Symptoms And Treatment Of Hypertension

Symptoms And Treatment Of Hypertension
BACKGROUND
Background1–6 Hypertension is persistent elevated blood pressure causing increased pressure against arterial walls leading to stretching and damage
to organs such as heart and kidneys, of which systolic blood pressure (SBP) is an important predictor.
Reduction in blood pressure is positively correlated with reduced incidence of cardiovascular events
Hypertension is treated with daily lifestyle changes along with pharmaceutical drugs to achieve a lower systolic blood pressure, however, the specific
number is uncertain.
Meta–analysis of 61 prospective observational studies show direct relation between cardiovascular mortality with increased blood pressure above 115
mmHg.
National Heart, Lung, and Blood Institute expert panel on hypertension treatments concluded there is a need to conduct trials on the benefits for lower
SBP as a top priority in non–diabetic patients compared to the recommended SBP of 140 mmHg
Patients with type 2 diabetes showed no significance in reduced cardiovascular risk by lowering SBP below 120 mmHg, however, it may reduce the
risk of stroke
According to Medscape, the 2013 updated JNC 8 guidelines recommend the first line of pharmaceutical treatment with combination therapy of
thiazide–type diuretics along with angiotensin converting enzyme inhibitors (ACE), angiotensin receptor blockers (ARB), or calcium channel blockers
(CCB).
Previous trials5Action to Control Cardiovascular Risk trial (ACCORD) assessed cardiovascular
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Hypertension With Rationale
5.Medical or Surgical Management of Hypertension with Rationale:
There are many methods of treatment for hypertension. This includes exercise, a healthy diet, quitting smoking, and medications. Some medications
that might be prescribed to a hypertension patient are thiazide diuretics, beta blockers, angiotensin–converting enzyme (ACE) inhibitors, calcium
channel blockers, and renin inhibitors. Thiazide diuretics, also known as water pills, help improve the kidneys. They eliminate the sodium (salt) and
excess water which reduces the blood volume. Thiazide diuretics are most commonly the first drug that is prescribed to a hypertension patient. These
types of drugs include hydrochlorothiazide (Microzide), chlorthalidone, and many others. Beta ... Show more content on Helpwriting.net ...
The patient diagnosed with having high blood pressure could easily deny it. This means that they don't want to believe that they do, in fact, have
hypertension. However, denial could also be a result of the patient not understanding what hypertension is and how it affects him/her. Once the
patient is diagnosed and understands what this means for him/her, this could lead to psychological distress. This includes anxiety and depression.
Anxiety and/or depression could come from simply knowing that they have hypertension or from the medications that the patient is placed on to
treat their high blood pressure. These are considered as side effects of the medication rather than from the high blood pressure itself, although that
is possible. Depression is a feeling of sadness, hopelessness, or a feeling of being discouraged. Anxiety is a feeling of worry or nervousness. The
family of a patient who is diagnosed with hypertension would be affected by the response of the patient. Seeing their loved one in distress caused
by the challenges that he/she faces to treat their high blood pressure or even the depression or anxiety can lead to psychological distress among the
family itself. This means that the loved one could become depressed or have anxiety. However, this can also be due to the expense of the treatment.
High levels of depression and anxiety in either the patient or family can lead to horrible events such as an abuse of alcohol or controlled substances, a
lack of motivation for life, or in extreme cases, suicide. Even though hypertension can be a hard thing to cope with, there are some methods that can
help. Some methods could include meditating or yoga. This relaxes the patient and family while also providing a form of physical activity. Another
way for the patient and even the family to cope could be exercising. Although exercise alone may not completely

Virtual Body Circulation, Respiration, Breathing
Sophia Ho
A13369046
Virtual Body Circulation, Respiration, Breathing
Ventilation is a process in which our body extracts oxygen from the atmosphere and releases carbon dioxide as a byproduct. Overall, this process
exchanges air between our lungs and the atmosphere.
According to Boyle's Law, at a constant temperature, pressure of a gas is inversely proportional to volume. Therefore, when we breathe in, the chest
cavity expands, and the pressure inside the lungs becomes slightly lower than the atmospheric pressure.
When the muscles relax and the volume of the chest cavity decreases, the air inside the lungs is forced out. This is the process of expiration .
For normal breathing, 3% of the body's energy is used.
For those with lung disease, ... Show more content on Helpwriting.net ...
Pharmacologic interventions are used to prevent blood clots from occurring in the body. Coronary vasodilators and antithrombotic drugs are used to
increase oxygen delivery to the myocardium. Vasodilators and cardiac depressants, which decrease heart rate and contractility), are drugs used to
decrease the oxygen demand. A decrease in demand compensates for the lack of oxygen going to the myocardium . Vasodilators include calcium
channel blockers and nitrodilators; cardioinhibitory drugs include beta–blockers and calcium channel blockers; and antithrombotic drugs include
anticoagulants and antiplatelet

Hypokalemia Research Paper
Electrolyte Disorder – Hypokalemia The human body contains blood and fluid compounds and elements like chloride, phosphate, potassium, calcium,
sodium, and magnesium known as electrolytes that occur naturally to control important physiologic functions. When the body levels of electrolytes are
low (hypo) or high (hyper) it results in electrolyte disorder. Depending on the affected electrolyte(s), when body electrolytes are hyper (high) or
hypo(low) it leads to electrolyte disorder, which in turn disrupts blood ionized salts balance ( Buttaro, et al., 2017). For instance, disruption of chloride
leads to either hyperchloremia or hypochloremia, calcium (hypercalcemia or hypocalcemia ), Potassium (hyperkalemia or hypokalemia), Magnesium
disruption ... Show more content on Helpwriting.net ...
Thiazides diuretics reduce sodium reabsorption that leads to increased fluid loss, decrease plasma volume and extracellular fluid. (Drugs.com 2012).
Other means of depleting potassium from the body are malignant hypertension (vascular), Type 1 and 2 renal tubular acidosis (Renal), trauma, and
diarrhea (Buttarro et. al., 2017). To be able to diagnose Hypokalemia it is important to be aware of the signs and the

Essay On Thiazide Diuretics
According to the Mayo Clinic there are many medication treatment options that are available to anyone who has high blood pressure. Thiazide diuretics
is one of the medication treatment option. The side effects include dizziness and lightheadedness, blurred vision, loss of appetite, itching, stomach
upset, headache, and weakness. Thiazide diuretics works by changing the reabsorption of sodium in the kidneys, leading to more fluid being produced
from the body into the urine. They also have an effect on the surrounding muscles in the blood vessels, causing the muscles to relax and allow blood to
pass through more easily. If taken as directed ones HBP will balance out. Another treatment option is Angiotensin
–converting enzyme (ACE) inhibitors
... Show more content on Helpwriting.net ...
As a conclusion, blood vessels may relax and open up which makes it easier for blood to flow through the vessels so in this event it can reduce the
blood pressure. Renin inhibitors contributes to another medication to balance hypertension. The side effects to Renin inhibitors is dizziness, headache,
diarrhea, and stuffy nose. As a result of direct renin inhibitors which help the regulation of blood pressure, blood vessels relax and widen, making it
easier for blood to flow through the vessels, which also lowers blood pressure. Direct renin inhibitors, angiotensin–converting enzyme (ACE) inhibitors,
and angiotensin II receptor blockers (ARBs) all help the same process that narrows blood vessels, but each type of medicine blocks a different part of
the process. Calcium channel blockers is another medication treatment option. The side effects of this medication is lightheadedness, low blood
pressure, slower heart rate, drowsiness, constipation, swelling of feet, ankles and legs, increased appetite, and gastroesophageal reflux disease
(GERD). Calcium channel blockers dilate the blood vessels and this makes it easier for blood to flow through the vessels and balances blood

