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Introduction of Respiratory System

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Introduction of Respiratory System

Introduction of Respiratory System

  • the respiratory system is responsible for taking the proper amount of oxygen in the blood and removing the co2 from the blood.
  • The respiratory tract is divided into the upper and lower respiratory tract
  • Upper respiratory tract from the nose to the larynx
  • Lower respiratory tract from the trachea to the bronchioles
  • Respiratory tract is

Mission Nursing

  • Conducting caution of the respiratory tract is responsible for the transport of air including (the nose and nasal cavity, pharynx, larynx, and trachea).
  • The respiratory portion of the respiratory tract is responsible for carrying out the gas exchange.

Key Point

 

  1. The upper respiratory tract consists of – Nose to the larynx
  2. The lower respiratory tract consists of – Trachea to bronchioles

Nose Anatomy

  • Nose pizza man route of air entry and the first part of the respiratory tract.
  • Nose inspired the humidified, warm and filtered air
  • The external opening of the nose is called the nares or nostrils.
  • 3 prominence (nasal concha) -superior, middle and inferior
  • 3 space (meatus)- superior, middle and inferior
  • palette acts to separate the nasal cavity and oral cavity.
  • nose hair helps to protect entering the dust particle into the respiratory tract from the environment.

Bones surrounded the nasal cavities

  1. Frontal bone
  2. Sphenoid bone
  3. Ethmoid bone
  4. Maxillary bone

Nasal cartilage

  1.  Septal
  2. Lateral
  3. Minor alar
  4. Major alar
  • Goblet cells responsible for secret mucus in the nose
  • the shape of the nose depends upon the nasal bone formation and formation of the bridge of the nose

Blood supply – The nose receives blood supply from ophthalmic, maxillary and facial arteries

Key Point

  1. The external opening of the nose is called – Nostrils/nares
  2. Which cell is responsible for secreting mucus in the nose – Goblet cell

Larynx Anatomy

  • Larynx also called the vocal cord or voice box
  • The larynx is responsible for the production of voice sound
  • a larynx is an air pass or organ, situated below the pharynx at the level of C3 to C6 vertebrae.
  • Larynx size in males – 44 mm and females- 36 mm
  • In puberty, the male larynx rapid growth the female larynx
  • The larynx is generally composed of various irregular shapes of cartilages
  • The larynx considers the 3 pairs and 3 unpaired cartilage.
  • 3 paired cartilage are-
  1. Corniculate
  2. Arytenoid
  3. Cuneiform
  • 3 unpaired cartilage are –
  1. Thyroid
  2. Cricoid
  3. Epiglottis

 

Thyroid cartilage

  • the thyroid cartilage is a ‘V’ shape in cross-section and the most prominent laryngeal cartilage
  • These cartilages is made of hyaline cartilage.
  • Thyroid cartilage’s upper part is made by the stratified squamous epithelium and the lower part is made by ciliated columnar epithelium tissue.

Cricoid cartilage

  • The cricoid cartilage is ring-shaped cartilage situated below the thyroid cartilage
  • These cartilages also made of hyaline cartilage
  • The cricoid cartilage is strong and thick cartilage than thyroid cartilage
  • The narrow anterior part of the record cartilage is called the arch, and the posterior broad is called the lamina.

Epiglottis cartilage

  • epiglottis cartilage is a leaf-shaped elastic flap structure, that is situated at the top of the larynx
  • epiglottis help to prevent the food passes in the tracheobronchial tree and cover the glottis during swallowing
  • It is a flexible and fibroelastic cartilage
  • Epiglottis cause temporary apnea during eating

Arytenoid cartilage

  • arytenoid cartilage is 2 small pyramid shaped cartilage, that are situated at top of the cricoid cartilage
  • This cartilage is form the posterior part of the larynx
  • There are two folds of mucous membrane on each side of the larynx
  1.  The upper fold is a vestibular fold
  2. The lower fold is a vocal fold

Key Point

  1. Which body part is responsible for the production of voice sound – The larynx
  2. The larynx extends from – C3 to C6 vertebra
  3. Leaf shape elastic flap cartilage of larynx – Epiglottis
  4. Ring-shaped cartilage of larynx – Cricoid cartilage
  5. The lower fold of the larynx is a – Vocal fold
  6. Low pitch sound produced by the larynx in case – Vocal cord muscles are relaxed

Pharynx

  • The pharynx is a common pathway for air and food passes.
  • Pharynx located behind the oral and nasal cavity
  • Pharynx age 12 – 14 cm long tube, that is extended from base of the skull to 6th cervical vertebra.
  • The pharynx is divided into-
  1.  Nasopharynx (from the base of the skull to the soft palate)
  2. Oropharynx (from the soft palate to C3 vertebra)
  3. Laryngopharynx (from C3-C6 vertebrae)
  • Laryngopharynx is a caudal part of the pharynx and is also called the hypopharynx.

Muscles of pharynx

  • It is divided into 2 groups
  1. Longitudinal muscles
  • Palatopharyngeus
  • Stylopharyngeus
  • Salpingopharyngeus
  1. Pharyngeal constrictors
  • Superior
  • Inferior
  • Middle

Pharynx Blood supply – pharynx receives blood supply from the external carotid artery

The external carotid artery is –

  1. Lingual artery
  2. Facial artery
  3. Maxillary artery

Pharynx Nerve supply – major 3 cranial nerves.

  1. Maxillary nerve
  2. Vagus nerve
  3. Glossopharyngeal nerve

Key Point

  1. Other names of laryngopharynx – Hypopharynx

Vocal Cord

  • vocal cords are covered with mucous membrane, that is located below the larynx and at the top of the trachea.
  • the vocal cord attached anteriorly with the thyroid cartilage posterior attach with arytenoid cartilage
  • When vocal cord muscles relax, the larynx causes a low pitched sound.
  • When vocal cord muscles contract, the larynx causes the High pitched sound.
  • larynx divided into three parts due to vestibular and vocal fold-
  1. Vestibule of larynx- top part of vegetable fold.
  2. Sinus or sinus of ventricle of the larynx – between vestibular and vocal fold.
  3. Infraglottic part – below part of vocal fold.

Intrinsic muscle of the larynx

  1. Cricothyroid muscle
  2.   Transverse arytenoid unpaired   muscle
  3. Thyroarytenoid and thyroepiglottic muscles
  4. Posterior cricoarytenoid triangular muscle
  5. Oblique arytenoid and aryepiglottic muscle
  6. Lateral cricothyroid muscle

Vocal Cord Blood supply

  • The larynx receives blood supply from the superior and inferior laryngeal artery

Vocal Cord Venous drainage

  • venous drain by thyroid vein, that connect with internal jugular vein

Vocal Cord Nerve supply

  • parasympathetic supply by the superior and recurrent nerve that is the branch of the vagus nerve.

Trachea Anatomy

  • Also known as the windpipe
  • trachea occupied the lower part of the neck and in the superior mediastinum
  • the starting point of the trachea connects with the lower and of the larynx
  • The isthmus of the thyroid gland is covering the trachea
  • The trachea situated between the larynx and bronchus
  • Length of trachea – 12 cm (10-15)
  • Diameter of trachea – Male – 2cm Female – 1.5cm
  • lover and off tracker divided into the right and left principal bronchi, at the level of T5 (carina) vertebral level.
  • The right bronchus is slightly wider and more vertical than the left bronchus.
  • Left bronchus is longer and narrower than right bronchus.

Structure of trachea

  • The trachea is a cartilaginous structure of the middle respiratory tract.
  • The trachea is extracted from the C6 vertebra to the T5 vertebra.
  • 16 to 20 regular incomplete C-shaped hyaline cartilage rings provide the support of the trachea.
  • These rings make the tubes convex anterolaterally.
  • rings are incomplete at the posterior surface, which prevents the collapse of the trachea.

Trachea layers

  1. The outer layer (made of elastic tissue)
  2. The middle layer (made by smooth muscles)
  3. The inner layer (made of epithelium tissue)

Relation of trachea

  • Anteriorly 
  1. Brachiocephalic artery
  2. Aortic arch
  3. Lymph node
  4. Manubrium sterni
  5. Sternothyroid muscle
  • Posteriorly
  1. Vertebral column
  2. Oesophagus
  • Right side
  1. Azygos vein
  2. Right lungs and pleura
  3. Right vagus
  • Left side
  1. Left common carotid artery
  2. Left subclavian artery and arch of aorta
  • Tracheobronchial tree

 

Introduction of Respiratory System
Introduction of Respiratory System

Blood supply of Trachea

  • The trachea receives blood supply from the inferior thyroid artery

Trachea Venous drainage

  • Drain into left brachiocephalic vein

Trachea Nerve supply

  • trachea receive nerve supply from sympathetic and parasympathetic laryngeal nerve

Teachea Lymphatic drainage

  • Into paratracheal and paratracheal nodes.

Key Point

  1. Windpipe of respiratory tract – Trachea
  2. Average length of the trachea is – 12 cm
  3. Trachea is divided into right and left bronchus at the level of – T5 vertebra
  4. The trachea extends from – C6 vertebra to T5 vertebra

Lungs Anatomy

  • Lungs are respiratory organs, occupying the thoracic cavity.
  • Lungs cover the major portion of the thoracic cavity.
  • lungs are spongy in texture and right and left are divided by the mediastinum.
  • lungs are extended from just above the clavicle to the diaphragm
  • Normal lung colour is the grey or brown but black colour of lungs due to deposition of carbon particles.
  • Weight of lungs
    1. Right lung – 650 gm
    2. Left lung – 600 gm
  • Thoracic cages (ribs) protect the lungs from injury.
  • The pleura is a serous membrane that covers the lungs.
  • The space between the parietal and visceral layer is called the pleural cavity.
  • Pleural cavity filled with serous fluid

Parts of lungs

  • Costal surface – it is the outer surface of the lungs, that is occupied against the costal cartilage. (large and convex shape service)
  • Medial surface – medial surface area of lungs is face is the mediastinum. medial surface divided into posterior vertebral part and anterior mediastinal part.

Border of lungs

  1. Anterior border
  2. Posterior border
  3. Inferior border
Anterior border
  • It is a very thin and shorter border than the posterior border
  • These borders correspond to the pleural reflection
Posterior border
  • It is a thick border
  • Extend from C7 to T10
  • help to separate the vertebral part of the medial surface from the costal part.
Inferior border
  • The border helps to separate the base of medial and postal service.

Fissures in the lungs

  • Fissures are helpful to divide each lobe into lobs.
  • Right lungs consist two fissures-
    1. Horizontal fissures
    2. Oblique fissures
  • Right lungs consist 3 lobes –
    • Upper lobe
    1. Middle lobe
    2. Lower lobe
  • Left lung consists 1 fissure – oblique fissure
  • Left lung consists 2 lobe – upper and lower

Cardiac notch

  • cardiac notch is an indentation on the left lung surface that provides the space for the lungs.
  • It is occupied the anterior border of the left lung

Difference between right lung and left lung

Right lung Left lung
The anterior border is straight The anterior border is interrupted due to cardiac notch
Consist 3 lobes Consist 2 lobes
Shorter and broader Longer and narrow
Consist 2 fissures Consist 1 fissure
Weight about 650 gm About 600gm
Provide the space for liver Provide the space for heart
Lingula absent Lingula present

 

  • Each lung consists that 10 bronchopulmonary segment

 

Hilum (roots of lungs)
  • The hilum is a palace, where structures enter or leave the lungs.
  • Roots of lungs situated opposite side of, 6th and 7th thoracic vertebra.

Contents 

  • Principal bronchus
  • 2 pulmonary vein
  • 1 pulmonary artery
  • Bronchial artery and vein
  • Areolar tissue
  • Bronchopulmonary lymph node
Blood supply of lungs
  • lungs receive the deoxygenated blood from the pulmonary artery and receive oxygenated blood from the pulmonary vein.
Nerve supply of lungs
  • Parasympathetic nerve supply from the vagus nerve
  • Sympathetic nerve supply from the 2nd and 5th sympathetic ganglia.

Key Point

  1. Which structure covers a major portion of the thoracic cavity – The lungs.
  2. The normal colour of the lungs – Gray, and brown colour.
  3. The pleural cavity is filled with – Serous fluid.
  4. Dome shaped part of the lungs is – Apex.
  5. A cardiac notch is an indentation of – Left lungs.

Diaphragm Anatomy

  • The diaphragm is a chief regulatory muscle of respiration.
  • The form is responsible to separate the thoracic and abdominal cavities.
  • The diaphragm is a dome-shaped muscle.
  • 75% inspiration done by diaphragm at resting period.
  • Diaphragm muscles fibres
  1. Sternal
  2. Costal
  3. Lumbar
  • Sternal muscle fibres arise from the back of the xiphoid process.
  • Costal muscle fibres arise from the inner surface of the cartilage.
  • Lumbar muscle fibre arises from lateral and medial costal arches.
  • The right diaphragm is slightly higher.
  • During inspiration, the diaphragm descends into the abdominal cavity.
  • During expiration, diaphragms move upward in the thoracic cavity.

Opening of diaphragm

  • The oesophageal opening.
  • The aortic opening.
  • Gastric and vagus nerve opening.
  • Vena cava opening.

Diaphragm relation

Superiorly – pericardium, pleurae

Inferiorly    – liver, stomach fundus

  • Suprarenal and kidney
  • Peritoneum
  • Spleen.
Diaphragm blood supply –
  •  Diaphragm receive blood supply from inferior phrenic arteries, Musculo phrenic artery, pericardiophrenic artery
Diaphragm venous drainage – 

Venous drain into the inferior phrenic vein and superior phrenic vein.

Diaphragm nerve supply – 

The diaphragm receives nerve supply from phrenic and lowers intercostal nerves.

Key Point

  1. Chief regulatory muscles of respiration – Diaphragm
  2. Normal shape of diaphragm is – Dome shape

Lungs Volume

Tidal volume – normal respiration volume.

  • Normal tidal volume about 500 ml.
  • Tidal volume is an amount of air, which is inspired and expired during single respiration.
  • Conductive airway – Airway from Rose to terminal bronchioles.
  • Normal conductive airway tidal volume = 150 ml.
  • Respiratory airway – airway from bronchiole to alveoli.
  • Normal respiratory airway tidal volume = 350 ml.
Inspiratory reserve volume (IRV)
  • IRV is an extra amount of air, which is inspired forcefully, after normal respiration.
  • Volume = 3300 ml.
Expiratory reserve volume (ERV)
  • ERV is an extra amount of air, which is expelled forcefully beyond tidal volume.
  • Volume= 1000 ml.

Residual volume – The lungs cannot be empty completely even after the forcefully expiration.

  • So residual volume is a remaining amount of air in the lungs after the forceful expiration.
  • Volume = 1200 ml.

Key Point

  1. Normal tidal volume – 500 ml
  2. Normal residual volume of lung – 1200 ml

Lungs Capacity

  1. Vital capacity – Vital capacity is a maximum amount of forceful best battery volume after maximum inspiration.

VC = TV + IRV + ERV

= 500 + 3300 + 1000

= 4800 ml.

  • Vital capacity also no timed Vital capacity.
  1. Inspiratory capacity – Maximum amount of forceful inspiratory volume after normal respiration.

IC = TV + IRV

= 500 + 3300

= 3800 ml.

  1. Total lung capacity – Maximum amount of air present in the lungs after the deep respiration.

TLC = TV + IRV + ERV + RV

= 500 + 3300 + 1000 + 1200

= 6000 ml.

  1. Residual capacity – Functional residual capacity is the volume of air, that is present in the lungs at the end of the passive expiration.

