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Academics
Posted 1 year ago

🔴LOOP DIURETICS REVIEW

EXAMPLES

🔸furosemide
🔹bumetanide
🔸ethacrynic acid
🔹torsemide

MECHANISM OF ACTION

Loop diuretics act on the thick ascending limb of the loop of Henle. Along this limb, loop diuretics inhibit a protein responsible for sodium, potassium, and chloride transport – a protein called the Na+/K+/2Cl– transporter.

More specifically, loop diuretics compete with the Cl– site of the transporter – reducing reabsorption of the ions – with water following by osmosis.

Loop diuretics also cause dilatation of capacitance veins. In acute heart failure, this reduces preload and improves contractile function of heart muscle.

SIDE EFFECTS

☑️hypotension
☑️hypokalemia
☑️hypocalcemia
☑️dehydration
☑️hyperglycemia
☑️electrolyte loss
☑️dizziness
☑️faintness
☑️elevated serum creatinine concentration
☑️hearing loss / tinnitus / vertigo (high doses)

CLINICAL PHARMACOLOGY

1⃣ loop diuretics are contraindicated in patients with dehydration or severe hypovolemia.

2⃣ loop diuretics can effect other drugs eliminated via the kidney. For example, loop diuretics increase the risk of lithium and digoxin toxicity.

3⃣ loop diuretics increase the risk of ototoxicity and nephrotoxicity in patients taking aminoglycosides.

4⃣ loop diuretics should be used with caution in patients with hepatic encephalopathy – a condition in which hypokalemia can worsen coma. Similarly, caution is warranted in patients with pre-existing hypokalemia and hyponatremia etc.

5⃣ taken long-term, loop diuretics reduce the excretion of uric acid and can worsen gout.

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6⃣ due to hypokalemia, loop diuretics increase the risk of arrhythmias; a risk potentiated if these drugs are taken with antipsychotics, such as amisulpride, or other drugs that increase the risk of arrhythmias.

7⃣ loop diuretics should be taken in the morning, to prevent nocturia.

8⃣ due to the risk of hypokalemia, drugs such as furosemide are available in combination products with potassium-sparing diuretics, such as amiloride (Co-amilofruse).

9⃣ loop diuretics, when combined with an NSAID and an ACE inhibitor, can cause the “triple whammy effect”, in which there is a heightened risk of kidney failure.

🔟ethacrynic acid is the only loop diuretic which is not a “sulfa drug”. Therefore, ethacrynic acid is not contraindicated in patients with sulfa allergies. Ethacrynic acid also has a higher rate of GI toxicity compared to other loop diuretics.

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Academics
Posted 1 year ago

All these Anti-hypertensive drugs are safe in pregnancy, except which

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Academics
Posted 1 year ago

Happy navratri to all ❤️

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Academics
Posted 1 year ago

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Academics
Posted 1 year ago

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Academics
Posted 1 year ago

Happy pharmacist day to all our Champs 🎊

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Academics
Posted 1 year ago

FACTS ABOUT CEPHALOSPORIN

1⃣Cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as Cephalosporium.

2⃣Earlier cephalosporins have enhanced activity against Gram-positive organisms, whereas later generations have greater activity against Gram-negative organisms.

3⃣Cephalosporins are bactericidal and, like other β-lactam antibiotics, disrupt the synthesis of the peptidoglycan layer forming the bacterial cell wall. The peptidoglycan layer is important for cell wall structural integrity. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by penicillin-binding proteins (PBPs). PBPs bind to the D-Ala-D-Ala at the end of muropeptides (peptidoglycan precursors) to crosslink the peptidoglycan. Beta-lactam antibiotics mimic the D-Ala-D-Ala site, thereby irreversibly inhibiting PBP crosslinking of peptidoglycan.

4⃣Fourth generation drugs, such as cefepime, cover pseudomonal infections. Fifth-generation drugs are effective against MRSA.

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Academics
Posted 1 year ago

⚕️Side Effects of Systemic Corticosteroids

CORTICOSTEROIDS

Cushing’s syndrome
Osteoporosis
Retardation of growth
Thin skin, easy bruising
Immunosuppression
Cataracts and glaucoma
Oedema
Suppression of HPA axis
Teratogenic
Emotional disturbance
Rise in BP
Obesity, truncal
Increased hair growth (hirsutism)
Diabetes mellitus
Striae

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Academics
Posted 1 year ago

⚠️Side Effects of ACE Inhibitors

🔹hypotension (particularly after 1st dose)

🔸persistent dry cough (due to bradykinin buildup)

🔹hyperkalemia

🔸renal failure (particularly with NSAID/diuretic)

🔹angioedema (due to bradykinin buildup)

🔸headache

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Academics
Posted 1 year ago

Calcium Channel Blockers

🔵Dihydropyridine

🔸amlodipine
🔸nifedipine
🔸felodipine

🟠Non-dihydropyridine

🔹verapamil
🔹diltiazem

◾️◾️◾️◾️◾️◾️◾️◾️◾️

👉dihydropyridines are relatively selective for the vasculature.

👉non-dihydropyridines are more selective for the heart.

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