Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
4Activity
0 of .
Results for:
No results containing your search query
P. 1
Kevin 123

Kevin 123

Ratings: (0)|Views: 138|Likes:
Published by Mark Kevin Borromeo

More info:

Published by: Mark Kevin Borromeo on Sep 21, 2010
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as DOCX, PDF, TXT or read online from Scribd
See more
See less

05/21/2012

pdf

text

original

 
DRUG STUDY
1. Furosemide
(INN) or 
rusemide
(former BAN) is aloop diureticused in the treatment of congestiveheart failureandedema. It is most commonly marketed bySanofi-Aventisunder the brand name
Lasix
. It has also been used to preventthoroughbredandstandardbredrace horses from bleeding through the nose during races. Along with some other diuretics, Furosemide is also included on theWorld Anti-Doping Agency's banned drug  list due to its alleged use as a masking agent for other drugs.
Mechanism o
action
Main article:Loop diuretic Like other loop diuretics, furosemide acts by inhibiting the Na-K-2Cl symporter in thethick ascending limbof  theloop of Henle. The action on the distal tubules is independent of any inhibitory effect on carbonic anhydraseor aldosterone; it also abolishes the corticomedullary osmotic gradient and blocks negative as well as positivefree water clearance.Due to the large NaCl absorptive capacity of the Loop of Henle, diuresis is not limited by development of acidosis, as it is with the carbonic anhydrase inhibitors.By inhibiting the transporter, the loop diuretics reduce the reabsorption of NaCl and also diminish the lumen- positive potential that derives from K 
+
recycling. This electrical potential normally drives divalent cationreabsorbtion in the loop, and by reducing this potential loop diuretics cause an increase in Mg
2+
and Ca
2+
 excretion. Prolonged use can cause significanthypomagnesemiain some patients. Since Ca
2+
is activelyreabsorbed in the distal convoluted tubule, loop diuretics do not generally cause hypocalcemia.Additionally, furosemide is a noncompetitive subtype-specific blocker of GABA-A receptors.
[1][2][3]
Furosemidehas been reported to reversibly antagonize GABA-evoked currents of 
6
2
2
receptors at µ
 M 
concentrations, butnot 
1
2
2
receptors.
[1][3]
During development, the 
6
2
2
receptor increases in expression in cerebellar granuleneurons, corresponding to increased sensitivity to furosemide.
[2]
 
Cl
inica
l
use in humans
Furosemide, as a loop diuretic, is principally used in the following indications (Aventis, 1998):
y
 
E
demaassociated withheart failure, hepaticcirrhosis,renal impairment,nephrotic syndrome 
y
 
Hypertension 
y
 
Adjunct incerebral/ pulmonary edemawhere rapiddiuresisis required (IVinjection) It is also sometimes used in the management of severehypercalcemiain combination with adequate rehydration
[4]
.Although disputed,
[5]
it is consideredototoxic:
"usually with large parenteral doses and rapid administrationand in renal impairment" 
[6]
 The tendency, as for all loop diuretics, to cause low potassium levels (hypokalemia
 
) has given rise tocombination products, either with potassium itself (e.g.
Lasix-K 
) or with the potassium sparing diureticof amiloride(Co-amilofruse
 
).
Use in research
Furosemide has been used in research on the inner-ear. It's known to decrease temporarily the response to sound by reducing the mobility of the basilar membrane of thecochleaand by reducing the transduction that normally
 
DRUG STUDY
results from the bending of stereocilia onhair cells. (demonstrated in 1991 by Mario Ruggero and Nola Richfrom the University of Minnesota)
P
recautions, side-e
ff 
ects, and administration
Furosemide is injected either intramuscularly(IM) or intravenously(IV), usually 0.5-1.0 mg/kg 2x/day, although less before a horse is raced. As with many diuretics, it can causedehydrationandelectrolyte imbalance, including loss of  potassium,calcium,sodium, andmagnesium. It is especially important to prevent  potassium loss.
E
xcessive use of Furosemide will most likely lead to ametabolic alkalosisdue tohypochloremia  andhypokalemia. The drug should therefore not be used in horses that are dehydrated or experiencing kidneyfailure. It should be used with caution in horses with liver problems or electrolyte abnormalities. Overdose maylead to dehydration, change in drinking patterns and urination, seizures, GI problems, kidney damage, lethargy,collapse, and coma.Furosemide should be used with caution when combined with corticosteroids (as this increases the risk of electrolyte imbalance), aminoglycoside antibiotics (increases risk of kidney or ear damage), and trimethoprimsulfa (causes decreased platelet count). It may also cause interactions with anesthesics, so its use should berelated to the veterinarian if the animal is going into surgery, and it decreases the kidney's ability to excreteaspirin, so dosages will need to be adjusted if combined with that drugFurosemide may causedigoxintoxicity due to hypokalemia.The drug is best not used during pregnancy or in a lactating mare, as it has been shown to be passed through the placenta and milk in studies with other species. It should not be used in horses with pituitary pars intermediadysfunction(Cushings).Furosemide is detectable in urine 36±72 hours following injection. Its use is prohibited by most equestrianorganizations.
Drug Interactions
Furosemide has potential interactions with the following medications:
[7]
 