FRC = ERV + RV

= 1000 + 1200

= 2200 ml.

Special Diwali Sale

AIIMS NORCET Recruitment 2022 Apply Now

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AIIMS NORCET 2022 Official Notification

Online Application is invited for the Nursing Officer Recruitment Common Eligibility Test (NORCET) 2022 for the recruitment of Nursing Officer posts at Level 07 in the Pay Matrix pre-revised Pay Band-2 o Rs.9300-34800 with Grade Pay of Rs.4600/-, Group-B for AIIMS

New Delhi and other AIIMS as per available vacancies in the respective Institutes.Recruitment

Eligibility Criteria for appearing in NORCET

AIIMS NORCET Essential Qualification2022:-

1.B.Sc Nursing
  1. B.Sc. (Hons.) Nursing / B.Sc. Nursing from an Indian Nursing Council/state Nursing  council  recognized  Institute  or   University  OR
  2. B.Sc. (Post-Certificate) / Post-Basic B.Sc. Nursing from an Indian Nursing Council/State Nursing Council recognized Institute/ University.
  3. Regist red as Nurses & Midwife with State / Indian Nursing Council

 

2. GNM
  1. Diplo a in General Nursing Midwifery (GNM)from an Indian Nursing Council/State Nursing council recognized Institute / Board or Council
  2. Regist red as Nurses & Midwife in State / Indian Nursing
  3. Two Years Experience in a minimum 50 bedded Hospital after acquiring the educational qualification mentioned above as applicable for all Participating

Remarks – The required two years of experience as in above is an essential criterion and to be valid, the experience shall be acquired after obtaining Essential Qualification, i.e. after completing the residency period f the course, declaration of result & registration with State/Indian Nursing Council.

 

AIIMS Norcet Recruitment 2022 Pay Scale

  • Grade Pay of Rs.4600/-
  • Pay Band-2 of Rs.9300-34800

AIIMS NORCET Recruitment 2022 Age Limit:

  • For all AIIMS: Between 18-30 Years.

AIIMS NORCET Recruitment 2022 APPLICATION FEES:

  1. General/OBC Candidates – 3000/- (Rupees Three Thousand only)
  2. SC/ST Candidates/EWS –   2400/- (Rupees Twenty-Four Hundred only)
  3. Persons with Disability,s – Exempted
    • The candidate can pay the prescribed application fee through DEBIT CARD/CREDIT CARD/ NET BANKING. Transaction / Processing fee, if any, as applicable, will be payable to the bank by the
    • Application fee once remitted shall not be refunded under any
    • Applications without the prescribed fee would not be considered and summarily

Application Fees of SC/ST candidates who appear in the Examination will be refunded after the declaration of results in due course of time.

AIIMS NORCET Recruitment 2022 Syllabus

The syllabus will be in accordance with education qualification and experience as mentioned in the Eligibility Section/Advertisement.

AIIMS NORCET Recruitment 2022 Exam Date:-

Online (CBT) mode Examination Date: 11th September 2022 (Sunday)

 

GENERAL CONDITIONS

  1. The posts carry the usual allowance as admissible to Central Government Servant of similar status stationed at respective cities of respective Institutes/Hospitals.
  2. The aspiring applicants satisfying the eligibility criteria in all respect can submit their application only through ON-LINE The Online applications can be done through the AIIMS website www.aiimsexams.ac.in from 04.08.2022 to 21.08.2022 up to 5:00 P.M. No documents including the Registration Slip of on-line application form are required to be sent in Physical form. However, all the applicants are advised to keep a copy of the registration slip with them, along with proof of payment for their record. Correction in registration will not be considered through any mode i.e. Email/letter. Hence candidates are advised to fill out their registration form carefully as no correction will be allowed after specified dates as per the procedure.
  3. Correction/edit of Registration: For candidates requiring correction in Registration & Basic candidate information OR Completion of application form, the edit panel will be available from 08.2022 to 23.08.2022 only. It may kindly be noted that the editing shall be done only by the candidate. The candidate will be responsible for all corrections. No corrections are allowed after the closing date of editing i.e. 23.08.2022 by 05:00 pm. Applicants may note that further correspondence will NOT be entertained in this regard. Category from SC/ST to UR/OBC/EWS cannot be corrected once registration fees are submitted. Candidature will be canceled in case found incorrect information at any stage of recruitment.
  4. The Online portal for application will be closed by 05:00 PM on 21.08.2022. The candidature of such applicants who fail to complete the online application by the stipulated date and time will not be considered and No correspondence in this regard will be entertained.
  5. Those applying in response to this advertisement should satisfy themselves regarding their eligibility for the post applied They must be fulfilling all the eligibility criteria as of the closing date of online submission of applications, failing which their application will be summarily rejected. Required educational qualification/ experience should be completed on or before the last date of online submission of application. In the case of educational qualification, the candidate should have completed the residency period for the desired educational qualification including an internship on or before the last date of online submission of the application. Likewise, the candidate must have completed duration of desired experience on or before cut-off date i.e last date of submission of the online application. Recruitment Rules of respective AIIMS will be applicable for selection and based on merit as per NORCET Score.
  6. The candidate must ensure that images of the photo, signature, and thumb impression should be as per the guidelines mentioned in the ‘Upload Image Instructions’ given in the General links and are clearly visible in preview at the time of filling of application in online mode. If the photo/signature/thumb impression image is not as per instructions given in the ‘Upload Image Instructions’ in that case, your application will be rejected. Due diligence and care should be taken while uploading images of photo, signature and thumb

7. AIIMS NORCET 2022 AGE RELAXATION:-

  1. The cut-off date to determine eligibility in terms of age of candidates will be the last date of Online submission of applications e. 21.08.2022.
  2. SC/ST/OBC/PWBD candidates who opt to apply for unreserved vacancies will not be eligible for age relaxation or relaxation in cut-off marks which are otherwise allowed to those belonging to these Further, reserve category candidates (SC/ST/OBC/PWBD) who become eligible by virtue of age relaxation applicable in their

 

Note: –

  1. Any other Institute/Hospital not included in the above list may also be included before the declaration of
  2. The NORCET score may be subsequently used by any of the AIIMSs for filling any of the vacancies for a period of one year at the discretion of competent

Important: As per the decision in the 4th meeting of CIB held on 27th July 2019, 80% of Seats are reserved for Females and 20% for Males.

Download Official notification of AIIMS NORCET 2022:-

Download Official notification of AIIMS NORCET 2022 Click

 

Pneumococcal Bacteria

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Pneumococcal Bacteria

Pneumococcus Meaning

  • Pneumococcus is a partner of the upper respiratory tract.
  • Pneumococci essential pathogen of pneumonia and oddities media in children.
  • Pneumococci is reclassified into the streptococcus pneumoniae.

 

Pneumococcus Morphology

  • It is a small, slightly elongated, gram positive cocci that is arranged in pair.
  • Each coccus consist two ends, one end is rounded or broad and other is pointed.
  • Each pair is enclosed by the capsule.
  • Pneumococcus is non motile and non sporing.

 

Pneumococcus Culture 

  • Pneumococci are aerobs and facultative anaerobes.
  • Pneumococci growth require 37° C temperature and 7.8 PH.
  • On the blood agar, the colonies are small, dome shaped after 18 hour incubation.
  • On the prolonged incubation, colonies flat with raised edge.
  • Pneumococci produce the uniform turbidity in the liquid medium.

Pneumococcus Biochemical reactions

  • Pneumococci ferment several sugars with the production of acid.
  • Generally, pneumococci are soluble in the bile.
  • Pneumococci is the catalase and oxidase negative.
  • Bile solubility test is a essential test to differentiate the pneumococcus from the streptococci.

 

Pneumococcal resistance mechanism

  • Pneumococci are more sensitive to the usual antiseptics.
  • Pneumococci are destroyed at 52° C temperature for 15 minutes.

 

Pneumococcal Antigenic structure

  • The most important antigen of pneumococcus – is capsular polysaccharides.
  • Other antigens are – M protein and cell wall carbohydrate.

 

  1. Capsular polysaccharide – It is a specific pneumococci that is classified based upon the capsular polysaccharide nature.

 

  1. M protein – It is another type of pneumococci that is associated with antibody and virulence to M protein.

 

  1. Cell wall carbohydrate – It is a specific carbohydrate Antigen that called C – substance.
  • It is precipitate due to abnormal protein and occur in the acute phase of pneumonia and disappear during convalescence.
  • C – Substance also occur in the patient blood with some other disease, is called C – reactive protein (CRD).

 

Pneumococcus Pathogenesis

  • Streptococcus pneumoniae is the most common bacteria which is causing pneumonia (both lobar and bronchopneumonia).
  • It is second most important cause of pyogenic meningitis.
  • This type disease most commonly occur in the children.

 

Pneumococcus Laboratory diagnosis

  1. Specimens – 

  • CSF, sputum, blood, pleural exudate, etc.
  • For pneumococci septicaemia, blood culture is useful.

  1. Collection and transport

  • All sample should be collected in the sterile container under the aseptic techniques and transport immediately in the lab.
  1. Direct microscopic – Gram staining of smear demonstrate the large number of polymorphs and typical organism.
  1. Culture – The sample should be incubated on the blood agar.
  • The sample also inoculated at 37° C temperature for 24 hours in the presence of CO2.
  1. Biochemical reaction – Biochemical test describe the steps to cocas pneumoniae is differentiate from the streptococcus viridans.
  • The biochemical test is insulin fermentation and bile solubility test.

Animal pathogenicity test 

  • The heart blood and peritoneal exudate of pneumococci.

Pneumococcus Treatment

  • Antibiotic of choice – Parenteral penicillin.

 

  • Reference – Textbook of microbiology 5th edition, By DR. C. P. Baveja.
  • Page no. 196 – 198.

SAIL Recruitment 2022 post-45 apply now

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SAIL Recruitment 2022 post-45

Steel Authority of India Limited ( SAIL has released a new staff nurse vacancy notification. notification for paramedic trainees with 45 Vacancies. Candidates who are qualified in the 10th pass ANM, GNM Degree/Diploma. Sc. Nursing, DMLD GNM, and intermediate are eligible for this post please read the full notification and apply to the official website of SAIL this web site only mad for information. Other SAIL Recruitment 2022-related details are given below read and apply.

SAIL Recruitment 2022 Details & Eligible Creteria:-

Name of the Post  Number of Vacancies Required Educational Qualification
Operation Theatre Technician 07 Intermediate/ Degree
Dresser 03 Intermediate/ Diploma
X-Ray Technician 04 Intermediate/ Degree/ Diploma
ECG Technician 03
Dialysis technician 02
Pharmacist 06 D. Pharma/ Intermediate/ B.Pharma
Laboratory 12 Intermedate/DMLT/ BMLT
PFT technician 01 Intermediate/ Degree/ Diploma
Phlebotomist 02 B.Sc/ DMLT/ Intermediate/ANM/10th Pass
Vaccinator 01 ANM/ GNM/ B.Sc Nursing
Dental Hygienist 01 Intermediate/ Diploma/ Degree in Dental Hygiene
Dental/ Dental Operating Room Assistant 01 Intermediate/ Diploma in Dental Operating Room Assistant

 

SAIL Recruitment 2022 Age Limit

  • Minimum Age limit:- 21 years
  • Maximum Age Limit:- 45 Years

SAIL Recruitment 2022 Selection Process:-

  • Selection Based on Walk-in-interview

SAIL Recruitment 2022 Pay scale:-

Selected Candidates get Consolidate remuneration of a minimum of Rs.15020/- to a maximum of Rs.25000/- per month.

SAIL Recruitment 2022 How to apply:-

  • Visit the official SAIL website.
  • Read the official notification and verified the details related to the vacancy.
  • Download the official Application Form of SAIL Recruitment 2022.
  • Fill in the complete Details and Check. all details are correct after that.
  • Eligible Candidates may attend the interview process with the Application form and other required Documents. Document 1 Copy And Original Relevant Document required

SAIL Recruitment  Interview  Address:-

Confluence, opp. to Burnpur Post Office,

Near Bharat Bhawan P.O Burnpur – 713325.

DT: Paschim bardhaman West Bangal.

SAIL Recruitment 2022 Interview Dates:-

Walk-in-Interview Dates 12th & 13 Aug 2022

 

SAIL Recruitment 2022 Official Notification:-

SAIL Recruitment 2022 official Notification Click Here

Mycobacterium Tuberculosis Morphology

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Mycobacterium Tuberculosis Morphology

Mycobacterium Tuberculosis Morphology 

  • Mycobacterium tuberculosis is a slender, straight or slightly curved shape bacillus associated with rounded ends.
  • M. Tuberculosis is an aerobic, noncapsulated, non motile and non sporing bacteria.
  • Measurement – 1 – 4 um * 0.2 – 0.8 um in size.
  • It is found in pair or small clumps.
  • Ziehl neelsen staining technique is required to study the M. Tuberculosis morphology.
  • It is a gram positive Bacteria.

 

Cultural characteristics of Mycobacterium Tuberculosis

  • M. Tuberculosis is an aerobie in nature that grows slowly within 14 – 15 hours.
  • The organism grows at 37° C temperature with PH between 6.4 to 7.
  • The colonies appear within 2 weeks (sometimes within 6 – 8 weeks).
  • LJ medium (Low enstein Jensen) is commonly useful, that consist of asparagine, mineral salt eggs and glycerol.
  • Bacilli are grown as a surface pellicle in the liquid media.

 

Biochemical reaction mycobacterium tuberculosis

  • Nitrate reduction test and niacin test are the biochemical tests that are positive in the mycobacterium tuberculosis.

 

mycobacterium tuberculosis Resistance  

  • M. Tuberculosis survives in sputum for 20 – 30 hrs and in dust for several months.
  • It is destroyed at 60° C temperature for 20 minutes.

 

Pathogenesis 

  • Tuberculosis disease involved pulmonary and extrapulmonary lungs.
  • M. Tuberculosis occurs due to inhalation of infected droplets, coughs or sneezes.
  • Bovine tuberculosis is developed due to infected cow milk.

 

Tuberculin skin test

  • It is a delayed and types 4th hypersensitivity reaction.
  • Resources – old tuberculin and purified protein derivative (PPD).
  • Old tuberculin described by Robert Koch is a crude product.
  • Methods – 0.1 ml of PPD is injected internally at the flexor aspect of the forearm.
  • Mark the inject site.
  • Result – Result are examined after 48 – 72 hours of PPD injected.
  • If Erythema diameter is 10 mm or more that indicates the positive tuberculin test.

 

Laboratory diagnosis of mycobacterium tuberculosis

    1. Specimen collection
  • Collect sputum for pulmonary tuberculosis.
  • Collect CSF for meningitis tuberculosis.
  • Collect morning urine for renal tuberculosis.
  • Biopsy of tissue is required for tissue tuberculosis.
  • For joint and bone tuberculosis, aspirate the fluid.

 

    1. Direct Microscopy
  • The specimen is stained by ziehl neelsen technique.
  • The acid fast Bacilli is appeased as a bright red Bacilli against a blue background.
  • Purulent part of the sputum is useful to prepare a smear.
  • The prepared smear is to be examined under fluorescent Microscopy.
  • Microscopy provides the only presumptive evidence of TB infection.

 

    1. mycobacterium tuberculosis Culture
  • It is a very sensitive method to determine the tubercle Bacilli.
  • Generally, the tubercle Bacilli grows in 2 to 8 weeks.
  • In the positive culture – calories appear on the culture medium, smear is made from the isolated colonies or stained with ziehl – neelsen technique.

