Wednesday, 19 November 2014

PREGNANCY (prevention iz better thn medicines)

PREGNANCY:-

PREVENTION IZ BETTER THN MEDICINES:-

Initiation

The event of fertilization is sometimes used as a mark of the initiation of pregnancy, with the derived age being termedfertilization age, and is an alternative to gestational age. Fertilization usually occurs about two weeks before her nextexpected menstrual period, and if either date is unknown in an individual case it is a frequent practice to add 14 days to the fertilization age to get the gestational age and vice versa.The most commonly used event to mark the initiation of pregnancy is the first day of the woman's last normal menstrual period, and the resulting fetal age is called thegestational age. This choice is a result of a lack of a convenient way to discern the point in time when the actual creation of the baby naturally happens. In case of in vitro fertilisation, gestational age is calculated by days from oocyte retrieval + 14 days.

Development of embryo and fetus


The development of the mass of cells that will become the infant is called 
embryogenesis during the first approximately 10 weeks of gestation. During this time, cells begin to differentiate into the various body systems. The basic outlines of the organ, body, and nervous systems are established. By the end of the embryonic stage, the beginnings of features such as fingers, eyes, mouth, and ears become visible. Also during this time, there is development of structures important to the support of the embryo, including the placenta and umbilical cord. The placentaconnects the developing embryo to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. The umbilical cord is the connecting cord from the embryo or fetus to the placenta.The sperm and the egg cell, which has been released from one of the female's twoovaries, unite in one of the two fallopian tubes. The fertilized egg, known as azygote, then moves toward the uterus, a journey that can take up to a week to complete. Cell division begins approximately 24 to 36 hours after the male and female cells unite. Cell division continues at a rapid rate and the cells then develop into what is known as a blastocyst. The blastocyst arrives at the uterus and attaches to the uterine wall, a process known as implantation.
After about 10 weeks of gestational age, the embryo becomes known as a fetus instead. At the beginning of the fetal stage, the risk of miscarriage decreases sharply, When the fetal stage commences, a fetus is typically about 30 mm (1.2 inches) in length, and the heart can be seen beating via ultrasound; the fetus can be seen making various involuntary motions at this stage. During continued fetal development, the early body systems and structures that were established in the embryonic stage continue to develop. Sex organs begin to appear during the third month of gestation. The fetus continues to grow in both weight and length, although the majority of the physical growth occurs in the last weeks of pregnancy.
Electrical brain activity is first detected between the 5th and 6th week of gestation, though this is still considered primitive neural activity rather than the beginning of conscious thought, something that develops much later in fetation. Synapses begin forming at 17 weeks, and at about week 28 begin to multiply at a rapid pace which continues until 3 to 4 months after birth.[17]

First trimester

Second trimesterMinute ventilation is increased by 40% in the first trimester. The womb will grow to the size of a lemon by eight weeks. Many symptoms and discomforts of pregnancy like nausea and tender breasts appear in the first trimester.
Although the fetus begins to move and takes a recognizable human shape during the first trimester, it is not until the second trimester that movement of the fetus, often referred to as "quickening", can be felt. This typically happens in the fourth month, more specifically in the 20th to 21st week, or by the 19th week if the woman has been pregnant before. It is common for some women not to feel the fetus move until much later. During the second trimester, most women begin to wear maternity clothes.Weeks 13 to 28 of the pregnancy are called the second trimester. Most women feel more energized in this period, and begin to put on weight as the symptoms of morning sickness subside and eventually fade away. The uterus, the muscular organ that holds the developing fetus, can expand up to 20 times its normal size during pregnancy.

Third trimester

Head engagement, where the fetal head descends into cephalic presentation, relieves pressure on the upper abdomen with renewed ease in breathing. It also severely reduces bladder capacity, and increases pressure on the pelvic floor and the rectum.Final weight gain takes place, which is the most weight gain throughout the pregnancy. The woman's abdomen will transform in shape as it drops due to the fetus turning in a downward position ready for birth. During the second trimester, the woman's abdomen would have been very upright, whereas in the third trimester it will drop down quite low, and the woman will be able to lift her abdomen up and down. The fetus begins to move regularly, and is felt by the woman. Fetal movement can become quite strong and be disruptive to the woman. The woman's navel will sometimes become convex, "popping" out, due to her expandingabdomen.
It is also during the third trimester that maternal activity and sleep positions may affect fetal development due to restricted blood flow. For instance, the enlarged uterus may impede blood flow by compressing the lower pressured vena cava, with the left lateral positions appearing to providing better oxygenation to the infant.

