PharmaXtract

ANTIANAEMICs

noreply@blogger.com (Anonymous) — Sat, 10 Oct 2015 06:16:00 +0000

Anemia is a general term for a large number of conditions marked by a reduction in the oxygen-carrying capacity of blood. Red blood cells carry oxygen in hemoglobin, so that anemia may be caused by a deficiency of blood or red blood cells or of hemoglobin. These conditions may be caused by a variety of other conditions. Injury can cause blood loss, which in turn can cause anemia.

Nutritional deficiency, inadequate amounts of some of the vitamins and minerals that are needed for hemoglobin production, may also cause anemia. Because hemoglobin is the pigment that makes blood cells red, a lack of hemoglobin will cause the cells to be a paler color, leading to the term hypochromic, lacking in color.

Anemia caused by blood loss is normally treated with either blood volume expanders such as plasma or with related blood products. More severe blood loss may require transfusions of red blood cells.
In some cases, blood loss may be due to ulcers of the stomach or intestines. In these cases, treatment of the underlying cause will normally correct the anemia.

The most common cause of anemia in adults is iron deficiency. Although the typical American diet contains enough iron to meet normal needs, individuals who are less able to absorb and store iron may experience inadequate hemoglobin production. Although the best way to meet daily iron requirements is through improved diet, iron supplements are widely used.

Antianemic drug, any drug that increases the number of red blood cells or the amount of hemoglobin (an oxygen-carrying protein) in the blood, deficiencies of which characterize the disorder known as anemia. The red cell and hemoglobin reductions associated with anemia result in tissue oxygen deficiencies that can lead to symptoms such as fainting, dizziness, and shortness of breath.

There are different types of anemia, and thus there exists a variety of antianemic agents. Iron salts, such as ferrous sulfate, are used to treat iron-deficiency anemia, which occurs when the body is deficient in iron, an essential component of hemoglobin. Folic acid and vitamin B12 are used to treat folic acid deficiency anemia and pernicious anemia, which occur because of a lack of these vitamins. Folic acid and vitamin B12 are necessary for red blood cell formation.

An agent used to treat or to prevent anemia. Whole blood is transfused in the treatment of anemia resulting from acute blood loss, and packed cells are usually administered when the deficiency is caused by chronic blood loss. Transfusions of blood components are used in the treatment of aplastic anemia. Iron deficiency anemia is usually treated with oral preparations of ferrous sulfate, fumarate, or gluconate, but a parenteral preparation is indicated for people who are unable to absorb iron from the GI tract or for those who respond with nausea and diarrhea to the oral administration of iron.

Cyanocobalamin is administered parenterally in the treatment of pernicious anemia. Folic acid is prescribed to correct a deficiency of that vitamin in the anemias accompanying general malnutrition or Laënnec's cirrhosis and to treat the anemia of infants on an exclusive milk diet. A combination of folic acid and vitamin B12 is prescribed for people who are anemic as result of an inadequate dietary intake of both vitamins.

PREPARATIONS

Iron bivalent, oral preparations

Ferrous glycine sulfate, Ferrous fumarate, Ferrous gluconate, Ferrous carbonate, Ferrous chloride, Ferrous succinate, Ferrous sulfate, Ferrous tartrate, Ferrous aspartate, Ferrous ascorbate, Ferrous iodine,

Iron trivalent oral preparations

Ferric sodium citrate, Saccharated iron oxide, Sodium feredetate, Ferric hydroxide, Ferric oxide polymaltose complexes, Ferric citrate, Chondroitin sulfate-iron complex, Ferric acetyl transferring, Ferric proteinsuccinylate, Iron dextran complexes

Iron parenteral preparations, Iron in combination with folic acid

Ferrous amino acid complex, Ferrous fumarate, Ferrous sulfate, Ferric oxide polymaltose complexes

Iron in other combinations

Iron, vitamin B12 and folic acid, Iron, multivitamins and folic acid, Iron and multivitamins, Iron, multivitamins and minerals, Various combinations

Vitamin B12 (cyanocobalamin and analogues) and folic acid

Cyanocobalamin, Cyanocobalamin tannin complex, Hydroxocobalamin, Cobamamide, Mecobalamin, Cyanocobalamin, combinations, Hydroxocobalamin, combinations

Folic acid and derivatives

Folic acid, Folic acid, combinations

Other antianemic preparations

Erythropoietin, Darbepoetin alfa, Methoxy polyethylene glycol-epoetin beta, Peginesatide

Sources

http://www.britannica.com/topic/antianemic-drug

http://medical-dictionary.thefreedictionary.com/Antianemia+Drugs

http://medical-dictionary.thefreedictionary.com/antianaemic

DIURETICS an overview

noreply@blogger.com (Anonymous) — Fri, 09 Oct 2015 18:32:00 +0000

The amount of fluid (water) retained by the body is controlled primarily by the kidneys. This occurs due to the kidney's ability to control the retention and elimination of sodium and chloride, because the amounts of sodium, chloride, and water in the body are carefully balanced. Thus, if sodium and chloride are eliminated from the body, water also is eliminated. Conversely, if sodium and chloride are retained by the body, so is water.

