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Tahdi Asad, Baghdad (2025)

12/03/2025

Cough drugs summary

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26/02/2025

Loop diuretics 🆚 thiazides diuretics
Comparison table
Basic pharmacology

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16/02/2025

Pharmaceutical Calculations

Drugs based on body weight (Summary)🔖

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25/01/2025

محاضرة باليوتوب
حول موضوع dosage calculation’s based on body Weight

المحاضرة على جزئين :
1-جزء نظري ( كلاميات وشروحات)
2-جزء عملي ( مسائل وأمثلة وقوانين)

https://www.youtube.com/watch?v=xj_Qe1YI-QE

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10/01/2025

Minoxidil

Originally developed as a blood pressure medication, it was later discovered to promote hair growth as a side effect.

Mechanism OF actions:
Vasodilation: It widens blood vessels, increasing blood flow to hair follicles, delivering more oxygen and nutrients.

How to Use Minoxidil? (Application)
1. Forms Available: Foam or liquid solutions (2% and 5% concentrations).
2. Apply to a clean, dry scalp.
3. Use the dropper or foam to apply directly to the affected area.
4. Gently massage it into the scalp.
5. Frequency: Twice daily for maximum effectiveness (morning and night).
6. Consistency is Key: Results may take 4–6 months to become noticeable.

Benefits of Minoxidil
1. Regrows Hair: Improves hair density in areas of thinning.
2. Non-Invasive Solution: Easy to use at home.
3. Cost-Effective: Affordable compared to other hair loss treatments like transplants.

Potential Side Effects:
1. scalp irritation and itching
2. Initial shedding (temporary and normal as weaker hairs are replaced).
3. Unwanted facial hair growth (if applied incorrectly).

Key Tips for Best Results
1. Be Patient: Hair regrowth takes time and persistence.
2. Avoid Washing Immediately: Wait at least 4 hours after applying.
3. Stick to Recommended Dosage: Overuse doesn’t speed up results and may increase side effects.
4. Pair with Other Treatments: Combine with oral medications like finasteride (for men) or supplements like biotin for enhanced results.

Realistic Expectations
1. Minoxidil does not cure baldness. It works to maintain and regrow existing hair.
2. Results vary based on the severity of hair loss and adherence to treatment.
3. Hair loss resumes if you stop using it.

💡Pro Tip: Pair minoxidil with a healthy diet, reduced stress, and a proper scalp care routine for the best outcomes!

02/01/2025

Ringer's Solution 🆚 Ringer's Lactate ?

1️⃣ Ringer's Solution (RS):
Composition: Sodium, potassium, calcium, chloride.
Uses: Replaces electrolytes; often used for fluid resuscitation.
Key Note: No buffer, so it doesn't correct acidosis.

2️⃣ Ringer's Lactate (RL):
Composition: Sodium, potassium, calcium, chloride + lactate.
Uses: Preferred in cases of acidosis (e.g., sepsis, burns); lactate acts as a buffer to correct pH.
Key Note: Avoid in liver failure (lactate metabolism impaired).

📌 Bottom Line:
Ringer’s Solution = Simple electrolyte replacement.
Ringer’s Lactate = Electrolytes + acidosis correction.

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30/12/2024

-Potency 🆚 Efficacy?

keywords:
1-potency.
2-potency practical examples.
3-efficacy.
4-efficacy practical example.
5-combined examples.
6-summary.

1-potency :
Refers to the amount of a drug needed to produce a certain effect. A highly potent drug requires a lower dose to achieve its effect compared to a less potent drug. Potency is typically measured using the EC50 (the concentration of a drug that produces 50% of its maximum effect).

-So the potency is about the affinity :

high potency drug—>> higher affinity to its receptor—>>lower doses needed.
low potency drug—>> lower affinity to its receptor—>> higher dose needed.

-High potency corresponds to high affinity, leading to lower doses needed to achieve therapeutic effects. Conversely, low potency corresponds to lower affinity, requiring higher doses to achieve similar effects. This relationship is a foundational concept in pharmacology and drug development.

