It was nearly dawn when the silence of the village was sharttered by a ululation that welcomes the late chief's long-awaited son before long people trooped to the palace.By day break one could counting the number of dancers that had come to share the joy of the chief.As sun rose promising the heat of the day.An army vehicle arrived vomiting soldiers everywhere,this marred the day's joy.An officer asked a young man standing by Danaa a headteacher a Yoo-Naa city primary school who had cheated so many people including a police officer.He had promised to secure them Visas to European countries but had failed.He however did not return to them the 500 dollar fee he collected from each of them.In no time, Danaa was arrested without the chief's notice but the chief stood between them success their mission but however told them they could not arrest anyone including Danaa without first informing him.An old man among the police dashed into a nearby local market bought some cola nuts and some token adding that the chief was visited before the hard criminal was arrested.Gone were the days our local palace was revered and respected by all local folks.
Today the "Sakawa" could have been averted but the law that says if you do not see him steal you not accuse(no business with luxury?) him has rotten the souls of the youth.Our chiefs could have been used to track down this menace among the youth.Today culprits can no longer be dealt with meanwhile the police often do not have 'enough evidence' to punish culprit and the menace continues.The healing cane has been forgotten.Miasma of colleagues whose parents have lost control of them under the pretext of freedom of association has the virulence to infect their colleagues.The writer is as well a victim of circumstances.
I feel ashamed of my inability to play my cultural roles,being an acclaim son of the Gong Gong family.Though not the only young man with this infection ,there are many more young ones who cannot tell you how the Damba festival,Bugum Festival and the mini Yam festival are performed.
How can we straightened this?If the falcon cannot hear the falconer.George W.B. Yeast was right for that saying.The youth do not see how they should learn from the old folks who never stepped foot in classroom forgetting that all are not learnt from the white board.Tradition is supreme.
No nation has ever developed under the ignorance of their own culture and tradition.An example is China an economic tiger of our times.
yakubu h.yakubu
This site gives you his Background in persona and other tit bits in Academics
Thursday, 27 December 2012
Tuesday, 9 October 2012
How to Configure Mtn Ghana internet settings access on your device
- Just dial *686# and send
- Wait for the confirmation message from Mtn on the receipt of your request.
- If you phone can’t be configured through this method, you would receive a notification message.
- If on the other hand, you phone can be configured using this method, mtn will send you’re the configuration settings. All you need to do is to open the message and click install. Follow the prompts to successfully get your phone internet connection enabled.
- Search for your device internet settings. You will mostly find it at Menu -> Settings -> Internet Settings or Connectivity or Phone Settings
- The next important thing you must look for is Access Point Name (APN). The APN for Mtn is internet.
- Go on and fill in the homepage field, and leave the rest blank. If it asks you for authentication settings, select none. Don’t fill in the proxy or ip settings, but if you are not able to connect to the internet, you can fill it in later. Mtn proxy or ip setting is 175.17.3.5 Port 80 or 8080.
- Save your settings and configure your browser or apps to connect to the internet through the new internet profile you’ve created.
Yakubu H.Yakubu
Director-CERT GHANA
0245115146.
Thursday, 30 August 2012
THE BEAUTIFUL EVENNING IN TAMALE
Tamale is the capital city of the Northern region of Ghana mostly inhabited by the Mole-Dagomba linguistic group. The city is home to about 350,000 people. It is a nodal city that serves as convergence zone as well as the commercial capital of the three northern regions.Tamale is reputed to be one of the fastest growing cities in West Africa. Even though limited in natural resources, seasonal farming is the major occupation of the natives who receive strangers with open arms.
Another beautiful culture of the natives of Tamale city is Motobike Riding.Ladies can be seen neately designed on their motobikes in the evening at trafics.The most popular motobike yearn is what we called 'Mapuka'.This exposes the natural African landmarks of this ladies and they look beautiful.Strangers are often amazed with the style Tamale ladies ride their motobikes and meander their ways through Vehicles to get to their destinations.They do not only add colour but shows the flare of this ladies.
The writer thinks this is one of the ways of achieving gender parity.In the north ladies are nowadays not seen to be the kitchen -mates but are robbing shoulders with men in motobike riding and other endevours.
