Week 15 Blog #1

Blog #1:

Week 15 April 11-17
Monday, April 11, 2016
4p-8p 4 Hours Interned 

Also want to make note that I will have only interned 4 hours this week and no hours next week due to review for finals week and finals week. In my internship agreement I am to complete 120 hours during the semester, roughly 8 hours a week, in which I have already surpassed. But I will still be doing my biweekly blog as another requirement to my internship agreement.

3. After being provided with a list of the 12 most commonly prescribed drugs at our facility, Robin will be able to verbally demonstrate knowledge of their pharmacotherapeutics, pharmacodynamics, and adverse effects.

Levothyroxine (Synthroid)

Drug Class – Hormone.

Therapeutic Class – Thyroid Hormone Replacement.

Indications – Hypothyroidism. Hypothyroidism means there is a low count of thyroid hormone thyroxine (T4) which is made and released by the thyroid gland.

Pharmacotherapeutics – Levothyroxine is used as replacement hormone therapy in hypothyroidism.

Pharmacodynamics (mechanism of action) – Levothyroxine acts as a replacement hormone for the natural thyroid hormone, T4, made by the thyroid gland. Levothyroxine (T4) is a naturally occurring hormone produced by the thyroid gland and converted to the more active hormone triiodothyronine (T3) in peripheral tissues. The precise signals controlling the conversion of T4 to T3 within the cell are not known. The thyroid hormones are required for normal growth and development, particularly of the nervous system. They increase the resting or basal metabolic rate of the whole organism and have stimulatory effects on the heart, skeletal muscle, liver and kidney. Thyroid hormones enhance lipolysis and the utilization of carbohydrate. Increased oxygen consumption, respiration, heart rate, growth and maturation, and speed of fat, protein, and carbohydrate metabolism occur secondary to increase in the basal metabolic rate.

Adverse Effects – Fever, headache, nervousness, insomnia, tremor, tachycardia, palpitations, arrhythmias, angina, hypertension, cardiac arrest, appetite change, nausea, diarrhea, menstrual irregularities, weight loss, leg cramps, diaphoresis, and heat intolerance.

Furosemide (Lasix)

           

Drug Class – Loop Diuretic.

Therapeutic Class – Diuretic, antihypertensive.

Indications – Edema from heart failure, hepatic cirrhosis, or nephrotic syndrome. Mild to moderate hypertension. And used as adjunct treatment in acute pulmonary edema or hypertensive crisis.

Pharmacotherapeutics – Furosemide is used to manage hypertension and edema associated with CHF, cirrhosis, and renal disease, including nephrotic syndrome.

Pharmacodynamics – Furosemide inhibits sodium and chloride reabsorption in the ascending loop of Henle, thus increasing renal excretion of sodium, chloride, potassium, and water. This is achieved through competitive inhibition at the chloride binding site in the cotransporter, thus, preventing the transport of sodium from the lumen of the loop of Henle into the basolateral interstitium. Consequently, the lumen becomes more hypertonic while the interstitium becomes less hypertonic, which in turn diminishes the osmotic gradient for water reabsorption throughout the nephron. Because the thick ascending limb is responsible for 25% of sodium reabsorption in the nephron, furosemide is a very potent diuretic.

Adverse Effects – Fever, vertigo, headache, dizziness, paresthesia, restlessness, weakness, volume depletion, dehydration, orthostatic hypotension, thrombophlebitis, transient deafness, blurred or yellow vision, abdominal discomfort and pain, diarrhea, anorexia, nausea, vomiting, constipation, pancreatitis, nocturia, polyuria, frequent urination, oliguria, agranulocytosis, leukopenia, thrombocytopenia, azotemia, anemia, aplastic anemia, hepatic dysfunction, hypokalemia, hypochloremic alkalosis, asymptomatic hyperuricemia, gout, fluid and electrolyte imbalances, impaired glucose intolerance, muscle spasm, dermatitis, purpura, and photosensitivity.

Metoprolol (Lopressor or Toprol XL)

Drug Class – Beta Blocker and/or antianginals.

Therapeutic Class – Antihypertensive, adjunct treatment for acute MI.

Indications – For the management of acute myocardial infarction, angina pectoris, heart failure and mild to moderate hypertension. May be used to treat supraventricular and tachyarrhythmias and as prophylaxis for migraine headaches.

Pharmacotherapeutics – Metoprolol is used to decrease heart rate, cardiac output, and blood pressure.

Pharmacodynamics – Metoprolol competes with adrenergic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart. Beta(1)-receptor blockade results in a decrease in heart rate, cardiac output, and blood pressure.

Adverse Effects – Bradycardia, heart failure, AV block, peripheral vascular disease, cough, diarrhea, disturbing dreams, dizziness, dyspnea, bronchospasm, fatigue, fever, hypotension, lethargy, nausea, peripheral edema, rash, and wheezing.