Answer: C. What psychosocial implications could this injury have on Melody and her family as she enters rehabilitation?
Explanation: That would be your answer
The nurse would focus on monitoring Melody's level of consciousness, assessing her pupils, and monitoring vital signs. Complications to consider include increased intracranial pressure and infection. The injury could have psychosocial implications for Melody and her family.
A. Continuing assessments for the neurologic injury:The nurse would focus on monitoring Melody's level of consciousness using the Glasgow Coma Scale. They would also assess her pupils for any changes in size or reaction to light, and watch her vital signs to detect any worsening of her condition.
B. Complications to assess for:The nurse should watch for signs of increased intracranial pressure, such as headache, vomiting, or changes in behaviour. They should also monitor for any signs of infection at the site of her injuries, such as redness, swelling, or drainage. Additionally, they should assess for signs of deep vein thrombosis or blood clots in her legs.
C. Psychosocial implications:This injury could have significant psychosocial implications for Melody and her family. They may experience grief and trauma from losing their friends, as well as anxiety and fear about their recovery and long-term outcomes. Rehabilitation will likely involve adjustments to her daily activities and routines, which could impact her sense of independence and self-esteem.
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The ______ conducts impulses toward the soma. The______ conducts impulses toward the synaptic terminals. The ______ is the region surrounding the nucleus. The ______ is the enlarged end of an axon. The contains neurotransmitters. The ______ is a cluster of RER and free ribosomes. The______ is another term for the soma of a neuron. The______ is the membrane of the axon. The______ is a cell that forms the blood 13 brain barrier. The ______ is a fine branch of an axon.
Answer:
1. dendrite = directs impulses toward the soma.
2. axon = conducts impulses toward the synaptic terminal.
3. perikaryon = region surrounding nucleus.
4. collateral branches = main branches of an axon.
5. synaptic terminal = enlarged end of an axon.
6. synaptic vesicles = contains neurotransmitters.
7. axon hillock = connects the cell body and axon.
8. Nissl bodies = clusters of RER and free ribosomes.
9. telodendria = fine branches of an axon.
10. myelinated internode = part of axon covered by Schwann cell.
11. neurilemma = Schwann cell's plasma membrane.
12. axolemma = membrane of the axon.
13. astrocyte = Forms the blood-brain barrier.
14. cell body = soma.
The missing parts in the question refer to the various parts of a typical neuron.
The dendrite directs electrical impulses toward the soma. The Axon conducts impulses towards the synaptic terminal. The perikaryon is the region surrounding the nucleus.The synaptic terminal is the enlarged end of an axon.
The synaptic vesicles contain neurotransmitters. The Nissl bodies contain clusters of Rough Endoplasmic Reticulum (RER) and free ribosomes. The cell body is another term for the soma of a neuron. The Axolemma is the membrane of the axon. The endothelial cell is a cell that forms the blood-brain barrier. The Telodendria is a fine branch of the axon.
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A single mother and her male child are sitting alone watching a news report that is showing the damage from the storm. You observe the child getting more nervous and upset.
Answer:
Comfort the child and ask what is wrong.
Explanation:
Calm the child and then if has a headache then give the child water and Tylenol
What bones are involved in the radiocarpal joint?
Radius
Scaphoid
Lunate
Triquetrum
The radiocarpal joint comprises the scaphoid, lunate, and triquetrum carpal bones, and the distal end of the radius, but not directly with the ulna, which is connected to the joint via a fibrocartilaginous pad.
The bones involved in the radiocarpal joint, which is the main joint of the wrist, are the scaphoid, lunate, and triquetrum from the proximal row of the carpal bones, as well as the distal end of the radius. Although the ulna is part of the forearm and lies next to the radius, it does not directly articulate with the carpal bones in the radiocarpal joint. Instead, the triquetrum bone articulates with a fibrocartilaginous pad between the radius and the styloid process of the ulna. The movement and function of the hand at the wrist are primarily dictated by the radiocarpal joint in conjunction with the midcarpal joint, where the proximal and distal rows of carpal bones interact.
