Common Medical Conditions: Symptoms, Causes, and Treatments

Posted on Jul 20, 2025 in Other university degrees and diplomas

Hypertension: High Blood Pressure Insights

Hypertension is defined as higher than normal blood pressure.

Hypertension Etiopathogenesis

Primary hypertension, a common type, arises from increased peripheral resistance or external factors in the absence of any underlying diseases. Blood pressure can vary from 100 mmHg to 250 mmHg. It can be controlled but not cured. Secondary hypertension arises due to underlying disorders. It may occur when body organs are not functioning properly or are imbalanced due to internal effects or infections. It is cured by treating the disease responsible for hypertension. For example, cardiovascular hypertension arises due to arterial blockage.

Clinical Manifestations of Hypertension

  • Renal failure
  • Myocardial Infarction
  • Arrhythmia
  • Cerebrovascular accident (strokes)

Pharmacological Management of Hypertension

  1. Calcium Channel Blockers: These block calcium channels in the myocardium, thereby reducing myocardial contractility. Examples include phenylalkylamine, benzothiazepine, and dihydropyridines.
  2. Vasodilators: These reduce blood pressure through vasodilation. Examples include sodium nitroprusside, hydralazine, minoxidil, fenoldopam, and diazoxide.
  3. Diuretics: Diuretics cause diuresis and reduce extracellular fluid (ECF) volume and blood volume.
  4. Angiotensin-Converting Enzyme (ACE) Inhibitors: These reduce blood pressure by blocking the formation of angiotensin.

Non-Pharmacological Management of Hypertension

  • Follow a proper routine for daily activities (waking, sleeping, and natural urges).
  • Engage in regular exercise and workouts (to prevent fat deposition and remove excessive fats).
  • Practice yoga and meditation (which helps maintain oxygen and carbon dioxide levels).

Angina Pectoris: Chest Pain & Heart Ischemia

Angina Pectoris is defined as any obstruction in the coronary artery of the heart due to deposition or blockage, leading to chest pain or discomfort and ischemia in the heart muscles.

Types of Angina Pectoris

It is mainly of three types:

  1. Stable Angina: Caused by the deposition of fatty material in the inner wall of the coronary artery (atherosclerosis).
  2. Unstable Angina: Caused by damage in the coronary arteries, leading to a blood clot and partial blockage (atherosclerosis with clot).
  3. Variant Angina: A variation in the coronary artery diameter due to any condition, also known as coronary spasm, Prinzmetal’s variant angina, or Angina inversa. It is usually rare and typically occurs in younger patients who have other pre-existing heart conditions.

Myocardial Infarction: Understanding Heart Attack

Myocardial Infarction, also known as a Heart Attack or myocardial necrosis, is a critical condition arising from myocardial tissue death due to lack of blood supply. It begins when any blockage or obstruction occurs in the arteries.

Clinical Manifestations of Myocardial Infarction

  • Chest pain
  • Dyspnea
  • Fatigue
  • Arrhythmia

Pharmacological Management for Myocardial Infarction

  1. Beta Blockers: metoprolol, propranolol, atenolol, alprenolol.
  2. Potassium Channel Openers: nicorandil.
  3. Calcium Channel Blockers: amlodipine, verapamil, mibefradil, bevantolol, diltiazem, nitrendipine.
  4. Nitrates:
    • Long-acting nitrates: isosorbide dinitrate, molsidomine.
    • Short-acting nitrates: nitroglycerin, erythrityl tetranitrate.

Non-Pharmacological Management for Myocardial Infarction

  • Follow a proper routine for daily activities (waking, sleeping, and natural urges).
  • Engage in regular exercise and workouts (to prevent fat deposition and remove excessive fats).
  • Practice yoga and meditation (which helps maintain oxygen and carbon dioxide levels).

Congestive Heart Failure: Impaired Cardiac Pumping

Congestive Heart Failure is an abnormal condition involving impaired cardiac pumping. In this condition, the heart fails to pump sufficient blood to the organs due to insufficient nutrient and oxygen supply, leading to myocardial dysfunction (reduced cardiac muscle ability).