The Pros And Cons Of Hypertension
According to CDC (2016), one out of three American adults suffers from hypertension (HTN). This accounts for about 75 million or 29% of the
adult population in the United States. Uncontrolled HTN is the leading cause of myocardial infarction, chronic kidney diseases (CKD), strokes, and
hypertensive heart diseases (HHD) (CDC, 2016). According to a report from CDC (2016), HTN costs 48.6 billion dollars including health care
expenditures, medications and missed days of work. According to the Texas Department of State Health Services (2013), among 26,448,196 residents
of Texas, 170.1 death rates related to HHD, 40.1 related to stroke and 15.9 related to CKD consecutively. AHRQ (2013) health expenditure data
demonstrates that the southern region of the United States, which includes Texas, exceeded the average health expenditure for a hypertensive patient
to a cost of $805 per hypertensive person. Two recent peer review audits of twenty charts at Southmore Medical Clinic revealed that we were
practicing with only a 45% compliance rate with the Joint National Committee (JNC) 8 guideline recommendations for managing HTN. In Southmore
Clinic HTN management protocol is based on JNC 6 guidelines and HTN parameters are more relaxed due to patients' noncompliance and the
physician's laid back attitude. Therefore, the revision of existing protocol and the aggressive management of HTN is recommended in conjunction with
JNC 8 guidelines (see Appendix A for more details). Available

Study on Essential Hypertension
PRESENTATION BY:
GIZELLE WILKINSON
SUBJECT: ESSENTIAL HYPERTENSION
STUDENT NUMBER: M00037713
CLINICAL SCIENCES II
INTRODUCTION
Essential hypertension, otherwise known as primary or idiopathic hypertension, is a condition of raised blood pressure with no identifiable cause.
Secondary hypertension occurs when blood pressure elevation results from a specific and potentially treatable cause. These include renal diseases,
endocrine causes, congenital cardiovascular causes and pregnancy.
This study however, will focus on essential hypertension so as to avoid unnecessary confusion. Blood pressure is relative to each individual and tends
to vary markedly depending on height and weight. Levels of blood pressure ... Show more content on Helpwriting.net ...
In the arteries, there is thickening of each of the layers in the vessel wall, thus narrowing the lumen and reducing its effectiveness. A similar
development occurs in the arterioles causing increased rigidity of the walls thus reducing their ability to contract and expand. Hence the lumen size is
reduced. As a result, there is slowing down of the blood flow resulting in 'ischaemia' of cell tissue.
This then increases the pressure through the vessels and the left ventricular myocardium or heart muscle undergoes hypertrophy. Ischaemic heart
disease and left ventricular failure are common results of hypertension in this case.
Due to occurrence of the above, the blood vessel in the brain become more fragile and paves the way for haemorrhage. Damage to small blood vessels
within the cerebral hemispheres produce microscopic infarctions (localised necrotic areas) appearing as small areas of brain destruction that fill with

fluid, otherwise known as hypertensive lacunae.
In malignant hypertension the vessels undergo similar changes but more acutely. Therefore the damage is more severe, leading to actual cessation of
blood flow through the vessels. This results in multiple areas of tissue necrosis as in the glomeruli of the kidney.
As the glomeruli are part of the filtration system in the nephron of the kidney, damage can hinder removal of waste products, salt and water from the
blood stream. Progressive destruction of

Inappropriate Hyponatremia Essay
EUVOLEMIC HYPONATREMIA: MECHANISM SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION [5,13] SIADH
is the most common cause of hyponatremia [13]. It is caused by inappropriate vasopressin secretion either from the pituitary or from the ectopic source
independent of the circulatory volume status and serum osmolality resulting in hyponatremia. Also there occurs inappropriate diuresis due to the
action of vasopressin in the collecting tubules and its action continues until V2 receptors are down regulated (vasopressin escape) [5]. There are
multiple etiological factors as mentioned earlier cause inappropriate ADH secretion. A Schwartz criterion is used for diagnosing SIADH which is
mentioned below: Diagnostic Criteria for SIADH:Schwartz diagnostic criteria [5,13] ESSENTIAL CRITERIA пѓ Decreasing measured serum... Show
more content on Helpwriting.net ...
ACEI causes hyponatremia by blocking the conversion of angiotensin I to angiotensin II in the peripheral circulation but not in the brain where
angiotensin I gets converted to angiotensin II [16]. Angiotensin II is known to stimulate the release of ADH resulting in hyponatremia [18].
Angiotensin II type I receptor blocker causes hyponatremia by blocking the effects of aldosterone resulting in hyponatremia when combined with
thiazides causes severe hyponatremia [17 ] . APPROACH TO A PATIENT WITH HYPONATREMIA [5,19] п
ѓ Assess for the severity of symptoms
пѓ Duration of the symptoms пѓ Check for the volume status пѓ Assess for the causes of hyponatremia such as drug history пѓ Do the necessary
investigations such as serum & urine osmolality, urine spot sodium, thyroid function test and serum cortisol levels. PRINCIPLES OF SODIUM
CORRECTION The treatment of hyponatremia depends upon пѓ Severity of symptoms пѓ Duration of hyponatremia(acute or chronic) пѓ Cause of

Muehrcke's Metamorphosis
Based on the patient information provided, the diagnosis of hypertension, fibromyalgia and hypothyroidism and the physical examination found dry
skin with keratosis pylari due to lack of omega –3 –fatty acid1 and noted white spots on the nails (leukonychia) which is caused by zinc deficiency,
Muehrcke's lines which indicates protein deficiency and tongue slightly thickened with scalloped edges, which is caused by underactive thyroid
glands2. The patient is currently taking medication Thiazide diuretics such as Hydrochlorothiazide, which depletes nutrients magnesium, coenzyme
Q10, potassium, sodium, zinc thiamine, vitamins B6 and C. I would recommend an anti–inflammatory based diet, such as Omega–3 fatty acids, found
in fatty fish, like salmon, walnuts, and flaxseed, known to reduce inflammation, and fruits and vegetables rich on antioxidants, like vitamins A, C, and
E, which fight free radicals and reduce oxidative stress.... Show more content on Helpwriting.net ...
The supplement I would recommend is CoQ10, 500 to 100–mg/vitamin; vitamin C, 300 to 700mg/day, 800 mg/day of the omega– 3 fatty acids EPA
and DHA, 2000–4000 IUs per day of vitamin D3, antioxidant vitamins A, D, E, the B–vitamins, and trace minerals, such as, calcium, selenium zinc,
and magnesium. Alpha–lipoic acid, 25 to 50 mg, twice daily, for antioxidant support, S–adenosylmethionine or SAMe, 800 mg daily, for mental and
immune support, and probiotic supplement for maintenance of gastrointestinal and immune