Determining gestational age

Since these are spread over a significant period of time, the duration of pregnancy necessarily depends on the date selected as the starting point chosen.
As measured on a reference group of women with a menstrual cycle of exactly 28-days prior to pregnancy, and who had spontaneous onset of labor, the mean pregnancy length has been estimated to be 283.4 days of gestational age as timed from the first day of the last menstrual period as recalled by the mother, and 280.6 days when the gestational age was retrospectively estimated by obstetric ultrasoundmeasurement of the fetal biparietal diameter (BPD) in the second trimester. Other algorithms take into account a variety of other variables, such as whether this is the first or subsequent child (i.e., pregnant woman is a primipara or a multipara, respectively), the mother's race, parental age, length of menstrual cycle, and menstrual regularity), but these are rarely used by healthcare professionals. In order to have a standard reference point, the normal pregnancy duration is generally assumed to be 280 days (or 40 weeks) of gestational age.
The best method of determining gestational age is ultrasound during the first trimester of pregnancy. This is typically accurate within seven days. This means that fewer than 5 percent of births occur on the day of being 40 weeks of gestational age; 50 percent of births are within a week of this duration, and about 80 percent are within 2 weeks. For the estimation of due date, mobile apps essentially always give consistent estimations compared to each other and correct for leap year, while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year.
The most common system used among healthcare professionals is Naegele's rule, which was developed in the early 19th century. This calculates the expected due date from the first day of the last normal menstrual period (LMP or LNMP) regardless of factors known to make this inaccurate, such as a shorter or longer menstrual cycle length. Pregnancy most commonly lasts for 40 weeks according to this LNMP-based method, assuming that the woman has a predictable menstrual cycle length of close to 28 days and conceives on the 14th day of that cycle.
As measured from the day of ovulation, the average time to birth has been estimated to be 268 days (38 weeks and two days), with a coefficient of variation of 3.7%.
Accurate dating of pregnancy is important, because it is used in calculating the results of various prenatal tests, (for example, in the triple test). A decision may be made to induce labour if a fetus is perceived to be overdue. Furthermore, if LMP and ultrasound dating predict different respective due dates, with the latter being later, this might signify slowed fetal growth and therefore require closer review.
The stage of pregnancy defined as the beginning of legal fetal viability varies around the world. It sometimes incorporates weight as well as gestational age.It ranges from 16 weeks in Norway, to 20 weeks in the US and Australia, 24 weeks in the UK and 26 weeks in Italy and Spain.

Nutrition


A balanced, nutritious diet is an important aspect of a healthy pregnancy. Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables, usually ensures good nutrition. Those whose diets are affected by health issues, religious requirements, or ethical beliefs may choose to consult a health professional for specific advice.

Medication use

Drugs used during pregnancy can have temporary or permanent effects on the fetus. Therefore many physicians would prefer not to prescribe for pregnant women, the major concern being over teratogenicity of the drugs.
Drugs have been classified into categories A,B,C,D and X based on the Food and Drug Administration (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks. Drugs, including some multivitamins, that have demonstrated no fetal risks after controlled studies in humans are classified as Category A. On the other hand drugs like thalidomide with proven fetal risks that outweigh all benefits are classified as Category





Saturday, 8 November 2014

Norcotic Drugs/Medicines


Narcotic Drugs:-

COCAINE LEAF :(COCA)

INTRODUCTION 
MEDICAL USAGES 


Coca is any of the four cultivated plants in the family Erythroxylaceae, native to western South America. The plant is a cash crop in ArgentinaBoliviaColombia, and Peru. It also plays a role in many traditional Andean cultures as well as the Sierra Nevada de Santa Marta (see Traditional uses). Coca is known throughout the world for its psychoactive alkaloidcocaine. The alkaloid content of coca leaves is low, between 0.25% and 0.77%.This means that chewing the leaves or drinkingcoca tea does not produce the intense high (euphoriamegalomaniadepression) people experience with cocaine. Coca leaf extract had been used in Coca-Cola products from 1885, with cocaine being completely eliminated from the products in or around 1929. Extraction of cocaine from coca requires several solvents and a chemical process known as an acid/base extraction, which can fairly easily extract the alkaloids from the plant.

