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part d Tutorial on blood pressure 2025 | PharmacoPhoto | YouTubeToText
YouTube Transcript: part d Tutorial on blood pressure 2025
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Core Theme
Fixed-dose combination pills, exemplified by candesartan and hydrochlorothiazide, offer significant advantages in drug therapy, primarily through enhanced efficacy, reduced side effects, and improved patient compliance, though careful monitoring for electrolyte imbalances remains crucial.
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Okay. So, if you don't have any
questions about that portion of the
tutorial, then we're going to take the
final sub question, which is sub
question three. That's going to be using
fixed pill combinations of candisartin
and hydrochloroioide
as an example. explain some of the
overall advantages of fixed pill
combinations of drugs and briefly
discuss the side effects of Candaceartin
combined pills cited in the tutorial as
the most important and what needs to be
done in order to prevent that side effect.
effect.
Now, one note about this is that there
is a TGA report that's available in the
area that you'll find your PowerPoint
and all of the notes and everything.
There's a TGA report about the combined
uh medication that we're talking about.
Candaceartin and hydrochloroioide are
combined. So, if you have any questions
about that, that's your first resource.
That's a really really really good
resource and you'll find you know lots
more information more than you you
actually need for the answer to this
question. But if you're missing anything
at the end of it just take a look at
that TGA report.
often times we uh have two different
drugs that are are used together and you
know a physician will start saying well
I'm going to give you two prescriptions
one for candisartin and one for hydrochloroarthide
hydrochloroarthide
and that's because you know a lot of
physicians have actually found that the
there's a lot of benefits there's
additional benefits to having the two uh
so then the drug companies will get
together and say, "Well, actually, it's
being prescribed a lot and there doesn't
seem to be anything. So, let's go
through these additional tests and
actually combine the two and sell them
as one drug." So, that happens uh that
happens a lot because there's a lot of
uh advantages to the the combined pills.
A lot of times there's a lot of
advantages to the combined pills and we
want to get those advantages. So for
instance, one of the advantages could be
that it's an additive effect. So maybe hydrochloroioide
hydrochloroioide
has uh a decrease in blood pressure by 7
millimeters of mercury and candisartin
has a decrease of blood pressure by the
same thing uh 7 millm of mercury. We
wind up with 14 millimeters of mercury.
We get that additive effect. A
synergistic effect would be better. It's
more like instead of 1 plus 1 equals
two, uh, synergistic would be like 1
plus 1 equals 21. Uh, but we don't
really have very many medications that
actually do that synergistic effect. Uh,
but the best we can hope for is usually
an additive effect. So with Candaceartin
and hydrochloroioide, we get the full
benefit of both medications, which is
really good.
And because of the fact that we get the
benefit from both medications, a lot of
times what we can do is decrease the
dose. And as we decrease the dose,
there's going to be less side effects.
The person is basically taking less
medication or having less of a
possibility of side effects or toxic
effects and so forth. So just there
there's a few uh different reasons. Uh
one of the other reasons that
candesartin and hydrochlorioide are good
combined is because one of them uh the
candaceartin is actually potassium
sparing and hydrochloroioide is
potassium wasting and combined you'll
often times find that you don't have to
uh analyze the the electrolytes as
frequently. you still have to analyze
the electrolytes because one could wind
up with hypo or hyper calmia. Uh but but
oftentimes it's much better controlled.
You you know you you don't have to worry
about it as much and there's a much less
possibility of having hyper or hypoc
calmia. Let's put it that way. Uh
another thing why there's an advantage
to the fixed pill combination of hydrochloroioide
hydrochloroioide
and uh candisartin
is that the TGA needs to analyze the
medication you know uh back in in the 1960s
1960s
in Australia there was a thing called
beex powders and what beex powders was
was a combination of analesics which
were widely ly sold separately. And as
they were widely sold separately, they
didn't really result in very much of
toxicity and we didn't really we weren't
really aware of extreme toxicity as they
were sold separately. But as they
combined them, what ended up happening
is you know how I said synergistic 1
plus 1 equals 21. We don't use that term
when we're talking about toxicity, but
it was acting like that. it was acting.
You know, there's a little bit of
toxicity here, there's a little bit of
tox, a little bit more toxicity here,
but you combine those two and you wind
up with endstage renal disease. And that
really happened that happened in the 1960s
1960s
and uh quite extensively, especially in
uh Queensland. So uh so it was
extensively marketed in Queensland. But
now because of that, because of the fact
that we have that to say never do that
again, the TGA says no drug company, if
you want to sell those two together, you
need to test them together. So, you know
that they're not as toxic as some other
combination might be. you know, uh you
we have it often times a lot of times we
we combine two or three
anti-hypertensive medications and you
wind up with a good control of your
hypertension, but of you don't know like
is it causing some some problems or is
it not? Well, with this combined pill,
you're going to be able to know for
sure. Yes, it's been tested together. we
know that there is no inherent toxicity
and so forth. And then finally, uh the
other thing that I just want you to
identify is that there's better
compliance in a lot of people. A lot of
your a lot of your clients are going to
be elderly, they're going to be
forgetting medication. This one
medication, you take it one time a day,
uh better compliance. So, so that's a a
another uh advantage to fixed pill combinations
combinations
of of pills.
And then the last portion of that ble
briefly discuss the most important side
effect of candisart and hydrochloroioide
combined pills. You might find other
side effects in the TGI report, but I
just did want to flag this just to
remember, just so that you can remember.
One of those two drugs causes hyperc
calalemia. The other causes hypocalemia.
And you would think that combined
they're going to cause no effect on on
potassium levels. But that's not always
true. Sometimes you find out find
somebody with hyperc calalemia other
times hypoc calalemia and both of them
are potentially life-threatening. So you
really really do have to test the
electrolytes. So with that one you say
it can cause hyper or hypoc calmia
despite the fact that you think that
they wouldn't and uh therefore the
electrolytes should be uh taken uh and
the client should be instructed as to
what to expect with one of those either
one of those you know so there's muscle
fatigue uh there's and it goes all the
way up to paralysis coma and death but
you just tell them you A few few of the
things uh that hyper or hypoc calmia
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