A-M

Question 0

Excipients

Answer 0

Fillers and entered substances that are used in drug preparation to allow the drug to take on a particular size and shape and to enhance drug dissolution.

Some additives in drugs, such as ions potassium and sodium in penicillin potassium and penicillin sodium, increased absorbability of the drug.

Question 1

Cardiac Tamponade

Answer 1

Cardiac tamponade is compression of the heart due to collection of fluid or blood in the pericardium. It may be either chronic or acute. Chronic cardiac tamponade occurs when fluid slowly enters the pericardial sac, allowing time for the membrane’s expansion to accommodate the fluid, which can be as much as 1 liter. This gradual filling may or may not produce changes in cardiac hemodynamics. However, if there is rapid filling of the pericardial sac, as little as 200 ml can precipitate a life-threatening emergency. The ultimate effect of cardiac tamponade is reduced cardiac output and inadequate tissue perfusion.

Causes of acute cardiac tamponade include pericarditis with effusion of serosanguineous fluid into the sac, and either surgical or accidental trauma with leakage of blood into the sac. Occasionally, anticoagulant therapy can lead to extensive bleeding around the heart and cardiac tamponade.

Excessive fluid within the pericardial sac causes pressure against the cardiac structures, interferes with ventricular and atrial filling, and compromises blood supply to the myocardium via the coronary vessels. These conditions occur because of the following events: The compressed atria cannot fill as they normally would and so less blood is available for the ventricles; thus preload (the volume of blood in the ventricles at the end of diastole) is reduced. Ventricular filling is further impaired by compression of the ventricles. As pressure within the ventricles rises because of tamponade, pressure differences between the atria and ventricles are reduced, causing the valves between the two chambers to close before the ventricles have had time to fill completely. Increasing pressure within the heart chambers and in the pericardium impinges on the coronary arteries and veins, reducing blood supply to the myocardium, slowing contractility, and further reducing cardiac output.

Clinical features of cardiac tamponade include increased central venous pressure, falling arterial blood pressure, tachycardia, faint or muffled heart sounds, a narrowing pulse pressure, and an exaggerated inspiratory fall in systolic blood pressure (pulsus paradoxus). Hypoxia of cerebral tissues can produce confusion, restlessness, agitation, panic, and a sense of impending doom. Peripheral hypoxia is signaled by changes in the color, temperature, and excessive sweating.

Diagnosis can be confirmed by echocardiography and other radiologic studies. However, if the situation is acute, these tests cannot be done without endangering the life of the patient; thus diagnosis must be based on clinical findings. Once tamponade is suspected, fluids are administered and a pericardiocentesis is done to remove the compressing fluid.

Question 2

Ethnopharmacology

Answer 2

The study of drug responses that may be unique to an individual due to social, cultural, and biologic phenomena. Ethnopharmacology Integrates pharmacokinetics (the process of drug movement in the body to achieve drug action and ultimately elimination), pharmacodynamics (drug concentrations and their effects on the body), and pharmacogenetics (the effect of the drug that varies from predicted responses due to genetic factors).

Question 3

Hilum

Answer 3

1. The depression or slit-like opening through which nerves, ducts, or blood vessels enter and leave in an organ or a glance. Also called porta.
2. A depression or slit resembling the hill on and the Oliveri nucleus of the brain.

Question 4

Diverticulum

Answer 4

A circumscribed pouch or sac occurring normally or created by herniation of the lining mucous membrane through a deficit in the muscular coat of a tubular organ.

Meckel’s diverticulum (ileal): an occasional sacculation or appendage of the ileum, derived from an unobliterated yolk stalk.

intestinal diverticulum: a pouch or sac formed by hernial protrusion of the mucous membrane through a deficit in the muscular coat of the intestine.

Pressure diverticulum (pulsion diverticulum): a sac or pouch formed by hernial protrusion of the mucous membrane through the muscular coat of the esophagus or colon as a result of pressure from within.

Traction diverticulum: a localized distortion, angulation, or funnel-shaped bulging of the esophageal wall, due to adhesions resulting from an external lesion.