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12:58, 30 April 2023 Nikolas talk contribs created page 82. Pharmacogenetics, pharmacogenomics. Effects of age, diet and disease on drug action (Created page with "== Personalized medicine == When studying the effect of a drug, we do it on populations with many hundred or thousand people. These clinical trials measure the average effect of the drug on many people. These trials don’t take into account the individual response of the drug. This is a problem, because while we study drug effects on large populations, physicians use the drugs to treat individual patients. The same drug given in the same dose doesn’t necessarily prod...") Tag: Visual edit
12:51, 30 April 2023 Nikolas talk contribs created page File:SSRI panel.jpg
12:51, 30 April 2023 Nikolas talk contribs uploaded File:SSRI panel.jpg
12:48, 30 April 2023 Nikolas talk contribs created page 81. Antiseptics and disinfectants (Created page with "A disinfectant is a compound which destroys or inhibits the growth of microorganisms on ''non-living objects'', like tables, walls, beds, etc. An antiseptic is a compound which destroys or inhibits the growth of microorganisms on ''living tissue'', like on the skin or on mucous membranes. They are not meant for systemic use, which separates them from antibiotics. An ideal antiseptic (or disinfectant) must have the following properties. It must: * destroy or remove all...") Tag: Visual edit
12:44, 30 April 2023 Nikolas talk contribs created page 80. Anthelminthic drugs (Created page with "== Helminths == Helminths are parasitic worms. They’re categorized like this: * Helminths (worms) ** Plathelminths (flatworms) *** Cestodes (tapeworms) *** Trematodes (flukes) ** Nemathelminths (roundworms) *** Nematodes (threadworms) **** Intestinal nematodes **** Filariae == Antihelminthic drugs == Classified according to mechanism of action: * Drugs against flatworms ** Drugs which bind tubulin *** Benzimidazoles ** Drugs which interfere with energy production **...") Tag: Visual edit
14:50, 26 April 2023 Nikolas talk contribs created page 79. Antiprotozoal drugs (Created page with "== Antimalarial drugs == Malaria is the most common disease in the world. It’s caused by the ''plasmodia'' species of parasites, which are spread by the ''Anopheles'' mosquito. Plasmodium vivax causes benign tertian malaria. Plasmodium falciparum causes malignant tertian malaria, which affects the CNS. === Compounds === * Chloroquine * Primaquine * Artesunate * Quinine * Atovaquone * Proguanil * Pyrimethamine * Doxycycline * Clindamycin Of all of the antimalarials t...") Tag: Visual edit
14:48, 26 April 2023 Nikolas talk contribs created page 78. Antiviral drugs against HIV and influenza viruses (Created page with "== Antivirals against HIV == * Nucleotide reverse transcriptase inhibitors (NRTIs) ** Zidovudine ** Lamivudine ** Abacavir * Non-nucleotide reverse transcriptase inhibitors (NNRTIs) ** Nevirapine ** Efavirenz * Protease inhibitors (PIs) ** Darunavir ** Lopinavir ** Ritonavir * Integrase strand transfer inhibitors (INSTIs) ** Raltegravir ** Dolutegravir * Entry inhibitors ** Enfuvirtide * CCR5-antagonists ** Maraviroc === Indications === The standard regimen for ''antir...") Tag: Visual edit
14:39, 26 April 2023 Nikolas talk contribs created page 77. Antiviral drugs against herpes and hepatitis viruses (Created page with "== Antivirals against HSV, VZV and CMV == We can classify the antivirals against herpes viruses according to the mechanism of action: * Guanosine analogues activated by thymidine kinase ** Acyclovir ** Valacyclovir – prodrug of acyclovir ** Penciclovir ** Famciclovir – prodrug of penciclovir * Guanosine analogues activated by UL97 kinase ** Ganciclovir ** Valganciclovir – prodrug of ganciclovir * Direct viral DNA/RNA polymerase inhibitor ** Foscarnet * Cytidine an...") Tag: Visual edit
14:37, 26 April 2023 Nikolas talk contribs created page 76. Antifungal drugs (Created page with "== Polyenes == === Compounds === * Amphotericin B * Nystatin * Natamycin === Indications === Amphotericin is the first choice for severe systemic fungal infections. Nystatin and natamycin are too toxic for systemic use and instead used topically for oral and vaginal candidiasis. === Mechanism of action === Polyenes disrubt fungal cell wall synthesis by binding to ergosterol in the fungal cell membrane, which leads to formation of pores in the membrane, causing leaka...") Tag: Visual edit