 

    1. mycobacterium tuberculosis Serology 
  • The method used to detect the mycobacterium antibiotics in the patient serum.
  • Serology include following test
  1. ELISA
  2. RIA
  3. Latex agglutination assay.

 

    1. Molecular methods 
  • PCR (polymerase chain reaction) is a rapid diagnostic method of Tuberculosis.
  • PCR test is based on the DNA amplification that detects the M. Tuberculosis directly in the clinical specimen.

 

Treatment of mycobacterium tuberculosis:-

  • Common antitubercular drugs are – isoniazid, rifampicin, streptomycin, pyrazinamide, ethambutol etc.
  • BCG vaccine – proposed by the calmette and guerin in 1921.
  • BCG is – Bacilli calmette guerin.
  • BCG dose – 0.1 ml at 1 month of birth and 0.05 ml at the birth.
  • The BCG vaccine is around 80% effective to protect against tuberculosis.

Read  Other Articles Related to Tuberculosis……..

????what is tuberculosis? Symptom Cause and Treatment

????Nosocomial infection

???? MOST Common Cause, Type, Symptom Of Any Disease 

Reference – Textbook of microbiology 5th edition by Dr. C.P. Baveja.

Page no. – 330 – 340.

Nosocomial infection

by
Hospital Acquired Infection

Nosocomial infection Definition – 

Hospital-acquired infection is also known as nosocomial infection and healthcare-associated infection.

  • According to Dr. William James – Infections are most often transmitted from patient to patient on the hands of healthcare workers.
  • According to WHO – An infection is acquired in a Health Care setting other than the primary reason for admission.
  • The nosocomial infection is developed at least 48 hrs after the admission and discharge.
  • Infection is the transmission of pathogens between the staff and patients and among patients.

 

Source of nosocomial infection

  1. Exogenous
  2. Endogenous

 

  1. Exogenous nosocomial infection – 

A hospital-acquired infection is mostly an exogenous form, that is transferred through another patient, hospital staff or hospital environment.

eg:- hospital equipment and devices.

  • Hospital environment – air, water, food etc.
  • Hospital patient secretion, excretion, blood product and body fluids.

 

  1. Endogenous nosocomial infection – 

The infection occurs through normal human flora.

  • Infection is caused by the organism that is present as a part of the normal flora of the patient.

 

Microorganism

  • All microorganisms can cause a nosocomial infection that is – viruses, bacteria, fungi and parasites.
  • Blood borne viral infections are – HIV, HCV, and HBV.
  • Other viral infections are – Rubella, SARS, and varicella.
  • Gram-negative bacteria are
  • Pseudomonas aeruginosa
  • E – Coli
  • Neisseria gonorrhoea etc.
  • Gram-positive bacteria are
  • Mycobacterium tuberculosis
  • Staphylococcus aureus
  • Staphylococcus epidermidis
  • Fungal infections are – candida albicans
  • Aspergillus etc.

 

Mode of transmission

  1. Contact – It is the most common route of transmission of nosocomial pathogens.
  • Hands and clothes – The infection is spread through contact with the hand and clothes of hospital staff.
  • It is an adequate scope of microorganism transmission from one person to another person.
  • Hospital equipment – Some hospital equipment such as bronchoscopes, endoscopes, cystoscopes, etc. are infected, which is responsible for to spread of the infection.

 

  1. Airborn

  • Droplet – Some infection particles are transmitted through inhalation routes.
  • Aerosols – The infection is transferred through nebulizers, humidifier and air conditioner etc.
  • Dust – Infection spread from bed making, floors, from wound during dressing etc.

 

  1. Parenteral route – The infection is spread through contaminated fluid infusion, blood transfusion, provide contaminate blood products and tissue donation etc.
  • For example – hepatitis and HIV virus also transfer through parenteral route.

 

  1. Oral route – Infection is spread through ingestion of contaminated food and water.

 

Types of Nosocomial infection

What are the 6 most common hospital-acquired infections?

  1. Respiratory infection –

 This type of nosocomial infection is spread through pulmonary ventilation and aspiration in unconscious patients.

 

  1. Urinary tract infection – 

These types of infections occur due to contaminated proceeding techniques of catheterization or unhygienic care of dressings.

  • The infection is prevented by the use of an aseptic technique during catheterization.

 

  1. GI infections –

 Infection occurs due to ingestion of contaminated food and fluid.

 

  1. Surgical infection – 

In the elder patient, post-operative infection is high. The infection occurs due to a lack of asepsis technique during surgery and during the dressing of wounds.

 

  1. Burn – 

In case of burn, staphylococcus aureus, streptococcus pyogenes, and pseudomonas aeruginosa are essential to cause hospital-acquired infection.

 

  1. Bacteraemia – 

Infection is spread through the infected intravenous cannula etc.

 

Prevention of Nosocomial infection

  • Proper hand washing is the most important vehicle to prevent the hospital from acquiring infection.
  • Use the alcohol hand rub.
  • Administer the antibiotics to the carrier staff or patient to destroy the pathogenic agents.
  • Isolated the infectious patient.
  • Use proper sterilization and disinfection techniques.
  • During the procedure, always use sterile equipment and dressing material.
  • All surgical and medical procedures are done under aseptic techniques.
  • Maintain proper personal hygiene.
  • Proper disposal of the hospital waste material.
  • Prevent overcrowding in the hospital and always use a face mask.
  • Maintain a well-ventilated hospital environment.
  • Staff use PPE kits during surgical procedures.
  • Standards to be maintained in the hospital.
  • Use proper investigation procedures.
  • Careful handling, cleaning and discarding the excreational waste.

Nursing Research Definition and 50+Research PPT

by
Introduction of Nursing Research

what is the mining of research?

  • The word research is derived from the French word “researcher “.
  • Research is divided into – Re and search.
  • ” Re ” means – New, once again, or fresh.
  • ” Search ” means – to look for something or examine it closely and carefully, to test and try or to prove.

 

Nursing research definition

  • Research is defined as the detailed and careful study of something to find out more information about it.
  • A/c to J.W. Best 1969 – Research may define a systematic and objective analysis and recording of controlled observation that may lead to the development of generalization, principles, and theories, resulting in prediction and possible ultimate control of events.
  • A/c to Ruth M. French 1968 – Research essentially is a problem-solving process a systematic, intensive study directed towards full scientific knowledge of subject studies.
  • Research is defined as a scientific and systematic process to answer the question in relation to the facts.

 

Definition of Nursing Research

  • A/c to ICN 1986 – Nursing research is a way to identify new knowledge and improve professional education and practice and use resources effectively.
  • A/c to S.K. Sharma 2005 – Nursing research is the scientific and systematic and orderly process to find out solutions for problems concerning nursing or generating and refining nursing knowledge, to improve quality of nursing Care, Nursing administration and nursing education.
  • A/c to polit and hungler 2001 – Nursing research is defined as a systematic search for knowledge about the issue of importance of nursing.

 

Purpose of Nursing Research

  • To provide a scientific basis for the nursing profession.
  • To provide evidence-based practice.
  • To refine and develop the nursing principles and theories.
  • To increase the professional knowledge in nursing.
  • To develop the scientific base of knowledge that is useful for providing quality nursing care, administration and education.
  • To help in the continuous growth of the nursing profession.
  • To provide advanced technology in the health sector.
  • To provide advanced practice to solve nursing problems.
  • To increase the accuracy of different nursing education and administrative techniques.
  • Help the nurse to identify the boundaries of her profession.
  • Nursing research helps to generate new ideas.
  • To make a precise formulation of the problem.
  • To prepare oneself to be a diligent researcher.
  • Develop new techniques, tools, or new knowledge.

 

Characteristics of good research

  1. Begin with a clearly defined purpose –

  •  Good research can always be conducted only in an effective manner and start with a clearly defined purpose.

 

  1. Orderly and systematic process –

  •  Orderly and systematic way conducted research is considered to be good, because it is the most important criteria for a scientific research process.

 

  1. Finding a solution to a problem –

  •  good research is essential for solving professional problems.

 

  1. Based on the current professional issues –

  •  always a good research based on the current’s issues and current problem that the public is facing.

 

  1. To develop, refine and expand the professional knowledge – 

  • good research essential to generate the new knowledge or expand the knowledge in the public.

 

  1. Perform the activity slowly –
  •  a good research does not do any activity quickly, it needs lots of time and patience.

 

  1. Try to collect first-hand information data –

  • A good researcher collects all information and data directly from the subject by different methods.

 

  1. Include appropriate methodology – 

  • The choice of methodology in any research depends on many factors as each variable and research has unique characteristics.

 

  1. Generate conclusions to repair and improve professional practices –

  • Good research cannot be conducted successfully unless it contributes to reinforcement and progress in the professional practice.

 

  1. Adequately carried out activity –

  • A good research activity is incomplete and poor until the data collected is adequately and properly analyzed using a standardized and accepted method of data analysis.

 

  1. Use of valid and reliable data collection tools – 

  • Good research depends upon the validity and reliability of the research tool.
  1. Good search is evidence-based practice.
  2. Good research is interesting and motivating.
  3. Good research is carefully recorded and reported.
  4. Directed towards development or testing the theories.
  5. Good research activity strives to communicate the findings as widely.

 

Types of Nursing Research

 

 

Types of research
Types of research

 

  1. Qualitative research

  • Qualitative research referred to the meanings, definitions, concepts, characteristics, symbols, metaphors and descriptions of things.
  • The qualitative research is used to understand the individual perceptions of events.
  • Qualitative research helpful to analysis of data such as words, pictures or objects.
  • Qualitative research is subjective data that provides a rich description of complex phenomena.
  • Qualitative research describes social phenomena as occurring naturally.

 

  1. Phenomenology research –

  • The goal of the phenomenological method of research is to explain how any participant experiences a specific event.
  • Phenomenological method used interview, observation and surveys to obtain information from the subjects.
  • Describe the structure of experience, as they present themselves to consciousness, without beliefs from theory, deduction or other discipline.

 

  • 2. Ethnography research – 
  • Ethnography is the primary research that provides a framework for studying the pattern, meaning and experience of a defined culture group in a holistic fashion.
  • They reach and intact the culture group in a natural setting during the prolonged period.
  • Ethnography research involves the researcher embedding himself into the daily life and routine of the subject.

 

  1. Grounded theory research –

  • grounded theory starts with questions or the collection of data.
  • Grounded theory research helps the nurses to understand and develop real-world knowledge about health.
  • It seeks theory that is comparable with the evidence.

 

  1. Case study research –

  • A case study research methodology that is commonly used in social science.
  • A case study is based on an in-depth investigation of a group, event or single individual to find out the cause of the underlying theories.

 

  1. Historical research – 

  • The meaning of historical research studies of past events in an attempt to effects and causes of events, and their effects in current events.
  • Historical research in which critical inquiry of the past events and produce an accurate description and interpretation of those events.

 

2.  Quantitative research

  • Quantitative research is a statistical research in which numerical data should be collected for assessment.
  • Quantitative research uses statistical, computational and mathematical tools to derive the results.
  • Quantitative research includes objective data that is concerned with tight control over the research situation and the ability to generalize findings.

 

  1. True experimental research –

  • In experimental research a researcher actively introduces the intervention or treatment.
  • Experimental studies are explicitly designed to test causal relationships.
  • True experimental research emphasizes the interval validity.

 

  1. Quasi-experimental research –

  • Quasi-experimental research essential to manipulate an independent variable without the random assignment of participants to condition.
  • The quasi experimental research schedule does not randomly assign participants to treatment or control groups for comparison.

 

  1. Non experimental research –

  • Lack of the manipulation of an independent variable in non-experimental Research and random assignment of participants to conditions or orders of condition or both.

 

  1. Descriptive research –

  • Descriptive research is responsible for describing the characteristics of the population phenomenon that is being studied.

 

  1. Exploratory research –

  • Exploratory research is unstructured and informal research that is conducted to clarify and define the nature of a problem.

 

  1. Cor- relational research –

  • Research is helpful to determine the relationship among 2 or more variables without any attempt to influence them.

 

Difference between quantitative and qualitative research

 

S.N   Qualitative research Quantitative research
1. Subjective data Objective data
2. Small sample size Large sample size
3. Flexible and emerging design Structured and predetermined designed
4. Whole is greater than part Parts are equal to whole
5. Inductive analysis Deductive analysis
6. Understandable research Predictable research
7. Data are not countable and measurable Data are countable and    measurable
8. Multiple truth One truth
9. Result presented as narrated data++ Result presented as statistics data
10 Data collection by interview, observation etc. Data collection by questionnaire, scales, tests, etc.

3.   Basic research

Basic research is pure Research and fundamental research.

Basic research conduct without specific purpose.

It is the aim to improve scientific theories for improved understanding for prediction of natural or other phenomena.

Basic research generally carried out by universities.

Basic research is motivated by a scientist’s curiosity or interest in scientific questions.

 

4.  Applied research

applied research based on functional purpose and practical uses.

The aim of applied research is to search for a solution for an immediate problem facing a society.

Applied research is methodology that is used to solve specific and practical issues that are affected by the individual or group.

 

Difference between basic and applied research

S.N Basic research Applied research
1. Seek generalization Study specific cases without the purpose of generalization
2. Wider scope More specific scope
3. Report in technical language Report in common language
4. Explain ” why ” things happen Explain ” How ” things can be changed
5. Curiosity driven Client driven
6. Less connected with the economy Highly connected with economic pursuits

 

Importance of nursing research

Nursing research is very important for the nurse to understand the various dimensions of the professions.

Research helps in the nursing profession to define the role of nurses.

Help to generate information regarding nursing careers.

Research is an essential tool for continuous development of nursing knowledge.

Nursing research helps to know about particular nursing situations.

Nursing research provides advanced technology in the health sector.

Nursing research helps in easing the services of Nursing.

Help to evaluate all nursing services.

To allow the nurses to make more informed decisions at each stage of the nursing process.

To provide the facility in the nursing practice and clarify the role of nurses in the healthcare delivery system.

To provide the effective and low-cost healthcare services.

Help in promotion of patient and nurse relationships.

To control the undesired outcomes.

 

Scope and areas of nursing research

Research in nursing practice.

Research in nursing education.

Research in nursing administration.

Health system and outcome care.

 

Research in nursing practice

Nursing research helps to evaluate the nursing experience and intervention for health promotion, prevention of illness and individual, family and community care in diverse settings.

To improve the quality of care.

To improve the quality of life.

To manage cardio-pulmonary critical illness.

To conduct the National health programmes.

To evaluate the success of community health Care.

 

Research in nursing education

To provide a skilled nursing education.

Research on teaching in the clinical setting.

To develop and evaluate the efficient educational techniques.

To identify the new method of education.

To develop learning skills of students through technology.

 

Research in Nursing Administration

To encounter the several problems and issues that require solutions.

To study nursing records.

Study of the hospital information system.

Manpower utilization study.

 

Research in health system and outcome care

To develop the cost-effective model of healthcare for rural and deprived communities.

 

Steps of the research process

Identification of research problem

↓

purpose of the study

↓

literature of review

↓

formulation of objective

↓

determine Research design

↓

Collection of data

↓

Analysis of data

↓

Analyse and evolution the information

↓

Execution of project

↓

analysis and interpretation

↓

Prepare and present the final Research report

↓

Communicate the research results.

 

Identification of research problems – The research problem is explained through a process from identifying a general area of interest for a particular subject.

Identify the importance of research problems in terms of contribution to the patient, society and nursing profession.

