Over secretion of GH before puberty cause" gigantism"


##pituitary

Over secretion of GH after puberty cause "acromegaly"


##pituitary

Reduced section of GH cause "Dwarfism"

Note:GH = growth hormone


##pituitary

Bisphosphonates

(alendronate, risedronate, zoledronic, etidronate, ibandronate, pamidronate, and tiludronate)

postmenopausal osteoporosis preferred agents  (Bisphosphont) totesreatment is

1-alendronate, ORAL
وهذا فائدتة تكمن بااستمرارة اخذة باانتظام بس يخل وقت اخذة تقل فعاليتة
2_risedronate, ORAL
3_ zoledronic IV

MOA
Bisphosphonates +hydroxyapatite crystals(العملية هاي بال bone )
⬇️
  decrease osteoclastic bone resorption
واذا قلت شراح يصير ؟؟؟يعني وقفت التدمير الذاتي للعظم بالتالي راح احصل على ⬇️

1_small increase in bone mass
2_decreased risk of fractures in patients with osteoporosis.

oral bisphosphonates alendronate, risedronate, and ibandronate
جرعتهن يومية اسبوعية شهرية حسب المدة الي مصنعيها لكل دوا
أنتبه📌
_Absorption after oral administration is poor(less than 1% of the dose absorbed.)لاتنسون الرقم

_Food  و medications interfere with absorption of oral bisphosphonates

rapidly cleared from the plasma!➡️bind to hydroxyapatite in the bone

Elimination ➡️ kidney,➡️ avoided in severe renal impairment

patients unable to tolerate oral bisphosphonate➡️ ibandronate ٫ zoledronic acid ( alternatives).

Adverse effects:
Common:
musculoskeletal pain, abdominal pain, diarrhea

Un common:
1_osteonecrosis of the jaw
2_atypical femur fracture
وثنينهن يحدثن مع اخذ فترة العلاج occur with use of bisphosphonates
risk of atypical fractures seems to➡️long-term use of bisphosphonates.


ولهذا السبب لازم اكو holiday
5 years of oral bisphosphonates
3 years of zoledronic acid

📍 Alendronate,risedronate،ibandronate
⬇️الاعراض الجانبية الهم
esophagitis
esophageal ulcers.
 To minimize esophageal irritation⬇️
patients should remain upright after taking oral bisphosphonates
حتى احل مشكلة هاي لازم مريض من ياخذة يضل بوضع مستقيم
#bone

📝 ملخص
Adrenocorticotropic hormone (ACTH)
##pituitary

🫀💥ملخص ع شكل قصص ادويه ال Diabetes

1⃣Sulfonylureas

Glimepiride ➡️ غليم🏃‍♂‍➡️
Glipizide ➡️غلب🙄
Glyburide ➡️غليبو👨‍🦼
🔴 غليم غلب غليبو بسباق السلفونيل Sulfonyl

2⃣DDP-4 inhibitors

Alogliptin➡️الوو🗣📞
Sitagliptin ➡️ ست 👩‍🦱
Linagliptin ➡️ لينا 👩
Saxagliptin ➡️ساكته🤐

🟣اكو هناك طالبه اسمها لينا ف اتصلوا الطلاب ع ست مالتهم قالوا الها
الو ست لينا ساكته منعرف شبيها



3⃣SGLT2 inhibitors

Canagliflozin ➡️ كانو
Empagliflozin ➡️ امبروطورين🦸‍♂
Dapagliflozin ➡️ دابه 🐪
Ertugliflozin ➡️ارتوايه💦

🟢كانو قبل الامبراطورين يصعدون ع دابه تتحمل العطش يعني ارتوايه حتى يعبرون مسافه طويله


4⃣Glp-1 receptor agonist

Semaglutide➡️ سما 🙎‍♀
Albiglutide➡️ البي👩‍❤️‍👩
Dulaglutide➡️ دله
Liraglutide➡️ليره 🥇
Exenatide➡️ Example مثال
Lixisenatide➡️ليگزز🚙

