Pharma notes ๐Ÿ’‰๐Ÿ’Š
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ู‡ู†ุง ุจุงุฐู† ุงู„ู„ู‡ ู‡ุชู‚ุฏุฑ ุชู„ุงู‚ู‰ ูƒู„ ุงู„ุชุฌู…ูŠุนุงุช ุงู„ุฎุงุตุฉ ุจุงู„ุตูŠุฏู„ูŠุฉ ูˆูƒู„ ุฌุฏูŠุฏ ูŠุฎุต ู…ุฌุงู„ ุงู„ุตูŠุฏู„ุฉ ูˆุญุงู„ุงุช otc ูˆู‡ุชู„ุงู‚ู‰ pdfs ู‡ุชุณู‡ู„ ุนู„ูŠูƒ
{ ูƒู„ ู…ุง ุชู… ู†ุดุฑู‡ ู‡ู†ุง ุตุฏู‚ุฉ ุฌุงุฑูŠุฉ ุฎุงู„ุตุฉ ู„ูˆุฌู‡ ุงู„ู„ู‡ }
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ุชู… ุงูุชุชุงุญ ุตูŠุฏู„ูŠู‡ ู…ุฌุงู†ุงู‹ ู„ุบูŠุฑ ุงู„ู‚ุงุฏุฑูŠู†
ูƒู„ ูŠูˆู… ู…ู† ูกูข ุฅู„ู‰ ูฅ ู…ุงุนุฏุง ุงู„ุณุจุช
ู„ู„ุชูˆุงุตู„: 01110286536
ูƒูˆุจูŠ ุจูŠุณุช ุนู†ุฏูƒู… ููŠ ู†ุงุณ ูƒุชูŠุฑ ุฌุฏุง ู…ุญุชุงุฌูŠู† ..
[ู„ูˆ ุญุฏ ูŠุนุฑู ุฃูŠ ู…ุฑูŠุถ ููŠุฑูˆุณ ุณูŠ ูู‚ูŠุฑ ุฃูˆ ุบูŠุฑ ู‚ุงุฏุฑ ุนู„ู‰ ุซู…ู† ุงู„ุนู„ุงุฌ ูŠุชูˆุงุตู„ ู…ุนุงูŠุง (ุนู„ุงุฌ ูˆุชุญุงู„ูŠู„ ู…ุฌุงู†ุง)
01144556262 / 01017557267 ุฏ.ุฎุงู„ุฏุตุงุจุฑ
ุงู†ุดุฑู‡ุง ุนู†ุฏ ุงูŠ ุญุฏ ุชุนุฑูู‡
: ุฏูˆุงุก ู„ู„ุณุฑุทุงู† ุงุณู…ู‡ ุฌู„ุงููŠูƒ 100.. GLIVEC 100MG
ุณุนุฑ ุงู„ุนู„ุจู‡ 11 ุงู„ู ุฌู†ูŠู‡ ู…ูˆุฌูˆุฏ ู…ุฌุงู†ุง ุงู„ู„ูŠ ู…ุนุงู‡ " ุงู„ุฑูˆุดุชู‡
ุงู…ุงู†ู‡ ุนู„ูŠูƒ ูˆูุฑู‚ุจุชูƒ ุฎุฏู‡ุง ูˆู†ู‚ู„ู‡ุง ุน ุฃุฏ ู…ุงุชู‚ุฏุฑ
ุงู„ุฏุงู„ ุนู„ู‰ ุงู„ุฎูŠุฑ ูƒูุงุนู„ู‡ ูˆุฑุจู†ุง ูŠุดูู‰ ู…ุฑุถุงู†ุง
ุงู„ุญู…ุฏ ู„ู„ู‡
โค8
๐Ÿ›‘ุงุฎุชุตุงุฑุงุช ุชููŠุฏ ุจุญูุธ ุงู„ุงุฏูˆูŠู‡ ๐Ÿ’Š๐Ÿ’Š
โœ”๏ธโœ”๏ธโœ”๏ธโœ”๏ธุงูŠ ุชุฑูƒูŠุจู‡ ุฏูˆุงุก ุนู„ู…ูŠู‡ ุชู†ุชู‡ูŠ ุจู…ู‚ุทุน prazol ู…ุง ุนุฏุง ุฏูˆุงุก( Aripiprazole ุฏูˆุงุก ุงู„ุงูƒุชุฆุงุจ ) ูู‡ูˆ ุฏูˆุงุก ู„ู„ู…ุนุฏู‡ ูŠู‚ู„ู„ ุญุงู…ุถูŠุฉ ุงู„ู…ุนุฏู‡  ู…ู† ุนุงุฆู„ุฉ
ุงู„ ppi ( proton pump inhapeter) ู…ุซู„ :
‏1-lanzoPRAZOL
‏2-omePRAZOL
‏3-esomePRAZOL
‏4-rapiPRAZOL
‏5-pantoPRAZOL

โœ”๏ธุงูŠ ุชุฑูƒูŠุจู‡ ุฏูˆุงุก ุนู„ู…ูŠุฉ ุชู†ุชู‡ูŠ  ุจู…ู‚ุทุน sartan ูู‡ูˆ ู„ู„ุถุบุท (ุนู„ุงุฌ hypertention )ู…ุซู„ :
‏1-candiSARTAN
‏2-irpeSARTAN
‏3-telmiSARTAN
‏4-valSARTAN
‏5-loSARTAN
‏6-eproSARTAN
‏7- OLMESARTAN

โœ”๏ธุงูŠ ุชุฑูƒูŠุจุฉ ุนู„ู…ูŠู‡ ุชู†ุชู‡ูŠ ุจู…ู‚ุทุน VASTATIN ูู‡ูˆ ู„ู„ุฏู‡ูˆู† ู…ุซู„ :
‏ 1-loVASTATIN
‏2-praVASTATIN
‏3-atorVASTATIN
‏4-simVASTATIN
‏5-fluVASTATIN
‏6-rosuVASTATIN

โœ”๏ธุงูŠ ุชุฑูƒูŠุจู‡ ุนู„ู…ูŠู‡ ุชู†ุชู‡ูŠ ุจุงู„ู…ู‚ุทุน CONAZOL ูู‡ูˆ ู…ุถุงุฏ ูุทุฑูŠ antifungal  ู…ุซู„:
‏ 1-miCONAZOL
‏2-itraCONAZOL
‏3-ketoCONAZOL
‏4-fluCONAZOL
‏5-isoCONAZOL
‏6-sertaCONAZOL

โœ”๏ธ ุงูŠ ุชุฑูƒูŠุจู‡ ุนู„ู…ูŠุฉ ุชู†ุชู‡ูŠ ุจุงู„ู…ู‚ุทุน gliptin  ูู‡ูˆ ู„ู„ุณูƒุฑูŠ ู…ุซู„:
‏1-vinlaGLIPTIN
‏2-saxaGLIPTIN
‏3-linaGLIPTIN
‏4-sitaGLIPTIN
‏5- ALOGLIPTIN

โœ”๏ธ ุงูŠ ุชุฑูƒูŠุจู‡ ุนู„ู…ูŠู‡ ุชู†ุชู‡ูŠ ุจุงู„ู…ู‚ุทุน PRIL  ูู‡ูˆ ู„ู„ุถุบุธ ุนู„ุงุฌ hypertension ู…ุซู„:
‏ 1-captoPRIL
‏2-lisnoPRIL
‏3-enalaPRIL
‏4- RAMIPRIL

โœ”๏ธ ุงูŠ ุชุฑูƒูŠุจู‡ ุนู„ู…ูŠู‡ ุชู†ุชู‡ูŠ ุจุงู„ู…ู‚ุทุน  osin  ูู‡ูˆ ู„ู„ุจุฑูˆุณุชุงุช BPH ู…ุซู„:
‏ 1-doxaZOSIN
‏2-prazOSIN
‏3-terazOSIN
‏4-alfuzOSIN
‏5-tamsulOSIN
๐Ÿ‘2
โ€ข Vaginal infection :
Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the balance of vaginal bacteria or an infection.
__
First :
โ€ข Vulvovaginal candidiasis (also known as a
yeast infection) ๐Ÿงซ

โ€ข Occurrence :
Approximately 75% of all women will experience
vulvovaginal candidiasis (VVC), at least once, and 50% will
have a second episode. Only 5% of women experience
recurrent infections (four or more infections within a 1-year
period).

โ€ข Cause : โ‰๏ธ
Candida albicans is responsible for up to 92% of infections.
Infections owing to C. glabrata are increasing

โ€ข Symptoms :
- Can include a thick, white, โ€œcottage cheese-like,โ€ but it is odorless,
- dysuria; vaginal
burning; and pruritus

โ€ข Pharmacologic treatment : ๐Ÿ’Š
Products proven safe and effective for the treatment of VVC are :
- "Azole" derivatives with antifungal activity and include tioconazole, miconazole, and clotrimazole.
- Each agent is available in a variety of formulations, including intravaginal creams,
vaginal suppositories, and ointments.
- The choice of product formulation is based on patient preference. One formulation is
not more effective than another
- Products are available as 1-, 3-, or 7-day treament
โ€ข Patient counseling : ๐Ÿ‘ฉ๐Ÿปโ€โš•๏ธ
1. Wash vaginal area before application.
2. For most available intravaginal products, application time should be
recommended as bedtime to increase vaginal mucosa contact time. However,
external creams can be used any time of day
3. Complete the course of therapy even if symptoms improve.
4. Symptom improvement typically will not be seen for 5 to 7 days after initiation
of treatment.
5. Seek medical treatment if symptoms have not resolved after 7 days.
6. Avoid sexual intercourse during therapy.
7. Avoid condoms use for 72 hrs after therapy is completed.
8. Continue use during menstrual period, but tampons should not be used during
VVC treatment.
9. Side effects can include burning or irritation.
10. Treatment of male partners is not necessary

โ€ข Exclusions to self-care :
1. Pregnant
2. Younger than 12 years of age
3. Systemic symptoms such as fever
4. History of recurrent vaginal yeast infections
5. Discharge with a fishy odor (indicates bacterial vaginosis, most often caused by
anaerobic bacteria).
๐Ÿ”ด ู‡ู†ุณุชูƒู…ู„ ุงู„ู†ู‡ุงุฑุฏุฉ ุฅู† ุดุงุก ุงู„ู„ู‡ ุงู„ู†ูˆุน ุงู„ุชุงู†ูŠ ููŠ ู…ูˆุถูˆุน ุงู„ vaginal infections ๐Ÿ‘‡๐Ÿป:
โ€ข Trichomoniasis :
-Trichomonas vaginitis, also called trichomoniasis,
- It is sexually transmitted infection.
- It is caused by a single-celled parasite, Trichomonas vaginalis, and is
passed from partner to partner during intercourse.

