💊 Calcium channel blockers (CCBs) are used in the treatment of many cardiovascular conditions including hypertension and angina so needless to say they easily make the top 200 drugs prescribed.⠀ ⠀ 👉🏻 They are divided into subclasses, non-dihydropyridines, and dihydropyridines and differ by their pharmacokinetic properties, clinical uses, response, and selectivity. ⠀ ⠀ 👉🏻 Dihydropyridine CCBs end in the suffix ‘-ine’: ⠀ ⠀ -AmlodipINE⠀ -NicardipINE⠀ -NifedipINE⠀ -NimodipINE⠀ -FelodipINE⠀ ⠀ 👉🏻 Non-dihydropyridine CCBs don’t end in the suffix ‘-ine’ hinted by the name of the subclass, NOn-dihydropyridINE:⠀ ⠀ -Verapamil⠀ -Diltiazem⠀ ⠀
Major depressive disorder (MDD) is a mood disorder characterized by persistent feelings of sadness and loss of interest that interferes with normal daily functioning. The exact chemical basis for depression is poorly understood but is thought to be linked to decreased levels of the neurotransmitters, serotonin, dopamine, and norepinephrine. This cause is also known as the monoamine hypothesis. Because of this, the drugs developed to treat MDD selectively target the reuptake of serotonin and norepinephrine, increasing levels of these neurotransmitters in the synapse and enhancing NT signaling. SSRIs are generally first-line due to their improved tolerability compared to the others (TCAs and MOAIs) and relative safety in cases of overdose. Studies have shown equivalent efficacy among antidepressants, therefore the initial choice is made empirically based on patient factors and the nuances of each drug.
💊 5-HT3 Inhibitors (ex: ondansetron) 🤢🤮 Nausea and vomiting are two of the most common presenting complaints 5-HT3 inhibitors (such as ondansetron) are one of the top 200 drugs prescribed and are used for the prevention of: 🌟 chemotherapy-induced nausea and vomiting 🌟 radiation-induced nausea and vomiting 🌟 postoperative nausea and vomiting 🌟 off-label for nausea and vomiting associated with pregnancy
❤️ Cardioselective beta-blockers work on the beta-1 receptors. Beta-1 receptors primarily are found in cardiac tissues whereas beta-2 receptors are located in the lungs (remember: 1 heart, two lungs).
❤️ Cardioselective beta-blockers exert their effect by binding to the beta-1 receptor sites selectively and inhibiting the action of epinephrine and norepinephrine on these sites. They are often preferred in patients with respiratory disease as they are less likely to cause constriction of airways or peripheral vasculature.
💊 Calcium channel blockers (CCBs) are used in the treatment of many cardiovascular conditions including hypertension and angina. They are divided into subclasses, non-dihydropyridines, and dihydropyridines and differ by their pharmacokinetic properties, clinical uses, response, and selectivity.
💊 The name of this class, calcium channel blockers, hints at its mechanism of action – inhibits the entry of calcium into cells of the cardiac and peripheral vascular smooth muscles.
🗒️ Calcium entry into L-type channels of cardiac and peripheral vascular cells is needed for them to contract or constrict more strongly.
🗒️ By blocking calcium entry, calcium channel blockers cause:
👉🏻 peripheral vascular smooth muscle relaxation (decreases blood pressure)
👉🏻 decreased myocardial contractility (decrease myocardial demand making them effective in angina)
👉🏻 decrease heart rate and conduction velocity (useful in arrhythmias).
Calcium channel blockers (CCBs) are used in the treatment of many cardiovascular conditions. They are divided into subclasses, non-dihydropyridines and dihydropyridines.
The non-dihydropyridine CCBs cause less vasodilation and more cardiac depression than dihydropyridine CCBs (hence why they are not recommended in decompensated heart failure). They cause reductions in heart rate and contractility.
Dihydropyridine CCBs have more vascular selectivity and fewer cardiac effects. They are indicated in the treatment of hypertension and angina. They do not suppress AV conduction or the SA node automaticity.
Proton pump inhibitors (PPIs) are one of the top 200 drugs prescribed (sometimes over-prescribed 😔) and are the strongest medications used to treat stomach acid disorders such as gastroesophageal reflux disease or peptic ulcers. ⠀ ⠀ The generics in this class all end in “prazole”, however, if you pay close attention, the brand names of these drugs also hint at what they do. See below for some examples:⠀ ⠀ 💊 Prilosec (omeprazole): Pr (short for proton), lo (low), sec (secretions) meaning lowered secretions of protons (acid)⠀ ⠀ 💊 Aciphex (rabeprazole): aci (acid), phex (fix) which means it can help fix acid problems⠀ ⠀ 💊 Prevacid (lansoprazole): Prev (prevent) acid ⠀ ⠀ 💊 Protonix (pantoprazole): Proton (acid) nix (get rid of) or in other words nix protons⠀
Statins are the drugs of choice in treating increases in non-HDL and LDL cholesterol, as they have shown a reduction in cardiovascular disease and mortality.
Statins inhibit the enzyme HMG-CoA reductase, which prevents the conversion of HMG-CoA to mevalonate. This is the rate-limiting step in cholesterol synthesis.