Thursday, 29 May 2014

Free post 3


Heart Failure
Today I will talk about at heart failure, its pathophysiology and some drugs used to treat it.
The reason I tell you about this disease is because the main cause of death in Chile are heart disease (heart failure mainly) inclusive more than cancer (first cause of death in developed country). Cancer is the second cause of death in Chile. Women are less prone to these diseases only until menopause, because the progesterone hormone that protects your cardiovascular system (protective function for the pregnancy). However it is only until menopause, after this incident, the chances are equal both men and women.
Heart DiagramHeart Diagram









The human heart is located within the thoracic cage in the middle of the lungs, shifted to the left. The heart is composed of many specialized tissues such as nerve tissue, whose failure also produces arrhythmias or muscle tissue, which results in heart failure.





The heart consists of four chambers, two upper called atria (right and left) and two lower chambers called ventricles (right and left). The atria and ventricles are separated by a septum, therefore there is no contact between the left and right blood from the heart. The atria and ventricles are separated by atrioventricular valves that open when the pressures are equalized between the chambers. The heart is the main organ of the cardiovascular system, where two types of circulation, pulmonary circulation where oxygen-poor blood from the heart is oxygenated, and systemic circulation which carries oxygenated blood to all tissues through the arteries. But there is a third circulation, the coronary circulation. Coronary circulation is responsible for oxygenating the tissues that form the heart. There is a right coronary artery and a left which bifurcates into two arteries, the circumflex artery and left descending coronary artery. When there is a demand on cardiac either for sport or any thrombus in blood vessels, normal heart becomes enlarged, what is known as cardiac hypertrophy. But there are two types, the physiological and pathological. Physiological hypertrophy is common in high-performance athletes and is completely reversible, the hypertrophic heart returns to a normal heart. Pathological hypertrophy is irreversible and is caused by a remodeling of the muscular wall of the left ventricle which mainly is what makes all pressure to the systemic circulation. After this remodeled heart if the demand continues to increase, the muscular walls are changed by fibrinogen, tissue is cardiac impulse insulation and is also very rigid, resulting in heart failure. Can also result in cardiac hypertrophy due to cardiac ischemia. Ischemia is a lack of oxygen in the cells which results in cell death. Cardiac ischemia is caused by the accumulation of cholesterol plaques in blood vessels called atheroma plaques. These plaques cause atherosclerosis. In the heart, at the bifurcation of the left coronary artery, high blood turbulence occurs which leads to increased accumulation of atheroma plaques, leading to ischemia in the left ventricle. Because of this ischemia, cell death occurs, which generates a hypertrophied heart which eventually will be heart failure. The most important risk factors of this disease are: salt, since it produces hypertension, a diet high in fat and cholesterol, due to the formation of atheroma plaques, a sedentary lifestyle, due to the accumulation of fat, stress, and that produces a constant pressure rise, family heritage, since this disease easily in a few generations . Pharmacological treatment for a person with heart failure is chronic use of antiplatelet drugs to prevent thrombus formation (aspirin), cholesterol lowering by hypocholesterolemic drugs (statins), antihypertensive drugs use to reduce peripheral vascular resistance to the blood pressure (nifedipine) and coronary vasodilators drugs in preventing cardiac ischemia (nitrates and nitrites).

Thursday, 22 May 2014

Blog session 7

A career-related website

The website that I'm going to comment is very important for health's professionals because here I find out information related with health problems on the country. 
The website is <http://www.ispch.cl/> and this page is the free access, have update information and is manager by Public Health Institute that belong to the Ministry of Public Health on Chile.
I discovered this website for obligation because I review must constantly for to be informed. The teacher of my Faculty Higher Studies we present the website and explain about this. This I use for know all drugs-related, for example, the drug withdrawal (active pharmaceutical ingredient) of the trade because the production laboratory failed to comply with the minimum requirements for the make this drug. Also in this page you find a list with the sanitary investigations, health scares, theft of the pharmaceutical products, information of the Pharmacovigilance, health studies and enrollment pharmaceutical and cosmetic products.
I recommend you this website for find out all health-related update information. Something very important for check I would be the health scares and new adverse drug reaction, thus if exist a serious adverse drug reaction, for example, rise the pressure or more serious (neurological problems) until to death, the Ministry study it and decide that do (pharmacovigilance committee). Also I find out a list of the pharmaceutical and cosmetic products enrollment and therefore if exist counterfeit products or no-enrollment products (that is illegal on Chile) that are to buy, you can report in this page and it perform a sanitary investigation for to resolve the problem and take legal actions. If you have had problems with a drug, for example, carton damage or blisters empty, you can report too in this page.

Thursday, 8 May 2014

Free post 2

The journey of the drug

When the drug is removed of the blister it begins a long journey to be completely degraded. The drug is swallowed together with water and this serves to disperse the granules compressed and solubilize them. Depending on the size of the granules is the rate at which it dissolves. Finally when is completely dissolved start a process very important and meaningful named absorption. If the entire drug was solubilized and absorbed we obtain a 100% of the drug in plasma but if it dissolved or absorbed least will exist fewer drug available in plasma.

Now we find with second process known as distribution. This process consists on how the blood drug is distributed to the tissues to produce the pharmacologic effect. Each drug has different properties that depend of her molecular structure, for examples some drugs are soluble in water known as hydrophilic drugs and also exists drugs are soluble in oil known as lipophilic drugs. For that pharmacological effect occurs the drug need interact with the cell receptor that is compatible. Therefore if we have an obese person and consume a lipophilic drug, this drug will be distributed in the fat (adipose tissue) and will be not distributed in the receptors tissues of the drug. Thus for those obese people should be increasing the dose of the drug, for increase the absorption and thus to increase percentage of drug distributed to the tissues for to produce pharmacological effect.

Parallel to this process occurs two more. Since the drug is distributed to the receptors tissues also is distributed to the liver in which is metabolized process term metabolization, however also is distributed to the kidneys in there occurs the last process denominated elimination. The metabolization consists in how the enzymes through of chemical reactions turn to the drugs in hydrophilic drugs for easy excretion through the urine. Here comes the concept of half-life, characteristic for each drug. The half-life is the time in which half of the drug in the blood is degraded. Therefore drug with less half-life should disappear en least time or vice versa. For example exists drugs that have a half-life of 6 hours. The blood drug is degraded a 99% when has passed 5 to 7 half-life, therefore if consume the previous drug (6 half-life) in 30 to 42 hour there will be not blood drug.


Thus the last process consist in the filtration the blood in which several substances are extracted, drugs including, producing the urine. In this way the journey of the drug terminates. All these processes are studied in detail by health professionals (ADME), process known as pharmacokinetics that is defined as what the body does to the drug.