Asthma and Chemotherapy Overview

Asthma Attack Medication

• Salbutamol is the first-line treatment for acute asthma attacks.

Severe Asthma Attack Procedures

• The initial step in a severe asthma attack is providing bronchodilation to relieve airway obstruction.

Asthma Medication Side Effects

• Propranolol can cause worsening of asthma symptoms (dyspnea and wheezing) in patients with asthma.

Asthma Treatment Mechanisms

• Montelukast (Singulair) works by inhibiting 5-lipoxygenase and leukotriene C4 and D4 receptors.

Chemotherapy Drug Families

• Vinblastine is a mitotic inhibitor.

Breast Cancer Treatment

• Tamoxifen is used to treat ER-positive breast cancer.

Calcineurin Inhibitors

• Tacrolimus is a calcineurin inhibitor.

Chemotherapy Drug Toxicity Rescue

• Leucovorin is used to rescue normal cells from the adverse effects of methotrexate.

Cardiotoxicity

• Doxorubicin causes irreversible, dose-dependent cardiotoxicity.

Tumour Cell Cycle Phase

• Vinblastine acts mainly in the M phase of the tumour cell cycle.

Doxorubicin Toxicity Reduction

• Dexrazoxane helps reduce doxorubicin toxicity.

Methotrexate Inhibition

• Methotrexate inhibits dihydrofolate reductase.

Muromonab-CD3 Action

• Muromonab-CD3 blocks the activation of T-cell receptor complex.

Cancer Treatment Kinetics

• Chemotherapy drugs for cancer follow first-order kinetics. After a course of treatment, the remaining cancer mass would contain a constant proportion of cancer cells.

Estrogen Receptor Positive Breast Cancer Treatment

• Cisplatin is not the first line treatment for estrogen receptor positive breast cancer, doxorubicin is.

High Emetogenic Potential

• Cisplatin has a high emetogenic potential.

Topoisomerase Inhibition

• Etoposide inhibits topoisomerase II.

Anti-metabolites

• Methotrexate is an anti-metabolite.

Chemotherapy Drug Toxicity

• Cyclophosphamide can cause hemorrhagic cystitis.

Chemotherapy Mechanism

• Cyclophosphamide is a nitrogen mustard alkylating agent, and after enzymatic metabolism, the active compound reacts with the guanine base of DNA.

Cisplatin Toxicity

• Cisplatin's major toxicity is dose-related nephrotoxicity (kidney damage).

Brain Tumor Treatment

• Nitrosoureas are primarily used for brain tumor treatment.

Immunosuppressant Drug Limitation

• The major limitation of most immunosuppressant drugs is myelosuppression (bone marrow suppression).

Skin Disease Treatment

• Corticosteroids are used for skin diseases due to their immunosuppressive effect.

Cyclosporine Inhibition

• Cyclosporine inhibits cytokine production and IL-2 receptor.

Muromonab-CD3 Action

• Muromonab-CD3 causes cytokine release syndrome when binding to T-cells.

Paracetamol Overdose Toxicity

• Liver damage is a toxicity resulting from a paracetamol overdose.

Non-Steroidal Analgesic with Limited Anti-Inflammatory Effect

• Paracetamol has a limited anti-inflammatory effect compared to other non-steroidal analgesics.

Anti-inflammatory Steroids Side Effects

• Chronic oral administration of anti-inflammatory steroids can cause osteoporosis and renal insufficiency.

Corticosteroids for Chronic Inflammation

• Dexamethasone is not routinely recommended for chronic oral anti-inflammatory use due to prolonged adverse effects.

Hydrocortisone Side Effect

• Hyperglycemia is a side effect of hydrocortisone.

Glucocorticoid Withdrawal Complications

• Renal insufficiency can be a complication of sudden glucocorticoid withdrawal.

Cocaine Mechanism

• Cocaine acts by blocking the reuptake of dopamine.

Excitatory Amino Acid Neurotransmitter

• Glutamate is a major excitatory amino acid neurotransmitter.

Serotonin Antagonist-Reuptake Inhibitor Mechanism

• Serotonin antagonist-reuptake inhibitors block the binding of serotonin to the serotonin-1A receptor, preventing reuptake, and thus maintaining a higher level of serotonin in the synapse.

Tyramine Diet

• Individuals taking monoamine oxidase inhibitors should adhere to a low-tyramine diet to avoid potentially harmful interactions.

Melatonin Receptor Agonist Mechanism

• Melatonin receptor agonists increase the brain's concentration of dopamine and norepinephrine.

Selective Serotonin Reuptake Inhibitor

• Fluoxetine is a selective serotonin reuptake inhibitor.

