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34 Cards in this Set

  • Front
  • Back
what drugs work at each site?
plug in the peripheral adrenergic drugs
plug in the chemical and enzyme
plug in site of action
plug in drugs
what diuretics work here?
what is normal, pre, stage 1, and stage 2 hypertension BP's?
normal-<120/<80
pre-120-139/80-89
stage1-140-159/80-89
stage2->160/>100
what is first line treatment for hypertension?
thiazide diuretics
what is the rate limiting step in catecholamine synthesis?
tyrosine conversion to dopa by tyrosine hydroxylases
what 2 substances breakdown catecholamines?
MAO and COMT
what is the site of action of centrally acting sympatholytics?
a2 receptors of the vasomotor center
3 drugs acting on a2 receptors
clonidine, guanabenz, guanfacine
prodrug that acts on a2 receptor
a-methyldopa
active form of a-methyldopa
a-methylnorepinephrine
intracerebroventricular injection of a2 agonists cause BP to go higher or lower?
lower
sedation, vertigo, and lactation in men are side effects of what class of drugs?
centrally acting sympatholytics
what type of drug would block the effect of clonidine and guanethadine?
tricyclic antidepressants
what is the MOA of reserpine?
blocks repackaging of NE, dopamine, seratonin taken up into cell causing eventual depletion of NE, dopamine, seratonin stores
what is the MOA of guanethadine?
displaces NE from vesicle, prevents release by anesthetic-like effect, causes eventual depletion of NE stores
what does vesicular depletion of transmitter stores do to post synaptic receptors?
causes upregulation, supersensitivity of receptors
caution should be taken when using OTC cold medicines while taking guanethadine because...
sympathomimmetics in cold medicines can cause hypertensive crisis
guanethadine is used in pheocromocytoma pts but can cause what?
hypertensive crisis by release of lg stores of NE in tumor
what were the problems with the first a blockers?
blocked both a1 and a2 and caused tachycardia and tolerance to antihypertensive effects
what is the major difference between phentolamine and phenoxybenzamine?
phenoxybenzamine is irreversible
which 2 a1 blockers have significant first pass effect?
prazosin and terazosin
which 4 B blockers have ISA?
acebutolol, carteolol, pindolol, penbutolol
what is the most selective B1 antagonist also thought to have B2 agonist properties?
nebivolol
Longest acting B antagonist, doesn't pass BBB
nadolol
what effect does B1 blockade have on the kidney?
blocks renin release thus blocking RAAS response to drop in BP
What is nebivolol's effect in the kidney?
blocks renin release and decreases peripheral resistance, B2 agonist action causes renal vasodilation via NO formation
what is missing in ESRD pts that normally breaks down NE and E in the synapse?
renalase
What are the 2 benefits of using a B blocker with ISA?
less resting bradycardia but still blocks exercise induced increase in HR, less receptor upregulation after long term use/less supersensitivity
what conditions are contraindicated for use of B blockers?
AVB, CHF, asthma, SB
How does B blockers contribute to atherogenesis?
increasing triglycerides and LDL, decreasing HDL