Concepts in Pharmacology- Dr. Ashish

Dear friends,

We have a opening for candidate with qualification MD Pharmacology at 1mg Tech Pvt Ltd, Gurgaon.

Interested candidate can touch base with me for more detail.

Looking forward.

Regards,
Dr Ashish

tricks
1. Repeat what you hear out loud
2. Make a note
3. Make associations between old and new information
4. Divide information into chunks

Lesinurad
MOA: Inhibit URAT1 (Uric acid transporter 1, responsible for the majority of the reabsorption of filtered uric acid from the renal tubular lumen)
Use: Gout (along with a xanthine oxidase inhibitor)

Mechanism of Action of Methotrexate:

A) Cancer:-Anti-metabolite (high dose)

Inhibits dihydrofolate reductase (DHFR), thereby interfering with the formation of DNA, RNA and proteins.

B) Autoimmune disorders (Rheumatoid Arthritis):- Anti-inflammatory (low dose)

Inhibits multiple enzymes involved in the synthesis of nucleotides, resulting in an increase in adenosine levels

Adenosine release into the extracellular space produces a potent anti-inflammatory effect, including a reduction in the number of activated T cells, and a reduction of TNF-α levels

"Use dependence" refers to increased pharmacologic effects of a drug during faster heart rates.
It is seen in class IC & Class IV (Calcium channel blockers) antiarrhythmic agents.
Class IC agents cause a progressive decrease in impulse conduction with faster heart rates, leading to an increase in QRS complex duration.
*Class IC drugs are Flecainide & Propafenone.

Desmopressin (intranasal form preferred) is the first- line treatment for central diabetes insipidus.

5 alpha reductase inhibitors (ARIs): Finasteride & Dutasteride
MOA: Prevent conversion of testosterone to DHT (more potent).
Decreases the prostate size or volume, improve the symptom in 3 to 6 months after treatment. Works better in prostate larger than 40 ml.
Use: BPH & androgenic alopecia.
Finasteride, oral (low dose, 1 mg/d) used in men with androgenic alopecia.
Finasteride (high dose, 5mg/d) used in BPH
Dutasteride (D-Dual) inhibits both Type 1 & 2 isoforms of 5α-reductase

Treatment of Infantile Spasms (West Syndrome):
1. Adrenocorticotropic hormone (ACTH)- I/M; drug of choice
2. Prednisolone, if no improvement
3. Vigabatrin, if no improvement with Prednisolone.
*Vigabatrin has orphan drug status for use in Infantile spasm

Dupilumab
MOA: IL-4 receptor antagonist
Uses: atopic dermatitis (AD)
*Mnemonics: il- Interleukin; D is the fourth (4) word
Other medicines used in AD are topical immunosuppressants, such as tacrolimus and pimecrolimus, apart from the steroid.

Basiliximab
MOA: block IL-2R.
Uses: To prevent kidney transplant rejection
ADR: Edema, hypertension, tremor
*Mnemonics: il- Interleukin, B- Second (2) letter