...Lisa Dauenhauer Pharmacology II- NSGD 326 Heather Paulson, MN, RN May 21st, 2013 There is no other organ in the body as magnificent as the heart. It seems interesting that it is also placed at the center of our bodies. Without this amazing muscle made of involuntary striated muscle cells, we would not be able to live. It is a mean machine! It only takes about 20 seconds to circulate the blood through the entire body. An adult heart pumps approximately 2,000 gallons of blood throughout the body. However, there are plenty of other organs in our bodies that we can do without and they do not necessarily sustain our wellbeing. For example, we can live just fine with only one kidney. Also, our spleen, tonsils, appendix and gallbladder can be removed, but that is not the case for our heart. We need its’ life sustaining abilities in order to live. The heart is not only associated with our physical well- being, but it also is strongly linked to our emotional well being as well. “The Greeks believed the heart was the seat of the spirit, the Chinese associated it with the center for happiness and the Egyptians thought the emotions and intellect rose from the heart.” (Condron, 2011). The heart is so much more than just an organ that pumps blood throughout the body. It is a key factor to life. When the heart has issues...
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...can lead to tissue damage, and in extreme cases gangrene/amputation. 5) It appears timely treatment can prevent permanent damage. I feel my case is extreme and urgent to treat before winter. 6) The above is in spite of keeping warm, wearing good gloves etc. 7) I have been trying to improve the circulation with exercise, herbal remedy containing calcium fluoride, ginger, garlic etc. 8) I am extremely worried about the progress of this condition any my hands/fingers are frightening to look at, at times. Treatment for Raynauds/interaction with A.F. I gather the blood vessels in my hands/fingers have to be widened. It appears that the prescription drugs recommended for treatment of Raynauds are calcium channel blockers e.g. Adalat ( Nifedine) Afeditab CR Procardia Vorvasc Plandil ( Peandil) Cardene Aldomet Diltiazem Cardizam Or Alpha blockers e.g. Cardura Mini press Or Cozaar Hyzaar Trental ( Pentoxifylline) Nicotinic acid Nitroglycerine On the leaflet with Adalat, for examole it states that it may cause irregular heartbeat; although I understand that calcium channel blockers are actually used to treat A.F., by controlling the heart rate. This is a contradiction. I urgently need medication for this and understandably my G.P. is reluctant to prescribe Adalat...
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...data that is observed. Depending on how and what data is being observed depends on the type of tool the researcher will want to use in order to collect their information. The researcher conducting this type of study is a passive observer and does not tamper in any way with the variable of interest or any factors that may affect it. When recording observation data, you have to remember that all answers are from your own perception and there is no right or wrong answer. In the observational study that I researched, researchers wanted to know if CCBs associated with LUTS in males. This was conducted on 38 males which ranged from the ages of 46 to 89 years old, with the median age being 67 for about five years. According to the study, calcium channel blockers associated to 100% of...
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...SIROY, Shanayne SOLAIMAN, Alyssa PATIENT D: Acetazolamide 250mg Levodopa/Carbidopa 25/250 Pilocarpine 4% Reserpine 0.25mg Diltiazem 30mg Vitamin B Complex with Vitamin C Entacapone Tablets Tolcapone POSSIBLE DRUG INTERACTIONS LEVODOPA + DILTIAZEM Levodopa and diltiazem may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. MONITOR: The hypotensive effects of levodopa and antihypertensive agents may be additive. Postural hypotension may occur. MANAGEMENT: Hemodynamic responses should be monitored during coadministration, especially during the first few weeks of therapy. Dose adjustments of the antihypertensive agent may be required. Patients should be advised to notify their physician if they experience dizziness or syncope. LEVODOPA...
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...data that is observed. Depending on how and what data is being observed depends on the type of tool the researcher will want to use in order to collect their information. The researcher conducting this type of study is a passive observer and does not tamper in any way with the variable of interest or any factors that may affect it. When recording observation data, you have to remember that all answers are from your own perception and there is no right or wrong answer. In the observational study that I researched, researchers wanted to know if CCBs associated with LUTS in males. This was conducted on 38 males which ranged from the ages of 46 to 89 years old, with the median age being 67 for about five years. According to the study, calcium channel blockers associated to 100% of the lower urinary tract symptoms within a 38 males. A few disadvantages of the observational data method are that some of the research conducted can be subject to the researcher’s biases. This is mainly due to the perception of the researcher. The researcher may also miss important milestones that may need it to have been observed. Because of the fact there is limited control with this method; people conducting this method can sometimes easily be led off the correct path by them. There also may not be enough information given to heaven in conclusion to the data observed because of the amount of studies, trials or objectives observed. Also, if not treated with care, results from this type of method can become...