14:36, 26 April 2023 Nikolas talk contribs created page 75. Antituberculotic drugs. Anti-leprosy drugs (Created page with "== Antituberculotic drugs == Treating mycobacteria is a challenge for the following reasons: * The mycobacterial cell wall is thick and less permeable for antibiotics, and it expresses several efflux transporters * Mycobacteria multiply slowly * Many mycobacteria are genetically resistant to many antibiotics For these reasons there are many drugs which are available for treating TB, so that we have multiple options in case of resistance. The first-line agents in treat...") Tag: Visual edit
14:32, 26 April 2023 Nikolas talk contribs created page 74. Macrolide antibiotics, clindamycin, chloramphenicol, oxazolidinones, streptogramins (Created page with "== Macrolides == === Compounds === * Erythromycin * Clarithromycin * Azithromycin === Mechanism of action === Macrolides bind to the 50S subunit of bacterial ribosomes, inhibiting translocation. This effect is bacteriostatic. === Mechanism of resistance === Resistance is often encoded by a plasmid. It can be mediated by drug efflux, enzymatic inactivation or changing the binding-site of macrolides on the ribosomes. === Pharmacokinetics === Macrolides are orally abso...") Tag: Visual edit
14:28, 26 April 2023 Nikolas talk contribs created page 73. Tetracyclines, aminoglycosides (Created page with "== Tetracyclines == Tetracyclines are a group of antibiotics. The most important ones are tetracycline, doxycycline, demeclocycline, minocycline, lymecycline and oxytetracycline. Tigecycline is technically not a tetracycline but is similar enough that it is mentioned here. === Mechanism of action === Tetracyclines bind to the 30S ribosomal subunit in bacteria and prevent elongation of the peptide chain. This elicits a bacteriostatic effect. === Mechanisms of resistance...") Tag: Visual edit
14:27, 26 April 2023 Nikolas talk contribs created page 72. Glycopeptide antibiotics. Daptomycin, fosfomycin, bacitracin, polymyxins, gramicidins (Created page with "== Glycopeptide antibiotics == The important glycopeptide antibiotics are vancomycin and teicoplanin. === Mechanism of action === Glycopeptide antibiotics inhibit cell wall synthesis by inhibiting the transpeptidation process which is essential for cell wall synthesis. They bind to the D-Ala-D-Ala residue of the substrate for the transpeptidation reaction. They are mainly effective against Gram positive bacteria. They are bactericidal. === Pharmacokinetics and dosing...") Tag: Visual edit
14:25, 26 April 2023 Nikolas talk contribs created page 71. Carbapenems, monobactams, beta lactamase inhibitors (Created page with "== Carbapenems == Carbapenems have the broadest antibacterial spectrum of all beta lactam antibiotics. They are effective against many Gram-positive, Gram-negative and anaerobes, but not MRSA or enterococci. The most important ones are imipenem, meropenem and ertapenem. Imipenem is combined with ''cilastatin'', a drug which delays its metabolism. Due to the potentially significant side effects and driving of resistance these drugs are considered a “last resort”. ==...") Tag: Visual edit
19:16, 23 April 2023 Nikolas talk contribs created page 70. Penicillins, cefalosporins (Created page with "== β-lactam antibiotics == thumb|211x211px|The structure of penicillin, with the beta lactam ring in red. From <nowiki>https://en.wikipedia.org/wiki/%CE%92-lactam_antibiotic</nowiki> The beta lactam antibiotics is a class of antibiotics that all contain a so-called beta lactam ring. All beta lactam antibiotics interfere with the synthesis of the bacterial cell wall peptidoglycan. They bind covalently to a protein called ''penicillin-bi...") Tag: Visual edit
18:46, 23 April 2023 Nikolas talk contribs created page File:Penicillin structure.png
18:46, 23 April 2023 Nikolas talk contribs uploaded File:Penicillin structure.png
