Important Drugs and Their Side Effects

drugs and their side effects
Nearly All Drugs Both OTC And Prescription Drugs Have Some Kind Of Undesirable Side effects From simple Muscle Pain to Death .Whether they are the simple drug like aspirin to the most sophisticated drugs In the Market , All Drugs Come With Some Minor Or serious Side Effects.Nearly All Drugs Can cause Nausea,Vomiting And For Drugs Used On Skin Will Cause Irritation.

Following Are Some Of The Most Commonly Used Drugs And Their Side Effects .

1.Ampicillin- Hypersensitivity
2. Amphotericin.B- Nephrotoxicity
3. Androgen- Virilization
4. Antipsychotics- Sedation, Orthostatic hypotension, Tardive dyskinesia
5. Anti- TB- Hepatotoxicity
6. Aspirin (cox-I Inhibitors)- Hepatotoxicity
7. ACE Inhibitors- Dry Cough
8. Atropine – Dryness of mouth, Blurred vision, Constipation
9. Chlorambucil- Alopecia
10.Celecoxib,Valdecoxib (cox-II Inhibitors)-cardio and Hepatotoxicity
11.Chloroquine – Phototoxicity
12.Chloramphenicol- Grey baby syndrome, Bone   marrow depression
13. Ciprofloxacin – Phototoxicity
14. Clofazimine- Pigmentation of skin, Discoloration of Urine
15. Clozapine – Agranulocytosis
16. Erythromyicin- Cholestatic Juandice
17. Ethambutol – Optic Neuritis, Retrobulbular Neuritis
18. Hydrochlorthiazide- Hypokalamia
19. Isoniazid – Peripheral Neurtis
20. Metronidazole- Disulfiram like reaction
21. Minoxidil- Hirsutism
22. Morphine- Constipation
23. Nimesulide – Hepatotoxicity
24. Nitrogen Mustard- Bone marrow depression
25. Nitroglycerin- Palpitation
26. Penicillin. G- Jarisch Heximer Reaction
27. Phenformin- Lactic acidosis, GI disturbance, Metalic taste
28. Phenytoin- Hirsutism
29. Quinidine- Cinchonism
30. Quinine Sulphate- Black Water Fever
31. Repaglinide- Althralgia
32. Rosaglitazone- Anemia,Weight gain
33. Sitagliptin- Coldness
34. Spironolactone- Hyperkalamia
35. Cimetidine- Gynacomastia
37. Sulfonyl Ureas derivatives- Bone marrow depression
38. Terfenadine- Type-I arrhythmia
39. Tetracyclines- Discoloration of teeth
40. Thalidomide- Phocomelia

41.Impotericin B – injection site reactions (pain, swelling, irritation),fever,shaking,chills,flushing, shortness of breat.

42.Lipitor-Joint Pain

43.Benzodiazepines – Drowsiness.,Confusion.,Dizziness.,Blurred vision.

44.Beta Blockers – Shortness of breath,Stomach Upset, Fatigue .Erectile Dysfunction.

45.Paracetamol-Liver Toxicity

46.Glucophage (Metformin)-Megaloblastic Anemia and Acute Respiratory Distress Syndrome.

47.Albuterol-Tremors,Chest Pain ,Bronchospasm.

48.Clonidine -Drowsiness.

49.Rosuvastatin- confusion, memory problems

50.Esomeprazole-Stomach Cramps, Gas, Diarrhea.

51.Insulin Glargin-Low Blood Sugar

52.Pregabalin-Blurred Vision,Drowsiness, Fluid Retention in the Legs, Feet, Arms or Hands, Weight Gain.

53.Tiotropium-Chest Pain,urinary tract infection,Nose Bleed,Rashes.

54.AdalimumabAcute Infection of the Nose, Throat or Sinus, Extreme Loss of Body Water.

55.Prednisone –infection, Nervous.

56.Viagra-flushing,Headache,Blurred Vision,stuffy nose.etc

 

Drugs To avoid when pregnant

Drugs To avoid when pregnant

Drugs That Cause Problems During Pregnancy

These Are The Drugs To avoid when pregnant because these drugs Cause Problems During Pregnancy.

1)Antibiotics

  • Fluoroquinolones (such as ciprofloxacin, ofloxacin, levofloxacin, and norfloxacin)
  • Nitrofurantoin
  • Streptomycin
  • Sulfonamides (such as sulfasalazine and trimethoprim- sulfamethoxazole)
  • Tetracycline

Abnormalities Caused By These Drugs

Possibility of bone and joint abnormalities (seen only in animals)

2) Anticonvulsants

  • Carbamazepine
  • Phenobarbital
  • Phenytoin
  • Valproate

Abnormalities Caused By These Drugs

  • Bleeding problems in the newborn. This Problem Can be prevented by Taking Vitamin K Orally 30 Days Before Delivery
  • Cause Risk of birth defects, including neural tube defects (such as spina bifida)
  • Volproate Cause Some (1%) risk of birth defects, including a neural tube defects (such as a meningomyelocele), cleft palate, and defects of face,  the heart, skull, limbs , and  spine

