Pharma Tips-320

1616. Lanoxin tablets and lanoxicaps (liquid form) have the same potency; lanoxicaps are more absorbed (90-100%) and less variable than lanoxin tablets. Digoxin is recommended with diuretics, ACEIs, and BBs to treat heart failure.

1617. Hydralazine may cause systemic lupus erythematosus (SLE) in long-term therapy; CBC should be performed, and antinuclear antibody titers should be obtained. 

1618. A combination of hydralazine + isosorbide dinitrate decreases mortality in heart failure.

1619. SLE (systemic lupus erythematosus) symptoms may include fatigue, malaise, low-grade fever, joint aches, butterfly rash, chest pain, and overall pain.

1620. Beta-blockers are recommended to treat heart failure due to left ventricular dysfunction, especially HFrEF, unless contraindicated for use or due to side effects like hypotension, bradycardia and bronchospasm.

Pharma Tips-319

1611. Ferrous sulfate (dry) desiccated contains 30% of elemental iron.

1612. Ferrous gluconate contains 12% of elemental iron.

1613. Ferrous fumarate contains 33% of elemental iron. 

1614. Lasix (furosemide) reduces excess sodium and water (decreases venous return to the heart, decreasing preload), recommended for heart failure with oedema, and it has an indirect dilating effect on the lungs (useful in pulmonary congestion).

1615. ACEIs reduce the preload (venous return) by decreasing aldosterone secretion (increasing Na and H2O secretion) and reducing the afterload (vasodilation) by decreasing angiotensin II formation (potent vasoconstrictor).

Pharma Tips-318

1606. Carvedilol is a non-selective β-blocker and α-1 blocker used to treat hypertension and heart failure; the dose must be titrated to the optimal value and should not be discontinued abruptly, as abrupt discontinuation may precipitate an acute coronary event.

1607. Left-sided heart failure presents with shortness of breath, rales, and paroxysmal nocturnal dyspnea. 

1608. HOPE = the Heart Outcomes Prevention Evaluation Trial.

1609. ACEIs are the drugs of choice in patients with hypertension, heart failure, and chronic kidney disease; they reduce cardiovascular deaths, myocardial infarction and stroke incidence.

1610. Ferrous sulfate (hydrous) contains 20% of elemental iron.

Pharma Tips-317

1601. Toxicity may occur for a drug that is highly albumin-bound (more free drug in the blood) for the following cases:

• Hypoalbuminemia.
• Hepatic disease.
• Malnutrition.
• Cancer diseases cause albuminemia (decreased albumin levels). So doses must be monitored.

1602. Salmeterol is a long-acting beta-2 agonist (LABA) with high selectivity for β₂-adrenergic receptors.

1603. LABAs increase the risk of asthma-related deaths (they must be used with inhaled corticosteroids for uncontrolled asthma and should not be used alone), and they are not used for acute asthma.

1604. Myocardial infarction is the leading cause of heart failure in people aged 40-50 years old.

1605. Corticosteroids may cause heart failure ( sodium and water retention).

Pharma Tips-316

1596. Insulin resistance is the need for more than 200 units/day of insulin in the absence of ketoacidosis, which can be caused by obesity, infection, glucocorticoids, and circulating IgG (anti-insulin antibodies). It may resolve without treatment, by insulin switching or with prednisone therapy.

1597. Lanolin is a hydrous wool fat, water-in-oil (W/O), containing 25% water, used as an emulsion base.

1598. Occlusive film can prevent water loss from the skin.

1599. Kaopectate and pepto-bismol both considered as adsorbents (bacteria, toxins and gases).

1600. Dopamine does not cross the BBB.

Pharma Tips-315

1591. The oblique plane passes through the body at an angle.

1592. Warfarin is active in vivo only.

1593. LMWH is active in vivo and minimal in vitro.

1594. Heparin is active in vivo and in vitro.

1595. Epoetin alpha (Eprex) is used in chronic kidney disease to treat anemia due to a decrease in the production of erythropoietin.

Pharma Tips-314

1586. The sagittal plane divides the body into right and left halves.

1587. The midsagittal plane (median plane) divides the body into equal left and right portions. 

1588. The parasagittal plane divides the body into unequal left and right portions. 

1589. The coronal plane (frontal) divides the body into anterior and posterior portions.

1590. The transverse plane (horizontal) divides the body into superior (upper) and inferior (lower) portions.