Drugs Mode of Action - Assignment Example

PHARMACOLOGY: DRUG MODE OF ACTION By Name Institution Lecturer Course Date Drugs Mode of Action Codeine Generic Name: codeine Brand Name: none Drug mechanism and class: Codeine is a cough suppressant, and a narcotic pain reliever similar to hydrocodone and morphine. Codeine binds to opioid receptors in the brain, which transmits pain sensation throughout the brain and body. It enhances pain tolerance making the patient comfortable even if the pain is apparent. In addition, codeine causes drowsiness and it depresses breathing. For effective relief of pain, codeine is often combined with aspirin and acetaminophen (Oqbru 2008). Preparations: Tablets are in 15mg, 30 mg and 60 mg. Solutions have 15mg/5ml per teaspoon. Injections are in 15mg/ml and 30 mg/ml (Oqbru 2008). Dosage: The adult dose is 15-60 mg after every 4 to 6 hours (Oqbru 2008a). Drug interaction: Codeine may impair physical ability required while operating machines or driving, and it can impair the thinking capacity. Sedatives like alprazolam and alcohol may lead to brain impairment and confusion when they are in combination with codeine. Therefore, when one is taking codeine, sedatives and alcohol should be limited (Oqbru 2008a). Side effects: The frequent side effects include vomiting, dizziness, lightheadedness, nausea, sedations and breath shortness. In addition, abdominal pain, allergic reactions, itching, constipation, and rash have also been observed in people who have taken codeine. Physical and mental dependence may occur, but not while in use for a short period. If the drug is withdrawn suddenly after a long period of use, withdrawal symptoms can develop. Consequently, codeine dose should be gradually reduced to avoid the withdrawal symptoms (Oqbru 2008a). Asprin Generic name: aspirin Brand Names: Aspir 81,Arthritis Pain, Aspir-Low, Ascriptin Enteric, Bayer Aspirin, Bufferin, Ecotrin, Childrens Aspirin, Easpirin, Ecpirin, Halfprin, Fasprin, St. Joseph Aspirin and Miniprin. Drug mechanism and class: It is a non-steroidal anti-inflammatory drug, which is effective in treatment of inflammation, pain, and fever in the body. Moreover, aspirin is an antithrombotic, and it prevents the blood from forming clots. Aspirin relieves mild to moderate pain caused by injury, arthritis, headaches, menstrual cramps, and musculoskeletal conditions. They work by reducing the prostaglandins level, leading to low concentration of prostaglandins. Consequently, it lowers fever, inflammations, and pain. Its ability to reduce function of platelets, and to prevent blood clot, enables aspirin to prevent stroke and heart attacks (Golan 2008). Aspirin is used mostly to prevent the arterial thrombosis that leads to myocardial infarction, stroke, and transient ischemic attack. Aspirin is used as an ant platelet agent because its action on platelets is permanent. It is widely used to prevent arterial thrombosis in comparison to other nonsteroidal anti-inflammatory drugs because the inhibitory action of the other drugs on the cyclooxygenase is never permanent. The predominant COX isoform in the platelets is COX-1. Endothelial cells express COX 1 and COX 2while under physiological conditions. Aspirin inhibits both COX 1 and COX 2 non-selectively making it an ant platelet agent that is effective (Golan 2008). Dosage: Mild to moderate pain dosage is 350 mg to 650 mg after every 4 hours or 500 mg after every 6 hours. Rheumatoid arthritis doses are 500mg after every 4 to 6 hours, 650 mg after every 4 hours, 1000mg after every 4 hours, and 1950 mg two times per day. The doses that are used to prevent heart attack are 81mg, 162 mg and 325 mg everyday (Golan 2008). Interaction: Aspirin may increase the level of lithium in the blood, because it reduces lithium excretion by the kidney, resulting to lithium toxicity. It can also lower the blood pressure, making medication to blood pressure less effective. In addition, when aspirin is used with aminoglycoside antibiotics or methotrexate, blood levels of the 2 drugs may increase, since aspirin reduce their elimination from the body. People taking anticoagulants or oral blood thinners are not supposed to take aspirin because it is also a blood thinner, and can result to excessive bleeding (Oqbru 2010). Side effects: The most side effects involve ears and gastrointestinal system. Side effects related to gastrointestinal system can cause abdominal