Friday, 24 February 2017

ANTIEMETIC DRUGS & PREGNENCY

Antiemetic drugs in Pregnancy

anti   - mean =against 

emet - mean =vomiting 

tic     - mean =drug 

Those drug which we can sued against the prevention of vomiting.
   

Morning sickness is a common condition associated with pregnancy and can be effectively managed with antiemetic in pregnancy such as metoclopramide and lifestyle changes.


Commonly known as the "morning sickness", the earliest symptoms experienced during pregnancy are nausea and vomiting which are brought about by the hormonal changes taking place within the body. Up to 90% of women complain of this condition.
Pregnant women develop nausea and vomiting early on during the first trimester of pregnancy. The symptoms peak between six and eight weeks, eventually receding around 12 weeks of pregnancy.
Morning sickness rarely persists after 20 weeks of pregnancy. If it does, the condition is known as "Hyperemesis Gravidarum", a disorder that affects about 35% of the pregnant women, proving to be quite debilitating with profound physical and psycho social consequences.

Nausea and vomiting can be adequately managed in most of the women by drinking plenty of water and by avoiding the foods that bring on the bouts of nausea and vomiting. If the symptoms preserve even after these measures, anti-emetic drugs are prescribed to the pregnant women.

 Use Antiemetic in Pregnancy?



It is quite a common notion that taking antiemetics can turn out to be dangerous during pregnancy. However, this myth needs to be busted as many of the antiemetic drugs have been proven to be safe for use in pregnant women. Contrary to the widespread idea, antiemetics are not associated with any increased risk of birth defects, low birth weight in neonates, preterm delivery and still births, if they are taken during the first 13 weeks of pregnancy.
Since the symptoms peak during the first trimester, the ideal time to start the treatment of morning sickness is during that time. It has been clinically proven that prompt drug treatment with antiemetics yields better results.
Usually, Hyperemesis Gravidarum can be adequately managed in the outpatient department. However, such cases often get neglected resulting in severe dehydration and weight loss. Such patients require immediate intravenous fluid therapy

Safe Antiemetic in Pregnancy



Despite the lifestyle changes and conservative management, nearly 10% of the pregnant women continue to experience severe nausea and vomiting. Numerous antiemetic drugs have been proven to be safe and effective for use during pregnancy. However, these drugs are prescribed only after weighing their advantages against their potential hazards. Following antiemetic drugs are commonly prescribed for the treatment of nausea and vomiting in pregnant women.

1.      Metoclopramide

The first line antiemetic agent prescribed for nausea and vomiting is metoclopramide, prescribed at a dose of 10 milligrams to be taken thrice daily. The effectiveness of metoclopramide has been proven through rigorous clinical trials. The dose of this drug should, however, be tightly regulated since it is associated with adverse effects including extrapyramidal symptoms like involuntary muscle spasms, movement disorders, etc.

2.      Prochlorperazine

The second drug of choice for nausea and vomiting, if metoclopramide fails to yield favorable results, is Prochlorperazine which belongs to the family of phenothiazines. It is commonly given at a dose of 5 milligrams three times a day. The side effects of Prochlorperazine to watch out for include excessive sedation and nervous system disorders.

3.      Cyclizine

The next drug preferred for the management of excessive nausea and vomiting is Cyclizine, which is an antihistaminic drug, taken at a dose of 50 milligrams three times a day. Cyclizine can also cause excessive sedation.

4.      Promethazine

Another effective and safe antiemetic in pregnancy that should be used if the above mentioned drugs fail to control the symptoms of nausea and vomiting is Promethazine. The drug is started at a dose of 25 milligrams to be taken before going to bed and the dose is gradually stepped up till it reaches the maximal allowed dosage of 100 milligrams. Promethazine is associated with the side effects of sedation and nervous disorders (extrapyramidal symptoms).

