SlideShare ist ein Scribd-Unternehmen logo
1 von 65
Adrenocorticosteroids and Adrenocortical Antagonists Ma. Victoria M. Villarica, M.D. Fatima College of Medicine
Objectives ,[object Object],[object Object],[object Object]
 
Types of steroid hormones ,[object Object],[object Object],[object Object],[object Object],[object Object]
Adrenal Gland ,[object Object],[object Object]
 
Adrenal Cortex ,[object Object],[object Object],[object Object],[object Object]
ACTH ,[object Object],[object Object],[object Object],[object Object]
ACTH ,[object Object],[object Object]
Regulation of ACTH secretion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Control of Endocrine Activity ,[object Object],[object Object]
 
 
[object Object],[object Object],Steroid hormones
cholesterol Extracellular lipoprotein Cholesterol pool LH ATP cAMP PKA+ Pregnenolone Progesterone Androstenedione TESTOSTERONE 3  HSD P450c17 17  HSD acetate
Steroid hormone production ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Steroidogenic Enzymes Common name "Old" name Current name Side-chain cleavage enzyme; desmolase P450 SCC CYP11A1 3 beta-hydroxysteroid dehydrogenase 3 beta-HSD 3 beta-HSD 17 alpha-hydroxylase/17,20 lyase P450 C17 CYP17 21-hydroxylase  P450 C21 CYP21A2 11 beta-hydroxylase P450 C11 CYP11B1 Aldosterone synthase P450 C11AS CYP11B2 Aromatase P450 aro CYP19
Adrenocorticosteroids ,[object Object],[object Object],[object Object],[object Object]
A. Mineralocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object]
B. Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CBG (transcortin) ,[object Object],[object Object]
C. Adrenal Androgens ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Physiologic effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physiologic effects (cont.): ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physiologic effects (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physiologic effects (cont.): ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Synthetic Steroids ,[object Object],[object Object],[object Object],[object Object]
Classification of Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
II. Intermediate-acting glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],IV. Mineralocorticoids
Uses: ,[object Object],[object Object]
Therapeutic Uses : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1. Adrenal Insufficiency (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
 
Therapeutic Uses (cont.) 2. Adrenocortical hypofunctioning and hyperfunctioning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Therapeutic Uses  2. Adrenocortical hypofunctioning and hyperfunctioning (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
B.  Stimulation of fetal lung maturation –   betamethasone 12mg ffed by 12mg    18-24 hrs. later ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object]
C. Non- Adrenal Diseases (cont.) ,[object Object],[object Object]
C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object]
C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object]
C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object]
D. Diagnostic Application –  dexamethasone: suppress production of ACTH  ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Toxicity: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Supplemental measures: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antagonists of Adrenocortical Agents ,[object Object],[object Object],[object Object],[object Object]
Synthetic inhibitors and glucocorticoid antagonists    (cont.) ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Synthetic inhibitors and glucocorticoid antagonists    (cont.)
[object Object],[object Object],[object Object],Synthetic inhibitors and glucocorticoid antagonists    (cont.)
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Classification of topical corticosteroids based on their potencies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Common side effects of topical corticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary of adrenocortical agonists and antagonists…… ,[object Object],[object Object],[object Object]
[object Object]

Weitere ähnliche Inhalte

Was ist angesagt?

Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation method
Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation methodExpt. 5 Bioassay of oxytocin using rat uterine horn by interpolation method
Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation methodVISHALJADHAV100
 
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.Mirza Anwar Baig
 
Antihyperlipidemic agents
Antihyperlipidemic agentsAntihyperlipidemic agents
Antihyperlipidemic agentskencha swathi
 
Expt. 7 Effect of saline purgative on frog intestine
Expt. 7 Effect of saline purgative on frog intestineExpt. 7 Effect of saline purgative on frog intestine
Expt. 7 Effect of saline purgative on frog intestineVISHALJADHAV100
 
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassayExpt. 2 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassayVISHALJADHAV100
 
Bioassay of Digitalis, d-tubocurarine , Oxytocin
Bioassay of Digitalis, d-tubocurarine , OxytocinBioassay of Digitalis, d-tubocurarine , Oxytocin
Bioassay of Digitalis, d-tubocurarine , OxytocinHeena Parveen
 
Molecular Aspects of Drug Action
Molecular Aspects of Drug ActionMolecular Aspects of Drug Action
Molecular Aspects of Drug ActionAmna Medani
 