We invite you to visit Tamale the cleanlliness city in Ghana and a place where culture and tradition are Supreme.
Thursday evening in Tamale----30/8/12
Yakubu H.Yakubu.
Another beautiful culture of the natives of Tamale city is Motobike Riding.Ladies can be seen neately designed on their motobikes in the evening at trafics.The most popular motobike yearn is what we called 'Mapuka'.This exposes the natural African landmarks of this ladies and they look beautiful.Strangers are often amazed with the style Tamale ladies ride their motobikes and meander their ways through Vehicles to get to their destinations.They do not only add colour but shows the flare of this ladies.
The writer thinks this is one of the ways of achieving gender parity.In the north ladies are nowadays not seen to be the kitchen -mates but are robbing shoulders with men in motobike riding and other endevours.
We invite you to visit Tamale the cleanlliness city in Ghana and a place where culture and tradition are Supreme.
Thursday evening in Tamale----30/8/12
Yakubu H.Yakubu.
Sunday, 10 June 2012
Kenyan minister George Saitoti killed in helicopter crash
Within one week Africa has recorded three aircraft crashed the west africa had two and the east africa recorded one.Ghana,Nigeria and Kenya respectively
Kenyan Internal Security Minister George Saitoti has been killed in a helicopter crash, officials say.
They say Mr Saitoti and his deputy, Orwa Ojode, died when the aircraft went down west of Nairobi, bursting into flames as it hit the ground.
There is no word on the cause of the crash, in which six people were killed, including bodyguards and pilots.
Mr Saitoti, a former vice-president, had been planning to run in a forthcoming presidential poll.
The 66-year-old was on his way to a security meeting when his helicopter crashed on Sunday morning.
A journalist for AFP news agency saw six charred bodies being removed from the wreckage.
Another reporter at the scene says debris of the burnt-out police helicopter were strewn in the brush.
Leading politician
George Saitoti had been a key figure in Kenyan politics, holding a number of senior ministerial posts over the last 30 years.
The professor of mathematics joined Daniel arap Moi's government as a finance minister in 1983, going on to become his vice-president in 1988.
He briefly stepped down as education minister in 1996 over accusations he was involved in the Goldenberg financial scandal, but was reinstated when a Kenyan court ruled he should not be charged.
After years as a senior member in the long-dominant Kanu party, Mr Saitoti joined the current president Mwai Kibaki's National Alliance of Kenya in 2002.
As Internal Security Minister under Mr Kibaki, he was a leading government voice against the Somali militant group al-Shabab.
Kenyan troops have been fighting al-Shabab in Somalia since they sent troops into the country last October.
The militants have killed several people in a string of grenade attacks in various parts of Kenya, including Nairobi.
Mr Saitoti announced he would stand for the presidency last November.
No date for the presidential election has so far been set. Mr Kibaki's mandate ends in January 2013.
Prime Minister Raila Odinga - a rival of both Mr Kibaki and Mr Saitoti - has also announced he was standing for president.
The last presidential election, in December 2007, was followed by a wave of ethnic and political violence in which about 1,500 were killed.
Mr Odinga has warned about the emergence of ethnically-based political groups in the run-up to the next poll.
Kenyan Internal Security Minister George Saitoti has been killed in a helicopter crash, officials say.
They say Mr Saitoti and his deputy, Orwa Ojode, died when the aircraft went down west of Nairobi, bursting into flames as it hit the ground.
There is no word on the cause of the crash, in which six people were killed, including bodyguards and pilots.
Mr Saitoti, a former vice-president, had been planning to run in a forthcoming presidential poll.
The 66-year-old was on his way to a security meeting when his helicopter crashed on Sunday morning.
A journalist for AFP news agency saw six charred bodies being removed from the wreckage.
Another reporter at the scene says debris of the burnt-out police helicopter were strewn in the brush.
Leading politician
George Saitoti had been a key figure in Kenyan politics, holding a number of senior ministerial posts over the last 30 years.
The professor of mathematics joined Daniel arap Moi's government as a finance minister in 1983, going on to become his vice-president in 1988.
