South Sudanese future pharmacists

08/06/2023

Aldosterone antagonists

EXAMPLES
Spironolactone, eplerenone or take a SEAT.

MECHANISM OF ACTION

Competitive antagonist at intracellular aldosterone receptors in
renal tubules causing reduced production of aldosterone-induced proteins. This indirectly
reduces activity of Na */K* ATase in the collecting ducts, increasing excretion of Na* and
decreasing K* loss. Spironolactone, in particular, also acts on receptors in other tissues, including androgen receptors.

INDICATIONS

• Congestive cardiac failure (spironolactone)
• Oedema and ascites in liver disease (spironolactone)
• Post-MI heart failure (eplerenone)
• Nephrotic syndrome (spironolactone)
• Primary hyperaldosteronism (including Conn's syndrome) (spironolactone)

CAUTIONS AND CONTRA- INDICATIONS

• Electrolyte disturbances (including hyperkalaemia and hyponatraemia)
• Caution in renal impairment

SIDE-EFFECTS

• Hyperkalaemia (K* sparing effect)
• GI disturbance
• Anti-androgenic effects (spironolactone - menstrual irregularities in females,
gynaecomastia and hypogonadism in males)

METABOLISM AND HALF-LIFE

Metabolised to active metabolites. ty of drug is 60-90 min
but ty of active metabolites is longer (up to 11 h).

MONITORING

Monitor plasma electrolytes for adverse effects as above.

DRUG INTERACTIONS

• Enhanced hypotensive effect with other antihypertensives
• Increased risk of hyperkalaemia with ACEls/ARBs and amiloride
• Increased risk of nephrotoxicity with NSAIDs

IMPORTANT POINTS

• Eplerenone is more selective than spironolactone and therefore causes fewer s*x hormone-related adverse effects
• Spironolactone may also be used in hypertension (unlicensed indication)

06/06/2023

Vein infrared finder.

06/06/2023

GERD (Gastroesophageal Reflux Disease) is a condition in which the gastric acid content in the stomach flows back to the oesophagus.

This usually causes a painful burning sensation in the middle of the chest (heartburn).

The Proton Pump Inhibitors (PPIs) are the most effective drugs used for treating GERD.

Examples include Omeprazole, Lansoprazole, Rabeprazole and regularly take 30 or 60 mins before lunch or dinner.

06/06/2023

Cimetidine Vs Ranitidine

Both drugs are used to treat peptic ulcer.
Chronic use of Cimetidine causes the abnormal enlargement of the male breasts (Gynaecomastia)

Ranitidine doesn't

Chronic use of Cimetidine decreases libido and causes impotence in male

Ranitidine doesn't.

04/06/2023

04/06/2023

The day mitochondria went from being "the powerhouse of the cell to the ATP synthesis by oxidative phosphorylation" was a horrible day.

04/06/2023

What is an absolute contraindication of ACE inhibitor.

30/05/2023

Hello hearty,love your stuff. I'm a pharmacist who has had addiction issues and I am in recovery but my job options are limited to say the least. I currently float for WURH and honestly they treat me fairly well. The problem is there aren't many stores close to me and I regularly have 3 or 4 hours a day of driving or hotel stays. I have an offer from CVS that is close with a set schedule. Your disdain for them is clear but do you honestly think that it would be much worse than what l'm doing?

Thanks for any help.