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Pharmacology - Essay Example

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Pharmacology Question 1 1. Glyceryl trinitrate is a vasodilator that has an effect on both veins and arteries. Nitro lingual Pump spray is a dose spray that is metered and contains Glyceryl trinitrate. Each metered dose has a delivery of 400µg for every spray emission and the product conveys Glyceryl trinitrate as spray droplets below the tongue…
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Download file to see previous pages To prevent exercise-induced angina and other precipitation-related conditions, at least one metered dose should be sprayed beneath the tongue shortly before the event. The highest number of Nitrolingual Pumpspray doses administered per day should be determined considering the full medical history of the patient, the angina severity, and any concurrent medication (Coyne 2008 p34). 2. The patient is complaining of discomfort and pain, which are angina’s main symptoms. It includes squeezing, pressure, tightness and burning in the chest, with the discomfort and pains starting from behind the breastbone. The patient is also complaining of nausea, shortness of breath, as well as a pale and cold skin, all which point to angina. The shortness of breath is common with elderly patients of angina, and the pain may make the patient feel as if he is suffering from indigestion or an uncomfortable feeling in the stomach. The blood pressure is also a factor to consider, as the patient was recorded to have 148mmHg, which is way above the recommended 100mmHg for a normal person. Additionally, the patient’s last oral intake was tea and biscuits, which indicates that within the previous 24 hours he did not consume sildenafil (Neal 2012 p34). Question 2 1. The main glyceryl trinitrate’s pharmacological action is that it relaxes vascular smooth muscle, and then vasodilates peripheral arteries and veins, with veins vasodilating more than arteries. Post-capillary vessels’ dilation that also includes large veins promotes blood peripheral flooding and reduces preload. A relaxation in the arteries significantly decreases afterload (arterial pressure and systematic vascular resistance). The reduced systolic wall tension and less ventricular radius reduce the oxygen requirements and the myocardial energy. This decrease in the filling pressures of the heart enhances subendocardial wall layer perfusion that ischemia threatens. Glyceryl trinitrate’s therapeutic doses may decrease diastolic, systolic and average blood pressure in the arteries. This helps in maintaining coronary perfusion pressure. However, should blood pressure reduce, or an increase in the heart rate lowers the diastolic filling time, it can be highly compromised (Coyne 2008 p34). 2. GNT is a prodrug that should be denitrated first so that it can produce NO (the metabolite nitric oxide that is active). Nitro vasodilators are nitrates that undergo denitration to produce NO in the body. NO being a potent activator of GC (Guannyl Cylase) with the help of mechanisms that are heme-dependent, its activation results in the formation of cGMP from cGTP (cyclic guanosine triphosphate) (Bersten 2009 p938). 3. When glyceryl trinitrate is administered sublingually, it is absorbed rapidly from the mouth’s mucosa and bypasses the liver to reach the vascular system. It is metabolized in the liver and other cells such as erythrocytes with cleavage of several nitrate groups. Numerous inter-individual as well as intra-individual variations can be seen after the sublingual administration, for the plasma concentration. Glyceryl trinitrate, together with its metabolites, is eliminated principally, with less than 1% excreted with no change (Broyles, Reiss & Evans 2012 p.437). 4. The application of glyceryl trinitrate in any form during acute myocardial infarction’s early days requires attention to be particularly paid to clinical status and ...Download file to see next pagesRead More
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