• I influence a receptor that shares its name with a mythical
creature's treasure keeper.
• Known for my dual nature—shielding the liver while calming
inflammation.
• I lower certain enzymes that hint at liver distress, but I might make
you scratch more than you'd like.
• My job is to swap out the troublemakers among my own kind,
making things safer.
• An agent of change in the realm of bile, my name echoes a
common suffix in chemistry.
Obeticholic acid
• Exerts its pharmacological action by selectively stimulating a
receptor subtype involved in gastrointestinal motility, primarily
influencing intrinsic enteric neurons.
• Unlike many agents in its class, it demonstrates minimal binding
affinity for certain serotonin receptors (5-HT1, 5-HT2) and cardiac
ion channels, reducing the risk of cardiovascular side effects.
• Enhance colonic transit and increase stool frequency
• It is predominantly prescribed for a condition characterized
by reduced bowel movement frequency, where traditional
treatments may prove insufficient.
Prucalopride
• This agent functions as a prodrug, undergoing rapid biotransformation
into an active metabolite known for its influence on neuropeptide
signaling.
• It exerts its pharmacological effect by inhibiting the enzymatic
degradation of endogenous opioid peptides, thereby modulating
gastrointestinal physiology.
• Unlike conventional treatments, it attenuates intestinal hypersecretion
without altering gut motility, making it unique among its class.
• Its primary therapeutic role lies in managing secretory disturbances of
the gastrointestinal tract, particularly in conditions associated with
excessive fluid loss.
Racecadotril
• Loss of sodium, potassium, magnesium and hydrogen ion is seen
in the urine
• Causes hypocalcemia, hyperglycemia and hyperurecemia
• Acts on thick ascending loop of henle
• Highly bound to plasma proteins
• Weak carbonic anhydrase inhibitor
• Used in severe renal failure and pulmonary edema
• Sodium potassium 2 chloride inhibitor
Furosemide
• A calcium sensitizer used to treat acute decompensated heart
failure
• Acts by inhibiting cardiac phosphodiesterase, sensitizing the
troponic system to calcium
• Produces positive ionotropic actions, acts by vasodilation of
coronary, cerebral,pulmonary and renal vessels
• It’s a non arrhythmogenic drug
LEVOSIMENDON
• It is a non -selective beta and weak selective alpha-1 blocker,
produces vasodilation, used as an antihypertensive
• It has an additional anti - oxidant property
• Contraindicated in pregnancy
• Drug of choice for long term treatment of CHF
CARVEDILOL
• Orally active amide derivative of a local anaesthetic with cardiac
electrophysiological action.
• Not an alpha blocker, causes less fall in BP
• Responsible for " torsedes de pointes" - longterm high dose therapy
of this drug can cause SLE, especially low acetylators.
Procainamide
• Analouge of theophylline, used for treating PVD
• Weak phosphodiesterase inhibitor, improves blood flow, lowers
BP.
• Indicated in intermittent claudication pain , trophic ulcers, chronic
cerebro vascular insufficiency
Pentoxifylline
• First long acting beta agonist, used as maintenance therapy for
bronchial asthma.
• More lipophilic , hence longer duration of action
• Used in combination with inhaled corticosteroids, effects being
equivalent to double dose of IC
SALMETEROL
• A barbiturate analogue which is used in generalised tonic clonic
seizures, focal onset seizures and focal to BTCS.
• It prolongs sodium channel inactivation and inhibits excitatory
glutamtergic synapse
• It causes side effects like gum hypertrophy , hirsutism and if given
during pregnancy causes foetal hydantoin syndrome
PHENYTOIN
• Weak D2 blocker, potent 5-HT2 and alpha1 adrenergic blocker and
significant H1 blocking property.
• Its quite sedating, moderately potent anticholinergic
but paradoxically induces hypersalivation
• Major limitation - higher incidence of agranulocytosis, weight gain,
hyperlipidemia, precipitates DM
• High doses induces seizures in nonepiliptics, causes
sedation, unstable BP, tachycardia and urinary incontinence
• Reserved drug in refractory "SCHIZOPHRENIA".