burning, nausea, pain, ulcerations, gastritis, liver toxicity, cramping and bleeding. The internal bleeding can occur with no pain and dizziness, black tarry stool, and weakness on standing can be the only signs of bleeding. Rash, vertigo and impairment of kidney also occur. If ringing in the ears occurs, daily dose ought to be minimised (Golan 2008). Sertraline Generic name: Sertraline Brand name: Zoloft Drug mechanism and class: It belongs to a the class of drugs that are called SSRIs (selective serotonin reuptake inhibitors). This drug is a neurotransmitter, which is produced by the nerve cells, and nerves use it while communication with each other. Nerves release the serotonin that they produce to the space in their surroundings. The process that is referred to as re uptake then occurs whereby serotonin travel across the surrounding space, and attach to nerve receptors or attach itself to the receptors on the nerves that released it. When balance between uptake of serotonin and attachment is reached, the selective inhibitors of serotonin block the serotonin uptake changing the serotonin level in the brain. Sertraline is used to treat panic disorder, depression, obsessive-compulsive disorder, social anxiety disorders, premenstrual dysphoric disorder, and posttraumatic stress disorder (Ogbru 2013). Dosage: Sertraline is administered in 25 mg -200mg once per day. When treating depression, obsessive-compulsive disorder, premenstrual dysphoric disorder and social anxiety, it is administered at 25mg -50 mg, initially, once per day (Ogbru 2013). Interaction: Sertraline should not be combined with monoamine oxidase inhibitors, because the combination may result to tremor, confusion, hyperactivity, coma, high blood pressure, and death. Before using the mentioned drugs, one should stay for 14 days without treatment. The same reactions are observed when sertraline is combined with the drugs, which increase the level of serotonin in brain (Ogbru 2013). Side effects: The common side effects of this drug are insomnia, sleepiness, dizziness, nervousness, skin rash, tremor, nausea, diarrhea, stomach upset, loss of appetite, weight loss, dry mouth, abnormal ejaculations and headache. If discontinued abruptly symptoms like fatigue, cramps, memory impairment and flu like symptoms are experienced (Ogbru 2013). Katamine Generic name: Ketamine Brand Name: Ketalar Mechanism of action: Ketamine is a general anesthetic that acts rapidly producing anesthetic state, which is characteristised by normal pharyngeal laryngeal reflexes, profound analgesia, slightly or normally enhanced tone of the skeletal muscle, respiratory and cardiovascular stimulation, and minimal and transient respiratory depression. The ketamine biotransformation includes N-dealkylation, hydroxylation of cyclohexone ring, conjugation with the glucuronic acid, and dehydration of hydroxylated metabolites resulting to cyclohexene derivative (Kluwer 2014). After intravenously administration, the concentration of ketamine has initial slope that last for 45 minutes, with half-life of about 10-15 minutes. This alpha phase corresponds to anesthetic effect of ketamine. Termination of the anesthetic effect is done by the combination of the redistribution from the central nervous system to a slower equilibration of the peripheral tissues, and hepatic biotransformation to N-dealkylation (metabolite 1). Later half life (beta phase) of ketamine is always 2.5 hours. The anesthetic state of ketamine is called dissociative anesthesia because it seems to selectively interrupt the association of the brain pathway, before it produce some esthetic sensory-blockade. ketamine selectively depress thalamoneocortical system before obtunding more ancient cerebral pathways and centers (Kluwer 2014). Uses: This is dissociative anesthetic, with hallucinogenic effects. Katemine distorts perceptions of sound and sight making the user disconnected and out of control. It makes the patient detach from environment and pain, and it make someone feel relaxed, calm, become immobile, have amnesia and be relieved from pain. Ketamine works in the brain and inhibits the painful sensations (Kluwer 2014). Interaction: Recovery time can be prolonged when katamine is used concurrently with narcotics or barbiturates. Katamine is compatible with local and general anesthetic agents, if respiratory exchange is adequately maintained (Kluwer 2014). Side effects: Ketamine causes