Purpose of the study – The purpose of this research is what researchers have to achieve with research.

 

Literature of review – Literature of review is helpful to develop the strong knowledge to carry out the research in the education and practice setting.

Literature of review provides a method of investigation already studied in relation to the proposed study.

It is also helpful to identify the variables that may influence research.

 

Formulation of objective – The object is the goal, you set to achieve in your studies.

Object informs a reader what you want to achieve through study.

Objectives are – main objectives

Subject objectives.

Determine Research design – Research design is a Blueprint that describes how to study and how to analyse it.

Generally, Research design based on the review of literature and theoretical framework.

 

Data collection – The researcher put the Research design into the action and collected data.

Data should be collected in an ideal way, it means reliable, accurate and unbiased data collection.

 

Data analysis

Before the data analysis, data should be collected in the quantitative research.

Statistical analysis fails to summarise, organise and reduce the data.

Descriptive analysis is useful to explain the specific characteristics of the data.

 

Analyse and evaluate the information

  • Collect all the information related to the topic and discard those not related to the topic.
  • Analysis and interpretations – Analysis and interpretations are helpful to summaries the collected data and provide the answer to the questions that triggered while research.
  •  

Prepare and present the final Research report

Prepare research completely and communicate research results through conferences, seminars, journals, reports, and verbally.

Nursing research Notes pdf

Introduction of Nursing Research.pdf
Problem Solving Nursing Research.pdf
Problem Solving Process.pdf
Introduction of Nursing Research.pdfDownload
Problem Solving Nursing Research.pdfDownload
Problem Solving Process.pdfDownload
Research Problem.pdfDownload
Review of Literature.pdfDownload
Scientific Method of Research.pdfDownload

Constipation Drugs

by
Constipation Drugs

Constipation Drugs

  • Constipation occur when stool becomes hard and difficult to pass.
  • Common cause of constipation are – inadequate fluid intake, food habits, immobility, medication and endocrine or metabolic disorders etc.

 

Constipation drugs Classification

  • Purgative (cathartics)
  • Laxatives (aperient)
  • Laxative drugs cause the mild action and eliminate of soft and formed stool.
  • Purgative drugs cause the strong action, resulting in more fluid evacuation.

 

  1. Bulk forming laxatives drugs

  • Methylcellulose
  • Dietary fibers – like – fruits, oats, etc.
  • Isapghulla – 3 – 12 gm – The drug swell and softens the stool.

 

  1. Stimulant purgatives

The drug irritate GI mucosa

↓

Increase secretion and motility of stool

↓

To promote bowel evacuation

 

  • Bisacodil – 5 mg.
  • Glycerol
  • Sinna (plants leaves)
  • Danthron

 

  1. Stool softness 

  • Docusate sodium – 100 – 400 mg.
  • Liquid paraffin (mineral oil) 15 – 30 ml.

 

  1. Osmotic purgatives

  • Lactolose – in children = 5 – 30 ml
    • In adult = 5 – 30 ml.

 

Lactolus retain water in intestinal lumen

↓

Increase bulk of the stool and increase the peristalsis

↓

Evacuation of stool

Constipation drug indication

  • Constipation
  • Pregnancy
  • Drug-induced constipation
  • Bedridden patient
  • Immobilized patient (paralysis patient)
  • Food and drug poisoning
  • Colonoscopy and radioscopy procedure
  • Post-operative patient.

 

 

Constipation drug Adverse effects 

    • GI irritation, dehydration
    • Rectal burning sensation
    • Bloating, cramping, diarrhea
    • Thirst, electrolyte imbalance, etc.

 

Constipation drugs Key Points–

  1. Antimotility drugs is a – Opioid drug
  2. Most commonly used antimotility drug – Loperamide
  3. Common constipation drugs is – Purgative and Laxatives.

Antidiuretic Drugs

by
Antidiuretic Drugs

what are antidiuretic drugs

  • It is a substance that inhibits water excretion without affecting the sodium excretion.
  • The drugs are useful to reduce the urine output.
  • The drugs mostly used in the diabetes insipidus.
  • Antidiuretic hormone (ADH) is secret from the posterior pituitary gland.
  • ADH hormone water reabsorption from distal and collecting tubules, and reduced urine output.
  • ADH is stimulated due to increased plasma osmolarity contraction of extracellular fluid volume.
  • ADH consists of the V1 and V2 receptors.

 

Antidiuretics drugs Classification –

  • Antidiuretic hormone – Desmopressin and vasopressin.
  • Thiazide diuretics – Amiloride.
  • Indomethacin, carbamazepine, chlorpropamide.

  1. what is vasopressin hormone?

Vasopressin acts on a V1 receptor of ADH that leads to blood vessel contraction and increases arterial pressure.

Vasopressin also acts on V2 receptors and leads to fluid reabsorption in the renal tubules and increases the water permeability, that result is decreased urine formation.

Vasopressin uses

  • Diabetic insipidus (DI)
  • Bleeding oesophageal varices
  • Hypotension and shock
  • Abdominal distension
  • Before abdominal radiography.

 

Vasopressin adverse effects

  • Water intoxication
  • Hyponatremia
  • Increase specific gravity of urine.

 

  1. Desmopressin –

  •  It is a synthetic analog of vasopressin, which is work on the V2 receptor.
  • Desmopressin acts on the CD cells.
  • Desmopressin is a man-made form of vasopressin.
  • Desmopressin causes the antidiuretic effect that increases water reabsorption, and decreases water excretion.

 

Uses of Desmopressin –

  • Nocturnal enuresis
  • To prevent dehydration
  • Diabetes insipidus
  • Hemophilia – A
  • Von Willebrand disease.

desmopressin dose –

  •  10 – 40 mg / day in adults.
  • 5 – 10 mcg / H. S. in children.

desmopressin Adverse effects –

  • Congestion, nasal irritation, epistaxis, hyponatremia etc.
  1. Thiazide (HCTZ) – Use to increase the tubular reabsorption in the.
  • It is useful in both neurogenic and nephrogenic DI.
  1. Amiloride – It is a drug of choice (DOC) of lithium-induced nephrogenic DI.
  1. Indomethacin – Use as an antidiuretic, and treat the nephrogenic DI and nephrotic syndrome.
  1. Carbamazepine – It is used in the neurogenic DI.

desmopressin Key points

  1. Which drug is useful to decrease the urine output – Antidiuretic
  2. Normal urine output – 1.5 liter / day
  3. Normal GFR in a healthy person – 180 liter/day
  4. Antidiuretic hormone secret from the – Posterior pituitary gland

Antihypertensive drugs Classification

by
Antihypertensive drugs Classification

What is Hypertension

  • Hypertension is the most common health disorder in the middle age group.
  • Hypertension is the most important risk factor for cardiovascular mortality and morbidity.
  • Hypertension means ‘ elevated blood pressure of more than 140/90 mm of Hg in the body.
  • Normal blood pressure – 120/80 mm of Hg.
  • Antihypertensive drugs are used to treat hypertension.

 

Hypertension classification

  • Prehypertension

= systolic BP = 120 – 139 mmHg.

= Diastolic BP= 80 – 89 mmHg.

  • Stage 1 hypertension

= Systolic = 140 – 159 mmHg.

= Diastolic = 90 – 99 mmHg.

  • Stage 2 hypertension

= Systolic = above 160 mmHg.

= Diastolic = above 100 mmHg.

  • Emergency hypertension

= Systolic = above 180 mmHg.

= Diastolic = above 120 mmHg.

  • Isolated systolic hypertension

= systolic = 140 and above

= Diastolic = below 90 mmHg.

 

  1. Primary hypertension-

It is idiopathic hypertension and the most common hypertension.

  1. Secondary hypertension – 

Occur due to disease condition.

Antihypertensive drugs Classification:-

  • Classification of antihypertensive drugs
  • Blood pressure is controlled by the anatomic nervous system renin-angiotensin – Aldosterone system.
  • The hypertensive drugs act on the heart, kidney, and blood vessels by influencing these systems.
  • Hypertensive drugs are
  1.  Beta-blockers.
  2. Alpha-blockers.
  3. Alpha and beta blockers
  4. Calcium channel blockers
  5. Central sympatholytic
  6. Vasodilators
  7.  Diuretics
  8. ACE inhibitors
  9. Angiotensin receptor blockers (ARB – inhibitors).

 

  1. Beta blockers –

  • It is a beta-adrenergic blocking agent that causes vasoconstriction in the blood vessels.
  • Beta-blocker drugs prevent the stimulation of beta-adrenergic receptors of the sympathetic nervous system and decrease cardiac output and lead to low blood pressure.
  • Drugs – Atenolol, timolol, metoprolol, propranolol, betaxolol, etc.
  • Dose – 25 – 100 mg.

Uses of Beta Blocker

  • To treat mild hypertension.
  • Arrhythmia.
  • Angina pectoris.
  • Chest pain and heart attack.
  • Glaucoma.
  • Myocardial infarction.

Contradiction of Beta Blocker

  • Asthma, COPD
  • Bradycardia and cardiogenic shock
  • Peripheral vascular disease
  • Prinzmetal angina, heart block.

Adverse effects of Beta Blocker

  • Orthostatic hypotension,
  • fatigue, nausea and vomiting,
  • bradycardia etc.

 

  1. Alpha-blockers 

It is an adrenoceptor antagonist which prevents the stimulation of the adrenergic receptors and leads to decreased blood pressure.

Alpha bocker Drugs

  • Doxazosin
  • Prazosin
  • Terazosin
  • Alpha blocker drugs cause the blood vessels dilation there by lowering blood pressure.

Uses of alpha blocker

  • Hypertension
  • Benign prostatic hyperplasia
  • Congestive heart failure
  • Pheochromocytoma.

Contraindication of alpha blocker

  • Hypersensitivity, hypotension
  • Pregnancy, lactation.

 

  1. Alpha beta blockers

  • The combined drugs are used to treat high blood pressure.
  • The drug causes vasodilation and decreases cardiac output.
  • Drug – Labetalol 50 mg BD.

 

  1. Calcium channel blockers –

It is a calcium channel antagonist that interferes in the movement of calcium through calcium channels.

  • The drug is used to treat hypertension.

Calcium channel blocker Mechanism of action-

Calcium channel blocker drugs

↓

Block the entry of calcium ions into calcium channels

↓

Reduce intracellular calcium ions

↓

Relax vascular smooth muscles

↓

Vasodilation

↓

Decrease blood pressure.

 

  • Calcium channel blocker Drugs

    • Amlodipine – 5 -10 mg OD
    • Nifedipine – 5 – 20 mg orally OD
    • Verapamil – 40 – 160 mg
    • Diltiazem – 30 – 60 mg.

 

  • Amlodipine and nifedipine drugs decrease the main arterial pressure and increase the heart rate.
  • Diltiazem and verapamil drugs depress the SA node and decrease the heart rate.

 

Calcium channel blocker drug uses 

  • Hypertension
  • Angina
  • Arrhythmia

Calcium channel blocker Adverse effects

  • Ankle edema, nausea, constipation.
  • Hypotension, drowsiness, headache.
  • Palpitation

 

  1. Vasodilators drugs-

Vasodilators drugs Mechanism of action

Vasodilators drugs

↓

Relax the vascular smooth muscles

↓

Vasodilation

↓

Decrease blood pressure.

 

  • Vasodilators drug name-

  • Hydralazine – 25 – 50 mg TDS.
  • Minoxidil.
  • These drugs are directly worked on the vessel walls.
  • Adverse effect – Rapid heartbeat, nausea or vomiting, edema, headache, hirsutism etc.

 

  1. Central sympatholytic drugs

Central sympatholytics drugs

↓

Stimulate the A2 adrenergic receptor in the brain stem center

↓

Decrease the sympathetic nerve activity and outflow

↓

Decrease blood pressure.

 

  • Drugs–
  • Clonidine (Catapres) – 100 ug OD.
  • Methyldopa (Aldomet) – 250 – 500 mg TDS.
  • Methyldopa is a drug of choice of hypertension during pregnancy.

  1. Diuretics drugs – 

The drugs are responsible for increasing urine output.

  • Drugs are
  • High efficacy drug = furosemide – 20 – 80 mg.
  • Medium efficacy drug = hydrochlorothiazide drug

= Thiazide-like drugs.

  • Low efficacy drug = spironolactone – 25 – 50 mg.

 

diuretics drug Mechanism of action –

Diuretics drugs

↓

Increase the urine output

↓

Decrease the extracellular fluid and plasma volume

↓

Decrease cardiac output

↓

Decrease blood pressure.

 

Uses Diuretics drugs

  • Hypertension
  • Edema and congestive heart failure.
  • Acute pulmonary edema.
  • Renal disease and liver cirrhosis.
  • Glaucoma.

 

Contraindication of Diuretics drugs

  • Gout disorder
  • Diabetes patient
  • Pregnant mother
  • Dehydrated patient.

 

Side effects of Diuretics drugs 

  • hypokalaemia
  • hyperglycemia
  • vertigo etc.

 

  1. ACE inhibitors –

  2. It is an angiotensin-converting enzyme inhibitor, which is used to treat high blood pressure and heart failure.

ACE inhibitor Mechanism of action

ACE inhibitor drugs

↓

Angiotensin – 1st is not converting into angiotensin – 2nd

↓

Decreased production of angiotensin – 2nd

↓

Decrease the sodium and water retention

↓

Cause the vasodilation

↵

  • Decrease blood volume
  • Decrease blood pressure
  • Decrease sympathetic activity
  • Decrease ventricular preload and afterload
  • Inhibit vascular and cardiac hypertrophy.

 

ACE inhibitor Drugs

  1. Captopril – 25 – 150 mg
  2. Lisinopril – 5 – 40 mg
  3. Enalapril – 2.5 – 40 mg
  4. Ramipril- 1.25 – 10 mg.

Uses of ACE inhibitor-

  • Hypertension
  • Congestive heart failure (CHF)
  • Myocardial infarction (MI)
  • Diabetic nephropathy
  • Treat high cardiovascular risk patients.

 

Contraindication of ACE inhibitor-

  • Pregnancy
  • Renal artery stenosis
  • Azotaemia
  • Hypotension
  • Hyperkalaemia patient
  • Severe stenosis of aortic and mitral valve
  • History of allergy.

 

ACE inhibitor Adverse effects

  • Hypotension, urticaria, cough
  • Rashes, angioedema, hyperkalemia
  • Proteinuria, taste change, leukopenia etc.

 

  1. ARB inhibitors –

  • Angiotensin receptor blocker drug.
  • It has a similar effect as ACE inhibitors.
  • The drug blocks the effect of angiotensin 2nd.
  • The ARB inhibitor drug is prescribed if the patient cannot tolerate the ACE inhibitor drugs.

ARB inhibitors Mechanism of action-

ARB inhibitors drugs

↓

To inhibit the action of angiotensin 2

↓

Decrease sodium and water retention

↓

Vasodilation

↓

Decrease blood pressure.

ARB inhibitors Drugs 

Atacand (Candesartan) – 8mg.

Cozaar (losartan) – 25 – 50 mg.

Micardis (Telmisartan) – 20 – 80 mg.

Diovan (Valsartan) – 80 – 160 mg.

Benicar (olmesartan) – 20 – 40 mg.

 

ARB inhibitors Use- 

  • Hypertension, congestive heart failure (CHF)
  • Myocardial infarction (MI)
  • Diabetic nephropathy.

 

ARB inhibitors Adverse effects

  • Hyperkalaemia, hypotension, fainting
  • Dizziness, fatigue, vomiting, diarrhoea
  • Angioedema, back pain, etc.