A 13-year-old girl is brought to the clinic with the complaint of emotional lability and restlessness. Other symptoms include gradual weight loss despite a good appetite; warm, moist skin; heat intolerance; and unusually fine hair. These manifestations are most suggestive of which of the following?
A. Hypothyroidism
B. Hyperthyroidism
C. Hypoparathyroidism
D. Hyperparathyroidism
Answer: B) Hyperthyroidism
Explanation: Hyperthyroidism is a situation where thyroxine hormone is produced in higher quantity than the body will usually need by the thyroid gland in the neck region. This usually leads to increase in the metabolism of the body, although the elderly individuals often don't experience any symptoms, some of the symptoms in younger individuals are as follows; Weight loss, excess sweating, excessive hunger, fatigue, heat intolerance, restlessness, hyperactivity, abnormal heart rhythm, fast heart rate, warm skin, weakness of muscles, diarrhea, insomnia, palpitation as well as mood swings.
With the series of symptoms been experienced by the 13 year old girl, these manifestations suggest she is suffering from Hyperthyroidism.
what are the components of epithelial cell membranes?
Epithelial cells are held together by tight junctions, adhering junction and desmosomes and attach to a specialized form of extracellular matrix called the basement membrane. Epithelial cells are polarized with an apical surface facing the lumen or external environment and a basal surface facing the basement membrane.
7. Which statement about the Spanish flu of 1918 is true? A. It killed about 100 million people. B. It could kill within hours. C. It mainly spread through air travel for leisure. D. It was not a pandemic.
A heavyset middle-aged insurance salesman who doesn't exercise often accepts his friend's invitation to a pickup basketball game. When attempting a jump shot, he falls to the ground in pain, grasping at the calf of his leg. There is an enormous bulge in his leg immediately below the knee, and he is unable to plantar flex that foot. Most likely he has injured his ___ and the bulge is ___.
Answer:Calcaneal tendon; his triceps surae
Explanation:
The Calcaneal tendon which is also called Achilles tendon is the thickest tendon located at the back of the leg that attaches the plantaris,calf and soleus muscles to the calcaneal bone. These muscles acting together at the tendon is responsible for plantar flexion of the foot of the ankle
The triceps surae on the other hand consisting of two muscles forms the main mass of the calf which are the gastrocnemius and the soleus which join their tendons of into the midline of the leg into one tendon by inserting at the calcaneal tendon are responsble for providing flexion of the leg
Therefore, the heavyset man who falls to the ground in pain, grasping at the calf of his leg and having an enormous bulge in his leg immediately below the knee, with the inability to plantar flex his foot must have injured his _Calcaneal tendon__ and the bulge is _triceps surae because those are the site for these tendon and muscle
What may be a problem with racial self-identification for the future of medicine and pharmacogenomics (drugs tailored to suit one's genome)? A. It may be linked to cultural associations. B. It may be defined by the possession of extreme physical traits. C. It may have traditional or historical bias. D. It may have a religious bias. E. Incorrect identification of ancestral background because of all of the above.
Answer:
I well go with the (A). It may be linked to cultural associations.
Explanation:
Mary is in an automobile accident and suffers a spinal cord injury. She has lost feeling in her lower body. Her doctor tells her that swelling is compressing a portion of her spinal cord. Which part of her cord is likely to be compressed?A) ascending tracts in the cervical region of her spinal cord.
B) descending tracts in the cervical region of her spinal cord.
C) ascending tracts in the lumbar region of her spinal cord.
D) descending tracts in the lumbar region of her spinal cord.
E) the anterior white commissures.
Final answer:
The spinal cord injury that caused Mary to lose feeling in her lower body likely involves the compression of ascending tracts in the lumbar region of her spinal cord. Option C is correct.
Explanation:
Mary has lost feeling in her lower body due to a spinal cord injury. The loss of sensation suggests that the injury is impacting parts of the spinal cord responsible for sensory information. Considering that the sensations lost are in her lower body, the ascending tracts in the lumbar region of the spinal cord are likely compressed. These tracts carry sensory information from the body to the brain, and because the lumbar region corresponds to the lower part of the spinal cord, it controls sensations in the lower extremities. Therefore, the correct answer is C) ascending tracts in the lumbar region of her spinal cord.