depression, agitation, amnesia, cognitive difficulties, and unconsciousness. Salivation, stiffening of muscles, nausea, dilated pupils, rapid eye movement and secretion of tears are also its side effects. Moreover, it causes headache, dizziness, irregular heartbeat, swelling of tongue, face, lips and mouth, confusion and painful urination (Kluwer 2014). Carbimazole Brand name: Neo-Mercazole Mechanism of action: Carbimazole is used to reduce the function of the thyroid. It works by reducing amount of the thyroid hormone that the thyroid glands produce. It is used in hyperthyroidism, a condition where thyroid glands produces a lot of hormones. During medication, carbimazole is initiated at high dose until the time that the function of the thyroid becomes normal. When the thyroid becomes normal the dose is reduced to ensure that the thyroid functions at the normal level. Treatment takes 6-8 months(National prescribing centre 2002). There are some cases where Carbimazole is administered at a dose that blocks the thyroid hormone by the glands. In such a case, tablets thyroid hormone are taken to replace production of the hormones being blocked. Carbimazole is administered during surgery, when part or all thyroid gland is being removed, to lower thyroid hormones level. Moreover, it is used when people with hyperthyroidism are receiving radioactive treatment, and it is administered before treatment. Carbimazole is available in tablets of 20 mg (National prescribing centre 2002).. Interactions: Ther is no interactions of carbimazole that is known. However, digoxin and theophylline doses may require to be reduced as the function of the thyroid become normalises (National prescribing centre 2002). Side effects: Carbimazole causes diarrhea, nausea, abdominal pain, constipation, headache, fever, joint pain, itching, rashes, alopecia (hair loss), decrease of blood cells, inflammation of liver, and myopathy (National prescribing centre 2002). Captopril Generic name: Captopril Brand name: Capoten Drug mechanism and class: Captopril, oral drug, is an inhibitor of angiotensin converting enzyme. This drug is used in treatment of hypertension or high blood pressure, kidney problem associated with diabetes, congestive heart failure and to enhance survival after one suffering from heart attack. Angiotensin II is a potent chemical, which makes the muscles that surrounds the blood vesicles to contact, narrowing vessels. Once the vessels are narrowed, the pressures in the vessels increase resulting to high blood pressure (Ogbru 2009). Angiosten I forms angiotensin II in the body with the help of angiotensin converting enzymes. Captopril, is a drug that inhibit activity of the angiotensin converting enzymes, decreasing angiotensin II production. Consequently, blood vessels dilate or enlarge, reducing the blood pressure. Lower blood pressure ensures that the heart pump blood, and improves the functions of the heart. Moreover, progression of blood vessel diseases in kidney resulting from diabetes or high blood pressure is decreased (Ogbru 2009). Dosage: The dose of captopril, which is recommended, is 25mg- 150mg 2 or 3 times per day. The maximum dose in a day should be 450 mg. This drug should be taken when the stomach is empty, 1 hour before meals or 2 hours after eating since captopril absorption is reduced by food (Ogbru 2009). Drug interaction: The use of captopril with potassium supplements, diuretics or salt substitutes such as spironolactone, which increase the potassium in blood can result into excessive levels of potassium. Therefore, when captopril is being used with potassium supplements, the level of potassium in the blood should be monitored. Nonsteroidal anti-inflammatory drugs have been reported to reduce effect of the angiotensin converting enzyme inhibitors (Ogbru 2009). Side effects: Captopril side effects are transient and mild. A persistent cough, which is dry, constipation, rash abdominal pain, diarrhea, headache, nausea, fatigue, dizziness, fainting, numbness in feet or hands, and lack of appetite are the side effects of Captopril. In addition, it can raise the level of potassium in blood, and cause kidney failure. It also has rare side effects such as liver failure and swelling of throat and lips, which obstruct breathing (Ogbru 2009). Chlorothiazide Brand name: Diuril Description: Chlorothiazide used in the treatment of fluid retention resulting from, cirrhosis, kidney disease, treatment