Speech On Drugs In Sports
Drugs In Sports In sports, many of the Olympic winners have been found in taking drugs to gain advantage from other participants with would help
them to perform better in their competition. Drugs come in different form, e.g. pills, injection or powder. The participants who take drugs only think
that the drugs will only give them positive results, but they don't think what are the after results and what happened if they got caught. Some athletes
don't even know that they are taking drugs because their trainer has been giving them supplements by telling them that they are vitamin pills but for
the people who actually are intentionally taking drugs, is it actually fair for the drugs to be banned because they naturally don't have as much strength
and power that the other participants have naturally? "A drug is a medicine or other substance which has a psychological effect when digested or
otherwise introduced in the body (Dictionary)." There are many different types of drugs, e.g. anabolic steroids, diuretics and stimulants (performance
enhancing drugs). These drugs are not the only ones used but these are one of the most common ones. Anabolic Steroids is used for allowing muscle
to grow quicker, work harder and recover faster form any... Show more content on Helpwriting.net ...
I also think that there should also be some types of awareness campaigns so people would be able to know what is going around the world because I
think that many people don't know about what is actually happening in the sports

Gestational Hypertension Developed Into Preeclampsia
Hypertension is defined as persistent increase of blood pressure in human body. A pregnant women is considered high blood pressure when the systolic
reading is greater than 140 mmHg and diastolic reading greater than 90 mmHg. High blood pressure in pregnancy is also known as 'gestational
hypertension'. Gestational hypertension could lead to development of a condition called preeclampsia. Initially, gestational hypertension is a new onset
of high blood pressure after the 20th weeks of pregnancy without the presence of proteinuria and end–organ dysfunction, while in preeclampsia, which
is a multi–systemic disorder will causes proteinuria and organ dysfunction1. When there is grand mal seizures happens in preeclampsia pregnant
women, it is known as eclampsia1. Eclampsia is a severe end of preeclampsia which may leads to death.
The risk factors of gestational hypertension developed into preeclampsia are having past history of preeclampsia, first pregnancy, a family history of
preeclampsia and some preexisting medical conditions1. Preexisting medical conditions like diabetes that related to renal or vascular disease which
lead to high blood pressure and chronic kidney disease (CKD) which causes low glomerular filtration rate and subsequently lead to hypertension may
develop preeclampsia. Moreover, pregnant women with twin pregnancies and maternal age may also contribute to preeclampsia3.
Other modifiable risk that lead to gestational hypertension and preeclampsia are related to

Reaction Paper On Diuretics
1.INTRODUCTION 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.Diuretics increase the rate of urine flow and
sodium excretion and are used to adjust the volume and/or composition of body fluids in a variety of clinical situations, including hypertension, heart
failure, renal failure, nephrotic syndrome, and cirrhosis. By definition, diuretics are drugs that increase the rate of urine flow; however, clinically
useful diuretics also increase the rate of excretion of Na+ (natriuresis) and of an accompanying anion, usually Cl–. NaCl in the body is the major
determinant of extracellular fluid volume, and most clinical... Show more content on Helpwriting.net ...
Consequently, the use of diuretics as antihypertensive agents has been relatively reduced, particularly since the newer drugs are associated with fewer
adverse metabolic reactions. However, diuretics have a specific activity of removing sodium from the body fluid, thereby rendering the blood pressure
insensitive to sodium intake, relieving the overload to systemic circulation, and normalizing the circadian rhythm of blood pressure from a non–dipper
to a dipper pattern. At low doses, diuretics are known to be as effective as all other antihypertensive agents for reducing nearly all types of
cardiovascular events. In this brief review, the indication for thiazide diuretics will be discussed based on the pathophysiology of hypertension and
antihypertensive therapy with diuretics mainly from the point of view of sodium

Thiazide Diuretic Essay
Thiazides are diuretic that works on removing extracellular fluid from the body. It is used in heart failure and hypertensive patients. Thiazide diuretic
works primarily in the distal tubular of the kidneys. Diuretics affects the electrolyte balance and reduce blood pressure in the body and therefore should
be monitored closely. Thiazide diuretic works by decreasing plasma volume which reduces venous return and diminishes cardiac output causing blood
pressure to fall. This change in plasma volume with a diuretic can stimulate both the sympathetic nervous system and the renin–angiotensin–aldosterone
system. The degree in which these systems activate governs the magnitude of acute blood pressure decrease with both diuretic monotherapy and
diuretics given in combination with ... Show more content on Helpwriting.net ...
During the first few weeks of treatment, plasma volume returns to slightly less that pretreatment levels, despite the continued administration of a
diuretic. In the chronic phase of treatment, the vasodepressor influence of a diuretic emerges as a process driven by a reduction in total peripheral
resistance (Sica, 2004). According to Woo & Robinson (2015), thiazide and loop diuretics decrease the renal excretion of lithium and may induce
lithium toxicity. Thiazide diuretic is one of the drugs that have been there for many years to treat high blood pressure. This drug works in such of way
that it excretes sodium and chloride out of the body; it lowers arterial pressure resulting in vasodilation and reduces cardiac output by decreasing
extracellular fluid and plasma volume (American Heart Association, 2016). One of the major problems associated with thiazide diuretic is hypokalemia
which can in result effect the kidneys (American Heart Association, 2016). It is important to ensure that patients who are taking thiazide diuretics that
their potassium level is within range. Low potassium can lead to abnormal rhythms in the heart and can even cause the heart to stop beating

Coronary Heart Failure Research Paper
"His heart is over flooded...." used to be the term for fluid overload or congestion associated to ailment of the heart. It is one of the phrases with
which congestive coronary heart failure (CHF) was described in the Ebers papyrus written in 1550 BC, at some point of the reign of Amenhotep
III, Pharaoh of the Eighteenth Dynasty, according to Saba et al.6 In a assessment of coronary heart failure (HF) by means of Katz,7 he describes
the Hippocratic Corpus, which describes rales already in the 4th century BC. Then Katz takes us through the history of HF with the aid of Galen
who lived in the Roman Empire, who noticed the coronary heart distributing warmness in an ebb and flow. This was believed till 1628 when William
Harvey described the circulation in animals as, "pulsatile movement", and created the groundwork for understanding the circulation. The use of
Foxglove (Digitalis purpurea) was once described via William Withering, an English physician and botanist. He had discovered from a country woman
that tea made from leaves of the foxglove used to be top for dropsy.... Show more content on Helpwriting.net ...
In the 1980s and early 1990s, it was once verified that angiotensin –converting–enzyme inhibitor (ACEi) have been associated with enchancment in the
clinical effects for HF patients. Then followed the introduction of the present day HF treatments; beta blocker, angiotensin receptor blockade,
mineralocorticoid receptor antagonist, Cardiac Resynchronisation Therapy (CRT), with or without defibrillation therapy, left ventricular aid device and
heart transplantation. Regarding the diagnostic possibilities, echocardiography has emerged as an vital device to consider HF patients, alongside with
natriuretic peptides (NP). Despite this enchancment in HF medication, the mortality charge is high. Can tailored HF remedy with the assist of
biochemical measures such as NP lead to a higher consequence for HF

