ENDOCRINE (explain why)

❗️explain why long acting insulin not used?
▫️due to delayed onset (no control PP hyperglycemia) and long duration (hypoglycemia)

❗️explain why oral hypoglycemics not used with type I DM?
▫️b/c depends on presence of functioning Beta cells

❗️explain why insulin release decreased when hypokalemia?
▫️b/c it needs K for depolarization

❗️explain why sulfonylurea increase insulin release?
▫️b/c close ATP sensitive K ch.

❗️explain why in severe renal - liver ds. stress - pregnancy insulin and not oral antidiabetics must be used?
▫️b/c oral hypoglycemics are not approved by the FDA (teratogenic)
▫️b/c is removed from circulation by liver and kidney

❗️explain why metformin is CI in renal - liver failure and in severe hypoxia?
▫️b/c 1. it acc. increase risk of lactic acidosis
2. hepatic metabolism of lactic acid is impaired
3. lactic acidosis reduces drug elimination or reduces tissue oxygenation

❗️explain why miglitol cause inflammatory bowel ds.?
▫️b/c acc. of undigested carb. which may cause gas and distention

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❗️explain why methimazole is prefered to propylthiouracil for ttt hyperthyroidism?
▫️b/c it has lower risk of serious liver injury and can be administered once daily

❗️explain why propylthiouracil is preferred to methimazole during pregnancy?
▫️b/c more strongly protein bound crosses placenta less readily

❗️explain why iodide should not be used alone and for long period?
▫️because the gland will escape from the iodide block in 2-8 weeks

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❗️explain why natural sex hormones are not used clinically?
▫️b/c it undergoes 1st pass metabolism

❗️explain why rifampicin decreases the efficact of oral contraceptives?
▫️b/c it is a hepatic inducer increase metabolism of contraceptives

❗️explain why contraceptives fail when use antibiotics?
▫️b/c antibiotics kill bacteria and estrogen is hydrolyzed in intestine by bacteria so decrease it's effect

❗️explain why progestins are added to oestrogen in contraceptive pills?
▫️b/c together decrease endometrium glycogen as to discourage implantation and make cervical mucus
or Unopposed Estrogen predisposes to Endometrial Carcinoma

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❗️explain why steroids are used in stress - cerebral edema - hypercalcemia?
▫️b/c prevents acute adrenal crisis

▫️decrease swelling - hotness - pain

▫️decrease Ca in bl. - bone by decrease activation of vit. D in liver

❗️why not give NSAIDs with glucocorticoids?
▫️to avoid peltic ulcer

❗️mouth wash after each steroid inhalation?
▫️to prevent candidiasis

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❗️explain why bisphosphonates (alendronate) is taken while sitting & with full glass of water?
▫️b/c cause gastric and esophageal irritation

ASTHMA (explain why)

❗explain why SABA agonists are 1st choice bronchodilators?
▫️rapidly effective safe inexpensive

❗explain why inhaled LABA have to be combined with corticosteroids and not to be given alone as controllers?
▫️b/c their anti inf. effect is insignificant and bronchodilator effect mask progressive asthma severity (+mortality)

❗explain the use of adrenaline in bronchial asthma and why it's replaced by selective beta 2?
▫️b/c short duration
▫️non selective: a) beta 1 effect > tachy
b) alpha effect > increase BP

❗explain advantage of tiotropium over ipratopium?
▫️not ass. with tolerance

❗explain why theophylline is considered 2nd line drug in asthma?
▫️b/c 1. require drug monitoring
2. narrow safety margin
3. drug interactions

❗explain why leukotriene antagonists are drug of choice for control of aspirin induced asthma?
▫️due to LTs production from arachidonic acid through LOX pathway following blockade of COX by aspirin

❗explain why LT antagonist are preffered in children?
▫️b/c it's oral easier than inhalation and well tolerated

❗explain why status asthmaticus is refractory to the usual line of ttt?
▫️due to down regulation of beta R - mucous plug -acidosis

GIT (explain why)

❗proton pump inhibitors have short half life acid inhibition last up to 24 hours?
▫️b/c of irreversible inactivation of the proton pump at least 18 hrs for synthesis of new H/K ATPase

❗explain why Al hydroxide and Mg are most commonly used antacid?
▫️no CO2 release or systemic alkalosis
▫️used combined to neutrilize effects of each other

❗explain why antacids should be cautiously used in elderly & renal impairment?
▫️chelate phosphates > induce osteomalacia encephalopathy Alzheimer cns depression

❗explain why misoprostol is rarely used?
▫️b/c it needs frequent stim. (4 times daily)

❗antacids should not be given within 2 hrs of doses?
▫️b/c effect absorption of other drugs by binding or increasing gastric PH

ANTIFUNGAL (explain why)

❗amphotericin B is selective in fungicidal effect?
▫️b/c it diff. b/w lipid composition of fungi and mammalian

❗drug interaction is less common with fluconazole?
▫️b/c has the least effect of all azole on hepatic enzyme interaction

❗nystatin is limited to topical ttt only?
▫️b/c narrow spectrum and no absorption from GIT

ان شاء الله كملت تنزيل جزئية الشورت نوت و الإكسبلاين اللي بعد الجزئي~
إكسبلاين CVS نزلتها مسبقا في القناة مثبت مع اهم نقاطها~

يفضل الantibiotic في نقاط مهمة نزلتها زميلتنا في قناتها بارك الله فيها 👇

أهم نقاط ال antibiotic ⁉️⁉️💡💡🧠

تركيزات الجامعة والمهم في ال Antibiotics ❤️.

⁉️⁉️ Warfarin 🆚 Heparin

بعض الإضافات اللي مش قاعدات في بي دي اف الشورت نوت:

❕uses of morphine?
1. anaelgesia
2. diarrhea
3. cough
4. acute pul. edema with lt. vent. failure
6. anaesthesia

❕uses of antidepressants?
1. major depression disorder
2. anxiety disorders
3. pain disorders
4. urinary incontinence
5. eating disorders
6. smoking cessation
7. prophylaxis of migraine

❕TTT of acute decompensated HF

❕drugs induced blood disorders

❕MOA of nitroprusside?
NO donor > increase C GMP > induce VD by inhibit Ca influx

❕indications of parenteral iron therapy?

و في الPDF جزئية GA سؤال الثاني بدال كلمة adjuncts غيروه stages 😅

شكرا لكل من دز و نبه عليهن 🤍

جمعت اي دواء عنده anti dote

Tetracyclines A/E (mnemonics)

STARS

S uper infections
T eeth and bone discoloration - deformity
A bdominal upsets
R enal impairment
S kin photo sensitivity

MeTroniDAzole A/E

M etallic taste
T eratogenic
D isulfiram like reaction
A taxia

Sulphonamides A/E

SHREK 😂❤ بإضافة A = shreak

S teven-Johnson reaction
H emolysis
R enal impairment (crystaluria)
E nzyme inhibitor
K ernicterus

A llergy-rash A granulocytosis
طبعا GIT upsets موجودة فيهن كلهن