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PHRM1011 Introductory Pharmacy 1
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PHRM1011 Introductory Pharmacy 1
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Course Code: PHRM1011
University: The University Of Queensland
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Country: Australia
Question:
Task
To produce a video on a classification of medications used to treat a common disease process for clients (patients) in your industry (i.e. a person who is unfamiliar with pharmacology). Choose one of the following medications / disease
Beta Blockers (Hypertension) (oral)
Benzodiazepines (Epilepsy) (oral or IM (emergency use))dical or Health Conditions
Answer:
As we all know that pharmacology is a branch of medicine that is concerned regarding the uses, effects and the modes of actions of different drugs. Hence, in this presentation we will discuss about the pharmacology of the oral Beta blockers that is used to treat hypertension in patients.
Pathophysiology
Hypertension can be considered as the chronic elevation of the blood pressure that is responsible for the long term end organ damage resulting in increased morbidity and mortality in patients (Rienstra et al., 2012). It is normally manifested by the systolic blood pressure (SBP) > 140 mmHg or diastolic blood pressure (DBP) > 90 mmHg. Patients having arterial hypertension can have an augmented cardiac output and increase in the systemic vascular resistance. In the older patients increased stiffness of the vasculature and systemic vascular resistance causes hypertension. Increase in the cytosolic calcium in the vascular smooth muscles can cause vasoconstriction leading to high blood pressure (Rienstra et al., 2012).
Pharmacokinetics (ADME)
Some of the Beta blockers are lipophilic and are well absorbed from the gut. They are metabolized using the first pass metabolism. Since some of them are lipophilic and hence they have short half-lives. In case of the hydrophilic beta blockers like atenolol, nadolol, sotalol undergo a negligible first pass metabolism.
Mechanisms of action of medication (pharmacodynamics)
Beta blockers work in hypertension by blocking the action of the endogenous catecholamine on the beta-adrenergic receptors, part of the sympathetic or the autonomic nervous system. The beta blockers either blocks the activation of all kinds of beta-adrenergic receptors or selectively the β1, β2 and β3 receptors. The intrinsic vasodilator property of the beta- blockers prevents the vasoconstriction and ensure blood flow through the arteries.
Adverse effect/s of medication
Several adverse effects are related to the beta blockers. The general adverse effects related to the beta blockers are diarrhea, nausea, hypotension, cold extremities, worsening of the Reynaud’s syndrome, bradycardia, fatigue, dizziness and modified glucose and lipid metabolism. Some of the lipophilic Beta –blockers can penetrate the blood brain barrier causing insomnia. The Beta blockers can increase the tri-glyceride levels and the lower the concentration of the high density cholesterol (HDL). Uptake of the non-selective beta blockers might give to bronchospasms.
Contraindications (people who should not take this medication)
Bradycardia
Beta blockers should not be used in patients with Bradycardia (heart rate fewer than 60 beats per minute) as patients might experience chest pain, light headedness, fatigue and the weakness on administering the beta blockers (Salles et al., 2013).
Asthma
One of the action of the Beta blockers is that they constrict the airways, which can trigger asthmatic attacks.
Diabetes
Beta blockers might cause a delayed response to hypoglycemia in diabetic patients. The beta blockers blocks the release of insulin by the interaction with the nerve signals to the pancreas.
3 medications in your chosen classification (generic and trade name)
Acebutolol (Sectral)
Metoprolol (Lopressor, Toprol XL)
Propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL)
Potential interactions of this medication classification with other drugs / foods
Acetabutolol –
Acetabutolol might interact with the other drugs for asthma, allergy, cold, diabetes or the migraines, diet pills, medications for high blood pressure like reserpine, Nonsteroidal anti-inflammatory drugs (NSAIDs), Advil or Motrin (ibuprofen) and Indocin (indomethacin). Alcohol might worsen the adverse effects of acetabutolol. It also might interact with the potassium rich food and some herbs, caffeine (Först et al., 2012).
Metoprolol –
Some of the drugs that can interact with Metoprolo are antidepressants like bupropion and paroxetine, antimalarial drugs such as hydroxychloroquine, some antihistamines like Benadryl, certain HIV drugs like Ritonavir, antifungals like Terbinafine and other medications used to treat heart burns such as cimetidine and ranitidine (Först et al., 2012). Alcohol should be avoided while talking Metoprolol. Metoprolol taken with multivitamin medicines might decrease its effects hence the administration time of the medicines should be separated by at least 2 hours (Först et al., 2012).
Propranolol-
Alcohol should be avoided during the treatment regimen. Propanolol and alcohol might have a combined effect in lowering the blood pressure and hence a person might face light headedness dizziness and changes in the heart rhythm (Wiysonge et al., 2013). Propranolol should not be taken together with agents that affect the catecholamines. Aluminium hydroxides, anticholinergics, chlorpromazine, drugs affecting the liver enzymes, some heart medications like digoxin and disopyramide . The medications might also interact with some of the laboratory tests like the glaucoma screening test, cardiovascular stress testing).
References
Först, G., Cwiklik, L., Jurkiewicz, P., Schubert, R., & Hof, M. (2014). Interactions of beta-blockers with model lipid membranes: molecular view of the interaction of acebutolol, oxprenolol, and propranolol with phosphatidylcholine vesicles by time-dependent fluorescence shift and molecular dynamics simulations. European Journal of Pharmaceutics and Biopharmaceutics, 87(3), 559-569.
Rienstra, M., Damman, K., Mulder, B. A., Van Gelder, I. C., McMurray, J. J., & Van Veldhuisen, D. J. (2013). Beta-blockers and outcome in heart failure and atrial fibrillation: a meta-analysis. JACC: Heart Failure, 1(1), 21-28.
Salles, G. F., Cardoso, C. R., Fonseca, L. L., Fiszman, R., & Muxfeldt, E. S. (2013). Prognostic significance of baseline heart rate and its interaction with beta-blocker use in resistant hypertension: a cohort study. American journal of hypertension, 26(2), 218-226.
Wiysonge, C. S., Bradley, H. A., Volmink, J., Mayosi, B. M., & Opie, L. H. (2017). Beta-blockers for hypertension. The Cochrane Database of Systematic Reviews, (1), CD002003. Advance online publication. https://doi.org/10.1002/14651858.CD002003.pub5
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