He briefly stepped down as education minister in 1996 over accusations he was involved in the Goldenberg financial scandal, but was reinstated when a Kenyan court ruled he should not be charged.
After years as a senior member in the long-dominant Kanu party, Mr Saitoti joined the current president Mwai Kibaki's National Alliance of Kenya in 2002.
As Internal Security Minister under Mr Kibaki, he was a leading government voice against the Somali militant group al-Shabab.
Kenyan troops have been fighting al-Shabab in Somalia since they sent troops into the country last October.
The militants have killed several people in a string of grenade attacks in various parts of Kenya, including Nairobi.
Mr Saitoti announced he would stand for the presidency last November.
No date for the presidential election has so far been set. Mr Kibaki's mandate ends in January 2013.
Prime Minister Raila Odinga - a rival of both Mr Kibaki and Mr Saitoti - has also announced he was standing for president.
The last presidential election, in December 2007, was followed by a wave of ethnic and political violence in which about 1,500 were killed.
Mr Odinga has warned about the emergence of ethnically-based political groups in the run-up to the next poll.
Monday, 2 April 2012
PHARMACOLOGY OBJECTIVES-----SOKPESH's Antedote
1. Which of the following is not a side effect of the cholinoreceptor blocker (Atropine)?
A. Increased pulse
B. Urinary retention
C. Constipation
D. Mydriasis
2. Which of the following is not a side effect of the Ace Inhibitor (Captopril)?
A. Rash
B. Angioedema
C. Cough
D. Congestion
3. Which of the following is not a side effect of the Vasodilator (Nifedipine)?
A. Nausea
B. Flush appearance
C. Vertigo
D. Sexual dysfunction
4. Which of the following is not a side effect of the Sympathoplegics (Clonidine)?
A. Hypertension
B. Asthma
C. Dry oral cavity
D. Lethargic behavior
5. Which of the following is not a side effect of the Dieuretics (Loop dieuretics)?
A. Alkalosis
B. Nausea
C. Hypotension
D. Potassium deficits
6. Which of the following is not an effect of the drug (Isoflurane)?
A. Elevated lipid levels
B. Nausea
C. Increased blood flow to the brain.
D. Decreased respiratory function
7. Which of the following is not an effect of the drug (Midazolam)?
A. Amnesia
B. Decreased respiratory function
C. Anesthetic
D. Dizziness
8. Which of the following is not an effect of the drug (Clozapine)?
A. Agranulocytosis
B. Antipsychotic
C. Used for Schizophrenia
D. Increased appetite
9. Which of the following is not treated with (Epinephrine)?
A. Renal disease
B. Asthma
C. Hypotension
D. Glaucoma
10. Which of the following is not treated with (Ephedrine)?
A. COPD
B. Hypotension
C. Congestion
D. Incontinence
11. Which of the following are not treated with Barbiturates?
A. Seizures
B. Hypotension
C. Insomnia
D. Anxiety
12. Which of the following are not treated with opoid analgesics like (dextromethorphan and methadone)?
A. Pulmonary Edema
B. Cough suppression
C. Sedation
D. Pain
13. Which of the following are not treated with Hydrochlorothiazide?
A. CHF
B. HTN
C. Nephritis
D. Hypercalciuria
14. Which of the following are not treated with Nifedipine?
A. Angina
B. Arrhythmias
C. Htn
D. Fluid retention
15. Which of the following are not treated with Methotrexate?
A. Sarcomas
B. Leukemias
C. Ectopic pregnancy
D. Rheumatic fever
16. Which of the following are not treated with Prednisone?
A. Cushing's disease
B. Testicular cancer
C. Lympthomas
D. Chronic leukemias
17. Which of the following are not treated with Dexamethasone?
A. Inflammation
B. Asthma
C. Addison's disease
D. Wilson's disease
18. Which of the following are not treated with Lansoprazole?
A. Zollinger-Ellison syndrome
B. Gastritis
C. Hypertension
D. Reflux
19. Which of the following is the antidote for the toxin Heparin?
A. Protamine
B. Methylene blue
C. N-acetylcysteine
D. Glucagon
20. Which of the following is the antidote for the toxin Copper?
A. Glucagon
B. Aminocaproic acid
C. Atropine
D. Penicillamine
Mark yourself
1. B
2. D
3. D
4. B
5. B
6. A
7. D
8. D
9. A
10. A
11. B
12. C
13. C
14. D
15. D
16. B
17. D
18. C
19. A
20. D
