| Infection ¢ acter, vital, eat Description Antiiserboal deayss work in severat ways: J Locally acting sents Kautia often cou with Pectin, Most widely used preparation avail Powder dosage form, I adsorbs bacterial tox binds witcr nd decreases Bismuth subvsaliey a 2. Cemeally etn Codeine has limited uss tivity onan use it teal to tolerance, addiction and withdrawal manifestations Diphenestate:opium-ike deag with fess active propeties Wakely ned cansinnet oth voi Laperauide: produces rapid and sustained inhibition ofthe peristaltic telex stosing the passage of stots through the intestine Sich wil allow more tie for Water and salts in the stools to be absored back ita the bads Octreotide: Iisa synthetic somatostatin analog, Highly efteetive in relieving diarrhea of Carcinoid Syndrome, Given SC or tna 1: infusion. Autidiarrheal medication in, digziness, dry mouth, + Can cause constipation (major side effect), Low back pain, headache, distension, res, ebPee Oe 5 ” ade isan agent which promote the formation and excretion of urine, PLUID ELECTROLYTE BALANCE : Nephron is divided nto five function anes. Tes five mes pla important rl i formation and regulation of ionic composition of urine bythe reabsorption or secretion of ons and water. These faetonal zones a ({) Proximal convoluted tubule (2) The descending loop of Henle (3) The ascending loop of ene 4) The distal convoluted tubule 5 ee (3) The collecting tubule, eY {1) Proximal ConvoletedTubite Site 1): Approinatly 50~ 60% of Na" and alinost al lucose biarbonteand ani | are | reabsorbed at this site, here Na* jons are ‘exchanged for H’ aS Carbonic anhydrase. iekblors at ‘on thi a ‘The fluid ingroing | tubule is isoosmotic. sa oo (2) The Descending Loop of Henle (Site I): It is highly permeable ro water which moves out passively under osmotic fra Due to excessive reabsorption of wate, the fluid becomes hypertonic. * (3) The Ascending Loop of Henle (Site II) : The ascending loop is highly impermeable to water. This isa major st oy | absorption where Na’, K* and Clare reabsorbed actively, Due to tis reason drugs acting at this site (e.g loop diuretics; ruse most efficaceous. i (4) The Distal Convoluted Tubule (Site IV) : In distal convoluted tubule Na’ is reabsorbed by Na’ Cl’ carrier, Thiazide diureig } act by inhibiting Na‘Cl- carrier. (5) The Collecting Tubule (Site V) : The cells of collecting tubule have Na’ and K* channels. (K’ is exchanged for Na’), amilocie and triamterene act by blocking Na* channels thereby inhibit the excretion of K*(i.c., spares K"). Also the reabsorption of Na is unk the control of aldosterone and the reabsorption of water is under the control of vasopressin (antidiuretic hormone). Spironolacene (aldosterone antagonist) act by antagonising the action of aldosterone, Various drugs lke likium carbonate colchicine and via alkaloids produce diuretic effect (secondary effect) by antagonising the action of vasopressin. i ‘Diuretics can be classified on the basis of the site of action on nephron, CLASSIFICATIONS : (Uy Drugs acting onsite 1: earboni anhydrase inhibitors e , Acetzolamide, Methazolamide, Ethozolamide, Dichlophenami ©. (2) Drugs acting on site IIT: {a) Loop or high ceiling diuretics: ¢g., Furosemide, Bumetanide, Ethaerynie acid (0) Organle mercurils : ¢, Mersalyl, Mereurous chloride (calomel), (B) Drugs acting on Site 1V : {o) Thiacides : ¢. Bendroflumethiazide, Chlorthiazide, Hydrochlorthiazide, Benathiazide, Polythiaztde, (6) Thiazide like diuretics : eg., Chlorthalidone, Xipamide. (4) Drugs acting on Site V (Potassium sparing diuretics) : (a) Aldosterone antagonist: €, Spironolactone. (0) Direcly acting : eg, Tiamterene, Amiloride. (5) Other Drugs (a) Xamhines: e,, Theophylline, Caffeine, Aminophylline, {bj Osmotic diuretics : ¢.g., Mannitol, Isosorbide, {c) Acidifying /alhalintzing agents: ¢.g,, Ammonium chloride, Potassium citrate/acetate, (0) Drugs Acting On Site 1: ‘Carbonic Anbydrase Inhibitors : The cells of renal tubule form carboni it Bora re form carbonic seid from CO, and H,0 inthe presence ofthe en\ ANTACIDS posted at el antag late sate poy un ws Fe gent ya te Wnty, ata Womting. Mo wit paste Ansacts soe wend fapes Hat 18 Sor eH gettcn anaes eater ws avis HI] ana on tel Commonly aed antachds are stn ie yates) ant alunit of AKOHD, 12. atnatauminon Akan pds ol BREE Ae eerie th hi, . f Satteot magmesisay Magnesium hy dose [8011] Cah FM 1 C1), at Ca), ais coms on suis ane sows ih 1H fora CO , bid Liem satat oar] ssa and ats ne emake te arated atm 9 eas fh HCL poe canto ioe aa NACL Hera coon i reantrowt and MeachingMhivmy had metabolic alos x Therapeutic user: ; * containing antachds can promote healing oF duodenal uleers, coxide may be eonstipatine, in that combine these agents in normalizing bowel function. {aL CO, libeiuies CO, casing belching snd Matulence. 1 is usually not s-preblen in patients with normal ree! function, bute authoea. Prep nay poedtace ual for sesteniy alkaose sorption of cations trom antaenls (Mg! AE soit sortent of antacids can be finpettant consideration Drug interactions: 4 Cotsurrent adm nistration of antacids and other diugs are avoided. By altering gastric and urinary pH or delaying gaste city iis can aflect rales of dissolution an! absorption, bioavailability, and renal elimination of many drugs. © Wrlrtetaacysine, AV" semmpaets ean form Aasoluble vomplees that are not absorbed. (© Anvavils can nerease the rate of absorption of same rugs for example, levodopa. ANTIULCER DRUGS Awuleor va discontinuity orbrcah in a bodily membrane that impedes the organ of which that membrane isa part from continua issmormal functions, Although the pathoxenesis oF peptic ulcer disease isnot tally understood, three maj i : snot filly food, three major factors are recognized, infection with gram-negative Helicobacter a a sia © invressed hydruchlone acid sevtction, © inwlequatermucosal detense Antiulver drugs seainst gastric acid. | Classification of deug used as AT ntimicrobial agent: Amovicillt ‘V2: Ht histamine receptor blocker A. Prostaglandins: Misupeostol. (Proton pump inhibitors: Lansoprazole, Meprazole, Dhawan Book Publications Bismuth compounds, Clarithromy Cimetidine, Famotidine, Pj Metronidazole, Tetracycline. ‘ratidine, Ranitidin, 582