Expt. 9 Test for pyrogens ( rabbit method)
Expt. 9 Test for pyrogens ( rabbit method)Expt. 9 Test for pyrogens ( rabbit method)
Expt. 9 Test for pyrogens ( rabbit method)VISHALJADHAV100
 
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassayExpt. 7 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassayVISHALJADHAV100
 
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)Osama Al-Zahrani
 

Was ist angesagt? (20)

Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation method
Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation methodExpt. 5 Bioassay of oxytocin using rat uterine horn by interpolation method
Expt. 5 Bioassay of oxytocin using rat uterine horn by interpolation method
 
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.
Expt 13 Study of stereotype and anti-catatonic activity of drugs on rats/mice.
 
Metabolism II
Metabolism IIMetabolism II
Metabolism II
 
Antihyperlipidemic agents
Antihyperlipidemic agentsAntihyperlipidemic agents
Antihyperlipidemic agents
 
Antihyperlipidemia
AntihyperlipidemiaAntihyperlipidemia
Antihyperlipidemia
 
Expt. 7 Effect of saline purgative on frog intestine
Expt. 7 Effect of saline purgative on frog intestineExpt. 7 Effect of saline purgative on frog intestine
Expt. 7 Effect of saline purgative on frog intestine
 
Nootropics (M.Pharm)
Nootropics (M.Pharm)Nootropics (M.Pharm)
Nootropics (M.Pharm)
 
Anterior pituitary hormones - drdhriti
Anterior pituitary hormones - drdhritiAnterior pituitary hormones - drdhriti
Anterior pituitary hormones - drdhriti
 
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassayExpt. 2 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 2 Bioassay of acetylcholine using rat ileum by four point bioassay
 
Cardiac glycosides
Cardiac glycosidesCardiac glycosides
Cardiac glycosides
 
Bioassay of Digitalis, d-tubocurarine , Oxytocin
Bioassay of Digitalis, d-tubocurarine , OxytocinBioassay of Digitalis, d-tubocurarine , Oxytocin
Bioassay of Digitalis, d-tubocurarine , Oxytocin
 
Molecular Aspects of Drug Action
Molecular Aspects of Drug ActionMolecular Aspects of Drug Action
Molecular Aspects of Drug Action
 
Drug metabolism
Drug  metabolismDrug  metabolism
Drug metabolism
 
Pharmacology of Alcohol
Pharmacology of Alcohol Pharmacology of Alcohol
Pharmacology of Alcohol
 
Expt. 9 Test for pyrogens ( rabbit method)
Expt. 9 Test for pyrogens ( rabbit method)Expt. 9 Test for pyrogens ( rabbit method)
Expt. 9 Test for pyrogens ( rabbit method)
 
Evaluation of diuretic activity
 Evaluation of diuretic activity Evaluation of diuretic activity
Evaluation of diuretic activity
 
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassayExpt. 7 Bioassay of acetylcholine using rat ileum by four point bioassay
Expt. 7 Bioassay of acetylcholine using rat ileum by four point bioassay
 
Drug absorption
Drug absorption Drug absorption
Drug absorption
 
Glucagon
GlucagonGlucagon
Glucagon
 
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)
Pharmacology (effects of drugs on the ciliary motility of forg oesophagus)
 

Andere mochten auch (8)

SURGICAL SITE INFECTIONS an update working protocol
SURGICAL SITE INFECTIONSan updateworking protocol  SURGICAL SITE INFECTIONSan updateworking protocol
SURGICAL SITE INFECTIONS an update working protocol
 
Surgical diseases of the thyroid gland and parathyroid gland
Surgical diseases of the thyroid gland and parathyroid glandSurgical diseases of the thyroid gland and parathyroid gland
Surgical diseases of the thyroid gland and parathyroid gland
 
Screening for MRSA
Screening for MRSAScreening for MRSA
Screening for MRSA
 
Git diseases presentn no. 2 applied nutrition
Git diseases presentn no. 2 applied nutritionGit diseases presentn no. 2 applied nutrition
Git diseases presentn no. 2 applied nutrition
 
Surgical operation theater standards Dr.T.V.Rao MD
Surgical operation theater standards Dr.T.V.Rao MDSurgical operation theater standards Dr.T.V.Rao MD
Surgical operation theater standards Dr.T.V.Rao MD
 
SURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARESURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARE
 