A. Increased pulse
B. Urinary retention
C. Constipation
D. Mydriasis
2. Which of the following is not a side effect of the Ace Inhibitor (Captopril)?
A. Rash
B. Angioedema
C. Cough
D. Congestion
3. Which of the following is not a side effect of the Vasodilator (Nifedipine)?
A. Nausea
B. Flush appearance
C. Vertigo
D. Sexual dysfunction
4. Which of the following is not a side effect of the Sympathoplegics (Clonidine)?
A. Hypertension
B. Asthma
C. Dry oral cavity
D. Lethargic behavior
5. Which of the following is not a side effect of the Dieuretics (Loop dieuretics)?
A. Alkalosis
B. Nausea
C. Hypotension
D. Potassium deficits
6. Which of the following is not an effect of the drug (Isoflurane)?
A. Elevated lipid levels
B. Nausea
C. Increased blood flow to the brain.
D. Decreased respiratory function
7. Which of the following is not an effect of the drug (Midazolam)?
A. Amnesia
B. Decreased respiratory function
C. Anesthetic
D. Dizziness
8. Which of the following is not an effect of the drug (Clozapine)?
A. Agranulocytosis
B. Antipsychotic
C. Used for Schizophrenia
D. Increased appetite
9. Which of the following is not treated with (Epinephrine)?
A. Renal disease
B. Asthma
C. Hypotension
D. Glaucoma
10. Which of the following is not treated with (Ephedrine)?
A. COPD
B. Hypotension
C. Congestion
D. Incontinence
11. Which of the following are not treated with Barbiturates?
A. Seizures
B. Hypotension
C. Insomnia
D. Anxiety
12. Which of the following are not treated with opoid analgesics like (dextromethorphan and methadone)?
A. Pulmonary Edema
B. Cough suppression
C. Sedation
D. Pain
13. Which of the following are not treated with Hydrochlorothiazide?
A. CHF
B. HTN
C. Nephritis
D. Hypercalciuria
14. Which of the following are not treated with Nifedipine?
A. Angina
B. Arrhythmias
C. Htn
D. Fluid retention
15. Which of the following are not treated with Methotrexate?
A. Sarcomas
B. Leukemias
C. Ectopic pregnancy
D. Rheumatic fever
16. Which of the following are not treated with Prednisone?
A. Cushing's disease
B. Testicular cancer
C. Lympthomas
D. Chronic leukemias
17. Which of the following are not treated with Dexamethasone?
A. Inflammation
B. Asthma
C. Addison's disease
D. Wilson's disease
18. Which of the following are not treated with Lansoprazole?
A. Zollinger-Ellison syndrome
B. Gastritis
C. Hypertension
D. Reflux
19. Which of the following is the antidote for the toxin Heparin?
A. Protamine
B. Methylene blue
C. N-acetylcysteine
D. Glucagon
20. Which of the following is the antidote for the toxin Copper?
A. Glucagon
B. Aminocaproic acid
C. Atropine
D. Penicillamine
Mark yourself
1. B
2. D
3. D
4. B
5. B
6. A
7. D
8. D
9. A
10. A
11. B
12. C
13. C
14. D
15. D
16. B
17. D
18. C
19. A
20. D
Objective test Antiarrhythmics
-
Not a class I antiarrhythmic Drug:
- quinidine gluconate (Quinaglute, Quinalan)
- lidocaine (Xylocaine)
- encainide (Enkaid)
- verapamil (Isoptin, Calan)
- Not classified as a Type I antiarrhythmic
- lidocaine (Xylocaine)
- quinidine gluconate (Quinaglute, Quinalan)
- adenosine (Adenocard)
- encainide (Enkaid)
- Correct match(es) between antiarrhythmic drugs and side effects:
- quinidine gluconate (Quinaglute, Quinalan): diarrhea, cinchonism
- tocainide (Tonocard): CNS-related side effects including drowsiness, paresthesias
- procainamide (Procan SR, Pronestyl-SR): Like tocainide,CNS-related side effects including, drowsiness, paraesthesias, and hypotension
- A & B
- Corneal microdeposits, blurred vision, and photophobia:
- adenosine (Adenocard)
- encainide (Enkaid)
- amiodarone (Cordarone)
- diltiazem (Cardiazem)
- Class III anti-arrhythmic drug which also blocks potassium channels:
- quinidine gluconate (Quinaglute, Quinalan)
- sotalol (Betapace)
- bretylium (Bretylol)
- propafenone (Rythmol)
- A patient is diagnosed with atrial fibrillation and exhibits a ventricular following rate of 150 beats / min. Quinidine gluconate (Quinaglute, Quinalan) was administered and although atrial fibrillation was converted to atrial flutter, the ventricular rate increased to 190 beats / min. What is the most likely explanation for the effect on heart rate?