Hypertension And High Blood Pressure
Hypertension
Hypertension is referred to as high blood pressure. Hypertension is frequently asymptomatic in the early stages, and the initial signs are often vague and
nonspecific. They include fatigue, malaise, and sometimes morning headache. Consistently elevated blood pressure under various conditions is the key
sign of hypertension. Because of the insidious onset and mild signs, hypertension is often undiagnosed until complications arise and has been called the
"silent killer." The complications are also asymptomatic until they are well advanced.
Pathophysiology
Hypertension is one of the most common chronic health problems seen in the primary–care setting. Hypertension in adults age 18 and older is defined
as a systolic blood pressure (SBP) of greater than 1400 mm Hg and or a diastolic blood pressure (DBP) of greater than 90 mm Hg, based on the average
of two or more properly measured seated BP readings on each of two or more office visits. The Seventh Report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure cites the following three categories for adults age 18 and older: (1)
prehypertension (SBP 120 to 139 mm Hg / DBP 80 to 89 mm Hg); (2) Stage 1 hypertension (SBP 140 to 159 mm Hg / DBP 90 to 99 mm Hg); and (3)
Stage 2 hypertension (SBP в‰Ґ 160 mm Hg / DBP в‰Ґ 100 mm Hg) (Sisson, Rastegar, Rice, Prokopowicz, & Hughes, 2010). In hypertension thee is
an increase in arteriolar vasoconstriction, which is

Hyponatremia Research Paper
Hyponatremia
Hyponatremia is a common electrolyte imbalance seen by medical professionals. The cause is a disruption of sodium water homeostasis usually
maintained by "complex multi–system physiological mechanism" explained Soiza et al (2014).
In hyponatremia the serum sodium concentration is below 135 meq/l. This condition is frequently seen in older patients due to degenerate physiology,
multiple co–morbidities and polypharmacy discussed Soiza et al (2014).
Symptoms of hyponatremia include nausea, vomiting, headaches, changes in cognition, restlessness, irritability, muscle weakness or spasms,
drowsiness, seizures and coma.
Particular causes of hyponatremia include fluids loss due to vomiting, diarrhea or diuretic therapy, low protein ... Show more content on Helpwriting.net
...
Hyponatremia can develop in patients treated with thiazide type diuretics after many months of treatment. Elderly patients with low body mass and a
reduce ability to excrete water load have a higher chance of developing thiazide induce hyponatremia Factors like gastrointestinal or respiratory illness,
increases of diuretic dosage or the development of heart failure can also increase the risk of hyponatremia in patients receiving treatment with thiazide
diuretics reported Sterns (2014).
Symptoms
The major clinical manifestation of hyponatremia includes nausea and malaise when serum sodium concentration falls below 125– 130meq/L. Other
symptoms associated with thiazide induce hyponatremia include malaise, lethargy, dizzy spells and vomiting which are symptoms experienced with
severe hyponatremia. In thiazide induce hyponatremia there is weight gain, blood urea nitrogen and plasma creatinine levels are usually low to normal
and hypouricemia may be present explained

Insulin: A Case Study
Insulin (medication) is the use of insulin and similar proteins as a medication to treat disease. Insulin comes in a number of different types including
short acting (such as regular insulin) and long acting such as NPH insulin. It is also may include: low blood sugar levels, skin reactions at the site of
injection and low potassium levels among others(ASH,2014). Insulin was first used by Canada Charles Bestfrederick Banting. Insulin helps regulate
sugar in the blood stream and also stores excess glucose of type 2 diabetes mellitus, the patients compensate for increased insulin resistance at the tissue
level by increasing pancreatic beta–cell insulin resistance (Weyer et.,al). When this compensation is no longer adequate to overcome the insulin... Show
In hypertensive black patients, initiate therapy with a thiazide type diuretic or calcium channel blockers.
Regardless of race or diabetes status, in patients 18 years or older with chronic kidney disease, initial or add–on therapy should consist of an ACE
inhibitor or ARB.
Do not use an ACE inhibitor in conjunction with an ARB in the same patient.
If a patient's BP goal is not achieved within one month of treatment, increase the dose of the dose initial agent from another of the recommended drug
classes: if 2–drug therapy is unsuccessful for reaching th target BP, add a third agent from the recommended drug classes.
In patients whose goal BP cannot be reached with 3 agents from the recommended drug classes and / or refer the patients to a hypertension

Title: Diuretics, Adverse Effects, Contraindications And
Title: Diuretics, adverse effects, contraindications and precautions.
Jose R Tapanes
International Institute for Health Care Professionals
ABSTRACT
Diuretics act primarily by blocking reabsorption of sodium at four major sites in the nephron. The diuretic known as water pills have specific indications
to maintain and control the blood pressure combined with beta–blocker, anti arrhythmic helping the cardiac and renal function in patient with chronic
hypertension, heart disease and kidney disease. Also there serious complication associated with overdose and interaction of diuretic with others drugs
in–patient with impaired kidney function also increase the risk of side effect and nephron damage. In this study we talk about the ... Show more content
on Helpwriting.net ...
(picture 1).
The diuretics have specific function depending where they act in the glomerular apparatus. Depending of their mechanism of action and
pharmacokinetics the diuretics can cause side effects directly in the kidney, vascular system or systemic complications
Diuretic drugs increase urine output by the kidney ( diuresis). This is accomplished by altering how the kidney handles sodium. If the kidney excretes
more sodium, then water excretion will also increase. Most diuretics produce diuresis by inhibiting or blocking the reabsorption of sodium at different
segments of the renal tubular system. Sometimes a combination of two diuretics is given because this can be significantly more effective than either
compound alone. There are different types of diuretics
Loop diuretics: Polythiazide, Bumetanide,furosemide, Torsemide. The main side effects of loop diuretic include hypokalemia, metabolic alkalosis,
hypomagnesmia, hyperuricemia, dehydratacion, and hypovolemia, tinnitus, vertigo, ototoxicity, deafness and shock.
Contraindication. Allergy to Sulfurs medication, hypotension, renal insuficiency
Thiazide diuretics: Chlorothiazide, chlortalidone, hydrochlorothiazide, hydroflurmethazyne, indamapide, methylchlotiazyde, metolazone, polythiazide.
The most important side effect of thiazide is hypokalemia, also include metabolic alkalosis,hyponatremia, hypovolemia, hyperglicemia in diabetics,

increasing of LDL, azotemia and

The New Drugs to Treat Hypertension Essay example
The New Drugs to Treat Hypertension The purpose of this report is two discuss the Pharmacodynamics, pharmacokinetics, proposed benefits, research
method, results of research, and possible–nursing implications of newly approved drugs for the treatment of hypertension. These drugs include Atacand
HCT and Diltiazem HCL. All newly approved drugs from the FDA are either new drugs or new formulations of older drugs. The information contained
in this report was derived from various web pages and online search engines. Pharmacokinetics: Atacand HCT (Candesartan celexetil) Candesartan is
quickly and completely bioactivated by hydrolysis during the absorption from the GI tract to a angiotensin II receptor antagonist (www.rxlist.com)....
Show more content on Helpwriting.net ...
In a 12 week study of diabetic type II patients (n=161) their where no changes in the level of HbA1C (www.rxlist.com). Proposed benefits of drug:
Atacand HCT Atacand HCT (Candesartan celexetil–hydrochlorothiazide) was developed for patients who were unsuccessfully treated with single
antihypertensive agents. The proposed benefit is elicited by the drugs action on angiotensin II receptor antagonists, the agent that causes
vasoconstriction. Additionally the second ingredient hydrochlorothiazide a diuretic reduces blood pressure by improving the kidneys ability to
eliminate salt and fluid from the body (www.centerwatch.com). Research method: Atacand HCT They were five double blind, placebo controlled trials
for Candesartan celexetil hydrochlorothiazide, which we're eight weeks to twelve weeks in duration. The combined study sample consisted of 3,037
hypertensive patients and dosage ranged from 2 to 32 mg Candesartan celexetil and from 6.25 to 25 mg hydrochlorothiazide administered once daily in
several combinations (www.centerwatch.com). Results of drug research: Atacand HCT The antihypertensive effects of Atacand was similar in men and
women in patients older and younger than 65 (www.rxlist.com). Atacand HCT or the combination (Candesartan celexetil and hydrochlorothiazide)
resulted in placebo adjusted decreases in sitting systolic and diastolic blood