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...Heart Rate Lab Report Pre-lab Quiz Results You scored 100% by answering 4 out of 4 questions correctly. 1. Which organelle in the cardiac muscle cell stores calcium? You correctly answered: b. sarcoplasmic reticulum 2. Verapamil is a calcium-channel blocker. Its effects could be described as You correctly answered: d. negative chronotropic and negative inotropic. 3. When the cardiac muscle cell is at rest, where is most of the potassium found? You correctly answered: c. in the cytosol 4. Resting cardiac muscle cells are most permeable to You correctly answered: b. potassium. 02/26/13 page 1 Experiment Results Predict Question: Predict Question 1: Because calcium-channel blockers are negative chronotropic and negative inotropic, what effect do you think increasing the concentration of calcium will have on heart rate? Your answer : a. positive chronotropic, positive inotropic Predict Question 2: Excess potassium outside of the cardiac cell decreases the resting potential of the plasma membrane, thus decreasing the force of contraction. What effect (if any) do you think it will initially have on heart rate? Your answer : b. decrease heart rate Stop & Think Questions: Where in the cardiac muscle cell is most of the sodium normally found? You correctly answered: a. outside of the cell Experiment Data: Solution ---Calcium Sodium Potassium Heart Rate 59 69 34 then erratic 28 then erratic 02/26/13 page 2 02/26/13 page 3 Post-lab Quiz Results You scored 100% by...
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...relation with one another in the genetic “glitches” they share, 2 of which concerning a major signaling system in the brain. Efforts began in 2007 and so investigative data from 19 countries of people’s DNA, with 33,332 people with psychiatric illness while studying 27,888 people who were free of the illness was collected. Researchers came to find overlapping genetic effects in identical twins, which further solidified the possible connections previously discussed. They had found 4 DNA regions that conferred a risk of psychiatric disorders. However, in 2 of the 4 regions, it was not clear what the genes were involved in doing. The other 2 genes were calcium channels. Calcium channels are used when neurons send signals to function our brains. Certain drugs prescribed by medical professionals are used to block calcium channels and therefore are used to treat high blood pressure. Furthermore, some researchers have even come to the conclusion that they may be useful to treat bipolar disorder. In studies including identical twins, researchers have previously found that while one child has been diagnosed with schizophrenia and the other had bipolar disorder, which arose some confusion and the need...
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...The Management of Hypertension Allison A. Torbert, Pharm.D. Roberta M. Skoronski, Pharm.D. Clinical Instructors UW School of Pharmacy Objectives • Explain the classification and goals of therapy in the treatment of hypertension based on JNC VI recommendations • Describe nonpharmacologic and pharmacologic treatment approaches • Recognize patients with hypertension and comorbid conditions in order to optimize therapy • Develop an approach to manage hypertensive patients Prevalence • Approximately 50-60 million Americans have HTN defined as: systolic BP (SBP) 140 mm Hg or > diastolic BP (DBP) 90 mm Hg or > • • • • Incidence increases with age Blacks > whites Men > women Greater in less educated, lower socioeconomic groups hard disk\course\728-721\htn.ppt 1 Classification of Blood Pressure for Adults Age 18 & Older* Category Optimal+ Normal High-normal Hypertension++ Stage 1 Stage 2 Stage 3 Systolic (mm Hg) < 120 < 130 130-139 140-159 160-179 > 180 & & & & & & Diastolic (mm Hg) < 80 < 85 85-89 90-99 100-109 > 110 *Not taking antiHTN drugs & not acutely ill. When SBP & DBP fall into different categories, highest classification should be used. Isolated systolic HTN defined as SBP > 140 and DBP < 90 and staged appropriately. In addition to classifying accordingly, clinicians should specify presence or absence of target organ disease & additional risk factors + Optimal BP with respect to CV risk is < 120/80; unusually low BP’s should be evaluated...
