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العودة   منتدى عالم الصيادلة | صيادلة على خطى الحبيب | Pharmacists world > منتديات الصيدله > عالم الادوية و التركيبات الدوائية
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امراض الجهاز الهضمى وعلاجها

عالم الادوية و التركيبات الدوائية

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أدوات الموضوع
قديم 04-11-2010, 02:27 PM   #41
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

rehydrating solutions
محاليل معالجة الجفاف
used to maintain hydration during severe &acute vomiting&emesis
also in gastroenteritis as it is accompained by vomiting
gastroenteritis=نزلة معوية
ex
rehydran -N sach
hydrosafe salts sach
balkab sach
rehydro-zinc sach
ors sach
pansol soln
babysol soln bottle
lohydran sach
they all contain salts&glucose&electrolytes&
  رد باقتباس
قديم 04-11-2010, 03:34 PM   #42
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

Constipation
Abnormally infrequent and difficult passage of feces through the lower GI tract
Symptom, not a disease
Disorder of movement through the colon and/or rectum
Can be caused by a variety of diseases
or drugs
Laxatives: Mechanism of Action

Bulk forming
High fiber
Absorbs water to increase bulk
Distends bowel to initiate reflex bowel activity
Examples:
psyllium (exregumucil pack)

polycarbophil
ex
evaculax cap
evak tab

Hyperosmotic
Increase fecal water content
Result: bowel distention, increased peristalsis, and evacuation
Examples:


glycerin
ex
glycerin inf supp
glycerin ad supp

lactulose (duphalac syr
lactulose syr
sedalac
laxolac
lactulax
optilax syrup
) Saline
Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines
Result: bowel distention, increased peristalsis, and evacuation
ex
laxel eff
Stimulant
Increases peristalsis via intestinal nerve stimulation
Examples:
castor oil
senna
ex
sennalax tab
purgaton tab
mentholax cap
dialox tab
senokat tab

cascara
mucinum tab
compound laxative tab
bisacodyl
abilaxine tab
abilaxine ped supp
abilaxine adult supp
laxin tab
bisadyl tab
bisadyl ad supp
bisadyl ped supp
minalax tab











  رد باقتباس
قديم 07-11-2010, 02:23 PM   #43
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها


NAUSEA & VOMITING
ANTI-EMETIC AGENTS Pathophysiology

Nausea and vomiting is a reasonably well understood physiological process thought to be a protective evolutionary mechanism to eject toxic substances from the stomach and to serve to remind animals about which plants are safe to eat, because the unpleasant effects of nausea caused by toxins are so well remembered.

Hence, patients who have had postoperative nausea and vomiting in hospitals remember it for longer than any postoperative complication and describe it as the worst side effect.1


The vomiting centre in the medulla in the brain stem controls vomiting.

Three physiological pathways stimulate the vomiting centre, and antiemetics act on one or more of these pathways to differing degrees

. The pathways are vestibular fibres (from the inner ear involved in perception of balance and movement);

afferent visceral fibres (nerves originating from the gastrointestinal tract);

and input from the chemoreceptor trigger zone in the base of the fourth ventricle, which detects exogenous substances (for example, inhaled anaesthetics) in the blood.

The neuromessengers include histamine, acetylcholine, serotonin, and dopamine and form the targets of most antiemetic treatment. Once stimulated, the active sensory and motor responses of nausea and vomiting are initiated







n
Mechanism of vomiting









  رد باقتباس
قديم 07-11-2010, 04:22 PM   #44
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

treatment
Treatment of postoperative nausea and vomiting is not an exact science as there is overlap in both the neural pathways regulating nausea and vomiting and the pharmaceuticals which are effective.

In general, antiemetics should only be prescribed when the cause of nausea and vomiting is known.

When a decision is made to instigate treatment with drugs, an understanding of the different classes of drugs is helpful in choosing the most appropriate.