The elimination of sodium, chloride, and water from the body is somewhat complex. In the kidneys, sodium, chloride, and other small molecules are filtered out of the blood and into the tubules of the kidney where urine is formed. Most of the sodium, chloride, and water are reabsorbed into the blood before the filtered fluid leaves the kidney in the form of urine. To make matters even more complex, there are different mechanisms that are active in different parts of the tubules that affect the reabsorption of sodium and chloride.

A diuretic is any substance that promotes the production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way. Alternatively, an antidiuretic such as vasopressin, or antidiuretic hormone, is an agent or drug which reduces the excretion of water in urine.

Uses of Diuretics

Diuretics are used with other types of medications (adjunctive therapy) in edema associated with congestive heart failure (CHF), cirrhosis of the liver, and corticosteroid and estrogen therapy. Also are useful in edema caused by renal dysfunction (for example, nephrotic syndrome, acute glomerulo nephritis, and chronic renal failure).

Diuretics are used to lower urinary calcium excretion, making them useful in preventing calcium-containing kidney stones and as the sole therapeutic agents to treat hypertension. Diuretics can also be used in combination with other antihypertensive drugs to treat more severe forms of hypertension. Diuretics (specifically the carbonic anhydrase inhibitors) are used as adjunctive treatment of chronic simple (open-angle) glaucoma and secondary glaucoma

CLASSIFICATION
1. Acting at proximal convoluted tubules

i. Osmotic diuretics - Osmotic diuretics are substances that increase osmolality but have limited tubular epithelial cell permeability. They work primarily by expanding extracellular fluid and plasma volume, therefore increasing blood flow to the kidney,particularly the peritubular capillaries.

· Glycerin, Mannitole, Isosorbide and Urea

ii. Carbonic anhydrase inhibitors - Carbonic anhydrase inhibitors inhibit the enzyme carbonic anhydrase which is found in the proximal convoluted tubule. This results in several effects including bicarbonate accumulation in the urine and decreased sodium absorption.

· Acetazolamide, Methazolamide

iii. Acidifying drugs

· Ammonium chloride

iv. Others

like tea, coffee, Theophylline, etc.

2.Acting at loop of Henle

i. Loop diuretics - Loop diuretics, such as furosemide, inhibit the body's ability to reabsorb sodium at the ascending loop in the nephron, which leads to an excretion of water in the urine, whereas water normally follows sodium back into the extracellular fluid.

· Furosemide, Torsemide, Ethacrynic acid and Bumetanide

ii. Mercurial agents

· Mercaptomerin

3.Acting at distal convoluted tubule

i. Thiazides diuretics - Thiazide diuretics such as hydrochlorothiazide act on the distal convoluted tubule and inhibit the sodium-chloride symporter leading to a retention of water in the urine, as water normally follows penetrating solutes.

· Chlorothiazide, Chlorothalidone, Hydrochlorothiazide, Methyclothiazide, Metolazone

ii. Sulfonamides

· Indapemide, Xipemide

4. Acting at collecting duct system

i. K- sparing diuretics - These are diuretics which do not promote the secretion of potassium into the urine; thus, potassium is retained and not lost as much as with other diuretics. The term "potassium-sparing" refers to an effect rather than a mechanism or location

. Aldosterone antagonist - Spironolactone

. Direct acting - Triamterene, Amiloride

ii. ADH antagonists

· Lithium salts, Demeclocycline

OTHERS

· Na/K acetate

· Na/K bicarbonate

· Na/K Acetate

· Albumin

· Dextrose

ANTI-DIURETICS

An antidiuretic is an agent or drug that, when administered to an organism, helps control body water balance by reducing urination opposing diuresis.Antidiuretics are the drugs that reduce urine volume, particularly in diabetes insipidus (DI) which is their primary indication.

Classification

1. Antidiuretic hormones - Vasopressin, also known as arginine vasopressin (AVP), antidiuretic hormone (ADH), or argipressin, is aneurohypophysial hormone found in most mammals. Its two primary functions are to retain water in the body and to constrict blood vessels. Vasopressin regulates the body's retention of water by acting to increase water reabsorption in the kidney's collecting ducts, the tubules which receive the very dilute urine produced by the functional unit of the kidney, the nephrons.
--ADH/Vasopressin, Desmopressin, Lypressin, Terlipressin

2. Miscellaneous
--Chlorpropamide, Carbamazepine

Sources

Dale, M. M., H. P. Rang, and Maureen M. Dale. 2007. Rang & Dale's pharmacology. [Edinburgh]: Churchill Livingstone.

