Term Paper on "Drug Treatment of Metabolic Syndrome"

Term Paper 5 pages (2046 words) Sources: 13

[EXCERPT] . . . .

Drug Treatment of Metaboilic Syndrome

Drug Treatment of Metabolic Syndrome

Metabolic Syndrome

Hypertension

Introduction and rationale for drug classification selection and its impact upon hypertension

It is significant considering a patients pressure of up to 160/100 with medication prescription for stage 1 treatment of necessity (140/90 to 159/99 mm Hg). Doctors regard the control of blood pressure as a number game with the value of any given antihypertensive drug's judgment basing on an individual. This depends on the medication significant reduction of blood pressure. It is recommendable by experts to start taking antihypertensive drugs within the considerable lowest dose. This is with gradually making increments until the pressure attains its perceived normal level. Following the occurrence of side effects, replacement with differing medication is, however, advisable. Blood pressure adequate control is possible in the majority with hypertension (Izzo, 2007).

Classes of hypertension drugs

Selection of several classes by the specified doctors is possible in antihypertensive drugs. The drugs include diuretics, calcium-channel blockers, anti-adrenergic, angiotensin-converting-enzyme (ACE) inhibitors, direct-acting vasodilators and angiotensin-receptor blockers (ARBs). Three significant, potent classes have been into test inclusive of endothelin-receptor antagonists, direct rennin inhibitors and vaso peptidase inhibitors (Lilly & Harvard Medical School, 2011).

(i) Diuretics

They are commonly referable to as "water
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pills." They are the least expensive and oldest class of antihypertensive drugs applicable in the treatment of hypertension. They contribute significantly to the kidney with the elimination of water and sodium from the body. The process enables the decrease in the volume of blood with the heart pumping less. This is with each beat in turn assisting in lowering the blood pressure. Intake of the drugs requires proper intake of potassium supplements (Izzo, 2007).

The common, experienced side effects of the drugs include lightheadedness, frequent urination, diarrhea, fatigue and muscle cramps. In men, the occasional experience is erectile dysfunction. Diuretic results to a painful arthritis known as gout that is from uric acid accumulation in the general body. This is since there is an elevation of blood levels of the specified substance. Thiazide diuretics cause the elevation of blood sugar levels enough to result into diabetes in some people. There should be proper monitoring of blood sugar levels in the individuals using diuretics for control of blood pressure (Mutnick, 2004).

Anti-Adrenergics

They tend to lower the pressure of blood through limiting of hormone action inclusive of nor epinephrine and epinephrine thereby inducing the relaxing aspect of the blood vessels. This enables the reduction of the force and speed of the heart contractions. The Peripheral adrenergic-receptor blockers work through the prevention of the neurotransmitters form an attachment to the cells that enable the stimulation of the blood and heart vessels. The alpha-blockers side effects include orthostatic hypotension, dizziness, heart palpitations, nasal congestion, dry mouth and headaches. The drugs can result to erectile dysfunction (Mutnick, 2004).

Direct-acting vasodilators

They tend to make the arteries relaxed. They are usually applicable during emergency cases and acts quickly. They can also cause tachycardia and fluid retention hence prescribed with the combination of other blood pressure medication slowing the rate of heart. The vasodilators directly acting are mostly applicable in treating hypertension. They may cause weakness, headaches, nausea and flushing. They can also cause an increment in blood sugar (hyperglycemia) and fluid retention (Mutnick, 2004).

Calcium blockers

They slow calcium movement into muscle cells that are smooth in the heart. This enables the weakening of the heart muscle contractions with dilate's blood vessels hence lowering the pressure of the blood. Their often prescription is for arrhythmias. The side effects common include edema, headache, heartburn, constipation and bradycardia (Porth & Hannon, 2009).

Angiotensin-receptor blockers (ARB)

The class of medication blocks the angiotensin from constricting the vessels with stimulating water and salt retention. They do not regularly produce side effects (Mutnick, 2004).

Direct rennin inhibitors

They inhibit rennin activity, the enzyme that contributes largely to angiotensin II levels.

The hypertension state pathophysiology

There is a considerable uncertainty with pathophysiology of hypertension. Patients in the percentage measure of 2% and 5% viewed to have the underlying adrenal or renal disease that enables the cause of raised blood pressure. A number of specified physiological mechanisms guaranteed to be involved in normal blood pressure maintenance with derangement playing the part in essential hypertension development (Mutnick, 2004). The physiological mechanisms considered in the essential hypertension development include:

Peripheral resistance and cardiac output

Rennin-angiotensin system

Autonomic nervous system

Endothelial dysfunction

Vasoactive substances

Hypercoagulability

Insulin sensitivity

Genetic factors

Intrauterine influences

Diastolic dysfunction

Drug Treatment of Metabolic Syndrome

Diabetes II

Diabetes II is a chronic disease which is caused by high sugar levels in the blood. This type of diabetes is the most common diabetes type. Diabetes 2 is caused by bodily predicament in that, the way a body makes and use insulin determines the disease. In a human body, insulin plays a vital role in the way blood sugar moves into cells, thus where storage and usage takes place. In case a person has the type diabetes 2, liver, fat and the muscle cells fail to respond correctly to the body insulin. Hence, it causes insulin resistance in the body. Consequently, the glucose in the body fails to get into the required cells which are for energy storage. In case sugar fails to enter the cells, high sugar levels will upsurge in the blood. This situation is called hyperglycemia (Codario, 2011).