-So potency about affinity and amount of dose needed to reach EC50%.

-EC50% :
its concentration of drug needed to produce 50% of the maximal effect (Emax).
It's used to determine potency.

-drug with high EC50% (require higher dose to reach 50% of its maximum effect ) have low potency.
-drug with low EC50%(require lower dose to reach 50 % of its maximum effect) have high potency.

-Practical example of potency :
1.Drug A vs Drug B for pain reliefs :
Drug A requires 5 mg to achieve a 50% reduction in pain (EC50). Drug B requires 50 mg to achieve the same 50% reduction in pain.
Drug A is more potent than Drug B because a lower dose is needed to produce the same level of pain relief (50%) .

2. Drug x vs drug Y :
Drug X achieves 50% of its maximum effect at a dose of 10 mg (EC50).
Drug Y achieves 50% of its maximum effect at a dose of 50 mg.
Drug X is more potent than Drug Y because it requires a lower dose (10 mg) to achieve 50% of its maximum effect, compared to Drug Y (50 mg).

2-Efficacy :
Refers to the maximum effect a drug can produce, regardless of dose.
Emax: refers to the maximum effect a drug can produce. If two drugs have the same Emax, they have the same efficacy.
-so Emax is an indicator of drug efficacy

-Two drugs can indeed have the same efficacy but different potencies. The same efficacy means they can achieve the same maximum effect, but the potency difference means they require different doses to reach a certain level of effect.
-important note:

Emax is determined by the drug's ability to activate its target receptors , or pathways to their fullest extent. Once all receptors are occupied and fully activated, increasing the drug concentration further will not increase the effect, (Increasing the concentration of the drug beyond the level needed to achieve Emax can lead to unwanted side effects and toxicity without providing additional therapeutic benefits.

-So Efficacy is about clinical effect on receptor (more important clinically than potency)

POTENCY since one could manipulate the drug dose to produce the desirable response in case of a drug with low potency but a drug with low efficacy could not be manipulated in the same way.

-practical example about efficacy ;

-Drug C vs. Drug D for Blood Pressure Control:
Drug C can lower blood pressure by up to 30 mmHg (Emax).
Drug D can lower blood pressure by up to 50 mmHg (Emax).
Drug D has higher efficacy than Drug C because it can produce a greater maximum reduction in blood pressure.

3-Combined Example:
-Consider two drugs, Drug E and Drug F, used to treat asthma:
Drug E has an EC50 of 2 µg/mL and an Emax of 80% improvement in lung function.
Drug F has an EC50 of 5 µg/mL and an Emax of 90% improvement in lung function.
Drug E is more potent than Drug F because it requires a lower concentration to achieve half of its maximum effect.
Drug F is more efficacious than Drug E because it can achieve a higher maximum improvement in lung function.

4-Summary:
-Potency is about the dose needed for a particular effect. A more potent drug requires a lower dose to achieve the same effect.
-Efficacy is about the maximum effect achievable. A drug with higher efficacy produces a greater maximum effect.
-A higher potency does not necessarily mean a higher efficacy.
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27/12/2024

Ceftriaxone and Ringer's (ca) Interactions ⚠️

The interaction between ceftriaxone and calcium-containing solutions, such as Ringer’s Lactate (RL) or Ringer’s Solution, can result in the formation of ceftriaxone-calcium crystals (precipitates). This interaction is particularly concerning as it can lead to severe complications, including embolic events, renal damage, and pulmonary damage. Neonates (≤28 days old) are especially vulnerable to these effects due to their immature organ systems and higher risk of precipitate formation.

Mechanism of Interaction:

Ceftriaxone + Calcium (from RL) → Precipitate Formation → Deposition in Lungs and Kidneys → Potentially Fatal Consequences.

In neonates, the formation of these precipitates can obstruct blood vessels, leading to critical damage in the kidneys and lungs. This interaction underscores the importance of careful administration protocols when using ceftriaxone alongside calcium-containing solutions.