Laurence L. Brunton (2011). Goodman & Gilman's pharmacological basis of therapeutics. (12th ed.). New York: McGraw-Hill.

http://www.rxlist.com/diuretics/drugs-condition.htm

https://en.wikipedia.org/wiki/Diuretic

https://en.wikipedia.org/wiki/Antidiuretic

How to Make Career as Pharmacist Abroad

noreply@blogger.com (Anonymous) — Thu, 08 Oct 2015 16:43:00 +0000

The pharmacy profession is highly demanding and rewarding profession for many years in USA, Canada, Australia, NZ, UK and all other first world countries. Pharmacist is the most important and positive contributing member of the health care system of any particular country. Health care sector is very important part of any particular country, in addition, developed countries give extra important to Health care sector and health care professionals. Thus, Pharmacist is an important and valuable member of health care system in Canada, USA, Aus, NZ, and UK etc.

The demand is continuously growing because of following reasons

· More than 47% of currently working Pharmacist are above age of 45 years

· Old age population is dramatically increase in developed countries due to long life expectance

· Increasing the rate and onset of chronic disease at early age

· Continually, increasing the responsibilities of pharmacist thus new era of pharmacy profession has evolved

o Registered Pharmacist

o Clinical Pharmacist

o Hospital Pharmacist

o Consultant Pharmacist

o Disease management Pharmacist

o MMR Pharmacist

o Nuclear Pharmacist

o Geriatric Pharmacist

o Industrial Pharmacist

o Prescribing Pharmacist

· Local students are not preferring to study Pharmacy courses

Pharmacist shortages are projected to increase over the next 20 years. Only strategic option to meet this shortage of Pharmacist can be achieved by offering Immigration to International pharmacist.

Pharmacists with specialized education and training become more versatile within the health care system to attain optimal health outcomes for patients through proper medication use.

These kind of intervention evolved new avenues of opportunities for pharmacist in developed countries. For Example

In Australia, Pharmacist receives wage from the Australian Government for conducting comprehensive Home Medicines Reviews.

In Canada, Pharmacists in certain provinces have prescribing rights (as in Alberta and British Columbia) or are salaried by their provincial

government for expanded services such as medications reviews (Meds checks in Ontario).

In United Kingdom , Pharmacists who undertake additional training are obtaining prescribing rights. They are also being paid by the government for

medicine use reviews.

In United States, Pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy.

In Scotland, Pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for Controlled drugs.

Thus, employment potential as a Pharmacist is very high in Canada, USA, AUS, NZ, and UK

To grab all this opportunities International Students must have to get “licence to practise as a pharmacist” In any particular country. In order to get Pharmacist licence, candidate must have to pass few steps.

Pharmacy Profession is regulated in all developed countries like USA, Canada, AUS, NZ and UK to practice as a Pharmacist.

Most important point, if any one wants to work as a Pharmacist they must have to get Pharmacist license from Pharmacy board of the respective country.

Eligibility to get License in all developed countries is 4 years Bachelor of Pharmacy (Note: Our 4 years Pharmacy Course is valid in all developed countries like Canada, Aus, NZ, UK and all gulf countries except for USA. USA is only accepting 5 years Bachelor ofPharmacy or PharmD Degree)

All developed countries have almost same licensing process to regulate Pharmacy profession by Conducting Examination as below.

Step - 1 : Pharmacist Evaluation Examination (Stage 1)

Step - 2 : Training as a Pharmacist

Step - 3 : Qualifying Examination (Stage 2)

source

http://www.mypharmavision.com/index.php?option=com_content&view=article&id=56&Itemid=61

List of CROs in INDIA

noreply@blogger.com (Anonymous) — Thu, 08 Oct 2015 11:02:00 +0000

List of CRO (Clinical Research Organisations) in INDIA

source

http://pharmaresearch.in/?page=72b32a1f754ba1c09b3695e0cb6cde7f

Pharmacy : Career Options

noreply@blogger.com (Anonymous) — Wed, 07 Oct 2015 12:57:00 +0000

After studying so much the main questions in the mind of everyone is what now what after I have completed my desired course of study. Same is the case with us who are in the pharmaceutical field, after completion of our degree or diploma we just keep on thinking which would be a better or great career to choose and start to have a bright future ahead.

So in this post I will try to summarize the relevant career paths available after degree/diploma/higher degree and hope it will be enough to guide you through to achieve what you aim for in future. I will be listing the careers whatever is relevant after degree or diploma in the options mentioned in the lower courses can also be taken by the higher degree professionals.

After D.Pharma

· Business development executive - marketing representative, MR, executive, sales personnel and many more names are available all are same and comprise of making sales and increasing the market share of the pharmaceutical company. The job comprises sales through one on one channels, direct or indirect sales, etc.

· Pharmacist – also known as chemists (Commonwealth English) or druggists (North American and, archaically, Commonwealth English), are healthcare professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. Retail pharmacists might work in small, independent pharmacies or in the pharmacy departments within grocery stores or larger retail establishments, filling and dispensing patients' medicines as prescribed by their doctors.

· Pharmacy assistant - Assistant pharmacists work alongside licensed and pharmacist technicians to help process prescriptions.Assistants' duties are typically clerical and organizational in nature and might include answering phones, filling out and filing paperwork, running cash registers and stocking shelves.

