Week 15 Blog #2

Blog #2:

Week 15 April 11-17

Wanted to make note that I only interned 4 hours this week due to review for 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.

Atorvastatin (Lipitor):

Drug Class – HMG-CoA reductase inhibitor.

Therapeutic Class – Antilipemic.

Indications – Hyperlipidemia and/or hypercholesterolemia. Hyperlipidemia means there is a high concentration of lipids in the blood. Hypercholesterolemia means there is an excess of cholesterol in the bloodstream.

Pharmacotherapeutics – Atovastatin is used to treat high cholesterol levels by reducing the levels of “bad cholesterol” (low-density lipoproteins) and triglycerides in the blood, while increasing the levels of “good cholesterol” (high-density lipoproteins). In doing so, atorvastatin lowers the risk of stroke, heart attack, and other heart complications in people with type two diabetes, coronary heart disease, and/or other risk factors.

Pharmacodynamics – Antilipemics lower elevated blood levels of lipids. Bile-sequencing drugs lower blood levels of low-density lipoproteins by forming insoluble complexes with bile salts, triggering cholesterol to leave the bloodstream and other storage areas to make new bile acids. Fibric acid derivatives reduce cholesterol formation, increase sterol excretion, and decrease lipoprotein and triglyceride synthesis. HMG-COa reductase inhibitors interfere with enzymatic activity that generates cholesterol in the liver. Selective cholesterol absorption inhibitors inhibit cholesterol absorption by the small intestine, decreasing hepatic stores of cholesterol and increasing clearance of cholesterol from the blood.

Adverse Effects – Headache, asthenia, sinusitis, pharyngitis, abdominal pain, constipation, diarrhea, dyspepsia, flatulence, back pain, arthralgia, myalgia, rash, anaphylaxis, angioedema, infection, flulike syndrome, and hypersensitivity reaction.

Omeprazole (Prilosec):

Drug Class – Proton pump inhibitor.

Therapeutic Class – Gastric acid suppressant.

Indications – Erosive esophagitis, gastroesophegeal reflux disease (GERD), GERD without erosive esophagitis, pathologic hypersecretory conditions, duodenal ulcer, gastric ulcer, H. pylori eradication to reduce risk of duodenal ulcer reoccurrence, and heartburn.

Pharmacotherapeutics – Omeprazole is used inhibit acid secretions.

Pharmacodynamics – Omeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H⁺/K⁺-ATPase in the gastric parietal cell. By acting specifically on the proton pump, omeprazole blocks the final step in acid production, thus reducing gastric acidity.

Adverse Effects – Headache, dizziness, diarrhea, abdominal pain, nausea, vomiting, constipation, flatulence, back pain, cough, and rash.

Amlodipine (Norvasc):

Drug Class – Calcium channel blocker and/or antianginal.

Therapeutic Class – Cardiovascular agent.

Indications – High blood pressure and angina.

Pharmacotherapeutics – Amlodipine is used to relax blood vessels and increase the supply of blood and oxygen to the heart while reducing the hearts workload, thus, lowering blood pressure and relieving angina.

Pharmacodynamics – Amlodipine decreases arterial smooth muscle contractility and subsequent vasoconstriction by inhibiting the influx of calcium ions through L-type calcium channels. Calcium ions entering the cell through these channels bind to calmodulin. Calcium-bound calmodulin then binds to and activates myosin light chain kinase (MLCK). Activated MLCK catalyzes the phosphorylation of the regulatory light chain subunit of myosin, a key step in muscle contraction. Signal amplification is achieved by calcium-induced calcium release from the sarcoplasmic reticulum through ryanodine receptors. Inhibition of the initial influx of calcium decreases the contractile activity of arterial smooth muscle cells and results in vasodilation. The vasodilatory effects of amlodipine result in an overall decrease in blood pressure. Amlodipine is a long-acting CCB that may be used to treat mild to moderate essential hypertension and exertion-related angina (chronic stable angina). Another possible mechanism is that amlodipine inhibits vascular smooth muscle carbonic anhydrase I activity causing cellular pH increases which may be involved in regulating intracelluar calcium influx through calcium channels

Adverse Effects – Bradycardia, confusion, constipation, depression, diarrhea, dizziness, edema, elevated liver enzyme levels, fatigue, flushing, headache, hypotension, insomnia, nervousness, and rash.