Etiopathogenesis of Congestive Heart Failure

  1. Coronary Artery Disease (CAD): This is a major cause of heart disease. The usual cause is the build-up of plaque, which causes coronary arteries to narrow, limiting blood flow to the heart.
  2. Autoimmune Disease: One of the causes of heart disease. It may be congenital or acquired.

Clinical Manifestations of Congestive Heart Failure

  • Tachycardia
  • Oedema (swelling in ankles, legs, and abdomen)
  • Cachexia and muscle wasting
  • Crepitations or wheeze
  • Third heart sound

Pharmacological Management for Heart Failure

  1. Calcium Channel Blockers: These block calcium channels in the myocardium, thereby reducing myocardial contractility. Examples include phenylalkylamine, benzothiazepine, and dihydropyridines.
  2. Sympathetic Inhibitors:
    • Alpha-Beta Adrenergic Blockers: arotinolol, labetalol, carvedilol, bucindolol.
    • Alpha Adrenergic Blockers: Prazosin, doxazosin, naftopidil, phenoxybenzamine.
    • Beta Adrenergic Blockers: Atenolol, metoprolol, timolol, oxprenolol, nipradilol.
    • Central Sympatholytics: methyldopa, reserpine, clonidine.

Non-Pharmacological Management for Heart Failure

  • Follow a proper routine for daily activities (waking, sleeping, and natural urges).
  • Engage in regular exercise and workouts (to prevent fat deposition and remove excessive fats).

Hyperlipidemia: Understanding High Blood Lipids

Hyperlipidemia is a condition characterized by high blood lipid levels.

Hyperlipidemia Etiopathogenesis

  1. Primary/Familial/Hereditary Hyperlipidemia: This is genetically inherited. Hereditary disorders in lipid metabolism include Tay-Sachs disease, Gaucher disease, metachromatic leukodystrophy, Fabry disease, and Refsum disease, among others. It further divides into many classes.

Clinical Manifestations of Hyperlipidemia

  • Loss of appetite
  • Arrhythmia
  • Diarrhea
  • Abdominal pain
  • Eye disorders

Pharmacological Management for Hyperlipidemia

  • HMG-CoA Reductase Inhibitors (Statins): lovastatin, simvastatin, atorvastatin, rosuvastatin.
  • Bile Acid Sequestrants: Cholestyramine, colestipol.
  • Fibric Acid Derivatives: fenofibrate, bezafibrate, gemfibrozil.
  • Nicotinic Acid.

Epilepsy: Neurological Seizure Disorder

Epilepsy is a neurological disorder in which brain activity becomes abnormal, causing seizures, unusual sensations, and sometimes loss of awareness.

Classification of Seizures

Seizures are classified based on behavioral and electrophysiologic patterns of activity as:

  1. Partial (Focal) Seizures: These mainly appear in only one hemisphere, meaning symptoms occur in a specific part or on one side of the body. However, focal seizures can sometimes spread and become generalized seizures.
    1. Simple partial seizures with motor, sensory, or autonomic symptoms.
    2. Complex partial seizures.
    3. Partial seizures with secondary generalization.
  2. Generalized Seizures: These seizures happen in both hemispheres of the brain. They tend to cause more severe effects and symptoms.
    1. Absence seizures.
    2. Tonic-clonic seizures.
    3. Other (Myoclonic, tonic, clonic, atonic).

Epilepsy Etiopathogenesis

  • Normal neuronal activity occurs in a nonsynchronized manner, with groups of neurons inhibited and excited sequentially during the transfer of information between different brain areas.
  • Seizures occur when neurons are activated synchronously. The type of seizure depends on the location of the abnormal activity and the pattern of spread to different parts of the brain; experimentally, this is known as the paroxysmal depolarizing shift.

