Minoxidil
Minoxidil is known as potassium channel activator. Minoxidil is given orally. Minoxidil will activates the potassium channel which cause the hyperpolarization of the membrane. This will inhibit the voltage gated calcium channel. There will reduce the contraction of the vascular smooth muscle. Minoxidil is useful in treating patient with severe cases of hypertension. Minoxidil may lead to hirsutism. In some cases, minoxidil is useful in providing topical therapy to treat baldness. Other sides effect may include angina and tachycardia ( beta blocker is given). Patient is given loop diuretic due to side effects of minoxidil which is retention of the water and salt. The half life of minoxidil is 4 hours.
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Hydralazine Hydralazine is useful in treating patient with hypertension. Mostly pregnant woman with severe hypertension. Allergic reaction may occur due to long term use of hydralazine. Hydralazine is a vasolidator which is given orally. Hydralazine will cause relaxation of the smooth muscle of the artery which lead to the lowering of the blood pressure. Hydralazine will affect the release of the calcium ion from the sarcoplasmic reticulum which present in the smooth muscle cells of the vascular system. The half life of hydralazine is 1-3 hours. The common side effects with hydralazine may include hypotension, dizziness and gastrointestinal disturbance as well as palpitations. Nicotinic acid
Nicotinic acid is useful in treating dyslipidemia. Nicotinic acid is a vitamin B3 with a lipid lowering mode of action. Nicotinic acid will act as an additional / adjunct therapy to dyslipidemia or as replacement due to contraindicated to statin. Nicotinic acid may increase the high density lipoprotein. There will reduction in the release of very low density lipoprotein from the hepatocytes and decrease in the synthesis of the plasma triglycerides. There will also be a low level of low density lipoprotein. Nicotinic acid is given orally while nicotinic acid is excreted through urine. Nicotinic acid may present with flushing. It is wise to consider ibuprofen to reduce the incidence of flushing before administrating nicotinic acid. Nicotinic acid may lead to gout, rashes, and pruritus as well as gastrointestinal discomfort. Glucose tolerance and impairment of the liver function are common in cases of high intake of nicotinic acid. Other rare side effects may include peripheral edema, dyspnea and palpitation. Flecainide
Flecainide is a class Ic anti arrhythmic agent. Flecainide is useful in treating patient with severe ventricular arrhythmias who is unresponsive to other forms of treatment. Flecainide is also used as preventive measure against paroxysmal atrial fibrillation. Flecainide will acts by blocking the opening of the sodium ion channels which will reduce the rates of depolarisation of the phase 0. This will lead to an increase in the refractory period with slowness in the atrioventricular conduction ( AV conduction). Flecainide will react at a slower rates to sodium channel than other class of anti arrhythmic agents. Flecainide is a well known anti dysrhythmic agent which is excreted unchanged in the urine. Flecainide is administered orally with half life of 20 hours. The common side effects of flecainide may include ventricular fibrillation which occur post infarction/ increase the risk of fatality and negative inotropic effects as well as ventricular dysrhythmic effects. Amiodarone
Amiodarone is class III anti arrhythmic agent which is useful in treating patient with atrial flutter, ventricular ectopic beat, atrial fibrillation and tachyarrhythmia. Amiodarone will block the beta adrenoceptors and block sodium ion channel. Amiodarone will also block the potassium ion channel in the cell membrane. Amiodarone will lead to an increase in the duration of the action potential while delaying the repolarization. This will finally lead to an increase in the refractory period. The half life of amiodarone may last for several weeks. Amiodarone is a long acting drugs which will bind to the tissue extensively. The common side effects of amiodarone may include thyroid disorders, liver damage/ hepatotoxicity, photosensitivity skin rashes, pulmonary fibrosis and torades de pointes. Lidocaine
Lidocaine is also known as class Ib anti arrhythmic agent. Lidocaine is useful in treating patient with digoxin induced arrhythmia and treating and prevention of ventricular fibrillation due to / post infarction. Lidocaine is mostly given intravenously with very high first pass metabolism. Lidocaine may metabolized by cytochrome P450 with half life of 2 hours. Lidocaine will block the opening of the sodium ion channel and lead to inactivation of the sodium ion channel in the cell membrane. Blockage of the sodium ion channel may lead to reduction the rate of depolarisation of the phase 0 which cause the slow AV conduction and increase in the refractory period. Lidocaine is associated with use dependence. Lidocaine is more likely to react on the depolarised damaged tissue. The common side effects of lidocaine may include convulsion, drowsiness and tremor. Lidocaine
Lidocaine is also known as class Ib anti arrhythmic agent. Lidocaine is useful in treating patient with digoxin induced arrhythmia and treating and prevention of ventricular fibrillation due to / post infarction. Lidocaine is mostly given intravenously with very high first pass metabolism. Lidocaine may metabolized by cytochrome P450 with half life of 2 hours. Lidocaine will block the opening of the sodium ion channel and lead to inactivation of the sodium ion channel in the cell membrane. Blockage of the sodium ion channel may lead to reduction the rate of depolarisation of the phase 0 which cause the slow AV conduction and increase in the refractory period. Lidocaine is associated with use dependence. Lidocaine is more likely to react on the depolarised damaged tissue. The common side effects of lidocaine may include convulsion, drowsiness and tremor. Disopyramide
Disopyramide is class Ia anti arrhythmic agent. Disopyramide is mostly used in treating patient with ventricular dysrhythmia and supraventricular dysrhythmia. Disopyramide is administered orally or via intravenous solution. Half of disopyramide will be metabolized in the hepatic system while half of disopyramide will remain unchanged and excreted by the kidney. Disopyramide will block the opening of the Na+ channel and lead to inactivation of the sodium ion channel in the cell membrane. This will cause and increase in the effective refractory period with slow AV conduction due to reduction in the rate of phase 0 depolarisation. There will also slowness in the repolarisation of the action potential. The half life of disopyramide is approximately 5 hours to 10 hours. Disopyramide may produce side effects such as dry mouth, constipation, blurred vision and urinary retention. Disopyramide may produce side effects associated with negative inotropic action. In certain cases, disopyramide may lead to the development of torsade de pointes. Magnesium Sulfate
Magnesium sulfate is an anti arrhythmic agents. Magnesium sulfate is useful in treating patient with torsade de pointes, digoxin toxicity which lead to ventricular dsyarrhythmia and after by pass surgery with hope in preventing patient developing ventricular arrhythmias or supra ventricular tachycardia. Magnesium sulfate will be given intravenously. Magnesium sulfate will affect the permeability of the membrane for ion transport. This will cause the slowness of the AV node conduction and reduction in cardiac excitability after cardiac surgery mostly due to hypomagnesemia. Magnesium sulfate is also useful as an osmotic purgative. Magnesium sulfate commonly associated with side effects such as weakness of the muscle. Ivermectin
Ivermectin is a form of broad spectrum anthelminthic agent. Ivermectin will be given orally. Ivermectin will activate the glutamate gated chloride channel and activated the GABA mediated inhibition. This will lead to paralysis of the worm. Ivermectin generally will act on the neuromuscular junction. Ivermectin will be useful in treating patient with onchocerciasis and stongyloidiasis. The common side effects of ivermectin may include dizziness, gastrointestinal discomfort, rashes, fatigue and itchiness. |
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