18:45, 23 April 2023 Nikolas talk contribs created page 69. Nitroimidazoles. RNA polymerase inhibitors (Created page with "''RNA polymerase inhibitors include the macrocyclines and rifamycins''. == Nitroimidazoles == === Compounds === * Metronidazole * Tinidazole The most important nitroimidazole is metronidazole, but tinidazole is very similar. === Mechanism of action === Nitroimidazoles are prodrugs which are metabolized into reactive metabolites by enzymes inside the pathogen cell. The reactive metabolites then bind to and damage DNA and proteins. This effect is bactericidal. === Me...") Tag: Visual edit
18:38, 23 April 2023 Nikolas talk contribs created page 68. Sulfonamides, trimethoprim, pyrimethamine. Fluoroquinolones (Created page with "== Sulphonamides and diaminopyrimidines == Sulphonamides and diaminopyrimidines both act on the folic acid metabolism of bacteria and parasites. They potentiate each other’s actions and are therefore almost always sold in fixed combinations. Here are the most important combinations: {| class="wikitable" !Sulphonamide !Diaminopyrimidines !Name of combination !Effective against |- |Sulfamethoxazole (SMX) |Trimethoprim (TMP) |Co-trimoxazole or Bactrim® or TMP/SMX |Bacter...") Tag: Visual edit
18:34, 23 April 2023 Nikolas talk contribs created page 67. Parathyroid hormone, calcitonin and vitamin D, drugs used to treat osteoporosis (Created page with "== Osteoporosis == === Preventative measures === * Elimination of risk factors ** Smoking ** Alcohol * Physical activity * Calcium supplementation ** 1 – 1,5g daily * Vitamin D supplementation ** 800 international units (IU) daily === Treatment === The first-line treatment of osteoporosis are bisphosphonates like alendronate. Other potential treatments include: * Teriparatide (parathyroid hormone analogue) * Oestrogens * Tibolone * Raloxifene * Denosumab Strontium...") Tag: Visual edit
18:30, 23 April 2023 Nikolas talk contribs created page 66. Insulin and oral hypoglycaemic agents. Glucagon (Created page with "== Insulin == === Preparations === * Rapid-acting insulin ** Insulin lispro (Humalog®) ** Insulin aspart (NovoRapid®) * Short-acting insulin ** Soluble insulin (Actrapid®) * Intermediate-acting insulin ** NPH insulin (Insulatard®) * Long-acting insulin ** Insulin glargine ** Insulin detemir * Mixed insulin The different insulin preparations have different pharmacokinetic properties. This is accomplished by modifying the insulin or by suspending insulin in certain...") Tag: Visual edit
18:03, 23 April 2023 Nikolas talk contribs created page 65. Thyroid hormones, antithyroid drugs (Created page with "== Pharmacological therapy of hypothyroidism == * L-thyroxine * Liothyronine * Iodine === Indication === The most frequently used drug to treat hypothyroidism is L-thyroxine (levothyroxine). Liothyronine is used when rapid effect is needed, or if it’s desirable that the effect should go over quickly after stopping the drug. This can be beneficial in the treatment of myxoedema coma. It’s never used alone and should always be combined with L-thyroxine. Iodine is us...") Tag: Visual edit
17:54, 23 April 2023 Nikolas talk contribs created page 64. Androgens, anabolic steroids, antiandrogens (Created page with "== Androgens == The main endogenous androgen is testosterone. Dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS) and androstenedione are all weaker androgens. The weak androgens can be converted into testosterone. === Endogenous biosynthesis === In men the Leydig cells of the testes are the main producer of androgens, while the adrenal cortex doesn’t contribute too much to overall androgen production. In women the adrenal cortex is the main produce...") Tag: Visual edit
17:51, 23 April 2023 Nikolas talk contribs created page 63. Postmenopausal hormone therapy and hormonal contraceptives (Created page with "== Postmenopausal hormone replacement therapy == At menopause ovarian function decreases and oestrogen levels fall. This causes several problems, like osteoporosis, genital atrophy and increased cardiovascular risk, but also less severe problems like hot flushes, sweating, sleep problems, palpitation and mood disturbances. In theory, replacing oestrogen to postmenopausal women should eliminate all these problems. However, hormone replacement therapy is not without its ow...") Tag: Visual edit
17:43, 23 April 2023 Nikolas talk contribs created page File:Types of oral contraceptives.png