HISTORY:-
Traces of coca have been found inmummies dating 3000 years back.[24] Other evidence dates the communal chewing of coca with lime 8000 years back.[25] Extensive archaeological evidence for the chewing of coca leaves dates back at least to the 6th century AD Moche period, and the subsequent Inca period, based on mummies found with a supply of coca leaves, pottery depicting the characteristic cheek bulge of a coca chewer, spatulas for extracting alkali and figured bags for coca leaves and lime made from precious metals, and gold representations of coca in special gardens of the Inca in Cuzco.
Coca chewing may originally have been limited to the eastern Andes before its introduction to the Incas. As the plant was viewed as having a divine origin, its cultivation became subject to a state monopoly and its use restricted to nobles and a few favored classes (court orators, couriers, favored public workers, and the army) by the rule of the Topa Inca (1471–1493). As the Incan empire declined, the leaf became more widely available. After some deliberation, Philip II of Spain issued a decree recognizing the drug as essential to the well-being of the Andean Indians but urging missionaries to end its religious use. The Spanish are believed to have effectively encouraged use of coca by an increasing majority of the population to increase their labor output and tolerance for starvation, but it is not clear that this was planned deliberately.
In the early 20th century, the Dutch colony of Java became a leading exporter of coca leaf. By 1912 shipments to Amsterdam, where the leaves were processed into cocaine, reached 1 million kg, overtaking the Peruvian export market. Apart from the years of the First World War, Java remained a greater exporter of coca than Peru until the end of the 1920s.Other colonial powers also tried to grow coca (including the British in India), but with the exception of the Japanese in Formosa, these were relatively unsuccessful.

Medicine

Traditional medical uses of coca are foremost as a stimulant to overcome fatigue, hunger, and thirst. It is considered particularly effective against altitude sickness.It also is used as an anesthetic and analgesic to alleviate the pain of headache,rheumatism, wounds and sores, etc. Before stronger anaesthetics were available, it also was used for broken bones, childbirth, and during trepanning operations on the skull. The high calcium content in coca explains why people used it for bone fractures. Because coca constricts blood vessels, it also serves to oppose bleeding, and coca seeds were used for nosebleeds. Indigenous use of coca has also been reported as a treatment for malariaulcersasthma, to improve digestion, to guard against bowel laxity, as an aphrodisiac, and credited with improving longevity. Modern studies have supported a number of these medical applications.

What are the medical complications of cocaine?

Cocaine causes many adverse effects to many organ systems. Some complications are dependent on the route of exposure.
  • Bones
  • Cocaine, when inserted in the nose (snorted) can cause breakdown of the cartilage and bones in and around the nose creating holes in the septum (the septum separates the nostrils).
  • Brain and nerves
  • Cocaine use can cause difficulty walking, headache, seizures, spontaneous bleeding, stroke, temporary or permanent memory and attention problems, and tremors. Intranasal (in the nose) users can lose their sense of smell and suffer from frequent nosebleeds. Intravenous (in the veins) users are at risk for infections that can be located in the brain in addition to other areas of the body.
  • Gastrointestinal
  • Cocaine can cause severe abdominal pain, bloody diarrhea, nausea and vomiting. Intravenous users are at increased risk for viral hepatitis if they use contaminated needles.
  • Heart
  • Cocaine can cause chest pain, high blood pressure, fast or abnormal heart rate, heart attack, problems with heart muscle contraction and rupture of the aorta (main blood vessel from the heart). Intravenous users are at increased risk for infections of the heart and its valves.
  • Lung
  • People who smoke cocaine can have shortness of breath and fluid or bleeding in the lung. They can rupture the lung, which results in air leaking into the chest.
  • Kidney
  • Cocaine can cause kidney damage
  • Muscles
  • Cocaine can cause severe muscle damage and pain.
  • Cocaine use during pregnancy




  • Cocaine use is associated with premature delivery, vaginal bleeding, sudden death, and birth defects.

  • prohibition of import export of norcotic drugs etc



  • 1) No one shall:-
    (a) import 
    (b) export 
    (c) transport 
  • (d) transship;
    any narcotic drug, psychotropic substance or controlled substance, save in accordance with rules made under sub-
  • section (2) and in accordance with the conditions of any licence, permit or authorization for that purpose which may be required to be obtained under those rules.
  • (2) The Federal Government may make rules permitting and regulating the import into and export  and transshipment of narcotic drugs, psychotropic substances or controlled substances, and such rules may prescribe the ports or places at which any kind fo narcotic drug, psychotropic substance or controlled substance may be imported, exported, transported within Pakistan or transshipped, the form and conditions of licence, permit or authorities by which such licences, permits or authorization may be granted, the fees that may be charged therefor, any other matter required to have effective control of the Federal Government over such import, export, transportation and transshipment .