COPD Case Study
Based on the symptoms of exacerbation of COPD, we decided to add Atrovent which is an anticholinergics, prednisone which is a glucocorticoid, and
doxycycline, an antibiotic (Stoller, 2017). The patient has already been prescribed albuterol, which is a short–acting beta–adrenergic agonist. In adding
Atrovent to the treatment therapy, it increases the effect of bronchodilation and helps the patient to breathe better (Stoller, 2017). For the antibiotics, it
is recommended that the "antibiotic regimen should target likely bacterial pathogens (Haemophilus influenza, Moraxella catarrhalis, and Streptococcus
pneumonia)" (Stoller, 2017). Thus, we chose doxycycline as the drug of choice for the treatment (Bartlett & Sethi, 2017).
Ipratropium ... Show more content on Helpwriting.net ...
Providers also need to be caution in using it on patients who has glaucoma, myasthenia gravis, and prostatic hyperplasia/bladder neck obstruction
(Lexicomp, 2017).
Drug to Drug, Food, Herb Interaction Ipratropium has many drug interactions. Some in the X category include aclidinium, anticholinergic agents,
glucagon, glycopyrrolate, potassium chloride which need to avoid combining with Atrovent (Lexicomp, 2017). Many of the X category drugs enhance
the anticholinergic effect. Other drugs that are C category include acetylcholinesterase inhibitor, gastrointestinal agents, nitroglycerin, thiazide diuretics
and tiotropium (Lexicomp, 2017). It is important to note that some of the common drug interactions. For nitro, it is important to remember the
anticholinergic agents may impair or decrease the absorption of sublingual nitrate (Lexicomp, 2017). Also, the potassium chloride, the anticholinergic
agent may enhance the ulcerogenic effect on the oral form of potassium (Lexicomp, 2017).
Administration Guidelines
For Metered–dose inhaler, it is important to prim the inhaler, by releasing two test spray in the air, before use (Lexicomp, 2017).
Clinical Drug Dosing
The recommended dose for acute exacerbation of COPD is 2 inhalation of MDI every four to six hours (Lexicomp, 2017).
Prednisone
For respiratory diseases, it treats disease such as aspiration pneumonitis, asthma, pulmonary tuberculosis, hypersensitivity pneumonitis, and pulmonary
fibrosis (Lexicomp, 2017).

Aldosterone Research Paper
While RAAS can be good for blood pressure maintenance there are some drawbacks. Angiotensin II can cause structural changes of the heart and
blood vessels. It can be implicated hypertrophy and remodeling within the heart. Aldosterone also has adverse effects. Like angiotensin II, aldosterone
can cause cardiac remodeling as well as a decreased reuptake of norepinephrine in the heart. This can increase the chances of dysrhythmias (Burchum
472). In a healthy heart these adverse effects would not be seen, but in a heart already in dysfunction, it can cause further complications. The
mechanism of action several drugs is to control the outcome of this system.
ACE inhibitors and Angiotensin II receptor blockers bother work to halt the process of

Hypertension : The Most Common Chronic Disease ( Barranger )
Hypertension is one of the most common chronic disease (Barranger, 2013). Many people are unaware of the fact that they have hypertension because
they do not have any symptoms associated with this chronic disease. Hypertension can be a major risk factor for many other chronic diseases such as
heart disease, stroke, congestive heart failure, and kidney disease. Hypertension is strongly associated with obesity and diabetes. Hypertension caused
morbidity and mortality are the highest, occur early and more severe among African American's (Barranger, 2013).
Essential hypertension is the most common type of hypertension (Barranger, 2013). Other types of hypertension include primary, idiopathic
hypertension and secondary hypertension (when other causes can be identified) (Barranger, 2013).
The pathophysiology of hypertension involves nervous system and/or renal system (Barranger, 2013). Centrally located beta receptors and alpha–2
receptors have effects on the production of norepinephrine. The production of norepinephrine is stimulated and inhibited by these receptors. When
norepinephrine production is inhibited, vasodilation effects occur, therefore blood pressure (BP) is reduced. Beta 1 receptor blockers and beta 2
receptor stimulators of the arteries and veins will decrease blood pressure by decreasing cardiac output, peripheral resistance, and causation of
vasodilation. Baroreceptors can auto regulate blood pressure in the circulatory system by sending impulse to the brain

JNC VIII Recommendations For Hypertension
What is JNC VIII recommendations for hypertension?
JNC 8 has a hypertension guideline algorithm. Patients older than 60 should be placed on pharmacological treatment if SPB is 150 mm Hg or
higher and DBP is 90 mm Hg or higher. Target goal is 150/90 Patient less than 60 should be placed on pharmacological treatment if SPB is 140 mm
Hg or higher and DBP is 90 mm Hg or higher. Target goal is 140/90. Initial drug of choice for nonblack patients is an ACEI, ARB, thiazide or CCB
alone or in combination. Black patients should be started on a thiazide or CCB alone or in combo. It is recommended to start one drug titrate to
maximum dose and then add another drug if target goal has not been achieved. Combination therapy is recommended if BP is greater than 20/10 mm
Hg from target. I also gives a guideline for all ages if the patient is diabetic without kidney disease or the patient has kidney disease without diabetes
(Armstrong, 2014). ... Show more content on Helpwriting.net ...
JNC 7 was shown that a SPB less than 120 mm Hg was normal. Patients with a range of 12–139 mm Hg were in the prehypertension stage.
Prehypertension stage was defined for patients that were at risk for developing hypertension. Stage 1 were patients with a SBP of 140–159 mm Hg.
Stage 2 were patients with a SBP 160–170 mm Hg. JNC 7 also recommended the initial start of a thiazide diuretic, which has not been the initial drug
of choice in JNC 8.
I personally like algorithms and I found JNC 8 easy to follow. I have the algorithm in my binder that I take to clinical. I have used it several times
and I think that the patients like to see that up to date medications are being used and it is backed by evidence based

Nonpharmological Method
It is very important to determine if medical intervention with medication is needed to control his blood pressure. The blood pressure should be
monitored after discontinuing the pseudoephedrine and implementing nonpharmological methods. Some nonpharmological methods involve increasing
their exercise, losing weight, and limiting their sodium intake. If the blood pressure is not able to be controlled an antihypertensive medication may
need to be implemented. A first line medication should initially be started to help control his blood pressure. There are different types that can be used.
Some of these comprise of a thiazide diuretic or an angiotensin converting enzyme (ACE) inhibitor. The patient should first be started on a low dosage
of these