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...COVER ARTICLE PRACTICAL THERAPEUTICS Acute Management of Atrial Fibrillation: Part I. Rate and Rhythm Control DANA E. KING, M.D., LORI M. DICKERSON, PHARM.D., and JONATHAN L. SACK, M.D. Medical University of South Carolina, Charleston, South Carolina Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or digoxin. Medical or electrical cardioversion to restore sinus rhythm is the next step in patients who remain in atrial fibrillation. Heparin should be administered to hospitalized patients undergoing medical or electrical cardioversion. Anticoagulation with warfarin should be used for three weeks before elective cardioversion and continued for four weeks after cardioversion. The recommendations provided in this two-part article are consistent with guidelines published by the American Heart Association and the Agency for Healthcare Research and Quality. (Am Fam Physician 2002;66:249-56. Copyright© 2002 American Academy of Family Physicians.) I Members of various family practice departments develop articles for “Practical Therapeutics.” This article is one in a series coordinated by the Department of Family Medicine at the Medical University of South Carolina. Guest editor of the series is ...
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...Each week before we head over to the center we take time to meet on campus as a group and discuss what we have planned, and our preceptor will give us tips regarding our activity. During the first blood pressure event our preceptor was educating us about the various classes of antihypertensive therapeutics. We discussed angiotensin receptor blockers, angiotensin converting enzymes inhibitors, calcium channel blockers, and beta blockers. Our preceptor than made it a point to educate us that calcium channel blockers, such as amlodipine are often considered first line treatments for African Americans, as they have been found to respond very well to these agents. This was an important consideration for the community at the senior center because most of the older adults are African American. We also learned that African Americans race is a risk factor for hypertension. Knowing both of these clinical facts is crucial when serving patients on the community level. This experience has made me realize that risk factors that I learn about in my pathophysiology, and clinical indications that I will learn about in therapeutics can help me serve patients on a community...
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...TOP 200 DRUGS FOR 2009 WITH CLASSIFICATION, ROUTE, AND USE GENERIC | BRAND | CLASS | MAJOR USE | SCHEDULE | ROUTES | atorvastatin | Lipitor | HMA-CoA reductase inhibitor | hypercholesterolemia | not controlled | PO | amoxicillin | Amoxil, Trimox | Penicillin antibiotic | infection | not controlled | PO | hydrochlorothiazide | Microzide | Thiazide Diuretic | Hypertension/edema | not controlled | PO | azithromycin | Zithromax | macrolide antibiotic | infection | not controlled | PO, IV | metformin | Glucophage, Glucophage XR | antidiabetic | Type 2 Diabetes | not controlled | PO | atenolol | Tenormin | beta blocker (B1) | hypertension/angina/acute M.I. | not controlled | PO, IV | Simvastatin | Zocor | HMG-CoA Redctase inhibitor | hypercholesterolemia | not controlled | PO | alprazolam | Xanax, Xanax XR | benzodiazepeine | anxietty/panic disorder | schedule 4 | PO | furosemide | Lasix | loop diuretic | edema/hypertension | not controlled | PO, IV | zolpidem | Ambien, Ambien CR | anxiolytic/hypnotic | insomnia | schedule 4 | PO | potassium chloride | K-Dur, Klor-Con, Micro-K | posassium supplement/electrolyte | hypokalemia | not controlled | PO, IV | sertraline | Zoloft | selective serotonin reuptake (SSRI) | major depression/ocd/panic disorder | not controlled | PO | montelukast | Singulair | leukotriene inhibitor | asthma maintenence | not controlled | PO | escitalopram | Lexapro | selective serotonin reuptake inhibitor (SSRI) | major depression/anxiety...
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...for Disease Control and Prevention [CDC], 2015). Many other cardiac diseases are seen with AF, either as a cause, or as a result of the atrial fibrillation. Left untreated, AF can result in tachycardia that causes ventricular dysfunction and/or heart failure, along with a significantly increased risk of thromboembolic stroke. I recently conducted an interview with my father who has had AF for nearly 20 years and I compared my findings in the literature against his experiences with the disease. Pathophysiology Atrial Fibrillation is a supraventricular tachyarrthymia. In the heart, ventricular rate is controlled by the conduction and refractory properties of the AV node and the progression of wave fronts entering the AV node. Calcium channels are accountable for the major depolarizing current in AV nodal cells. Beta-adrenergic receptor stimulation boosts AV nodal conduction, whereas vagal stimulation impedes AV nodal conduction. Sympathetic activation and vagal withdrawal, as with illness or exertion, speeds up the ventricular rate. After each atrial excitation wave that depolarizes AV nodal tissue, those cells become refractory for a time, preventing subsequent impulses from propagating in the node (American College of Cardiology/American Heart Association/Heart Rhythm Society Task Force, 2014). Loss of atrial coordination will decrease cardiac output and cause contractions to be ineffective. This leads to a disruption in the flow of the blood through the ventricular...
