Question

Please write 1 paragraph for each of the following (total 3 paragraphs) and each paragraph shall be no more than 6 sentences 1. Discuss ONE SPECIFIC diuretic. Give class; actions and uses; side effects & adverse effects, CONTRA-INDICATIONS; any other pertinent information. 2. Discuss ONE SPECIFIC bronchodilator or other asthma medication. Give class; actions and uses; side effects & contra-indications; any other pertinent information. 3. Please discuss ONE SPECIFIC cardiac medication in chapter 37 (Cardiac Glycosides, Antianginals, and Antidysrhythmics) Give class; actions and uses; side effects & adverse reactions; contraindications & toxicity; administration; any other pertinent information.

Answer 1

1. Diuretic: Furosemide

Furosemide is high ceiling (loop) diuretic drug.

Mechanism of action: It inhibits the Na⁺K⁺2Cl^- cotransport.

Major site of action is ascending loop of Henle.

It is rapidly absorbed orally and bioavailability is 60%.

Side effects: excess volume depletion, hyperuricemia, hypokalemia, cardiac arrhythmia, hypocalcemia, hypomagnesemia, ototoxicity.

Uses: Used in edema, congestive heart failure, acute pulmonary edema, cirrhosis, nephrotic syndrome, hypertension, hypercalcemia, and in forced diuresis.

2. Bronchodilator: Salbutamol

Salbutamol, also known as albuterol, is highly selective β₂ agonist and produces bronchodilation within 5 minute and the action duration is 2-4 hours.

Side effects: tremor, headache, tachycardia, dizziness, and feeling anxious, bronchospasm, hypokalemia, muscle cramp, dry mouth, palpitation, flushing of the skin, myocardial ischemia, insomnia, etc.

Uses: It used to treat bronchospasm, ashtma attack, excercise induced bronchoconstriction and chronic obstructive pulmonary disease, hyperkalemia.

3. Cardiac glycoside: Digoxin

Digoxine is a cardiac glycoside obtained from a plant named digitalis pupurea.

It act by inhibiting Na/K ATPase enzyme in the cell membrane. It has mild vasoconstriction action. It causes increase in the contactility of the cardiac muscle. Digoxin increases the force of cardiac contraction.

It is completely absorbed orally and distributed widely to tissues including CNS.

Toxicity of digitalis is high and margin of safety is low.

Adverse effects:

Anorexia, nausea, vomiting, abdominal pain, gastric irritation, fatigue, malaise, headache, mental confusion, restlessness, hyperapnoea, disorientation, psychosis and visual disturbance, skin rashes, etc.

Cardiac side effects like tachyarrhythmia, ventricular arrhythmias, AV block and bradycardia.

4. Antianginal: Nitrates (GTN, Glyceryl trinitrate)

Glyceryl trinitrate is volatile liquid used through various route: sublingal, transdermal and parenteral.

Organic nitrates are rapidly denitrated enzymatically in the smooth muscle cell to release the reactive free radical nitric oxide (NO).

Adverse effects mostly caused due to vasodilation, Fullness in head, flushing, weakness, sweating, palpitation, tolerance develops, methemoglobinemia, rashes.

Dependence: Sudden withdrawal after prolonged exposure has resulted in spasm of coronary and peripheral blood vessels.

Interaction: Sildenafil cause dangerous potentiation of nitrate action: severe hypotension, MI and deaths are on record.

Uses: Unstable angina, coronary vasospasm, MI and hypertension during cardiac surgery