Alcohol And Anti Hypertension Medications Essay
Ethnicity and Anti–hypertension Medications
Hypertension is a devastating disease state, increasing the risk for patients to develop strokes, heart attacks, heart failure, and kidney dysfunction. It is
prevalent in our population with an estimated 10–15% of Americans diagnosed with hypertension (Hitner & Nagle, 2016). Hypertension is the leading
cause of cardiovascular disease (CVD), which results in nearly 1/3 of deaths annually in the United States (Still, Ferdinand, Ogedegbe, & Wright,
2015). Hypertension is more likely after the age 60, and is more common in African American patients. It affects 40.4% of African Americans and only
27.4% of whites, causing the African American community to carry a higher burden of hypertension–related complications (Still et al., 2015). There is
evidence that suggests some anti–hypertensive medications are more effective in the African American population, including diuretics and calcium
channel blockers (Flack, Nasser, & Levy, 2011). It is important to understand how ethnicity affects hypertension medications and what medications are
preferential when treating patients, especially of African American decent.
What is Hypertension?
There are two types of hypertension (hypertension), the most common is essential hypertension and is the result of an unknown cause. Secondary
hypertension occurs when the cause can be established. Because the majority of hypertension is from an unknown there is little we can do to manage
blood pressure

Breast Calcification Research Paper
By Jonas Wilson, Ing. Med.
Diagnosing calcification
In addition to routine blood and biochemical tests to check for underlying factors such as hypovitaminosis K, hypervitaminosis D or hypercalcemia,
X–rays (e.g. for the breasts) and CT scans (e.g. for the brain) may be used to detect calcifying deposits. The two types of breasts calcifications, macro
and micro calcifications look like large randomly dispersed dots and white specks on the mammogram (breast X–ray), respectively. Breast calcification
tissue may be removed and biopsied in order to rule out more serious pathologies such as cancer.
Arterial calcifications, for example in the coronary arteries, may be detected in vivo (in a living person) by methods such as electron beam computed
tomography (EBCT) coronary arteriography, plain film X rays, fluoroscopy, intravascular ultrasound, MRI and CT scan. EBCT and fluoroscopy are the
most commonly used techniques in the blood vessel investigations, while CT scans are very sensitive for the detection as well as the localization of
intracranial calcifications. Calcifications produce the appearance of high–density material on CT scans and X–rays.
Non–neoplastic dystrophic and metastatic calcifications caused by conditions such as infections, trauma and neoplasms, appear with radiolucent
centers on radiographs. ... Show more content on Helpwriting.net ...
Cases of hypercalcemia can be further broken down into those that are PTH–dependent and PTH–independent (parathyroid hormone). PTH is usually
elevated in physiological conditions when there is a drop of calcium in the blood and then returns to baseline once it corrects the problem. This is not
the case however in hyperparathyroidism. Furthermore, PTH–related peptide (PTHrP), which is capable of acting on PTH receptors is abnormally
elevated in certain cancers such cancers of the genitourinary tract and

Mandatory Synthesis Essay
Angiotensin II receptor blockers (ARBs) on the other hand, block angiotensin II receptor sites. ARBs have a similar mechanism of action to ACEI.
Where ACEI stops the production of angiotensin II, an ARB prevents angiotensin II from binding to the receptor cites. The outcome of this
medication would be much the same as an ACEI. On an ARB the patient would exhibit vasodilation, decreased blood volume, and decrease
ventricular remodeling. One major difference in the two classes is that ARBs have less incidence of cough because they do not inhibit Kinase II. This
would make ARBs a great second choice for patients who could not tolerate the side effects of an ACEI. Although ARBs can extend the life of a
patient in heart failure, there is no conclusive... Show more content on Helpwriting.net ...
They are considered a first line drug to treat hypertension and heart failure. Overall, diuretics will decrease blood volume, decrease venous and
arterial pressure (preload and afterload), and decrease edema both peripheral and pulmonary (Burcham 519). Thiazide diuretics are mild and only work
with relatively normal glomerular filtration rate; if the patient has low GFR a thiazide will not provide optimal benefits. When low GFR is indicated a
loop diuretic may be the better choice. These diuretics produce an exceptional amount of fluid loss; therefore, these drugs should be reserved for
patients with especially decreased cardiac output. When combined with an ACEI or and ARB, both the thiazide diuretic and the loop diuretic could
substantially improve symptomatic complication in the patient; however, the patients can experience some adverse side effects. Both can cause
hypokalemia due to the increased water elimination, this can be avoided by including a potassium supplement in the daily routine or conscientiously
eating foods high in potassium. Potassium–sparing diuretics can cause hyperkalemia because of the potassium sparing effects, especially when paired
with an ACEI or

Using Medications As A Worldwide Problem
Scenario: A 42 year old female with a history of T2DM arrives to the clinic for a quarterly office visit. The patient's blood pressure Data: 148/84.
BMI 42. Medications: Insulin Rational Use of Medications: The APN wants to start antihypertensive therapy since this is the second visit with an
elevated blood pressure. The APN needs to make a choice given there are a wide array of medication classes. The WHO coined the term "rational
drug use" in 1985. The WHO identifies "Irrational" use of medications as a worldwide problem. 1.Describe the key concepts in rational use of
medications. (20 points) According to the World Health Organization, rational use of medicines requires that "patients receive medications appropriate
to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their
community" (WHO, 2012). There are 12 key concepts that the WHO advocates to promote more rational use. These are: establishment of a
multidisciplinary national body to coordinate policies on medicine use, use of clinical guidelines, development and use of national essential medicines
list, establishment of drug and therapeutics committees in districts and hospitals, inclusion of problem–based pharmacotherapy training in
undergraduate curricula, continuing in–service medical education as a licensure requirement, supervision, audit and feedback, use of independent
information on medicines, public

Literature Review On Hypertension
Article Review on Hypertension
Lourdes Marasigan
San Diego City College
IntroductionHypertension or high blood pressure is one of the leading causes of cardiovascular diseases in the United States. High blood pressure
simply means that the pressure in the blood vessels are higher than it normally is. Hypertension is called the "silent killer" because people are unaware
they have it. That is why it is very important to check our blood pressure on a regular basis.
Summary
The article Treating Hypertension– Losing sight of the Forest for the Trees? by Professor Tamera Pearson (Clinical Western Carolina University),
focused on the different blood pressure guidelines, and how these guidelines led to the confusion in the discussion of the diagnosis, treatment, and
management of hypertension by organizations such as the Eight Joint National Committee (JNC 8), American Heart Association (AHA),
American College of Cardiology (ACC), and American Society of Hypertension (ASH). JNC 8's target blood pressure is 150/90 mm Hg for
people 60 to 79 years old in order to be diagnosed with hypertension. However, AHA, ACC, and ASH recommended that a blood pressure of 140/50
mm Hg in individuals 60 to 79 years old is the basis for treatment. These different guidelines and individualized care for the said age bracket, the
"trees", put many 45 to 65 years old individuals, the "forest" for cardiovascular diseases because of untreated and uncontrolled diabetes. The

