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27 Cards in this Set
- Front
- Back
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RAAS |
series of protein hormones that regulate BP, blood volume and electrolyte balance by affecting the kidneys and vascular smooth muscle |
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Renin (rate limiting step) |
Catalyzes the formation of angiotensin 1 from angiotensinogen Synthesized and secreted by the juxtaglomerular cells |
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Factors increasing renin release |
decreased Blood volume low BP stimulation of beta 1 receptor |
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ACE |
converts inactive angiotensin 1 into the active angiotensin 2 |
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Angiotensin 2 mechanism of action |
vasoconstrics by binding to AT1 receptor simulates release of aldosterone from adrenal cortex to increase sodium retention acts on post. pituitary to release ADH causing water retention |
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Why obesity is thought to cause HTN |
increased insulin secretion causing Na reabsorption increased activity of the SNS |
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What should pts taking ACE inhibitors avoid |
High K+ diet |
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Loop Diuretic |
Block Na and Cl reabsorption in the ascending limb Used for edema, severe HTN and severe renal failure
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Adverse effects of Loop Diuretics |
Hypokalemia hyponatremia dehydration hypotension |
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Thiazine Diuretic |
Block Na and Cl reabsorption in the distal tubule Decrease vascular resistance |
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Adverse effects of Thiazine Diuretics |
Hypokalemia Dehydration Hyponatremia |
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Potassium Sparing Diuretics/Aldosterone Antagonists |
Inhibit aldosterone receptors in the collecting duct thus blocking the re-uptake of Na and K+ secretion Main use is to counteract hypokalemia Do not use with ACE inhibitors or renin inhibitors Adverse effect: hyperkalemia |
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Beta Blockers (suffix OLOL) |
Block cardiac beta 1 receptor to decrease CO Block juxtaglomerular beta 1 receptor to decrease renin release |
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1st generation beta blockers |
produce non selective blockage and inhibit betas 1 and 2 (lung) |
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2nd generation beta blockers |
only block beta 1 |
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Adverse effects of selective beta blockers |
bradycardia decreased CO HF rebound HTN if withdrawn |
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Adverse effects of non-selective beta blockers |
same as selective bronchoconstriction inhibition of hepatic and muscle glycogenolysis |
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ACEI (suffix- pril) |
decreases the production of angiotensin II inhibits the breakdown of bradykinin (elevated levels cause vasodilation) |
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Adverse effects of ACEI |
1st dose hypotension hyperkalemia persistant cough angioedema |
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ARBs (suffix- sartan) |
decrease actions of angiotensin II by blocking the AT1 receptor and cause vasodilation and decreased aldosterone release therefore increased sodium and water excretion |
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Direct Renin Inhibitors |
Bind to renin to block the conversion of angiotensinogen to angiotensin 1 |
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Adverse effects of DRIs |
hyperkalemia persistent cough and angioedema diarrhea |
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Calcium Channel Blockers |
block the bringing of calcium from outside the cell to the inside, which is essential for contraction of the heart and smooth vasculature |
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Kinds of Calcium Channel Blockers |
Dihydropyridine and non-dihydropyidine |
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Dihydropyridine (suffix- dipine) mechanism of action and adverse effects |
decrease calcium influx into smooth muscle of arteries Adverse: flusing, dizziness, headache, peripheral edema, reflex tachycardia, rash |
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non-dihydropyridine mechanism of action and adverse effects |
block calcium channels in both the heart and smooth muscle therefore also decreased CO adverse effects: constipation, dizziness, flushing, headache, edema, compromised cardiac function |
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Centrally Acting Alpha 2 Agonists |
bind and activate alpha 2 receptors in the brainstem to decrease sympathetic outflow therefore decrease CO and peripheral resistance adverse effects: drowsiness, dry mouth, rebound HTN |
