let us discuss olmisartan. Blood pressure is one of the essential condition to maintain the daily activities. But when this blood pressure is elevated, it may lead to so many types of cardiovascular complications. The elevated levels of blood pressure may increase the formation of atherosclerosis in those patients with elevated levels of cholesterol.
And this atherosclerosis can block the blood vessels, resulting in development of stroke or cardiovascular complications like tachycardia, atrial fibrillation and finally, myocardial infarction. So all these cardiovascular complications are linked with elevation of blood pressure. The blood pressure can be controlled by so many types of drugs. And one group of drugs are acting on renin angiotensin aldosterone system. This renin angiotensin system involves so many types of organs, even it is linked with renal system.
Olmesartan medoxomil tablets for hypertension
But many of the organs are linked with res. Lungs play an important role by producing the AC enzyme. Kidney is another organ which is going to produce renin as the enzyme. And liver is a third organ which is going to produce a precursor for angiotensin system. From the liver, one of the precursor that is going to be produced is the angiotensinogen.
This angiotensinogen can be converted into angiotensin one by one of the enzyme renin. So kidney can produce this renin, which is going to convert the angiotensinogen into angiotensin one. Now, this angiotensin one is further converted by another enzyme, AC angiotensin converting enzyme produced from the lungs. By this conversion, they produce one of the mediator which targets blood vessels. So now AC can convert the angutansin one to angiotensin two, which is going to act on the blood vessels to produce vasoconstriction.
So this increases the blood pressure, which increases cardiovascular complications. That’s why one of the target to control the blood pressure is to inhibit the Acuity of training angiotensin system. So many drugs are acting on ras, but one group of drugs are sartans. These sartans can block the renin angiotensin system by antagonizing the angiotensin receptors. So they are commonly called as angiotensin receptor blockers.
So olemisarton is having the suffix Sarton, which is a ARB angiotensin receptor blocker. This drug is given as an ester olemisarton medoxomil, which can be given either alone to control the blood pressure. Otherwise it can be combined with few of the diuretics like chlorothyldone or hydrochlorothychide. So volvisoton can be used either alone or in combination to reduce the blood pressure in the hypertensive patient. So today, we are going to see how this drug acts.
What are the important precautions, side effects, doses? All these things we will discuss in this . First of all, let us see the chemical nature of this drug. So this is a structure of olmisata. Olmisata is having the imdigol nucleus.
Let us give the numbering. This is 1234 and five. So it is having carboxylic acid at the fourth portion, which forms ester to form olmisoton medoxomil. If we write the IUPAC name for this drug, we can write the suffix as emidojole four carboxylic acid. At the fifth portion it is having a propane two ile chain with hydroxyl group at the second portion.
So five two hydroxy propane two ile. Similarly, at the second portion it is hang the propyle chain. So two propyle third portion methyl chain is attached. This methyl chain is further attached with phenyl ring and this phenyl ring is hang the fourth portion ender phenyl ring. So four phenyl.
And now to this phenyl at the second portion tetrazole ring system is attached by fifth portion. So we can write this as two two h tetrazole five il that is a complete name of olmisarton. So Ole Missarton is a imitazole derivative with carboxylic acid at the fourth portion, which forms the ester to form ole misarton medoxomil.
Now let us see the precautions of this drug. Olmisoton can be given to the pediatric patients, but in the children with age less than one year, this Ole Missarton should not be given because during the first year organs are going to be developed and this Ole Miss autonom acts on reigning angiotensin system, so it can affect the functionality of the renal system.
Therefore, in the pediatrics with age less than one year, if this volisaton is given, it can impair the renal activity resulting in the immature development of kidneys. That’s why this drug should not be given to the children with a’s less than one year. And even this drug is safe in the children with age six to 16 years, so less than six years.
Again, this is not preferred, and in the children with a’s less than one year, it severely impairs the renal functionality. Similarly, another important precaution of Vulmisatin is that this drug is going to block the renin angiotensin system.
Therefore, this drug should not be given to the pregnant woman because it can affect the development of the fetus in the pregnant woman, particularly Vulmis autumn should not be administered in the second and third trimester of pregnancy in order to avoid renal damage, because this drug is tertogenic and it can produce fetal damage.
So this drug can produce fetal renal failure and fetal lung hypoplasia. Decreased development of the lungs, fetal hypotension and skeletal deformalities can be observed. Even this drug can reduce amniotic fluid resulting in miscarriage. So all these effects are observed with Ole Missartan, so it should not be given to the pregnant woman, particularly at second and third trimester.
Just to ask you that olemisarten is a antihypertensu. It is going to inhibit training angiotensin system. So this drug can reduce the blood pressure resulting in hypotension. When this drug is coadministered with other drugs such as Diuretics, it can again produce a hypotension. Drugs like Lube diotex can produce significant hypotension.
So when they are combined with ole misarton, they can produce severe hypotension, which should be avoided. And ole misarton should be carefully given in those patients who are salt depleted or those patients who are already suffering with Hypotension due to loss of minerals dehydration diarrhea. In such conditions, this drug may further increase the Hypotension. And the important precaution is that this drug is going to acting on the renal system. On the renal organ, it targets renal angiotensin system.
Read More: Naltrexone and Bupropion combination for obesity
Since this drug is going to inhibit acid of Ras, it may develop acute renal failure resulting in few other symptoms such as oligo, urea, decreased urinary output, edemia, the decreased blood uria nitrogen, and even it can produce hyperkalemia.
All these effects are observed with Omisoton on long term use because of reduced renal functionality. So care should be taken to check development of any of these symptoms. And renal functionality should be measured on very long term treatment with Ole Missarton. Now, let us see how this drug acts.
Angiotensin one is a peptide with ten amin acids. So it is going to be converted by one of the enzyme AC angiotensin converting enzyme. This enzyme is going to remove the two amino acids such that it produce one of the mediator angiotensin two. Angiotensin two is having the eight amino acids. From this angiotensin two, one of the amino acid is going to be removed such that it is going to form angiotensin three and the amino acid is going to be removed to produce angiotensin four.
But among these mediators, angiotensin two play an important role in producing vasoconstriction which is blocked by Ole Missata. Now angiotensin two can act on two types of receptors 81 receptor which is a receptor for angiotensin two type one. Similarly, it can also act on 82 receptors, which is again a receptor for angiotensin two with subtype two. By acting on 81 receptors, it can produce vasoconstriction, increased autosterone release and hypertrophy proliferation. By acting on 82 receptors, it can produce vasodilation, decreased proliferation and apoptosis.
Now, action on 81 receptors are mainly responsible for development of hypertension. Therefore, Omisotron selectory blocks the action of angiotensin two on 81 receptors. Now, on the blood vessels, 81 receptors are present which are G protein coupled receptors coupled with alpha beta gamma subunits. These are the receptors for angiotensin two. Now angiotensin two can act on 81 receptors which activates the phospholipase system such that they can convert the phosphorididal Ioshal bifhosphate into two fragments.