17:43, 23 April 2023 Nikolas talk contribs uploaded File:Types of oral contraceptives.png
10:33, 23 April 2023 Nikolas talk contribs created page 62. Estrogens, antiestrogens, progestins, antiprogestins (Created page with "== Pharmacology of oestrogens == Oestrogens have some uses in pharmacology. The important oestrogens are: * Natural oestrogens ** Estradiol ** Estriol ** Estrone * Semi-synthetic ** Ethinyl estradiol ** Estradiol valerate Oestrogens elicit the following effects: * Induction of primary and secondary female sex characteristics * Induction of the proliferative phase of the menstrual cycle * Hyperplasia of endometrium * Increased expression of progesterone receptor * Prep...") Tag: Visual edit
10:27, 23 April 2023 Nikolas talk contribs created page 61. Corticosteroids (Created page with "The corticosteroids are hormones released from the adrenal cortex. We distinguish two types of corticosteroids, the glucocorticoids and the mineralocorticoids, although in clinical practice the term “corticosteroids” is often used to mean glucocorticoids only. The release of glucocorticoids is stimulated by ACTH. The level of ACTH, and therefore glucocorticoids, follows a diurnal rhythm, meaning that it is at its highest at 8:00 and at its lowest at midnight. == Eff...") Tag: Visual edit
10:23, 23 April 2023 Nikolas talk contribs created page 60. Hypothalamic and pituitary hormones (Created page with "== The hypothalamo-pituitary axis == Hypothalamic hormones: {| class="wikitable" !Hormone !Receptor type !Stimulatory/inhibitory !Effect |- !Thyrotropin-releasing hormone (TRH) |Gs-coupled |Stimulatory |TSH↑ |- !Corticotropin-releasing hormone (CRH) |Gq-coupled |Stimulatory |ACTH↑ |- !Somatostatin (SST) |Gi-coupled |Inhibitory |GH↓, TSH↓, ACTH↓, <abbr>GI</abbr> hormones ↓ |- !Growth hormone-releasing hormone (GHRH) |Gs-coupled |Stimulatory |GH↑ |- !Gonadotr...") Tag: Visual edit
10:20, 23 April 2023 Nikolas talk contribs created page 59. Drug abuse and dependence. Psychomotor stimulants, psychedelics, cannabis (Created page with "== Abuse of amphetamines == The most frequently abused amphetamines are methamphetamine, dextroamphetamine, mephedrone and “bath salts”. === Administration === Amphetamines are mostly taken orally but can be taken IV or by inhalation as well. === Effect === Amphetamines cause locomotor stimulation, euphoria, reduced fatigue, reduced appetite, stereotypical behaviour and sympathetic activation. MDMA causes psychedelic and hallucinogenic effects. === Dependence ===...") Tag: Visual edit
10:13, 23 April 2023 Nikolas talk contribs created page 58. Drug abuse and dependence: general principles, opioids, anti-anxiety and hypnotic drugs, inhalants, ethanol (Created page with "== General principles of drug dependence and abuse == Drug dependence or addiction refers to the state when drug-taking becomes compulsive and starts to take precedence over other needs. There is an excessive craving for the drug. A common feature of dependence-producing drugs is the activation of the dopaminergic “reward” pathway, the mesolimbic pathway. Most dependence-producing drugs produce a rewarding experience, like an elevation of mood or a feeling of euphori...") Tag: Visual edit
10:05, 23 April 2023 Nikolas talk contribs created page 57. Adjuvant analgesics. Centrally-acting muscle relaxants (Created page with "== Analgesics for neuropathic pain == Neuropathic pain is caused by damage to peripheral or central pathways. This pain is not easily treated as it responds poorly to conventional analgesics like NSAIDs, and even to opioids. Other drug types are necessary. === Compounds === * Tricyclic antidepressants ** Amitriptyline ** Nortriptyline * Antiepileptics ** Gabapentin ** Pregabalin ** Carbamazepine ** Oxcarbazepine * Local anaesthetics (as patch) * Capsaicin (as patch) **...") Tag: Visual edit
10:04, 23 April 2023 Nikolas talk contribs created page 56. Opioid analgesic drugs. Semisynthetic, synthetic opioids, opioid antagonists (Created page with "== Semisynthetic opioids == The semisynthetic opioids are derived from natural opioids (opiates). === Compounds === * Semisynthetic opioids used for analgesia ** Oxycodone (OxyNorm®, OxyContin®) ** Hydromorphone (Dilaudid®) ** Oxymorphone ** Hydrocodone *** (Hydrocodone/paracetamol is the famous Vicodin®, known from House M.D.) * Semisynthetic opioids used as cough suppressants ** Dihydrocodeine ** Ethylmorphine * Semisynthetic opioids used as drugs of abuse ** Her...") Tag: Visual edit
