Hypertension: Treatment
ABCD:
ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also)
Beta blockers
Calcium antagonists
Diuretics (sometimes vasoDilators also)
Aspirin Side Effect
ASPIRIN:
Asthma
Salicyalism
Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)
CLOPIdogrel is a drug that prevents
CLots, an Oral Platelet Inhibitor (OPI).
Teratogenic drugs: major non-antibiotics
TAP CAP:
Thalidomide
Androgens
Progestins
Corticosteroids
Aspirin & indomethacin
Phenytoin
Physostigmine vs. neostigmine
LMNOP:
Lipid soluble
Miotic
Natural
Orally absorbed well
Physostigmine
· Neostigmine, on the contrary, is:
Water soluble
Used in myesthenia gravis
Synthetic
Poor oral absorption
Steroid side effects
CUSHINGOID:
Cataracts
Ulcers
Skin: striae, thinning, bruising
Hypertension/ Hirsutism/ Hyperglycemia
Infections
Necrosis, avascular necrosis of the femoral head
Glycosuria
Osteoporosis, obesity
Immunosuppression
Diabetes
Beta blockers with CYP2D6 polymorphic metabolism
"I Met Tim Carver, the metabolic polymorph":
· The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism:
Metoprolol
Timolol
Carvedilol
(in patients with lower or higher than normal CYP2D6 activity)
Beta blockers with intrinsic sympathomimetic activity
Picture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels.
Pindolol and Carteolol have high and moderate ISA respectively, making them acceptable for use in some diabetics or asthmatics despite the fact that they are non-seletive beta blockers.
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