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There are two phases in the treatment of tuberculosis generic silagra 50mg overnight delivery; the intensive phase discount silagra 50 mg without a prescription, which lasts 8 weeks generic silagra 50 mg visa, makes the patients noninfectious discount silagra 50 mg. The continuation phase, which lasts 6 months or more and at least two drugs should be taken. During the continuation phase drugs have to be collected every month and self-administered by the patient. These patients are: - Relapses; Treatment failures; Returns after default who are pulmonary tuberculosis positive. The drugs should be taken under direct observation of the health worker throughout the duration of Retreatment including the continuation phase. It consists of 8 weeks of treatment with Rifampicin, Isoniazid and Pyrazinamide during the intensive phase followed by 6 months of Ethambutol and Isoniazid. Second-line antitubercular drugs include ethionamide, para-aminosalicylic acid, capreomycin, cycloserine, amikacin, ciprofloxacin, etc. These agents are considered during failure of clinical response to first-line drugs under supervision of their adverse effects. Drugs Active against Atypical Mycobacteria Disease caused by "atypical" mycobacteria is often less severe than tuberculosis and not communicable from person to person. Azithromycin or clarithromycin, plus ethambutol are effective and well-tolerated regimen for treatment of disseminated disease. Because of increasing reports of dapsone resistance, treatment of leprosy with combinations of the drugs is recommended. Therefore, the combination of dapsone, rifampin, and clofazimine is recommended for initial therapy. Sulfones are well absorbed from the gut and widely distributed throughout body fluids and tissues. Because of the probable risk of emergence of rifampin-resistant M leprae, the drug is given in combination with dapsone or another antileprosy drug. Clofazimine The absorption of clofazimine from the gut is variable, and a major portion of the drug is excreted in feces. Clofazimine is given for sulfone-resistant leprosy or when patients are intolerant to sulfone. The most prominent untoward effect is skin discoloration ranging from red-brown to nearly black. The antifungal drugs fall into two groups: antifungal antibiotics and synthetic antifungals. Antifungal antibiotics Amphotericin B Amphotericin B is poorly absorbed from the gastrointestinal tract. Oral amphotericin B is thus effective only on fungi within the lumen of the tract. The pore allows the leakage of intracellular ions and macromolecules, eventually leading to cell death. Adverse Effects: The toxicity of amphotericin B which may occur immediately or delayed include fever, chills, muscle spasms, vomiting, headache, hypotension (related to infusion), renal damage associated with decreased renal perfusion (a reversible) and renal tubular injury (irreversible). It has activity against yeasts including; Candida albicans and Cryptococcus neoformans; molds, Aspergillus fumigatus. Clinical Use: Amphotericin B remains the drug of choice for nearly all life-threatening mycotic infections. Used as the initial induction regimen for serious fungal infections (immunosuppressed patients, severe fungal pneumonia, and cryptococcal meningitis with altered mental status). Nystatin Nystatin has similar structure with amphotericin B and has the same pore-forming mechanism of action. Nystatin is active against most Candida species and is most commonly used for suppression of local candidal infections. Nystatin is used in the treatment of oropharyngeal thrush, vaginal candidiasis, and intertriginous candidal infections. Griseofulvin Griseofulvin is a fungistatic and used is in the treatment of dermatophytosis. Griseofulvin is deposited in newly forming skin where it binds to keratin, protecting the skin from new infection. It must be administered for 2-6 weeks for skin and hair infections to allow the replacement of infected keratin by the resistant structures.
Gastrostomy Making an artificial opening into the stomach through which the patient is fed by pouring nourishment through a tube directly into the stomach generic 100mg silagra visa. Kusmal’s breathing sever paroxysmal dyspnea generic silagra 50mg with mastercard, as in diabetic acidocis and coma Laceration a wound produced by tearing or ripping (as opposed to an incision made in surgery) quality 50 mg silagra. Line of gravity direction of gravitation pull discount silagra 50 mg amex; an imaginary vertical line through the top of the head, center of gravity, and base of support. Medication substance other than food used to prevent disease, to aid in diagnosis and treatment and to restor or maintain functions in the body tissues; also called drug. Occupied bed bed holding a client that is unable to get up as a result of his or her condition or generalized weakness. Oral of or pertaining to the mouth Orthopenia difficult breathing relieved by seating or standing erect Output All fluid lost from the body. Parenteral administered in to the body in a way other than through the alimentary canal (subcutaneous, intravenous, intramuscular), as parenteral medication Pedal pulse pulse on the foot felt over the dorsal pedis artery or posterior tibial artery Perineal care bathing the genital and surrounding area. Perioperative the period surrounding surgery; includes preoperative, intraoperative, and postoperative periods. Pharmachokinetics actions of drug Pharmachology the study of chemicals (drugs, medications) and their effect. Potentiation enhancement of one agent by another, so that the combined action is greater than the sum of the two. Postural drainage Position adapted to facilitate expectoration of material in patients with lung disease. Pressure ulcer ulcerated sore often cause by prolonged pressure on a bony prominence or other area, especially if the client is allowed to lie in one position for an extended period. Protective device piece of equipment, most often a vest or a belt, used to ensure the safety of the client ()ie, helping client to remain in a chair without falling); also called a client reminder device. Protective isolation attempts to prevent harmful microorganisms from coming into contact with the client; also called reverse or neutropenic isolation Pulse The beat of the heart felt in the arteries. Recumbent lying down Rotation process of turining about an axis, as rotation of the hand of the fetus in preparation of delivery. Rectal of the rectum Retention enema An injection of fluid that is retained in