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Q. Beta blocker with all activity like cardioselectovity , membrane stabilizing action and intrinsic sympathomimetic activity ?
Nebivolol
Celiprolol
Acebutolol
Metoprolol
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The prodrug of adrenaline used in the treatment of glaucoma is:
*Dipivefrine*
_Dipivefrine is a prodrug of epinephrine (adrenaline), which is converted to epinephrine within the eye._
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*Mechanism:*
Dipivefrine reduces intraocular pressure (IOP) by:
1. Decreasing aqueous humor production
2. Increasing outflow of aqueous humor
*Indications:*
1. Glaucoma (open-angle)
2. Ocular hypertension
*Advantages:*
1. Reduced systemic side effects compared to topical epinephrine
2. Improved corneal penetration
*Trade names:*
1. Dipivefrin (generic)
2. Propine (brand name)
Sacubitril is used in combination with valsartan for the treatment of heart failure.
*Sacubitril + Valsartan = Entresto (Trade Name)*
*Class:*
1. Sacubitril: Neprilysin inhibitor
2. Valsartan: Angiotensin II receptor blocker (ARB)
*Mechanism:*
1. Sacubitril inhibits neprilysin, an enzyme that breaks down natriuretic peptides, leading to increased levels of these peptides, which help reduce blood pressure and fluid retention.
2. Valsartan blocks the action of angiotensin II, a potent vasoconstrictor, reducing blood pressure and workload on the heart.
*Indications:*
1. Heart failure with reduced ejection fraction (HFrEF)
2. Treatment of symptomatic heart failure
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*Benefits:*
1. Reduced risk of cardiovascular death and hospitalization
2. Improved survival and quality of life
3. Reduced blood pressure and fluid retention
*Approved by:*
1. FDA (2015)
2. EMA (2015)
*Important note:*
Entresto is usually used in patients who are already taking an ACE inhibitor or ARB, but are not adequately controlled.
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