3) Antihypertensives

a)Angiotensin-converting enzyme (ACE) inhibitors

  • Captopril
  • Benazepril
  • Fosinopril
  • Enalapril
  • Lisinopril
  • Quinapril
  • Ramipril
  • Trandolapril
  • Perindopril

Abnormalities Caused By These Drugs :Serious Injury To The Fetus ,May Cause Kidney Damage In The Fetus ,Reduce Amniotic Fluid,Also Cause Defects Of Lungs ,Face And Limbs

b)Calcium Channel Blockers:

  • Isradipine
  • Nisoldipine
  • Amlodipine
  • Verapamil
  • Nifedipine (sustained-release only)
  • Diltiazem(sustained-release only)
  • Nicardipine
  • Felodipine

Abnormalities Caused By CCB:

Fluid retention in the ankles ,Dizziness, headache,  flushing, heartburn,an abnormally fast heart rate (tachycardia)  And enlarged gums.

Verapamil also caused Constipation.

c)Beta Blockers Drugs :

  • Atenolol
  • Bisoprolol
  • Metoprolol
  • Acebutolol
  • Nadolol
  • Penbutolol
  • Propranolol
  • Betaxolol
  • Carteolol
  • Timolol
  • Nebivolol
  • Pindolol

Problems Caused By Beta Blockers:

Beta Blockers Caused Slow Growth Rate In The Fetus And Also Cause Low Level Of Blood Sugar And Low Heart Rate .

d)Thiazide Diuretics:

  • Chlorothiazide
  • Bendroflumethiazide
  • Hydroflumethiazide
  • Chlorthalidone
  • Hydrochlorothiazide
  • Methyclothiazide
  • Metolazone
  • Indapamide

Problems Caused By Diuretics:

Taking Thiazide Diuretics During Pregnancy Will Cause Decrease In The Level Of oxygen,Potasium Sodium.Also Decrease In  Number Of  Platelets  In The Fetus. Inadequate Growth Before Birth.

4) Antianxiety drug:

  • Diazepam

Abnormalities Caused By Diazepam :

When This Drug Is Taken In The Third Trimester Of Pregnancy It cause irritability, exaggerated reflexes in the newborn depression, and shaking.

5) Mood-stabilizing drug:

  • Lithium

Abnormalities:

Poor feeding, Lethargy, reduced muscle tone, nephrogenic diabetes insipidus in the newborn And underactivity of the thyroid gland.

6) Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Naproxen
  • Ibuprofen
  • Aspirin and other salicylates

 

Problems Or Abnormalities :

When the medication are taken in large doses, probably miscarriages during the first trimester, a delay within thebegin of labor, premature closing of the connection between the aorta and artery to the lungs (ductus arteriosus), jaundice, necrotizing enterocolitis (damage to the liner of the intestine), and (occasionally) brain injury within thefoetus and bleeding issues within the woman throughout and after delivery and/or within the newborn

When the medication are taken late in pregnancy, a discount in the amount of fluid round the developing foetus.

 

7)Sex Hormones:

  • Synthetic progestins (but not the low doses used in oral contraceptives)
  • Danazol

(When Synthetic Progestin And Danazol  are taken In The early stages Of pregnancy, masculinization of a female fetus’s genitals, sometimes requiring surgery for correction)

  • Diethylstilbestrol (DES)

(Abnormalities of the penis in sons.Abnormalities of the uterus, an increased risk of vaginal cancer ,menstrual problems, and complications during pregnancy in daughters)

8)Vaccines:

Vaccines for polio, measles, mumps or yellow fever

This Vaccine cause Potential infection of the placenta and developing fetus.

Vaccine for  chickenpox (varicella) and rubella.

This Is Associated With Unknow Risks.

9)Drugs Used In Skin Treatment:

Isotretinoin

Etretinate

Problems:

Both Of these Drugs Cause Birth defects, such as small ears,  heart defects, and hydrocephalus .

While Isotretinoin Also Cause  Intellectual disability And Risk of miscarriage.

10) Oral ant diabetic drugs:

  • Metformin
  • Glyburide
  • Tolbutamide
  • Chlorpropamide

Problems/Abnormalities Caused By These Drugs :

Inadequate control of diabetes in the pregnant woman

When a Pregnant woman with type 2 diabetes Takle The Drugs, possibility of increased risk of miscarriage Are More .

Also Cause a  very low blood sugar level in the newborn.

 

 

DRUGS USED IN EMERGENCY SITUATIONS

 Emergency Drugs

1)COMMONLY USED DRUGS IN ICU AND CCU

The main groups of drugs used in ICU are as follows:

OPOIDS: • Fentanyl • Naloxone • Morphine • Pethidine

Non Opoids:  Analog of phencyclidine,And  Ketamine

BENZODIAZEPINES: • Midazolam • Diazepam• Flumazenil • Lorazepam

SEDATIVES: Propofol.

The main groups of drugs used in CCU are as follows:

Digoxin ,Propanolol ,Lignocaine, Adenosine, Amiodarone Verapamil Aspirin, Sodium bicarbonate, GTN Streptokinase Isosorbide di-nitrate ,Nicorandil, Atrovastin.