- Quinidine activated beta-1 cardiac receptors which cause the increase in heart rate.
- Quinidine converted the atrial fibrillation to atrial flutter which resulted in an increase in heart rate.
- Quinidine produced an anti-vagal effect and converted atrial fibrillation to atrial flutter. Both effects caused the heart rate to increase.
- Quinidine has an anti-vagal effect which facilitated transmission through the A-V node.
- Agent(s) may be effective in terminating paroxysmal supraventricular tachycardia (PSVT)?
- adenosine (Adenocard)
- methoxamine (Vasoxyl)
- propranolol (Inderal)
- all of the above
- Useful in treating third-degree (complete) heart block:
- atropine
- isoproterenol (Isuprel)
- edrophonium (Tensilon)
- A & B
- A 70 year old female patient is being treated for ventricular arrhythmias following a myocardial infarction. Runs of ventricular tachyarrythmias, episodes of ventricular fibrillation requiring cardioversion, and pulmonary congestion have been noted. Myocardial ejection fraction is very poor at 25%. Which drugs might be appropriate in this case to suppress these malignant arrhythmias?
- i.v. bretylium (Bretylol)
- i.v. lidocaine (Xylocaine)
- i.v. propranolol (Inderal)
- A & B
- Torsades de Pointes, a polymorphic ventricular arrhythmia, is associated with prolongation of Q-T intervals. Which antiarrhythmic agent is most likely to cause this arrhythmia?
- lidocaine (Xylocaine)
- quinidine gluconate (Quinaglute, Quinalan)
- digoxin (Lanoxin, Lanoxicaps)
- propranolol (Inderal)
- Best indicator of digoxin (Lanoxin, Lanoxicaps) efficacy in treating atrial fibrillation:
- shortened P-R interval
- decreased ventricular rate
- weight loss
- accelerated ventricular repolarization
- cardiac effects resemble those of quinidine gluconate (Quinaglute, Quinalan):
- digoxin (Lanoxin, Lanoxicaps)
- procainamide (Procan SR, Pronestyl-SR)
- lidocaine (Xylocaine)
- adenosine (Adenocard)
- Intravenous lidocaine (Xylocaine):
- supraventricular tachycardia
- angina
- congestive heart failure
- ventricular arrhythmias
- Most ominous sign of digoxin (Lanoxin, Lanoxicaps) intoxication:
- nausea and vomiting
- irregular P waves
- ventricular tachycardia with alterations in the QRS complex
- atrial fibrillation
- Increases automaticity:
- mechanical stretch
- isoproterenol
- hypokalemia
- all of the above
- A patient is admitted for treatment of myocardial infarction. During a prolonged recovery period, the patient experienced episodes of vetnricular tachycardia. Following discharge from hospital, the patient was instructed to take a drug to prevent recurrence of ventricular tachycardia. After a few days, the patient complained of dizziness and then lost consciousness. Upon admission to the hospital, the patient was found to be somewhat hypokalemic. A diagnosis of Torsades de Pointes was made. A test to determine the blood level of the antiarrhythmic reveal the drug was present in a slightly subtherapeutic level. What was the drug?
