Question

.-Digoxin mechanism of actions and its desired therapeutic effects •-Pathophysiological of hypertension and diagnosis criteria of secondary hypertension •-Hypertension crisis medication management .-ACE inhibitor side effect and patient teaching

Answer 1

Digoxin belongs to a class of medications called cardic glycosides. Digoxin is used to treat heart failure and atrial fibrillation (a heart rhythm disorder of the atria). It works by affecting certain minerals like sodium and potasium inside the heart . This reduces strain on the heart and helps it maintain a normal, steady and a strong heart beat. The main therapeutic effects are increased cardiac output and slowing the heart rate.

The pathophysiology of hypertension are the increased systemic vascular resistence, increased vascular stiffness, and increased vascular responsiveness to stimuli.

Secondary hypertension is termed as an elevated blood pressure that results from underlying, identifiable, potentially correctable cause. The diagnosis criteria of secondary hypertension is based on a code refered as ABCDE. From this code

A refers Accuracy of diagnosis, Apnea, Aldosteronism.

B refers Bruits, Bad kidneys(Renal parenchymal disease).

C refers Catecholamines, Coarctation of the aorta, Cushing's syndrome.

D refers Drug, and Diet

E refers Erythropoietin and Endocrine disorders

Hypertension crisis Medication management

The medication used in the treatment of hypertension is diuretics, angiotensin-converting enzymes (ACE) inhibitors, or angiotensin receptor blockers (ARBs), beta blockers and calcium channel blockers (CCBs). Some patient needs 2 or more hypertensive agents to control their hypertension.

ACE inhibitor side effects and Patient teching: Main side effects are Dry cough, fatigue, Dizziness, decreased ability to taste, fainting, rash, swelling of face and neck and tongue area, high potassium levels, kidney damage and failure, etc.

Patient Teaching:

1.Patient avoid ACE inhibitors who are hypersensitive to ACE inhibitors.

2. Pregnant patient should stop this medicine during the last 6 months of pregnancy.

3. Renal impaired patients should avoid this meidcine.

4. Breast feeding woman should avoid this medicine.

5. Older adults should avoid this medicine because of precaution to kidneys.