5.      Ondansetron

In women suffering from hyperemesis gravidarum, ondansetron is the drug of choice which is taken twice or thrice daily at a dose of four to eight milligrams. The common side effects of ondansetron include fatigue, headache, drowsiness, constipation, bloating and abdominal discomfort.

6.      Corticosteroids

If all other measures fail, corticosteroids are used as a last measure for treating severe nausea and vomiting. Despite the fact that the symptoms improve dramatically with the use of corticosteroids, therapy with corticosteroids should not be initiated before 10 weeks of pregnancy since its use is associated with congenital malformations like cleft palate in the neonates.

What Increases Your Risk?


Numerous risk factors increase the risk of developing nausea and vomiting during pregnancy. These include:
  • Previous history of nausea and vomiting during a former pregnancy
  • Family history of morning sickness
  • Motion sickness
  • Use of estrogen based contraceptive agents
  • Obesity (Body Mass Index of 30 or more)
  • Stress
  • Multiple pregnancies
  • First pregnancy
Since morning sickness occurs during the first trimester, a time when the baby’s development is taking place, using an antiemetic in pregnancy should always follow thorough consultation with the obstetrician to avoid any adverse effects. With proper care and caution, the symptoms of nausea and vomiting can be effectively managed.

Friday, 25 November 2016

Cardiac Diseases(HEART )


HEART (CARDIAC DISEASES )

The heart is a muscular organ in humans and other animals, which pumps blood through the blood vessels of the circulatory system.Blood provides the body with oxygen and nutrients, as well as assists in the removal of metabolic wastes. The heart is located in the middle compartment of the chest.
In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria; and lower left and right ventricles.Commonly the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. Fish in contrast have two chambers, an atrium and a ventricle, while reptiles have three chambers.In a healthy heart blood flows one way through the heart due to heart valves, which prevent backflow.The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall of the heart is made up of three layers :epicardiummyocardium, and endocardium.
The heart pumps blood with a rhythm determined by a group of pacemaking cells in the sinoatrial node. These generate a current that causes contraction of the heart, traveling through the atrioventricular node and along theconduction system of the heart. The heart receives blood low in oxygen from the systemic circulation, which enters the right atrium from the superior andinferior venae cavae and passes to the right ventricle. From here it is pumped into the pulmonary circulation, through the lungs where it receives oxygen and gives off carbon dioxide. Oxygenated blood then returns to the left atrium, passes through the left ventricle and is pumped out through the aorta to the systemic circulation−where the oxygen is used and metabolized to carbon dioxide.The heart beats at a resting rate close to 72 beats per minute.Exercise temporarily increases the rate, but lowers resting heart rate in the long term, and is good for heart health.

Overview of basics of heart disease:-


Heart disease is a word used to describe many different conditions affecting the heart. Coronary heart disease is a common type of heart disease. This condition results from a buildup of plaque on the inside of the arteries, which reduces blood flow to the heart and increases the risk of a heart attack and other heart complications. Other forms of heart disease include:
  • irregular heartbeat (arrhythmias)
  • congenital heart defects
  • weak heart muscles (cardiomyopathy)
  • heart valve problems
  • heart infections
  • cardiovascular disease.

Heart disease statistics:-




Approximately 610,000 people die from heart disease in the United States every year, according to the estimated .It’s the leading cause of death in both men and women. Coronary heart disease is the deadliest of all heart diseases, just as it’s the most common form. the heart foundation  estimates 380,000 related deaths per year.
The symptoms of heart disease vary between gender. Some are more obvious in men, who made up more than half of all heart disease-related deaths in the United States in 2009, according to the CDC. According to The Heart Foundation, 1 in 3 women die of heart disease every year in the United States. In 90 percent of these cases, women had at least one preventable risk factor.
Symptoms of heart disease:-
Heart disease is often called a “silent killer.” Your doctor may not diagnose the disease until you show signs of a heart attack or heart failure. Symptoms of heart disease vary depending on the specific condition. For example, if you have a heart arrhythmia, symptoms may include:
  • a fast or slow heartbeat
  • dizziness
  • lightheadedness
  • chest pains
  • shortness of breath
Symptoms of a congenital (present at birth) heart defect may include skin discoloration, such as a bluish or pale color. You may also notice swelling in your legs and stomach. You might become easily tired or have shortness of breath shortly after beginning any type of physical activity.
If you have weak heart muscles, physical activity may cause tiredness and shortness of breath. Dizziness and swelling in the legs, ankle, or feet are also common with cardiomyopathy. Signs and symptoms of a heart infection can include:
  • tiredness
  • coughing
  • skin rash
  • irregular heartbeat
  • swelling in legs and stomach