2)Common Emergency Drugs

Life Saving Drugs: • Atropine• Sodabicarbonate • Adrenaline• Calcium Gluconate • Xylocard

Other Emergency Drugs are:

  • Atropine •Midazolam Common drugs used for OP poisoning •Diazepam

3)Drugs used in Congestive Cardiac Failure:

  • ACE inhibitors: captopril, enalapril
  • ARBS: losartan. Candesartan
  • Beta blockers
  • Diuretics
  • vasodilators
  • Digoxin

4) Most Common drugs used for cardiac arrest:

  • Antiarrythmic- amiodarone, lidocaine.
  • Epinephrine
  • Vasopressors dopamine, dobutamine
  • Other drugs-, sodium bicarbonate atropine, , thrombolytic Agents(STK, tPA) ,calcium

 5) Drugs used in Angina

  • Isosrbide dinitrate
  • Amlodipine
  • Glyceryl trinitrate(GTN)
  • Propanolol • Verapamil

6) Common drugs used in Myocardial Infarction:

  • Vasodilators: Nitroglycerine
  • Antiplatelet: aspirin
  • Anticoagulant: heparin
  • Pain relief : Morphine
  • Vasopressor: dopamine, dobutamine
  • Stool softner: cremaffin .

7) Commonly Used Drugs In Operation Theater:

  • Local Anesthetics:

This Includes Lignocaine/Lidocaine HCL,And Bupivacaine HCL

  • General anesthetics:This Group Inclides

Ether,Isoflurane,halothane,nitrous oxide,thiopentone sodium,Sevoflurane,Propofol.

10) MUSCLE RELAXANT:

  • Vecuronium
  • Mivacurium
  • Succinyl choline
  • Atracurium

A new drug Xadago approves By FDA to treat Parkinson’s disease

Fda approves new drug for parkinson disease

US FDA approves A new Drug i.e Xadago (safinamide) For the treatment of Parkinson Disease A Disease In Which Cells In The Brain Which Produce Dopamine Become Impaired Or Die. Dopamine Is A chemical That helps transmit signals between the areas of the brain that produce smooth, purposeful movement  such as eating, shaving and writing.According To Report Of National Institute Of Health More Then 1 Million Americans Have Parkinson Disease And  Approximately 50,000 US Citizens Are Diagnosed With Parkinson Disease Each Year.

The New Drug Is A Great Plus To The Treatment Of Parkinson Patients Who are Currently Using Levodopa or carbidopa For OFF Episodes.

According To FDA press Release The effectiveness of Xadago in treating Parkinson’s sickness was shown In Two Clinical Trials.In First clinical test of 645 participants who were additionally taking levodopa and were experiencing “off” time. Those receiving Xadago experienced a lot of useful “on” time, a time when Parkinson’s symptoms are reduced, without difficult uncontrolled involuntary movement (dyskinesia), compared to those receiving a placebo. the rise in “on” time was among a reduction in “off” time and better scores on a measure of motor function assessed throughout “on” time than before treatment.

In The Second Clinical Trial of 549 participants, the participants adding Xadago to their L-dopa treatment had additional “on” time without difficult  uncontrolled involuntary movement compared to those taking a placebo, and additionally had better scores on a measure of motor function assessed throughout “on” time than before treatment.

Some Very Common Adverse reactions Were Seen With The Use Of Xadago Like Trouble In Sleeping (Insomnia), Falls ,Nausea ,And uncontrolled involuntary movement,hallucinations and psychotic behavior; withdrawal-emergent hyperpyrexia (fever) problems with impulse control/compulsive behaviors; retinal pathology and confusion.

According To FDA The Drug Is Contraindicated In Severe Liver Problems And Those Who Are already TaKing Drugs For Cold And Flu Like dextromethorphan.It Is also Contraindicated in Patients Who Are Taking Mono amine Oxidase Inhibitors (MAOI) Because This May Cause Sudden Increase In BP.(Blood Pressure)Some Antidepressants Drugs Like Tricyclic , serotonin-norepinephrine reuptake inhibitors (SNRIs),Tetracyclic,  triazolopyridines and  cyclobenzaprine Can Also Cause Life threatening Conditions Know As Serotonins Syndrome.

 

How To Treat Depression ?

How To Treat Depression

Depression Also Called  major depressive disorder ; could be a common and serious medical health problem that negatively affects how you’re feeling, the way you think that and the way you act. luckily, it’s treatable. Depression causes feelings of unhappiness and/or a loss of interest in activities once enjoyed. It will cause a range of emotional and physical issues and may decrease a person’s ability to perform at work and at home.

Research tells us that different factors contribute to the onset of depression, including genetics, grief or difficult life circumstances certain medical conditions, changes in hormone levels,stress,. Any of those factors alone or together will precipitate changes in brain chemistry that cause depression’s several symptoms.

According To WHO depression is one of the foremost disabling disorders in the world, affecting roughly one in 5 ladies and one in 10 men at some point in their life.