Friday, 7 November 2014

Reproductive Diseses

Reproductive system disease


reproductive system disease is any disease of the reproductive system.


Types

Infections

Reproductive tract infection (RTI) are infections that affect the reproductive tract, which is part of the Reproductive System. For females, reproductive tract infections can be in either the upper reproductive tract (fallopian tubesovary and uterus), and the lower reproductive tract (vaginacervix and vulva); for males these infections are at the penistesticlesurethra or the vas deferens. The three types of reproductive tract infections are endogenous infectionsiatrogenic infections and the more commonly known sexually transmitted infections.Each has its own specific causes and symptoms, caused by a bacterium, virus, fungus or other organism. Some infections are easily treatable and can be cured, some are more difficult, and some are non curable such as AIDS and herpes.

Congenital abnormalities

Examples of congenital abnormalities of the reproductive system include:
  • Kallmann syndrome - Genetic disorder causing decreased functioning of the sex hormone-producing glands caused by a deficiency or both testes from the scrotum.
  • Androgen insensitivity syndrome - A genetic disorder causing people who are genetically male (i.e. XY chromosome pair) to develop sexually as a female due to an inability to utilize androgen.
  • Intersexuality - A person who has genitalia and/or other sexual traits which are not clearly male or female.

Examples of cancers

Examples of cancers of the reproductive system include:

Examples of functional problems

Examples of functional problems of the reproductive system include:

Health & Medicines pharmacist tips : Antibiotics (Quinolone )

Health & Medicines pharmacist tips : Antibiotics (Quinolone ): antibiotic .(quinolone group):- The newer fluoroquinolones have broad-spectrum bactericidal activity, excellent oral bioavailability, g...

Antibiotics (Quinolone )



antibiotic .(quinolone group):-



The newer fluoroquinolones have broad-spectrum bactericidal activity, excellent oral bioavailability, good tissue penetration and favorable safety and tolerability profiles. A new four-generation classification of the quinolone drugs takes into account the expanded antimicrobial spectrum of the more recently introduced fluoroquinolones and their clinical indications. First-generation drugs (e.g., nalidixic acid) achieve minimal serum levels. Second-generation quinolones (e.g., ciprofloxacin) have increased gram-negative and systemic activity. Third-generation drugs (e.g., levofloxacin) have expanded activity against gram-positive bacteria and atypical pathogens. Fourth-generation quinolone drugs (currently only trovafloxacin) add significant activity against anaerobes. The quinolones can be differentiated within classes based on their pharmacokinetic properties.

Overview of Fluoroquinolones:-

The fluoroquinolones are broad-spectrum antibiotics with particular activity against gram-negative organisms, especially Pseudomonas aeruginosa. These agents are well absorbed when given orally. Because tissue and fluid concentrations often exceed the serum drug concentration, these antibiotics are particularly useful for certain infections, such as pneumonia.4-6 Fluoroquinolones are usually well tolerated, with few side effects. However, they can have serious adverse effects

SIDE EFFECTS:-

The most common adverse effects of the fluoroquinolones are nausea, vomiting and diarrhea, which occur in 3 to 6 percent of recipients.5 Other more serious but less common side effects are central nervous system effects (headache, confusion and dizziness), phototoxicity (more common with lomefloxacin [Maxaquin] and sparfloxacin [Zagam]), cardiotoxicity (sparfloxacin) and hepatotoxicity (trovafloxacin .

CLINICALLY IMPORTANT PHARMACOKINETIC:-

The newer fluoroquinolone antibiotics also have improved pharmacokinetic parameters compared with the original quinolones. They are rapidly and almost completely absorbed from the gastrointestinal tract. Peak serum concentrations obtained after oral administration are very near those achieved with intravenous administration.3 Consequently, the oral route is generally preferred in most situations, and hospitalized patients should be switched from intravenous to oral formulations as soon as oral medications can be tolerated.
Absorption of orally administered fluoroquinolones is significantly decreased when these agents are coadministered with aluminum, magnesium, calcium, iron or zinc, because of the formation of insoluble drug–cationic chelate complexes in the gastrointestinal tract.3,10 The problem can be overcome largely by administering products containing these metal ions at least four hours before or two hours after oral administration of a fluoroquinolone. Because sucralfate (Carafate) contains aluminum, it can also reduce absorption of the quinolones. Adequate spacing of administration times has not been determined, and coadministration of quinolones and sucralfate should be avoided.