The _____ conducts impulses toward the synaptic terminals.
The _____ is the enlarged end of an axon.
The _____contains neurotransmitters.
The _____ is a cluster of RER and free ribosomes.
The_____ is another term for the soma of a neuron.
The _____ is the membrane of the axon.
The _____ is a cell that forms the blood 13brain barrier.
The _____is a fine branch of an axon.
Answer:
axon
synaptic end bulb
neurons
Nissl bodies
cell body of a neuron
axolemma
BB-endothelial cells
telodendria
Explanation:
Answer:
The _axon_ conducts impulses toward the synaptic terminals.
The _synaptic end bulb _ is the enlarged end of an axon.
The _neurons _contains neurotransmitters.
The _Nissl bodies _ is a cluster of RER and free ribosomes.
The_cell body of a neuron _ is another term for the soma of a neuron.
The _axolemma _ is the membrane of the axon.
The _BB-endothelial cells _ is a cell that forms the blood 13brain barrier.
The _telodendria_is a fine branch of an axon.
Explanation:
Axon (or nerve fibre): is a long projection of a nerve cell or neuron in vertebrates animals, that typically conducts electrical impulses away from the nerve cell body.
Synaptic end bulb: They contains synaptic vesicles that are filled with a neurotransmitter substance. The neurotransmitter substance is responsible for the transmission of impulses from axon to muscle fibers through the synapse.
Neurons: They are nerve cells and nerve fibers, which are electrically excitable cells in the nervous system that transmit and process information. Neurons are the basic working unit of the brain.
Nissl bodies: They synthesize proteins for intracellular use, they are responsible for the manufacture and release of proteins and amino acids in the body system.
Cell body of a neuron: The cell body is the part of the neuron that contains the nucleus and as well connects the dendrites, that bring information into the neuron and the axon which sends information to other neurons. They control all of the functions of the cell.
Axolemma: it is the cell membrane of an axon, it is responsible for maintaining the membrane of the axon and contains ion channels through which ions flows rapidly.
BB-endothelial cells : They are the main regulator of vascular homeostasis, they interacts with circulating cells on one hand and the cells present in the vascular wall on the other hand.
Telodendria: It is the branched ends of nerve cells, they establishes the functional contact with other nerve cells.
Dr. Kabir, an emergency room doctor, is starting to evaluate a patient who has a limp of the right leg. What should Dr. Kabir do first? A. Ask the patient to describe the leg pain. B. Order an x-ray of the leg. C. Prescribe physical therapy. D. Research other cases where patients have experienced similar leg pain. E. Contact an orthopedic specialist
Answer:
Letter E
Explanation:
I truly wouldn't take this advice from me; I'm a high school freshman who's dream is to become a surgical nurse. However, letter E is the most logical. You wouldn't order an x-ray first. You definitely wouldn't prescribe pt. You wouldn't have the time to do the research if the patient is in pain and if it's limp. And if the leg is limp, then the patient might not be able to feel it. If they can, then the ortho specialist can ask questions about the pain.
Smallpox is no longer a threat to anyone in the United States. And the vaccination against it is unpleasant and, in rare cases, life-threatening. conclusion : We were wise when we ceased the routine vaccination of our children.'
Which of the following is a possible delay in in-hospital care to definitive treatment for patients experiencing an acute myocardial infarction?
What is the correct answer?
1. Door to data
2. Data to decision
3. Decision to terminate treatment
4. Door to vital sign exam
Final answer:
The potential delay in in-hospital care for an acute myocardial infarction patient is the 2) 'Data to decision' phase. It involves the time taken to process clinical information and reach a treatment decision, which is critical in acute cases.