- sotalol (Betapace)
- procainamide (Procan SR, Pronestyl-SR)
- quinidine gluconate (Quinaglute, Quinalan) than
- lidocaine (Xylocaine)
- Procainamide (Procan SR, Pronestyl-SR) side effects:
- nausea
- hypotension
- drug-induced lupus
- all of the above
- A patient is being treated with digoxin (Lanoxin, Lanoxicaps) for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken. ECG finding(s) consistent with digitalis intoxication include:
- ectopic A-V junctional beats
- sinus bradycardia
- third degree heart block
- all of the above
- A patient is being treated with digoxin for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken. What ECG finding(s) would be consistent with digitalis intoxication?A patient is being treated with digoxin for congestive heart failure. To enhance inotropic effects, the dosage was increased. Soon afterwards, the patient complained of dizziness, fatigue, and disturbances in color vision. An ECG was taken and exhibit arrhythmias consistent with digitialis intoxication.
What antiarrhythmic drugs might be used to treat worsening ventricular arrhythmias with hemodynamic compromise?- amiodarone (Cordarone)
- lidocaine (Xylocaine)
- adenosine (Adenocard)
- propranolol (Inderal)
- Phase of ventricular muscle action potential is associated with an inward,depolarizing Ca2+ current and an outward, repolarizing K+ current.
- Phase 0
- Phase 1
- Phase 2
- Phase 3
- Automaticity:
- Phase 0
- Phase 2
- Phase 4
- none of the above
Sunday, 1 April 2012
THE PRIDE OF MY PEOPLE YESTERDAY
It was nearly dawn when the silence of the village was shattered by a
ululation which welcomes the late chief's long-awaited son.Before long
people trooped to the palace by day break one could count the number of
dancers that had come to share joy of the chief.As sun rose promising
the heat of the day.An Army vehicle arrived vomiting soldiers everywhere
this marred the day's joy.An officer
asked a young man standing by Naporoo a head teacher in Zugu primary
school who cheated so many people including a policeman he promised
securing visas to European countries but had failed.He however did not
return to them the five hundred dollar fee he collected from each of
them in no time Naporoo was arrested but the chief stood between them
and said no..(THE POWER OF CHIEFS IN THE FIGHTING DAYS)
The chief said they could not arrest anyone including Napooro without first consulting him and hence the happiness of the day pave the way for a mixed feelings.To appease the chief for a misconduct the commander veered to the market haven bought some collar and added an amount they apologized to the chief.The blessings of the chiefdom was bestowed and calm was reinstated in the village.My dear youth gone where the days when no one could there the pride of the land.Today chiefs could be arrested,killed and prosecuted all because of our lack of verisimilitude.This was a nabob fish cake and who has taken the fish cake, first-rate it was.........and now the cat has taken the fish cake....The kingdom needs peace !
The kingdom is sold today for one chillings.The potentials of the kingdom is rusted.Hatred is traded from brother to the other and from onr sista to the other.I dream peace to this kingdom before demise.God shall birth and rain peace in this kingdom!
The chief said they could not arrest anyone including Napooro without first consulting him and hence the happiness of the day pave the way for a mixed feelings.To appease the chief for a misconduct the commander veered to the market haven bought some collar and added an amount they apologized to the chief.The blessings of the chiefdom was bestowed and calm was reinstated in the village.My dear youth gone where the days when no one could there the pride of the land.Today chiefs could be arrested,killed and prosecuted all because of our lack of verisimilitude.This was a nabob fish cake and who has taken the fish cake, first-rate it was.........and now the cat has taken the fish cake....The kingdom needs peace !
The kingdom is sold today for one chillings.The potentials of the kingdom is rusted.Hatred is traded from brother to the other and from onr sista to the other.I dream peace to this kingdom before demise.God shall birth and rain peace in this kingdom!
Wednesday, 4 January 2012
2ND TRIMME PHARMACOLOGY!
<> > | ||
Thiazides
|
Potassium
Sparing
|
Loop
Diuretics
|
- Chlorothiazide (Diuril)
- The thiazides act in the distal tubule to decrease
sodium reabsorption (inhibits Na/Cl transporter).
- As a result of decreased
sodium and chloride reabsorption, a hyperosmolar diuresis ensues.
- Delivery of more sodium to
the distal tubule results in potassium loss by an exchange mechanism.