· Pharmacy aide - Pharmacy Aides are responsible for storing merchandise, maintaining inventory, and recording drugs delivered to the pharmacy. The key difference between pharmacy aides and pharmacy technicians is that aides are not allowed to dispense prescriptions. Instead, they spend most of their time operating cash registers and accepting prescription orders from customers.

· In manufacturing - In a manufacturing environment a pharmacist would initially supervise one or more units (such as packaging or tablet manufacturing). The production pharmacist will also be responsible for the safety and health at work of their staff. He or she is expected to bring leadership to a group or department; this would include those individuals reporting directly to them as well as other groups.

· Lab technician – many academic institutes require lab assistants or technicians to get help in the research or lab work so it is also a bright option.

So these are a few career options after diploma in pharmacy (D.Pharma) or you can study further and take a bachelors degree (B.Pharma) and explore more options.

AFTER B.Pharma

· In QA department - QA department is to maintain an oversight function over Production, Analytical laboratory, Warehouse, Utilities/Water supply and the environment (hygiene)to assure that good manufacturing practices, good laboratory practices and good storage practices are in place.

· In QC department - Quality control is an essential operation of the pharmaceutical industry. Drugs must be marketed as safe and therapeutically active formulations whose performance is consistent and predictable. New and better medicinal agents are being produced at an accelerated rate. At the same time more exacting and sophisticated analytical methods are being developed for their evaluation.

· Academics – or you can also start as a lecturer in any diploma institute of pharmacy and help build the career of coming students.

· In FDA - Pharmacists at the Food and Drug Administration (FDA) work in a variety of jobs at the Center for Drug Evaluation and Research, including positions in the Office of Drug Safety, the Office of Generic and Orphan Drug Products, the Division of Drug Information, and the Division of Metabolic and Endocrine Drug Products.

· In testing laboratory – also there is a bright scope of pharmacist in testing laboratories as trainees.

· IPR - Intellectual property rights (IPR) is prerequisite for better identification, planning, commercialization, rendering, and thereby protection of invention or creativity. Each industry should evolve its own IPR policies, management style, strategies, and so on depending on its area of specialty.

· Clinical pharmacist - As a clinical pharmacist, your opportunities to be a leader are greatly expanding. All pharmacists are leaders in their everyday practices by successfully influencing the behavior of physicians, nurses, pharmacy technicians, interns, support staff, and others to enhance medication safety and optimize patient outcomes.

· Bulk drug manufacturing and distribution - "Manufacturing" means the production, preparation, propagation, conversion or processing of a drug or device, either directly or indirectly, by large volume extraction from substances of natural origin, or independently by means of chemical or biological synthesis, and includes any packaging or repackaging of a substance or labeling or relabeling of its container, and the promotion and marketing of such drugs and devices. "Manufacturing" also includes the preparation and promotion of commercially available products from bulk compounds for resale by pharmacists to anyone other than a patient via a prescription, practitioners, or other persons. "Wholesaler" means a person with facilities in or outside this state who obtains drugs for distribution or delivery to persons other than consumers.

· Pharmaceutical consultancy - A consultant pharmacist is a who works as a consultant providing expert advice on the use of medications or on the provision of pharmacy services to medical institutions, medical practices and individual patients.

After bachelors degree you have two options either to take a master degree or opt for management studies.

After B.Pharma + MBA/MMS

· Management trainee in various departments of pharma industry.

· Product executive - same job role as a MR (discussed above under D.Pharma)

· Product manager - sales job with a higher managerial post like – area sales manager, district sales manager, regional sales manager, etc.

· Administrative manager – under this category you can make a career in hospital management or management of other administrative positions in pharmaceutical industries and institutions.

After M.Pharma

· Academics – work as lecturer in degree pharmacy institutes and with experience or PhD can be promoted to assistant professor/associate professor/ professor.

· In R&D – can work as JRF (junior research fellow) and then can be promoted to SRF (senior research fellow) within 2-3years of experience and then as scientist after completion of PhD.

· \In formulation and manufacturing – senior positions of supervisors or head of the department can be achieved with prior experience.

· In QA/QC – same as discussed in B.Pharm but getting a good position and good salary can be expected if you have some relevant experience.

· In marketing/sales – yes after masters you can go into sales and with relevant experience you can also go into product management (PMT).

· In regulatory affairs - Regulatory Affairs is involved in the development of new medicinal products from early on, by integrating regulatory principles and by preparing and submitting the relevant regulatory dossiers to health authorities. Regulatory Affairs is actively involved in every stage of development of a new medicine and in the post-marketing activities with authorised medicinal products.

Or after your masters you can move forward to PhD/doctoral/post doctoral studies and research work. And opt for careers such as scientist, senior positions in R&D and pharma industries.

So option are many and future is bright all you do is to choose the right career and make a start.