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...Accord Healthcare Limited | | Sage House, 319 Pinner Road, North Harrow, Middlesex, HA1 4HF, UK Telephone: +44 (0)208 8631 427 Fax: +44 (0)208 863 1426 WWW: http://www.accord-healthcare.eu Medical Information Direct Line: +44 (0)208 901 3370 Medical Information e-mail: uk@accord-healthcare.com Customer Care direct line: +44 (0)208 863 1427 Medical Information Fax: +44 (0)208 863 1426 Before you contact this company: often several companies will market medicines with the same active ingredient. Please check that this is the correct company before contacting them. Why? | | Summary of Product Characteristics last updated on the eMC: 01/08/2013 SPC | Atenolol 100 mg Tablets | Table of Contents * 1. Name of the medicinal product * 2. Qualitative and quantitative composition * 3. Pharmaceutical form * 4. Clinical particulars * 4.1 Therapeutic indications * 4.2 Posology and method of administration * 4.3 Contraindications * 4.4 Special warnings and precautions for use * 4.5 Interaction with other medicinal products and other forms of interaction * 4.6 Pregnancy and lactation * 4.7 Effects on ability to drive and use machines * 4.8 Undesirable effects * 4.9 Overdose * 5. Pharmacological properties * 5.1 Pharmacodynamic properties * 5.2 Pharmacokinetic properties * 5.3 Preclinical safety data * 6. Pharmaceutical particulars * 6.1 List of excipients * 6.2 Incompatibilities * 6.3 Shelf life * 6.4 Special precautions...
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...The rationale for stopping Maxzide is that, according to Micromedex, taking Maxzide is not recommended for patients with diabetes mellitus, since it increases the risk for hyperglycemia, glycosuria, and altered insulin requirements ("Micromedex ," n.d.). JNC 8 recommendation 7 states that in the general black population, including with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or calcium channel blocker (CCB) (James et al., 2014). The panel recommended a CCB over an ACE inhibitor (ACEI) as first-line therapy in black patients because there was a 51% higher rate of stroke in black persons in ALLHAT with the use of an ACEI as initial therapy compared with the use of CCB. The initial dose for Amlodipine would be 2.5mg once a day, taken in the morning. The patient will be instructed to monitor his blood pressure daily at home if possible. Follow-up visit in two weeks will be arranged to evaluate the effectiveness of the medications. If the blood pressure reading still shows SBP> 150/90mmHG, the dose will be titrated to 5mg daily. In addition, a diet modification will be recommended to the patient, such as to follow a low salt, low fat...
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...What is Angina? Angina is a heart condition a chest pain that occurs if there’s an area of your heart muscle that does not get enough oxygen-rich blood. Angina is a symptom of heart problem, usually a symptom of coronary heart disease this only happens to adults, how it works is a substance called plaque builds up on the inner walls of coronary arteries, these are the arteries that carry rich oxygen blood to your heart. Angina pain is similar to the asthma pain, but in this case the pain can also occur in your shoulders, arms, jaw, neck and even back. What system does it affect & what causes it? Angina is affected by the cardiovascular system. Angina is caused by the result of underlying coronary artery disease the arteries that supply the heart with blood rich blood, when the cholesterol aggregates on the artery wall and the hard plaque form the artery narrows. It is very difficult for the oxygen rich blood to reach the heart muscle as these arteries will then become more narrower, in addition the damage to the arteries from such as smoking and high levels fat or sugar in the blood can cause plaque to build up where the arteries are damaged, these narrow the arteries or may break off and form blood clots that block the arteries. Types of Angina? * Stable Angina occurs when the heart is working harder and faster than usual. Angina is a painful condition but if a person takes angina medication or rest’s for a bit then the pain will go. The stable...
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