The following classes of drugs are the most commonly prescribed. Anticholinergics
The only anticholinergic to have been shown to have any antiemetic quality is hyoscine. It may be of use in patients for whom the main stimulus is vestibular (that is, nausea and vomiting caused by movement or ear, nose, and throat surgery).

Its main use, however, is now in palliative care where it is used to dry upper airway secretions and ease breathing at the end of life



.
Dopamine antagonists
These pharmaceuticals, for example prochlorperazine, haloperidol, domperidone and metoclopramide, have been used as antiemetics for many years.

They work by inhibiting the activity of dopamine at the D2 receptor in the chemoreceptor trigger zone, thereby limiting the emetic input to the medullary vomiting centre.
These drugs are effective at blocking nausea and vomiting caused by general anaesthetics, opiates, and cytotoxic drugs
.
Prochlorperazine has been in clinical use as an antiemeitc since the 1950s and is still widely used; it is not favoured by anaesthetists because it cannot be given intravenously, and it has relatively common extrapyramidal side effects
.

Certain other antipsychotics, especially haloperidol,domperidone are often used in palliative care to treat nausea and vomiting caused by malignancy. Low doses of haloperidol, such as 1 mg once a day, are effective and are the treatment of choice for nausea and vomiting caused by intestinal obstruction.


These drugs may well have a place in the management of postoperative nausea and
vomiting, but as yet little evidence supports their effectiveness
.
Metoclopramide closely resembles the phenothiazines but has a limited role as an antiemetic for postoperative nausea and vomiting. It is effective in certain settings, such as emesis associated with hepatic disease, but has been shown to be ineffective in many trials for the treatment of postoperative nausea and vomiting and should not be considered without senior input. Because it also increases gastrointestinal motility, it

should never be considered in patients where bowel obstruction is possible
ex
metchloperamide

primperan tab&syrup&amp
primperan ad supp
primperan ped supp.
primperan drps
plasil tab&syrup&dops
sorbiperan syup
vomistop cap
anausn syrup
meclopram tab&mp&syr&suppfor adul&pediatric
domperidone
ex
domperidone10baby supp
domperidon10 tab
dompeidone30supp
gastromotil10,3060supp
gastromotil10tab
gatromotil5supp
motinormtab&susp
motinorm10baby&30children&60adult supp
moteliumtab&syr&10baby&30children&60adult supp
farcotilumcap&sup&syrup
dompidonebaby&child&adul upp&tab&cap&susp
synchro git tab&sup
motlfast sach
domigest sach
tribudat100tab

prochloroperazine
ex
emedrotec tab
gastreg50mp
gastreg100&200tab
gastreg24syrup
gastreg100supp
tritone100,20tab
metopimazine
phenothiazine derivative
ex
vogalene syrupجديد

التعديل الأخير تم بواسطة : صيدلانية مصرية بتاريخ 07-11-2010 الساعة 05:25 PM
  رد باقتباس
قديم 07-11-2010, 04:45 PM   #45
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

Serotonin antagonists
Ondansetron
ex
zofran4,8tab&amp
danofran 4&8tab&amp
danset4&8amp
emerest4tab

, granisetron

ex
granitrlamp
granistronamp
gsteron1tb
emex1amp
kytril1tab&3amp


, and tropisetron
ex

navoban2am
navoban5amp
navoban5cap
inhibit the action of serotonin at the 5-hydroxytryptamine 3 (5-HT3) receptor in the small bowel, vagus nerve, and chemoreceptor trigger zone. They therefore decrease afferent visceral and chemoreceptor trigger zone stimulation of the medullary vomiting centre.
These drugs were developed for use with chemotherapy and have been shown in trials to be the most effective of the currently available agents for both prevention and treatment of postoperative nausea and vomiting.
They are, however, expensive and can cause clinically asymptomatic changes in electrocardiograms

Steroids
Steroids such as dexamethasone may be given preoperatively as
prophylaxis in patients with a high risk of nausea and vomiting
. Steroids act by reducing inflammatory oedema and altering central and peripheral responsiveness to proemetic compounds such as
anaesthetics and analgesics.
They can also be used as a last line rescue treatment.

