hello everypony, in this page i'll be talking about what we call in pharmacy - fast runners.
aka drugs that are constantly being prescribed therefore we run out fast. every pharmacy has
their own select fast runners but i'll be going over the more popular ones such as -sartans, -statins and ACE inhibitors.
i've gone over other fast runners on these pages
bowel disorders, depression and axniety and epilepsy
so lets get started on the -sartans! what does the suffix mean? it's creates the group name for the angiotensin ii receptor blockers. they are also known as ARBs. it's used to treat hypertension, heart failure and chronic kidney disease. they bind to the angiotensin II receptor type 1 and inhibits it. it then blocks the arteriolar contraction aka vasoconstriction which is the narrowing of blood vessels. and blocks sodium retention effects which is when there is a high concentration of sodium in the blood (Hypernatremia) those are effects of the renin-angiotensin system which is a hormone system that regulates the blood pressure, fluid and electrolyte balance and the systemic vascular resistance. these drugs selectively block the activation of the AT1 receptor which prevents the binding of angiotensin II. it's a first-line antihypertensive. the blockers have different potencies in relation to controlling blood pressure with very different effects at maximal doses. some of the drugs have a uricosuric effect which is the increase of uric acid in the urine which reduces the concentration of uric acid in the blood plasma. since angiotensin II becomes a major stress hormone through AT1 receptor stimulation and ARBs block those receptors it may be used for treatment of stress disorders. the drugs in this group are lorsartan (Cozaar), irbesartan (Aprovel), olmesartan (Benicar), candesartan (Atacand), valsartan (Diovan) and fimasartan (Kanarb) include the tetrazole group which is a ring with four nitrogen and one carbon. losartan, irbesartan, olmesartan, candesartan and telmisartan (Micardis) include one or two imidazole groups. the AT1 receptors are found in the smooth muscle cells of vessels, adrenergic nerve synapses and cortical cells of the adrenal gland. the blockage of that receptor causes vasodilation, reduces the secretion of vasopressin and reduces secretion and production of aldosterone and the mix of that among other actions reduces blood pressure.
next we have the -statins! their more professional name is HMG-CoA reductase inhibitors. they lower cholesterol. the bad cholesterol aka low-density lipoprotein (LPL) plays a key role in the development of coronary heart dsease via lipid hypothesis. statins are lipid-lowering meds they are effective in lowering apoilpoprotein B and LDL. they inhibit the enzyme HMG-CoA reducatse which plays a big role in the production of cholesterol. the most important and know adverse effects is the increased risk of diabetes mellitus, increased liver enzymes in the blood due to liver damage and muscle problems. and in this section is where CYP3A4 comes in. which is found in grapefruit and its juice. it inhibits the metabolism of certain statins and many other drugs. furanocoumarins are found in grapefruit juice and that inhibits the cytochrome P450 enzyme CYP3A4 which is involved of metabolizing of statins and other drugs. this increases the levels of statin in the bloodstream which increases the risk of those adverse effects. statins and HMG-CoA are similar in structure on a molecular level the statin can fit into the enzymes active site and compete with its native substrate, this reduces the rate at which the enzyme can produce mevalonate which is the next molecule that ends up producing cholesterol. natural statins are produced by penicillium and aspergillus fungi.