Chauhan Shivam 541
1. Clinical pharmacology of neuroleptic drugs.
Neuroleptics typically work by affecting dopamine and, sometimes, serotonin levels in the brain to
decrease psychosis symptoms. Dopamine and serotonin are both neurotransmitters, small
molecules that transmit information across nerve cells and affect many major body systems, like the
cardiovascular and nervous systems. Dopamine can affect four pathways in the brain: the
mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular pathways. Due to its effect on these
pathways, dopamine plays an important role in significant body functions, including motor control,
motivation, arousal, reinforcement, and reward. Meanwhile, serotonin is known for its roles in the
regulation of mood, body temperature, and appetite, among other body functions. Maintaining a
balance of neurotransmitters is critical for proper execution and regulation of body functions. In
cases of imbalance, neuroleptics work to regulate the associated functions.
Neuroleptics block dopamine receptors in the brain, so they are prescribed when symptoms are
associated with an excess of dopamine in the body. Most neuroleptics affect dopamine D2 receptors
in the mesolimbic pathway of the brain, decreasing the positive, or present, symptoms of psychosis,
such as hallucination, delusion, and disorganized thought. However, first-generation neuroleptics
also block the dopamine receptors on other pathways, such as the mesocortical pathway. These
additional blocks have been associated with potentially worsening negative symptoms, or symptoms
that take away typical functions. Examples of negative symptoms include lack of emotionality, social
withdrawal, and lack of motivation. In contrast, second-generation neuroleptics block both D2
receptors and serotonin 5-HT2A receptors in the mesocortical pathway of the brain, which reduces
negative symptoms.
2. Clinical pharmacology of agents that reduce gastric secretion.
H2 Receptor Antagonists
Histamine is clearly one of the primary regulators of acid secretion, and the parietal cell receptor for
histamine is of the H2 type. Evidence of histamine's role in acid secretion is strongly supported by
finding that H2 receptor antagonists are quite effective in inhibiting acid secretion. Examples of H2
antagonists commonly used to suppress gastric acid secretion include cimetidine (Tagamet HB),
ranitidine (Zantac 75), famotidine (Pepcid AC) and nizatidine (Axid AR).
These drugs, particularly cimetidine, are among the most widely prescribed drugs in man. They are
also useful for management of certain gastric diseases in dogs and horses. Antihistamines that
engage H1 receptors (e.g. those used to treat colds) have no effect on acid secretion.
Proton Pump Inhibitors
Acid secretion is absolutely dependent on function of the H+/K+ ATPase or proton pump located in
the cannilicular membrane of the parietal cell. Several drugs have been developed that noncompetively bind and inactivate the ATPase, resulting in strong inhibition of acid secretion.
Omeprazole (Prilosec) is an acid-activated prodrug that binds covalently to two cysteines on the
ATPase, resulting in its irreversible inactivation. Other inhibitors, including lansoprazole (Prevacid),
esomeprazole (Nexium), rabeprazole (Aciphex) and pantoprazole (Protonix) have similar modes of
action.
3)
Rp.: Grippferoni 10,000 IU - 5 ml
Dtd No. 1
S. 1 drop in each nasal passage 5 times a day (single dose 1000 IU, daily dose 5000 IU)
Rp.: Tab. Ribavirini 0.2
Dtd: №20 in tab.
S. 1 tablet 3 r / day