 

Key points

  • what is The most common hypertension is a – Primary hypertension
  • Secondary hypertension occurs due to – Disease conditions
  • Which system controls the blood pressure? – Autonomic nervous system
  • Alpha and beta blockers combined drug is – Labetalol
  • Drug of choice for pregnancy-induced hypertension – Methyldopa
  • ACE inhibitor drug full form? – Angiotensin-converting enzymes
  • ACE inhibitor drugs cause the – Decreased production of angiotensin 2nd
  • Which hypertensive drugs are contraindicated in pregnancy? – ACE inhibitors
  • ARB inhibitor drug full form – Angiotensin receptor blocker drug

dmms nursing coaching notes pdf

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dmms nursing coaching notes pdf

Hello Dear Nursing Student. If you are preparing for a competitive nursing exam preparation. Like NORCET, DSSSB, RRB, JIPMER, CHO, and any other State nursing preparation. Missionnursing helps you to provide the best nursing coaching institute in the nursing field The DMMS Medical And Nursing Academy.

DMMS Medical And Nursing Academy

DMMS is one of the best nursing coaching institutes in Jaipur. DMMS Coaching provides full support during and after the coaching period. DMMS provides the best teaching experiences and knowledge classes. DMMS has no official notes provided. During and after the coaching time. all notes Students self-prepared notes. So all Notes are demo notes and some self-hand-writing notes are available below.

DMMS Director:- Shri Naval Kishor Sharma

Facilities are available in DMMS:-

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  • Exclusive Study material
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  • Systematic teaching method with anatomical graphs, charts, pictures, and video, all class on the projector.
  • All Classrooms are fully air-conditioned (AC) And fire Safety equipment is also installed in every classroom.
  • Mock Test and Pree Competitive Exams and After exams Discussion session.

All pdf materials are available on the internet. we also collect the pdf in different ways. all pdf provide free of cost. This PDF collection helps poor medical students.

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  1. All DMMS Notes are easy to read.
  2. DMMS Nursing Academy Notes are multilanguage like Hindi and Engish. 
  3. no Notes Extra Charges.

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    Peptic Ulcer Drugs Types uses and Side effects

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    Peptic Ulcer Drugs Types uses and Side effects

    Peptic Ulcer Drugs Types uses and Side effects

    • Peptic ulcer, a lesion or sore develops on the lining of the GI tract, including – the oesophagus, stomach or small intestine.
    • Peptic ulcers occur due to an imbalance between the secretion of acid, pepsin, bile and gastric mucosal defence.
    • An ulcer found in the stomach is called a gastric ulcer and an ulcer found in the duodenum is called a duodenal ulcer.
    • Gastric ulcer cause pain after meals and duodenal ulcer pain relieve after meals.

    Peptic ulcer drugs

    1. To reduce gastric acid secretion

      1. H2 – blockers drugs – H2 – blockers drugs taken empty stomach at night to treat peptic ulcer.

    To block the action of the H2 receptor and prevent the action of histamine on parietal cell

    ↓

    To reduce the gastric secretion

    ↓

    Also reduce the pepsin activity

    ↓

    Peptic ulcer healing is faster.

    Peptic ulcer Drugs are 

    • Ranitidine – 150 – 300 mg tablet (Rantac).
    • Cimetidine – 200 mg.
    • Famotidine – 20 – 40 mg.
    • Roxatidine – 75 – 150 mg.

    Uses 

    • Duodenal and gastric ulcer
    • Gastroesophageal reflux disorder
    • Stress ulcer.

    1. Proton pump inhibitors – 

    The drugs are more potent inhibitors of acid secretion in the stomach. It is a more effective and more usable drug that is taken one hour before the meal.

    Proton pump inhibitors Mechanism of action

    Proton pump inhibitors drug

    ↓

    Block the H+, K+ ATPase pump

    ↓

    Inhibit the gastric acid secretion.

    • Drugs
      • Omeprazole – 20 – 40 mg capsule / injection.
      • Pantoprazole – 40 mg.
      • Esomeprazole – 20 – 40 mg.
      • Lansoprazole – 15 – 20 mg.
      • Rabeprazole
      • Dexlansoprazole.
    • Uses
    • Gastric ulcer and duodenal ulcer.
    • Gastroesophageal reflux disorder (GERD)
    • Stress ulcer
    • Zollinger – Elinson syndrome (Z – E syndrome).

    1. Prostaglandin analogue 

    • Misoprostol – 200 ug.
    1. Anticholinergic drugs – It is a selective M1 receptor blocker.
    • The drug block the gastric M1 receptors and inhibits the gastric secretion.
    • Drugs
    • Pirenzepin – 100 – 150 mg.
    • Propantheline – 15 – 30 mg.
    • Telsnzepine.

    2.   To neutralize the gastric acids

    • Antacids – Antacids is a chemical substance which is react with gastric acid and inhibit the gastric contents activities.
    • It is an insoluble substance, that useful to relieve pain and treat peptic ulcer.
    • Mechanism of action – It neutralizes the gastric acid and inhibit the gastric acid secretion.

    Drugs 

    • Systemic drug – Sodium bicarbonate drug.
    • 1 – 5 gm orally.

    Non-systemic drug 

    • Aluminium hydroxide – up to 1 gm.
    • Magnesium hydroxide – 0.5 – 1 gm.
    • Calcium carbonate – up to 1.5 gm orally.
    • Magnesium carbonate – 250 – 500 gm orally.
    • Uses
    • Gastric and duodenal ulcer.
    • Indigestion, gastritis, heartburn.
    • Peptic ulcer pain and burning.
    • Adverse effects
    • Constipation, hypermagnesemia, diarrhoea
    • Hyperphosphatemia, alkalosis.

    3.  Anti H – pylori Drugs – Helicobacter pylori is a Gram negative bacteria, and most common cause of peptic ulcer.

    • The drug take empty stomach.
    • Drugs
    • Amoxicillin
    • Clarithromycin
    • Bismuth subsalicylate
    • Metronidazole
    • Tetracycline

    Key Points

    1. A lesion or sore develops in the lining of GI tract – Peptic ulcer
    2. Which peptic ulcer causes pain after meals – Gastric ulcer
    3. Which drug is useful to neutralize the gastric acid – Antacids
    4. Most common cause of peptic ulcer – H. Pylori

    what is Pharmacokinetics

    by
    what is Pharmacokinetics

    what is the Pharmacokinetics

    Pharmacokinetics 

    • Pharmacokinetics is a quantitative study of the drug movement, and it includes the response of the body to drugs.
    • The pharmacokinetics involve
    • Absorption
    • Distribution
    • Metabolism
    • Excretion
    • All of these processes involve the transport of drugs across the biological membrane.

    Biological membrane- 

    It is a cell membrane or bilayer of a phospholipid, about 100 Å thick.

    • The biological membrane is made up of cholesterol, phospholipid, and a small amount of carbohydrates.
    • Lipid soluble substances easily cross the biological membrane and restrict the transportation of water-soluble substances.
    • The drug transport the biological membrane by
    1. Passive diffusion
    2. Filtration
    3. Specialized transport.

     

    1. Passive diffusions – Mostly drugs are absorbed by the passive diffusion in which drugs cross the biological membrane from high concentration to low concentration.
    • Use of energy is not required in this process.
    • Lipid soluble drugs diffused through the membrane are called passive diffusions.

     

    1. Filtration – Water soluble drugs are filtered through aqueous pores in the membrane from high concentration to low concentration, is called filtration.

     

    1. Specialized transport
      1. Carrier transport – The drug is combined with a carrier that is present in the membrane, and transported from one side to another side of the membrane.

    Carrier transport include (types of Carrier transport)

    • Active transport
    • Facilitated diffusion

     

    1. Active transport 
    • The movement of drugs against the concentration gradient.
    • It is divided into primary and secondary active transport.

     

    • In primary active transport, substances move low to high concentration, so require energy.
    • In the second active transport, one substance moves low to high concentration and another substance moves high to low concentration.
    • If both substances move in the same direction, it is called symport.
    • If both substances move in the opposite direction it is called antiport.
    1. Facilitated diffusion – The drugs move from high to low, so no need of energy.

     

    1. Pinocytosis – The protein nature substances are uptake by the cells in the form of vacuoles.

     

    Drug Absorption

    • The meaning of absorption, the movement of drug from its site of administration in the bloodstream.
    • Factors that affect the drug absorption
    1. Aqueous solubility – When a drug is taken through the oral route, it is available for absorption only after dissolution.
    • More aqueous solubility has fast dissolution.
    1. Concentration – High concentrations of drugs have fast absorption.
    2. Solubility – The lipid-soluble drugs are absorbed faster.
    3. Area of absorbing surface – Large surface areas have faster absorption.

    eg:- intestine is large surface area, so allows fast and more absorption, the stomach is less surface area, so allows slow and less absorption.

     

    1. Route of drug administration –

    • Drug absorption is also affected by the route of drug administration.
    • Lipid soluble or nonpolar drugs are absorbed orally and enter the cell.
    • Water soluble or polar drugs are not absorbed orally and do not enter the cell.

     

    1. Vascularity – High vascular area allows fast absorption. Eg:- muscles.
    • Less vascular area allowed the slow absorption.

    eg:- subcutaneous tissue.

     

    1. Drug ionization – Unionized are the lipid soluble drugs, so well absorbed, and ionised drugs are less absorbed.

     

    Drug Distribution

    • After absorption, the drug enters the bloodstream and gets distributed to the various fluid compartments.
    • Eg:- intestinal fluid and plasma compartment, CSF, cellular fluid, transcellular fluid, etc.
    • Each drug is distributed throughout the body tissue.

     

    Factors that affect the drug distribution process are

    • Lipid solubility of drugs.
    • Ionization of physiological PH
    • Plasma protein binding
    • Some diseases like cirrhosis, uremia, and CHF.
    • Regional blood flow difference.

     

    The volume of drug distribution (Vd)

    Vd = Dose administer through Iv route / plasma concentration.

    • If the volume of distribution is increased, when less concentration of plasma.
    • If high concentrations of plasma conduct less volume of distribution.

     

    Re-Distribution of Drugs

    When highly lipid-soluble drug administration through the IV route

    ↓

    Firstly drugs is distributed in the high vascular body organs like – the heart, brain, kidney, etc.

    ↓

    High concentration of drug

    ↓

    Laterly drug is redistributed to the less vascular body organs like muscles and fat.

    ↓

    Decrease the concentration of drugs in the blood.

    ↓

    The drug takes from the high vascular tissue

    ↓

    Decrease concentration

     

    The barrier to Drug Distribution

    • The blood-brain barrier (BBBr)
    • Placental barrier
    • Blood, CSF.
    • Only lipid-soluble drugs can cross the blood-brain barrier and restrict the water-soluble drug.
    • The placental barrier allowed the lipid-soluble drug only.
    • P-gaps are present in the placenta, so the placental barrier is incomplete, if there is a high amount of water-soluble drug for a long time, and then they also cross the placental barrier.

     

    Plasma protein binding 

    • The drugs are bound with the plasma protein (Albumin or Alpha1 – acid glycoprotein).
    • Plasma protein binding of drugs is dependent upon the nature of drugs. Eg:- diclofenac = 99% plasma binding

    Lithium = 0% plasma binding.

     

    • Acidic drugs bind with albumin protein and alkaline drugs bind with Alpha1 – acid glycoprotein.

    eg:- Beta-blockers drug is – alkaline drug.

    NSAID drug is – Acidic drug.

    • Plasma protein binding acts as a temporary storage of the drug.
    • Plasma protein bind drugs are not available for distribution, metabolism and excretion.

     

    Drug displacement 

    • Drug displacement causes the drug toxicity.
    • When 2 drugs are bound with the same plasma protein on the same side.
    • A drug displaced to another drug and causes the free concentration of the drug in the blood and causes toxicity.

     

    Tissue storage

    • The storage of drugs in the specific tissue, which is based on active transport on continuous use.
    • It is the cause of the toxicity.
    • Eg:- Iodine drug storage in thyroid gland and tetracycline drug store in bone and teeths.

     

    Drug Metabolism (Biotransformation)

    • It is a chemical alteration of the drug in the body.
    • The metabolism process of the drug converts the non-polar (Lipid soluble drug) into polar (Water soluble drug), to make the drug suitable for excretion.
    • Many sites of the body, which take the metabolism process, like – liver, kidney, plasma, lungs etc.
    • Mainly the metabolism process done in the liver.
    • Biotransformation is a chemical alteration of a drug inside the body.
    • The metabolism chemical reaction is done in the presence of enzymes (Microsomal and non-microsomal).
    • Microsomal enzymes are stimulated by drugs, smoke, barbeque etc.
    • Both enzymes are absent in the new-born.
    • Biotransformation chemical reaction done into 2 phases

    Phases 1 – Non Synthetic reaction

    Phases 2 – synthetic reaction.

     

    • Phase 1 (Non-Synthetic reaction) functionalization reaction that converts the drug to a more polar metabolite through oxidation, reduction, and hydrolysis.
    • Phase 2 (synthetic reaction) is a conjugation reaction that is combined with sulphuric acid, glucuronic acid, glycine, acetylation, or methylation.

    Factors affecting the drug metabolism

    • Age and sex
    • Nutrition and diet
    • Disease condition
    • Genetic variation
    • Species.

     

    Drug Excretion 

    what is drug excretion

    • Excretion is a process, which passes out of the systemically absorbed through various channels are – urine, feces, saliva, sweat, milk, exhaled air, etc.
    • Excretion is an essential process to determine the duration of drug action and toxicity.

     

    1. Urine – The kidney is the most important organ for the excretion of drugs through urine, also known as renal excretion.
    • Renal excretion =

    = {Glomerular filtration + tubular secretion} – tubular reabsorption.

    • In the case of renal disorders, the kidney is unable to excrete drugs.
    • After the glomerular filtration, the ionising drugs are not reabsorbed – Excrete.
    • If unionizing drugs are 99% reabsorb and sent to the systemic circulation.

     

    1. Faces – Drugs are not absorbed in the GI tract that is excreted with faces.

    eg:- sulphaguanidine drug.

    • High molecular weight substance above 300, that is not easily excreted through urine, excrete via faces through the biliary excretion.

     

    1. Bile – Uncharged drug and their metabolic products are excreted with bile.
    2. Exhaled air – Some volatile gases are liquids that are excreted through the exhaled air.

    eg:- nitrous oxides.

    1. Milk – Generally lipid-soluble drugs are entered in breast milk.
    • Excretion of drugs through breast milk in small amounts.

    Eg:- tetracycline, anti-cancer, lithium, sulphonamide, etc.

    1. Saliva and sweat – It is a minor route of drug excretion.
    • Rifampicin drugs are excreted through sweat and tears.
    • Lithium, phenytoin, and metronidazole drugs are excreted through saliva.

     

    Key Points

    1. The study of drag movement is – Pharmacokinetics
    2. Which soluble substance crosses the biological membrane – Lipid soluble
    3. Lipid soluble drug diffused through the membrane is called – Passive diffusion
    4. Water soluble drug filters through pores in membranes are called – Filtration
    5. the movement of drugs against the concentration gradient – Active transport
    6. If drug distribution volume is increased when – Plasma concentration is low
    7. which type of drug crosses the blood-brain barrier – Lipid soluble drug
    8. which type of drug commonly crosses the placental barrier – Lipid soluble drug
    9. Diclofenac consists of plasma protein binding properties of about – 99%
    10. Lithium consists of plasma protein binding property – 0%
    11. Acidic drugs bind with the – Albumin protein
    12. Alkaline drugs bind with the – Alpha 1 acid glycoprotein
    13. The drug displacement process in the body causes the – Drug toxicity
    14. Metabolism of drugs in the body is called – Biotransformation
    15. Metabolism of drugs is a – Chemical alteration of drugs in the body

    If any quary related to this post please comment me.

