*Nonsteroidal Antiinflammatory Drugs

*Drugs used in Gouty Arthritis

*Opioid

*Anti fungal

Mediators of inflammation:
*Histamine
*Bradykinin
*Serotonin
*Endogenous peptides
*Prostaglandins
*Leukotrienes
*Cytokines







 Synaptic
Arrangement of Dorsal Horn

Descending Projections from Raphe' N.

To Reticular Formation,
Thalamus

Dorsal Root Ganglion

Excitatory
Synapses

Serotonin Serotonin
From
Nociceceptors

Inhibitory
Synapses

Enkephalin
Dynorphin or GABA

Substance and
P
other transmitters


Naturalopiumalkaloids
(Papaversomniferum)

Morphinegoldstandard
Codeine
Thebaine(nonanalgesic)


 Opioids

NSAIDS


Fungi Disease in man.

*Mould (filamentous fungi)

*True yeasts (round or oval fungi)

*Yeast-like fungi
Moulds:
*Dermatophytes digest keratin cause
infections of skin,nails and hair.

*Aspergillus fumigatus:
-Pulmonary Aspergillosis
-Disseminated Aspergillosis
True yeasts

*Cryptococcus neoformans cause:

Cryptococcal meningitis or pulmonary
Infections (in immunocompromised pts).

Polyenes:
Amphotericin
-wide spectrum
-use to treat fatal infection (aspergillus,candida,
cryptococcus)
-oral abs. poor i.v. infusion or intrathecal (cns infection)
-ADR: fever,chills,nausea,renal damage.

Nystatin
-too toxic for parenteral use.
-candida albicans infection of skin,mucous membrane (mouth,
vagina).
-administration: topical/local
Yeast-like fungi

*Candida albicans common comensal

organism in the gut,mouth,vagina.
It causes oral thrush,vaginitis,endocardi
tis,septicaemia (often fatal).
Imidazoles
-wide spectrum,resistance rarely develops
-oral abs. poor,except ketoconazole
-clotrimzole,econazole,miconazole are used topically for dermato
phytes and candida albicans
-ketoconazol oral is used for local and systemic mycoses
-miconazole i.v. is used for treatment of systemic infection who
cannot tolerate amphotericin.

Tiazole
Fluconazole
-is used orally or i.v.
-superficial or systemic mycoses (not aspergillus)
Itraconazole is used orally ,active against asperillus.
Flucytosine
-is given orally or i.v. infusion
-is used to treat systemic candidiasis or cryptococcal infection
-resistance develops rapidly combine with amphotericin
-narrow specrum