Pharmacology: Diuretics and Anticonvulsants

Diuretics

• Mannitol: Alters osmosis, reducing water volume and intracranial pressure (ICP). Used for cerebral edema, increased ocular pressure. Risks include fluid leaking back into interstitial spaces, potentially worsening cerebral edema.

Opioid Antagonist

• Naloxone: Blocks opioid effects at mu opioid receptors, preventing G protein coupling. Used for opioid overdose. Quick onset, short-acting, requiring repeated dosing.

Anti-Seizure Medications

• Sodium Valproate (Epilim): Increases GABA, blocks sodium channels. Used for seizures, epilepsy, and mania.
• Phenobarbital (Barbital): Enhances GABA action, reducing seizure spread. Used for epilepsy and sedation.
• Phenytoin (Dilantin): Modulates sodium channels, stabilizing nerve excitability. Used in tonic-clonic seizures and post-surgery.
• Carbamazepine: Reduces nerve impulses, treating seizures, nerve pain, schizophrenia, and bipolar disorder.
• Gabapentin: Blocks nerve signals, treating seizures and nerve pain. Associated with risks of dependence and suicidal thoughts.
• Lamotrigine: Modulates sodium channels, reduces glutamate release. Used for seizures, nerve pain, and bipolar disorder.

Dopamine Precursor and Decarboxylase Inhibitor

• Levodopa (Sinemet): Converts to dopamine in the brain, used for Parkinson's disease.
• Carbidopa: Inhibits peripheral conversion of levodopa.

Sedative

• Midazolam: Acts on GABA A receptors, calming the brain. Used for seizures and anesthesia.

Gastrointestinal (GIT) Medications

• Histamine 2 Blockers (Ranitidine, Famotidine): H2 receptor antagonists inhibit gastric acid production. Used for gastric ulcers, heartburn, and GERD.
• Anti-Diarrheal (Loperamide): Activates opioid receptors in the gut, reducing stool frequency. Used for diarrhea.
• Proton Pump Inhibitors (Pantoprazole): Suppresses gastric acid secretion. Used for GI lesions, ulcers, and GERD.

Laxative

• Lactulose: Prevents ammonia absorption, softening stools. Used for hepatic encephalopathy and stool softening.

Endocrine Medications

• Insulin (Short-Acting: Actrapid, Novorapid; Long-Acting: Solostar, Optisulin): Regulates glucose metabolism, lowering blood glucose levels. Used for Type 1 and Type 2 diabetes mellitus (T1DM, T2DM).
• Biguanide (Metformin): Reduces liver glucose production, increasing insulin sensitivity. First-line treatment for T2DM.
• Sulfonylureas (Glipizide): Increases insulin secretion. Adjunct for T2DM.
• SGLT2 Inhibitor (Dapagliflozin): Reduces glucose reabsorption in the kidneys. Used for T2DM, weight loss, and fluid management.

Renal Medications

• Diuretics (Loop Diuretic: Frusemide; Thiazide: Hydrochlorothiazide; K-Sparing: Spironolactone): Affect sodium reabsorption at different points in the nephron. Used for hypertension and chronic kidney failure.
• Erythropoietin (EPO): Stimulates red blood cell production. Used for anemia in chronic kidney failure or cancer.

Vitamin D

• Vitamin D: Increases calcium and phosphate absorption. Used for vitamin D and calcium deficiencies.

Colloid

• Albumin: Increases osmotic pressure, retaining fluid intravascularly. Used for fluid resuscitation, shock, and rehydration.

Electrolytes and Fluids

• Electrolyte (Potassium): Maintains muscle and nerve function. Used for potassium deficiency.
• Crystalloid Solutions (NS 0.9%, CSL, Dex5%): Match the osmolarity of blood, preventing fluid shifts. Used for fluid resuscitation and shock.
• Hypotonic Solutions (10% Dextrose, 50% Dextrose): Move water into cells. Used for hyponatremia and cellular dehydration.
• Hypertonic Solutions (0.45% N/S): Move water out of cells. Used for hypernatremia and to reduce intracranial pressure.

Test your knowledge on diuretics and anti-seizure medications. This quiz covers key drugs like Mannitol, Naloxone, and various anticonvulsants including Sodium Valproate and Phenytoin. Dive into their uses, mechanisms of action, and potential risks.