โ€ข The symptoms of trichomoniasis are :
- burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. Some women also experience pain during urination

Pharmacologic treatment : ๐Ÿ’Š
Trichomoniasis can be cured with
- Metronidazole 2 g orally in a single dose or
- Tinidazole 2 g orally in a single dose
Alternative Regimen
- Metronidazole 500 mg orally twice a day for 7 days.

Note ๐Ÿ“‘ :
- It is okay for pregnant women to take this medication.

- Topical vaginal medications (creams and gels) and pessaries can be prescribed for the treatment of T. vaginalis in women. Modern preparations include clotrimazole, povidone-iodine.

- These preparations provide local symptom relief, but documentation on their effectiveness as cures has been inconsistent. There are no topical treatments for trichomoniasis in men.
ุงู„ูู„ุงุฌูŠู„ ( Metronidazole  ) ู„ูŠู‡ ุงุณุชุฎุฏุงู…ุงุช ูƒุชูŠุฑุฉ ุฌุฏุง ุชุนุงู„ูˆุง ู†ุดูˆูู‡ู… ู…ุน ุจุนุถ ..

๐ŸŽˆ ู…ุน protozol infection  ุฒูŠ ุงู„ Aomeba  ุงู„ุงู…ุจูŠุจุง   ูˆุงู„ Gardia  lambila  ูˆุงู„ุฌุฑุนุฉ ุงู„ู…ุนุชุงุฏุฉ ู„ู„ุจุงู„ุบูŠู† 500 ู…ู„ุฌู… ู…ุฑุชูŠู† ุงูˆ ุซู„ุงุซุฉ ุจุชุณุชู…ุฑ ู…ู† ุฃุณุจูˆุน ู„ 10 ุฃูŠุงู…  ูˆู…ู†ู†ุณุงุด ู„ูˆ ููŠู‡ dehydration ู„ุงุฒู… ู…ุนุงู‡  ู…ุญุงู„ูŠู„ ุฌูุงู

๐ŸŽˆ  ูŠุนุชุจุฑ  ู‡ูˆ ุงู„ Drug of choice  ููŠ ุญุงู„ุงุช ุงู„ุฅุตุงุจุฉ
ุจ trichomonas vaginitis  ูˆุงู„ุฌุฑุนุฉ  ุจุชูƒูˆู† 
2 ุฌุฑุงู… ูƒ single dose
ุฃูˆ 500 ุฌุฑุงู… ู…ุฑุชูŠู† ุฃูˆ ุซู„ุงุซ ู…ุฑุงุช ูŠูˆู…ูŠุง ู„ู…ุฏุฉ ุฃุณุจูˆุน

๐ŸŽˆ   ุงู„ Flagyl  ู…ู† ุงู„ุญุงุฌุงุช ุงู„ูุนุงู„ุฉ ุฌุฏุง ุถุฏ ุงู„ุจูƒุชุฑูŠุง ุงู„ู„ุงู‡ูˆุงุฆูŠุฉ ุงู„ู…ูˆุฌูˆุฏุฉ ููŠ ุงู„ุฌู‡ุงุฒ ุงู„ู‡ุถู…ูŠ ุณูˆุงุก negative ุฃูˆ positive 

๐ŸŽˆ ุจุนุฏ ุงู„ุงุณุชุฎุฏุงู… ุงู„ุทูˆูŠู„  ู„ู„ู…ุถุงุฏุงุช ุงู„ุญูŠูˆูŠุฉ ูˆุงุณุนุฉ ุงู„ู…ุฏู‰ ูŠู†ุตุญ ุจุงุณุชุฎุฏุงู… ุงู„ Flagyl  ูƒูˆู‚ุงูŠุฉ ู…ู† ุงู„ superinfection  ุงู„ู„ูŠ ู…ู…ูƒู† ุชุญุตู„ ุจุณุจุจ ุงู„ C difficle  ูˆุงู„ู„ูŠ ุชุนุชุจุฑ ู…ู† ุงู„ normal flora ู„ูƒู† ู…ุน ุงู„ุงุณุชุฎุฏุงู… ุงู„ุทูˆูŠู„ ู„ู„ู…ุถุงุฏุงุช ุงู„ุญูŠูˆูŠุฉ ูˆุงุณุนุฉ ุงู„ู…ุฏู‰  ุจูŠุญุตู„ู‡ุง ุนู…ู„ูŠุฉ ุชุญูˆู„ ูˆุชุจุฏุฃ ุชุนู…ู„ูŠ ู…ุดูƒู„ุฉ ู…ุดู‡ูˆุฑุฉ ุฌุฏุง  ุฅุณู…ู‡ุง  
Pseudomembranous colitis 
ุจุชุคุฏูŠ ุฅู„ู‰ ุญุฏูˆุซ Abdominal pain  + diarrhea
ู…ุน ุงุณุชุฎุฏุงู… ุงู„ูู„ุงุฌูŠู„ ุจูŠุญุฏ  ู…ู† ุญุฏูˆุซ ุญุงุฌุฉ ุฒูŠ ูƒุฏุฉ ู„ุฃู†ู‡ ุฒูŠ ู…ุงู‚ูˆู„ู†ุง ูุนุงู„ ุฌุฏุง ุนู„ู‰ ุงู„ gram negative anerobic bactria  ุฒูŠ ุงู„   C difficle 
ููŠ ุญุงู„ุงุช ุงู„ sever infection  ูŠูุถู„ ุงุณุชุฎุฏุงู… ุงู„ vancomycin  ุฃูˆ ุงู„ Rifaximin  ู…ูˆุฌูˆุฏ ููŠ ุงู„  gastrobiotic

๐ŸŽˆ ุงู„ Flagyl  ุจูŠุชูƒุชุจ ุฏุงูŠู…ุง ููŠ ุฑูˆุดุชุงุช ุงู„ุฃุณู†ุงู† ู„ุฃู†ู‡ ุฒูŠ ู…ุงู‚ูˆู„ู†ุง ู„ูŠู‡ ู‚ุฏุฑุฉ ุนุงู„ูŠุฉ ุถุฏุฏ  ุงู„ุจูƒุชุฑูŠุง ุงู„ู„ุงู‡ูˆุงุฆูŠุฉ ุงู„ู„ูŠ ุจุชูƒูˆู† ู…ูˆุฌูˆุฏุฉ ููŠ ุงู„ูู…

๐ŸŽˆ ุงู„ Flagyl  ุจูŠุณุชุฎุฏู… ุถู…ู† ุงู„ trible therapy  ุงู„ู…ุดู‡ูˆุฑ ููŠ ุนู„ุงุฌ ุงู„ H pylori  ูˆูŠู…ูƒู† ุงุณุชุฎุฏุงู… ุงู„ amoxicillin ูƒุจุฏูŠู„ ุนู†ู‡ 

๐ŸŽˆ ุงู„ Flagyl ู…ุน ุงู„ Mebendazol  ู…ู…ูƒู† ูŠุคุฏูŠ ุฅู„ู‰ ุญุฏูˆุซ ุญุงุฌุฉ ุงุณู…ู‡ุง  Steven Johnson syndrom  ุชุคุฏูŠ ุฅู„ู‰ Allergic Rex and  Rash ุนุดุงู† ูƒุฏุฉ ูŠูุถู„ ุนุฏู… ุฅุนุทุงุก ุงู„ุฏูˆุงุฆูŠู†  ู…ุนุง 

๐ŸŽˆ ุงู„ Metronidazole ุจูŠุนุฏูŠ ููŠ ุงู„ brest milk ูˆูƒู…ุงู† ู…ู…ูƒู† ูŠุฃุซุฑ ุนู„ู‰ ุงู„ุฌู†ูŠู† ูˆุงุณุชุฎุฏุงู…ู‡ ุจูŠุฎุถุน ู„ู‚ุงุนุฏุฉ risk benifits ratio
ุชุนุฑู ุฅู† ุงู„ Acetylcysteine ู„ูŠู‡ 5 ุฅุณุชุฎุฏุงู…ุงุช ู…ู‡ู…ุฉ ุฌุฏุง...

ุชุนุงู„ูˆุง ู†ุดูˆู ูƒู„ ูˆุงุญุฏ ููŠู‡ู…

ุงู„ุงุณุชูŠู„ ุณูŠุณุชุงูŠูŠู† ู„ูŠู‡ Anti oxidant (ู…ุถุงุฏ ุฃูƒุณุฏุฉ) ุญู„ูˆุฉ ุฌุฏุง ุฌุฏุง ุจุชุณุงุนุฏู‡ ุฅู†ู‡ ูŠูƒูˆู† ู„ูŠู‡ ุฃูƒุซุฑ ู…ู† ุฅุณุชุฎุฏุงู… ุทุจูŠ


(1)ุฃุดู‡ุฑ ุฅุณุชุฎุฏุงู… ูˆุฏู‡ ูƒู„ู†ุง ุนุงุฑููŠู†ู‡ ู‡ูˆ ุฅู†ู‡ ุจูŠุณุชุฎุฏู… ููŠ ุญุงู„ุงุช ุงู„ุชุณู…ู… ุจุงู„ุจุงุฑุณูŠุชุงู…ูˆู„ .