10:00, 23 April 2023 Nikolas talk contribs created page 55. Opioid analgesic drugs. Morphine and codeine (Created page with "== Nociception == The main type of peripheral sensory neuron that mediates pain is the ''polymodal nociceptor'' (PMN). This is non-myelinated C-type fibre that responds to thermal, mechanical and chemical stimuli. The chemical stimuli that act on PMNs include bradykinin, protons and vanilloids like capsaicin, which is what makes spicy food spicy. The sensitivity of PMNs is increased by prostaglandins, which explains the hyperalgesia that occurs during inflammation. The...") Tag: Visual edit
09:58, 23 April 2023 Nikolas talk contribs created page 54. Psychomotor stimulants and nootropic agents (Created page with "== Psychomotor stimulants == Psychomotor stimulants are drugs that have a marked effect on mental function and behaviour, producing excitement and euphoria, reduced sensation of fatigue and an increase in motor activity. The important drugs here are: * Amphetamines and related compounds * Cocaine * Methylxanthines ** Caffeine ** Theophylline Many of these drugs are drugs of abuse and don’t have any clinical use. Intoxication, withdrawal and treatment of intoxicatio...") Tag: Visual edit
09:52, 23 April 2023 Nikolas talk contribs created page 53. Drug treatment of neurodegenerative disorders (Created page with "== Mechanisms behind neurodegenerative diseases == Protein misfolding and aggregation is the first step in many neurodegenerative diseases, including Alzheimer and Parkinson disease, which are important in this topic. When proteins misfold their hydrophobic parts are exposed to the surface of the protein, which makes the proteins clump together into aggregates. These aggregates form structures we call ''amyloid deposits''. We don’t know how, but these amyloid deposits...") Tag: Visual edit
09:50, 23 April 2023 Nikolas talk contribs created page 52. General anaesthetics (Created page with "General anaesthetics are drugs that are used to put the patient into a state of general anaesthesia for the purpose of performing surgical procedures. A state of general anaesthesia is characterised by: * Reversible loss of consciousness * Amnesia * Analgesia * Loss of arousability * Immobility We usually need multiple drugs to reach general anaesthesia. Many different drugs are used as general anaesthetics. They’re either inhalation anaesthetics or intravenous anaes...") Tag: Visual edit
15:05, 18 April 2023 Nikolas talk contribs created page 51. Antiepileptic drugs (Created page with "== Epilepsy == An epileptic seizure occurs when there is abnormal electrical activity in the brain. This electric activity is often comprised of synchronous high frequency discharges in groups of neurons in the brain. If a one seizure lasts for more than five minutes or if the patient has two seizures without recovering their consciousness between the seizures, the condition is called ''status epilepticus''. Unlike most other seizures, status epilepticus is a medical em...") Tag: Visual edit
14:50, 18 April 2023 Nikolas talk contribs created page 50. Antidepressants (Created page with "== Depression == Depression is a common mental illness. It’s a major cause of disability and premature death. There is an increased risk for suicide, and people suffering from depression have increased risk to die of other causes as well. === Clinical features === * Low mood * Apathy * Anhedonia (reduced feeling of pleasure) * Loss of motivation * Feeling of guilt === Pathomechanism === According to the monoamine theory depression is caused by a deficit of monoamine...") Tag: Visual edit
14:17, 18 April 2023 Nikolas talk contribs created page 49. Antipsychotic drugs (Created page with "Psychosis refers to a disordered perception of reality, characterised by delusions, hallucinations and/or disorganized behaviour. It can be a symptom of psychiatric disorders like schizophrenia, bipolar disorder, psychotic depression or drugs like methamphetamine, cannabis or alcohol. In the context of pharmacology “antipsychotic drugs”, also called “neuroleptic drugs” usually refer to those drugs that are used to treat schizophrenia, but these drugs are used fo...") Tag: Visual edit
