast-feeding.
Precautions: To monitor toxicity throughout the treatment period; a full blood count should be performed every week (or more for larger doses and renal or hepatic impairment) for 4 weeks of treatment and at least 3 months thereafter; Renal impairment; liver disease.
Suppression of bone marrow. Patients should be warned to immediately report any signs or symptoms of bone marrow suppression, such as unexplained bruising, bleeding or infection.
Dosage:
Rejection of bait, oral or intravenous (for at least 1 minute followed by 50 ml sodium intravenous infusion) or intravenous infusion, ADULT up to 5 mg / kg on surgery day, then reduced to 1-4 mg / kg daily according to the response to sustainability.
Restructuring and giving. As directed by the manufacturer.
Note: Intravenous injection is very alkaline and irritating; intravenous injection should only be used if oral administration is not possible.
Hypersensitivity reactions include allergic reactions including dizziness, vomiting, fever, muscle pain, arthralgia, rash, hypotension or renal renal inflammation requiring immediate abstinence; blood poisoning including leukopenia and thrombocytopenia (reversible when refraining from use) ; Hair loss; increased exposure to infections and colitis in patients who are also taking corticosteroid nausea; rarely pancreatitis, pneumonia, and hepatic hepatic disease.

Cyclosporine is a strong immunosuppressant. Dosage is determined according to plasma cyclosporine concentrations and renal function free of toxic effects of puree

Cyclosporine is a strong immunosuppressant that is almost free from toxic effects of purity, but is remarkably toxic to the kidney. It is especially useful to prevent the rejection of taste and to prevent bait disease against the host. The dose is adjusted according to plasma cyclosporine concentrations and kidney function. The increase in plasma creatinine and urinary serum urinain in the blood during the first few weeks may require dose reduction. Corticosteroids such as prednisolone (section 3.8) have a large immunosuppressive activity and can also be used to prevent rejection of organ stings.

Azathioprine is the most widely used drug in transplant recipients when corticosteroid therapy is metabolized to mercaptopurine

Azathioprine is the most widely used drug in transplant recipients.
It is useful when corticosteroid therapy alone has been shown to be inadequate or for other cases when corticosteroid dose reduction is required. It is metabolized to mercaptopurine and as with mercaptopurine doses should be reduced when given with alopurinol.
The predominant toxic effect is pure suppression, although hepatotoxicity also occurs.

Immunosuppressive drugs. Recipients of the taste of organs to suppress rejection and second line drugs in cases of chronic inflammation

WHO advises that this group of drugs is used only when adequate resources and specialist care are available. Specific experience, accuracy in diagnosis, and dose or special equipment are required to be used correctly.
Immunosuppressive drugs are used in the recipient of organ taste to suppress rejection; they are also used as second-line drugs in cases of chronic inflammation. Treatment must be initiated by a specialist. Accurate monitoring of blood counts is required in patients receiving immunosuppressive drugs and dose should be controlled to prevent bone marrow poisoning. Patients receiving immunosuppression are particularly vulnerable to non-stereotypical infections.

Antihypertensives and anticoagulants. Acetylcysteine. Naloxone. Penicillamine. Calcium gluconate. Deferoxamine. Dual Merkaprol. Methionine. Sodium nitrite. Methyl thionium chloride

Antiseptics and other substances used in poisoning:
Non-quality:
Charcoal, activated charcoal
Quality:
- acetylcysteine
- naloxone
- atropine
- penicillamine
  calcium gluconate
- potassium ferric hexacyanoferrate (ll). 2H2O (Prussian blue)
- deferoxamine
- dimercaprol
- sodium calcium edetate
- DL-methionine
- sodium nitrite
- (methylthioninium chloride (methyl blue
- sodium thiosulfate.