Metformin
Inhibit hepatic gluconeogenesis
Inhibits electron transport chain
Increases insulin sensitivity
Increase glycolysis
What is mechanism of action?
It will go to angiotensin (AT1) receptor and will prevent the angiotensin 2 from stimulating adrenal gland
What type of beta blocker is this drug?
Selective Beta 1 blocker
What type of inhibitor is this drug?
A competitive inhibitor. Is a structural analog of HMG- COA that competitively inhibits the enzyme.
Mechanism of action
Inhibits cyclooxygenase (1 and 2) irreversibly for the lifetime of the platelet, and thus will inhibit the formation of thromboxane A2 from arachidonic acid.
Also inhibits the format of prostaglandins
11 y/o old child is recently diagnosed with diabetes mellitus. What is first line treatment?
Insulin
What type of inhibitor is losartan?
Competitive inhibitor
What is the direct effect of this drug on the kidneys?
Inhibits beta 1 receptors on the juxtaglomerular cell, which will prevent Renin from being released
1. Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A reductase aka HMG-CoA reductase in the liver. This results in reduced synthesis of cholesterol
2. Increases the LDL receptor synthesis on liver cells, which clears LDL and VLDL remnants from the blood.
What is one adverse effect of aspirin?
Acute Renal injury due to a a drug induced interstitial nephritis
Gastric ulcer bc it inhibits formation of pge2
Reye’s syndrome in children with a viral infection
How is metformin excreted?
Renal via urine
How is losartan excreted?
Through the kidneys
What is the advantage of using Metoprolol over propranolol?
Propranolol will also block beta-2 receptors, causing bronchodilation. Exacerbating asthma and COPD.
How is this drug excreted?
it is excreted through the bile
What type of rate of elimination does aspirin have?
Zero order elimination. This means that a constant amount of aspirin is released after each half time
What is a major side effect to metformin use?
metabolic acidosis
What is one side effect of losartan and why does it happen?
Hyperkalemia due to the lack of aldosterone activating the ROMK channel.
What is the side effect of this drug in diabetic patients and why?
It can cause hypoglycemia reaction in diabetics.
Beta receptors are on the liver allows for glycogenolysis and gluconeogenesis. Therefore, if there is inhibition of beta blockers, then there will be no glucose available during fasting conditions, which will exacerbate hypoglycemia in diabetics during their state of fasting.
Muscle Pain
If HMG-CoA reductase is inhibited, there will be no oxidative phosphorylation, causing a lack of ATP synthesis from pathways like the TCA cycle. The lack of ATP makes the muscles unable to contract and breakdown causing the pain
How can we treat salicylate overdose?
Na+ HCO3- will help alkalize the urine in order to get stuck in its conjugate base form
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What is the mechanism of action for this drug?
Irreversibly binds to platelet ADP receptor (a G(i) receptor) and will deactivate the G(i) pathway and therefore cause an increase in caMP in platelets, which will stop platelet activation.
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What are the side effects of this drug?
Bleeding and neutropenia (low neutrophils)
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What is the major use of this drug?
Routinely used to prevent thrombosis in pts who have received a coronary artery stent. Preventing strokes from ischemia, especially in patient who can’t tolerate aspirin.
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What is a serious complication of ADP receptor antagonists?
thrombotic thrombocytopenic purpura: disseminated formation of small thrombi, and platelet consumption.
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This drug can be combined with which other drug in order to prevent thrombosis in coronary artery stents?
Aspirin