from hormonal medicines or steroids and congestive heart failure. It is also used in treatment of high blood pressure. High blood pressure overloads the arteries and the heart, and if happens for a long time, it results to malfunction of the arteries and the heart. Consequently, the blood vessels of the kidney, heart and brain can get damaged resulting to kidney failure, heart failure, stroke, and heart attack. Once blood pressure is controlled, the mentioned problems can rarely occur. Chlorothiazide is a water pill (thiazide diuretic), and it reduces the water retained in the body, by enhancing flow of urine. High flow of urine removes excess water from the body, and lowers the pressure of the blood (Micromedex 2013). Interactions: When chlorothiazide is used concurrently with narcotics, alcohol or barbiturates, and antihypertensive drugs, hypotension may occur. Combining chlorothiazide with colestipol resin and cholestyramine, reduces its absorption. Chlorothiazide should not be used concurrently with lithium since the clearance of lithium from the body will be reduced leading to lithium toxicity (Micromedex 2013). Side effects: Weakness, hypotension, vomiting, cramping, diarrhea dizziness, headache, renal failure, anemia, hypersensitivity and jaundice are some of the side effects observed in patients who are on chlorothiazide. Headache, vomiting, nausea, hallucinations, loss of appetite, muscle pain, confusion, uneven heartbeats, are the side effects that this medication should be stopped once they have been observed. Moreover, difficulties in breathing, swelling of lips, throat, face or tongue are the signs that one should seek emergency doctors’ help on observation (Micromedex 2013). Digoxin Gereric name: digoxin Brand name: lanoxin Drug mechanism and class: Digoxin enhances vigor and strength of the contractions of heart, and it is used to treat heart failure. This drug increase contraction force of heart muscles by inhibiting activity of enzyme ATPase, which controls movement of potassium, sodium and calcium into the muscles of the heart. Calcium controls contraction force. When ATPase is inhibited, calcium increases in the muscles of the heart, increasing the force of contraction in the heart. In addition, Digoxin slows the electrical conduction between ventricles and atria of heart, and is used in treatment of abnormal atria rhythms like atria tachycardia, atria fibrillation and atria flutter (Ogbru 2008). These abnormal rhythms may be caused by alcoholism, heart attack, excess thyroid hormones, and infections. During abnormal rapid rhythms in atria, electrical signals, from atria makes the ventricles to contract rapidly. Rapid contractions in the ventricles are inefficient in pumping of the blood that has nutrients and oxygen, to the whole body. As a result, symptoms like dizziness, chest pain, shortness of breath and weakness are observed. Dogoxin alleviates all these symptoms through blockage of conduction of electrical between ventricles and atria, ensuring that the ventricular contractions are slow (Ogbru 2008). Dosage: Digoxin is taken with food or without food. The starting dose is 0.0625 mg to 0.25 mg everyday depending on kidney function and age. To achieve the expected response, the dose in increased in every 2 weeks (Ogbru 2008). Drug interaction: Drugs like Quinidine, verapamil, indomethacin, amiodarone, alprazolam, itraconazole, and spironolactone can increase the levels of digoxin and risk of the toxicity. Co-administration beta blockers, such as propranolol, and digoxin may slow down the heart rate (Ogbru 2008). Side effects: The common side effects are skin rash, vomiting, dizziness, nausea, mental changes and headache . Serious side effects include rapid heartbeat, slow heart rate, and heart block. It is also associated with enlargement of breast, blurred vision, and abdominal pain (Ogbru 2008). Statin Mechanism of action: Satin belongs to the class of drugs that lowers the cholesterol levels in the blood. This happens by reduction of cholesterol production by the liver. Statins block the enzyme hydroxyl-methylglutaryl-coenzyme, which synthesis cholesterol in the liver. Cholesterol is significant in normal function of cells in the body. However, cholesterol contributes to atherosclerosis, where plaques that contain cholesterol form in arteries. The formed plagues block arteries, reducing blood flow to tissues that are supplied by the arteries. The