 

Symptoms  Of Depression:

Depression symptoms can vary from mild to severe and can include:

  • Thoughts of death or suicide
  • Difficulty thinking, concentrating or making decisions
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Feeling sad or having a depressed mood
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Feeling worthless or guilty
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)

 

Types Of Depression And  How To Treat Depression  :

There Are Three Types of Depression,

1)Mild Depression

2)Moderate Depression

3)Sever Depression .

 

1)Mild Depression :

If Your Depression Is Mild One You Should  Wait And See For Atleast 2 Weeks That Whether Your Depression May Subside By Itself Or Not.

Take Help Of Exercise Some Studies Have Shown That Exercise Is One of The Main Treatment For Depression . Antidepressant Drugs Should not be use routinely in mild depression.

2)Moderate Depression :

If You Have Been Diagnosed With Mild Or Moderate Depression Your Strategies Should Be Talking Therapy There are differing kinds of talking medical care for depression, as well as cognitive behavioral therapy (CBT) and guidance. Your general practitioner will refer you for talking treatment, or in some elements of the country you would possibly be able to refer yourself.

3)Severe Depression:

If Your Depression Is Sever One The Controlling Strategies Should Be Antidepressant Drugs .There are approximately 30 type of Antidepressant drugs. Keep In Mind That These Drugs Should be Prescribed By A License Physician Or A Team Of Psychologists.

 

How To Treat Depression Naturally  ?

1)Be Socially Active:

keep in regular contact with friends and family, or consider joining a class or group. Strong social networks cut back isolation, a key risk factor for depression. Volunteering may be a marvelous way to get social support and facilitate others while additionally helping yourself.

2) Exercise:

Exercise Is The Best Natural Remedy For Reducing Your Depression Daily About 30-60 Minutes Of Exercise will Be A Great Plus for Your Health Because Due To Exercise Your Body Release Different Hormones Like Serotonin And Endorphins, It Also Increase The Growth Of New Brain Cells .

3)Sleep Well:

Depression will build it exhausting to induce enough shut-eye, and insufficient  sleep will make depression worse.

4)Try To Be Happy:

According To Some Studies Feeling Happy May Increase Your Serotonins Level Which Will Make You Happy Low serotonin receptor function is related to poor mood, and high 5-hydroxytryptamine (serotonin) levels are related to better mood. Basically, whereas low 5-hydroxytryptamine (serotonin) could cause you to feel unhappy, feeling happy may additionally increase your 5-hydroxytryptamine (serotonin ) levels. It’s not clear that is more powerful, however a technique to extend 5-hydroxytryptamine (serotonin )may be through  psychotherapy strategies like cognitive behavioral medical care, meditation

5)Avoid Caffeine Which Decrease Level Of 5 hydroxytryptamine (Serotonin)

6)Never Avoid Meal Because This Will Stable Your Blood Sugar Which Reduce Mood Swing.

Drugs That Are Used In Depression :

1.Selective Serotonin Reuptake Inhibitors: (SSRI)

fluoxetine (Prozac, Sarafem)

escitalopram (Lexapro)

paroxetine (Paxil, Pexeva, Brisdelle)

sertraline (Zoloft)

trazodone (Oleptro)

citalopram (Celexa)

fluvoxamine (Luvox)

2.Serotonin & Nor epinephrine  Reuptake Inhibitors: (SNRI)

These drugs include:

duloxetine (Cymbalta)

desvenlafaxine (Pristiq, Khedezla)

venlafaxine (Effexor XR)

levomilnacipran (Fetzima)

 

3)Tricyclic antidepressants (TCAs)

TCAs include:

desipramine (Norpramin)

imipramine (Tofranil)

amoxapine

trimipramine (Surmontil)

clomipramine (Anafranil)

amitriptyline

doxepin

nortriptyline (Pamelor)

protriptyline

4)Mono Amine Oxidase Inhibitors (MAOIs) :

Phenelzine (Nardil)

Selegiline (Smsam)

Isocarboxazid (Marplan)

Tranylcyromine (Parnate)

 

Treatment Strategies :

There’s very little to decide on among the various classes of antidepressant medication in terms of efficaciousness, therefore selection should be based on the person patient’s needs, together with the presence of concomitant illness, current clinical aid, suicide risk, and previous reaction to antidepressant therapy. because there may be an interval of 2 weeks before the antidepressant action takes place, electroconvulsive treatment can be required in extreme depression whilst delay is unsafe or intolerable. at some stage in the first few weeks of treatment, there’s an accelerated potential for agitation, anxiety, and suicidal ideation.

SSRIs are higher tolerated and are safer in overdose than other classes of antidepressants and need to be considered first-line for treating depression. In patients with unstable angina or who have had a recent myocardial infarction, sertraline has been proven to be safe.

Tricyclic antidepressants have comparable efficacy to SSRIs however are much more likely to be discontinued due to side- effects; toxicity in overdosage is likewise a problem. SSRIs are less sedating and have fewer antimuscarinic and cardiotoxic results than tricyclic antidepressants.

MAOIs have dangerous interactions with some foods and drugs, and need to be reserved to be used by experts. although anxiety is frequently present in depressive illness (and can be the presenting symptom), the usage of an antipsychotic or an anxiolytic might also mask the genuine diagnosis. Anxiolytics or antipsychotic drugs have to consequently be used with warning in depression but they’re useful adjuncts in agitated patients. Augmenting antidepressants with antipsychotics under professional superintendence may additionally be important in patients who’ve depression with psychotic signs.