(2) ุจูŠุณุชุฎุฏู… ูƒ liver supporting agent )
ุฏุงุนู… ู„ูˆุธุงุฆู ุงู„ูƒุจุฏ )ู„ุฃู† ู„ูŠู‡ Anti oxidant ุญู„ูˆุฉ ุฌุฏุง ูู‡ู†ู„ุงู‚ูŠู‡ ู…ูˆุฌูˆุฏ ููŠ ู…ู†ุชุฌ ุฅุณู…ู‡ Hepagaurd ุฃูˆ Hepastrong

(2 ) ุจูŠู‚ู„ู„ ู„ุฒูˆุฌุฉ ุงู„ู…ุฎุงุท (ุงู„ุจู„ุบู…) ุงู„ู…ูˆุฌูˆุฏ ููŠ ุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠ ูˆุจุงู„ุชุงู„ูŠ ูŠุณุงุนุฏ ุนู„ู‰ ุฎุฑูˆุฌู‡. ูู‡ู†ู„ุงู‚ูŠู‡ ุจูŠุถุงู ููŠ ูˆุตูุงุช ู„ุนู„ุงุฌ ุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠ

(3) ุจูŠู‚ู„ู„ ุงู„ viscosity (ุงู„ู„ุฒูˆุฌุฉ ) ุจุชุงุน ุงู„ semen ุงู„ุณุงุฆู„ ุงู„ู…ู†ูˆูŠ ูˆุจุงู„ุชุงู„ูŠ ุจูŠุนู…ู„ ุจุนุถ ุฃู…ุฑุงุถ ุงู„ุฐูƒูˆุฑุฉ ุงู„ู†ุงุชุฌุฉ ุนู† ุฒูŠุงุฏุฉ ู„ุฒูˆุฌุฉ ุงู„ุณุงุฆู„ ุงู„ู…ู†ูˆูŠ ูˆุงู„ู„ูŠ ุจุชุคุฏูŠ ู„ู„ุนู‚ู… ููŠ ุจุนุถ ุงู„ุญุงู„ุงุช .

(4) ุจูŠุณุชุฎุฏู… ููŠ ู…ุณุชุญุถุฑุงุช ุงู„ุนูŠูˆู† ุงู„ู‚ุทุฑุงุช ุงู„ุทุจูŠุฉ ู„ุนู„ุงุฌ ุฌูุงู ุงู„ุนูŠู† ู„ุฃู†ู‡ ู„ูŠู‡ ู‚ุฏุฑุฉ ุนู„ู‰ ุชู‚ู„ูŠู„ ุงู„( stickiness ) ู„ุฒูˆุฌุฉ ุงู„ุฏู…ูˆุน ูˆุจุงู„ุชุงู„ูŠ ุจูŠุณุชุฎุฏู… ูƒุฏู…ูˆุน ุฅุตุทู†ุงุนูŠุฉ artificial tears ู…ูˆุฌูˆุฏ ููŠ ู…ู†ุชุฌ ูˆุญูŠุฏ ู…ุตุฑูŠ ุฅุณู…ู‡ Brixitears

ูŠุจู‚ู‰ ุจูŠุฏุฎู„ ููŠ

(1)ุนู„ุงุฌ ุงู„ุชุณู…ู… ุจุงู„ุจุงุฑุณูŠุชุงู…ูˆู„ โœ”๏ธ
(2)ุฏุงุนู… ู„ูˆุธุงุฆู ุงู„ูƒุจุฏ โœ”๏ธ
(3)ูˆุตูุงุช ุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠ โœ”๏ธ
(4)ูˆุตูุงุช ู„ุนู„ุงุฌ ุงู„ุนู‚ู… โœ”๏ธ
(5)ุนู„ุงุฌ ุฌูุงู ุงู„ุนูŠู† โœ”๏ธ
โค6๐Ÿ‘2
ูƒู„ู†ุง ุจู†ุณุชุฎุฏู… ุงู„ุจุงู†ุซูŠู†ูˆู„ ููŠ ุชุฑุทูŠุจ ุงู„ุฌู„ุฏ ..
ุงู„ุจุงู†ุซูŠู†ูˆู„ ุจู…ุฌุฑุฏ ู…ุงุจู†ุญุทู‡ ุนู„ู‰ ุงู„ุฌู„ุฏ ุจุชุงุนู†ุง ุจูŠู…ุชุต ุณุฑูŠุนุง ูˆุจูŠุชุญูˆู„ ู„ู„ pantothenic acid ุงู„ู„ูŠ ู‡ูˆ (ููŠุชุงู…ูŠู† B5 )

ุงู„ panthenol ุงู„ุชู‚ู„ูŠุฏูŠ ุงู„ู„ูŠ ุงุชุนูˆุฏู†ุง ุนู„ูŠู‡ ุจูŠูƒูˆู† mixture ู…ู† L ุŒ D ุจุงู†ุซูŠู†ูˆู„

ุงู„ู„ูŠ ุจูŠุชุญูˆู„ ู„ vit B 5 ู‡ูˆ ุงู„ D ูู‚ุท

ูุตู„ูˆุง ุงู„ู…ุฑูƒุจูŠู† ุนู† ุจุนุถู‡ู… ุนู„ุดุงู† ูŠุนู…ู„ูˆุง ู…ู†ุชุฌ ุฃูƒุซุฑ ูุงุนู„ูŠุฉ ูŠูƒูˆู† ููŠู‡ dexapanthenol ูู‚ุท

ูˆุจุงู„ูุนู„ ุงู„ู…ู†ุชุฌุงุช ุงู„ู„ูŠ ุจุชุญุชูˆูŠ ุนู„ู‰ Dexapanthenol ุจุชูƒูˆู† ูุงุนู„ูŠุชู‡ุง ุถุนู ุงู„ู„ูŠ ุจุชุญุชูˆูŠ ุนู„ู‰ ุงู„ panthenol ูู‚ุท ูˆุฏู‡ ูŠุนู†ูŠ ุชุฑุทูŠุจ ูˆู†ุชุงุฆุฌ ุฃูุถู„ ู…ู† ุงู„ู…ู†ุชุฌุงุช ุงู„ู„ูŠ ููŠู‡ุง dexapanthenol ููŠ ุงู„ุณูˆู‚ ู…ู†ุชุฌ ุฒูŠ( bepanthen)

ุงู„ุจุงู†ุซูŠู†ูˆู„ ุนู…ูˆู…ุง ุจูŠุญุงูุธ ุนู„ู‰ ุฑุทูˆุจุฉ ุงู„ุฌู„ุฏ ...ูˆุจุงู„ุชุงู„ูŠ ุจูŠุญุงูุธ ุนู„ูŠู‡ ู…ู† ุงู„ุฌูุงู ูˆู„ุงุฒู… ู†ุนุฑู ุฅู† ุงู„ุฌู„ุฏ ุงู„ุฌุงู ุฃูƒุซุฑ ุนุฑุถุฉ ู„ู„ infection ู…ู† ุงู„ุฌู„ุฏ ุงู„ุฑุทุจ

ุถูˆุงูุฑุงู†ุง ุจุชุชูƒูˆู† ู…ู† ุงู„ูƒูŠุฑุงุชูŠู† ูˆุจุนุถ ุงู„ุฃุธุงูุฑ ุจูŠุญุตู„ ููŠู‡ุง ุฌูุงู ุงู„ุจุงู†ุซูŠู†ูˆู„ ุจูŠุดุชุบู„ ูƒูˆูŠุณ ุฌุฏุง ู…ุน ุงู„ูƒูŠุฑุงุชูŠู† ูˆูŠุญุงูุธ ุนู„ู‰ ุงู„ุฃุธุงูุฑ ู…ู† ุงู„ุฌูุงู

ุงู„ panthenol ุฒูŠ ู…ุงุจูŠุนุงู„ุฌ ุฌูุงู ุงู„ุฌู„ุฏ ูˆุงู„ุงุธุงูุฑ ูู‡ูˆ ูƒู…ุงู† ู…ู…ูƒู† ูŠุณุชุฎุฏู… ู„ุฌูุงู ุงู„ุนูŠู† ูˆู‡ู†ู„ุงู‚ูŠ ู…ู†ุชุฌุงุช ุฒูŠ corneregel ุจุชุญุชูˆูŠ ุนู„ู‰ ุงู„ dexapanthenol ู„ุนู„ุงุฌ ุฌูุงู ุงู„ุนูŠู†
โค6๐Ÿ‘2
ุฅุชูƒู„ู…ู†ุง ุนู† ุงู„ุจุงู†ุซูŠู†ูˆู„ ูˆู‚ูˆู„ู†ุง ุฅู†ู‡ ู…ุฑุทุจ ู„ู„ุฌู„ุฏ ุงู„ุฌุงู
ุทูŠุจ ุงูŠู‡ ู‡ู‰ ุฃุณุจุงุจ ุฌูุงู ุงู„ุฌู„ุฏ ุฃุตู„ุงู‹
ุฃูˆู„ุงู‹ ู„ุงุฒู… ู†ุนุฑู ุฅู† ู…ุดูƒู„ุฉ ุฌูุงู ุงู„ุฌู„ุฏ ุจุชุฒูŠุฏ ู…ุน ุงู„ุนู…ุฑ ูˆุฅู† ุญูˆุงู„ู‰ 50% ู…ู† ุงู„ุจุงู„ุบูŠู† ุจูŠุนุงู†ูˆุง ู…ู† ุฌูุงู ุงู„ุฌู„ุฏ 

ุฃุณุจุงุจ ุฌูุงู ุงู„ุฌู„ุฏ โ”

๐Ÿ‘ˆุฅุณุชุฎุฏุงู… ุงู„ุตุงุจูˆู† ุงู„ุทุจูŠ ุฃูˆ ุงู„ุบูŠุฑ ุงู„ุทุจูŠ ุจูƒุซุฑุฉ ุฃูˆ ุฒูŠุงุฏุฉ ุนู† ุงู„ู„ุฒูˆู… ุจูŠุคุฏู‰ ุฅู„ู‰ ุฌูุงู  ูˆุชุดู‚ู‚ ุงู„ุฌู„ุฏ

๐Ÿ‘ˆ ุงู„ุงุณุชุญู…ุงู… ุจูƒุซุฑุฉ ุฒูŠุงุฏุฉ ุนู† ุงู„ู„ุฒูˆู…

๐Ÿ‘ˆุนุฏู… ุดุฑุจ ูƒู…ูŠุงุช ูƒุงููŠุฉ ู…ู† ุงู„ู…ูŠุงู‡ ูŠูˆู…ูŠุงู‹ ุฃูˆ ุงู„ุชุบุฐูŠุฉ ุงู„ุณูŠุฆุฉ

