1. Treatment for dyspepsia (消化不良), heartburn, GORD
Dyspepsia due to food (spicy, high fibre, fatty, too quick eating, overeating)
Heartburn due to acid from stomach into oesophagus
GORD-heartburn & reguigitation due to weak/open lower oesophageal sphincter caused by pregnancy, obesity and hiatus hernia… can lead to cancer,
Antacid: can be used for all the 5 illness,
Mylanta: alkaline to neutralise acid, mixture of Mg++ and Al+++ hydroxide. Accumulation of Al+++ can lead to osteoporosis and myopathy
Gaviscon: mixture of Ca++ carbonate, Na+ bicarbonate and alignate (helps mucus stick to oesop.)
PPI: can be used for all the 5 illness
Omeprazole, a prodrug- enteric-coated, need acid environment, alkaline pH-intestine, inhibit P450, decrease clearance of benzodiazepine, phenytoin and warfarin
H2 antagonist(ranitidine): only used for the top 3
2. Treatment for peptic ulcer: AB and PPI, antacid, Sucralfate
Peptic ulcer due to H. pylori, excessive acid(imbalance mucous defence and aggressive factor)
AB: combination of amoxicillin and clarithromycin, or with PPI
Sucralfate: produce sticky gel to ulcer and inhibit digestion of mucosal protein which digested by pepsin in intestine. Side effect: antacid can prevent sucralfate, sulcralfate can prevent some drugs
3. Treatment for NSAIDs-induced ulcer: PPI or misoprostol, antacid, Sucralfate
NSAIDs induced ulcer:Non selective inhibitor of COX-aspirin remove cytoprotective prostaglandins (PGI2) Misoprostol: selective agonist at prostaglandins EP receptor inhibiting acid secr, oral, long lasting
Side effect: diarrhoea due to EP stimulate gut mobility; contraction of uterus
4. Treatment for gut motility: Domperidone, Prucalopride, Metoclopramide
Gut motility (peristalsis) due to release of ACH in the enteric nervous system from excitatory motor neurones binding to M2(smooth muscle contraction).DA:D2 receptor agonist, inhibits release of ACH .
Gastroparesis: paralysis of stomach muscle due to loss of neural control with DM. Domperidone
Irritable bowel syndrome: symptoms between diarrhea and constipation
Increase ACH to increase gut motility: D2 antagonist (Domperidone), 5-HT (Prucalopride)
Domperidone: D2 receptor antagonist-prevents DA , increase ACH, increase gut motility—used in GORD,gastroparesis
Prucalopride: selective 5-HT4 receptor agonist. Used in constipation
Metoclopramide: D2 antagonist & 5-HT4 agonist, used in GORD and gastroparesis
5. Treatment for emetics due to cytotoxic drugs, motion sickness, post-operation
Cytotoxic drug: irritate GIT (5-HT3 receptor); chemoreceptor trigger zone(CTZ), 5-HT3-D2-NK1
Ondansetron: 5-HT3 antagonist, acts on CTZ(central) and gut(peripheral)
Prochlorperazine/Metoclopramide: D2 antagonist in CTZ, cytotoxic drug or pregnancy(morning)
Aprepitant: NK1- antagonist(neurokinin) to inhibit substance P (neurotransmitter peptide) binding
Dexamethasone: GCS, inhibit PGE2
Motion sickness: motion monitored by inner ear into cerebellum, H1, M receptor- nausea vomiting
Promethazine: H1 & M antagonist, cross BBB to act on H1&M in cerebellum, make drowzy
Scopolamine: M antagonist, cross BBB. Transdermal patch
6. Treatment for diarrhea:
Due to infection: no need tx, give fluid and electrolyte
Due to malabsorption: lactose intolerance, gluten malabsorption--AB
Due to inflammatory Bowel dx. AB
Loperamide; stimulate GIT u receptor anti-diarrhea (mimicking morphine which can cause constipation by stimulating u receptor decreasing gut motility)
7. Treatment for constipation: high fibre, low fat intake,^ fluid, exercise
Methylcellulose: bulking forming laxatives:poorly fermented-发酵 fibre attracts
CT050-3-3 Project Management In-course Assignment Company : Healthy Living Pte. Ltd. (HL) - Singapore Service : Global IT Services (GITS) - Malaysia Project : Global Supply Chain Management Project (GSCMP) I. Assignment Learning Outcomes 1. Decide the aims and objectives, deliverables and scope of a typical IT project within the wider context of IT management, create appropriate standards and procedures and communicate the outline of the project effectively to a variety of stakeholders, discuss…
8th hourly. She is ordered 4/24 neuro obs for 24hrs. Julia’s parents have just arrived. | Social history | Lives with her mother. Parents from a low social economic background. Julia works as a shop assistant at the local Coles, casually one day a week after school. She is an only child. Her parents are divorced. Julia is socially active and goes partying every weekend. She admits to binge drinking at parties; states approx 6 glasses of spirits in pm. She says she has taken illicit drugs such as…
Animals 2012, 2, 261-274; doi:10.3390/ani2020261 OPEN ACCESS animals ISSN 2076-2615 www.mdpi.com/journal/animals Review Mannan Oligosaccharides in Nursery Pig Nutrition and Their Potential Mode of Action Veronika Halas 1,* and Imre Nochta 2 1 2 Department of Animal Nutrition, Faculty of Animal Science, Kaposvár University, P.O. Box 16, H-7400 Kaposvár, Hungary Provimi, P.O. Box 1, H-8112 Zichyújfalu, Hungary; E-Mail: inochta@hu.provimi.com * Author to whom correspondence should be addressed;…
capable of causing CNS side effects: including dizziness, drowsiness, sleepiness, insomnia, vivid dreams, nightmares, and hallucinations These side effects occur shortly after a patient initiates Sustiva base therapy and could last up to four weeks After four weeks, these side effects usually subdue and the patient experiences these side effects less frequently tolerance Individuals who have certain genomic polymorphisms, more specifically, mutations in the COIP OV 6 enzyme which is responsible for…
disease. The infection may stay inactive (dormant) for years. However, in some people it can reactivate. Most people who develop symptoms of a TB infection first became infected in the past. However, in some cases, the disease may become active within weeks after…
NTR 109 Week Six - Ten Vitamins and Phytochemicals Vitamins Essential organic substances Produce deficiency symptoms when missing from diet Yield no energy Basic functions: Facilitate energy-yielding chemical reactions Function as co-enzymes Fat-soluble vitamins A, D, E and K Absorbed with fat Transported by protein carriers Stored in large amounts in liver and fatty tissues More time to become deficient Highly toxic—especially Vitamin D and A Dissolve in lipids or solvents Water-soluble vitamins…
Perspectives on Political Science, 40:123–131, 2011 Copyright C Taylor & Francis Group, LLC ISSN: 1045-7097 print / 1930-5478 online DOI: 10.1080/10457097.2011.585930 Science and the Fate of the Human Soul in Tom Wolfe CAROL MCNAMARA Abstract: This article investigates Tom Wolfe’s assessment of the age-old debate between nature and nurture, the Cartesian mind–body problem, and the tensions between science, politics, and morality that result from the human struggle to explain what the components…