Sources : BNF

Lippincott Pharmacology

Note:Treatment And Drugs Therapy Are Only For Medical Students And Professionals.Its Better To Consult Your Physician Before Starting Antidepressant Drugs

How To Treat Hypertension ?

How To Treat Hypertension

 

Definition :

Hypertension (high pressure level) is outlined as having a blood pressure reading of over 140/90 mmHg over a number of weeks. Our blood pressures change all the time throughout the day, therefore your doctor is trying to make sure that your hypertensive reading isn’t simply a natural event.
Hypertension Is The Leading Cause Of Cardiovascular Disease And In The United States Alone There Are More Then 75 Million People Have Hypertension.

Lowering raised blood pressure decreases the risk of stroke, coronary events, heart failure, and renal impairment.

Normal Blood Pressure According To Age:

1)Age 60 or more healthy Person Your BP treatment Goal Should be At least less than 150/90 mmHg

2)Age Less Than 60 years You need to control Your Blood Pressure In less than 140/90 mmHg.

3)Ideal Blood Pressure Is 120/80 mmHg.

How To Control Blood Pressure With Out Using Medicines:

If you have been diagnosed with high blood pressure, you can follow a few simple steps to learn how to change your lifestyle, your diet,to treat hypertension.

1)Changing Your Life Style:

Reduce Smoking.

Increase Exercise.

Reduce Stress.

2))Changing Your Diet:

Reduce Sodium Intake.

Eat More Whole Grains.

Increase Vegetable And Fruit Intake.

Avoid Alcoholic Beverages.

Control Sugar.

 

Drugs Used In Hypertension:

Diuretics

GenericBrand
AmilorideMidamor
CholrthalidoneHygroton
BumetonideBumex
Ethacrynic AcidEdecrin
FurosemideLasix
EplerenoneInspra
HydrochlorthiazideMicrozide
IndipamideLozol
TorsemideDemadex
SpironolactoneAldactone
MetolazoneZaroxylyn

Angiotensin 2 Converting Enzyme Inhibitors

GenericBrand
CandesartanAtacand
IrbesartanAvapro
EprosartanTeveten
Azilsartan MedoxomilEdarbi
LosartanCoozar
OlmesartanBenicar
ValsartanDiovan
TelmisartanMicardis

ACE inhibitors

GenericBrand
CaptoprilCapoten
BenzaprilLotensin
FosinoprilMonopril
EnalaprilVasotec
LisinoprilZestril
QuinaprilAccupril
MoexiprilUnivasc
RamiprilAltace
TrandolaprilMavik

Beta Blockers

GenericBrands
AtenololTenormin
AcebutololSectral
BisoprololZebeta
BetaxololKerlone
LabetololTrandate
CarvedololCoreg
NadololTrandate
MetoprololLopressor
PindololVisken
PenbutololLevatol
NadololCorgard
PropranololInderal,
TimololBlocadrin

Alpha Blockers

GenericBrand
DoxazosinCardura
PrazosinMinipress
TerazosinHytrin

Calcium Channel Blockers

GenericBrands
NicardipineCardene
IsradipineDynacirc CR
NifedipineAdalat
NisoldipineSular
VerapamilCalan,Isoptin
AmlopdipineNorvasc
ClevidipineCleviprex
DiltiazemCardizem
FelodipinePlendil

Others

GenericBrand
HydralazineApresoline
ClonidineCatapres
FenoldopamCorlopam
MinoxidilAldomet
NitroprussideNitropress
MinoxidilLoniten

 

Treatment  Strategies for  hypertension /High Blood Pressure:

A single antihypertensive is commonly inadequate within the management of high blood pressure, and extra antihypertensive medication are sometimes added in a step-wise manner until control is achieved. Unless it’s necessary to lower the pressure level urgently , an interval of at least four weeks should be allowed to see response; clinicians should guarantee antihypertensive drugs are titrated to the optimum or maximum tolerated dose at every step of treatment. Response to drug treatment could also be affected by age and ethnicity.

Patients under 55 years:

1 . ACE inhibitor; if not tolerated, offer an angiotensin-II receptor antagonist. If both ACE inhibitors and angiotensin-II receptor antagonists are contra- indicated or not tolerated, consider a beta-blocker; beta-blockers, especially when combined with a thiazide diuretic, should be avoided for the routine treatment of uncomplicated hypertension in patients with diabetes or at high risk of developing diabetes

2 . ACE inhibitor or angiotensin-II receptor antagonist in combination with a calcium-channel blocker. If a calcium-channel blocker is not tolerated or if there is evidence of, or a high risk of, Congestive heart failure, give a thiazide-related diuretic (e.g.indapamide or chlortalidone). If a beta-blocker was given at Step 1, add a calcium channel blocker in preference to a thiazide- related diuretic (see Step 1)

3 .ACE inhibitor or angiotensin-II receptor antagonist in combination with a calcium-channel blocker and a thiazide-related diuretic

4 (resistant hypertension) . Consider seeking specialist advice . Add low-dose spironolactone [unlicensed indication], or use high-dose thiazide related diuretic if plasma- potassium concentration More Than 4.5 mmol/litre . Monitor renal function and electrolytes . If additional diuretic therapy is contra-indicated, ineffective, or not tolerated, consider an a beta-blocker  or alpha-blocker.