14:12, 18 April 2023 Nikolas talk contribs created page 48. Alcohols: Pharmacology, toxicology (Created page with "Ethanol (hereafter alcohol) is the most commonly used recreational drug in humans. Overdose can cause death due to respiratory and circulation depression. Ethanol itself is responsible for the “positive” CNS effects of alcohol, like euphoria and decreased inhibition. The “negative” effects like headache and nausea are rather caused by ethanol’s metabolite acetaldehyde. == Pharmacodynamics of alcohol == Alcohol acts on the CNS both as a stimulant and as a depre...") Tag: Visual edit
14:11, 18 April 2023 Nikolas talk contribs created page 47. Antianxiety and hypnotic drugs (Created page with "Anxiolytic and hypnotic drugs (often called sedative-hypnotic drugs) are those that induce sedation, decrease consciousness, and prevent seizures. They have a general inhibitory effect on the brain. They’re used on a wide range of indications, like anxiety and agitation, insomnia, status epilepticus, to induce anaesthesia, etc. Hypnotic drugs (sleeping pills) are those that induce sleep. It’s not easy to draw a clear line between anxiolytic and hypnotic drugs. Mostl...") Tag: Visual edit
14:06, 18 April 2023 Nikolas talk contribs created page 46. Local anaesthetics (Created page with "{| class="wikitable" !Ester type local anaesthetics ! colspan="2" |Amide type local anaesthetics !Toxins |- |Benzocaine !Intermediate duration !Long duration |Saxitoxin (STX) |- |Cocaine |Lidocaine |Bupivacaine |Tetrodotoxin (TTX) |- |Procaine |Mepivacaine |Levobupivacaine | |- |Tetracaine |Prilocaine |Ropivacaine | |} Local anaesthetics are drugs that are used to prevent or eliminate pain, often during smaller surgical procedures. This is in contrast to general anaesthe...") Tag: Visual edit
14:05, 18 April 2023 Nikolas talk contribs created page File:MoA of local anaesthetics.png
14:05, 18 April 2023 Nikolas talk contribs uploaded File:MoA of local anaesthetics.png
14:03, 18 April 2023 Nikolas talk contribs created page 45. Laxatives, antidiarrhoeal agents, drug treatment of inflammatory bowel disease and paralytic ileus, digestives, drugs used in cholelithiasis (Created page with "== Laxatives == These drugs stimulate the transit of food through the intestine. The user should always ensure sufficient fluid and electrolyte intake when using any of these. Overuse can lead to an atonic colon where the natural peristaltic activity is diminished. === Indications === * Obstipation * Enteritis – to remove toxins or infective agents * Colon cleansing before surgery, endoscopy or radiological examination === Classification === We differentiate four di...") Tag: Visual edit
12:32, 18 April 2023 Nikolas talk contribs created page 44. Emetics, antiemetics and prokinetic drugs (Created page with "== Introduction to vomiting == Vomiting is a defensive response intended to rid the body of toxic or irritating material. It’s regulating by a vomiting centre, comprised of the reticular formation and the area postrema/chemosensitive trigger zone in the fourth ventricle. Many receptors are involved in stimulating vomiting, including: * Histamine H1 receptor * Dopamine D2 receptor * Muscarinic receptor * Serotonin 5-HT3 receptor * Neurokinin NK1 receptor The chemorec...") Tag: Visual edit
12:29, 18 April 2023 Nikolas talk contribs created page 43. Drugs used in the treatment of peptic ulcer (Created page with "== Peptic ulcer == Peptic ulcers are mucosal breaks that penetrate the mucosa and may penetrate into the submucosa. They’re usually in the stomach or duodenum. Duodenal ulcers are mostly associated with too much acid while gastric ulcers are mostly associated with decreased protective factors. Both types are associated with alcohol, NSAID use, stress and most importantly, helicobacter pylori. H. pylori is responsible for the vast majority of peptic ulcers. It’s diag...") Tag: Visual edit
12:28, 18 April 2023 Nikolas talk contribs created page File:Regulation of gastric acid production.png
12:28, 18 April 2023 Nikolas talk contribs uploaded File:Regulation of gastric acid production.png