Antidepressants and Suicidal Risk

• Antidepressants, such as fluoxetine, can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults.

Monoamine Oxidase Inhibitors Mechanism

• Monoamine oxidase inhibitors increase the levels of serotonin, norepinephrine, and dopamine.

Dopamine D2 Receptor Blockade

• Blocking dopamine D2 receptors is associated with extrapyramidal symptoms and may increase the chance of addiction.

Parkinson's Disease Treatment

• Selegiline inhibits MAO-B, helping in Parkinson's disease.

Parkinson's Disease Symptoms Improvement

• Levodopa increases dopamine production and improves Parkinson's symptoms.

Dopamine Use in Parkinson's Disease

• Dopamine itself cannot be used directly in Parkinson's due to the blood-brain barrier.

Muscle Relaxants and Liver Function

• Vecuronium is a muscle relaxant that is well-suited for patients with liver dysfunction.

Spasmolytics

• Dantrolene is a peripherally-acting spasmolytic.

Organ Independent Elimination

• Cisatracurium undergoes organ-independent elimination.

Cholinesterase Inhibitor

• Edrophonium is a cholinesterase inhibitor and is used in diagnosing myasthenia gravis.

Cisatracurium Properties

• Cisatracurium is a 1R-cis / 10R-cis isomer of atracurium, more potent, and undergoes Hoffman degradation.

Neuromuscular Blocking Agent Reversal

• Sugammadex directly reverses neuromuscular blocking effects of atracurium, cis-atracurium, rocuronium, and succinylcholine.

Neuromuscular Blocker for Ventilator Use

• Atracurium is an appropriate choice.

Local Anesthetic Vasoconstrictor

• The addition of adrenaline to a local anesthetic solution reduces surgical bleeding.

Local Anesthetic Volume Limit

• The maximum volume of 0.5% lignocaine solution for a patient weighing 50 kilograms is 40ml.

Inhalational Anesthetics for Kids

• Nitrous oxide is a suitable inhalant anesthetic for children.

Senior Patient Anesthetic Induction

• Propofol is a suitable anesthetic induction drug for senior patients with impaired cardiac function.

Adrenaline Concentration

• 1:200,000 adrenaline concentration is equivalent to 1 µg/ml (1000 µg in 200 ml or 1 gm in 200,000ml)

Difference in Anesthetics (Isoflurane vs Sevoflurane)

• The difference between the anesthetics is not their effect on respiratory rate but on the effect on the heart rate and blood pressure.

Anaesthetic Agent Effect on Consciousness

• Sodium thiopental, Ketamine, and Etomidate effect on consciousness.

Opioid Reconstitution

• Remifentanil is the opioid agent that requires reconstitution for intravenous infusion.

Water Soluble General Anesthetic

• Midazolam (a benzodiazepine) is a water-soluble general anesthetic that allows painless injection.

General Anesthetics with Less Cardiovascular Depression

• Propofol has less cardiovascular depression compared to some other general anesthetics.

Drug Toxicity Treatment

• Lipid emulsion therapy is effective in treating sevoflurane toxicity.

Local Anesthetic for Intravenous Cannula Insertion

• Bupivacaine is an appropriate local anesthetic for pain relief prior to IV cannula insertion.

Intravenous Anaesthetic Drugs

• Etomidate is an intravenous anaesthetic drug.

Side Effects of Drugs

• Nausea and vomiting are side effects associated with some drugs like morphine and other opioid medications.

Drug Half Life

• Remifentanil has a consistent half-life that is dose-independent.

Chronic Pain vs Acute Pain

• Chronic pain can persist even in the absence of ongoing injury, unlike acute pain which is always associated with ongoing injury at the site.

Pain Treatment and Antidepressants

• Antidepressants may interfere with other prescribed pain relief medication, especially opioids.

Local Anesthetic Systemic Toxicity

• Local anesthetic systemic toxicity (LAST) can cause severe cardiovascular, neurological, and other symptoms.

Adverse Effects of Local Anesthetics (LAS)

• The adverse effects of local anesthetics (LAS) are dose-dependent.

Treatments for Eczema

• Moisturizers, particularly those for dryness, may be effective for eczema.

Acne Treatment Contraindications

• Retinoids are contraindicated during pregnancy.

Topical Salicylic Acid Treatments

• Salicylic acid is used to treat corns, psoriasis, and acne respectively.

Infertility Treatment and Estrogen

• Clomiphene acts as a partial estrogen agonist, inhibiting the negative feedback of estrogen on ovulation.

Osteoporosis Treatment

• Raloxifene is a selective estrogen receptor modulator (SERM) used for osteoporosis.

Contraceptive Pill Composition

• The "mini-pill" or mini-contraceptive contains only progestin.