    Comment for any type of correction and Updates in the Data.

    Read also …….

    Anatomy & Physiology Notes PDF

    Nursing Books PDF

    B.Sc Nursing Old Paper PDF

    Introduction of Pharmacology

    by
    Introduction of Pharmacology

    Introduction of Pharmacology

    • Pharmacology is the science of drugs (study of the drug).
    • Drug is a chemical product that provides useful therapeutic effects.
    • Before administration of drug, required knowledge about drug are
    • Mode of action
    • Toxicity and side effects
    • Route of drug administration
    • Drug doses
    • Drug interaction with other drugs.

    what is pharmacology?

    • The “pharmacology” word derived from the Greek word

    Pharmakon – Drugs

    Logos – Study.

    • It means pharmacology is a study of drugs.
    • Father of pharmacology – Oswald schmiedeberg.
    • Drugs are an important part of patient care.

     

    Pharmacology is divide into

    1. Pharmacodynamic
    2. Pharmacokinetics
    • Pharmacokinetic is derived from Greek word

    Pharmakon – Drug

    Kinetics – Movement

    • It means Pharmacokinetic is a study of the drug movements.
    • Pharmadynamic is derived from the Greek word

    Pharmakon – Drug

    Dynamics – power (effects)

    • It means pharmacodynamics study of the drug effects.

    what is pharmacology of a drug

    What is Drug? 

    • Drug is a chemical substance or active ingredient that is present in dose form that is used for prevention, cure, diagnosis and treatment of a disease.
    • French word of drug = Drogue (means – dry herb).
    • Greek word of drug = Pharmakon.
    • According to WHO – Drug is any substance or product that is used or intended to be used to modify or explore physiological systems or pathological states for the benefit of the recipient.

    what are the sources of drugs?

    Sources of drug – The drug is obtained from the plants, microbes, animals and mineral sources.

    1. Plants – Active constituents from the plants are divided into – Alkaloids, volatile oils, gums, glycosides, tannins resins etc.
    • Alkaloids – It contains cyclic nitrogen.

    eg :- Atropine drug – from atropa belladonna plant

    Morphine drug – from papaver somniferum plant

    Nicotine drug – from tobacco leaves

    Quinine drug – from cinchona bark plant.

    • Volatile oils – It is an essential oil containing the terpene hydrocarbon.
    • Used in the carminatives drugs, antiseptic solution, pain relieving agents, flavouring agents etc.
    • Gums – It is a secretory product of plants.

    Gums are chemically related with polysaccharides. Eg :- Gum acacia.

    • Glycosides – It is a combination of sugar with the other organic structure.

    eg :- digoxin drug is obtained from the leaves of digitalis purpurea.

    • Tannins – It is a non-nitrogenous phenolic derivative.

    Eg :- Astringents (Action on mucous membrane).

    • Resins – It is produced by the oxidation and polymerization of volatile oil that is insoluble in water.

    eg :- Asafoetida.

    1. Micro – organism source – Bacteria and fungi is an essential source of antibiotics other drugs are produced by other micro – organism.

    Eg :- Penicillin obtained from fungus penicillium chrysogenum.

    Streptokinase obtained from gram positive cocci.

    1. Animal source – Some drugs are obtained from the animals.

    Eg :- Vitamins, vaccine, hormones and sera.

    • Some drugs examples
    • Heparin from leech animal
    • Insulin from sheep or pig pancreas
    • Vitamin A from the liver of shark fish.

     

    1. Minerals source 

    Magnesium, iodine, aluminium, salt of iron, radioactive isotopes etc are minerals that are used to treat diseases.

    Eg :- sodium bicarbonate used to treat antacids.

     

    1. Human source – Some drugs are available from the human source.

    eg :- Growth hormone from pituitary gland.

    Immunoglobulin from – Blood.

    HCG hormone from – pregnant women.

    Urokinase from – human renal cells.

     

    Drug terminology

    1. Orphan drugs – That drugs are used for the rare disease.

    eg :- sodium nitrate – for cyanide poisoning.

    1. Toxicology – It is the study of the poisons effects of drugs and other chemicals.
    2. Chemotherapy – Treatment of systemic infection and neoplasm by the use of chemical agents, is called chemotherapy.
    3. Pharmacy – Pharmacy is a science of compounding and dispensing of drugs.
    4. Pharmacotherapeutic – It deals with the uses of drugs in the treatment and prevention of disease.
    5. Clinical pharmacology – It is the study of drugs in the human, that include the pharmacodynamic and pharmacokinetics.

    Drug nomenclature

    • Each drug has 3 types of names
    1. Chemical name
    2. Generic name or non-proprietary name
    3. Trade or brand name or proprietary name

     

    1. Chemical name – These names are given based on the chemical constitution of drugs.
    • Chemical names are difficult to learn, so they are not popular.
    • Eg :- acetylsalicylic acid.
    1. Generic name – It is a non-proprietary name.
    • The generic name of the drug is given by the United State adopted name council (VSAN).
    • Generic name is a salt name, the name is easy to remember.

    eg :- Aspirin.

    1. Brand or trade name – The name is given according to property of the drug manufacture.

    eg :- Disprin.

    Key Points

    1. French word of drug – Drogue
    2. Greek word of drug – Pharmakon
    3. Atropine drug is obtained from – Atropa belladonna plant
    4. Morphine drug is obtained from – Papaver somniferum plant
    5. Which microorganism is an essential source of antibiotics – Bacteria and fungi
    6. Which drugs are used for the rare disease – Orphan
    7. Study of the poisons effect of drugs – Toxicology
    8. Which drug is useful to treat cancer – Chemotherapy

    Route of drug administration

    Routes of drug administration

    • Drugs may be applied locally or systemically.
    • Route of drug administration depends upon the nature of the drug and the patient.

     

    Local Application

    ↓

    Drug retain in the Particular area, where is applied

    ↓

    Result – effect only a Particular area where systemically is applied

     

    Systemic application

    ↓

    The drug is absorbed systemically

    ↓

    Drug is circulate

    ↓

    Show the Systemic effect (In the whole body).

     

    Local route of drug administration – 

    This route can only be used for the localised action.

    • Local routes are – Topical, deeper tissue, arterial supply.

      1. Topical 

    • It is a simplest mode of drug administration, on the skin and mucous membrane, where the action of drug is localised to the area of application.
    • eg :- Lotion, cream, ointment, vaginal cream, jelly, gargles, nasal spray, eye ear or nose drop, mouth wash etc.

      1. Deeper tissue –

    • Some drugs are injected into deep tissues by use of needle syringes for the localisation.
      • eg :- intra articular injection
    • Lignocaine injection.

      1. Arterial supply 

    • Some drugs are injected into arteries for localised action.
      • eg :- anticancer drugs
      • Angiography.

     Systemic route of drug administration

    • Drugs absorb systemically and show systemic effects.

      1. Oral route – 

      2. Oral route is the most common and oldest method of drug administration.
    • The drug is ingestion through the oral cavity.
    • Oral route drugs are – Tablet, capsule, syrup, powder drug etc.
    • Advantage 
    • Most safest route
    • Easy to administer drug
    • The route allow to self-medication
    • No need of privacy and sterility
    • Most economical and convenient route
    • Painless route
    • No need for assistance to administer drugs.

     

    • Disadvantage
    • Not suitable for unconscious patients and if patients cause vomiting.
    • Not suitable in case of emergency because of slow effects.
    • Some drugs are not effective in the GI tract, because they are destroyed by gastric juice. Eg:- Insulin.

    1. Sublingual route – 

    2. In these routes, drugs are placed under the tongue.
    • These routes cause fast action of drugs so used in the emergency.
    • Only lipid soluble drugs are suitable for these routes.

    Eg :- Nitroglycerin drugs.

    1. Rectal route – 

    2. Some drugs are administered rectally, that are absorbed into the bloodstream and cause systemic effects.

    eg :- Suppositories, diazepam, indomethacin, enema.

    • Advantage

    • Used in vomiting patient
    • Avoid the gastric irritation
    • Administer the irritated and unpleasant drugs.
    • Disadvantage
    • Irregular, slow and unpredictable absorption of drugs.
    • Inconvenient route
    • Some irritating drugs cause inflammation.

    1. Nasal route – 

    2. Some drugs are placed in the nasal cavity that is absorbed by the mucous membrane of the nose. Eg :- Desmopressin.

    1. Inhalation route – 

    2. Some drugs are administered with inspiration. Volatile liquids and gases are administered through inhalation.

    eg :- general anaesthetics drug – Nitrous oxide.

    •  The drugs are administered through actively and passively.
    • The drug inhales actively through rotacap and metered dose inhaler (MDI).
    • Drugs inhale passively through nebulization.
    1. Cutaneous route – Drugs are applied on the skin, in the form of adhesive patch.
    • These routes use highly lipid soluble drugs.

    eg :- pantanil 200 mg (as an analgesic).

    1. Parenteral route
    • The route is administration of drugs by use of injection directly into the blood, or tissue fluid without crossing the intestinal mucosa.
    • The parenteral means

    Par = beyond

    Enteral = intestinal.

    • The route is suitable for unconscious or uncooperative patients, and causes rapid action.

    • Advantage

    • Small dose is more efficient.
    • Useful in the emergency situation.
    • Provide the accurate drug concentration.
    • Large volumes of drugs are increased for a longer period.

    • Disadvantage 

    • Self-medication is difficult.
    • Less safe and inconvenient.
    • It is a more expensive route, and painful.
    • The route requires strict aseptic measures.
    • Parenteral routes are – IM, IV, subcutaneous, ID.
    1. Intramuscular (IM) route – Some drugs are injected in the large skeletal muscles.

    eg :- deltoid, gluteus maximus, triceps, and rectus femoris muscles.

    • IM route is the most common parenteral route.
    • 2 ml drug injection in deltoid muscles and 5 ml drug in gluteus Maximus muscles by injection.
    • IM route is a high vascular route compared to subcutaneous route.
    • Mild to moderate irritable drugs can be injected in these routes.
    • Anticoagulant drugs are avoided in IM routes because they cause hematoma.
    1. Intravenous route – In these routes, drugs are directly injected into a vein.
    • No drug limit of administration.
    • Clear emulsion solution should be administered.
    • IV fluid administered into 2 forms – Bolus and infusion.
    • Fast single time push the IV fluid by needle and syringe, is called bolus.
    • Infusion maintains the constant plasma level of the drug.
    • IV infusion done into small amounts and large amounts.
    • Small volume of IV fluid up to 100 ml and large volume include 1000 ml.
    • Highly irritating drugs can be administered in these routes.
    1. Intradermal – Injection is inserted into the dermis layer for drug administration.
    • The route is useful for vaccination and allergic sensitive test (AST).
    • The route allows – 0.1 ml only.
    1. Subcutaneous – The drugs are injected into the subcutaneous tissue of skin.

    eg :- insulin injection.

    • Amount of drug – up to 1 ml.
    • Angle – 15 – 45° and use the 26 – 30 G needle size.
    • The route is self-injectable, because deep penetration is not required.

    eg :- adrenaline, lignocaine, Morphine, insulin.

    Principle of drug administration

    8 principles of drug administration

    • Nurses are accountable for the safe administration of drugs.
    • Nurses follow the right of drug administration.
    • Five right of drug are
    • Right patient
    • Right dose
    • Right time
    • Right route
    • Right drug.

    Drug doses forms 

    • Drugs are designed, based upon the route of drug administration.
    • Drugs are usually divided into solid and liquid forms.
    • Solid forms of drug include – capsule, granules, tablets, suppositories, powders, insufflations etc.
    • Semi solid forms of drug include – drops, gel, syrups, emulsions, enema, creams, tinctures, lotions, ointment, paints, paste, gargles, mouthwash, mixtures etc.
    • Inhalation form of drug is – sprays, aerosols, nebulizers, inhalants, spacers etc.

    Tablets form of drugs are – Tablets are different according to shape, size and uses.

    • Soluble tablet
    • Film coated tablet
    • Uncoated tablet
    • Enteric coated tablet
    • Sublingual tablets
    • Chewable tablet
    • Scored tablet
    • Retard tablet
    • Sugar coated tablets
    • Implants tablet.

    Key Points

    1. Most common and oldest route of drug administration – Oral route
    2. Most common parenteral route – IM route
    3. Deltoid muscles injectable drug amount – 2 ml
    4. Gluteus Maximus muscle injectable drug amount – Up to 5 ml
    5. Drug directly injected in the vein by which route – Intravenous route
    6. Which route passes the highly irritable drugs – IV route
    7. Insulin injection administered through – Subcutaneous route
    8. Self-injectable parenteral route – Subcutaneous route
    9. Before drug administration, nurses follow – 5 rights of drugs
    10. Brand name of aspirin – Disprin

    If any quary related to this post please comment me.

    Comment for any type of correction and Updates in the Data.

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    what is vector borne diseases?

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    what is vector borne diseases?

    vector borne diseases

    What is malaria?

    Malaria is a protozoal disease caused by Plasmodium and transmitted by the female anopheles mosquito. Malaria is a common public health problem in India. Among the many species of Plasmodium, Plasmodium vivax and Falciparum, and others are common main causes of Malaria in India. According to the National Vector Borne Diseases Control Programme (NVBDCP), in 2015, 11.2 lakh cases of Malaria were reported with 7.6 lakh Falciparum cases and 287 deaths

    what is filaria disease?

    Lymphatic Filariasis, commonly known as Filaria is caused by 3 nematode parasites– Wucheria bancrofti, Brugia malayi, and Brugia Timor. Only Wucheria bancrofti and Brugia malayi are found in India. Predominantly, Wucheria bancrofti spread by Culex mosquito causes– 99.4 % of the Filariasis in India. Brugia malayi infection has been reported earlier from some rural areas in seven States viz., Kerala, Odisha, Tamil Nadu, Andhra Pradesh, Madhya Pradesh, Assam, and West Bengal, but now it is restricted to rural areas of Kerala. Brugia Malayi is spread through the Mansonia mosquito. Filariasis affects 120 million people worldwide, with India, Indonesia, Nigeria, and Bangladesh alone contributing to about 70% of the infection worldwide. Indigenous lymphatic filariasis cases are reported from 20 States/UTs namely Andhra Pradesh, Assam, Bihar, Chhattisgarh, Goa, Gujarat, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Odisha, Tamil Nadu, Uttar Pradesh, West Bengal, Puducherry, Andaman & Nicobar Islands, Daman & Diu, Lakshadweep and Dadra & Nagar Haveli. From these States/UTs, a total of 250 districts have been identified to be endemic to filariasis with a population of about 600 million at risk.

    what is Kala-Azar?

    Kala-azar or Indian Leishmaniasis is caused by the parasite – Leishmania donovani and transmitted by Sandfly (Phlebotomus argentipes). In 2015, 8500 cases were reported with 5 deaths in India.

    what is Japanese Encephalitis?

    Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia, with up to 70,000 cases reported annually, caused by the Japanese Encephalitis virus. The disease is transmitted by the culex mosquito. Japanese Encephalitis is widespread in India, its annual incidence ranges between 1714–6594, with 367– 1665 deaths.

    what is dengue?