plagues then rupture and blood clots forms on plague, blocking arteries further. Consequently the blood fails to flow and heart attack or chest pain occur. Statins work by reducing production of cholesterol, and this ensures that there is slow formation of plagues, and it reduces the size of the existing plagues. In addition, statin, stabilise plagues ensuring that they do not rupture or form clots (Cohen 2005). Interactions: Statin have an interaction that involves enzymes that eliminates it from the liver. Cytochrome P450 are the liver enzymes, which eliminates all statins except rosuvastatin and pravastatin from the body. The drugs that blocks action of the P-450 enzymes increase lovastatin, simvastation, atorvastatin, and fluvastation levels in blood, and may result to development of rhabdomyolysis. Examples of agents or drugs, which block P -450 liver enzymes include protease inhibitors, itraconazole, erythromycin, telithromycin and clarithomycin (Cohen 2005). Side effects: The common side effects are muscle aches, headache, flushing of skin, dizziness, drowsiness, nausea, abdominal pain, bloating, rash, diarrhea and constipation. It also has warnings of mental confusion, loss of memory, diabetes (type 2) and high blood sugar may occur as its side effects. Statin serious side effects are inflammation of muscles, high levels of creatine kinase enzyme resulting to painful and weak muscles and extreme damage and inflammation of the muscles (Cohen 2005). Penicillin Generic name: Ampicillin, Penicillin V,Pipetacillin, amoxicillin, ticarcillin and others Brand name: Pipracil, Unasyn, and Ticar Drug mechanism and class: This drug is an antibiotic. It work by stopping the bacteria multiplication, through stopping formation of bacteria wall, which protect the bacterial from surrounding environment, and also keeps the bacteria cell content together. Without the cell wall, the bacteria are not able to survive. Penicillin is effective against bacteria such as N. gonorrhea, H. influenza, Strettococci, E.coli and some strains of the Staphylococci (Kee. Layes and McCuistion 2011). Drug interaction: Benemid (Probenecid) leads to an increase in the penicillin level in the blood, because they reduce elimination of penicillin by the kidney. There are times probenecid is combined with penicillin to ensure that smaller penicillin amount leads to higher levels in the blood (Kee. Layes and McCuistion 2011). Side effects: Penicillin side effects are nausea, dizziness, insomnia, itching, heartburn, confusion, bleeding, vomiting, abdominal pain and allergic reaction. Serious side effects are anaphylaxis, seizures and low red blood cells or platelets count. It can also interfere with the normal bacteria colon and encourage overgrowth leading to colon inflammation (Kee. Layes and McCuistion 2011). Phenothiazines Mechanism of action: Phenothiazines are the widely used antipsychotics drugs. They are also called neuroleptic drugs. These drugs reduce the intensity of the psychotic symptoms such as delusions, hallucinations, disordered thinking, confused speech and paranoid suspiciousness in mental patients. The chlorpromazine, is the most popular phenothiazine (Bernstein 2011). Drug Interaction: Chlorpromazine enhances depression of central nervous system, which is produced by other drugs that depress the central nervous system. When Chlorpromazine is taken together with drugs like anti arrhythmic agents, terfenadine or astemizole, the ventricular arrhythmias risk is enhanced. Combination of Chlorpromazine with the antidopaminergic agents like Prochlorperazine or Metoclopramide enhace risk of the extrapyramidal effects (Bernstein 2011). Half Life: Chlorpromazine has a half-life of 8 to thirty five hours. However, it can range between 2 hours and 60 hours in some patients (Bernstein 2011). Side effect: Antipsychotic drugs have side effects such as dizziness, dry mouth, tremors, slow movement, restlessness and muscle rigidity. Some of the symptoms are treatable but some patients who take chlorpromazine for a long time develop a movement disorder, which is irreversible. This movement disorder is called tardive dyskinesia, and it causes repetitive actions such as twisting of face, tongue thrusting and flailing of the legs and arms uncontrollably (Bernstein 2011). Psychonutrition Drug – (Fatty Acid, Minerals and B Vitamins) Relationship of neuronal function to nutrition: All the nervous system phases