Hypertension (HTN)
Hypertension (HTN)
Hypertension (HTN), a chronic form of high blood pressure is diagnosed through a series of diagnostic tests which are performed in order to formally
establish the particular disease or condition. Once this is recognized, treatment options can be identified for the particular diagnosis and help lower
blood pressure. Because of Vicki's frequent travelling it could be a potential barrier to treatment options, so due to the unique situation the patient is
taught that a lifestyle change will be imminent. In addition to prescribing medication, complementary and alternative medicine treatments are also
available which could benefit the patient. When the particular disease or condition is established, a prognosis for the disease ... Show more content on
Helpwriting.net ...
The tests also concluded that Vicki is suffering from Congestive Heart Failure (CHF) and will be supplemented with Lozol (Thiazide diuretic) to
remove excess fluid and is also used to help lower hypertension levels. Frequent monitoring of body systems is important to prevent serious side
effects from prolonged hypertension and the use of the drug therapy. There are still other alternative treatment therapies available, namely a lifestyle
change.
Since the patient does not live a stable or an average existence several lifestyle changes will have to be made. First, eating healthy foods at home and
while travelling will be of the utmost importance, also decreasing the salt intake in her diet. Increasing physical activity to maintain a healthy weight
and reduce stress while helping to control high blood pressure, alcohol consumption and smoking must cease as well. Checking her blood pressure at
home will attest that the medication is

Hypertension Of Hypertension And Secondary Hypertension
Hypertension is defined as blood pressure greater than 140/90 mm Hg on two or more blood pressure readings taken at each of two or more visits after
initial screening. There are two types of hypertension which are the primary (essential) hypertension and secondary hypertension. Essential
hypertension is referred to patients with hypertension without any secondary identifiable cause. Secondary hypertension has an identifiable cause, such
as renal artery stenosis or pheochromocytoma, and is managed as part of the primary condition (Papadakis, 2014).
The Joint National Committee published JNC 7 in 2003 which established different classification of hypertension. According to JNC 7, blood pressure
was considered normal when systolic was less than 120 mmHg and diastolic was less than 80 mmHg. The prehypertension range was systolic 120–139
mmHg or diastolic 80–89 mmHg. Stage 1 hypertension was categorized as systolic of 140–159 mmHg or diastolic 90–99. Stage 2 hypertension was
categorized as systolic greater than 160 mmHg or diastolic greater than 100 mmHg (JNC 7, 2003).
Hypertension is a major medical problem in America with high morbidity and mortality. According to Center for Disease Control statistics released on
2015, it is estimated that about 70 million American adults have high blood pressure, with a ratio of 1 out of every 3 adults in America living with
hypertension (CDC, 2015). In 2012, CDC conducted a statistical analysis of data collected by National Health and

Generic Drug Profile : Salbutamol
Generic Drug Profile – Salbutamol
New Zealand trade names: Ventolin, Respigen, Salamol, Asthalin, Salapin and Broncolin.
Drug Class: Therapeutic class: bronchodilator. Pharmacologic class: sympathomimetic (stimulates the sympathetic nervous system). It is also classified
as a SABA (short acting ОІ2–agonist).
Formulations: The most common administration is by inhalation of a pressurised metered dose aerosol. Inhalation of Salbutamol directly reaches the
lungs and acts rapidly with fewer side effects, but only 10–25% is actively absorbed as the remainder is swallowed (Orion Phama, 2015). Oral
administrations by tablet and syrup forms are used by patients who can't manage the inhaled route. Salbutamol has a lower onset of action via the oral
route and 50% of the dosage is absorbed from the intestinal tract (Salbutamol, 2014). Salbutamol can also be given intravenously for severe or life
threatening asthma. It may also be given by intramuscular injection. Patients are best treated with single–ingredient ОІ2–agonist preparations so dose
adjustment is simple (NZ Formularya, 2015).
Indications: Salbutamol is a ОІ2–agonist which causes bronchodilation by relaxing smooth muscles on the bronchiole. It is a reliever of bronchospasms
in asthma, chronic obstructive pulmonary disorder (COPD) and emphysema. It provides short acting but instant bronchodilation to reverse airways
obstruction. Inhalation of Salbutamol has an onset period of 5–15 minutes and lasts for 2–5 hours. Salbutamol is

High Blood Pressure Is The Resistance Of Blood Vessels
Blood pressure is the force exerted by the blood against the walls of blood vessels, and the magnitude of this force depends on the cardiac output
and the resistance of the blood vessels. When the systolic blood pressure (SBP) which is the pressure as the heart pumps blood around the body is
140 mm Hg or more, or a diastolic blood pressure (DBP) which is the pressure as the heart relaxes and refills with blood, is 90 mm Hg or more, and
the individual is taking antihypertensive medication, it is called Hypertension (Madhur, 2014). High blood pressure is a major risk factor for various
other illnesses and even death due to several cardiac and vascular diseases. It is assessed that about 54% of strokes, 47% of heart attacks, 75% of
hypertensive disease, 25% of other heart disease, 13.5% of all mortality, and 6% of morbidity are linked to Hypertension (Khraim & Pike, 2014).
Hypertension affects about 70 million adults in the United States. Only about half (52%) of people with hypertension have their blood pressure under
control. Nearly 1 in 3 American adults have prehypertension which means that blood pressure numbers are greater than usual, but not in the high blood
pressure range. Hypertension costs the country about $46 billion annually. This comprises the cost of health care services, drugs to treat hypertension,
and days of absence from work (CDC, 2015).
Pathophysiology of the disease
The pathogenesis of essential hypertension involves various elements and is extremely

Amiloride Research Paper
Amiloride is a selective inhibitor of sodium transport in the nephron, which function as interfering with the distal renal tubular and collecting duct in
the epithelial sodium channel, in the proximal renal tubular inhibition of sodium–hydrogen and sodium–potassium exchange, resulting in depression of
potassium secretion. Amiloride is a potent diuretic drug, excreting sodium without changing serum potassium level, and the excretion can function in
the absence of aldosterone, it acts on the distal renal tubules, blocking the sodium–potassium exchange mechanism, to promote sodium and chlorine
excretion but still keeping potassium and hydrogen secretion on normal state, promoting a more alkaline urine. Amiloride itself has relative weak
sodium

Market Analysis Of Amidipine
Executive Summary:
Manidipine is a long acting dihydropyridine calcium channel blocker, a subclass of antihypertensive drugs.
Manidipine competes direct with CCBs especially with Amlodipine Molecule (CCBs Market Leader).
The total Amlodipine market volume reached 4.4 million strips (10 Tablets) forAmlodipine 5 mg and 1.9 million strips for 10 mg.
Amlodipine is considered a first line of treatment of hypertension, especially in elderly patient, according to international guidelines.
Manidipine is newly oriented to the market.
Situation Analysis:
Market Overview:
Defined Market
Long acting Calcium Channel Blockers (Mono Molecule).
Sub–Market: Amlodipine Antihypertensive (Mono Molecule).
Current Market Trend (5 Years) IMS–Data: ... Show more content on Helpwriting.net ...
Financial Objectives:
Thousands EGPFY/2013FY/2014FY/2015
Total Brand3,7465,5947,033
Amlodipine 5 mg Tablets2,4744,0045,045
Amlodipine 10 mg Tablets1,2721,5901,988
Target Audience:
Cardiologist
Internist
General Practionner
Positioning Statement:

Amlodipine Tablets (Amriya) offers a 24 hour cardio protection beyond hypertension control for those patient suffering hypertension with or without
other risk factors, Amlodipine offers a high quality product at an affordable cost and convenient once daily dose.
Main Indications:
Hypertension
Angina
Strategies:
Growth strategy:
Drive growth through market penetration:
Expanding prescribing doctor list.
Maintain current lists.
Addition of new pack (3 strips) for Amlodipine 5 mg Tablets.
Working in two dimensions:
Newly diagnosed patients.
Current un–controlled patients.
Marketing Mix:
Customer services
Revising calling lists and working on expanding prescribing and loyal doctor list in all regions.
Hammering in physicians in AM centers.
Regular PM visits/

Jnc's Six Subsections
The following section is broken into six subsections that will assess how each topic relates to JNC 6, 7, and 8. The subsections are organized into the
following: algorithms, classification of hypertension, lifestyle modifications, pharmacological treatment, and management of care. It is important to
note that JNC 6 and 7 have a greater correlation in format and the types of recommendations presented to clinicians. Contrastingly JNC 8 varies in
format, as well as the type of recommendations presented to clinicians, therefore each of the subsections may not contain information on JNC 8.
Algorithms:
Algorithms are useful for clinicians because they provide a schematic visual that is presented in a multistep model to help in the diagnosis and ... Show
The algorithm begins with an indication that is used for adults over the age of 18 and noted that lifestyle interventions should be continued
throughout management. Goal blood pressures are separated by age and presence of chronic disease. The goal for patients over 60 is SBP < 150
mmHg and DBP < 90 mmHg. The goal for patients under 60 is < 140 mmHg and DBP < 90 mmHg. Different goal values are presented for patients
with chronic conditions. Treatment with medication is categorized by: general population nonblack, general population black, chronic conditions
black, and chronic condition all races. Based on the algorithm black patients should only be prescribed thiazide type diuretics and/or calcium channel
blockers. While non–black patients can take all of the medications listed in JNC 8 (thiazide type diuretics, ACEI, ARB, and/or CCB). If patient does
not reach goal blood pressure then three strategies are listed, along with lifestyle adherence. The algorithm also explains not to use ACEI and ARB
together. The final option for patients not at goal blood pressure includes additional medications and/or referral to physician with an expertise in
hypertension

Prescribing Patterns Of Drugs Used For Treating...
Original Research Article
PRESCRIBING PATTERN STUDY IN HYPERTENSIVE OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL
M.S.K.M.CHAITANYA*, D.SATHEESH KUMAR and V.J.VISHNU VARTHAN.
Department of Pharmacy Practice, SRM College of Pharmacy, SRM University, Kattankulathur zip code 603203, Chennai, India.
ABSTRACT
Aims: The prescribing pattern of drugs used for treating hypertension changes over time in response to changes in recommended guidelines and
innovations in drug formulations, among others. In addition, the classes of antihypertensive drugs used vary among the countries. The aim of this
study was to investigate the practice of antihypertensive medications in Tertiary care hospital in India.
Study Design: Retrospective analysis of prescription pattern for hypertensive outpatients.
Place and Duration of the Study: Tertiary care hospital, Tamil Nadu, India and duration of the study was 12 months.
Methodology: Prescription pattern of 400 hypertensive outpatients were analyzed on basis of age, percentage of male and female patients,
anti–hypertensive drug category, most frequently prescribed hypertensive drug and percentage of one/two drug combination.
Results: As monotherapy ACE–Inhibitors 38.25% (153 prescriptions) were the most commonly

Hypertension: A Case Study
Hypertension in African Americans is a major clinical and public health problem because of the high prevalence and premature onset of elevated
blood pressure (BP) as well as the high burden of co–morbid factors that lead to pharmacological treatment resistance (obesity, diabetes mellitus,
depressed glomerular filtration rate, and albuminuria). BP control rates are lower in African Americans, especially men, than in other major race
/ethnicity–sex groups; overall control rates are 29.9% for non–Hispanic Black men (Flack, Nasser, & Levy, 2011). Optimal antihypertensive treatment
requires a comprehensive approach that encompasses multifactorial lifestyle modifications (weight loss, salt and alcohol restriction, and increased
physical activity)... Show more content on Helpwriting.net ...
Educate regarding lifestyle modification such as the necessity to lose weight (Loss of as little as 10 pounds may significantly reduce blood pressure),
increasing aerobic physical activity to 30 to 45 min most days of the week, reducing sodium intake to no more than 6 grams per day and to adopt the
dietary approaches to lower hypertension (DASH) diet, which is high in fruits, vegetables, and low–fat dairy products as well as low in dietary
cholesterol, saturated fat, and total fat (Woo & Wynne, 2011). Follow up will be done in two to four weeks and the medications will be titrated as
needed in four to six weeks as the body needs time to demonstrate the full response to the medication (Woo & Wynne, 2011).
Flack, J. M., Nasser, S. A., & Levy, P. D. (2011). Therapy of hypertension in African Americans. American Journal of Cardiovascular Drugs, 11(2),
83–92. doi:10.2165/11586930–000000000–00000
Medscape. (2016). Amlodipine (Rx). Retrieved from http://reference.medscape.com/drug/norvasc–amlodipine–342372#91
Medscape. (2016). Triamterene/hydrochlorothiazide (Rx). Retrieved from http://reference.medscape.com/drug/norvasc–amlodipine–342372#91
Woo, T. & Wynn, A. (2012). Pharmacotherapeutics for nurse practitioner providers (3rd Ed.). Philadelphia, PA: F.A. Davis

Reaction Paper On Aldactazide
ALDACTAZIDE BEST ONLINE BUY|Aldactazide profile,stacks,prices,...Aldactazide is a trade name for an oral, combination diuretic. Aldactazide
contains a mixture of spironolactone (Aldactide) and hydrochlorthiazide (Hydrodiuril). Aldactone is a milder, potassium sparing diuretic while
Hydrodiuril is a more potent compound from the thiazide family. The combination produces a diuretic with potency comparable to that seen with a
doubling in thiazide dosage (when used alone), but without the same level of calcium and potassium excretion. While a potassium supplement is often
required with thiazide treatment, the balance of the two drugs in Aldactazide virtually eliminates this need. ... Show more content on Helpwriting.net ...
The user, depending on individual needs, will need to judge the timing of his diuretic use in relation to the weigh–in or show. The whole intake
/preparation schedule should also not run longer than a few days, so as to minimize potential health risks. It is also much more effective when the
athlete is familiar with the process well before actually needing to do so. This way frantic last minute diuretic use can be avoided, as the user should
be fully prepared. When administered haphazardly, it is very easy to achieve too great a diuretic effect. The result in this case might not be a defined
look, but a flat, deflated appearance brought about by severe dehydration.The most common practice among athletes is to administer a single 50 mg/50
mg tablet in the morning (with a meal), and to wait and judge the diuretic effect. After a number of hours, this is repeated if a stronger effect is needed.
Usually 2–3 tablets will be

Symptoms And Treatment Of Hypertension

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