Surgical infections
Surgical infectionsSurgical infections
Surgical infections
 
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
 

Ähnlich wie Adrenocorticosteroids

Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptx
Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptxMolecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptx
Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptxSamikshaHamane
 
ACTH and Corticosteroids.ppt
ACTH and Corticosteroids.pptACTH and Corticosteroids.ppt
ACTH and Corticosteroids.pptrajender arutla
 
Corticosteroids + immunomodulators
Corticosteroids + immunomodulatorsCorticosteroids + immunomodulators
Corticosteroids + immunomodulatorsDrMeghaBahal
 
4th unit corticosteroids
4th unit corticosteroids4th unit corticosteroids
4th unit corticosteroidsNikithaGopalpet
 
The Adrenal Gland-converted.pptx
The Adrenal Gland-converted.pptxThe Adrenal Gland-converted.pptx
The Adrenal Gland-converted.pptxPsyrystAllado2
 
Adrenal hormones - Pharmacology
Adrenal hormones - PharmacologyAdrenal hormones - Pharmacology
Adrenal hormones - PharmacologyAreej Abu Hanieh
 
Adrenal hormone
Adrenal hormoneAdrenal hormone
Adrenal hormoneAtai Rabby
 
Endocrine disorders of adrenal gland
Endocrine disorders of adrenal glandEndocrine disorders of adrenal gland
Endocrine disorders of adrenal glandSubhasish Deb
 
Corticosteroid in dentistry
Corticosteroid in dentistryCorticosteroid in dentistry
Corticosteroid in dentistryAnkit Patel
 
Lec 2 - Adrenal hormones.pptx
Lec 2 - Adrenal hormones.pptxLec 2 - Adrenal hormones.pptx
Lec 2 - Adrenal hormones.pptxAymanshahzad4
 
Adrenal gland & Cushing's Disease - Seminar August 2015
Adrenal gland & Cushing's Disease - Seminar August  2015Adrenal gland & Cushing's Disease - Seminar August  2015
Adrenal gland & Cushing's Disease - Seminar August 2015Arun Vasireddy
 
Principles of Hormonal regulations
Principles of Hormonal regulationsPrinciples of Hormonal regulations
Principles of Hormonal regulationsEneutron
 
Adrenal, pancreas[1]
Adrenal, pancreas[1]Adrenal, pancreas[1]
Adrenal, pancreas[1]MBBS IMS MSU
 
Steroids converted
Steroids convertedSteroids converted
Steroids convertedankit sharma
 
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...Indian dental academy
 

Ähnlich wie Adrenocorticosteroids (20)

Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptx
Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptxMolecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptx
Molecular & Cellular Pharmacology & Mechanism of Action of Corticosteroids.pptx
 
ACTH and Corticosteroids.ppt
ACTH and Corticosteroids.pptACTH and Corticosteroids.ppt
ACTH and Corticosteroids.ppt
 
Corticosteroids + immunomodulators
Corticosteroids + immunomodulatorsCorticosteroids + immunomodulators
Corticosteroids + immunomodulators
 
4th unit corticosteroids
4th unit corticosteroids4th unit corticosteroids
4th unit corticosteroids
 
Adrenal cortex
Adrenal cortexAdrenal cortex
Adrenal cortex
 
The Adrenal Gland-converted.pptx
The Adrenal Gland-converted.pptxThe Adrenal Gland-converted.pptx
The Adrenal Gland-converted.pptx
 
Adrenal hormones - Pharmacology
Adrenal hormones - PharmacologyAdrenal hormones - Pharmacology
Adrenal hormones - Pharmacology
 
Icbt08i10p1039
Icbt08i10p1039Icbt08i10p1039
Icbt08i10p1039
 
Adrenal hormone
Adrenal hormoneAdrenal hormone
Adrenal hormone
 
Endocrine disorders of adrenal gland
Endocrine disorders of adrenal glandEndocrine disorders of adrenal gland
Endocrine disorders of adrenal gland
 
Corticosteroid in dentistry
Corticosteroid in dentistryCorticosteroid in dentistry
Corticosteroid in dentistry
 
Lec 2 - Adrenal hormones.pptx
Lec 2 - Adrenal hormones.pptxLec 2 - Adrenal hormones.pptx
Lec 2 - Adrenal hormones.pptx
 
Corticosteroids(2&3)
Corticosteroids(2&3)Corticosteroids(2&3)
Corticosteroids(2&3)
 