Seek medical attention if you have any signs of heart problem. It’s important to address symptoms early since there are many types of heart diseases, each with its own set of symptoms.

Risk factors of heart disease:-

Several factors increase your risk of heart disease, like a family history of the disease, age, or ethnicity. Other common risk factors include:
  • smoking
  • high blood pressure
  • high blood cholesterol
  • diabetes
  • poor diet
  • lack of exercise
  • obesity
  • stress
  • poor hygiene (some viral and bacterial infections can affect the heart)
  • Diagnosing heart disease;-

    Different tests are used to diagnose heart disease, and your doctor may choose a particular test based on your symptoms and a review of your family history. After a blood test and chest X-ray, other tests include:
    • electrocardiogram (EKG): a test that helps doctors identify problems with your heart’s rhythm
    • echocardiogram: a test that uses ultrasound waves to view the flow of blood through the heart
    • cardiac CT scan: an X-ray that creates cross-sectional views of your heart
    • cardiac MRI: a test that uses powerful magnets and radio waves to create images of your heart and surrounding tissue
    • stress test: a test that monitors your heart during periods of strenuous activity or exercise.

    How to treat heart disease;-



  • Heart disease treatments depend on the condition, but may include lifestyle changes and medications. Lifestyle changes can include the following.
    Eat a healthy diet rich in fiber, omega-3 fatty acids, fruits, and vegetables. Choose foods that are low in fat, sodium, and cholesterol to help control
    your blood pressure.
    Increase physical activity to maintain a healthy weight, reduce your risk of diabetes, and improve cholesterol levels. Aim for at least 60 minutes of activity per week, says the National Heart, Lung, and Blood Institute.
    Quit smoking, as it can lower your risk of heart disease and complications.
    Drink alcohol in moderation, which can lower blood pressure and decrease the risk for heart disease. Men should drink no more than two, and women no more than one alcoholic beverage per day, according to the National Institute on Alcohol Abuse and Alcoholism.
    Learn how to deal with stress, either through exercise, medication, stress management therapy or support groups
    When lifestyle changes do not improve your conditions, doctors may prescribe certain medications to reduce your risk of a heart attack or stroke. These include medications that lower blood pressure or prevent blood clotting.
    Sometimes, medical procedures are necessary to treat certain types of heart disease. These include an angioplasty (the doctor inserts a flexible tube into arteries to improve blood flow). A stent is often inserted as well, to keep the vessel open, or coronary artery bypass surgery is performed (blood vessels surgically moved from one area of the body to another to improve blood flow to the heart).

    Outlook for heart disease

    Between the cost of healthcare and lost productivity, coronary heart disease costs the United States $108.9 billion annually, according to the CDC. It’s important to diagnose and treat heart disease early. If left untreated, heart disease can cause a variety of complications, such as a heart attack, heart failure, stroke, aneurysm, and even death. Talk to your doctor if you think you have any symptoms of heart disease.

