Pills Talk

How are all you doing pills talkers 👋
Today, I bring to you 3 significant medical Snacks 🥨😋

(L- Carnitine)
🥇 First Snack :
L- Carnitine has a well-established role in valproic acid toxicity or overdose.

🥈 Second Snack :
The most distinctive adverse effect of " L- Carnitine "is a fishy body odor due to trimethylamine formation.

🥉 Third Snack
L- Carnitine is commonly marketed for weight loss and athletic performance, however evidence for these uses is generally modest and less robust than for its approved indications.

See you soon 🔜

Medical snack 🥨🥨
Lactoferrin is exceedingly underrated, it's not only indicated for the management of IDA (Iron deficiency anemia), here are other indications for Lactoferrin.

Iron-binding: Sequesters free iron, limiting availability for bacterial growth and reducing oxidative stress.

Antimicrobial: Disrupts bacterial membranes, binds LPS (lipopolysaccharides), and inhibits bacterial adhesion.

Immunomodulation: Enhances activity of T cells, NK cells, and modulates cytokine production.

Antiviral: Interferes with viral entry into host cells (e.g., HSV, HIV, coronaviruses).

Anti-inflammatory: Reduces pro-inflammatory cytokines and promotes mucosal healing.

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Medical snack 🥨
Sulpiride, particularly its levorotatory enantiomer ((levosulpiride)), has demonstrated in low doses (25-50 mg) efficacy in treating vertigo through Dopamine (D2&D3) receptor antagonism.

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We touched on the last lecture a new medication for diabetes control 🛂 🎛️ which is ((Mounjaro)) that contains ((Tirzepatide)) as the main API , so let's go on showing the second part

((Black box warnings))⚠️☣️
Contraindicated in patients with a personal or family history of MTC (medullary thyroid cancer❌) or in patients with multiple endocrine neoplasia syndrome type 2.

Routine monitoring of serum calcitonin 🎚️ or use of thyroid ultrasound is of uncertain value for early detection of MTC.

Advise patients of potential risk for MTC and possible symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness)

((Mechanism of action))💊
Dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.

GIP is an incretin hormone that induces insulin secretion in response to a meal (primarily by hyperosmolarity of glucose in the duodenum) to facilitate the metabolism of carbohydrates, fats, and proteins.

GLP-1 receptor agonists increase insulin secretion in the presence of elevated blood glucose, suppress glucagon postprandially, delay gastric emptying to decrease postprandial glucose, and decrease glucagon secretion.

Pharmacodynamic effects observed include lower fasting and postprandial glucose concentration, decreased food intake, and reduced body weight.

Delays gastric emptying; delay is largest after first dose and this effect diminishes over time.

🌟New drug for diabetes control 🆕🆕
In next 3 lectures, Beta will make you familiar with all aspects of this new medication.

((Brand name))
🌟💊Mounjaro
((Tirzepatide))

(Dosage Forms & Strengths))
2.5mg/0.5mL
5mg/0.5mL
7.5mg/0.5mL
10mg/0.5mL
12.5mg/0.5mL
15mg/0.5mL

((Indication))
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

((Dose))
2.5 mg SC every week x 4 weeks initially; THEN increase to 5 mg SC weekly

If additional glycemic control needed, increase by 2.5-mg increments after at least 4 weeks at current dose.

Maximum dose: 15 mg SC weekly

((Initial dose))
Initiate with low dose and gradually escalate to maintenance dose of 2.5 mg/week SC to minimize GI adverse reactions

((Maintenance dose))
After 4 weeks, increase to 5 mg SC weekly

Recommended maintenance dosages are 5 mg, 10 mg, or 15 mg SC every week.

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Medical snack 🥨
Antihistamine drug-drug interactions 💊
- many first generation antihistamines are metabolized by CYPs
So, inhibitors of CYP 🚫🚫 can raise antihistamine concentration causing toxicity ☣️

Instances of CYP inhibitors
Macrolide antibiotics 🦠🦠 (erythromycin - Clarithromycin)

Antifungals (imidazoles, ex: ketoconazole) can enhance antihistamine activity leading to toxicity.

📝📝N.B
Azithromycin is a weak substrate of CYP , thus it neither induce or reduce CYP activity.

Second& third generation antihistamine (Cetirizine- Fexofenadine - Levocabastine- Acrivastine) are not subjected to these drug interactions

Medical Snack 🥨

IV iron supplementation is contraindicated in bacterial🦠 infections , as it raises the level of circulating non transferrin bound iron which contributes to bacterial growth leading to more complicated infection.

The next few lectures are around autoimmunity & autoimmune diseases, so let's touch on a brief introduction about autoimmunity
Autoimmunity is characterised by self-aggression of the immune system which occurs when the adaptive immune responses target our own tissues, specifically with self-antigens. The reactions in autoimmune conditions recapitulate (or reproduce) those mounted against an infectious pathogen, except that auto-antigens are targeted by autoreactive B and T cells. Unlike with infection, these adaptive immune cells identify antigens originating from proteins of a bodily organ, which results in chronic inflammation and tissue damage. These inflammatory responses can be also more general (systemic), affecting multiple organ systems.

The pathogenesis (or origin and development) of autoimmune conditions involves is multifactorial (i.e. it involves a number of factors, particularly environmental and genetic ones). Autoimmune conditions generally cannot be cured, although they are successfully controlled in many cases.

Play the attached video to know the disorders & triggers of autoimmune diseases.






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Asthma and allergic diseases constitute the most common chronic inflammatory disorders, particularly in children, with constantly increasing prevalence in Westernised countries. They are complex conditions with local tissue inflammation that are triggered by the interaction between genetic and environmental factors. The steep rise in the prevalence of asthma and allergies since the 1960s, in addition to the genetic predisposition, may be linked to contaminants produced as a result of urbanisation and industrialisation, which generate air pollutants that the population is exposed to. The human microbiome may also play a role in the increased risk of asthma or allergies.

Allergy is a heterogeneous disease that may be manifested over a wide spectrum of disorders, including asthma, AD, atopic rhinitis, FA, and EoE. These aberrant immune responses may be initiated by a broad array of factors acting alone or in concert, such as exposure to air pollution, inflammation, infection, alterations in the specific microbiome, and inherent genetic predisposition. A better understanding of both the distinct and shared web of factors underlying the spectrum of allergic disorders may lead to the development of individualized, disease-modifying interventions.

(( AD, atopic dermatitis; EoE, eosinophilic esophagitis; FA, food allergy))