๐Ÿ‘ˆุงู„ุทู‚ุณ ุงู„ุญุงุฑ ุงู„ุฌุงู ุฃูˆ ุงู„ุดุชุงุก


ูƒู„ ุฏู‡ ุจูŠุณุงู‡ู… ูู‰ ุฌูุงู ุงู„ุฌู„ุฏ
ูˆูŠุจุฏุฃ ุงู„ุฌู„ุฏ ูŠุธู‡ุฑ ุจู…ุธู‡ุฑ ุถุนูŠู ุบูŠุฑ ู…ุฑู† ุฎุดู† ุฃูˆ ู…ุดู‚ู‚ ุฃูƒุซุฑ ุนุฑุถุฉ ู„ู„ุนุฏูˆุงุช ูˆุงู„ุญูƒุฉ

ุทูŠุจ ุงู„ุนู„ุงุฌ โ“

๐Ÿ‘ˆู†ุญุงูˆู„ ู‚ุฏุฑ ุงู„ุฅู…ูƒุงู† ู†ุดุฑุจ ู…ูŠุงู‡ ูƒุงููŠุฉ

๐Ÿ‘ˆ ู„ูˆ ู‡ู†ุฎุฑุฌ ููŠ ุงู„ุดู…ุณ ู„ูุชุฑุฉ ุทูˆูŠู„ุฉ ู†ุณุชุฎุฏู… ูˆุงู‚ูŠ ุดู…ุณ

๐Ÿ‘ˆู†ู‡ุชู… ุจู†ุธุงู… ุบุฐุงุฆู‰ ุตุญูŠ ู…ุชูˆุงุฒู†

๐Ÿ‘ˆู†ุณุชุฎุฏู… ู…ุฑุทุจุงุช ู„ู„ุฌู„ุฏ ุจุนุฏ ุงู„ุงุณุชุญู…ุงู… ุฒูŠ ุงู„ุจุงู†ุซูŠู†ูˆู„ ุฃูˆ ุงู„ุฌู„ุณุฑูŠู† ุฃูˆ ุฃู‰ ู…ุฑุทุจ ุซุงู†ูŠ 

ุงู„ุฌู„ุณุฑูŠู† ุจูŠู…ุชุต ุงู„ุฑุทูˆุจุฉ ู…ู† ุงู„ุฌูˆ ูˆูŠุถูŠูู‡ุง ู„ู„ุฌู„ุฏ ูˆุจุงู„ุชุงู„ู‰ ูŠุญุงูุธ ุนู„ูŠู‡ ุฑุทุจ .

ูŠุจู‚ู‰ ู„ูˆ ู‚ุฏุฑู†ุง ู†ุธุจุท ุงู„ life style + ุงู„ู…ุฑุทุจุงุช  ู‡ู†ู„ุงู‚ู‰ ู†ุชุงูŠุฌ ูƒูˆูŠุณุฉ ุฅู† ุดุงุก ุงู„ู„ู‡ 

ูˆุจู…ู†ุงุณุจุฉ ุงู„ูƒูˆุฑูˆู†ุง ุจู‚ู‰ โ—
ุฅุณุชุฎุฏุงู… ุงู„ูƒุญูˆู„ ุงู„ุทุจูŠ ู„ู„ุชุนู‚ูŠู…  ุจุงุณุชู…ุฑุงุฑ ุจุฏูˆู† ู…ุงูŠูƒูˆู† ู…ุนุงู‡ ุฌู„ุณุฑูŠู†  ุจูŠุคุฏูŠ ู„ุฌูุงู ุงู„ุฌู„ุฏ .
โค3
ุงูŠู‡ ู‡ูŠ ุงู„ุฃุฏูˆูŠุฉ ุงู„ู„ูŠ ุจู†ุณุชุฎุฏู…ู‡ุง ุนุดุงู† ู†ุนุงู„ุฌ ุงู„ู†ู‚ุฑุณ ูˆ ู†ุญุฏ ู…ู† ุฒูŠุงุฏุฉ ู†ุณุจุฉ ุงู„ Uric acid  ููŠ ุฌุณู…ู†ุง 

ุฃูˆู„ุง ู‹  ู„ุงุฒู… ู†ุนุฑู ุดูˆูŠุฉ ุญุงุฌุงุช ุนู† ุงู„  Uric acid

ู‡ูˆ ุงู„ู…ูุฑูˆุถ ู†ุณุจุฉ ุงู„ urate ููŠ ุฌุณู…ู†ุง ูƒู… ุŸ! 

Female.. 2.4 _ 6 mg/dl
Male ...  3.4 _ 7 mg / dl

ุงูˆู„ ู…ุงุชุจุฏุง ุชุฒูŠุฏ ุนู† ุงู„ Range  ุฏู‡ ุจูŠุจุฏุฃ ูŠุญุต ุชุฑุณูŠุจ  ู„ุฃู…ู„ุงุญ ุงู„ urate  ููŠ ุงู„ุงู†ุณุฌุฉ ุฎุงุตุฉ   (joint  _ kidney  )

ู…ุน ุงู„ู…ูุงุตู„ ุชุนู…ู„ ุงู„ุชู‡ุงุจุงุช ู…ุตุญูˆุจุฉ ุจุฃุงู„ู…
ูˆููŠ ุงู„ kidney ุจุชุนู…ู„ ุญุตูˆุงุช  ูˆู…ุบุต ูƒู„ูˆูŠ

ุทูŠุจ ู‡ูˆ ุงูŠู‡ ุงุตู„ุง ุงู„ู„ูŠ ูŠุฎู„ูŠ ุงู„ Uric acid ูŠุชุฌู†ู† ูˆูŠุฒูŠุฏ ุนู† ู…ุนุฏู„ู‡ ุงู„ุทุจูŠุนูŠ  ุŸ!

ุจูŠุญุตู„ ุญุงุฌุฉ ุงุณู…ู‡ุง  (imbalance  )
ุจู…ุนู†ู‰ ุงู† ุฌุณู…ูƒ ููŠ ุงู„ุทุจูŠุนูŠ ุจูŠุทู„ุน ุงู„ Uric acid  ูƒู†ุงุชุญ ุฃูŠุถูŠ ู…ู† ุจุนุถ ุงู„ุฃูƒู„ุงุช ุฒูŠ ุงู„ู„ุญูˆู… ูˆุงู„ุจู‚ูˆู„ูŠุงุช 
ุชู…ุงู…
ุจูŠุฌูŠ ุฏูˆุฑ ุงู„ kidney  ุจุนุฏู‡ุง  ูุชุฑูˆุญ ู…ุทู„ุนุฉ ุงู„ Uric acid ุนู† ุทุฑูŠู‚ ุงู„ Urine 
ูˆู‡ู†ุง ุจูŠูƒูˆู† ููŠู‡ balance ุจูŠู† ุฅู†ุชุงุฌ ุงู„ Uric acid  ูˆุจูŠู† ุฅุฎุฑุงุฌู‡  ูู…ููŠุด  ู…ุดูƒู„ุฉ 

ุทูŠุจ ุงู…ุชู‰ ูŠุญุตู„ ุงู„ imbalance  ( ุนุฏู… ุชูˆุงุฒู†) ุจู‚ู‰
ู„ู…ุง ูŠูƒูˆู† ููŠู‡ ุฒูŠุงุฏุฉ ุฃูˆ over production  ู…ู† ุงู„  Uric acid  ูˆุงู„ kidney  ู…ุด ุนุงุฑูุฉ ุฃูˆ ู…ุด ู‚ุงุฏุฑุฉ ุชุฎุฑุฌ ุงู„ูƒู…ูŠุฉ ุงู„ูƒุจูŠุฑุฉ ุฏูŠ ูƒู„ู‡ุง

ูˆุณุงุนุชู‡ุง ุงู„ Uric acid  ุจูŠุงุฎุฏ ู…ูˆู‚ู !!
ู…ุงุฏุงู… ู…ุด ุนุงุฑููŠู† ุชุฎุฑุฌูˆู†ูŠ ู…ุน ุงู„ Urine  ุชุนุงู„ูˆุง ุฏูˆุฑูˆุง ุนู„ูŠุง ููŠ ุงู„ joints ูˆุงู„ kidneys
ูุจูŠุฑูˆุญ ูŠุชุฑุณุจ ููŠ ุงู„ joints ูˆูŠุจุฏุฃ ูŠุนู…ู„ ุงู„ู…ุดุงูƒู„ ุงู„ู„ูŠ ู‚ูˆู„ู†ุง ุนู„ูŠู‡ุง

ูˆุนุดุงู† ูƒุฏุฉ ู…ุนุธู…  ุงู„ุฃุฏูˆูŠุฉ ุงู„ู„ูŠ ุจุชุนุงู„ุฌ ุงู„ chronic gout ุจูŠูƒูˆู† ู‡ุฏูู‡ุง ูˆุงุญุฏ ู…ู† ุงู„ุงุซู†ูŠู†  ..