التعديل الأخير تم بواسطة : صيدلانية مصرية بتاريخ 07-11-2010 الساعة 05:29 PM
  رد باقتباس
قديم 07-11-2010, 05:23 PM   #46
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

Antihistamines
Several drugs inhibit the action of histamine at the H1 synaptic pathways, which are predominantly involved in signalling from the vestibular centre,

but only cyclizine ,meclizine,chlorphenoxamine are commanlu used
cyclizine&meclizine are used to treat postoperative nausea and vomiting
. they have antimuscarinic in addition to antihistamine actions,

they can be given by multiple routes (intravenously, sub-cutaneously, intramuscularly, and orally) and has few side effects. Common mild side effects are a consequence of its antimuscarinic actions and include sedation and dry mouth
cyclizine&meclizine used safely in pregnancy
ex
1-cyclizine
ex
emetrex tab&amp
cortigenb6amp
cortiplex b6 amp
meclozine
ex
postadoxine tab
restine tab
vomidoxinetab&supp
dizirestb6
meclodoxinetab
ezadoxine tab
navoproxinetab&supp
navidoxine tab
chlorphenoxamine
ex
emeraltab&adult supp
dramenex tab
used for motion sickness
  رد باقتباس
قديم 08-11-2010, 12:29 AM   #47
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

جيوب الامعاء بسبب قلة تناول الالياف
Diverticular Disease
Outpocketing of the bowel that becomes inflamed
Results from a deficiency in fiber over a period of time
Related to eating more refined carbohydrates and processed foods
  رد باقتباس
قديم 08-11-2010, 12:47 AM   #48
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

Hiatal Hernia
فتق الحجاب الحاجز
What is a hiatal hernia?
A hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest.

Although hiatal hernias are present in approximately 15% of the population, they are associated with symptoms in only a minority of those afflicted

.
Normally, the esophagus or food tube passes down through the chest, crosses the diaphragm, and enters the abdomen through a hole in the diaphragm called the esophageal hiatus. Just below the diaphragm, the esophagus joins the stomach

. In individuals with hiatal hernias, the opening of the esophageal hiatus (hiatal opening) is larger than normal, and a portion of the upper stomach slips up or passes (herniates) through the hiatus and into the chest

. Although hiatal hernias are occasionally seen in infants where they probably have been present from birth, most hiatal hernias in adults are believed to have developed over many years.

.

What causes a hiatal hernia?

It is thought that hiatal hernias are caused by a larger-than-normal esophageal hiatus, the opening in the diaphragm through which the esophagus passes from the chest into the abdomen.

As a result of the large opening, part of the stomach "slips" into the chest

. Other potentially contributing factors include

: 1) a permanent shortening of the esophagus (perhaps caused by inflammation and scarring from the reflux or regurgitation of stomach acid) which pulls the stomach up; and

2) an abnormally loose attachment of the esophagus to the diaphragm which allows the esophagus and stomach to slip upwards.

What symptoms do hiatal hernias cause?
The vast majority of hiatal hernias are of the sliding type, and most of them are not associated with symptom

The larger the hernia, the more likely it is to cause symptoms
.
When hiatal hernias produce symptoms, they almost always are those of gastro-esophageal reflux disease (GERD) or its complications

. This occurs because the formation of the hernia often interferes with the barrier (lower esophageal sphincter) which prevents acid from refluxing from the stomach into the esophagus.

Additionally, it is known that patients with GERD are much more likely to have a hiatal hernia than individuals not afflicted by GERD.

Thus, it is clear that hiatal hernias contribute to GERD. However, it is not clear if hiatal hernias alone can result in GERD.