    Preventing heart disease;-

    Heart disease is the most common health condition in the United States, but it’s also the most preventable. The preventive steps you can take include:
    • exercise regularly: the recommends at least 30 minutes per day
    • avoid trans fatty acids: these are often found in packaged foods and labeled as “hydrogenated” or “partially hydrogenated” oils in the ingredient .
    • limit your intake of saturated fat
    • watch your salt intake
    • eat more plant-based foods
    • quit smoking
    • lose weight or maintain your weight: talk to your doctor about healthy ways you can avoid weight gain or obesity
    • While risk factors for heart disease (such as hypertension) can run in the family, this doesn’t mean you can’t prevent your overall risk. Talk to your doctor about other steps you can take to reduce your chances of developing heart disease. 
      prevention iz better thn medicines. 

Monday, 24 October 2016

Amoxicillin/clavulanic acid(augmentine)


Amoxicillin/clavulanic acid;-


Amoxicillin/clavulanic acid;-(augmentine)


Amoxicillin/clavulanic acid or co-amoxiclav is an antibiotic useful for the treatment of a number of bacterial infections. It is a combination antibiotic consisting of amoxicillin trihydrate, a β-lactam antibiotic, and potassium clavulanate, a β-lactamase inhibitor. This combination results in an antibiotic with an increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce β-lactamase.

medical uses;-
Amoxicillin/clavulanic acid is widely used to treat or prevent many infections caused by susceptible bacteria, such as:
Bacterial antibiotic resistance is a growing problem in veterinary medicine. Amoxicillin/clavulanic acid is reported to be effective against clinicalKlebsiella infections, but is not efficacious against Pseudomonas infections.

Adverse effects;-

Possible side effects include diarrhea, vomiting, nauseathrush, and skin rash. These do not usually require medical attention. As with all antimicrobial agents, antibiotic-associated diarrhea due to Clostridium difficile infection—sometimes leading to pseudomembranous colitis—may occur during or after treatment with amoxicillin/clavulanic acid.
Rarely, cholestatic jaundice (also referred to as cholestatic hepatitis, a form of liver toxicity) has been associated with amoxicillin/clavulanic acid. The reaction may occur up to several weeks after treatment has stopped, and usually takes weeks to resolve. It is more frequent in men, older people, and those who have taken long courses of treatment; the estimated overall incidence is one in 100,000 exposures. In the United Kingdom, co-amoxiclav carries a warning from the Committee on Safety of Medicines to this effect.


warning:-
prevention iz better thn medicines.

Thursday, 25 August 2016

CONGO VIRUS .

CONGO VIRUS :-




Crimean-Congo Hemorrhagic fever (CCHF) is a viral disease that spreads through tick bite. It was first described in Crimea in 1944 and was called Crimean Hemorrhagic fever. 

It was later also described in Congo, hence it was named Crimean-Congo Hemorrhagic fever. The disease is more common in Africa, Asia, East Europe and the Middle East. A recent outbreak has been reported in the Indian State of Gujarat.
CONGO VIRUS IN PAKISTAN

Congo virus is a widespread viral disease that is commonly spread by ticks found on hairy animals. The situation needs extra attention as cattle markets are being set up across the country for public to buy sacrificial animals for the religious occasion of Eid-ul-Azha. Death toll from the Crimean Congo Hemorrhagic Fever or Congo virus in Pakistan has climbed to 19 this year, with five deaths reported in Karachi, twelve in Quetta and two in Bahawalpur.



Symptoms:-


Symptoms of this disease include high fever along with pain in joints and other parts of the body, vomiting, diarrhea, some people also exhibit signs of hemorrhage signs. Throat pain is also one of the common discomforts experienced as a symptom of this condition. Bleeding from gums, skin and large intestine may also occur and red spot appears on the body.
Precautionary Measures:-


•The government should spray sacrificial animal markets and diseased animals should be banned from entering the cities and isolated to avoid contact
•The waste material of sacrificial animals should be disposed properly.
•Government needs to make isolated wards in every tertiary and secondary care hospital rather than waiting for a case to emerge.
•Government should focus on villages to control the virus from spreading, since the primary outbreak location is where cattle are bred and kept.