y
 
Aminoglycoside antibioticssuch asGentamicin 
y
 
Aspirinand other salicylates
y
 
Other diuretics (e.g.ethacrynic acid,hydrochlorothiazide
 
)
y
 
Indomethacin 
y
 
Lithium 
y
 
Synergistic effects with other antihypertensives(e.g.Doxazosin
 
)
y
 
Sucralfate 
2
. Essentia
l
e
orte-
is a preparation of essential phospholipids.
E
ssentiale normalizes themetabolismof lipidsand proteins, improves thedetoxificationfunction of the liver, restores the cellular structure of the liver andretards the producing of conjunctive tissue.
E
ssentiale medications are indicated for the treatment of fattydegenerationof the liver,hepatitis(including toxic hepatitis, liver damage caused by medicines or alcohol abuse),cirrhosisof the liver, disturbances in liver function associated with different illnesses.
P
harmaceutica
l
action
Phospholipids are essential structural components of all cellular membranes.
E
ssential phospholipids (substance
E
PL) - are the complex substances of natural origin (ethersof cholinephosphoric acid ( phosphatidylcholine
 
) andunsaturated fatty acids (linoleic, linolenic, olein)).
E
ssentiale medications possess the membranotropic properties, metabolic andhepatoprotectiveaction; regulateslipidandcarbohydratemetabolism.
E
ssential phospholipids increase functional status of the liver.
 
DRUG STUDY
While the disturbance of the liver metabolism essential phospholipids ensure the entering the high energy phospholipids, which are ideally combined with the endogenous phospholipids. Under the
E
ssentialle phospholipids influence clinical and biochemical liver indexes are improved.Combination of 
E
ssentiale with cordiamin (nikethamide) and vitamin
E
(50 mg/kg for 35 days) considerablyactivates the mono-oxigenase, glucoro- and glutathione transferase systems of the liver: and as a result the free-radical processes became less intense
[1]
.The spectrum of essential phospholipids' activity in chronic degenerative liver diseases can be described in thefollowing properties:
y
 
recovery and maintaining the consistency of the hepatocytes;
y
 
activation of the phospholipid-depending ferments;
y
 
improvement in the lipids metabolism caused by accelerated synthesis of lipoproteins in the liver;
y
 
activation of synthesis RNA and as a result the normalization of the proteins metabolism
;
y
 
increased synthesis of glycogen in the liver;
y
 
improvement in the detoxification function of the liver;
y
 
the conversion of neutral fats and cholesterol into the easily metabolizing forms;
y
 
decreased the fatty infiltration of the hepatocytes.
C
ommon use
E
ssentiale is used to treat the following diseases:
y
 
Hepatitis(acute and chronic), toxic hepatitis, medicinal and alcoholic hepatitis, poisonings. Hepaticsteatosis of different aetiology(in 53.6 % of patients the effect of six-month treatment with
E
ssentialeforte was very good (improvement of all investigated parameters)
[2]
 diabetes(the data suggests that
E
ssentiale protects and improves liver function in diabetic subjects with nonalcoholic fatty liver[3]
[3]
) and chronic infections);
y
 
Disturbance in liver function in somatic diseases;
y
 
Hepatic cirrhosis;
y
 
 Necrosisof the liver cells, liver failure, liver coma;
y
 
Pre- and Post- surgical treatment, especially in hepatobiliary area;
y
 
Hyperlipoproteinemia, hypercholesterolemia, hypertriglyceridemia;
y
 
Diseases of the cardiovascular system: coronary heart disease, stable stenocardia
[4]
, post-infarctioncondition, disturbance of the cerebral and peripheral circulation, Hypertension, thrombembolia prophylaxis, atherosclerosis, diabetic angiopathy, thrombembolia prophylaxis and fatembolism(solution for injection);
y
 
Digestive system diseases (chronic pancreatitis, gastric and duodenum ulcer;
y
 
or
Toxicosis of pregnancy(edema, proteinuria  and blood pressure disorders);
y
 
Radiation sickness (radiation syndrome);
y
 
Psoriasis, atomic dermatitis, eczema;
y
 
Pyelonephritis
[5]
 
y
 
Prophylaxis of micromegaly.
Av
ai
l
abi
l
ity
E
ssentiale medications are manufactured under 4 trade names:
E
SS
E
 NTIAL
E
- solution for intravenous injectionsin vials 5 ml.
E
ssentiale contains essential phospholipids(
E
PL substance) 250 mg, Pyridoxine chidrochloride 2,5 mg (Vitamin B
6
), Cyanocobolamine0,1 mg (Vitamin B
12
), Sodium Pantothenate 1.5 mg, Nicotinamide 25 mg

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->