Week 16 Blog #2

Blog #2:

Week 16 April 18-24
Sunday, April 23, 2016
2p-10p 8 Hours Interned
Wanted to make note that this is the last week I will be blogging related to my internship. The academic semester is technically over on Friday, April 22, 2016 but am still in agreement to intern until April 30, 2016.

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.

Digoxin

Drug Class – Inotropics.

Therapeutic Class – Cardiac glycoside.

Indications – Heart failure, congestive cardiac insufficiency, arrhythmias, heart failure, paroxysmal supraventricular tachycardia, and atrial fibrillation and flutter.

Pharmacotherapeutics – Digoxin also acts on the electrical activity of the heart, increasing the slope of phase 4 depolarization, shortening the action potential duration, and decreasing the maximal diastolic potential, thus, preventing the diagnoses listed above from occurring.

Pharmacodynamics – Digoxin inhibits the Na-K-ATPase membrane pump, resulting in an increase in intracellular sodium. The sodium calcium exchanger (NCX)in turn tries to extrude the sodium and in so doing, pumps in more calcium. Increased intracellular concentrations of calcium may promote activation of contractile proteins (e.g., actin, myosin).

Adverse Effects – Agitation, fatigue, generalized muscle weakness, hallucinations, dizziness, headache, stupor, vertigo, arrhythmias, heart block, blurred vision, diplopia, light flashes, photophobia, yellow-green halos around vidual images, anorexia, nausea, diarrhea, and vomiting.

Hydrocodone / APAP

Drug Class – Opioid.

Therapeutic Class – Opioid analgesic combination.

Indications – Mild to moderate pain.

Pharmacotherapeutics – Used for pain management.

Pharmacodynamics – Hydrocodone acts as a weak agonist at OP1, OP2, and OP3 opiate receptors within the central nervous system (CNS). Hydrocodone primarily affects OP3 receptors, which are coupled with G-protein receptors and function as modulators, both positive and negative, of synaptic transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine, and noradrenaline is inhibited. Opioids such as hydrocodone also inhibit the release of vasopressin, somatostatin, insulin, and glucagon. Opioids close N-type voltage-operated calcium channels (OP2-receptor agonist) and open calcium-dependent inwardly rectifying potassium channels (OP3 and OP1 receptor agonist). This results in hyperpolarization and reduced neuronal excitability.

Adverse Effects – Drowsiness, sedation, dizziness, light-headedness,physical dependence, confusion, bradycardia, flushing, hypotension, constipation, dry mouth, nausea, vomiting, urine retention, and respiratory depression.

Latanoprost Eye Drops (Xalatan)

Drug Class – Antiglaucomas.

Therapeutic Class – Prostaglandin analogue.

Indications – For patients with ocular hypertension or open-angle glaucoma.

Pharmacotherapeutics – Decreases intraocular pressure and increases the outflow of aqueous fluid in an individuals eye to prevent the progression of ocular hypertension and/or open-angle glaucoma.

Pharmacodynamics – Latanoprost is a prostaglandin F2a analogue. Specifically, Latanoprost is a prostanoid selective FP receptor agonist that is believed to reduce the intraocular pressure (IOP) by increasing the outflow of aqueous humor. Studies in animals and man suggest that the main mechanism of action is increased uveoscleral outflow. Elevated IOP represents a major risk factor for glaucomatous field loss. The higher the level of IOP, the greater the likelihood of optic nerve damage and visual field loss.

Adverse Effects – Blurred vision, burning, foreign body sensation, increased brown pigmentation of the iris, itching, stinging, conjunctival hyperemia, dry eye, excessive tearing, eye pain, eyelash changes, lid crusting or edema, lid discomfort, photophobia, muscle, joint, or back pain, upper respiratory tract infection, allergic skin reactions, rash, cold, and/or flulike syndrome.

This is my last post guys! Thanks for reading! Hope you learned as much as I did!