โฌ…ู†ู‚ูู„ ุงู„ pathway ุจุชุงุน ุงู„ Uric acid synthesis
โฌ…ุฃูˆ  increase Uric acid excretion

ูŠุนู†ูŠ "ู†ู‚ู„ู„ ุฅู†ุชุงุฌู‡ ุฃูˆ ู†ุฒูˆุฏ ุฅุฎุฑุงุฌู‡"

ุจู†ู‚ุณู… ุงู„ gout ู„ู†ูˆุนูŠู†

โฌ›Acute gout       โฌ›Chronic gout

โฌ›ุงู„ acute gout

ุจูŠุฌูŠ ุจุณุจุจ ุดูˆูŠุฉ ุญุงุฌุงุช ู…ู†ู‡ุง
๐Ÿ”ธeccessive alcohol consumption
๐Ÿ”ธdiet rich in purines ููˆู„ _ู„ุญูˆู…
๐Ÿ”ธkidney disease ู…ุด ุจูŠู‚ุฏุฑ ูŠุฎุฑุฌ ุงู„ urate 

ู…ูŠู† ุจู‚ู‰ ุงู„ุนู„ุงุฌุงุช ุงู„ู„ูŠ ุจู†ุณุชุฎุฏู…ู‡ุง ู…ุน ุงู„ุญุงู„ุงุช ุฏูŠ
ู‡ู†ุง ุงุญู†ุง ู‡ู†ุนุงู„ุฌ  ุงู„ inflammation  ุงู„ู„ูŠ ู‡ูŠุณุจุจู‡ ุงู„ Uric acid  ููŠ ุงู„ tissue  ูˆู‡ู†ุจุฏุง
ู†ุฏูŠ ุญุงุฌุงุช ุฒูŠ ุงู„ corticosteroids  ูˆุงู„ NSAIDs

ุงู„ NSAIDs  ุจุชู‚ู„ู„ ุงู„ inflammation  ูˆููŠ ู†ูุณ ุงู„ูˆู‚ุช ู‡ุชุดุชุบู„ ูƒ analgesic  ูˆู‡ุชุดูŠู„ ุงู„ pain

ุงู„ corticosteroids ู…ู…ูƒู† ุชุชุงุฎุฏ systemically  ู„ูˆ ุงู„ inflammation  ููŠ ุงู„ุฌุณู… ูƒู„ู‡ 
ูˆู„ูˆ ููŠ ู…ู†ุทู‚ุฉ ู…ุนูŠู†ุฉ ุจุญุฏ ุฐุงุชู‡ุง ู…ู…ูƒู† ู†ุณุชุฎุฏู…
Intra_articular corticosteroids injection 

ูƒู…ุงู† ุจุงู„ุฅุถุงูุฉ ู„ู„ NSAIDs  ูˆุงู„ corticosteroids 
ููŠ ุฏูˆุงุก ุซุงู†ูŠ ู…ุดู‡ูˆุฑ ุงุณู…ู‡  Colchicine
  ูˆุนู„ู‰ ุงู„ุฑุบู… ู…ู† ุฃู†ู‡
ู„ุง ู‡ูˆ ู…ุณูƒู† ูˆู„ุง ู‡ูˆ ุจูŠุฎุฑุฌ ุงู„ Uric acid  ููŠ ุงู„ Urine ู„ูƒู†ู‡ ุจูŠุฎูู ุงู„ุฃู„ู… ุจุชุงุน ุงู„ acute  attack
ูƒู…ุงู† ุนู†ุฏู‡
anti inflammatory effect specific for gout 

ูŠุจู‚ู‰ ููŠ ุงู„ acute ุจู†ุนุงู„ุฌู‡ุง ุจุฏูˆู„
.๐Ÿ‘‰NSAIDs  _ corticosteroids  _  Colchicine 
ูˆุทุจุนุง ุงู„ NSAIDs ุงูƒุชุฑู‡ู… ุงุณุชุฎุฏุงู…ุงู‹
ุจุงู„ุฅุถุงูุฉ ุทุจุนุง ู„ู„ life style  โœ”

ู†ูŠุฌูŠ ุจู‚ู‰ ู„ู„ ""Chronic gout""
ุฒูŠ ู…ุง ู‚ูˆู„ู†ุง ููˆู‚ ู‡ู†ุณุชุฎุฏู… ุฃุฏูˆูŠุฉ  ..๐Ÿ‘‡

โฌ…ุชู‚ูู„ ุฅู†ุชุงุฌ ุงู„ Uric acid
โฌ…ุฃูˆ  ุชุฒูˆุฏ ุฅุฎุฑุงุฌู‡ 


ุนู†ุฏู†ุง  ูค  ุฃุฏูˆูŠุฉ 

โฌ›allopurinol โฌ›Febuxostat โฌ›probenecid โฌ›pegloticase

ุชุนุงู„ูˆุง ู†ุดูˆู ูƒู„ ูˆุงุญุฏ ููŠู‡ู…

๐Ÿ”ธallopurinol ....  (zyloric)
Xanthine oxidase inhibitor ุฏู‡ ุนุจุงุฑุฉ ุนู†

ุงู„ xanthine oxidase ุฏู‡ ูŠุนุชุจุฑ ุงู†ุฒูŠู… ู…ู‡ู… ููŠ ุงู„ biosynthesis ุจุชุงุน ุงู„ Uric acid  ุงู†ุง ุจุณุชุฎุฏู… ุงู„ allopurinol  ูˆู‡ูˆ ุจุฏูˆุฑู‡ ุจูŠุนู…ู„ู‡ inhibation  ูˆุจุงู„ุชุงู„ูŠ ูŠู‚ู„ู„ ุงู„ production  ุจุชุงุน ุงู„ Uric acid  ุฌูˆู‡ ุฌุณู…ู†ุง
ูˆุงู„ allopurinol ุงูˆู„ ู…ุง ุจูŠุชุงุฎุฏ ุจูŠู…ุชุต ุณุฑูŠุนุง ูˆุจูŠุทู„ุน metabolite  ุงุณู…ู‡ oxypurinol ูˆุฏู‡ ุงู„ half life ุจุชุงุนู‡ ุจูŠูˆุตู„ ู„ 18  ุณุงุนุฉ ูˆุนุดุงู† ูƒุฏุฉ  ู‡ูˆ ุจูŠุชุงุฎุฏ ู…ุฑุฉ ูˆุงุญุฏุฉ ููŠ ุงู„ูŠูˆู…  (Once daily dosing )

๐Ÿ”ธFebuxostat    (feburic  and  staturic)
Xanthine oxidase inhibitor

ู†ูุณ ุงู„ู†ุธุงู…  ุจูŠู‚ู„ู„ ุฅู†ุชุงุฌ ุงู„ Uric acid

๐Ÿ”ธprobenecid
Uricosuric drug
ุงู„ุจุฑูˆุจูŠู†ุณูŠุฏ ุจูŠุฒูˆุฏ ุฎุฑูˆุฌ ุงู„ Uric acid ูˆุจูŠู‚ู„ู„ ุฅุนุงุฏุฉ ุงู…ุชุตุงุตู‡

๐Ÿ”ธ pegloticase
ู„ูˆ ูƒู„ ุงู„ุฃุฏูˆูŠุฉ ุงู„ู„ูŠ ูุงุชุช ุฏูŠ ู…ู‚ุฏุฑุชุด ุชู…ู†ุน ุชูƒูˆู† ุงู„ Uric acid ุฃูˆ ุชุชุฎู„ุต ู…ู†ู‡
ุจุฑูˆุญ ู„ู„ pegloticase 
ูˆุฏู‡ ุจูŠุชุงุฎุฏ ูƒุง IV infusion  ูƒู„ ุฃุณุจูˆุนูŠู†
โค4๐Ÿ‘1
ุงู„ NSAIDS ุฒูŠ ุงู„ุจุฑูˆููŠู† ู„ู…ุง ุจูŠุชุงุฎุฏ ู…ุน ุฃู‚ุฑุงุต Yasmin ุงู„ู„ูŠ ุจุชุญุชูˆูŠ ุนู„ู‰ ู…ุงุฏุฉ Drospirenone 
ุจูŠุคุฏูŠ ุฅู„ู‰ ุญุฏูˆุซ ุฒูŠุงุฏุฉ ููŠ ู…ุนุฏู„ุงุช ุงู„ุจูˆุชุงุณูŠูˆู…  (hyperkalemia  )
ูˆุฏูŠ ุจุชุคุฏูŠ ุฅู„ู‰
 
โš kidney failure
โš  muscle paralysis
โš Irregular heart rhythm

ูุนุดุงู† ูƒุฏุฉ ุฃุกู…ู† ู…ุณูƒู† ู…ุน ุงู„ Yasmin ู‡ูˆ ุงู„ุจุงุฑุณูŠุชุงู…ูˆู„

ุฅุณุชุฎุฏุงู… ุงู„ NSADS ู…ุด ุจุณ ู…ุด ุจุณ ู…ู…ูƒู† ูŠุชุนุงุฑุถ ู…ุน ู…ูˆุงู†ุน ุงู„ุญู…ู„ ุฒูŠ ุงู„ Yasmin

ูƒู…ุงู† ุงู„ุงุณุชุฎุฏุงู… ุงู„ุทูˆูŠู„ ู„ู„ NSAIDS  ู…ุน ุงู„ุณูŠุฏุงุช ุจูŠู‚ู„ู„ ุงู„ fertility ู„ุฃู†ู‡ ุจูŠุนู…ู„ ุญุงุฌุฉ ุฅุณู…ู‡ุง
Lutenizing unruptured follicles syndrom( LUF)
ูˆุฏูŠ ุญุงู„ุฉ ุจุชุคุฏูŠ ุฅู„ู‰ ุญุฏูˆุซ ุฎู„ู„ ููŠ ู…ุฑุญู„ุฉ ุงู„ุชุจูˆูŠุถ ูˆุจุงู„ุชุงู„ูŠ ุจุชุฃุซุฑ ุนู„ู‰ ุงู„ุฎุตูˆุจุฉ

ุนู„ุดุงู† ูƒุฏุฉ ู†ุนุชุฏู„ ููŠ ุชู†ุงูˆู„ ุงู„ NSADs
ูˆุงู„ุฃูุถู„ ุฃู†ู†ุง ู†ุฑู…ูŠ ูƒู„ ุฃูˆุฌุงุนู†ุง ุงู„ู…ุญุชู…ู„ุฉ ุนู„ู‰ ุตุฏูŠู‚ู†ุง  ุงู„ู…ุญุจ ุงู„ paracetamol  ูˆู„ุงุจุฃุณ ุจุจุนุถ ุงู„ูƒุงููŠูŠู† ู…ุนู‡ ุญุชู‰ ูŠุฒูˆุฏ ูุงุนู„ูŠุชู‡. ..