- Thiazides also promote calcium reabsorption, in
contrast to loop diuretics.
- The initial decrease in blood volume followed by a
longer-termed reduction in vascular resistance appear to account for the
hypotensive effects of the thiazides.
- Adverse Effects
- Potassium depletion is a
potentially serious side-effect that may require potassium
supplementation and/or concurrent use of potassium-sparing diuretics.
- Hyperuricemia may occur
precipitating gout.
- The increase in systemic
uric acid is due to a decrease in the effectiveness of the organic acid
secretory system.
- Diabetic patient may
have difficulty in maintaining proper blood sugar levels.
|
- Furosemide (Lasix), Bumetanide
(Bumex),Ethacrynic acid (Edecrin)
- Furosemide (Lasix), bumetanide (Bumex), and ethacrynic
acid (Edecrin) are "high-ceiling" loop diuretics acting
primarily at the ascending limb of the loop of Henle.
- The effectiveness of these
agents is related to their site of action because reabsorption of about
30 - 40% of the filtered sodium and chloride load occurs at the
ascending loop.
- Distal sites are not able to
compensate completely for this magnitude of reduction of NaCl
reabsorption.
- Loop diuretics increase urinary Ca2+ in
contrast to the action of thiazides.
- Loop diuretics also increase renal blood flow by
decreasing renal vascular resistance.
- These drugs are rarely used in the management of
hypertension because of their short duration of action and the
availability of better drugs.
- Adverse Effects
- Ototoxicity
- Furosemide (Lasix) and
ethacrynic acid (Edecrin) block renal excretion of uric acid by
competition with renal secretory and biliary secretory systems.Therefore
these agents can precipitate gout.
- Potassium depletion.
Furosemide
|
|
<> > | ||
Centrally
Active
|
Adrenergic
Neuron Blocker
|
Adrenoceptor
Antagonists
|
- Clonidine
(Catapres) (Sympatholytic)
- Antihypertensive:
- Clonidine (Catapres) acts in
the brain, inhibiting adrenergic outflow from the brainstem. Inhibition
of sympathetic outflow results in a decrease in blood pressure.
- Mechanism of action:
centrally acting selective a2 adrenergic agonist.
- Especially effective in
- Transdermal clonidine
(Catapres) patch: useful for surgical patients unable to take oral
formulation
- Clonidine (Catapres) reduces
cardiac output (by reducing both stroke volume and heart rate) and
peripheral resistance.
- Reduction in stoke volume
occurs due to increased venous pooling (decreased preload).
- Clonidine (Catapres) does not
interfere with cardiovascular responses to exercise.
- Renal blood flow and function
is maintained during clonidine treatment.
- Clonidine (Catapres) has
minimal or no effect on plasma lipids.
- Other Clinical Uses
- Analgesia--
- Preservative-free clonidine
administered into epidural/subarachnoid space (150-450 micrograms)--
dose-dependent analgesia
- No respiratory depression,
nausea, vomiting, delayed gastric emptying or pruritus -- effects
associated with opioids
- Probable Mechanism: activation
postsynaptic a2 receptors in the spinal cord substantia
gelatinosa
- Clonidine (Catapres)
& morphine: no cross-tolerance when used concurrently in neuraxial
analgesia
- Side effects of neuraxial
clonidine (Catapres)
- hypotension,
sedation, dry mouth
- Preanesthetic Medication:
- Oral clonidine (Catapres)
(preanesthetic medication):
- Enhances intrathecal
morphine + tetracaine (pontocaine) for postoperative analgesia (no
increase in morphine-related side effects)
- Preanesthetic clonidine
(Catapres) also:
- Reduces reflex tachycardia
that may be caused by direct laryngoscopy for tracheal intubation
- Reduces intraoperative
blood-pressure heart rate lability
- Reduces plasma
catecholamines levels
- Significantly decreases
anesthetic requirements for inhaled (MAC) and injected agents.
- Adverse Effects
- Dry Mouth (xerostomia)
- bradycardia (in patients with
SA nodal abnormality)
- Withdrawal syndrome upon
abrupt discontinuation (increased blood pressure, headache, tachycardia,
apprehension, tremors
Clonidine
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