Patients over 55 years:

1 . Calcium-channel blocker; if not tolerated or if there is evidence of, or a high risk of, heart failure, give a thiazide-related diuretic (e.g. chlortalidone or indapamide)

2 .ACE inhibitor or angiotensin-II receptor antagonist in combination with a calcium-channel blocker and a thiazide-related diuretic.

3.(resistant hypertension) . Consider seeking specialist advice . Add low-dose spironolactone [unlicensed indication], or use high-dose thiazide related diuretic if plasma- potassium concentration More Than 4.5 mmol/litre . Monitor renal function and electrolytes . If additional diuretic therapy is contra-indicated, ineffective, or not tolerated, consider an a beta-blocker  or alpha-blocker.

Sources : BNF

Lippincott Illustrated Reviews Pharmacology .

FDA Approves A new Drug For Nocturnal Polyuria (Frequent Urination At Night)

                  FDA Approves A new Drug For Nocturnal Polyuria FDA approves a new drug for Nocturnal polyuria

FDA Approves New Drug For Nocturnal Polyuria (Frequent Urination  At Night)

Good News:US FDA  Approves A New Drug  For Nocturnal Polyuria In Adults i.e Noctiva, That Will Control Your Frequent Urination At Night.The Drug Is In Nasal Spray Form And Will Only Be used For Adult Nocturnal Enuresis.

The active ingredient in Noctiva Spray Is desmopressin acetate, is included in some other medicine, as well as an injected version for bleeding disorders. The FDA said the nasal spray version is that the first approved treatment for frequent nighttime urination.

An Official From FDA’s Center for Drug evaluation and research said during a statement on Friday said, “Today’s approval provides adults who overproduce pee at midnight with the primary FDA-approved therapeutic option tofacilitate reduce the amount of times a night they get up to urinate”. The Food and Drug Administration Further said the spray, referred to as Noctiva, isn’t approved to treat all causes of frequent nighttime urination, thus doctors should confirm the cause and best treatment for each person.

Actually The Spray Is Originally Approved For A Common Condition Caused By Uncontrolled Diabetes ,Chronic Heart Failure (CHF), Prostate And Bladder Problems.

Noctiva’s effectiveness was Checked in randomized, placebo-controlled trials in 1,045 patients 50 years elderly and older with nocturia because of nocturnal polyuria. though these trials showed alittle reduction within the average range of night-time urinations with Noctiva compared to placebo, a lot of patients treated with Noctiva were able to at least halve their range of night-time urinations, and patients treated with Noctiva had more nights with one or fewer night-time urinations.

How To Use The Spray:

The nasal spray is employed daily about half-hour before bedtime. It works by making the kidneys absorb a lot of water, that reduces the quantity of urine.

FDA’s strongest Black Box  warning :

The drug will cause hazardously low levels of sodium within the blood (Hyponatremia). alternative side effects include increased blood pressure, colds, dizziness, bronchitis, nose bleeds,And back pain.

Milford ,Pennsylvania-based Renaissance Lakewood, LLC for Serenity Pharmaceuticals, LLC Has Marketed The Noctiva Spray.

 

Why Do Medical Professionals Wear White Coats ?

Why Do Medical Professionals Wear White Coats ?

New medical students are slipping on their short white coats, a big and exciting occasion that marks the start of their careers.

The tradition of the white coat initially fashioned within the early decades of the twentieth century. Before that, doctors wore formal, black apparel instead of white. White coats are thought to have been adopted in an exceedingly aware effort to mimic lab coats and make the image of doctors as people of science and to pursue the idea of sterility in treatment that was changing into vital at that time. each aims were meant to set doctors aside from the common person and, since its adoption, the white coat stood as a standing image. It reworked an individual into the embodiment of life science — like a white knife cutting through the contaminated world of death and disease — pure and superior in her knowledge and treatments. To go together with this, as doctors advance in training, they usually receive longer and longer white coats — enhancing their status and image.

According To JRSM (Journal Of The Royal Society Of The Medicine)  “ 72 % of all hospital doctors and medical students wear white coats and most wear them bigger than 75th of the time. White coats are worn principally for straightforward recognition by colleagues and patients, to put things within the pockets and to stay clothes clean. Psychiatrists and pediatricians try and maximize rapport with patients by deliberately not carrying white coats.”

Traditionally, they were buff, however white is substitutable with innocence, being trustworthy, cleanliness and life. within the past, doctors wore their street clothes most frequently or black, reflecting the mortality and frequent deaths seen in their chosen profession.But Indeed, a number of studies have shown that the coats harbor doubtless harmful microorganism.The Intresting Question Is  If white coats are therefore unhealthy, why do doctors still wear them?