Adrenal gland & Cushing's Disease - Seminar August 2015
Adrenal gland & Cushing's Disease - Seminar August  2015Adrenal gland & Cushing's Disease - Seminar August  2015
Adrenal gland & Cushing's Disease - Seminar August 2015
 
Adrenal gland Surgery(2)
Adrenal gland Surgery(2)Adrenal gland Surgery(2)
Adrenal gland Surgery(2)
 
CORTICOSTERIODS.pdf
CORTICOSTERIODS.pdfCORTICOSTERIODS.pdf
CORTICOSTERIODS.pdf
 
Principles of Hormonal regulations
Principles of Hormonal regulationsPrinciples of Hormonal regulations
Principles of Hormonal regulations
 
Adrenal, pancreas[1]
Adrenal, pancreas[1]Adrenal, pancreas[1]
Adrenal, pancreas[1]
 
Steroids converted
Steroids convertedSteroids converted
Steroids converted
 
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
 

Mehr von MD Specialclass (20)

Getting ahead of headaches
Getting ahead of headachesGetting ahead of headaches
Getting ahead of headaches
 
Acute brain attack 911
Acute brain attack  911Acute brain attack  911
Acute brain attack 911
 
Hema intro anemia
Hema intro anemiaHema intro anemia
Hema intro anemia
 
EXCRETA, SEWAGE, REFUSE DISPOSAL
EXCRETA, SEWAGE, REFUSE DISPOSAL EXCRETA, SEWAGE, REFUSE DISPOSAL
EXCRETA, SEWAGE, REFUSE DISPOSAL
 
EXCRETA, SEWAGE, REFUSE DISPOSAL
EXCRETA, SEWAGE, REFUSE DISPOSAL EXCRETA, SEWAGE, REFUSE DISPOSAL
EXCRETA, SEWAGE, REFUSE DISPOSAL
 
Fever & id diet final
Fever & id diet finalFever & id diet final
Fever & id diet final
 
Eating disorders
Eating disordersEating disorders
Eating disorders
 
Hepatocellular carcinoma
Hepatocellular carcinomaHepatocellular carcinoma
Hepatocellular carcinoma
 
Eating disorders
Eating disordersEating disorders
Eating disorders
 
Normal sleep and sleep disorders
Normal sleep and sleep disordersNormal sleep and sleep disorders
Normal sleep and sleep disorders
 
Tic disorder
Tic disorderTic disorder
Tic disorder
 
Thyroid
ThyroidThyroid
Thyroid
 
Dermatology dr.n.ramos
Dermatology   dr.n.ramosDermatology   dr.n.ramos
Dermatology dr.n.ramos
 
Tic disorder
Tic disorderTic disorder
Tic disorder
 
Toxic and drug induced hepatitis
Toxic and drug induced hepatitisToxic and drug induced hepatitis
Toxic and drug induced hepatitis
 
Pancreatic disease
Pancreatic diseasePancreatic disease
Pancreatic disease
 
Liver disease
Liver diseaseLiver disease
Liver disease
 
Complications of cirrhosis
Complications of cirrhosisComplications of cirrhosis
Complications of cirrhosis
 
Cirrhosis
CirrhosisCirrhosis
Cirrhosis
 
Chronic hep b
Chronic hep bChronic hep b
Chronic hep b
 

Adrenocorticosteroids

  • 1. Adrenocorticosteroids and Adrenocortical Antagonists Ma. Victoria M. Villarica, M.D. Fatima College of Medicine
  • 2.
  • 3.  
  • 4.
  • 5.
  • 6.  
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.  
  • 13.  
  • 14.
  • 15. cholesterol Extracellular lipoprotein Cholesterol pool LH ATP cAMP PKA+ Pregnenolone Progesterone Androstenedione TESTOSTERONE 3  HSD P450c17 17  HSD acetate
  • 16.
  • 17.  
  • 18. Steroidogenic Enzymes Common name "Old" name Current name Side-chain cleavage enzyme; desmolase P450 SCC CYP11A1 3 beta-hydroxysteroid dehydrogenase 3 beta-HSD 3 beta-HSD 17 alpha-hydroxylase/17,20 lyase P450 C17 CYP17 21-hydroxylase P450 C21 CYP21A2 11 beta-hydroxylase P450 C11 CYP11B1 Aldosterone synthase P450 C11AS CYP11B2 Aromatase P450 aro CYP19
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.  
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.  
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.  
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.