1.ciproflaxacine 
2.enoxicine
3.levoflaxacine
5.noreflaxacine
6.oflaxacine
7.travaflaxacine
the above 7 drugs have same group but different chemical structures & mechanism of actions.

New Classification of Quinolones


FIRST GENERATION

The first-generation agents include cinoxacin and nalidixic acid, which are the oldest and least often used quinolones. Because minimal serum levels are achieved, use of these drugs has been restricted to the treatment of uncomplicated urinary tract infections.
Cinoxacin and nalidixic acid require more frequent dosing than the newer quinolones, and they are more susceptible to the development of bacterial resistance. These agents are not recommended for use in patients with poor renal function because of significantly decreased urine concentrations.

SECOND GENERATION

The second-generation quinolones have increased gram-negative activity, as well as some gram-positive and atypical pathogen coverage. Compared with first-generation drugs and considered as a group, these agents have broader clinical applications in the treatment of complicated urinary tract infections and pyelonephritis, sexually transmitted diseases, selected pneumonias and skin infections.
Second-generation agents include ciprofloxacin, enoxacin, lomefloxacin, norfloxacin and ofloxacin. Ciprofloxacin is the most potent fluoroquinolone against P. aeruginosa.21,22 Because of its good penetration into bone, orally administered ciprofloxacin is a useful alternative to parenterally administered antibiotics for the treatment of osteomyelitis caused by susceptible organisms.
Although the FDA has labeled some second-generation quinolones for the treatment of lower respiratory tract infections and acute sinusitis, it should be stressed that S. pneumoniae is frequently resistant to agents in this class. Consequently, second-generation quinolones are not the drugs of first choice for lower respiratory tract infections and acute sinusitis.
Of the second-generation agents, ofloxacin has the greatest activity against Chlamydia trachomatis.
Ciprofloxacin and ofloxacin are the most widely used second-generation quinolones because of their availability in oral and intravenous formulations and their broad set of FDA-labeled indications.

THIRD GENERATION

The third-generation quinolones currently include levofloxacin, gatifloxacin, moxifloxacin and sparfloxacin. These agents are separated into a third class because of their expanded activity against gram-positive organisms, particularly penicillin-sensitive and penicillin-resistant S. pneumoniae, and atypical pathogens such as Mycoplasma pneumoniae and Chlamydia pneumoniae.6,12,19 Although the third-generation quinolones retain broad gram-negative coverage, they are less active than ciprofloxacin against Pseudomonas species.
Because of their expanded antimicrobial spectrum, third-generation quinolones are useful in the treatment of community-acquired pneumonia, acute sinusitis and acute exacerbations of chronic bronchitis, which are their primary FDA-labeled indications. Gatifloxacin also has FDA-labeled indications for urinary tract infections and gonorrhea.20 Levofloxacin (the more active component of the ofloxacin racemic mixture12,21) and gatifloxacin are available in oral and intravenous formulations.
Sparfloxacin carries a significant risk of phototoxicity.21,23 Grepafloxacin, sparfloxacin and moxifloxacin have been reported to cause prolongation of the QT interval; gatifloxacin has not. However, the FDA recommends that all of these drugs should be avoided in patients who are taking drugs that are known to prolong the QT interval, such as tricyclic antidepressants, phenothiazines and class I antiarrhythmics.24 In contrast, levofloxacin does not affect the QT interval.

FOURTH GENERATION:-

Trovafloxacin, currently the only member of the fourth-generation class, adds significant antimicrobial activity against anaerobes while maintaining the gram-positive and gram-negative activity of the third-generation quinolones. It also retains activity against Pseudomonas species comparable to that of ciprofloxacin.17,18
Trovafloxacin is available in an oral tablet and as the prodrug alatrofloxacin (Trovan IV) in an intravenous formulation. Although the findings of few clinical trials on trovafloxacin have been published, the drug was originally labeled by the FDA for the treatment of a wide spectrum of infectious diseases.18 Because of concern about hepatotoxicity, trovafloxacin therapy should be reserved for life- or limb-threatening infections requiring inpatient treatment (hospital or long-term care facility), and the drug should be taken for no longer than 14 days.