ู…ุนู„ูˆู…ุฉ ุจุณูŠุทุฉ ุจุณ ุจุชูุฑู‚. .
โค1๐Ÿ‘1
ุงูŠู‡ ู‡ูŠ ุงู„ุฃุฏูˆูŠุฉ ุงู„ู„ูŠ ุจู†ุณุชุฎุฏู…ู‡ุง ููŠ ู‚ุฑุญุฉ ุงู„ู…ุนุฏุฉ ..
ู…ุนุงู†ุง 6 ูƒู„ุงุณุงุช ู…ู† ุงู„ุฃุฏูˆูŠุฉ ...ูŠู„ุง ู†ุดูˆูู‡ู…

(1 )H2 receptor Antagonists
(2 )proton pump inhibitors                      
(3 )antacids
~~

(4 )misoprostol
(5)scuralfate
~~

(6)anticholinergic antagonist

ุชุนุงู„ูˆุง ู†ุดูˆู ูƒู„ ูˆุงุญุฏ ุจูŠุดุชุบู„ ุงุฒุงูŠ ูˆุฃู…ุซู„ุฉ ุนู„ูŠู‡ู…

๐ŸŽˆ(1) H2 receptors Antagonists
e.g  Ranitidine ...famotidine. ..
ูŠูุถู„ ุงู†ู‡ู… ูŠุชุงุฎุฏูˆุง ู‚ุจู„ ุงู„ุฃูƒู„ ุจู†ุตู ุณุงุนุฉ 

ุจูŠุดุชุบู„ูˆุง ุงุฒุงูŠ !!
ุงู„ุทุจูŠุนูŠ ุงู† ู„ู…ุง ุงู„ู…ุนุฏุฉ ุจุชุชู…ู„ูŠ ุจุงู„ุทุนุงู… ุงู„ HCL ุจูŠุชู… ุฅูุฑุงุฒุงู‡ ุฅุณุชุฌุงุจุฉ ู„ู„ุนู…ู„ูŠุฉ ุฏูŠ ...ูุงู„ู†ูˆุน ุฏู‡ ู…ู† ุงู„ุฃุฏูˆูŠุฉ ุจูŠูˆู‚ู ุฃูˆ ุจูŠู‚ู„ู„ ุงู„ุงุณุชุฌุงุจุฉ ุจุงู„ุฅุถุงูุฉ ุงู†ู‡ ุจูŠู‚ู„ู„ ุฅูุฑุงุฒ ุงู„ HCL ุฃุซู†ุงุก ูุชุฑุงุช ุงู„ู„ูŠู„ ุฏู‡ ู„ุฃู†ู‡ ุจูŠู‚ู„ู„ ุจุทุฑูŠู‚ุฉ ุบูŠุฑ ู…ุจุงุดุฑุฉ( indirect ) ู…ู† ู†ุดุงุท ู…ุถุฎุงุช ุงู„H ูˆุจูƒุฏุฉ ูŠู‚ู„ ุฅูุฑุงุฒ ุงู„ HCL

๐ŸŽˆ(2)proton pump inhibitors PPIs
eg.Omeprazole ...pantoprazole...
ูŠูุถู„ ูŠุชุงุฎุฏูˆุง ู‚ุจู„ ุงู„ุฃูƒู„ ุจู†ุตู ุณุงุนุฉ ุนู„ู‰ ุงู„ุฃู‚ู„
ุฏูˆู„ ุจู‚ู‰ ุฃู‚ูˆู‰ ู…ู† ุงู„ู„ูŠ ูุงุชูˆุง !!
ู„ุฃู†ู‡ู… ุจูŠุนู…ู„ูˆุง irreversibl( direct) inhibation ู„ู…ุถุฎุงุช ุงู„ H  ูŠุนู†ูŠ ุจูŠุดุชุบู„ูˆุง ุนู„ู‰ ุงู„ู…ุถุฎุฉ ู†ูุณู‡ุง ูˆูŠู‚ูู„ูˆู‡ุง ุฎุงู„ุต
ูˆุนุดุงู† ูƒุฏุฉ ุฃู‡ู… ุฃู‚ูˆู‰ ู…ู† ุฅุฎูˆุงุชู‡ู… ุงู„ู„ูŠ ููˆู‚
ูˆู‡ู…ุง ุฃูุถู„ ู†ุงุณ ูŠุดุชุบู„ูˆุง ู…ุน ุงู„ H pylori

๐ŸŽˆ(3) Antacids
eg.Mucogel  ...epicogel  (trade name )
ุฏูˆู„ ุนุจุงุฑุฉ ุนู† bases  ุฒูŠ  Al(OH)3ใ€ŠMg (OH)2ใ€‹
ูˆุฏูˆู„ ุดุบู„ู‡ู… ุฃู†ู‡ู… ูŠุนุงุฏู„ูˆุง  ุงู„ HCL ุนู† ุทุฑูŠู‚ ุงู†ู‡ู… ูŠุชูุงุนู„ูˆุง ู…ุนุงู‡  acid base Rex ุนุงุฏูŠ ุฌุฏุง
ูˆุนุดุงู† ูƒุฏุฉ ูŠูุถู„ ุงู†ู‡ู… ูŠุชุงุฎุฏูˆุง ุจุนุฏ ุงู„ุฃูƒู„ ุนุดุงู† ูŠุชูุงุนู„ูˆุง ู…ุน ุงู„ HCL  ูˆูŠุนุงุฏู„ูˆู‡  . ูˆุงู„ู†ูˆุน ุฏู‡ ุจูŠุณุชุฎุฏู… ู…ุน ุงู„ุญุงู„ุงุช ุงู„ mild ุฃูˆ ุจุนุฏ ูˆุฌุจุฉ ุซู‚ูŠู„ุฉ ูˆูƒุฏุฉ 

๐ŸŽˆ(4 )misoprostol
eg .Misotac
ุงู„misoprostol ุนุจุงุฑุฉ ุนู† ุจุฑูˆุณุชุงุฌู„ุงู†ุฏูŠู† analogue  ู„ูŠู‡ cytoprotective activity ุนู† ุทุฑูŠู‚ ุฃู†ู‡
(1)ุจูŠุฒูˆุฏ ุณู…ูƒ ุงู„  mucusูˆ ุจูŠุฒูˆุฏุงู„ bicarbonate   
(2)ูˆูƒู…ุงู† ุจูŠู‚ู„ู„ ุงู„ volume  ุจุชุงุน ุงู„ pepsin
ูˆูƒู…ุงู† ุจูŠู‚ู„ู„ ุฅูุฑุงุฒ ุงู„ HCL
ู…ุจู‚ุงุด ูŠุณุชุฎุฏู… ู„ู„ุบุฑุถ ุฏู‡ ุฏู„ูˆู‚ุชูŠ ูˆุจู‚ู‰ ุจูŠุณุชุฎุฏู… ููŠ ุญุงู„ุงุช ุงู„ Abortion .

๐ŸŽˆ (5) scuralfate
ุฏู‡ ุจู‚ู‰ ู…ู„ูˆุด ุชุฃุซูŠุฑ ุนู„ู‰ ุงู„ HCL ุจูŠุดุชุบู„ ุนู„ู‰ ุงู„ ulcers ู†ูุณู‡ุง ุจุณ ู„ุงุฒู… ุนุดุงู† ูŠุดุชุบู„ ูŠูƒูˆู† ุงู„ูˆุณุท ูƒู„ู‡ acidic  ุนุดุงู† ูƒุฏุฉ ู…ู…ูƒู† ูŠุนู…ู„ interference ู„ูˆ ุงุณุชุฎุฏู…ู†ุงู‡ ู…ุน ุงู„ antacids  
ุงู„ scuralfate ุจู…ุฌุฑุฏ ู…ุงูŠุฎุด ุงู„ู…ุนุฏุฉ ุจูŠุญุตู„ู‡ polymarization ูˆูŠุชุญูˆู„ ู„ุทุจู‚ุฉ gel   ุจุชุนู…ู„ coating ุนู„ู‰ ุงู„ ulcer ูุชุณุงุนุฏ ุนู„ู‰ ุงู„ healing  ุจุชุงุนู‡ุง

๐ŸŽˆ(6) muscarinic  antagonist
ุจูŠู‚ู„ู„ูˆุง ุงู„HCl ููŠ ุงู„ู…ุงุถูŠ ุชู… ุงุณุชุฎุฏุงู…ู‡ู… ู„ูุชุฑุฉ ุทูˆูŠู„ุฉ ู„ู„ุบุฑุถ ุฏู‡ ุจุณ ุญุงู„ูŠุง ู…ุจู‚ูˆุด ูŠุณุชุฎุฏู…ูˆุง ู†ุชูŠุฌุฉ ูˆุฌูˆุฏ ุญุงุฌุงุช ุฃูุถู„ ูˆุจุฏูˆู† ุขุซุงุฑ ุฌุงู†ุจูŠุฉ ุฒูŠ H2 receptor Antagonists  ูˆ PPIs
โค3๐Ÿ‘3
1โƒฃ ุงูุถู„ ู…ู„ูุงุช ุชู‚ุณู… ุงู„ุงุฏูˆูŠุฉ ุจุทุฑูŠู‚ุฉ alphabetical
ู…ู„ู ู„ุงุฏูˆูŠุฉ ุงู„ุตูŠุฏู„ูŠุฉ ุจุงู„ูƒุงู…ู„ ููŠ ูฆูฆ ุตูุญุฉ ุจุทุฑูŠู‚ุฉ ู…ู†ุธู…ุฉุŒ ุงุนุฏุงุฏ EPSF Minia ((ุจุฏูˆู† ุตูˆุฑ - ุดุงู…ู„ ุฌู…ูŠุน ุงู„ุงุฏูˆูŠุฉ))
https://uglyprescriptions.blogspot.com/2021/01/pharmacy-drugs-guide.html
ู…ู„ู ุฌู…ูŠุน ุงู„ุฃุฏูˆูŠุฉ ุงู„ุดุงุฆุนุฉ ููŠ ุงู„ุตูŠุฏู„ูŠุฉ ูˆุงุณุชุฎุฏุงู…ุงุชู‡ุง ูˆู…ูˆุงู†ุน ุงู„ุงุณุชุนู…ุงู„ ((ุจุงู„ุตูˆุฑ))
https://uglyprescriptions.blogspot.com/2021/03/common-drugs-in-pharmacy-pdf.html

