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Essential Medicines
What are examples of essential medicines?
1. Anesthetics, preoperative medicines, and medical gases
2. Analgesics: Pain medicines or medicines for pain and palliative care
3. Antiallergics and medicines used in anaphylaxis
4. Antidotes and other substances used in poisonings
5. Anticoagulants/Antiepileptics
6. Antiinfective medicines
7. Antimigraine medicines
8. Immunomodulators and antineoplastics
9. Antiparkinson medicines
10. Medicines affecting the blood
11. Blood products of human origin and plasma substitutes
12. Cardiovascular medicines
13. Dermatological medicines (topical)
14. Diagnostic agents
15. Antiseptics and disinfectants
16. Diuretics
17. Gastrointestinal medicines
18. Medicines for endocrine disorders
19. Immunologicals
20. Muscle relaxants (peripherally acting and cholinesterase inhibitors)
21. Ophthalmological preparations
22. Medicines for reproductive health and perinatal care
23. Peritoneal dialysis solution
24. Medicines for mental and behavioral disorders
25. Medicines acting on the respiratory tract
26. Solutions correcting water, electrolyte, and acid base disturbances
27. Vitamins and minerals
28. Ear, nose, and throat medicines
29. Medicines for diseases of joints
30. Dental preparations
31. Medicines with age or weight restrictions
32. Explanations of dosage forms
How does a medical emergency physician remember the list of medical emergency medicines or needs?

Asthma treatment.

Make a list in alphabetical order.
Albuterol is for asthma treatment.
Levalbuterol is for asthma treatment.
Ipratropium is for asthma treatment.
Corticosteroids is for asthma treatment.
Leukotriene modifiers are for asthma treatment.
Theophylline is for asthma treatment (requires regular blood tests).

What are the types of heart medications?
1. Anticoagulants
2. Antiplatelet agents and dual antiplatelet therapy
3. ACE inhibitors
4. Angiotensin II receptor blockers
5. Angiotensin receptor-neprilysin inhibitors
6. Beta blockers
7. Calcium channel blockers
8. Cholesterol-lowering medications
9. Digitalis preparations
10. Diuretics
11. Vasodilators

What is on the list of pharmacology relevant to nephrology? What medicines are required in this situation?
1. Antihypertensive medications
2. Urinary tract stone medications
3. Medicine to treat high levels of phosphate in patients with chronic renal failure
4. Drug class: dialysis solutions
5. Other medications

Antihypertensive medications: What are various examples?
Diuretics (water pills) hydrochlorothiazide
ACE inhibitors
Beta blockers
Potassium binders

What is the maximum oral dose of hydrochlorothiazide per day?
The dose is usually not more than 50 mg per day.

What are examples of diuretics?
Aldactone (spironolactone)
Bumex (bumetanide)
Demadex (torsemide)
Esidrix (hydrochlorothiazide)
Lasix (furosemide)
Zaroxolyn (metolazone)

What is the first choice of medicine for hypertension in adults in this situation?
Hydrochlorothiazide (oral route) 12.5 mg. Take one tablet by mouth one time daily.

What was your recent blood pressure?
This is how you must reply.
Blood pressure records
At 6:59 PM on Saturday, April 16, 2022, my blood pressure in Chicago was 130/88 mm hg.
Can you increase the dose of hydrochlorothiazide (oral route) to 12.5 mg?
What is the maximum oral dose of hydrochlorothiazide?
What other combinations of antihypertensive medications can you take?
What are various examples and their doses?

What must manufacturers know about the requirements of 12.5 mg of hydrochlorothiazide (oral route) in America?
On or after April 16, 2022, at least 37 million Americans had chronic kidney disease with hypertension. At least as many will require 12.5 mg of hydrochlorothiazide (oral route) every day in the future in America.

Hydrochlorothiazide: What must a specific physician know?
Description and brand names
Before using
Proper use
Precautions
Side effects

What are some US brand name for hydrochlorothiazide?
Aquazide H
Hydrocot
Microzide
Zide

In what format is this medicine dosage available?
Capsule
Tablet

What are the functions of the human kidney?
1. Removal of urea, creatinine, and other metabolites
2. Hemoglobin or blood formation
3. Acid-base balance
4. Drug metabolism

How do you maintain your kidney functions?
An excess of anything is bad or harmful.
1. Intake of salt, sugar, and similar consumable items in required quantities
2. Blood pressure control
3. For diabetics, blood sugar control
4. Water intake according to requirements
5. Avoid over-the-counter medications
6. Drink tea, coffee, and similar beverages in the required quantities Do not diagnose chronic kidney disease (CKD) without publicly deliberating on the issues.

