امسيكيوات د. محمد العمامي

قررت أن أفضل نزلهن بعد المعمل لأن دكتورة خديجة احتمال تنزل فويس علي تفاصيل الإمتحان و ممكن تقول علي شن نركزوا في الشورت~ 🤍

تجميعة شورت نوت للكورسات الكبار (cvs - cns - endo - blood)
في نقاط سمعتها من تسجيلات الجامعة و اضافات مني~ 🙏🏻

لو في استفسار أو تعرفوا سؤال مهم مضفتش دزولي
@kukxu0

تركيزات ال جامعه في منهج قبل الجزئي

الحمد لله مفش شورت نوت قبل الجزئي بس ليا ساعات كنت نجهز فيه و جيت بنزله توا 🙂😂
ان شاء الله حنزل باقي شورت نوت و الإكسبلاين اللي بعد الجزئي اليوم أو بكرة 🤍

طلب لو في حد كاتب الإكسبلاين قبل الجزئي يدزها بيش نزلها و نستفيدوا كلنا للأسف حصلتش فرصة نلمهن 🙏🏻
@kukxu0

BRONCHIAL ASTHMA (SN)

❕write MOA of SABA?
stimulate beta 2 receptors:
1. bronchodilation
2. inhibition of mast cell and cytokines
3. increase bronchial mucociliary clearance

❕list adverse effects of selective beta 2 agonists?
1. tremors - anxiety
2. tachycardia
3. tolerance
4. hypokalemia and ms. cramps

❕what are indications of ipratopium?
1. asthma induced by psychogenic or beta stim.
2. asthmatic pt. intolerant to tachycardia or anxiety of beta 2 agonists or theophylline (cardiac - thyrotoxicosis - elderly)
3. acute severe asthma (adjuvant)
4. COPD

❕mention disadvantages of ipratopium?
1. tolerance > blocks presynaptic M2 receptord > ACh release
2. delayed onset less effective than beta 2

❕write MOA of methylxanthines?
1. inhibit phosphodiesterase > increase CAMP
a. direct BD
b. anti inf. decrease cytokines and mast cell mediators - inhibit late asthmatic response
2. block adenosine receptors

❕list adverse effects of theophylline?
1. headache - insomnia - anxiety
2. tachy - arrhythmia
3. peptic ulcer
4. narrow safety margin (monitor serum lvl)

❕mention indications of theophylline?
1. bronchial asthma 2nd choice
a. short term relief of acute bronchospam
b. long term control (nocturnal asthma)
c. acute severe asthma
2. COPD
3. neonatal apnea

❕write MOA of corticosteroids in bronchial asthma?
1. PLA2 > decrease LT PGs > decrease inf.
2. VC > decongestant
3. increase number of beta 2 > indirect BD (potentiate beta 2 agonist)

GIT (SN)

❕classify peptic ulcer drugs?
1. drugs that inhibit gastric acid secretion
2. drugs that neutrilize gastric acid
3. mucosal protective drugs
4. anti H.pylori drugs

❕list drugs that inhibit gastric acid secretion?
1. H2 receptor antagonists (cimetidine - ranitidine - famotidine)
2. proton pump inhibitor (omeprazole)
3. anticholinergic drugs (pirenzipine - telenzipine)
4. prostaglandin analogues (misoprostol)

❕write MOA of H2 antagonists?
1. competitive inhibitor suppress basal and meal stimulated acid secretion in a linear dose dependant manner
2. reduce secretion stimulated by histamine as well as by gastrin and cholinomimetic agents

❕what are A/E of H2 blockers?
1. headache diarrhea constipation
2. tolerance (rebound hyperacidity)
3. sedation - hallucination (cimetidine)
4. antiandrogenic (cimetidine): gymecomastia - impotence - mestrual problems - galactorrhea
5. enzyme inhibition (cimetidine)
6. hypotension - brady (if give IV)

❕write MOA of proton pump inhibitors?
1. are lipophilic weak bases (PH 4-5)
2. after int. absorption diffuse into acidified compartments (parietal cell)
3. becomes protonated (active form)
4. forms a covalent disulfide bond with H/K ATPase
5. irreversibly inactivates enzymes

❕write MOA of sucralfate?
1. in acidic environment PH<4 it polymerizes by cross linking molecule to form sticky viscous gel that adhere ulcer
2. act as physical barrier
3. stim. PG and HCO3
4. bind to epithelial - fibroblast growth factor

❕list adverse effects of sucralfate?
1. nausea - vomiting - dry mouth
2. flatulence - constipation
3. AL toxicity: osteomalacia - encephalopathy