the rectum for absorption into the blood stream. Splint A device for immobilizing part of the body Spore The seeds of microorganisms, which are resistant to drying, heat, and disinfectants Standard precaution precautions designed for the care of all clients regardless of diagnosis or infection status. Sterile Specially treated so that all microorganisms are destroyed 361 Stethoscope Instrument for magnifying sound Specimen A small amount of body excretion or body fluid that is sent to a laboratory for examination. Suppository Rectally administered cones containing a medication in the base that is soluble at body temperature. Systole Blood pressure period during the beating phase of the heartbeat during which blood is expelled from heat. Synergism joint action of agents in which the combined effects is greater than the sum of the individual parts. Tachypenea conditions in which breaths are abnormally rapid, more than 20 per minute Thermometer An instrument used to measure temperature. Traction exertion of a pulling force ; an apparatus attached to the client to maintain stability of 362 a joint or aligned fracture or to exert a pulling force elsewhere, as in the lower back, to relieve pressure. Transimission-based- precaution: precaution designed for clients with specific infection or diagnoses Tympanic membrane eardrum. Elizabeth College of Nursing Government Higher Secondary School Chengalpet Medical College Ottanchantram. Special recognition and due acknowledgement is hereby made to the Director of School Education and the Joint Director of School Education Chennai. Nursing is a major component of the health care develivery system and nurses make up the largest employment group within the system. Nursing services are necessary for every patient seeking care of various types including primary, secondary, tertiary and restorative. As nursing is an important part of health care delivery system, the nurses need to have a sound knowledge about nursing as a profession and common professional activi ties. With the present introduction of Vocational courses such as nursing in the academic stream as one of the options, it is believed that it will contribute towards the basic nursing care of individuals, families and community for health and happiness.
The build-up of ketones in the blood causes ketoacidosis cheap 100mg silagra visa, which—if left untreated—may lead to a life-threatening “diabetic coma effective 50mg silagra. Diabetes is diagnosed when lab tests reveal that blood glucose levels are higher than normal generic silagra 100mg with mastercard, a condition called hyperglycemia generic silagra 50mg on-line. The treatment of diabetes depends on the type, the severity of the condition, and the ability of the patient to make lifestyle changes. As noted earlier, moderate weight loss, regular physical activity, and consumption of a healthful diet can reduce blood glucose levels. Some patients with type 2 diabetes may be unable to control their disease with these lifestyle changes, and will require medication. Research advances have resulted in alternative options, including medications that enhance pancreatic function. Here, you will learn about the hormone-producing activities of the heart, gastrointestinal tract, kidneys, skeleton, adipose tissue, skin, and thymus. Heart When the body experiences an increase in blood volume or pressure, the cells of the heart’s atrial wall stretch. An example of a hormone secreted by the stomach cells is gastrin, a peptide hormone secreted in response to stomach distention that stimulates the release of hydrochloric acid. Secretin is a peptide hormone secreted by the small intestine as acidic chyme (partially digested food and fluid) moves from the stomach. It stimulates the release of bicarbonate from the pancreas, which buffers the acidic chyme, and inhibits the further secretion of hydrochloric acid by the stomach. It promotes the secretion of pancreatic enzymes and the release of bile from the gallbladder, both of which facilitate digestion. Other hormones produced by the intestinal cells aid in glucose metabolism, such as by stimulating the pancreatic beta cells to secrete insulin, reducing glucagon secretion from the alpha cells, or enhancing cellular sensitivity to insulin. It triggers the kidneys to inhibit the formation of calcitriol from vitamin D and to increase phosphorus excretion. Osteocalcin, produced by osteoblasts, stimulates the pancreatic beta cells3 to increase insulin production. It also acts on peripheral tissues to increase their sensitivity to insulin and their utilization of glucose. Adipose Tissue Adipose tissue produces and secretes several hormones involved in lipid metabolism and storage. One important example is leptin, a protein manufactured by adipose cells that circulates in amounts directly proportional to levels of body fat. Leptin is released in response to food consumption and acts by binding to brain neurons involved in energy intake and expenditure. It also appears that the binding of leptin to brain receptors triggers the sympathetic nervous system to regulate bone metabolism, increasing deposition of cortical bone. Adiponectin—another hormone synthesized by adipose cells—appears to reduce cellular insulin resistance and to protect blood vessels from inflammation and atherosclerosis. Skin The skin functions as an endocrine organ in the production of the inactive form of vitamin D , cholecalciferol. When3 cholesterol present in the epidermis is exposed to ultraviolet radiation, it is converted to cholecalciferol, which then enters the blood. In the liver, cholecalciferol is converted to an intermediate that travels to the kidneys and is further converted to calcitriol, the active form of vitamin D. Vitamin D is important in a variety of physiological processes, including intestinal3 calcium absorption and immune system function. In some studies, low levels of vitamin D have been associated with increased risks of cancer, severe asthma, and multiple sclerosis. Vitamin D deficiency in children causes rickets, and in adults, osteomalacia—both of which are characterized by bone deterioration. Thymus The thymus is an organ of the immune system that is larger and more active during infancy and early childhood, and begins to atrophy as we age. Its endocrine function is the production of a group of hormones called thymosins that contribute to the development and differentiation of T lymphocytes, which are immune cells. Although the role of thymosins is not yet well understood, it is clear that they contribute to the immune response.