Strategies to Prevent Interactions:

1. Use Separate Infusion Lines:
Administer ceftriaxone and calcium-containing solutions through different infusion lines sequentially rather than simultaneously, whenever feasible.

2. Implement a Flushing Protocol:
If the same infusion line must be used, thoroughly flush it with a compatible solution, such as 20 mL of normal saline, between administering ceftriaxone and RL. This prevents residual calcium from reacting with ceftriaxone.

3. Avoid Mixing in IV Bags or Syringes:
Do not mix ceftriaxone with calcium-containing solutions in the same intravenous (IV) bag or syringe to avoid direct precipitation.

4. Monitor for Signs of Precipitation:
Observe IV lines for any signs of precipitation during administration. Visible precipitates indicate incompatibility and a risk of adverse events.

5. Avoid Use in Neonates:
Given the elevated risk in neonates, the combination of ceftriaxone and calcium-containing solutions Must be avoided entirely for patients ≤28 days old.

Alternative Solutions:

To eliminate the risk of interactions, use calcium-free solutions, such as normal saline or dextrose, when administering ceftriaxone.

Practical Example:

Scenario: A patient requires ceftriaxone and IV fluids for hydration.

Solution: Administer ceftriaxone through a separate IV line sequentially or flush the existing line with 20 mL of normal saline before starting the infusion of Ringer’s Lactate.

Key Terminology📝

1. Simultaneous Infusion: Administering two medications at the same time through different IV lines or lumens to achieve rapid therapeutic effects. Used when immediate action is required or when drugs are compatible.

2. Sequential Infusion: Administering medications one after the other through the same IV line or lumen, typically flushed in between. Used to avoid drug interactions or when timing is less critical.

3. Hartmann's Solution or RL: A balanced crystalloid intravenous fluid containing sodium, potassium, calcium, chloride, and lactate. It is used for fluid resuscitation and to restore electrolyte balance, commonly in cases of dehydration, blood loss, or metabolic acidosis.

28/11/2024

Anti-Obesity 💡
Short summary 📝

1-Anorexiant:
A-amphetamine.
B-methamphetamine.
C-phentermine.
D-phendimetrazine.
C-diethylpropion.

Key Note💡
Anorexiants are central nervous system stimulants that suppress appetite by modulating neurotransmitters in the brain, particularly norepinephrine, dopamine, and serotonin.

2-Orlistat:
Lipase inhibitors decrease fat absorption.

Key Notes 💡

1. Orlistat is a lipase inhibitor that blocks the enzyme responsible for breaking down dietary fat in the gastrointestinal tract, thereby reducing fat absorption by approximately 30%.

2. Side effects:
A-Gastrointestinal issues like oily stools, flatulence, and f***l urgency.
B-May reduce the absorption of fat-soluble vitamins (A, D, E, K), necessitating supplementation.

3-Antidiabetic drugs:
A-metformin
B-liraglutide/semaglutide

Key Notes💡
Some antidiabetic medications have shown efficacy in promoting weight loss alongside glycemic control.

4- Drug Combinations:
A-phentermine/topiramate.
B-naltrexone/bupropion.

Key Notes💡
1. Combination therapies often target multiple pathways for greater efficacy in weight loss.
2. Naltrexone: decrease the reward effect associated with food intake.

5-setmelanotide :
mimic the action of a-MSH leading to increased satiety (WT. loss).

Takeaway Points:✍️

1. Lifestyle Integration: These medications are most effective when combined with diet, exercise, and behavioral changes.

2. Tailored Approach: Drug selection depends on the patient's health profile, comorbidities, and potential side effects.

3. Monitoring: Regular follow-ups are crucial to assess efficacy and manage side effects.

Obesity is a chronic medical condition characterized by excessive body fat accumulation, often linked to various health risks like heart disease, diabetes, and hypertension. Medications for obesity are used as part of a comprehensive treatment plan that includes lifestyle changes such as diet, exercise, and behavioral therapy. Below is a detailed breakdown of common drug classes and examples used for managing obesity.