The pathophysiology of Diabetes II mellitus is usually distinguished by insulin insensitivity or peripheral insulin resistance, damaged regulation of the bodily hepatic glucose production, cell damage and a decline in beta (ss) cell function. All these will result to a possible ss-cell failure. The primary occurrences are said to be an original insulin insensitivity which will result to peripheral insulin resistance. As the disease drags on, it will result to a relative insulin deficiency (Davidson, 2010).

Dose and Treatment

Patients suffering from Diabetes II require excessive and regular monitoring or constant treatment in order to maintain a semi-normal sugar levels in the blood. Treatment of the Diabetes II disease may include medications which are essential in minimizing diabetes risk and cardiovascular problems such as strokes and heart attacks, self-care measures, and life adjustments. In some cases, higher dose are required with insulin. The daily basal insulin dose is required substantially. With the intention of determining whether there is insulin dose required and pancreatic reserve relationship, thus in order to achieve a perfect metabolic control in the Diabetes II patients, various researches has to be done to achieve good results.

Rationale for drug classification selection for Diabetes II

Oral drugs which may be used to cure this type of diabetes may cause heart failure. Many medics propose the usage of thiazolidinediones class of drugs. Although in some cases, the oral drugs help in reducing sugar levels in the blood (Wilson, 2010).

Side effects of diabetic 2 drugs

Medications to a diabetic 2 patient are administered depending on the person's health and the blood sugar levels. Depending on the person's health history, the physician will then know whether to administer one or various oral medications to the patient. Some of the side effects of diabetic 2 drugs include; sulfonylureas, Biguanides, alpha-glucosidase inhibitors, thiazolidinediones and Meglitinides. Generally, these side effects may entail issues with weight whereby a patient might lose or gain a lot of weight, swelling of the ankle or the legs, anemia, appetite lose, nausea, yellowing of the skin, excessive vomiting and dark urine. In some cases, a patient might suffer from stomach pains or may have bloating problem (Aronson, 2011).

Obesity

Obesity is defined as the accumulation of excess body fats. It is a chronic disease just like diabetes or high blood pressure. The disease has long-term effects on the health of the victim. Weight loss drugs or anti-obesity medication are all pharmacological agents that would either manage or reduce weight (Sharma 2008). FDA approved (in 1999) the use orlistat (Xenical) on long-term basis as anti-obesity medicine. Orlistat reduces the rate of intestinal fat absorption by inhibiting the secretion and activities of the pancreatic lipase. Orlistat is only applicable in instances where the BMI exceeds 30. Rimonabant (Acomplia) is another obesity drug that works best via specific blockade of the endocannabinoid system (Sharma 2008).

Sibutramine (Meridia), works in the brain by inhibiting the process of deactivating the neurotransmitters and in the end reducing appetite. Just like Orlistat, Sibutramine has side effects to user. This drug has since been withdrawn from the shelves in the United States and Canadian markets due to rising cases of cardiovascular apprehensions (Bolen et al. 2010). Phentamine (Adipex-P, lonamin, Fastin) is a stimulation medication that FDA approved in 1959. It suppresses appetite. However, the drug is only applicable for short-term use (for a few weeks). Relevant side effects of the drug include lung and heart conditions usually resulting from a combination of phentermine and fenfluramine. The diagnostic and laboratory testing needed is about measuring the BMI of the patient before making conclusive remarks of the presence or absence of obesity (Bolen et al.… READ MORE

Quoted Instructions for "Drug Treatment of Metabolic Syndrome" Assignment:

Hello *****,

These are the instructions for the research paper that I need to be completed ASAP! In 24 hours (). This paper is in regards to the Pharmacological Treatment of Hypertension, Diabetes II and Obesity (Metabolic Syndrome). The paper is a research paper that must include the following information (As headings regarding the SPECIFIC MEDICATIONS THAT WILL BE USED FROM WITHIN A DRUG CLASS). This paper has to include 10 to 13 sources of PEER REVIEWED SOURCES AND OTHER CLINICAL EVIDENCE (NO NEWSPAPER ARTICLES OR OTHER NON VALIDATED RESEARCH). The paper has to be no more than 5 pages (excluding the title and reference pages) and written in APA 6th edition format. I just want a really well written evidence based paper

Instructions and Headings for the paper (must be followed)

Introduction and rationale for drug classification selection and its impact upon the co-morbid disease states.

Must identify disease state pathophysiology (co-morbid conditions that are selected from the list

discuss classification of drugs commonly used and specific medications that would be considered in the management of common concomitant disease states.--- MUST BE SPECIFIC NOT JUST GENERAL

Discuss selection of therapeutic agents (within the classification) --SPECIFIC

Appropriate dose and dose increments required

Relevant side effects and drug-drug interactions

Metabolism and excretion patterns of the specific drugs

An appropriate follow up plan for the patient

Diagnostic and laboratory testing needed or required

Patient and family education

APA 6th edition format

No more than 5 pages (excluding the title page and references (13 peer reviewed references)

Appropriate use of primary references that hold the highest level of clinical evidence

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