including the activites at synapses and axons are influenced by nutritional status. The brain is fueled by glucose, and glucose is metabolised in presence of minerals and vitamins in the mitochondria, to form energy intermediates like adenosine triphosphate. Adenosine triphosphate is essential in secretion and synthesis of the neurotransmitters. Neurotransmitters regulate physiological processes, which are associated with perspiration when one is nervous, racing heart beat when frightened, thirsty when body need fluids and racing heart beat when frightened. How information is processed in the brain depends on the status of nutrients in the nervous system (Brand 2005). Poor nutrition status has been associated with altered psychological performance, and low performance in cognitive function tests. Research shows that the children who take food rich in vitamin B perform well in school while compared to those who do not take B vitamins. However, children who are exposed to lead through air, food and water have low intelligence quotient, impaired memory impaired learning. Nutrients are also important in controlling the synaptic function. Messages of the nervous system, which pass across synaptic cleft, require acetylcholine to be released. Acetylcholine is derived from diets with B complex nutrient-choline. Lack of B complex and choline alters the neuronal function, since release, metabolism and synthesis of acetylcholine is affected (Brand 2005). Treatment of depression: B vitamins, fatty acids and minerals are used in treatment of depression. Nutrition is directly involved when depression is concerned. Firstly, people rarely eat fruits, vegetables, and fish, while they take a lot of sugar. Each nutrient named above is associated with depression and if not taken the chances of suffering from depression are high. Secondly, depression happens because of biochemical imbalance, and the brain normalises its biochemistry using nutrients. Thirdly, when the psychological demands increase out of stressful living, nutritional requirements ought to be increased since brain functionally and structurally depends on nutrients (Holford 2003). B vitamins work as co factors in enzymes, which control balance and production of the neurotransmitters. For instance, serotonin (5-HT) is synthesised from 5-HTP when methyl group is added. This enzymatic process depends on vitamin B6 and vitamin B12 together with folate, and they help in preventing and treatment of depression. Fatty acids such as omega3 fats influence serotonin directly by enhancing reception and production. It is reported that people who eat fish are less likely to suffer from depression (Holford 2003). Bibliography Bernstein, D 2011, Essentials of Psychology (5th Ed). USA: Dovetail Publishing Services. Cohen, JS 2005, What you must know about Statin Drugs and their natural alternatives. USA: Square One Publishers. Golan, DE 2008, Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy. P. 401 Holford, P 2003, Depression: the nutrition connection. Primary Care Mental Health, vol. 1, pp. 9-16. Kee, J., Layes, E. & McCuistion, L 2011, Pharmacology: A patient Centered Nursing Process Approach. USA: Elsevier Publishing Services. Kluwer, W 2014, Ketamine. [online] retrieved from [Accessed May 3, 2014]. Micromedex 2013, Drugs and Supplements: Chlorothiazide (Oral Route). [Online] Retrieved from [Accessed May 3, 2014]. National prescribing centre 2002, Management of common thyroid diseases. MeReC bulletin, vol. 12, p. 3. Oqbru, O 2008, digoxin, Lanoxin. [online] Retrieved from [Accessed May 3, 2014]. Oqbru O 2008a, Codeine. [Online] Retrieved from [Accessed May 3, 2014]. Oqbru, O 2009, captopril - oral, Capoten. [online] Retrieved from [Accessed May 3, 2014]. Oqbru, O 2010, acetylsalicylic acid, Aspirin, Ecotrin. [Online] Retrieved from [Accessed May 3, 2014]. Oqbru, O 2013, sertraline, Zoloft. [Online] Retrieved from [Accessed May 3, 2014]. Read More

Once the vessels are narrowed, the pressures in the vessels increase resulting to high blood pressure (Ogbru 2009). Angiosten I forms angiotensin II in the body with the help of angiotensin converting enzymes. Captopril, is a drug that inhibit activity of the angiotensin converting enzymes, decreasing angiotensin II production. Consequently, blood vessels dilate or enlarge, reducing the blood pressure. Lower blood pressure ensures that the heart pump blood, and improves the functions of the heart.