2โƒฃ ุงูุถู„ ู…ู„ูุงุช ุชู‚ุณู… ุงู„ุงุฏูˆูŠุฉ ุจุทุฑูŠู‚ุฉ systemic
ุดุฑุญ ุฃุฏูˆูŠุฉ ุงู„GIT ุจุงู„ุงุณู…ุงุก ุงู„ุชุฌุงุฑูŠุฉ
https://uglyprescriptions.blogspot.com/2021/06/gastrointestinal-drugs.html
ุฃุฏูˆูŠุฉ ุงู„ุฌู‡ุงุฒ ุงู„ุชู†ูุณูŠ ุจุงู„ุตูˆุฑ Respiratory drugs
https://uglyprescriptions.blogspot.com/2021/07/respiratory-system-drugs-pdf.html
ู…ู„ู ูƒุงู…ู„ ุนู† ุงู„ู…ุถุงุฏุงุช ุงู„ุญูŠูˆูŠุฉ ุจุตูˆุฑ ุนู„ุจ ุงู„ุงุฏูˆูŠุฉ
https://uglyprescriptions.blogspot.com/2021/12/complete-file-on-antibiotics-pdf.html
ู…ู„ู ุงู†ูˆุงุน ุงู„ู…ุณูƒู†ุงุช ูˆุงุณุชุฎุฏุงู…ุงุชู‡ุง pdf
https://uglyprescriptions.blogspot.com/2022/03/types-of-analgesics-and-their-uses-pdf.html

3โƒฃ ุชุฌู…ูŠุนุงุช OTC
ู…ู„ู ุดุฑุญ ุงุดู‡ุฑ ุญุงู„ุงุช otc ุจุฎุท ุงู„ูŠุฏ
https://t.me/uglyprescribtions/617
ุชุฌู…ูŠุนุฉ ู…ู„ูุงุช otc
https://uglyprescriptions.blogspot.com/search/label/OTC

4โƒฃ ุงุดู‡ุฑ ุงู„ูƒุชุจ ุงู„ุทุจูŠุฉ pdf (ู„ู…ุคู„ููŠู† ู…ุตุฑูŠูŠู†/ุนุฑุจ)
https://m.facebook.com/story.php?story_fbid=362229989248047&id=100063831468090

5โƒฃ ุฑูˆุดุชุงุช
ุงูƒุซุฑ ู…ู† ูกู ู  ุฑูˆุดุชุฉ ู…ุญู„ูˆู„ุฉ ุจุตูˆุฑ ุงู„ุงุฏูˆูŠุฉ
https://uglyprescriptions.blogspot.com/2021/06/100-prescriptions-pdf.html
ุงูƒุซุฑ ู…ู† ูกู ู  ุฑูˆุดุชุฉ ู…ุญู„ูˆู„ุฉ ุจุฏูˆู† ุตูˆุฑ ุงู„ุงุฏูˆูŠุฉ
https://t.me/uglyprescribtions/691

6โƒฃ ุงู„ุชุญุงู„ูŠู„ ุงู„ุทุจูŠุฉ
ุดุฑุญ ุงู„ุชุญุงู„ูŠู„ ุงู„ุทุจูŠุฉ ู…ู† ุงู„ุงู„ู ู„ู„ูŠุงุก ูƒู„ ู†ูˆุน ุชุญู„ูŠู„ ููŠ ู…ู„ู (ุงูƒุซุฑ ู…ู† 30 ู…ู„ู ู„ุดุฑุญ ุฌู…ูŠุน ุงู†ูˆุงุน ุงู„ุชุญุงู„ูŠู„)
https://uglyprescriptions.blogspot.com/2021/01/medical-analysis-from-a-to-z.html
โค2
ุฏู„ูŠู„ ุฃุฏูˆูŠุฉ ุงู„ุทูˆุงุฑุฆ ๐Ÿš‘
โž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธโž–๏ธ
ุฃุชุฑูˆุจูŠู† Atropine ๐Ÿ’‰
ุจูŠุดุชุบู„ ุนู„ู‰ ุฒูŠุงุฏุฉ ุถุฑุจุงุช ุงู„ู‚ู„ุจ ููŠ ุญุงู„ุงุช ุจุทุก ุงู„ู†ุจุถ Bradycardia ู„ุฃู†ู‡ ุจูŠู…ู†ุน ุชุฃุซูŠุฑ ุงู„ุนุตุจ ุงู„ุญุงุฆุฑ Vagus nerve ุนู„ู‰ ุงู„ู‚ู„ุจ
ู…ู‡ู… ุฌุฏู‹ุง ููŠ ุชูˆู‚ู ุงู„ู‚ู„ุจ ุจู†ู…ุท Asystole ุฃูˆ Severe Bradycardia

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ุฏูˆุจูˆุชุงู…ูŠู† Dobutamine ๐Ÿ’‰
ู…ู†ุดู‘ุท ู‚ูˆูŠ ู„ุนุถู„ุฉ ุงู„ู‚ู„ุจ
ุจูŠุฒูˆุฏ ู‚ูˆุฉ ุงู†ู‚ุจุงุถ ุงู„ู‚ู„ุจ Cardiac contractility ูˆุจูŠุณุชุฎุฏู… ููŠ ุญุงู„ุงุช ู‡ุจูˆุท ุงู„ู‚ู„ุจ ุงู„ุญุงุฏ Cardiac failure

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ุฃุฏุฑูŠู†ุงู„ูŠู† Adrenaline ๐Ÿ’‰
ู…ู† ุฃู‚ูˆู‰ ุฃุฏูˆูŠุฉ ุงู„ุทูˆุงุฑุฆ
ุจูŠุฑูุน ุงู„ุถุบุท ูˆูŠุฒูˆุฏ ุถุฑุจุงุช ุงู„ู‚ู„ุจ ูˆูŠู‚ูู„ ุงู„ุฃูˆุนูŠุฉ ุงู„ุฏู…ูˆูŠุฉ
ูŠูุณุชุฎุฏู… ููŠ ุงู„ุฅู†ุนุงุด ุงู„ู‚ู„ุจูŠ ุงู„ุฑุฆูˆูŠ CPR ูˆุงู„ุฃู†ููŠู„ุงูƒุณุณ Anaphylaxis ูˆุงู„ุฑุจูˆ ุงู„ุญุงุฏ

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ู„ูŠุฏูˆูƒุงูŠูŠู† Lidocaine ๐Ÿ’‰
ู…ุฎุฏุฑ ู…ูˆุถุนูŠ
ูˆูƒู…ุงู† ู…ุถุงุฏ ู„ุงุถุทุฑุงุจ ุงู„ู†ุธู… ุงู„ู‚ู„ุจูŠ Ventricular arrhythmias
ูŠูุณุชุฎุฏู… ู…ุน ุงู„ุฎูŠุงุทุฉ ูˆุฃุญูŠุงู†ู‹ุง ููŠ ุงู„ุทูˆุงุฑุฆ ุงู„ู‚ู„ุจูŠุฉ

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ู†ูŠุชุฑูˆุฌู„ูŠุณุฑูŠู† Nitroglycerin ๐Ÿ’Š
ูŠูˆุณู‘ุน ุงู„ุดุฑุงูŠูŠู† ุงู„ุชุงุฌูŠุฉ
ุจูŠู‚ู„ู„ ุฃู„ู… ุงู„ุฐุจุญุฉ ุงู„ุตุฏุฑูŠุฉ Angina
ู„ุงุฒู… ุญุฐุฑ ู…ุน ู‡ุจูˆุท ุงู„ุถุบุท

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ุฏูŠุฌูˆูƒุณูŠู† Digoxin ๐Ÿ’‰
ูŠุฒูˆู‘ุฏ ู‚ูˆุฉ ุงู†ู‚ุจุงุถ ุงู„ู‚ู„ุจ
ู…ููŠุฏ ููŠ ูุดู„ ุงู„ู‚ู„ุจ ุงู„ุงุญุชู‚ุงู†ูŠ Heart failure ูˆุจุนุถ ุงุถุทุฑุงุจุงุช ุงู„ู†ุธู…
ุฌุฑุนุงุชู‡ ู„ุงุฒู… ุชูƒูˆู† ุฏู‚ูŠู‚ุฉ ู„ุฃู†ู‡ Narrow therapeutic index

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ุฅู†ุฏุฑุงู„ Inderal ๐Ÿ’Š
ุญุงุตุฑ ุจูŠุชุง Beta blocker
ุจูŠู‚ู„ู„ ุถุฑุจุงุช ุงู„ู‚ู„ุจ ูˆุงู„ุถุบุท
ู…ู…ู†ูˆุน ููŠ ู…ุฑุถู‰ ุงู„ุฑุจูˆ ู„ุฃู†ู‡ ูŠู‚ูู„ ุงู„ุดุนุจ ุงู„ู‡ูˆุงุฆูŠุฉ

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ุณุชุฑุจุชูˆูƒูŠู†ุงุฒ Streptokinase ๐Ÿ’‰
ู…ุฐูŠุจ ู„ู„ุฌู„ุทุงุช Thrombolytic
ูŠูุณุชุฎุฏู… ููŠ ุงู„ุฌู„ุทุงุช ุงู„ุญุงุฏุฉ ุฒูŠ ุฌู„ุทุฉ ุงู„ู‚ู„ุจ ุฃูˆ ุงู„ุฑุฆุฉ
ุฎุทุฑู‡ ุงู„ุฃุณุงุณูŠ ุงู„ู†ุฒูŠู

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ุฃู…ูŠู†ูˆููŠู„ูŠู† Aminophylline ๐Ÿ’‰
ู…ูˆุณู‘ุน ู„ู„ุดุนุจ ุงู„ู‡ูˆุงุฆูŠุฉ
ุจูŠูุณุชุฎุฏู… ููŠ ู†ูˆุจุงุช ุงู„ุฑุจูˆ ุงู„ุดุฏูŠุฏุฉ
ู…ู…ูƒู† ูŠุณุจุจ ุฑุนุดุฉ ูˆุฒูŠุงุฏุฉ ุถุฑุจุงุช ุงู„ู‚ู„ุจ