    Dengue is a mosquito-borne viral infection transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. This is the same mosquito that transmits chikungunya, yellow fever, and Zika infection.There are 4 distinct, but closely related, serotypes of the virus that cause

    what is chikungunya?

    Chikungunya disease is a viral disease transmitted in humans by the bite of infected mosquitoes. Two types of Aedes species are implicated in causing this disease, Ae. aegypti and Ae. albopictus. Ae. aegypti mosquito (which you must be familiar with from the yellow fever section) is the primary transmission agent of the Chikungunya Virus in the Indian subcontinent. In 2015, a total of 27,553 cases of Chikungunya were reported in our country.

    Vitamins and Classification of Vitamins | Functions of Vitamins

    by
    Classification of Vitamins

    Vitamins

    What is a vitamin?

    • these are required by the body in much smaller amounts. They do not yield energy like fats But they are vital for the survival of man as catalysts in various body processes.

    Classification of Vitamins:-

    Fat soluble vitamins : Vitamins A, D, E, and K are fat saluble vitamins.

    1. Vitamin A or retinol
    2. Vitamin D (Caliciferol-D2, cholecalciferol D3)
    3. Vitamin E (Tocopherol)
    4. Vitamin K

    Water-soluble vitamins :

    1. Thiamine ( vitamin B1)
    2. Riboflavin (vitamin B2)
    3. Nicotinic acid
    4. Pyridoxine ( vitamin B6)
    5. Pantothenic acid
    6. Folic acid
    7. Vitamin B12
    8. Ascorbic acid (vitamin C)

    <<<Important Question>>>

    Nutrition Quiz Questions and Answers 

    What is Vitamin A (Retinol)

    • Vitamin A is a fat-soluble vitamin. Its chemical name is “retinol”. In India 8% of children aged 6 months–6 years have vitamin A deficiency. It is a major cause of preventable

    The function of Vitamin A:

    • Normal vision and health of the
    • The health of the skin and mucous

    Sources of Vitamin A: Animal Sources: Butter, ghee, egg, milk, liver, and fish are good sources.

    The daily requirement of Vitamin A: (1 I.U. of vitamin A =0.3 u g retinol)

    Effects of deficiency: Night blindness, Bitot’s spots, Xerophthalmia, Keratomalacia.

    What is Vitamin D

    • It occurs in mainly 2
    • Vitamin D2 or ergocalciferol (does not occur in nature)
    • Vitamin D3 or cholecalciferol (occurs widely in animal fats and fish oils)

    Functions of Vitamin D:-

    1. formation of the healthy bones and It has a direct action on the mineralization of the bones.
    2. It promotes the intestinal absorption and utilization of calcium and

    Sources: Sunlight, Food, Daily requirement

    1. Adults: They need 5 micrograms (100 i.u.) per day.
    2. Pregnancy, lactation, and growing children: This may be up to 10 micrograms (400 u.) per day.

    What is Vitamin E?

    • It is available in small quantities in meats, fruits, and vegetables.
    • The richest sources are vegetable oils (e.g., oils of sunflower seeds). Humans on a balanced diet do not easily suffer from its

    The function of Vitamin K( Thiamine)

    • It is also synthesized to some extent by intestinal
    • It is necessary for proper clotting It is used, therefore, for the prevention and treatment of bleeding.
    • . Its daily requirement is about 03 mg/kg for the adult.

    Function of Thiamine

    • It is a water-soluble
    • It plays an important part in carbohydrate metabolism. In thiamine deficiency, there is an accumulation of pyruvic and lactic acids in the tissues and body fluids. It is also essential for the proper functioning of the nervous

    Sources of Thiamine: in small amounts in all-natural foods, cereals, pulses, and nuts groundnut.

    Daily requirements of Thiamine: It is 0.5 mg per 100 kcals of energy intake.

    Function of Riboflavin

    The function of Riboflavin: It is involved in protein, fat, and carbohydrate metabolism.

    Sources of Riboflavin: Good sources are milk and milk products, eggs, liver, and green leafy vegetables. Wheat, millets, and pulses are fair sources, but rice is a poor source.

    The daily requirement of Riboflavin is- 0.6 mg per 1,000 calories.

    Deficiency: cheilosis (red lips, with the fissured angle of the mouth), soreness of the tongue, redness and burning sensation in the eyes, dermatitis.

    What is Niacin?

    Function: It is required by the body for the utilization of carbohydrate and tissue respiration.

    Sources: grain cereals, pulses, nuts, meat, liver, and chicken. Requirement: The daily requirement is 6.6 mg. per 1,000 calories. Deficiency: It may lead to pellagra, characterized by soreness of the tongue, pigmented scaly skin, dementia, and diarrhea.

    Pyridoxine (Vitamin B6)

    It plays an important role in the metabolism of amino acids, fats, and carbohydrates.

    Source- Food rich in pyridoxine are liver, meat, fish, whole cereals, and legumes.

    Deficiency – skin lesions, cheilosis, glossitis, and convulsions in children.

    Requirement – require 2.0 mg per day

    Pantothenic acid

    • It is widely distributed in animal and vegetable
    • No deficiency symptoms have been reported in
    • The human requirement for this vitamin has not been clearly

    What is Folic acid?

    It is essential for the synthesis of DNA (deoxyribonucleic acid).

    Sources: The liver is one of the richest sources. It is also found in pulses, nuts, and whole grains.

    Deficiency results in anemia which is common among poor people and also among pregnant women.

    Requirement: For healthy adults, it is 100 micrograms and during pregnancy 400 micrograms; children need 100 micrograms.

    What is Vitamin B12?

    It is also necessary for the synthesis of DNA and also in carbohydrate, fat, and protein metabolism.

    Source: Liver, eggs, fish, and milk contain vitamin B12.

    Deficiency: It leads to pernicious anemia. It can also affect the nervous system, including the spinal cord.

    Requirement: About 1 microgram for adults. For proper utilization of vitamin B12 intestinal secretion should be normal.

    What is Vitamin C?

    It is a water-soluble vitamin. It is the most unstable of all the vitamins. It gets rapidly destroyed by high temperature, oxidation, drying, or storage.

    Functions: It is required to form collagen, the protein substance that binds the cells together, if this substance is not formed, healing of the wounds will be delayed. Bleeding phenomena appear on vitamin C deficiency. It helps in the absorption of iron. It helps in increasing the general resistance of the body to fight infection.

    Sources: All fresh fruits contain vitamin C. Amla is one of the richest sources, Guavas are cheap but rich sources. Green leafy vegetables are rich in vitamin C. Roots and tubers (potatoes) contain very small amounts.

    Deficiency: It results in a bleeding disease called scurvy seen in infants on artificial feeds.

    What is Minerals –

    These are divided into two major groups: •

    Major minerals: Calcium, phosphorus, sodium, potassium, and magnesium.

    Trace elements: These are required by the body in less than a few milligrams per day e.g. iron, iodine, fluorine, zinc, copper, and cobalt.

    <<<Important Question>>>

    Nutrition Quiz Questions and Answers 

    nutritional requirements during pregnancy and lactation

    by
    Mission Nursing

    Nutrition is required During Pregnancy and Lactation Mother: Vitamins, Proteins, Minerals, Calcium, Zink Requirement.

    A pregnant woman’s body undergoes several Physical and Mental changes to prepare her for upcoming motherhood. Her requirements for all the nutrients increase. Malnutrition in mothers has been found to be associated with adverse pregnancy outcomes, e.g. anaemia in pregnant women may compromise maternal and foetal health. During lactation nutrition of the baby is solely dependent on the mother. So, diet during lactation helps the mother to maintain sound health and also ensures a good milk supply for the baby.

    PHYSIOLOGICAL CHANGES IN THE BODY DURING PREGNANCY-

    • Changes in Uterus and Breasts
    • Weight Gain
    • Changes in Body Fluids

    INCREASED NUTRITIONAL REQUIREMENTS DURING PREGNANCY

    1. Calories – Additional energy is required during pregnancy to support the metabolic demands of pregnancy and foetal The average pregnant woman needs only an additional 150 kcal/day during the first trimester of pregnancy and 350 kcal/day during the second and third trimesters of pregnancy.
    2. Proteins- To support the synthesis of maternal and foetal tissues, additional protein is required (up to 20 gm per day). This demand increases throughout gestation. It is maximised during the third Protein deficiency during pregnancy has adverse consequences, including poor foetal growth.
    3. Micronutrients – All vitamins and minerals are needed for optimal pregnancy outcomes. In some instances requirements may be met through diet; for others, a supplement is often The requirement for most of the vitamins and minerals increases with pregnancy.

    The following micronutrients such as minerals and vitamins are given in detail below:

    Minerals Required During Pregnancy

    1. Iron: Its requirement increases from 21 mg/day to 35 mg/day during This is due to –
      • expansion of maternal tissues including red cell mass,
      • the iron content of the placenta,
      • blood loss during
      • Total iron requirement during pregnancy is estimated to be approximately 1,000 This is distributed in the foetus and placenta (300 mg) and expanded red cell mass (400 mg).
    2. Calcium: Its requirement for an adult woman is 600 mg/day/woman for good Growth of the baby. During pregnancy, there is an increase in the demand for calcium by the growing So the requirement increases up to 1200 mg/day.
    3. Zinc: Deficiency of zinc adversely affects the outcome of Severe deficiency in the mother can lead to spontaneous abortions and congenital malformations. The requirement increases from 10 mg/ day (pre-pregnant) to 12 mg/day during pregnancy. Dietary sources of zinc are meat and fish. Wheat, pulses and nuts also provide zinc.

    Vitamins Required During Pregnancy

    Vitamin A: High levels of some forms of vitamin A can harm the foetus’s development if taken in too high amounts during pregnancy. Mothers should avoid vitamin A supplements and animal sources of vitamin A (e.g. Liver) throughout pregnancy.

    Vitamin D: Its active forms (calcidiol and calcitriol) can pass through the placenta with ease and help in the calcium metabolism of the foetus.

    Vitamin B complex: Requirement for Thiamine, Riboflavin and Niacin increase during pregnancy i.e. +0.2 mg, +0.3 mg and +2.0 mg respectively. Pyridoxine (vitamin B6) needs are increased during pregnancy. (2.5mg of vitamin B6 during pregnancy; vitamin B12 = 1.2 mg / day). Dietary sources of vitamin B are milk and orange juice are good sources.

    Folic acid: Adult women require 200 µg of folic acid per day necessary. In pregnancy, it is 500 µg/day. It is an essential element for blood formation and synthesis of essential components of DNA/RNA which increase rapidly during the growth of a baby. It may also lead to congenital

    malformations (spina bifida and anencephaly), cleft lip and congenital heart defects. Supplementation of folic acid before conception and during the first twelve weeks of pregnancy is therefore recommended. Dietary sources of folic acid are Liver, soybean and dark green leafy vegetables.

    Vitamin C: Its daily requirement for an adult woman is 40 mg/day. Additional 20 mg are needed during pregnancy. Dietary sources are Fresh fruits, lemon, amla, tomato, orange, and fresh green leafy vegetables.

    DIET DURING PREGNANCY –

    Additional* Allowances during Pregnancy and Lactation

    Food Items Pregnancy (gm) Calories (Kcal) Lactation (gm) Calories (KcaL)
    Cereals 32 118 60 203
    Pulses 15 52 30 105
    Milk 100 83 100 83
    Oil & Fat – – 10 90
    Sugar 10 40 10 40
    Total – 293 – 521

    Meal Planning for a Pregnant Woman-

    the pregnant woman should eat a variety of foods. There is no need to modify the usual diet if the quantity and frequency of usage of the different foods should be increased to and maximum.

    • She can derive maximum energy (about 60%) from cereals like rice, wheat and (9 portions-30 g each)
    • Cooking oil is a concentrated source of both energy and polyunsaturated fatty (Fats/Oils-6 portions-5 gm each)
    • Good quality protein is derived from milk, fish, meat, poultry and eggs. However, a proper combination of cereals, pulses and nuts also provides adequate (2 portions of pulses and 1 portion of non-veg-30 gm each)
    • (vegetables- 5 portions and fruits- 2 portions- 100 gm each)
    • Bioavailability of iron in pulses can be improved by fermentation and sprouting and eating foods rich in vitamin C such as citrus •
    • Milk and milk products are the best sources of biologically available (5 portions-100 gm each)

    Model Menu during Pregnancy-

    1. Before getting off the bed: Tea 1 cup with 1–2 teaspoons of sugar + milk rusk/biscuit
    2. Breakfast: Milk 200 ml (1 glass) Porridge (1 bowl)/ Idli (2 medium)/ Chapati Parantha (2 medium) Cheese 30 gm (1 cube)/ egg-1/ sprouts 25 gm (1 bowl)
    3. Mid Morning: Buttermilk 1 glass or fruit – 1 medium
    4. Lunch: Fresh salad, Chapati – 4 medium sizes (100 gm), preferably made with a mix of wheat with Bengal gram/soya Or Rice (100 gm)- 4 servings Pulses (25 gm)- 1 Katori or meat or fish or chicken (90 gm), Curd 125 gm (1 bowl), Green vegetables 250 gm (2 bowls), Cooking oil 10 gm (2 teaspoons) Fruit: 1–2 servings any time during the day
    5. Evening Snacks: Freshly prepared snacks, such as sandwiches, pav bhaji, noodles, dhokla, khandvi, dal Wada, medu Wada, Dahi Wada, and appams. Milk 200 ml (1 glass) Cheese sandwich (1 small) or Poha (1 bowl) or Upma (1 bowl) or Vada (1 large)
    6. Dinner: Same as Lunch, Bed Time: Milk 200 ml (1 glass)

    Iron Folic Acid Supplementation-

    • Prophylactic dose: All pregnant women need to be given one tablet of IFA (100 mg elemental iron and 5 mg folic acid) every day for at least 100 days, starting after the first trimester, at 14–16 weeks of gestation to prevent the occurrence of anaemia (prophylactic dose).
    • Therapeutic dose: If a woman is anaemic (haemoglobin less than 11 g/dl) or has pallor, give her two IFA tablets per day (one morning and one evening) for three months. This means that a pregnant woman with anaemia needs to take at least 200 tablets of IFA for correction of anaemia (therapeutic dose).

    Nutrition Quiz Questions and Answers

    by
    NCLEX Questions Quiz

    Nutrition Quiz Questions and Answers are very important for medical Exams like NCLEX, AIIMS, PGI, RRB, NEET, CHO, and other nursing and medical exams nutrition is very important Some important Questions are Given Below. Any Dought-in Questions and quiz comments.

    [HDquiz quiz = “80”]

    Nutrition

    by
    Mission Nursing

    CONCEPT OF NUTRITION-

    Nutrition is the science of food and its relationship to health. The following three processes are involved in the utilization of food in our bodies.

    Ingestion: It implies intake of food (by mouth)
    Digestion: After ingestion food is digested to make it absorbable. It is achieved by enzymes present in our mouth (saliva), stomach, and intestines.
    Absorption: Digested food gets absorbed and passes from our intestines into the blood circulation and lymphatic system for distribution all over the body.

    Food has major physiological functions as follows:

    • Provides energy for body functions. •
    • Nutrients build and maintain body tissues. •
    • Safeguarding body against diseases. •
    • Regulating body functions.

    The psychological function of food includes the following:

    • Satisfying hunger and taste buds. •
    • Provides comfort in a depressive mood. •
    • Used as a reward or punishment e.g. good or bad food.

    TYPES OF NUTRIENTS-

    There are a variety of nutrients that are supplied through the foods. Nutrients play a critical role in health and disease. Each nutrient performs a specific function in the body. The absence of a particular nutrient can cause a specific deficiency disorder.