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25/11/2024

Learn in the easiest way!!👍

The common uses of drugs with practical examples📌.

Lecture Objectives:
In this lecture you will understand each of the following 📌.

1-The common uses of drugs with practical examples.
2- Know the differences between each use.
3- Cure disease vs. treat disease.

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17/10/2024

HOW TO INCREASE PATIENT COMPLIANCE (best explanation)?

Learning Objectives:

1.Define Patient Compliance.
2.Define Non- Compliance.
3.Explore the correlation between patient compliance and health outcomes.
4.Analyze the Reasons behind Patient Non-compliance.
5.Provide Strategies to Improve Patient Compliance.
6.Understand why the patient Compliance Matter?

Patient Compliance:

it also known as adherence.
It refers to the extent to which a patient's behavior aligns with medical advice, including taking medications as prescribed, following dietary recommendations, and making lifestyle changes.

It includes medication or drug compliance, as well as medical device use, self-care, self-directed exercises, or cognitive assessments.

it directly impacts the effectiveness of treatments and overall health outcomes.

Studies Outcomes:

1-Only 50% of patients with chronic diseases such as diabetes and hypertension are compliant with their medication regimens, according to the World Health Organization (WHO).

2-According to research published in the Mayo Clinic Proceedings, 50% of patients do not take their prescribed medications as directed, and most will stop the treatment as soon as they feel better.

non-compliance:

poor adherence can lead to disease progression, increased hospitalizations, and higher healthcare costs.

Reason :
1-poor patient education about medication.
2-poor health literacy.
3- poor health provider communication skills.
4-patient misunderstanding.
5-patient cognitive or memory problems.
6-Inconsistency (e.g. patient stops treatment or medication after starting).
7-Complex medication routines and regimen
8-Lack of understanding of treatment benefits
9-Poor treatment satisfaction
10-Cost of prescription medication
11-poor Accessibility and affordability of healthcare
12-side effect of medication
13-extended treatment duration
14-Psychological factors (e.g., depression, anxiety)
15-patient Beliefs about the necessity and efficacy of treatment

Strategies to Improve Patient Compliance:

1-Clear Communication:
One of the most effective methods to enhance patient compliance. Patients need to understand:
1.1 Their health condition
1.2 The benefits of their prescribed treatment
1.3 The consequences of non-compliance
1.4 The steps involved in their care

2-Simplifying Treatment Regimens:
2.1 Prescribing once-daily dosing when possible.
2.2 Using combination pills to reduce pill burden.
2.3 Offering long-acting formulations.
2.4 Aligning medication schedules with daily routines.

3-Technology and Reminders:
3.1implementing pill organizers and reminder apps.
3.2 Utilizing text message reminders for medications and appointments.
3.3 Employing electronic monitoring devices for medication adherence.

4-Improving Patient-Provider Communication:
4.1 Encouraging open dialogue about adherence challenges
4.2 Involving patients in decision-making processes
43 Providing regular follow-up and support
4.4 Utilizing videoconferencing to regularly observe patients

Good Patient Compliance outcome:

1-Better Clinical outcomes:
• Improved disease control and symptom management.
• Reduced risk of complications and disease progression.
• Lower rates of hospitalization and emergency department visits.
• lower mortality rate.
2-Better Economic impact:
• Decreased healthcare costs due to better disease management.
• Reduced need for additional treatments or interventions.
• Potential savings for both patients and healthcare systems.
• reduce wasted medication.
3- Better Quality of life

Summary and Review
Strategies to improve compliance include patient education, simplification of treatment regimens, use of technology, and enhanced patient-provider communication. The benefits of improved compliance are significant, ranging from better health outcomes to reduced healthcare costs and improved quality of life.