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ุฏูŠุงุฒูŠุจุงู… Diazepam ๐Ÿ’‰
ู…ู‡ุฏุฆ ูˆู…ุถุงุฏ ู„ู„ุชุดู†ุฌุงุช
ูŠูุณุชุฎุฏู… ููŠ ุงู„ุตุฑุน ูˆุงู„ู‚ู„ู‚ ุงู„ุญุงุฏ
ูŠุนู…ู„ ูƒุจุช ู„ู„ุชู†ูุณ ู„ูˆ ุงู„ุฌุฑุนุฉ ุฒุงุฏุช

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ู„ุงุฒูƒุณ Lazix (Furosemide) ๐Ÿ’‰
ู…ุฏุฑ ุจูˆู„ ู‚ูˆูŠ
ู…ู‡ู… ุฌุฏู‹ุง ููŠ ูˆุฐู…ุฉ ุงู„ุฑุฆุฉ ูˆุงู„ู€ Heart failure
ุจูŠู‚ู„ู„ ุงู„ุณูˆุงุฆู„ ูˆุงู„ุถุบุท ุนู„ู‰ ุงู„ู‚ู„ุจ

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ู†ูŠููŠุฏูŠุจูŠู† Nifedipine ๐Ÿ’Š
ู…ูˆุณู‘ุน ู„ู„ุฃูˆุนูŠุฉ ุงู„ุฏู…ูˆูŠุฉ
ู„ุนู„ุงุฌ ุงู„ุถุบุท ุงู„ู…ุฑุชูุน ูˆุงู„ุฐุจุญุฉ ุงู„ุตุฏุฑูŠุฉ
ูŠูู…ู†ุน ุงุณุชุฎุฏุงู…ู‡ ุชุญุช ุงู„ู„ุณุงู† ููŠ ุงู„ุทูˆุงุฑุฆ

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ู‡ูŠูˆุณูŠู† Hyoscine ๐Ÿ’‰
ู…ุถุงุฏ ู„ู„ุชู‚ู„ุตุงุช
ุจูŠุนุงู„ุฌ ุงู„ู…ุบุต ุงู„ู…ุนูˆูŠ ูˆุงู„ูƒู„ูˆูŠ
ุจูŠุดุชุบู„ ุนู„ู‰ ุงู„ุนุถู„ุงุช ุงู„ู…ู„ุณุงุก

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ู…ูŠุชูˆูƒู„ูˆุจุฑุงู…ูŠุฏ Metoclopramide ๐Ÿ’‰
ู…ุถุงุฏ ู„ู„ุบุซูŠุงู† ูˆุงู„ู‚ูŠุก
ูŠุฒูˆู‘ุฏ ุญุฑูƒุฉ ุงู„ู…ุนุฏุฉ
ู„ุง ูŠูุถู„ ู…ุน ู…ุฑุถู‰ ุงู„ุดู„ู„ ุงู„ุฑุนุงุด

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ุฏูŠูƒุณุงู…ูŠุซุงุฒูˆู† Dexamethasone ๐Ÿ’‰
ูƒูˆุฑุชูŠุฒูˆู† ู‚ูˆูŠ
ูŠูุณุชุฎุฏู… ููŠ ุงู„ุญุณุงุณูŠุฉ ูˆุงู„ุฑุจูˆ ูˆูˆุฐู…ุฉ ุงู„ู…ุฎ
ุจูŠู‚ู„ู„ ุงู„ุงู„ุชู‡ุงุจ ูˆุงู„ุชูˆุฑู…

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ู‡ูŠุฏุฑูˆูƒูˆุฑุชูŠุฒูˆู† Hydrocortisone ๐Ÿ’‰
ูƒูˆุฑุชูŠุฒูˆู† ุทูˆุงุฑุฆ
ุฃุณุงุณูŠ ููŠ ุงู„ุญุณุงุณูŠุฉ ุงู„ุดุฏูŠุฏุฉ ูˆุงู„ุฃู†ููŠู„ุงูƒุณุณ
ุฃูƒุซุฑ ุฃู…ุงู†ู‹ุง ููŠ ุงู„ุทูˆุงุฑุฆ

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ุฏูŠูƒู„ูˆููŠู†ุงูƒ Diclofenac ๐Ÿ’‰
ู…ุณูƒู† ูˆู…ุถุงุฏ ุงู„ุชู‡ุงุจ
ูŠูุณุชุฎุฏู… ู„ู„ุฃู„ู… ุงู„ุญุงุฏ
ูŠูู…ู†ุน ููŠ ู‚ุฑุญุฉ ุงู„ู…ุนุฏุฉ ูˆุงู„ูุดู„ ุงู„ูƒู„ูˆูŠ

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ุฃูˆู…ูŠุจุฑุงุฒูˆู„ Omeprazole ๐Ÿ’‰
ูŠู‚ู„ู„ ุฅูุฑุงุฒ ุญู…ุถ ุงู„ู…ุนุฏุฉ
ู…ู‡ู… ููŠ ุงู„ู†ุฒูŠู ุงู„ู‡ุถู…ูŠ ูˆู‚ุฑุญุฉ ุงู„ู…ุนุฏุฉ

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ุจูŠูƒุฑุจูˆู†ุงุช ุงู„ุตูˆุฏูŠูˆู… Sodium bicarbonate ๐Ÿ’‰
ุชูุณุชุฎุฏู… ููŠ ุญุงู„ุงุช ุงู„ุญู…ูˆุถุฉ ุงู„ุดุฏูŠุฏุฉ Metabolic acidosis
ูˆูƒู…ุงู† ููŠ ุจุนุถ ุญุงู„ุงุช ุงู„ุชุณู…ู…
ู…ุด ู…ุฌุฑุฏ ุฏูˆุงุก ู„ู„ุญู…ูˆุถุฉ ูˆุฎู„ุงุต
๐€๐ง๐ญ๐ข๐๐ข๐š๐›๐ž๐ญ๐ข๐œ ๐๐ก๐š๐ซ๐ฆ๐š๐œ๐จ๐ญ๐ก๐ž๐ซ๐š๐ฉ๐ฒ ๐ข๐ง ๐๐ซ๐ž๐ ๐ง๐š๐ง๐œ๐ฒ

Pharmacotherapy in diabetes during pregnancy should be guided by one principle: use agents with the best maternal glycemic control and the strongest pregnancy safety data. Current American Diabetes Association guidelines states the preferred agents for type 1 diabetes in pregnancy and also the preferred option for gestational diabetes and type 2 diabetes in pregnancy.

๐Ÿ”น๐…๐ข๐ซ๐ฌ๐ญ-๐ฅ๐ข๐ง๐ž ๐“๐ก๐ž๐ซ๐š๐ฉ๐ฒ

โ€ข ๐ˆ๐ง๐ฌ๐ฎ๐ฅ๐ข๐ง: remains the preferred agent for:
โ€“ Type 1 diabetes
โ€“ Type 2 diabetes in pregnancy
โ€“ Gestational diabetes (when medication is required)

โ€ข Rationale: does not cross the placenta and allows flexible titration to achieve strict glycemic targets ()

๐Ÿ”น ๐Ž๐ซ๐š๐ฅ ๐€๐ ๐ž๐ง๐ญ๐ฌ โ€“ ๐๐จ๐ญ ๐…๐ข๐ซ๐ฌ๐ญ-๐‹๐ข๐ง๐ž

โ€ข ๐Œ๐ž๐ญ๐Ÿ๐จ๐ซ๐ฆ๐ข๐ง

โ€“ Crosses the placenta
โ€“ May be considered in selected patients, but not recommended as first-line
โ€“ Long-term offspring outcomes remain uncertain ()

โ€ข ๐†๐ฅ๐ฒ๐›๐ฎ๐ซ๐ข๐๐ž (๐†๐ฅ๐ข๐›๐ž๐ง๐œ๐ฅ๐š๐ฆ๐ข๐๐ž)

โ€“ Crosses the placenta
โ€“ Associated with โ†‘ neonatal hypoglycemia & macrosomia
โ€“ Inferior to insulin in achieving optimal outcomes ()

๐Ÿ”น ๐๐ซ๐ž๐œ๐จ๐ง๐œ๐ž๐ฉ๐ญ๐ข๐จ๐ง ๐๐ก๐š๐ซ๐ฆ๐š๐œ๐จ๐ญ๐ก๐ž๐ซ๐š๐ฉ๐ฒ

โ€ข ๐†๐‹๐-๐Ÿ receptor agonists & other non-insulin agents โ†’ should be discontinued prior to conception
โ€ข Transition to insulin-based regimens is recommended to ensure safety and control

๐Ÿ”น ๐‚๐จ๐ฆ๐›๐ข๐ง๐š๐ญ๐ข๐จ๐ง ๐“๐ก๐ž๐ซ๐š๐ฉ๐ฒ
โ€ข Routine addition of metformin to insulin in pregnancy โ†’ not routinely recommended based on current guideline direction

๐Ÿ”น ๐Š๐ž๐ฒ ๐‚๐ฅ๐ข๐ง๐ข๐œ๐š๐ฅ ๐“๐š๐ค๐ž๐š๐ฐ๐š๐ฒ

โ€ข Insulin remains the cornerstone of therapy
โ€ข Non-insulin agents = case-by-case use only
โ€ข Management must be individualized, safety-driven, and guideline-based

References:
https://lnkd.in/dRUbTSNx
Antibiotics Safe in Pregnancy

๐Ÿ”ท๏ธ Penicillins (e.g., amoxicillin) โ†’ safest, widely used
๐Ÿ”ท๏ธ Cephalosporins โ†’ safe alternative
๐Ÿ”ท๏ธ Azithromycin / Erythromycin โ†’ safe macrolides
๐Ÿ”ท๏ธ Clindamycin โ†’ safe in anaerobic infections
๐Ÿ”ท๏ธ Metronidazole โ†’ safe (especially after 1st trimester)
๐Ÿ”ท๏ธ Nitrofurantoin โ†’ safe (avoid near term)
๐Ÿ”ท๏ธ Fosfomycin โ†’ safe for UTIs

๐Ÿ”ฅ Avoid in Pregnancy (Exam Pearl):
โŒ Tetracyclines
โŒ Aminoglycosides (ototoxic)
โŒ Fluoroquinolones
โŒ Chloramphenicol