🔵جانت هناك بنيه اسمها سما عدها حبيب قالت اله البي اشتريت دله ب ليره
هو راد يكافها ع اليره😁🥇 قال الها شتريدن مثال سياره هديه اجيب الج مثال قالت ليگزز

سما البي اشتريت دله ب ليره، شنو تريدين مثال سياره قالت مثل ليگزز

💥💥هاي فقط ال مجموعه ماخوذه من قناه يوسف فارما 🥹😁



5⃣Glinides

Nateglinide➡️ نادئ🤲
Repaglinide ➡️ربه🙏
🟡اكو هناك واحد اسمه كلينايد كعد نادئ ربه حتى ينجح بالوزاري ❤️‍🩹


6⃣Biguanides

Metformin
⚫️ مثلا اكو قطار ميترو يعتبر big


7⃣ Thiazolldinedlones

Pioglitazone➡️ بايو
Rosiglitazon➡️روز

🟤روز عدها امتحان بايو

#Diabetes_

#صناعيةنظري ملخص الاجهزة بجابتر ال milling

Cutter mill

Mechanism of milling: cutting

Uses: For fibrous materials

Note: Close system

Roller mill

Mechanism of milling: compression and shearing action and attrition in some rollers

Uses: For ointments, pastes and suspensions by attrition mechanism

Hammer mill

Mechanism of milling: Impact

Uses: For dry materials, wet filter cakes, ointments, slurries and granulation

Notes:

- Close system

- Produce irregular shape not free flowable

Ball mill

Mechanism of milling: At low speed attrition at high speed impact

Uses: Wet and dry milling
Sterile milling of ophthalmic and parenteral products
Milling of hard and abrasive materials

Note: It’s batch or continuous operation but mostly batch

Fluid energy mill

Mechanism of milling: Attrition

Uses: For powder below few micrometers
#milling

#صناعيةنظري ملخص ال filter aids بجابتر ال filtration اعداد احدى الطالبات

1 - Diatomite

-Most important filter aid

- Has irregularly shaped porous particles

-Form a rigid incompressible cake.

- Diatomite is primarily silica

- It is inert and insoluble

2 - Cellulose

- Highly compressible

- Costs two to four times more than diatomite or perlite

- For liquids may be incompatible with silica compounds.

- Used as a coarse precoat

3 - Asbestos

- Has good retention on coarse screens

- Has limited application because of its high cost and filterate that might be toxic

- Used in pharmaceutical industry if their application is followed by membrane filtration

4 - Polymers

- Derived from vegetable or animal sources or they may be produced synthetically

- Classified as nonionic, anionic, or cationic, depending on their property to ionize in water

#صناعيةنظري ملخص استعمالات ال filter medium بجابتر ال filtration

1) Filter cloth

- Nylon and cotton filter medium used for coarse straining in aseptic filtration

- Teflon filter medium for liquid filtration

2) Woven wire cloth

- Cake filtration

3) Non woven filter media

- Gelatinous solutions and fine particles

4) Porous stainless steel

- Clarification in milk, syrup, sulfuric acid and caustic soda.

5) Membrane filter media

- Sterile filtration

6) Surface type cartridges

- Asbestos and porcelain filters for sterile filtration along with membrane filters

#filtartion

#صناعيةنظري ملخص الاجزهة بجابتر ال filtration

1) Gravity filters

Type of driving force: gravity

Notes: give low filtration rates
simple , cheap
used for small scale laboratory filtration

2) Vacuum filters

Type of driving force: vacuum

General notes: used for large scale
cannot be used for cake filtration or sterile filtration
Continuous operation

Types: Rotary drum filter and rotary disc filter

Rotary drum filter

Type of driving force: vacuum

Notes: each filter unit rectangular in shape

Rotary disc filter

Type of driving force: vacuum

Notes: Is less floor space and requires lower cost

3) Pressure filters

Type of driving force: pressure

General notes: batch and continuous operation
Have disadvantage that the cake are difficult to remove and it’s complex and expensive

Types: Plate and frame filter press and pressure disc filters

Plate and frame filter press

Type of driving force: pressure

Notes: Can be used for cake filtration
Disadvantages include costs in assembly and cleaning