Reference

http://careers.abpi.org.uk/working-in-the-industry/manufacturingandsupply/manufacturing/Pages/pharmacists-manufacturing.aspx

study.com/.../Assistant_Pharmacist_Salary_Duties_and_Requirements.html

https://en.wikipedia.org/wiki/Pharmacist

www.ncbi.nlm.nih.gov › NCBI › Literature › PubMed Central (PMC)

http://www.medscape.com/viewarticle/547385_5

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217699/

https://en.wikipedia.org/wiki/Consultant_pharmacist

https://www.pharmatching.com/inforena/the-role-and-responsibility-of-the-regulatory-affairs-department

Hypertension : An overview

noreply@blogger.com (Anonymous) — Sun, 04 Oct 2015 18:26:00 +0000

Hypertension (HTN or HT), also known as high blood pressure or arterial hypertension, chronic abnormal increase in arterial blood pressure. Blood pressure (BP) is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively, in the arterial system. The systolic pressure occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction. Normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. Hypertension is present if the blood pressure is persistently at or above 140/90 mmHg for most adults; different numbers apply to children.

Increase in blood pressure can be seen during exercise, during endurance work or during heavy labored work but it gets normalized with time and is not harmful. But long term increase in BP can lead to hypertensive heart disease, coronary artery disease, stroke, aortic aneurysm, peripheral artery disease, and chronic kidney disease. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34%, of ischaemic heart disease by 21%, and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease.

Hypertension can be mainly of two types – primary hypertension (or essential) maximum cases are of such types of hypertension and in this no underlying cause of the disease is known. And the rest of the other causes are of secondary hypertension which is caused due to an identifiable cause such as renal disease or adrenal hyperfunction, or an endocrine disorder such as excess aldosterone, cortisol, or catecholamines.

Systolic BP (mm hg) Diastolic BP (mm hg)

Normal 130-139 85-89

Mild 140-159 90-99

Moderate 160-179 100-110

Severe 180-209 110-119

Very severe >210 >120

Reno-vascular hypertension is mainly caused due to improper functioning of RAS (rennin-angiotensin system), which when functioning normally can regulate blood pressure and fluid balance. Angiotensinogen (in liver) is the starting inactive peptide which is converted to angiotensin-I (A-I) in presence of renin (kidney), which is then converted to angiotensin-II (A-II) by angiotensin converting enzyme (ACE) (thought to be found in lung capillary).

A-II is 100 times more biologically potent than A-I but has a very short t_1/2(1 min) and its first degradation product is termed as angiotensin-III (A-III) which is 3-9times less potent that A-II, except when secreting aldosterone it is equipotent. Angiotensin-I may have some minor activity, but angiotensin-II is the major bio-active product. So, whenever there is problem in the RAS cycle there is abnormality in blood pressure and fluid balance in our body.

Angiotensin-II increases sympathetic activity causes tubular Na⁺ Cl^-, K⁺ excretion and water retention,arteriolar vasoconstriction and increase in BP, ADH (antidiuretic hormone secretion) secretion which causes water absorption in collecting duct, enhancing adrenaline/nor-adrenaline release from adrenal medulla/adrenergic nerve endings and by increasing central sympathetic outflow. In addition to secreting aldosterone, A-III promotes Na⁺/H⁺ exchange in proximal tubule causing increased Na⁺ Cl^- and bicarb reabsorption. Vasodilators and diuretics stimulate rennin release by lowering BP.

Classification of antihypertensive drugs

1.Adrenergic receptor antagonists

a.Beta blockers

 atenolol

 metoprolol

 nadolol

 oxprenolol

 pindolol

 propranolol

 timolol

 b.Alpha blockers:

 doxazosin

 phentolamine

 indoramin

 phenoxybenzamine

 prazosin

 terazosin

 tolazoline

 c.Mixed Alpha + Beta blockers:

 bucindolol

 carvedilol

 labetalol

2.Diuretics

Diuretics help the kidneys eliminate excess salt and water from the body's tissues and blood.

 a.Loop diuretics:

 bumetanide

 ethacrynic acid

 furosemide

 torsemide

 b.Thiazide diuretics:

 epitizide

 hydrochlorothiazide and chlorothiazide

 bendroflumethiazide

 c.Thiazide-like diuretics:

 indapamide

 chlorthalidone

 metolazone

 d.Potassium-sparing diuretics:

 amiloride

 triamterene

 spironolactone

3.Calcium channel blockers

Calcium channel blockers block the entry of calcium into muscle cells in artery walls.

 a.dihydropyridines:

 amlodipine

 felodipine

 isradipine

 lercanidipine

 nicardipine

 nifedipine

 nimodipine

 nitrendipine

 b.non-dihydropyridines:

 diltiazem

 verapamil

4.ACE inhibitors

ACE inhibitors inhibit the activity of Angiotensin-converting enzyme (ACE), an enzyme responsible for the conversion of angiotensin I into angiotensin II, a potent vasoconstrictor.

 captopril

 enalapril

 fosinopril

 lisinopril

 perindopril

 quinapril

 ramipril

 trandolapril

 benazepril

Indomethacin (and other NSAIDs) attenuates the hypotensive action of captopril.