Explanation:
The correct answer to the question is option 2: Data to decision. A delay in this stage occurs when there is a gap between obtaining clinical information and the care team's decision on the treatment approach. During this time, critical decisions about how to manage an acute myocardial infarction are made, and any delay can adversely affect patient outcomes. Conversely, 'Door to data' would refer to the time taken to gather initial information upon patient arrival. 'Decision to terminate treatment' is related to end-of-life care, and 'Door to vital sign exam' describes the initial assessment of a patient, which typically does not involve a delay significant enough to impact definitive treatment for an acute condition such as a heart attack.
The steps to follow in an emergency are:
A-Call-Check-Secure.
B-Care-Call-Check.
C-Check-Call-Care
D-Check-Care-Defibrillate
Final answer:
The steps to follow in an emergency are Check-Call-Care. This procedure involves checking the area for safety, checking the victim, calling for help, and caring for the victim until professional help arrives. AEDs are essential and user-friendly devices that can assist in cardiac emergencies.
Explanation:
The correct steps to follow in an emergency are C-Check-Call-Care. Initially, one must Check the scene to ensure it's safe before approaching the victim. Once safety is confirmed, you Check the victim for responsiveness and breathing. After assessing the situation, you Call for emergency services (such as 911 in the United States) for professional medical help. Finally, you provide Care by performing first aid or CPR if you are trained to do so. In certain cases where a cardiac emergency is suspected, the use of an automated external defibrillator (AED) may be necessary. As per the information provided, AEDs are designed to be user-friendly and can be found in many public places. They come with verbal instructions and will automatically diagnose the patient’s heart rhythm to apply the correct shock, which can save a life during the early minutes of a cardiac attack. It is essential that everyone learns about these lifesaving steps, for instance through programs like Be The Beat, which raises awareness about Sudden Cardiac Arrest.
Biomes can be classified geographically.
Please select the best answer from the choices provided
Answer:True
Explanation:
In quiet breathing, muscular effort is mainly in inspiration, and expiration is largely passive, due to elastic recoiling of the lung. Can you relate this fact to the pattern of expiratory and inspiratory flow? Hint: The normal pattern of breathing is efficient in that it requires muscular effort for only a short time.
Explanation:
during exercise,there is receptors which are present in skeletal muscle ,send sensory afferent to CAC ,in turn stimulate If,so amount of oxygen to muscles increase
An agent would make a good antibiotic if it affected a structure or process only found in bacterial cells and not in our (eukaryotic) cells. Which of the following actions would theoretically make a good antibiotic:
Answer:
A good antibiotic would effect the structure in which the bacteria is forming, and not the structure of the Eukaryota cells.
Explanation:
Anemia is a condition where the blood does not have enough healthy, normal red blood cells. There are many anemias caused by factors not related to nutrition, but nutrient deficiencies can also be the culprit. The most common nutrient deficiencies that result in anemias are deficiencies of iron, folate, vitamin B12, and vitamin B6.
Identify the types of Anemia given the symptoms below:
1) A form of this anemia, called pernicious anemia, occurs when inadequate intrinsic factor is secreted into the stomach.
2) This type of anemia is caused by a recessive mutation that causes hemoglobin molecules to fold incorrectly.
3) Treatment may involve injections of vitamin B12.
4) Red blood cells may abnormally formed into half-moon shapes.
5) A deficiency of vitamin Bs or iron may cause this type of anemia.
6) Treatment often involves supplementation with iron and vitamin C.
7) This may be caused by a deficiency of folate.
8) Red blood cells are smaller than normal.
a) Microcytic Anemia
b) Macrocytic Anemia
c) Sickle-Cell Anemia
Answer:
1_vitamin B12
2_thalassemia
3_cyanocobolamine
5_iron diffecency anemi
6_
7_megaloblastic anemia
8_a
Final answer:
There are different types of anemia that can be identified based on specific symptoms. Pernicious anemia is caused by inadequate secretion of intrinsic factor in the stomach. Sickle-cell anemia is caused by a genetic mutation. Macrocytic anemia is associated with deficiencies of vitamin B12 and folate, while microcytic anemia is caused by iron deficiency.