Pressure disc filters

Type of driving force: pressure

Notes: Advantages are compactness,portability and cleanliness

4) Centrifugation filtration

Type of driving force: centrifugation

Notes: Have the advantages of effective washing and drying
Can be used for cake filtration

Type: Perforated basket

5) Sterilization filtration

Type of driving force: pressure

Notes: Type of filter media is membrane filter
Porosity 0.2micron and 0.45micron
Can be used for intravenous, ophthalmic and other aqueous products
#filtartion

Dpp-4 inhibitors (Alogliptin +saxagliptin)❌ contraindicated with cardiovascular disease

وتسبب
Nasopharyngitis+pancreatitis


Thiazolidinediones ( rosiglitazone) ❌ contraindicated with cardiovascular disease

Epagliflozin ☑️✅ reduce risk of cardiovascular death

Liraglutide ✅☑️ reduce risk of cardiovascular mortality

مهمات ويخربطن نحاول نفرق بينهن

*چابتر السكري

#Diabetes

ملخص ال adverse effects لكل ادوية ال Diabetes Mellitus

⭕ Insulin

Hypoglycemia, weight gain, lipodystrophy

⭕ Amylin analog (Pramlintide)

Nausea, anorexia, vomiting
ولا ننسى لازم نتجنبه ب pt الي عدهم حساسية cresol او الي يعانون من diabetic gastroparesis او اذا عدهم hypoglycemia وما يدرون بيها

⭕ GLP-1 receptor agonists

N,V,D constipation
والاهم Pancreatitis and C cell tumor in rodents

⭕ Sulfonylureas

Hypoglycemia, (hyperinsulinemia), weight gain
و ال glyburide ما ننطيه في حالة renal impairment و الامنات
(Glipizide and Glimepiride)

⭕ Glinides

نفس ال adverse effects مالت ال sulfonylureas بس اخف تكون

ما انطيها في حالة استخدام الGemfibrozil

⭕ Biguanide (Metformin)

NVD
والاهم
Lactic acidosis

ممنوع ننطيه لل pt الي يعاني من
renal dysfunction

ولازم نتوقف عن استخدامه في حالات :
▷Acute myocardial infarction,
exacerbation of heart failure
, Sepsis, Other disorders that can cause acute renal failure

▷ Metformin should be used with caution in patients older than 80 years

▷ Those with heart failure or alcohol abuse

في حالة الاستخدام المطول ممكن يسبب
Vitamin B12 deficiency
فلازم ننطي وياه B12 خصوصا بحالات ال anemia and peripheral neuropathy

#diabetes

𝗔𝗥𝗢𝗡 𝗦𝗧𝗨𝗗𝗬

⭕ Thiazolidindiones

Liver toxicity, osteopenia and increased risk of fractures and weight gain (fat deposition and fluid retention)

وما دام تسبب احتباس بالسوائل ف اكيد
ممنوع انطيه لمريض ال heart failure

Pioglitazone ➔ Bladder cancer

Rosiglitazone ➔ Cardiovascular adverse effects (increased risk of myocardial infarction and angina)

⭕ α-glucosidase inhibitors

Flatulence, diarrhea and abdominal cramping

ما ننطيهن لل pt الي يعاني من
▷Inflammatory bowel disease
▷Colonic ulceration
▷Intestinal obstruction

⭕ DDP-4 inhibitors

Nasopharangitis and headache

infrequent pancreatitis

disabiling joint pain

▷Saxagliptin and Alogliptin increase risk of heart failure hospitalization

تأثيرها على الوزن محايد
weight neutral

⭕ SGLT2 inhibitors

Female genital mycotic infections (vulvovaginal candidiasis), urinary tract infections and urinary frequency

ممكن تسبب Hypotension خصوصا في كبار السن او المرضى الي يستخدمون Diuretics

▷Ketoacidosis
خصوصا في ال pt الي عدهم risk factors مثلا
Alcohol abuse
Caloric restriction

#diabetes

𝗔𝗥𝗢𝗡 𝗦𝗧𝗨𝗗𝗬