Mechanism of Insulin Resistance 



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Major Side effects of Nitroglycerine Major side effect is Peripheral Oedema  Explanation: Nitroglycerine is a potent vasodilator, it Dephosphorylates the phosphorylated Myosin light chain and thereby prevents the actin-myosin crosslinking and relaxes the Vascular smooth muscle. In that way, Nitroglycerine increases the Vascular Permeability and more exudate can reach the peripheral Tissues resulting Oedema.  Less Common Side Effects: Bloating or swelling of the face, arms, hands, lower legs, or feet Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings Difficult or labored breathing Feeling of warmth or heat Flushing or redness of the skin, especially on the face and neck Sweating Rare Side Effects: Bluish-colored lips, fingernails, or palms Dark urine Fever Pale skin Rapid heart rate Incidence Not Known: Arm, back, or jaw pain Blurred vision Symptoms of Overdose: Bluish-colored lips, fingernails, or palms Blurred or loss of vision
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Osmotic diuretics are a type of medication that can be used to manage cerebral edema.  Cerebral edema is a condition where an excess of cerebral water accumulates due to primary neurological or non-neurological causes. This excess fluid can cause additional injury often in excess of the original neurological insult. MOA Osmotic diuretics work by increasing the osmolality of the blood. This increase in osmolality draws water out of the brain’s cells and interstitial spaces and into the bloodstream. This shift of fluid helps to decrease the intracranial pressure (ICP), which is often elevated in cases of cerebral edema. One commonly used osmotic diuretic is mannitol. Although the osmotic diuresis seen with mannitol does facilitate reduction in cerebral edema, redistribution of the cerebral plasma volume ultimately leads to increased cerebral blood flow and a concomitant vasoconstrictive response of the intracerebral vasculature that decreases intracerebral pressure. DOSE  Oral -...
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ARACHIDONIC METABOLISM PATHWAY  Introduction Arachidonic Acid pathway describes the synthesis of different Prostanoids (PGs, TXs, Prostacyclin) and Leukotrienes, Cysteinyl Leukotrienes, and Lipoxanes. Steps of AA pathway Step – 01 (Activation of Phospholipase A 2 and release of Arachidonic Acid) Release of AA from phospholipid membrane is carried out by Phospholipase A2 Stimuli initiates the Ca+2 dependent translocation of cytosolic PLA2 to the membrane where it hydrolyses the AA and releases It into the cytosol. Step – 02 (Cyclooxygenase Pathway)  Arachidonic acid is converted to Prostaglandin G2 and Prostaglandin H2 catalyzed by Cyclooxygenase (COX-1 & COX-2) enzyme.  Prostaglandin H2 is then Converted to various Prostanoids by several enzymes- Thromboxane A2 ( Converted by Thromboxane A synthase )  Prostaglandin E2 ( Microsomal Prostaglandin E synthase and cytosolic prostaglandin E Synthase )  Prostaglandin F 2 alpha ( Prostaglandin F synthase ...
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