Explanation:
Identifying Types of Anemia:
Type of Anemia: Pernicious Anemia (b)1. Review the remittance advice (Figure 4-13), and circ
ittance advice (Figure 4-13), and circle the payment
2. Determine whether each payment denial
other each payment denial reason code would result in writing an):
• Appeal letter to the third-party payer (Figure 4-14)
• Collection letter to the patient (Figure 4-15)
3. Refer to the sample letters in Figures 4-14 and 4-15, and prepare apped
gures 4-14 and 4-15, and prepare appeal letter(s) and/or
collection letter(s) for each payment denial re
etter(s) for each payment denial reason code. (Do not prepare provider letters
of medical necessity.)
to wa
Answer:
???????
1. Review the remittance advice (Figure 4-13), and circExplanation:
Final answer:
The student is asked to review remittance advice, determine if an appeal or collection letter is needed, and prepare letters for payment denial reason codes.
Explanation:
The subject of this question is Health. The question asks the student to review a remittance advice, determine if each payment denial reason code would result in writing an appeal letter to the third-party payer or a collection letter to the patient, and prepare appeal letters and/or collection letters for each payment denial reason code.
What is the purpose of Good Samaritan Laws?
A-To help protect people who voluntarily give care without accepting anything in
return.
B-To discourage people from helping others in an emergency situation.
C-To protect people who give care beyond their level of training.
D-None of the above.
The answer would be A :D
Good Samaritan Laws primarily exist to protect people who voluntarily assist others in emergency situations, encouraging them to help without fear of legal retaliation should something unintentionally go wrong.
Explanation:The purpose of Good Samaritan Laws is primarily Option A: to help protect people who voluntarily provide aid in an emergency situation without expecting any return.
These laws are designed to encourage bystanders to lend a helping hand without fear of legal repercussions if something unintentionally goes wrong.
They serve to shield individuals who give care within their level of training and expertise. However, protection may not be provided if care is delivered negligently or recklessly, or extends beyond the person's level of knowledge.
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The term goiter means:
Which of the following is a true statement?
A) The greater tubercle of the humerus articulates at the coracoid process of the scapula.
B) The rotator cuff is responsible for the flexible extensions at the elbow joint.
C) The head of the humerus articulates with the acromion process.
D) The annular ligament surrounds the head of the radius.
Answer:
The annular ligament surrounds the head of the radius.
The true statement is D) The annular ligament surrounds the head of the radius.
This ligament is important as it stabilizes the proximal radioulnar joint, allowing the radius to pivot around the ulna which facilitates the forearm's ability to rotate. It does not involve the greater tubercle, humeral head, scapular acromion, or the scapular coracoid process.
leslie gunther is scheduled for surgery today ag 1 p.m. The hospital calls this morning to state the PAT information is not in her chart. You pull up leslie’s electronic chart snd see documentation that states the information was sent electronically to the hospital three days ago what would you do?
Answer:
vhj
Explanation:
Final answer:
In the case of missing Pre-Admission Testing (PAT) information for a surgery, verify the communication records, contact the hospital to resolve the issue, and prepare a contingency plan to resubmit the PAT information if necessary, ensuring professionalism and efficiency.
Explanation:
In a healthcare setting, when there is a concern about missing Pre-Admission Testing (PAT) information, it is imperative to act swiftly to ensure patient safety and to maintain the quality of care. Since the electronic chart indicates that the information was sent to the hospital three days ago, the next step should involve verifying the communication.
This can be done by checking if there is a confirmation receipt or any other evidence of successful transmission. If there is proof of sending the PAT information, one should contact the hospital to clarify and rectify the situation.
This would involve reaching out to the appropriate department or individual to ensure that they locate the information in their system. Sometimes electronic information can end up in the wrong folder or be overlooked due to human error.
Infectious disease of humans whose occurrence during the past two decades has substantially increased or threatens to increase in the near future relative to populations affected, geographic distribution, or magnitude of impacts is known as: Select one: a. Modern hazard b. Emerging and reemerging disease c. Contemporary disease d. Antibiotic resistance
Answer:
b. Emerging and reemerging disease
Explanation:
Emerging and reemerging disease are infectious diseases which showed growth in last two decades by targeting large populations, spreading in many geographical areas and demonstrating an increased fatality rate. For example, Ebola and HIV AIDS.