Since GERD occurs in the absence of a hiatal hernia, factors other than the presence of a hernia can cause GERD.

How is a hiatal hernia treated?
Treatment of large para-esophageal hernias causing symptoms requires surgery

. During surgery, the stomach is pulled down into the abdomen, the esophageal hiatus is made smaller, and the esophagus is attached firmly to the diaphragm. This procedure restores the normal anatomy
.
Since sliding hiatal hernias rarely cause problems themselves but rather contribute to acid reflux, the treatment for patients with hiatal hernias is usually the same as for the associated GERD.

If the GERD is severe, complicated, or unresponsive to reasonable doses of medications, surgery often is performed.

.
  رد باقتباس
قديم 08-11-2010, 12:59 AM   #49
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

القولون العصبىىىىىىىىىىىىى
Irritable Bowel Syndrome (IBS)



What causes irritable bowel syndrome?

The digestion and propulsion of nutrients and fluids through the gastrointestinal system (GI) is a very complicated and very well organized proces

The GI tract has its own intrinsic muscles and nerves that connect, like an electrical circuit, to the spinal cord and brain.

Neuromuscular events occurring in the GI tract are relayed to the brain through neural connections,
and the response of the brain is also relayed back to the gastrointestinal tract

. As a result of this activity, motility and sensation in the bowel is generated.

An abnormality in this process results in a disordered propulsion of the intestinal contents, which generates the sensation of pain.
The person with IBS has a colon that is more sensitive and reactive than usual, so it responds strongly to stimuli that would not affect others. The colon muscle of a person with IBS begins to spasm after only mild stimulation or ordinary events such as the following:
  • eating
  • distention from gas or other material in the colon
  • certain medications
  • certain foods
Women with IBS seem to have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms
Criteria for diagnosis:
Abdominal distention
Gas
Increased colonic mucus
Irregular bowel habits (diarrhea or constipation)
Pain
اهم مايميزة هو المخاط والغازات ونوبات الامساك والاسهال

What are triggers for IBS

?

The most likely triggers for IBS are diet and emotional stress. Scientists have some clues as to why this happens. Consider the following:
  • diet
    Eating causes contractions of the colon, normally causing an urge to have a bowel movement within 30 to 60 minutes after a meal. Fat in the diet can cause contractions of the colon following a meal. With IBS, however, the urge may come sooner, accompanied by cramps and diarrhea.
  • stress
    Stress stimulates colonic spasm in people with IBS. Although not completely understood, it is believed to be because the colon is partly controlled by the nervous system. Counseling and stress reduction techniques can help relieve the symptoms of IBS, however, this does not mean IBS is the result of a personality disorder. It is at least partly a disorder of colon motility.
  رد باقتباس
قديم 08-11-2010, 01:48 AM   #50
صيدلانية مصرية

 








صيدلانية مصرية غير متواجد حالياً
افتراضي رد: امراض الجهاز الهضمى وعلاجها

علاج القولون العصبى
natural colon calming oils
ex
anisol tab
peppermint oil
ex
mintec cap
mincaps cap
colomint cap

anticholinergics
decrease spasms
a stomach relaxant
decrease gastric acid secretions
ex
otilonium bromide ex
spasmomen tab
anticholinergic+antidepressant

clidinium bromide+chlorodiazepoxide
ex
cloxide cap
diabex tab
clidinum bromide+librium
ex
librax
isopropamide+trifluroperazine
ex stellamide tab
belladona+phenobarbitone
ex
bellacid tab
antispasmodic
ex
mebeverine
ex
duspatalintab
colospasmin tab
colospasmine forte tab
spasmotalin tab
spastaline tab
colona
coloverin sr
coloverinD
coloverinA
colorelax tab


bran+celluolose
ex
bran tab&cap
pharcofibe tab
flaxinlife cap

psyllium+bentonite+rhubarb+citrus pectin+wheat grass
ex
colon aid
used for irregular digestion+irritable colon

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