Moreover, progression of blood vessel diseases in kidney resulting from diabetes or high blood pressure is decreased (Ogbru 2009). Dosage: The dose of captopril, which is recommended, is 25mg- 150mg 2 or 3 times per day. The maximum dose in a day should be 450 mg. This drug should be taken when the stomach is empty, 1 hour before meals or 2 hours after eating since captopril absorption is reduced by food (Ogbru 2009). Drug interaction: The use of captopril with potassium supplements, diuretics or salt substitutes such as spironolactone, which increase the potassium in blood can result into excessive levels of potassium.

Therefore, when captopril is being used with potassium supplements, the level of potassium in the blood should be monitored. Nonsteroidal anti-inflammatory drugs have been reported to reduce effect of the angiotensin converting enzyme inhibitors (Ogbru 2009). Side effects: Captopril side effects are transient and mild. A persistent cough, which is dry, constipation, rash abdominal pain, diarrhea, headache, nausea, fatigue, dizziness, fainting, numbness in feet or hands, and lack of appetite are the side effects of Captopril.

In addition, it can raise the level of potassium in blood, and cause kidney failure. It also has rare side effects such as liver failure and swelling of throat and lips, which obstruct breathing (Ogbru 2009). Chlorothiazide Brand name: Diuril Description: Chlorothiazide used in the treatment of fluid retention resulting from, cirrhosis, kidney disease, treatment from hormonal medicines or steroids and congestive heart failure. It is also used in treatment of high blood pressure. High blood pressure overloads the arteries and the heart, and if happens for a long time, it results to malfunction of the arteries and the heart.

Consequently, the blood vessels of the kidney, heart and brain can get damaged resulting to kidney failure, heart failure, stroke, and heart attack. Once blood pressure is controlled, the mentioned problems can rarely occur. Chlorothiazide is a water pill (thiazide diuretic), and it reduces the water retained in the body, by enhancing flow of urine. High flow of urine removes excess water from the body, and lowers the pressure of the blood (Micromedex 2013). Interactions: When chlorothiazide is used concurrently with narcotics, alcohol or barbiturates, and antihypertensive drugs, hypotension may occur.

Combining chlorothiazide with colestipol resin and cholestyramine, reduces its absorption. Chlorothiazide should not be used concurrently with lithium since the clearance of lithium from the body will be reduced leading to lithium toxicity (Micromedex 2013). Side effects: Weakness, hypotension, vomiting, cramping, diarrhea dizziness, headache, renal failure, anemia, hypersensitivity and jaundice are some of the side effects observed in patients who are on chlorothiazide. Headache, vomiting, nausea, hallucinations, loss of appetite, muscle pain, confusion, uneven heartbeats, are the side effects that this medication should be stopped once they have been observed.

Moreover, difficulties in breathing, swelling of lips, throat, face or tongue are the signs that one should seek emergency doctors’ help on observation (Micromedex 2013). Digoxin Gereric name: digoxin Brand name: lanoxin Drug mechanism and class: Digoxin enhances vigor and strength of the contractions of heart, and it is used to treat heart failure. This drug increase contraction force of heart muscles by inhibiting activity of enzyme ATPase, which controls movement of potassium, sodium and calcium into the muscles of the heart.

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