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04-11-2010, 02:27 PM
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#41 |
رد: امراض الجهاز الهضمى وعلاجها
rehydrating solutions محاليل معالجة الجفاف used to maintain hydration during severe ´ 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& |
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04-11-2010, 03:34 PM
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#42 |
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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 |
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07-11-2010, 02:23 PM
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#43 |
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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  |
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07-11-2010, 04:22 PM
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#44 |
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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& 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 |
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07-11-2010, 04:45 PM
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#45 |
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رد: امراض الجهاز الهضمى وعلاجها
Serotonin antagonists Ondansetron ex zofran4,8tab& danofran 4&8tab& 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 |
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07-11-2010, 05:23 PM
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#46 |
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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& 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 |
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08-11-2010, 12:29 AM
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#47 |
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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 
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08-11-2010, 12:47 AM
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#48 |
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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. . |
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08-11-2010, 12:59 AM
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#49 |
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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:
• 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:
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08-11-2010, 01:48 AM
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#50 |
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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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