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Assalamu alaikum this is aisha rule number bp 165046 and my topic is athenanol adrenal is used for the management of hypertension and angina pectoris it is used for chronic conditions rather for the treatment of acute conditions because it is used for the management of acute conditions like in case of myocardial infarction irrational use that it shouldn’t be used

With bradycardia in case of bradycardia shouldn’t be used because it causes a decrease in heart rate and blood pressure so if used in bradycardia may worsen the condition shouldn’t be used in case of metabolic acidosis because it is itself an acidic drug so if used in metabolic acidosis may worsen the condition shouldn’t be using patients taking calcium channel

Blockers because calcium channel blockers decrease their blood pressure so if used with calcium channel blockers uh may worsen the situation clonidine is a hypotensive drug so adrenal shouldn’t be used with lunadine because they can severe they can more they can cause more severe hypertension alternative choices include metaprolol which is when evaluated for

A decrease in risk of stroke it is it was proved to be superior to a tenolune so it is a good alternative of a ten alloy visceral oil is more cardio specific so associated with less less side effects uh serves as a better alternative of a tenderloin the lol is good for controlling chest pain and heart failure so it is also a better alternative those age dosage

Adjustment is required in renally impaired patients like in case of elderly patient in which renal impairment is more common for hypertension it is given in a dose of 50 100 milligram and fungi it is usually uh given in a dose of 100 milligram or 15 milligram twice daily side effects include chest pain worse chest pain slower in uneven heartbeat if taken

In higher doses cause shortness of breath and cold feeling in hands of heat because of beta blocking effects brands available with price comparison so the three brands i have taken if we compare the prices of those brands uh at enos cot by scotland pharmaceuticals is way cheaper than other two which costs rupees 35 for 25 milligram tablet which comes in a

Packet of 20 tablets and other two costs more available dosage forms with choices in case of acute heart attack chest pain and high blood pressure oral dosage form is preferred which is usually tablet iv injection which comes under the name of the norman which is a brand name of paterno lol is a beta blocker used for control of hypertension and janna and for

The management of acute myocardial infarction and angelina is a 60 year old woman and she has number of chronic medical problems like coronary heart disease congestive heart failure hypertension diabetes and hyperlipidemia she takes a glass of red one with dinner and several cups of licorice tea so what would be the initial steps for effective management of her

Therapy and she has a complaint of sluggishness and painting because of your semen potential pressure supplements so her chief complaint is sluggishness and fainting because of her medications history of illness include coronary artery disease heart failure hypertension and diabetes location of chief contain is by observing her medical conditions obviously it

Is cardiovascular system characterization is chronic so her history reveals that she has chronic medical problems like coronary artery disease congestive heart failure hypertension diabetes and hyperlipidemia her medications include medications for diabetes or hypertension and congestive heart failure like gliborite propanol niacin digoxin as you saw by the nitrate

Which is advisor dilator keptropyl which is ac inhibitor where apparel is a calcium channel blocker and other multivitamins and minerals vital signs showing that her bb is extremely high and heart rate is extremely low this priority seems to be normal and physical exam shows that she has sluggishness and chest pain so electrocut her ecg shows sinus bradycardia

With an old anterior myocardial infarction assessment her sluggishness in painting are most likely due to her lower heart rate because of digoxin she is taking in a very higher dose it is not appropriate for elderly patients she is taking propanol and verapamil together which are is it is also not recommended because propeller holds the beta blocker and vapor is

The calcium channel blocker both lower down the heart rate so they contribute to her sluggishness based on her old history of myocardial infarction she is also in stage b of american college of cardiology according to a migrant college of cardiology classification scheme so her treatment plan included digoxin dose reduction to be lowered down to 0.125 milligram

Daily because digoxin is known to have cardiotoxic effects if taken in higher dose so the dose then would be monitored for two weeks and then after two weeks so changes could be made to her dose switching from perpendicular to a cardio selective beta blocker at any hole in a dose of 50 milligram daily would help because eternal lowell is a selective beta blocker

And proportional is not grab ml should be discontinued because it is with propanolol worsening the effects the current angiotensin converting enzyme inhibitor in her regimen is kept operal which is taken three times a day uh because of it because of this she is overly adherent to kept opera we will change a drug from captopril to them april which is the most

Suitable angiotensin converting islam inhibitor and initiated at a dose of 1.25 to 2.5 milligram and has to be taken only once daily so she will be more adherent to this compared to kept opera varapamil may be discontinued because of her angina aspirin will be added in her regimen so recommended therapy for stage b includes an ac inhibitor which we have a ramipril

Which include in our regimen and the beta blocker then alone loop diabetics are generally more effective and thorough cement is preferred uh when we observe her case other considerations likely quality she drinks she has to cut down because she has because that tea has mineralocorticoid properties which cause blood pressure elevation salt and water retention she

Uh is suffering from a condition of hypertension so uh she shouldn’t take liquorice t because it will make the situation more worse so for her hyperlipidemia she should begin with lifestyle dietary modifications lifestyle modifications like she should do a small uh exercise daily like brisk walking and for dietary modification she should take uh uh green vegetables

And fruits daily uh for the management that will also be uh beneficial for her management of hypertension as well as the it will uh also lower down the cholesterol levels and statins are the drug out choice for the management of hybrid up now for the management of a hyperlipidemia and also be considered in elderly population as they are very effective and well

Tolerated antidote of a tunnel as a tunnel can cause toxic toxicity and adrenal toxicity toxic effects include hypotension bradycardian cardiac depression which can appear within two hours of administration so uh antidote of beta blocker is high dose luca gone uh which will reverse the effects of hypotension dragon directions if a tunnel hole is taken with the

Uh calcium channel blockers it may worsen the effects because they both lower down the heart rate if taken with monoamine oxidase inhibitors they may increase or add to the effects of ethanol other drugs like digitalis and neutron and modal is a diuretic digitalis contains digoxin if taken with ethanol they may worsen the situation so that is all thank you so much

Transcribed from video
Atenolol By Pharmacy by Dr. Shahana wahid