5.Angiotensin II receptor antagonists

Angiotensin II receptor antagonists work by antagonizing the activation of angiotensin receptors.

 candesartan

 eprosartan

 irbesartan

 losartan

 olmesartan

 telmisartan

 valsartan

Losartan is 10,000 times more selective for A-I than A-II still is its competitive antagonist but has partial activity. It causes fall in BP in hypertensives which lasts for 24hours.

6.Aldosterone antagonists

Aldosterone receptor antagonists:

 eplerenone

 spironolactone

Aldosterone antagonists are not recommended as first-line agents for blood pressure, but spironolactone and eplerenone are both used in the treatment of heart failure.

7.Centrally acting adrenergic drugs

Central alpha agonists lower blood pressure by stimulating alpha-receptors in the brain which open peripheral arteries easing blood flow. Central alpha agonists, such as clonidine, are usually prescribed when all other anti-hypertensive medications have failed. For treating hypertension, these drugs are usually administered in combination with a diuretic.

 Clonidine

 Guanabenz

 Methyldopa

 Moxonidine

Adverse effects of this class of drugs include sedation, drying of the nasal mucosa and rebound hypertension.

Some adrenergic neuron blockers are used for the most resistant forms of hypertension:

 Guanethidine

 Reserpine

8.Vasodilators

Vasodilators act directly on the smooth muscle of arteries to relax their walls so blood can move more easily through them; they are only used in hypertensive emergencies or when other drugs have failed, and even so are rarely given alone.

Sodium nitroprusside, a very potent, short-acting vasodilator, is most commonly used for the quick, temporary reduction of blood pressure in emergencies (such as malignant hypertension or aortic dissection). Hydralazine and its derivatives are also used in the treatment of severe hypertension, although they should be avoided in emergencies. They are no longer indicated as first-line therapy for high blood pressure due to side effects and safety concerns, but hydralazine remains a drug of choice in gestational hypertension.

9.Adrenergic receptor agonists

 Alpha-2 agonists:

 clonidine

 methyldopa

 Guanfacine

Referred from:

https://en.wikipedia.org/wiki/Hypertension

https://en.wikipedia.org/wiki/Renin%E2%80%93angiotensin_system

https://en.wikipedia.org/wiki/Antihypertensive_drug

http://studenttopics.blogspot.in/2011/03/antihypertensive-drug-classification.html

An intro with Diabetes

noreply@blogger.com (Anonymous) — Sat, 03 Oct 2015 06:17:00 +0000

Diabetes is mainly of two types - Diabetes insipidus - a rare form of diabetes caused by a deficiency of the pituitary hormone vasopressin, which regulates kidney function that may cause frequent urination & Diabetes mellitus - caused by impaired formation of insulin by pancreas mainly due to destruction/decreased responsiveness of islet b-cells.

Diabetes mellitus is characterized by the imbalance in the secretion and/or utilization of insulin which leads to the disorder of carbohydrates (glucose) metabolism in the body. This results the increase or decrease in the blood glucose. Carbohydrates from various dietary sources are the primary exogenous source of glucose which is the main fuel for energy requirement of the body. Therefore, a continuous supply of glucose is necessary to ensure the proper function and survival of all organs.

Hence, mammals have evolved sophisticated systems to maintain the glucose level in the blood within tight limits, despite large fluctuations in food intake. Homeostatic mechanisms are in place to maintain blood glucose levels with very narrow range protecting the body against hypoglycemia during period of fasting and against the hyperglycemia following the ingestion of a high carbohydrate diet. These goals are met chiefly through the hormonal modulation of the production of glucose by the liver and the peripheral uptake of glucose by skeletal muscle, heart muscle and fat.

When mammals fast, glucose homeostasis is achieved by triggering expression of gluconeogenic genes in response to glucagon, and when they take a carbohydrate-rich diet, the function is taken over by the insulin for its uptake and utilization peripherally. Defects in carbohydrate metabolizing machinery and consistent efforts of the physiological system to correct the imbalance in carbohydrate metabolism place an over-exertion on the endocrine system, which leads to the deterioration of endocrine control. Continuing deterioration of endocrine control exacerbates the metabolic disturbances leading primarily to hyperglycemia and subsequently, the complication thus developed is called diabetes mellitus.

Type I diabetes is believed to be an autoimmune disease that results in specific immunologic destruction of b-cells of islets of Langerhans's, presence of islet cell antibodies in type I diabetes, lymphocytic infiltration in and around islets (insulitis) and association of type I diabetes with other autoimmune diseases supports the evidence of autoimmunity. About 10% of cases of type I diabetes has other organ specific autoimmune diseases such as Graves’ disease, Addison’s disease or autoimmune thyroiditis. The another presentation of insulin-dependent diabetes mellitus has been recently demonstrated that with immunological testing approximately 10% of patients initially diagnosed of having non-insulin dependent diabetes mellitus (NIDDM) may have a slow onset for IDDM that has been termed latent autoimmune diabetes in adults.