Further Reading Resources:

1-WHO - Adherence to Long-Term Therapies : https://who.int
2-Mayo Clinic Proceedings - Medication Adherence: A Patient-Centered Perspective: Thttps://mayoclinicproceedings.org
3-Centers for Disease Control and Prevention (CDC) - Patient Education: Resources:https://cdc.gov

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14/10/2024

WHY FORTIFIED FOOD IS SO IMPORTANT?

Fortified Food Brief Article

Objectives:
1.Understand the concept of fortified foods.
2.Differentiate between mandatory and voluntary food fortification practices.
3.Identify common examples of fortified foods and their role in public health.
4.Understand the benefits of fortified foods for specific populations like children, older adults, and those with dietary restrictions.
5.Acknowledge the potential limits and risks of consuming fortified foods.

INTRODUCTION:

Fortified foods are foods with nutrients added to them. This can help boost their nutritional value and benefit your health.

Fortified foods have added vitamins, minerals, and other micronutrients. Micronutrients are necessary for many important body functions. Your body can’t make its own micronutrients. They need to come from your diet.

Fortification refers to the process of adding essential vitamins and minerals to foods.

The main goal of fortification is to improve the nutritional quality of the food supply and reduce the prevalence of dietary deficiencies. Fortified foods can be an essential tool in public health, especially in populations with limited access to a varied diet.

Types of Food Fortification:
• Mandatory Fortification: Required by law, often to address widespread nutrient deficiencies. An example is adding folic acid to wheat flour.
• Voluntary Fortification: Carried out by food manufacturers based on market demand or health trends. An example is adding vitamin D to certain breakfast cereals.

Common Fortified Foods
• Milk fortified with vitamin D
• Cereals enriched with iron and B vitamins
• Salt iodized to prevent thyroid disorders
• Orange juice fortified with calcium

Practical Example:
In a small town, there is a high prevalence of children suffering from rickets due to a lack of vitamin D in their diet. To combat this, the local government introduces a new program to fortify milk with vitamin D and provides it to schools at a reduced cost. Over time, the incidence of rickets decreases as more children gain access to fortified milk, improving their overall bone health.

Benefits and Impact:

1-Fortified foods provide a budget-friendly alternative to costly nutrient-rich options, like fish. Products such as fortified eggs and milk offer similar nutrients, like omega-3s, at a lower cost.‌

2-Fortified foods help meet dietary needs by providing essential nutrients that may be missing due to dietary restrictions, such as being vegetarian, lactose-intolerant, or having food allergies.

3-Fortified foods support older adults by maintaining healthy vitamin and mineral levels, promoting strong bones, aiding digestion, and preventing heart issues as nutrient absorption declines with age.

4-other benefits:
Reduced incidence of goiter through iodized salt·
Decreased neural tube defects with folic acid fortification.
Improved bone health due to vitamin D-fortified dairy products.

Limits of Fortified Foods

1-Added to unhealthy foods. Just because a food product is fortified doesn’t mean it’s healthy. Fortified foods are often high in sugars, fats, sodium, and other ingredients that can lead to problems like obesity.

‌2-Risk of vitamin overdose. You might get too many vitamins and minerals in your diet.

Multiple Choice Questions (MCQs):

1-Which of the following is NOT a common nutrient used in food fortification? a) Vitamin D b) Iron c) Caffeine d) Folic acid.

2-Which of the following is a potential challenge of food fortification? a) Increased food spoilage b) Risk of over-fortification c) Decreased food flavor d) Higher production costs

3-The addition of which nutrient to flour has been credited with reducing the incidence of pellagra? a) Thiamine (B1) b) Riboflavin (B2) c) Niacin (B3) d) Pyridoxine (B6)

Further Reading Resources:

1-Harvard School of Public Health: Fortification of Foods and Public Health.
2-Fortified Foods: Definition, Benefits, and Limits (webmd.com).
3-Fortified Foods: Benefits and Risks (healthline.com).

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Tahdi Asad

12/03/2025

26/02/2025

16/02/2025

25/01/2025

10/01/2025

02/01/2025

30/12/2024

27/12/2024

28/11/2024

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17/10/2024

14/10/2024

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