Pharma Tips-347

1751. Heart rate and blood pressure are the parameters to watch when administering beta-blockers to patients with MI for acute treatment; if the heart rate and BP are too low, don't give beta-blockers.

1752. Hyperkalemia can be treated by stabilising the cardiac membrane with IV calcium, shifting potassium intracellularly with insulin and dextrose, and removing potassium from the body with dialysis or potassium-binding agents such as sodium polystyrene sulfonate. 

1753. Elemental iron percentage in ferrous gluconate is 12%, in ferrous sulfate is 20%, and in ferrous fumarate is 33%.

1754. Protease inhibitor antivirals include amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir. Other HIV protease inhibitors include atazanavir, darunavir, fosamprenavir, and lopinavir.

1755. NRTIs (nucleoside reverse transcriptase inhibitors) include zalcitabine, lamivudine, and stavudine. Other important NRTIs include abacavir, emtricitabine, didanosine, tenofovir, and zidovudine.

Pharma Tips-346

1746. Henderson-Hasselbalch equation describes the pKa and pH of a weak acid or base.

1747. The Noyes-Whitney equation describes the rate of dissolution of a solid drug.

1748. Amiodarone has a very long half-life (up to 50 days); the therapeutic effect may be delayed for weeks, and side effects may persist for up to 4 months after therapy ends.

1749. Propranolol is used to treat hyperthyroidism because it provides symptomatic relief and reduces tachycardia, sweating and tremor; it also inhibits the conversion of thyroxine (T₄) to triiodothyronine (T₃).

1750. Tenecteplase (TNKase) is easier to administer than tissue plasminogen activator (t-PA) as a single IV bolus dose for acute management of MI. 

Pharma Tips-345

1741. Controlled release dosage forms are:

1. Dospan = erosion core tablet.
2. OROS = osmotic drug delivery system.
3. TDDS = transdermal drug delivery system.
4. Pennkinetic = ion exchange resin delivery system. 
5. HBS = hydrodynamically balanced system.

1742. Azathioprine, basiliximab, and cyclosporine are used after a kidney transplant.

1743. The Cockcroft-Gault equation is a common method for estimating creatinine clearance (age-, weight-, and gender-based).

1744. Fick's law describes drug diffusion via passive transport (from high to low concentration).

1745. The law of mass action describes the rate of a chemical reaction in terms of the reactants' concentration.

Pharma Tips-344

1736. Anticholinergic side effects include dry mouth, blurred vision, constipation, urinary retention, tachycardia, hallucinations, ataxia, mental slowing, confusion, and memory impairment. Anticholinergic drugs should be used with caution in patients with narrow-angle glaucoma, as they can increase intraocular pressure and may precipitate an acute glaucoma attack.

1737. Anticholinergic drugs are equally effective as a group, but their use is limited by their anticholinergic side effects and reduced effectiveness against bradykinesia.

1738. Drugs that are used to treat parkinsonism are pergolide and bromocriptine, which directly stimulate dopamine receptors. Levodopa is converted to dopamine in the brain; amantadine stimulates the presynaptic release of dopamine; and selegiline inhibits MAO-B and prevents the breakdown of dopamine in the brain. Pramipexole and ropinirole are non-ergot dopamine agents, and tolcapone and entacapone, COMT inhibitors, delay the breakdown of dopamine in the brain.

1739. Dopa-decarboxylase converts levodopa to dopamine, but this reaction is important to happen inside the brain. If the patient is taking pyridoxine (B6), which is a coenzyme for dopa-decarboxylase, that means more levodopa is converted to dopamine peripherally, so less dopamine in the brain.

1740. For the on-off therapy of levodopa for parkinsonism, the use of pramipexole or ropinirole has shown effectiveness as a adjunctive therapy. 

Pharma Tips-343

1731. Diphenhydramine could be used to treat mild, symptomatic tremor in Parkinson's patients.

1732. Biperiden is an anticholinergic agent in the treatment of parkinsonism, the daily dose is 2 - 8 mg, with a maximum dose that could reach up to 16mg.

1733. Benztropine, an anticholinergic drug for parkinsonism, dose 1-6 mg.

1734. Pramipexole is a non-ergot dopamine receptor agonist; the daily dose ranges from 1.5 to 4.5 mg for the treatment of parkinsonism.

1735. Tolcapone 300-600 mg and entacapone 200-1600 mg are both COMT inhibitors; they are adjunctive therapies to levodopa/carbidopa (wearing off) and increase levodopa bioavailability.

Pharma Tips-342

1726. TB testing is performed when the patient uses infliximab, due to its immunosuppressive properties.

1727. Secondary parkinsonism may be caused by dopamine antagonists, such as phenothiazines and butyrophenones (e.g., haloperidol), as well as dopamine-depleting agents such as reserpine.

1728. Secondary parkinsonism may be caused by poisoning with certain chemicals and heavy metals, including manganese, mercury, and cobalt.

1729. Secondary parkinsonism may be caused by infectious diseases such as viral encephalitis and neurosyphilis.

1730. Secondary parkinsonism may be caused by cerebrovascular disease (vascular parkinsonism), neurodegenerative diseases of the CNS, and metabolic disorders.

Pharma Tips-341

1721. Vasopressin and oxytocin are released by the posterior pituitary gland.

1722. Metoprolol is a selective β₁‑blocker. Non‑selective beta‑blockers (e.g., timolol) decrease aqueous humour production; metoprolol does not significantly do so.

1723. Valacyclovir is indicated for the treatment of shingles and genital herpes.

1724. Tegaserod is a 5-HT₄ agonist, used for irritable bowel syndrome in women with constipation predominant.

1725. Ritonavir is a protease inhibitor; it is used for HIV.