Top Prescribed Drugs

Top Prescribed DrugsThe Top Prescribed Drugs

The top filled medication treat a growing range of people with high cholesterol, thyroid disorders, high blood pressure, GERD ,Pain, Inflammation and type 2 diabetes. the other medication rounding out the highest List additionally treat high blood pressure, additionally as high cholesterol and chronic pain.

Almost 4,065,175,064 prescriptions for medications were written within the united states in 2015.Remember this is often just for USA now Lets assume For a moment how much Prescription are going to be filled within the whole world? Major studies that analyzed the financial impacts of increased therapeutic drug use on treatment outcomes and spending have come to totally different conclusions. However, it’s known that a lot of diseases may be prevented, treated effectively or cured through prescription medications.

Following Are Top Prescribed Drugs .

1)Narcotic Analgesics:

Narcotic analgesics Is The Number One Class Of Top Prescribed Drugs And  Are Used For The Treatment Of  Pain and Inflammation.In 2010, over 244,300 prescriptions were filled for these kinds of pain killers.

According To GoodRx A US Base Startup That List Drugs Prices And Sell Prescription Drugs At Discounted Rate ,Compiled A list Of “Top 10 Most Popular Prescription Drugs” According To That Firm Vicodin (Hydrocodone And Acetaminophen) Is The Top Prescribed Drug In The First Month Of 2017 .The Lisiting Is based On Claims That Are Reported In Pharmacies.Some leading narcotic analgesics include Vicodin (hydrocodone and acetaminophen), Oxycodone (oxycodone), Percocet (acetaminophen and oxycodone), codeine, morphine and Ultram (tramadol).

2)Lipid Lowering Drugs:

More than 255.4 million prescriptions for statins and other lipid-lowering medicine were filled in 2010.Lipid regulators, mainly statin drugs, are used to stop dyslipidemia (high blood cholesterol) and other cardiovascular issues and are prescribed for the interference and treatment of the many different diseases including osteoporosis and post-menopause complications.

Pfizer’s Lipitor (atorvastatin calcium) was the best marketing branded statin, followed by, alternative branded statins included Mevacor (lovastatin), Crestor (rosuvastatin calcium) by AstraZeneca  Zocor (simvastatin), Lescol (fluvastatin sodium), Vytorin (Ezetimibe/Simvastatin), Pravachol (pravastatin, sodium),  and Pitavastatin.

3) Beta-Adrenergic  Blockers:

Beta-adrenergic blocking agents or beta-blockers (plain and in combination with alternative medicine, are prescribed for the treatment of heart condition, notably high blood pressure, as well as migraines glaucoma, and  hyperthyroidism. more than 191.5 million prescriptions for beta-blockers were filled in 2010.

Commonly prescribed beta-blockers include), Normodyne, Trandate (labetalol), Coreg (carvedilol), Inderal (propranolol), Sectral (acebutolol)), Brevibloc (esmolol . ), atenolol (atenolol, Lopressor, Toprol-XL (metoprolol)and Zebeta (bisoprolol).

4)Antidepressants:

Antidepressants are one of the fastest growing categories of prescription drugs. In 2010, over 253.6 million prescriptions were filled for antidepressants, according to the IMS report.

One of the main factors driving the rise in scripts for antidepressants is that a growing range of primary care providers and others practicing outside the sector of psychological medicine are writing the prescriptions for patients who haven’t received a clinical psychiatrical diagnosing,

5)Ace Inhibitors:

Angiotensin-converting enzyme (ACE) inhibitors are utilized in the treatment of high blood pressure, scleroderma, migraines and alternative conditions. In 2010, pharmacies dispensed over 168.7 million prescriptions for ACE inhibitors.

ACE inhibitors include capoten (captopril), vasotec (enalapril), , Lotensin (benazepril),  Aceon (perindopril), zestril (Lisinopril), Univasc (Moexipril), Accupril (quinapril), Altace (ramipril) Fosinopril, Prinivil and Mavik (trandolapril).

Autonomic Nervous System Pharmacology & Adrenergic Antagonists

Autonomic Nervous System PharmacologyAutonomic Nervous System Pharmacology

Short introduction Of Nervous System:

The nervous system is divided into two;
A) Central Nervous System
B) Peripheral Nervous System
Central Nervous system composed of brain and spinal cord.While The peripheral nervous system includes neurons located outside the brain and spinal cord.i.e any nerves that enter or leave the CNS.
The Peripheral nervous system is subdivided into Two;A)Efferent B)Afferent
A)Efferent:The Efferent neurons carry signals away from brain and spinal cord to the peripheral tissues.
B)Afferent:The afferent neurons bring information from periphery to the CNS.These neurons provide sensory input to modulate the function of the efferent division through the reflex arc or neural pathways that mediate reflex action.
The efferent division further divided into;
A)Autonomic System

B)Somatic

In this Chapter we will Discuss about Autonomic Nervous system in detail.

Autonomic Nervous System Pharmacology

ANS is further classified into three
(1)Sympathetic
(2)Parasympathetic
(3)Enteric.