    Functions of nutrients:

    • Energy production for physical
    • Growth, development and •
    • Resistance to infection and protection from •
    • Control of temperature, blood pressure, metabolism, and waste

    Macronutrients –

    These are organic nutrients required in large quantities. These are proteins, fats, and carbohydrates.

    1. Proteins- These are of the greatest importance in humans Proteins are composed of carbon, hydrogen, oxygen, nitrogen and sulfur, phosphorus, iron, and other elements in varying amounts. These are built of amino acids. The human body requires 22 amino acids. Of

     

    these 8 are called “essential” because the body cannot synthesize them in sufficient quantity. The essential amino acids are as follows: 1) Isoleucine 2) Leucine 3) Lysine 4) Sulphur-containing amino acids (methionine + cysteine) 5) Phenylalanine Tyrosine 6) Threonine 7) Tryptophan, and 8) Valine.

    Functions of Proteins:

    • For growth and development: since they provide the building material e. the amino acids
    • For repair of body tissues and their maintenance
    • For the synthesis of antibodies, enzymes and The body requires protein to produce anti-bodies.

    Sources of proteins:

    • Animal Source: found in milk, meat, eggs, cheese, and fish.
    • Plant Source: found in pulses (legumes) cereals, beans, nuts, oil-seed cakes, etc
    • Protein Requirements: Usually 1.0 gm protein/ kg body weight is needed for an Indian adult.

    Fats

    Fats are composed of carbon, hydrogen, and oxygen. They are composed of fatty acids. Fats are again classified into saturated and unsaturated fats. In general, animal fats are “saturated” fats; vegetable oils and fats are “unsaturated” fats.

    Functions of Fats:

    • It is the source of One gram of fat and supplies 9 calories of energy.
    • Fats are carriers of fat-soluble vitamins, g. vitamins A, D, E, and K.
    • Fats provide cushioning for many organs in the body (heart, kidney, intestine )

    Sources of Fats:

    • Animal sources: These are ghee, butter, fat from meat, fish oil, etc.
    • Vegetable sources: these are various vegetable oils such as groundnut, ginger, mustard, cottonseed, safflower (kardi), and coconut

    Fat requirements:

    • In developed countries, dietary fats provide 30–40 % of total energy Ideally only 20–30 % of total dietary energy should be provided by fats.

    Carbohydrates:

    These are the main source of energy, providing 4 kcals per gram. Carbohydrate is also essential for the oxidation of fats and for the synthesis of certain non-essential amino acids. There are 3 main sources of carbohydrates, viz., starches, sugar, and cellulose.

    Micronutrients –

    • Micronutrients are needed only in minuscule amounts, these substances enable the body to produce enzymes, hormones, and other substances essential for proper growth and
    • There are two types of Micronutrients, these are Vitamins and

     

    MEAL PLANNING –

    • A suitable diet for the individuals and families shall be as per the local food items available, individual dietary habits, and as per the economic status of families. The diet should also satisfy hunger and
    • It provides 50–60% energy from carbohydrates (preferably complex carbohydrates), 10– 15% from protein, and 20–30% from oils and

    Aims of Meal Planning

    • Fulfill the nutrition needs of an individual or members of a
    • Invest in nutrient-dense food items rather than energy-dense
    • Help in the purchase, preparation, and service of appropriate food
    • Provide variety in the diet through proper selection of

    Diet Plan for Different Age Groups

    Diet Plan for a Toddler: Children aged 1–4 years can eat the same foods as an adult, about half the amount. Healthy foods are good to include. But do not forget to remind the

    parents to ensure that their children drink plenty of fluids throughout the day. Try also to make foods fun and easy to eat.

    Diet Plan for Children aged 5–12 yrs: They are still developing both physically and mentally. They also need good nutrition. Calcium-rich foods, sources of essential fats; high protein foods, and slow-released carbohydrate sources need particular attention. They should be encouraged to eat the same meal as the whole family. Sitting down together is also important to help behavioral development and for the re-enforcement of family values.

    Diet Plan for Adolescents: Adolescence ranges from 10–19 years of age. If they are into sports or heavy physical activities, they need to eat more. Good calcium and iron intake are important in girls. They should avoid junk foods.

    Diet Plan for an Elderly Person: One particular concern in the elderly is obtaining sufficient fluid intake. Some old people also have difficulty in passing stools; therefore a good fiber intake is encouraged.

    NUTRITIONAL ASSESSMENT –

    The nutritional status of an individual is the result of many interrelated factors. It is influenced by the adequacy of food intake both in terms of quality and quantity and also by the physical health of the individual.

    Objectives of Nutritional Assessment –

    • To obtain information on the extent of nutritional problems of a
    • To identify the population group ‘at risk’ or in greatest need of
    • To develop a nutrition program that meets the needs defined by the
    • To evaluate the failure or success of nutrition
    • To assess the degree of malnutrition in preschool and school going

    Methods of Assessment – This involves various techniques and methods.

    1. Clinical Examination: It is also the most practical method of ascertaining the nutritional status of a group of individuals. There are a number of physical signs, some specific and many When two or more clinical signs/characteristics of a deficiency disease are present simultaneously, their diagnostic significance is greatly enhanced.

    Signs used in the nutritional survey:

    • Not related to nutrition, g. alopecia, pyorrhoea, pterygium.
    • That needs further investigation (molar pigmentation, coined vascularisation, geographic tongue)
    • Known to be of value, g. angular stomatitis, Bitot’s spot, calf tenderness, absence of knee or ankle jerks (beriberi), enlargement of the thyroid gland (endemic goiter), etc.

    2. Laboratory and Biochemical Assessment:

    Hemoglobin estimations: It is the most important laboratory test that is carried out in nutritional surveys. It is a useful index of the overall state of nutrition. Stools and urine be examined for intestinal parasites. History of parasitic infestation, chronic dysentery, and diarrhea provide useful information about the nutritional status. Urine should also be examined for albumin and sugar.

    Biochemical test: These may be applied to measure individual nutrient concentration in body fluids (e.g. serum retinol, serum iron) or to detect abnormal amounts of metabolites in urine (iodine). Biochemical tests are time-consuming and expensive. They cannot be applied on a large scale, e.g. in the nutritional assessment for the whole community.

    1. Assessment of Dietary Intake: Direct assessment of food consumption involves dietary surveys which may be household inquiries on individual food consumption surveys. A diet survey may be carried out by one of the following methods:
      • Weight of raw foods
      • Weighing of cooked foods

    Nutrition Quiz Questions and Answers

    Food Borne Diseases and Food Safety

    by
    Food Borne Diseases and Food Safety

    Food Borne Diseases and Food Safety Introduction

    • Food safety can be compromised at any stage from the farm (where food is grown) to the fork (when it is consumed)
    • Food can easily become unsafe when we do not follow hygienic Cleaning principles during its transport, storage, cooking, and serving of food and food items

    Objectives of Food Safety:-

    • Recognize, assess and classify different food-borne diseases
    • Investigate food poisoning cases/outbreaks
    • Describe preventive and control measures for food-borne diseases
    • Identify the signs and symptoms of food poisoning and refer for management
    • Identify the measures to be taken at various levels to ensure food safety
    • Make people aware of practicing the five keys to safer food
    • Describe the food storage, food handling, and cooking

    What is Food borne diseases

    • The illnesses resulting from the ingestion of food contaminated with microorganisms (bacteria, viruses, parasites, etc) or harmful chemicals (toxins)
    • The contamination may occur at any stage in the process from food production to consumption
    • An estimated 600 million – almost 1 in 10 people in the world – fall ill after eating contaminated food and 420 000 die every year
    • Children under 5 yrs age carry 40% of the FBD burden

    Causes of Food Borne Diseases

    • Bacteria – Salmonella, Campylobacter, Escherichia coli, Vibrio cholera, Listeria, Staphylococcus
    • Virus – Norovirus, Rotavirus, Hepatitis A and E virus, and other viruses.
    • Parasites – Entamoeba histolytica, Giardia lamblia, Cryptosporidium, Fish- borne
    • Toxins – Mycotoxins (e.g. aflatoxins), Marine biotoxins, Mushroom toxins,
    • Chemicals – Pesticides, Polychlorinated biphenyls (PCBs) Heavy metals (lead, cadmium, mercury, copper) Nitrites

    Classification of Food Borne Diseases

    • Food-borne infections – Caused by microorganisms
    • Food-borne intoxications – Caused by toxins and chemicals

    Differences between Food-borne Infections and Intoxication

    Infections Intoxication
    Cause Bacteria / Viruses /Parasites Toxins/Chemicals
    Mechanism Invade and/or multiply within the lining of the intestines No invasion or multiplication
    Incubation period Hours to days Minutes to hours
    Symptoms Diarrhea, Nausea / Vomiting, Abdominal cramps, and/or Fever Vomiting, Nausea, Diarrhoea, Double vision, Weakness Respiratory failure, Numbness, Sensory and motor dysfunction
    Transmission Can spread from person to person via the Falco-oral route Not communicable
    Factors for food contamination Inadequate cooking, Cross-contamination, Poor personal hygiene, Bare hand contact Inadequate cooking, Improper holding temperatures

     

    Signs and Symptoms of Foodborne Disease:-

    • Abdominal cramps
    • Diarrhea (bloody)
    • Nausea
    • Vomiting, Fever, Headache, Fatigue, Body aches

    Transmission of Food-Borne Pathogens and Toxins

    1. Food production and processing –
      • Foods get contaminated if washed or irrigated with water that is contaminated with pathogens from animal or human feces
      • Animals naturally harbor many food-borne bacteria in their intestines that can cause illness in humans
      • During slaughter, meat and poultry carcasses can become contaminated if they are exposed to small amounts of intestinal contents

    2. Food preparation and handling

    • Infected individuals
      • Food-borne pathogens are shed in the feces of infected persons
      • These are transferred to others through food via the fecal-oral route
      • Bacteria present in infected lesions and our nose may also be transmitted from an infected food handler to ready-to-eat foods
    • Cross-contamination-
      • Pathogens present in one food may be transferred to other foods during cooking if utensils are used without washing and disinfecting
    • Inadequate cooking temperature
    1. Food storage
      • Food held or stored at more than 250C to 600C) temperature allows multiplication of

    Food poisoning and food intoxications –

    Epidemiological Features / Clinical Characteristics –

    • Food poisoning is an acute inflammatory disease of the gastrointestinal tract
    • It is caused by the ingestion of food contaminated with toxin-producing bacteria, their pre-formed toxins, chemical substances, or other poisonous substances
    • Food poisoning is very More than 10 million cases occur in India per year

    Characteristics of Food Poisoning

    • History of ingestion of common food (as in family functions, hostels/hotels)
    • A group of persons being affected simultaneously
    • The similarity of signs and symptoms in the majority of cases
    • Common symptoms are vomiting, diarrhea, pain in the abdomen, fever, etc
    • Short incubation period
    • Absence of secondary cases
    • Laboratory tests are rarely required Types of Food Poisoning

    Bacterial food poisoning

      • Caused by taking contaminated food
      • It may be:
        • Infective: Organism enters the body through the food, produce toxin, cause pathology and result in clinical manifestations (Salmonella, Clostridium perfringes, Vibrio parahaemolyticus) ‒
        • Toxic: Due to already formed toxins in the food (Staphylococcus aureus, Clostridium botulinum, Bacillus cereus

    Nonbacterial food poisoning

    • Chemical poisoning: Due to pesticides, arsenic, mercury

    Food Intoxications

    • Intoxications are of two categories:
      • Due to naturally occurring toxins in the food grains:
      • Lathyrism, Epidemic dropsy, Endemic ascites, Toxic polyphenol
      • Due to toxins produced by the fungi in the food grains: ‒Aflatoxicosis, Ergotism

    Public health response to food-borne diseases

    1. Early detection, management, and referral
      • Identify the cases and assess for severity
      • Refer the severe cases urgently to the health center for proper management
      • Assure and help patients accordingly
      • Ensuring hydration is the mainstay of
      • Focus on assessment and reversal of dehydration, through ORS or IV fluids in serious cases
    1. Reporting of any case /outbreak and investigation
      • Inform any case/ outbreak immediately to a higher level as per the existing program /project (e.g. IDSP) guidelines
      • Outbreaks of food poisoning need to be investigated by a team and take part in such investigations (as has been discussed elsewhere in other units)
      • Investigations will help to identify appropriate control and preventive measures
    1. Health Education
      • Educating people about reservoir/source of contamination and transmission, common foods involved, signs/symptoms and danger signs, personal hygiene, and food hygiene
      • Most FBD are preventable by simple behavioral changes

    Food Safety

    • Food safety describes the handling, preparation, and storage of food in ways that prevent food-borne diseases
    • The main idea is a concept of defense to prevent harm to the
    • Unsafe food poses health threats; endangering
    • It creates a vicious cycle of illness and

    Food Safety Considerations and Measures

    • Policy making/administrative level – Role is of government:
      • Developing policies and regulatory frameworks (Laws, Acts, etc)
      • Establishing and implementing effective food safety systems to respond to and manage food safety risks along the entire food chain
      • Fostering collaboration among health and other sectors
    • Food handlers and consumers level:
      • Be aware of the common hazards linked with the food they use
      • Handle and prepare food safely
      • Practicing the WHO Five Keys to Safer Food at home, or when selling at restaurants or at local markets
      • Grow fruits and vegetables to decrease microbial contamination

    Food Safety Regulatory Measures in India

    • FSSAI (Food Safety and Standards Authority of India)is responsible for setting standards for food by:
    • Framing of Regulations to lay down food safety standards
    • Laying down guidelines for accreditation of laboratories for food testing
    • Providing scientific advice and technical support
    • Disseminating information and promoting awareness
    • Food Safety Voice’ has been launched which helps consumers to register their complaints and feedback about food safety issues

    Keep Clean

    • Wash your hands before handling food and often during food preparation
    • Wash your hands after going to the toilet
    • Wash and sanitize all surfaces and equipment used for food preparation
    • Protect kitchen areas and food from insects, pests, and other animals

    Separate raw and cooked food

    • Separate raw meat, poultry, and seafood from other foods
    • Use separate utensils, knives, and cutting boards for handling raw foods
    • Store food in containers to avoid contact between raw and prepared foods

    Keep food at safe temperatures

    • Do not leave cooked food at room temperature for more than 2 hours
    • Refrigerate promptly all cooked and perishable food (preferably below 5°C)
    • Keep cooked food piping hot (more than 60°C) prior to serving
    • Do not store food too long even in the refrigerator
    • Do not thaw frozen food at room temperature

    Food storage, food handling, and cooking

    • General Principles of Safe Storage of Food Items
      • Chemicals and cleaning supplies are stored away from food
      • Non-vegetarian and vegetarian products are kept physically separated
      • Raw materials are kept separately with proper labeling from semi-processed and processed (cooked) foods
      • All foods are stored off the floor and away from the walls (at least 6 inches)
      • The principles of FIFO (first in first out) and FEFO (first expiry first out) should be applied

    Role of Food Handlers in Food Borne Diseases

    • The term food handler includes all those involved in various stages/activities related to preparation, processing, cleaning, and chopping, making, boiling/ frying/sauté, washing of utensils, cooking and serving of food
    • Similarly, if food handlers have eye /ear/skin infection, cough, or running nose the related germs will infect the consumers
    • This spreads through their hands through eye/ ear/ skin discharges, urine, sputum
    • A cook with diseases like jaundice or typhoid may continue to spread these for a long time
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