CLOZAPINE
• It is a potent hypnotic, antianxiety drug known for its short duration
of action and minimal residual effects
• It has a high affinity to plasma proteins and gets reversibly bound
like the other drugs of this class
• It is the preferred anti-anxiety drug in cases where mild depression
is present
• This drug is preferred in case of “panic attacks” rather than in
maintenance therapy as long term use can lead to withdrawal when
stopped
• It is known to antagonise the actions of platelet activation factors,
hence given cautiously
Alprazolam
• Inhibits Antibodies to PCSK-9
• ↑Hepatic clearance of LDL & lower plasma LDL devels
• Adjunct to statin therapy
• Contraindicated in pregnant & lactating mother
ALIROCUMAB
• It was first efficacious antiepileptic
• It has anticonvulsant activity, which is not dependent on CNS
activity
• It has wide spectrum of anticonvulsant activity
• It’s a barbiturate
• This drug competitively inhibit phenytoin
Phenobarbitone
• Specific inhibitor of alcohol dehydrogenase
• Drug of choice for methanol poisoning
• Its effective and safe over ethanol
• Inebriating action (intoxicate)
• Commercially not available in India
Fomepizole
• An 8-month-old female infant presents with recurrent prolonged
seizures that began at 6 months of age, often triggered by fever.
The first seizure occurred following a mild fever and lasted 6
minutes. Since then, the infant has experienced multiple febrile
and afebrile seizures, sometimes hemiclonic and frequently
prolonged (>5 minutes). Parents report that seizures are triggered
by fever. EEG shows generalized and focal epileptiform
discharges, worsened by fever. MRI brain is normal. The child
initially achieved milestones appropriately, but parents have
noticed a delay in motor skills and reduced babbling over the past
two months
VALPROATE
• Patient: A 58-year-old male with a history of chronic pain and
osteoarthritis, who has been on non-steroidal anti-inflammatory
drugs (NSAIDs) (e.g., ibuprofen) for pain management.
• Symptoms: The patient presents with upper abdominal pain,
nausea, and bloating. An endoscopy reveals a peptic ulcer in the
duodenum.
• Diagnosis: The ulcer is determined to be NSAID-induced, and
Helicobacter pylori infection is ruled out through a negative breath
test and biopsy.
Omeprazole
• MR.rajesh, 60 year old, visited his primary care physician for
uncontrolled hypertension despite being on hydrochlorothiazide
• 25mg daily . His BP at the clinic was 160/95 mm hg. He also reported
occasional episodes of palpitations but no chest pain, dizziness, or
shortness of breath. He is also asthmatic from past 6 months.
• Medical history;
• Hypertension for 8 years, mild left ventricular hypertrophy(LVH), history
of supra ventricular tachycardia(SVT). Takes salbutamol inhaler once a
day.
• Diagnosis: hypertension with LVH and SVT (Intermittent episodes)
Verapamil
• Rahul,54 years old, was bought to the emergency department with
neurological symptoms.
• History of : hypertension, DM
• Chief complaints : sudden onset of severe headache,confusion and
vomiting.
• A CT scan revealed cerebral edema due to ischemic stroke.
• Vital signs: bp:
170/100 mm hg, HR: 90bpm, RR: 20 bpm, glasgow coma scale:12/15
• Given the risk of intracranial pressure leading to brain herniation ,
which is the best medication?
Mannitol(osmotic diuretic)
AMBRINSENTAN
SACUBITRIL
ALISKIREN
SPIRONOLACTONE
MONTELUKAST/ZAFIRLUKAST
BISACODYL
ONDANSETRON
PIRENZEPINE
MUSCIMOL
EZETIMIBE
THIAZIDE
MORPHINE
• Identify the condition shown in the figure, name any drug
providing relief in the above condition
ANGINA IS THE CONDITION
DRUG USED IS –
ANTIANGINAL DRUGS (NITRATES,PROP
RANOLOL,VERAMPIL,ETC)
CLOZAPINE
TIAGABINE
