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@reflectiveminds3: #fyp #philosophy #quotes

ReflectiveMinds
ReflectiveMinds
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Thursday 25 September 2025 02:39:16 GMT
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inexcelsis_junior
Inexcelsis10 :
Excellent intelliegence by pristine persevering with establish laws for prosperty wity welfare of life evolving through precious and proficient ways
2025-09-26 05:06:21
1
ace99013
ace99013 :
oh we are so far removed from being excellent though... thanks to the criminal ideology of politics.
2025-09-25 10:52:11
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Isosorbide mononitrate (ISMN) is the active metabolite of ISDN •ليش اذا استخدمنة ال ISDN +hydralazine بال HF مننطي اهمية لل nitrate free interval بال dosing •هي ال tolerance شلون راح تصير ؟ Nitrate tolerance occurs by different mechanisms: 1. Increased oxidative stress • Continuous nitrate use increases production of reactive oxygen species (ROS) in vascular smooth muscle. • ROS inactivate nitric oxide (NO) which reduce vasodilation. 2. Depletion/inactivation of mitochondrial aldehyde dehydrogenase (ALDH2) • ALDH2 is the enzyme that converts nitrates into NO. • ROS inactivate this enzyme. 3. Neurohormonal counter-regulation • Continuous vasodilation → reflex activation of the renin–angiotensin system and sympathetic nervous system → vasoconstriction and sodium/water retention. ⸻ شلون وجود ال hydralazine راح يساعد ال tolerance ؟ 2. How hydralazine helps • • Hydralazine scavenges ROS in the vascular wall. • This reduces oxidative inactivation of NO and preserves ALDH2 function. • Synergistic vasodilation: • ISDN mainly venodilates → ↓ preload • Hydralazine mainly arteriolar dilates → ↓ afterload • Combined effect greatly reduces cardiac workload without depending solely on one pathway. Reference Dipiro’s pharmacotherapy handbook #pharmacy #pharmacists #medications
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