It usually manifest at early age, generally below the age of 40. The plasma insulin levels are low and patients respond to exogenous insulin therapy. The onset is marked by polyurea, polyphagia, and with extreme derangement, ketoacidosis, all resulting from metabolic dearrangements. A catabolic state is reached because of insulin deficiency which results in glucose, fat and protein metabolism. Glucose assimilation in the muscle and liver is greatly reduced and also the stores of glycogen are depleted by increased glycogenolysis.

This causes glycosuria. The glycosuria induces osmosis and thus results in polyurea, causing profound loss of electrolytes and water. Such a renal water loss and hyperosmolarity causes depletion of intracellular water provokes the osmoreceptors of the thirst centers of brain and causes intense thirst i.e. polydipsia. Due to lack of insulin catabolism of protein and fats occurs resulting in removal of gluconeogenic amino acid from the liver, this result in negative energy balance which in turn leads to increasing appetite i.e. polyphagia. Despite of increased appetite catabolic effect prevails resulting in weight loss and fatigue but the patients are not obese. Thus type I DM is a classic triad of polyurea, polydipsia and polyphagia, weight loss and fatigue.

Type II diabetes, or maturity onset diabetes, or non-insulin dependent diabetes mellitus (NIDDM), is more common and constitutes 80-90% cases of diabetes. The basic metabolic defect in this type of diabetes is either a delayed insulin secretion relative to glucose load (deranged insulin secretion), or the peripheral tissues are unable to respond to insulin (insulin resistance). In this type, the patient is usually 40 years of age at presentation and 80% are obese. Ketoacidosis is not a feature but hyperosmolar non-ketotic coma may be a complication. The pancreas in NIDDM is usually of normal size but with a tendency to fatty infiltration, most probably due to the obesity present in many of these patients.

The type II diabetes is further of two subtypes i.e., obese and non-obese. Obesity is a common finding in type II diabetes. There is impaired insulin sensitivity of peripheral tissues, such as muscle and fat cells to the action of insulin, in obese individuals (insulin resistance). Lack of exercise and obesity are considered major contributors to type II diabetes; roughly 90% of individuals with type II diabetes are obese. These conditions predispose to hyperinsulinemia. Increased insulin resistance results in increased fasting and postprandial b-cells synthesis, which leads to “b-cell burnout” and eventually diabetes.

The condition of insulin resistance may exist for many years before pancreatic b-cell function actually becomes impaired. Weight reduction in such obese patients produces improvement in the diabetic state. It has been observed that insulin resistance is a factor not only in obese type II diabetes but also in non-obese type II diabetes. In such individuals, the increased insulin resistance of peripheral tissues is due to either decrease in the number of insulin receptors or there is post defect.

Gestational diabetes which refers to the hyperglycemia temporarily during pregnancy in individuals, having inherited liability to develop this disorder. Although this form usually disappears following delivery, 40% of women with gestational diabetes will go on to develop type II diabetes later in life. Other types of diabetes may be secondary to pancreatic disease or removal of pancreatic tissue; secondary to endocrine disease such as acromegaly, Cushing’s syndrome, pheochromocytoma, glucagonoma, somatostatinoma or primary aldosteronism; secondary to administration of hormones causing hyperglycemia.

Iatrogenic diabetes may develop during various forms of therapies by drugs such as antihyperglycemic drugs, thiazide diuretics, preparations containing estrogen, psychoactive drugs, sympathomimetic agents etc. It is also occurring mainly in those patients who are genetically susceptible.

The prevalence of insulin dependent diabetes mellitus (IDDM) is 10% whereas that of non-insulin dependent diabetes mellitus (NIDDM) is 90% of the diabetic population. Diabetes mellitus, the most pervasive and costly chronic disease is afflicted by an estimated 175 million people worldwide. It is a leading cause of adult blindness and end-stage kidneys disease. Additionally diabetics are two to four times more likely to have heart disease or to suffer a stroke .

Therefore, Diabetes mellitus has been recognized as a growing world-wide epidemic by many health advocacy groups including the World Health Organization (WHO). Approximately 5% of the world’s population suffers from diabetes. Independent forecasters have suggested that the global prevalence of the disease will increase from 150 million in 2000 to 220 million in 2010 and to 300 million by 2025. The global burden of diabetes mellitus would rise from 135.3 in 1995 to 300 million in 2025. The WHO has also estimated that diabetes will be one of the leading causes of death and disability within the next quarter century.

India being at top of the world in diabetes cases, known as diabetes capital of the world. The Indians are more prone to diabetes due to the reason being that Indian healthcare policies have by and large emphasized on the prevention of infectious diseases only. Also, with the improved living conditions in India, we are increasingly following western dietary habits unsuited for our environs, adopting sedentary life style, and exposed to psycho-social stress. This has resulted in an unprecedented rise in diabetes population to epidemic proportions during last few decades in India.

