Read the summary and the most important questions on Cases for HNE23306

• 1 Atorvastatin

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• What are the cholesterol reducing mechanisms of Atorvastatin?

  • Atorvastatin inhibits HMG-CoA reductase (catalysation HMG-CoA --> mevalonate), which is the rate-limiting step in cholesterol synthesis.
  • Atorvastatin upregulates hepatic LDL-C receptors, which reduces serum LDL-C concentrations. 

• Why should Atorvastatin be combined with a diet low in saturated fat and cholesterol?

  Cholesterol levels in the body will be reduced by decreased dietary intake and drug treatment with Atorvastatin.

• 2 Cetirizine

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• What is the working mechanism of Cetirizine?

  Ceterizine has an antagonistic effect on the H1-receptor. Histamine binding is inhibited, thereby reducing allergic symptoms.

• What is the advantage of Cetirizine being a second generation anti-histamine?

  Second generation anti-histamines are more selective to peripheral H1-receptors and less likely to pass te blood-brain barrier.

• 3 Ciprofloxacin

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• How inhibits Ciprofloxacin the multiplication of gram-negative and gram-positive bacteria?

  Ciprofloxacin reduces the activity of topoisomerase II and IV, which inhibits multiplication processes in the bacteria.

• Why should Ciprofloxacin not be taken in combination with milk?

  Binding of calcium with Ciprofloxacin result in an insoluble complex, which reduces the bioavailability.

• What is the advantage of Ciprofloxacin being partially excreted unchanged in the urine?

  Ciprofloxacin reaches its site of action rapidly as a drug treatment of bladder infection.

• 4 Famotidine

• What is the working mechanism of Famotidine?

  Famotidine has an antagonistic effect on the H2-receptor. Histamine binding is inhibited, thereby reducing acid production by parietal cells.

• Why are patients with renal failure at risk of Famotidine overdosing?

  Since Famotidine is excreted via the urinary tract, patients with decreased renal function have ineffective excretion and risk of accumulation.

• Which patient groups shouw be warned to use Famotidine?

  • Patients with hypersensitivity. 
  • Patients with renal function problems. 
  • Women that are pregnant of lactating.