●Sympathetic and parasympathetic NS are working against each other.
●Under stress sympathetic Nervous system activate while in Relax position your parasympathetic nervous system activates.e.g When You are lying on your bed.
I will take advantage of Dr.Najeeb Very Famous Example.

Scenario Example : A Person walking on the road suddenly a very big dog appears behind him in a very hostile Manner.The sympathetic nervous system Will Activate & his body will prepare for fight or flight.Here his body will prepare for flight because the dog is big and dangerous but if the dog is too small your body will prepare for fight and the dog sympathetic nervous system will activate and the dog will run away.
Taking the first example we will see the sympathetic N.S of The Person.

Question: How the sympathetic N.S Will be activated?
How Adrenergic System Start ?

Note :
1)Sympathetic preganglionic fibers release acetylcholine as a neurotransmitter at neuro effector organs.Means All the neurons Coming out of CNS are cholinergic.
2)Sympathetic Postganglionic fiber release Norepinephrine as a neurotransmitter.

3)The acetylcholine release in the 2 example will act on adrenal medulla and adrenal medulla will then release Epinephrine.The epinephrine released by adrenal medulla to the general circulation will act on all the receptors in the body.

Q)How adrenergic Receptor Work?

This is very important because a lot of drugs act on this area
The main neurotransmitter here is Norepinephrine This N.E is synthesized in the nerve ending.Basically, Amino acids come from absorption of food from GIT into the General circulation.This amino acid converted into tyrosine in the blood and then taken up intracellularly into nerve ending where tyrosine converts into Dopa with the help of Tyrosine Hydroxylase enzyme.The Dopa then converted into Dopamine by an enzyme which is called Dopa decarboxylase enzyme.The Dopamine then Stored in the vesicles if not stored the dopamine is destroyed in the cytosol by MAO(Monoamine oxidase) enzyme so that’s why they are stored in the vesicles.In the vesicle, the dopamine converts into Norepinephrine if the neuron is adrenergic but if the neuron is dopaminergic the dopamine inside the vesicle will and store and will release as such.Here the neuron is adrenergic so the Norepinephrine will release in the nerve ending.
》Now the Ca+ Channels will open intracellular Calcium Level will increase.
There is a protein on the wall of vesicles which is called synaptobrevin
And the other protein on the membrane of the neuron  i.e Syntaxin.
Whenever sympathetic nervous system release Norepinephrine some of the N.E work on presynaptic membrane (alpha 2 AR)and causes inhibition of the cyclic AMP and Increase outflux of potassium (k+) from the nerve ending which control the release of N.E

How Norepinephrine Release

Q)What Happens to N.E after Using?

》There is a special reuptake mechanism and unlike cholinergic system in which the acetylcholine is destroyed by acetylcholinesterase enzyme.But in this case, the N.E is reuptake to the cell.After Reuptake there is a 50 % chance for N.E to take back by vesicle or destroyed by MAO Enzyme.
》Small Amount of N.E is methylated by an enzyme COMPT Which cause methylation some very small amount of NE comes into General circulation.

Q)How Drugs Act On This Whole System?/ Autonomic Nervous System Pharmacology

Following are some of the drugs which work on this system and show their effects.

Sympatholytic Drugs/adrenergic antagonist:

These drugs work on the above system and reduce the release of Norepinephrine.

1)Methyl Tyrosine:(CH5-Tyrosine)

The mechanism of action of methyl tyrosine is same like that of tyrosine.This drug enters into the system just like tyrosine and will work/bind on methyl hydroxylase enzyme.The enzyme will not work properly and eventually less dopamine will produce so fewer N.E will produce Less N.E means adrenergic activity decreases so this drug is sympatholytic, or adrenergic antagonist.

2)Reserpine: 

This Drug Work On dopamine transporter on the vesicle and Don’t let dopamine to enter into the vesicle and we know that dopamine outside the vesicle will be destroyed by MAO enzyme.There will no or less N.vesicle.So after action potential, the Nerve ending will not release N.E because of empty vesicle.This drug is called resperine.

3)Bretylium & Guanadrel:

These drugs Don’t allow the vesicle to fuse with the membrane of neuron and don’t let the vesicle to expel N.E.So Less N.E release from the neve terminal.

4)Alpha Methyl Dopa:

This drug is taken up by the transport mechanism i same like tyrosine.It is going to fool the dopa. Dopa work/bind on this Drug (Alpha methyldopa) instead of dopa decarboxylase enzyme.The drug continuously fooling this system up to the end and in the end no N.E release but instead the nerve terminal release alpha methyl N.E. so When action potential generated alpha methyl norepinephrine will release into the synaptic cleft.

Note: These drugs decrease the activity of norepinephrine but by binding direct into the normal Mechanism.These drugs don’t work on receptor.

Drugs That Block the receptor:

These drugs are also called adrenergic receptor blockers/antagonist:
These drugs also decrease the effect of N.E but by blocking the receptor on which N.E act.

Adrenergic Receptor Blockers/Antagonists

Sources: Lippincott Illustrated Reviews Pharmacology

                     Doctor Najeeb Lectures.

We Will Discuss Sympathomimetic Drugs In The Upcoming Posts.Keep Sharing Our Contents.