These infections emerged because of presence of many favorable factors at the same time. Increasing population made it easier for the infection to spread because it is difficult to maintain a distance between people now. Increase in global travel also increased the chances of contacting the virus as the carrier can take it to a new unaffected region. Change in temperature also made it favorable for many viruses to propagate.
A 23 year old, overweight, black woman with a history of hemolytic anemia presents to the emergency department with fever and right upper quadrant pain. A right upper quadrant ultrasound is performed which demonstrates gallstones, a thickened gallbladder wall, and pericholecystic fluid. which patient characteristic puts her at higest risk of developing acute cholecystitis?a.female sexb.young agec.ethnicityd.patients with hemolytice.anemiaf.obesity
Answer:
A, D, and F are most correct (female sex, hemolytic anemia, and obesity)
Explanation:
Acute cholecystitis is the inflammation of the gallbladder, an organ whose main function is to act as a reservoir of bile (a substance made by the liver which helps digest fats). The pathophysiology of this disease is characterized by the presence of stones in the gallbladder, known as gallstones, which block the duct, obstructing the exit of this fluid and favoring inflammation/infection of the organ.
To answer this question, one has to know the risk factors of producing gallstones. An easy way to remember is with the ”F” rule:
Female: Women are more affected than menForty: Refers to the age that the patient has higher riskFertile: Women who had multiple pregnancies (due to the high concentration of estrogens, which promote the production of gallstones)Fat: Obese patients have higher concentration of steroid hormones, promoting production of gallstonesFair: Normally fair skinned people tend to have increased risk.Additionally, hemolytic anemia is associated with production of pigmented gallstones due to the increased breakdown of red blood cells.
If one had to chose one answer for this specific case, the most likely answer would be hemolytic anemia, since this patient is relatively young and has not been exposed to increased concentration of steroid hormones for a long time In her lifespan. Nevertheless, female sex and obesity still are technically correct answers.
The characteristic that puts the patient at the highest risk of developing acute cholecystitis is obesity. Hence, the correct option is f.
Obesity increases the cholesterol in the bile which in turn increases the risk of developing gallstones. These gallstones, when lodged in ducts, can lead to acute cholecystitis, a sudden onset of gallbladder inflammation that may necessitate medical intervention, such as surgery.
As Mrs. F stands up, you notice that she is limping She tells you that she banged her foot against a chair several days ago, and it is still sore. When you examine it, you see a swollen, dark purple little toe on her right foot. What is the significance of this sign? What further assessment would be most appropriate for 6. Mrs. F's bruised toe?
a. It might indicate that she is a drinker, so she should be tested with a breathalyzer
b. She may have trouble absorbing calcium, so you should check to see if the toe is broken.
c. It may indicate an inner ear problem, so she should be referred to an ear, nose, and throat specialist
d. It may indicate a cerebellar problem, so she should have a CAT scan
e. It was just a random accident, but her liver's ability to metabolize painkillers should be assessed before treating it.
Answer:
Hm, I think its b if not maybe e
Explanation:
What are the possible mechanisms by which obesity increases the risk of osteoporosis?
In many biomedical devices, the role of a transducer is... Group of answer choices to convert the output from a MEME into an electrical voltage or current. to digitize heart rate. to estimate blood oxygenation. to filter the MEMS output. to amplifier the MEMS output
Answer:
convert the output from a MEME into an electrical voltage or current.
Explanation:
A transducer is a device that converts certain energy into a useful electrical current, in other words, it transforms energy. A good example of a transducer can be the keyboards in a machine that transform the energy of pressing a button into a code that instructs the machine.
Which of the following is a possible delay in in-hospital care to definitive treatment for patients experiencing an acute myocardial infarction?
What is the correct answer?
1. Door to data
2. Data to decision
3. Decision to terminate treatment
4. Door to vital sign exam
A heart attack, or acute myocardial infarction, is a potentially fatal disorder that develops when the blood supply to the heart muscle is suddenly interrupted, resulting in tissue damage. Door-to-data delay in in-hospital care, hence option 1 is correct.