Pharmacological Management for Epilepsy

Drugs are chemically classified as:

  • Benzodiazepines: clonazepam, lorazepam, diazepam.
  • Barbiturates: phenobarbital, desoxyphenobarbital.
  • Deoxybarbiturates: primidone.
  • Hydantoins: phenytoin, ethotoin.

Non-Pharmacological Management for Epilepsy

  • Avoid all activities that cause or induce depression, stress, sleep disorders, etc.
  • Follow and adjust diet plans according to individual needs or prescription by a Registered Medical Practitioner (RMP).

Parkinson’s Disease: Neurodegenerative Movement

Parkinson’s Disease (PD) is a neurodegenerative disease marked by a prominent hypokinetic movement disorder caused by the loss of dopaminergic neurons from the substantia nigra.

Parkinson’s Disease Etiopathogenesis

  • PD is associated with protein accumulation and aggregation, mitochondrial abnormalities, and neuronal loss in the substantia nigra and elsewhere in the brain.

Clinical Manifestations of Parkinson’s Disease

  1. Primary Symptoms:
    • Bradykinesia
    • Parkinsonian gait
    • Rigidity

Pharmacological Management for Parkinson’s Disease

  1. Drugs Acting on the Cholinergic System:
    • Antihistaminics: promethazine, orphenadrine.
    • Central Cholinergics: biperiden, trihexyphenidyl, procyclidine.
  2. Drugs Acting on the Dopaminergic System:
    • Glutamate (NMDA Receptor) Agonists: Amantadine.
    • Catechol-O-Methyltransferase (COMT) Inhibitors: entacapone.

Non-Pharmacological Management for Parkinson’s Disease

  • Avoid all activities that cause or induce depression, stress, sleep disorders, etc.
  • Follow and adjust diet plans according to individual needs or prescription by a Registered Medical Practitioner (RMP).

Antimicrobial Resistance: Types & Mechanisms

Antimicrobials are of two types:

  • Bacteriostatic: Chloramphenicol, macrolides, clindamycin, sulfa, trimethoprim, tetracyclines.
  • Bactericidal: Aminoglycosides, beta-lactams, vancomycin, rifampin, metronidazole.

Factors Contributing to Antibiotic Resistance

  1. Environmental Factors:
    • Population and overcrowding.
    • Poor sanitation.
    • Ineffective infection control programs.
  2. Drug-Related Factors:
    • Fake and poor quality of drugs.
    • Soaring use of antibiotics.
    • Over-the-counter (OTC) availability of antimicrobials.
  3. Patient-Related Factors:
    • Poverty.
    • Poor adherence to dosage regimens.
    • Lack of sanitation awareness.
  4. Physician/Prescriber-Related Factors:
    • Inappropriate use of available drugs.
    • Overuse of antimicrobials.

Types of Antimicrobial Resistance

  1. Intrinsic or Natural: The most common bacterial mechanisms involved in intrinsic resistance are reduced permeability of the outer membrane and the natural activity of efflux pumps. It is always expressed in the species.
  2. Acquired: Bacteria acquire genetic material through transformation, transposition, conjugation, mutations, etc.

Mechanisms of Antimicrobial Resistance

  • Limiting Uptake of a Drug: Certain bacteria modify their cell membrane porin channels, thereby preventing antimicrobials from entering the cell. There are two main ways in which porin changes can limit drug uptake: a decrease in the number of porins present, and mutations that change the selectivity of the porin channel.
  • Modification of a Drug Target: One mechanism of resistance to beta-lactam drugs, used almost exclusively by Gram-positive bacteria, is via alteration in the structure and number of PBPs (penicillin-binding proteins). Changes in number decrease binding ability.
  • Inactivation of a Drug: This is done by two mechanisms:
    1. Actual degradation of the drug.
    2. Transfer of a chemical group to the drug.
  • Active Efflux of a Drug: Bacteria possess chromosomally encoded genes for efflux pumps. Some are expressed constitutively, and others are induced or overexpressed under certain environmental stimuli or when a suitable substrate is present.