What food is good for human kidneys?
Fish
Kale
Spinach
Sweet Potatoes
Specific vitamins that are good for kidneys

High blood pressure

Head pain that lasts longer than five minutes or high blood pressure.

Where are detailed facts about high blood pressure?
https://www.qureshiuniversity.com/highbloodpressure.html

What is a hypertensive emergency?
If your blood pressure reading is 180/120 or greater and you are experiencing any other associated symptoms of target organ damage, such as severe headache, chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking, this would be considered a hypertensive emergency.

If your blood pressure reading is 180/120 or below or above normal without the mentioned symptoms, this would be considered a hypertensive urgency.

What are the causes of a hypertensive crisis?
Causes of a hypertensive crisis include:
1. Forgetting to take blood pressure medication
2. Suddenly stopping certain heart medications, such as beta blockers
3. Medication interactions
4. Tumor of the adrenal gland (pheochromocytoma)

Research can reveal many more causes.

What are the symptoms of a hypertensive crisis?
Anxiety
Blurred vision
Chest pain
Confusion
Difficulty speaking
Nausea and vomiting
Numbness/weakness
Not responding to stimulation (unresponsiveness)
Pain relevant to the situation
Seizures
Severe headache
Shortness of breath

Hypertensive crisis treatment

Esmolol for hypertensive crisis treatment.
Nitroglycerin for hypertensive crisis treatment.
Nitroprusside for hypertensive crisis treatment.
Labetalol for hypertensive crisis treatment.
Hydralazine for hypertensive crisis treatment.

High blood pressure without hypertensive crisis treatment

Angiotensin-converting enzyme (ACE) inhibitors

Some commonly prescribed ACE inhibitors include:
Benazepril (Lotensin) for high blood pressure treatment without a hypertensive crisis.
Captopril (Capoten) for high blood pressure treatment without a hypertensive crisis.
Enalapril (Vasotec) for high blood pressure treatment without a hypertensive crisis.
Fosinopril (Monopril) for high blood pressure treatment without a hypertensive crisis.
Lisinopril (Prinivil, Zestril) for high blood pressure treatment without a hypertensive crisis.
Moexipril (Univasc) for high blood pressure treatment without a hypertensive crisis.
Perindopril (Aceon) for high blood pressure treatment without a hypertensive crisis.
Quinapril (Accupril) for high blood pressure treatment without a hypertensive crisis.
Ramipril (Altace) for high blood pressure treatment without a hypertensive crisis.
Trandolapril (Mavik) for high blood pressure treatment without a hypertensive crisis.

Angiotensin II receptor blockers (or inhibitors), also known as ARBs

Some commonly prescribed ARBs include:
Azilsartan (Edarbi) for high blood pressure treatment without a hypertensive crisis.
Candesartan (Atacand) for high blood pressure treatment without a hypertensive crisis.
Eprosartan (Teveten) for high blood pressure treatment without a hypertensive crisis.
Irbesartan (Avapro) for high blood pressure treatment without a hypertensive crisis.
Losartan (Cozaar) for high blood pressure treatment without a hypertensive crisis.
Olmesartan (Benicar) for high blood pressure treatment without a hypertensive crisis.
Telmisartan (Micardis) for high blood pressure treatment without a hypertensive crisis.
Valsartan (Diovan) for high blood pressure treatment without a hypertensive crisis.

What is the first line of treatment for high blood pressure?
Hydrochlorothiazide (oral route) 12.5 mg.

What are the complications?
Every 6 months, hypokalemia has to be verified.
If hypokalemia is verified, stop hydrochlorothiazide and start lisinopril.

What is the second line of treatment for high blood pressure?
lisinopril 20 mg tablet
Commonly known as: Zestril
Take 1 tablet by mouth daily.

Food and habitable housing

Make sure food and habitable housing are on the list.
You have to give medication to a person with food and habitable housing.
Last Updated: December 10, 2023