* triple therapy: omeprazole - clarithromycin - amoxicillin (14 days)

❕list advantages of famotidine and ranitidine over cimetidine?*
FAMOTIDINE:
1. most potent
2. 50% decomposed by acid
3. 50% bioavailability
4. excreted mainly by kidney
5. no enzyme inhibiting

RANITIDINE
1. more potent -less enzyme inhibiting
2. anti H.pylori
3. 50% bioavailability
4. 50% metabolized in liver

❕discuss advantage of PPI over H2 antagonists?*
1. higher efficacy better relief
2. more prolonged effect
3. more effect in H.pylori

❕mention uses of anti secretory drugs?*
1. PU 2. anti H.pylori 3. GERD
4. zollinger ellison syndrome
5. stress ulcer
6. acute gastritis
7. bleeding esophageal varices

❕explain antacid drug interaction?*
1. change gastric urinary PH
2. delay gastric emptying
3. chelation: Al salts form insoluble complexes with other drugs

❕differentiate b/w 2 types of antacid?*
LOCAL ANTACID
•Al hydroxide > constipation
•Mg salts > diarrhea
•Ca carbonate:
1. constipation
2. rebound hyperacidity
3. milk alkali syndrome
4. increase CO2 flatulence

SYSTEMIC ANTACIDS
•NaHCO3 > rapid onset potent
1. systemic alkalosis
2. rebound hyperacidity
3. Na dangerous in HF HTN renal ds.
4. increase CO2 flatulence
5. alkaline urine - renal stones

صح كثرت الأسئلة 😅 بس لاحظت أن حتى بعض الأمسيكيوات تبي حفظ كيف الشورت فحتساعدكم ان شاء الله على كل حال~
و تقدروا تختصروهن أو تشوفوا المهم بالنسبة لكم و ان شاء الله نلقوا نفس الأسئلة اللي قريناها~

من الخاص:
بنقولك في blood دكتورة قالت مرات تجيب شورت نوت مقارنه بين heparin و warfarin

وال CNS جزئية دكتورة نيروز قالت استخدامات فقط ي اما استخدامات Benzodiazepin أو استخدامات المورفين بسسسس قالت مش هنجيب شورت نوت غيرهن
قالت ال side effect مهمات مع ذكر السبب يعني ممكن تجي explain why

MOA of sitagliptin (SN)

شكرا لكل من دز و نبه عالنقاط المهمة في ميزان حسناتكم 🙏🏻🤍

ANTIVIRAL (SN)

❕write MOA of acyclovir?*
(require 3 phosphorylation steps)
1. inhibits viral DNA synthesis
2. competitive inhibitor with deoxy GTP for viral DNA polymerase
3. bind to template (irreversible) > chain termination

❕write MOA and A/E of zidovudine?
▫️converted to triphosphate by thymidine kinase
▫️incorporate into chain of viral DNA > chain termination
1. myelosuppresion
2. headache insomnia anxiety
3. hyperpigmentation of nail - myopathy

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ANTIFUNGAL (SN)

❕write MOA of amphotericin B?*
1. binds to ergosterol and alters permeability by forming pores
2. allows leakage of ions > cell death

❕list A/E of amphotericin B?**
1. fever chills
2. renal impairment (due to decrease GFR)
3. hypotension (shock with hypokalemia)
4. anemia (due to reduced erythropoietin production)

*pharmacokinetics of fluconazole* mcq مهم

*imidazoles & triazoles* مهم الفروقات بيناتهن

❕list A/E of griseofulvin?
1. headache vomiting diarrhea
2. photosensitivity peripheral neuritis
3. hepatotoxicity
4. coumarin anticoagulant activity altered

ANTICANCER (SN)

❕write MOA of alkylating agents (cyclophosphamide)?*
1. work by covalent binding of alkyl group to guanine
2. cross link DNA in intra strand & inter strand manner > interrupt DNA replication

❕write MOA of cytotoxic antibiotics (doxorubicin)?*
1. intercalate with DNA base pairs causing breakage of DNA
2. inhibit enzyme topoisomerase II > damage - apoptosis

❕write MOA of trastuzumab?*
1. binds to HER2 > inhibit signaling + activation
2. activate ADCC

❕list A/E of anticancer drugs?**
1. bome marrow suppression
2. damages lining of the mouth and intestines > bacteria enter blood
3. nausea vomiting
4. temporary hair loss
5. rashes - sterility
6. peripheral neuropathy - ototoxicity
7. tumor lysis syndrome > arrhythmia - seizures - acute kidney failure - death