Complications related to Diabetes mellitus is that the patients with long-standing diabetes may develop complications affecting the eyes, kidneys or nerves (micro vascular complications) or major arteries. The major arteries are affected in people with diabetes, causing a substantial increase in both in coronary artery disease and strokes as well as peripheral vascular disease. The greatest risk of large vessel disease occurs in those diabetic patients who develop proteinuria or micro albuminuria, which are associated with widespread vascular damage.

An intro with Liposome

noreply@blogger.com (Anonymous) — Fri, 02 Oct 2015 18:21:00 +0000

A liposome is a tiny bubble (vesicle), made out of the same material as a cell membrane. Liposomes can be filled with drugs, and used to deliver drugs for cancer and other diseases. Membranes are usually made of phospholipids, which are molecules that have a head group and a tail group. The head is attracted to water, and the tail, which is made of a long hydrocarbon chain, is repelled by water.

In nature, phospholipids are found in stable membranes composed of two layers (a bilayer). In the presence of water, the heads are attracted to water and line up to form a surface facing the water. The tails are repelled by water, and line up to form a surface away from the water. In a cell, one layer of heads faces outside of the cell, attracted to the water in the environment. Another layer of heads faces inside the cell, attracted by the water inside the cell. The hydrocarbon tails of one layer face the hydrocarbon tails of the other layer, and the combined structure forms a bilayer.

When membrane phospholipids are disrupted, they can reassemble themselves into tiny spheres, smaller than a normal cell, either as bilayers or monolayers. The bilayer structures are liposomes. The monolayer structures are called micelles. The lipids in the plasma membrane are chiefly phospholipids like phosphatidylethanolamine and phosphatidylcholine. Phospholipids are amphiphilic with the hydrocarbon tail of the molecule being hydrophobic; its polar head hydrophilic. As the plasma membrane faces watery solutions on both sides, its phospholipids accommodate this by forming a phospholipid bilayer with the hydrophobic tails facing each other.

Liposomes can be composed of naturally-derived phospholipids with mixed lipid chains (like egg phosphatidylethanolamine), or of pure surfactant components like DOPE (dioleoylphosphatidylethanolamine). Liposomes, usually but not by definition, contain a core of aqueous solution; lipid spheres that contain no aqueous material are called micelles, however, reverse micelles can be made to encompass an aqueous environment.

Discovery

Liposomes were first described by British haematologist Dr Alec D Bangham FRS in 1961 (published 1964), at the Babraham Institute, in Cambridge. They were discovered when Bangham and R. W. Horne were testing the institute's new electron microscope by adding negative stain to dry phospholipids. The resemblance to the plasmalemma was obvious, and the microscope pictures served as the first real evidence for the cell membrane being a bilayer lipid structure.

Etymology

The name liposome is derived from two Greek words: 'Lipos' meaning fat and 'Soma' meaning body. A liposome can be formed at a variety of sizes as uni-lamellar or multi-lamellar construction, and its name relates to its structural building blocks, phospholipids, and not to its size. In contrast, the term Nanosome does relate to size and was coined in the early 1990s to denote special liposomes in the low nanometer range; liposome and Nanosome are not synonyms. A liposome does not necessarily have lipophobic contents, such as water, although it usually does.

PHARMACY

noreply@blogger.com (Anonymous) — Fri, 02 Oct 2015 16:51:00 +0000

This is an introductory post on Pharmacy and this blog will cover everything about pharmacy and will get more informative with the coming updates. Pharmacy is the science or practice of the preparation and dispensing of medicinal drugs. It is a health profession that links health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs.

The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals who optimize use of medication for the benefit of the patients. However, the original Greek roots from pharmakos imply "sorcery or even poison".

The earliest known compilation of medicinal substances was the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD. Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine. Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC.

There are mainly two symbols used by pharmacy organizations worldwide. One of them is the mortar and pestle and the ℞ (recipere) character, which is often written as "Rx" in typed text. Rx stands for “treatment / take as prescribed / take thou”

Pharmacy organizations often use other symbols, such as the "Bowl of Hygieia" which consists of a bowl with a snake around it. Snake denotes poison which relates to drug or medicine as in some ancient and modern treatment uses snake venom and bowl denotes hygiene.

According to PCI - Indian Pharma industry which has registered a spectacular progress today ranks 4th in volume and 13th in value in the global pharmaceutical market with exports worth US Dollars 2.6 billion besides domestic sales amounting to over US Dollars 4 million.

The ever expanding Pharma's industrial and practice sectors need clinically and technologically trained pharmacy professionals who can face global challenges and compete with the multinationals. The pharmacist is no longer a mere dispenser of drugs but has assumed a more crucial role in medicine management and as overall health care programmer.

Pharmacists are healthcare professionals with specialised education and training who perform various roles to ensure optimal health outcomes for their patients through the quality use of medicines. Pharmacists may also be small-business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimization of a drug treatment for an individual.

Pharmacy Technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with medics's offices and insurance companies to ensure correct medications are provided and payment is received.

In coming future pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills.