Angina pectoris

Treatment protocol:
1. Nitroglycerine:

Generic name Brand name

Nitroglycerine Nitrostat, Tradil, Nitro-dur
Uses: It is used to treat angina pectoris, heart failure and myocardial infarction.
Adrs: Headache, flushing, rash, dizziness, weakness, tachycardia
2. Beta adrenergic blocking agents:
GENERIC NAME BRAND NAME
Atenolol Adonax, Tenormin, Atelor
Propranolol Butanol, betablock, Inderal
Metoprolol Merol, Meprol, Lopressor
Uses: it is used in arrhythmia, heart failure, angina, migraine and certain types of tremors.
Adrs: Drowsiness, fatigue, dizziness, and weakness
3. Calcium channel blocking agents:

GENERIC NAME BRAND NAME

Amlodipine Norvasc
Diltiazem Cardizem & Tiazac
Felodipine Felpine & plendil
Isradipine Dynacirc
Nicardipine Nicarpress-R
Verapamil Calan SR, Verelan
Uses: Calcium channel blockers are medications used to lower blood pressure, cluster
headache and heart arrhythmia The medications may also be prescribed to relieve chest pain
(angina) and control an irregular heartbeat.
Adrs: Constipation. Dizziness. Fast heartbeat (palpitations)

4. Antiplatelet medication:
Generic name Brand name
Clopidogrel Plavix
Ticagrelor Brilinta
Prasugrel Effient
Aspirin Aggrenox
USES:
Antiplatelet drugs can reduce the chance of a heart attack because they prevent abnormal
clotting in the arteries by telling platelets not to stick together and form a blood clot.
ADRS:
GI bleeding, angioneurotic edema, rhinitis and urticaria
5. Anticoagulant MEDICATION

GENERIC NAME BRAND NAME

Apixaban Eliquis
Dabigatran Pradaxa
Edoxaban Lixiana
Warfarin Coumadin
USES:
Anticoagulants are used to prevent blood clots, or in conditions where the risk of blood clots is
increased to reduce the risk example, Atrial fibrillation, Deep vein thrombosis (DVT), Hip or
knee replacement surgery, Ischemic stroke, Myocardial infarction (heart attack) and Pulmonary
embolism.
ADRS:
Bleeding, Gastrointestinal effects such as diarrhea, heartburn, nausea, and loss of appetite and
Shortness of breath.

Gastroenterology (peptic ulcer disease)

TREATMENT PROTOCOL:
1. PROTON PUMP INHIBITORS
GENERIC NAME BRAND NAME
Omeprazole Prilosec

Esomeprazole Nexium

Lansoprazole Prevacid

Rabeprazole AcipHex

Pantoprazole Protonix

USES:
PPIs treat conditions that are caused by either an overproduction of stomach acid or
exacerbated by stomach acid. PPIs used for the treatment of Acid reflux, also
called gastroesophageal reflux disease (GERD), Conditions characterized by an overproduction
of stomach acid (such as Zollinger-Ellison syndrome), Duodenal or stomach ulcers including
those caused by NSAIDs.

ADRS:
Headache, Fever, Gastrointestinal effects (such as abdominal
pain, constipation, diarrhea, flatulence, nausea, or vomiting), Light-headedness, Rash, Tongue
discoloration or taste disturbances.

2. H2-RECEPTOR ANTAGONISTS:
GENERIC NAME BRAND NAME
Famotidine Pepcid AC, Pepcid
Cimetidine Tagamet, Tagamet
Ranitidine Zantac, Zantac
Nizatidine Axid AR, Axid
USES:
H2 blockers are used to treat a peptic or stomach ulcer and used to relieve symptoms of acid
reflux, or gastroesophageal reflux disease (GERD). This is a condition where food or liquid
moves up from the stomach into the esophagus (the tube from the mouth to the stomach).
ADRS: constipation, diarrhea, difficulty sleeping, dry mouth, dry skin, headaches, ringing in the
ears & runny nose.
3. PROSTAGLANDINS
GENERIC NAME BRAND NAME
Carboprost Hemabate
Dinoprostone Cervidil
Misoprostol Cytotec
Latanoprost Xalatan

USES: They are used to treat stomach ulcers, glaucoma and congenital heart disease in
newborn babies.
ADRS: Heart attack and stroke, Increased blood pressure, Kidney problems, Allergic reactions
& bleeding.
4. BISMUTH PREPARATION

GENERIC NAME BRAND NAME

Bismuth salicylate Kaopectate, Pepto Bismol, Maalox

USES:
This medication is used to treat occasional upset stomach, heartburn, and nausea.
ADRS:
Abdominal pain, anal discomfort, anxiety, black or 'hairy' tongue, clay-colored or gray-black
stools and dark urine.
5.  Protectants (Sucralfate)
Generic name Brand name
Sucralfate Carafate
Uses:
Sucralfate is used to treat and prevent the return of duodenal ulcers. It sticks to damaged ulcer
tissue and protects against acid and enzymes so healing can occur.
adrs:
Constipation, diarrhea, nausea, vomiting, gas, indigestion, itching, rash, dizziness, drowsiness &
sleep problems (insomnia)
6. Antacids
Generic name Brand name
Aluminum hydroxide gel Alternagel, Amphojel
Calcium carbonate Alka-Seltzer, Tums
Magnesium hydroxide Milk of Magnesia
Uses:
An antacid is a substance which neutralizes stomach acidity and is used to relieve heartburn,
indigestion or an upset stomach.
adrs:
Constipation, aluminum-intoxication, osteomalacia, and hypophosphatemia.

PART 2
MODELS OF CLINICAL
PHARMACY

 Medicine information: Clinical pharmacists are the experts in the therapeutic use

of medicines in the healthcare team and may perform various tasks including: Evaluating
medication therapy and making appropriate recommendations to patients or health
practitioners. ... Assisting in direct care of patients in hospitals and surgeries. The medicines
information research has concerned different levels of pharmaceutical care and healthcare,
aiming to promote the accessibility and quality of medicines information.
 Quality assurance:
The purpose of a QA program for hospitals and clinic’s is to ensure that every medicine
reaching a patient is safe, effective, and meets quality standards. ... Medicines received from
suppliers and donors are monitored to meet quality standards. QA activities in a hospital or
 clinic should be comprehensive, spanning the entire supply process from medicine selection
to patient use. Many areas within a health care system may be involved with quality
assurance, including procurement, pharmacy, medical, and nursing departments, as well as
the DTC.

 Technical service:
Pharmacy technical services include aseptic dispensing and preparation, production, radio
pharmacy and quality assurance and control.

 Medicine aquisition/ purchasing:

The pharmaceuticals and related items form a specialty which requires technical skills of a
properly trained individuals for their proper selection and purchase. Considering this
pharmacist should carry the purchasing of drugs.
The taskforce recommends that pharmacists
(1) purchase medications from known, reliable sources.
(2) warn patients of the dangers of purchasing medications over the Internet.
(3) confirm with distributors that products were purchased from manufacturers or other
reliable sources.
(4) Monitor counterfeit product alerts.

 Medicine management:
Clinical pharmacists provide medication therapy management to help patients get the best
benefits from their medications by actively managing drug therapy and by identifying,
preventing and resolving medication-related problems. Comprehensive review of patient's full
medication regimen to ensure medications work well together and avoid problems Pharmacist
review may determine which of several medications is causing an adverse effect; simplify a
patient's medication regimen; identify gaps in reaching treatment goals; or prevent prescription
of medications that have adverse interactions.

 INFORMATION TECHNOLOGY:
The use of information technology has greatly advanced the field of clinical pharmacy. Many
slow task that was long, cumbersome and time consuming have now be replaced by computers,
electronics, and Robotics.
 Automated Dispensing Machines
 Bar Code Systems
 Computerized Physician Order Entry Systems
  Electronic Health Record
  National Council for Prescription Drug Programs
  Electronic Prescription
 A Very Basic Electronic Prescription Flowchart
 Electronic Prescription Vendor Software Companies

 RESEARCH AND DEVELOPMENT:

Within clinical research, pharmacists can help assess the safety and efficacy of new medicines.
Skills learnt during pharmacy training allow them to contribute to the entire clinical trial process
from planning the trial, developing the prototype formulations for administration first in
animals and later for trials in humans, the production, packaging, labelling and supply of the
medicine to clinical researchers, through to the monitoring and reporting of complex studies. 
If the drug performs well in trials and is nominated to go into full-scale commercial production,
the process development team will be involved with the s scale up and technology transfer to
one or more manufacturing sites. This is another area where many pharmacists are employed.

 EDUCATION AND TRAINING:

Pre- and post-graduate teaching and activities to provide training and education programmers
for pharmacists and other health care practitioners.

 MEDICINE SUPPLY:
Pharmacists are responsible for ensuring that the supply of medicines is within the
law. ensuring that the medicines prescribed to patients are suitable. advising patients about
medicines, including how to take them, what reactions may occur and answering patients'
questions.
 DISPANSARY:
Labels must be attached to the medication container in such a way that it does not cover the
generic name, batch number or the expiry date of the medicine •Handwritten labels, as is often
the practice, should be legible • Record keeping ◦ All prescriptions that have been dispensed
must be recorded, by the pharmacist, in a permanent record (manual or electronic), e.g. in the
patient file (or Dispensing Program in hospitals) and should contain the following information
 Name of the medicine
 Date of dispensing
 Dosage form and quantity of medicine
 Name and address of patient
 Name of person who issued the prescription
 Reference number