What is myocardial infarction?Acute myocardial infarction, often known as a heart attack, is a potentially deadly condition that arises when the blood supply to the heart muscle is abruptly cut off, causing tissue damage.
A blockage in one or more of the coronary arteries frequently causes this.
The following three areas of delay in the care of patients with in-hospital STEMI warrant special attention: ECG acquisition delays, delays in the interpretation of the ECG, and the activation of the current STEMI care systems.
Therefore, for Door-to-data delay in in-hospital care, hence option 1 is correct.
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For this presentation, your job in this presentation is to research the drug lovastatin and walk the audience through the cholesterol biosynthesis and how lovastatin inhibits high cholesterol. If lovastatin goes through any structural changes before becoming active, please discuss this. Feel free to use images from the book or the internet to illustrate your point. Presentations should be around 5-10 minutes.
Work of lovastatin in cholesterol reduction:
Explanation:
Cholesterol is necessary for the functioning of all human organs, however it has been associated that there is a relationship between increased blood cholesterol, atherosclerosis and coronary heart disease, thus drugs were developed that decrease cholesterol levels by decreasing also the incidence of myocardial infarction.
Since the 1950s when John Gofman, from the University of California at Berkeley studied the association between coronary heart disease and cholesterol, he discovered that there are more harmful forms of cholesterol called LDL or low-density lipoproteins and another with a protective effect, HDL or lipoproteins of high density, later the Framingham study confirmed this hypothesis, in the following decade in 1960, studies were continued by biochemists Konrad E. Bloch, Feodor Lynen, John Cornforth and George Popják who made them worthy of the Nobel prize by describing the Cholesterol synthesis in four stages, and gained importance in showing that the reduction of HMG-CoA to mevalonate is the main point in maintaining the cholesterol pathway, studies that were completed by Nobel Prize winners Bloch and Lynen.
The high cholesterol content in the diet prevents the simultaneous production of it by the liver, a mechanism regulated by HMG-CoA reductase that catalyzes the conversion of HMG-CoA into mevalonate, an enzyme that, when reduced, can contribute to reducing cholesterol levels. in plasma. Later, after several attempts, the Merck laboratory was able to demonstrate the efficacy of a molecule under the name of lovastatin that produced a significant decrease in plasma LDL levels.
Lovastatin is a selective and competitive inhibitor of the enzyme hydroxymethylglutaryl coenzyme A or HMG-CoA reductase, which catalyzes the reduction of HMG-CoA to mevalonate which is the basis for the formation of sterols and among them the synthesis of cholesterol. Lovastatin in its inactive form is a closed ring of gamma-lactone that, when activated, hydrolyzes to an open ring of β-hydroxy acid, producing a reversible inhibitory binding of HMG-CoA, its main effect is to prevent the formation of mevalonate, an essential component for the formation of cholesterol. In the liver, triglycerides and cholesterol bind to VLDLs and go to plasma to reach peripheral tissues. Low-density lipoproteins (LDL) are created from VLDLs.
Approximately 10% of cholesterol is synthesized in the liver and 15% in the intestine, being carried out in the microsomes and cytoplasm, acetyl-CoA, is a product of oxidation in the mitochondria and by the synthesis of fatty acids is transported to the citoplasma mainly, the process has five important steps:
1. Acetyl-CoAs are converted to 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA)
2. HMG-CoA is converted to mevalonate
3. Mevalonate is converted to the isoprene based molecule, isopentenyl pyrophosphate (IPP), with the concomitant loss of CO2
4. IPP are converted to squalene
5. Squalene is converted to cholesterol.
Lovastatin reduces plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and increasing the number of liver LDL receptors on the cell surface, which in turn increases absorption and catabolism of LDL. Lovastatin reduces LDL production and the number of LDL particles, increases the activity of LDL receptors, decreasing their plasma levels.
Thus today, new molecules continue to be produced with different specific applications, seeking a longer half-life or reduction of side effects, what is certain is that the discovery of lovastatin marks a historical fact for the treatment of cardiovascular disease.