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23 Cards in this Set
- Front
- Back
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What are the a-Adrenoceptor Antagonists drugs? and what are the MoA of these drugs?
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Prazosin
- smooth muscle relaxation - inhibition of activation of phospholipase C – inhibiting Ca2+ influx and stored Ca2+ - arterial and venous dilation Tamsulosin - can be used in benign prostatic hyperplasia to increase urine flow rates. |
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What are b-Adrenoceptor Antagonists (Beta Blockers)- 1st and 2nd gen. What are the MoA of these drugs?
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First gen: Propanolol and Pindolol.
-decrease cardiac output (HR and FOC) - decrease sympathetic outflow and rennin release. Second Gen: Atenolol and Metoprolol - more cardio selective. |
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What is the Combined a/b – adrenergic antagonists drug? and what is its MoA?
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Carvedilol
Dec. in bp achieved by reduction of systemic vascular resistance not associated with the reflex increase in hr and CO. |
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What is a K+ channel activation drug? and what is its MoA?
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Minoxidil
-preferentially dilates arterioles, decreasing TPR - closes K+ channels causing hyperpolarisation and the reflex closing of Ca2+ channels. |
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What is a Ca2+ channel antagonists (CCAs)? and what is its MoA?
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Amlodipine (Dihydropyridines)
- bind to L-type channels therefore blocking entry of Ca2+ in vascular and smooth muscle. Verapamil (Non Dihydropyridines) - preferentially affects the heart. - potent LA properties (Na+ channel block) -myocardial depression -affects the SA node. - reduced cardiac output. - used to treat supraventricular tachycardia. Diltiazem (Non Dihydropyridines) - affects both cardiac muscle and VSM. - dec. TPR – magnitude of bp reduction is related to the degree of hypertension. |
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What is a type of Nitrate and what is its MoA
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Nitroprusside
- decomposes in the blood to release NO – an unstable compound that causes vasodilation. |
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What is type of ACE inhibitor? and what is its MoA?
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Ramipril
- affect angiotensin 11 – a powerful circulating vasoconstrictor. -used for hypertension, cardiac failure, following MI or ppl at risk of ischemic HD -nephroprotective for diabetics – reduces protein filtration. |
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What is a type of ARB? and what is its MoA?
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Irbesartan
-bind selectively to AT-1 receptors on VSM & adrenal cortex - blocks effect of non-ACE angiotensin. -may be more effective than ACE inhibitors – in trial. |
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What is a type of Loop Dieuretic? and what is its MoA?
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Frusemide
- inhibit NaCl reabsorption in the thick ascending LOH - inhibit the Na+/K+/2Cl+ pump - inc. Na+, Cl-,K+, Ca2+ & Mg2+ excretion. |
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What is a type of Osmotic Diuretic? and what is its MoA?
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Mannitol (IV)
-EXTREME SITUATION - substance filtered but not reabsorbed - no K+ depletion |
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What is a type of Thiazide? and what is its MoA?
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Hydrochlorothiazide
- inc. Na+, Cl-,K+, Ca2+ & H2O excretion - vasodilator (K+ channel activation) -inducer of renal PG synthesis (inc. cGMP) - required functioning nephrons |
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What is a type of K+ Sparing Diuretics? and what is its MoA?
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Spironolactone (aldosterone antagonist)
-blocks action of aldosterone in DT and collecting ducts. - retains K+ blocks Na/K pump synthesis. -inc. sodium excretion. Triameterene (nonaldosterone antagonists) - block luminal Na+ channels (K+ retention, Na+ secretion) - faster acting - mild dieresis |
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Other than hypertension what else can beta blockers be used for?
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Beta blockers are used for treating hypertension, angina, myocardial infarction, arrhythmias and heart failure.
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How does beta blockers decrease atrial pressure?
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through decreasing cardiac output ... even more effective when used in conjunction with diuretics
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What is an additional useful effect of beta blockers?
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Inhibits the release of renin
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The first generation of beta blockers are non selective...what does this mean?
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The first generation of beta-blockers were non-selective, meaning that they blocked both beta-1(β1) and beta-1(β2) adrenoceptors.
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Second generation beta blockers are more cardio selective... exaplain? When is this mechanism lost?
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Second generation beta-blockers are more cardio selective in that they are relatively selective for β1 adrenoceptors. Although selectivity may be lost at high doses.
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Where are calcium channel blockers most active?
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These drugs are primarily active on the cardiovascular and circulatory system
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What is a major contrindication for CCB?
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Not given to people who have heart failure or actual physical damage to the heart muscle
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What is the major difference between a dihydropyridine and non dihydropyridine CCB?
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The most important difference between the two types is that non-dihydropyridine calcium channel blockers can slow down the heart rate, while dihydropyridine calcium channel blockers do not.
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What is the role of angiotensin 2?
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Angiotensin II is a very potent chemical that causes the muscles surrounding blood vessels to contract, there by narrowing the vessels
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What else can ACE inhibitors be used for?
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ACE inhibitors are used for controlling bloodpressure, treating heart failure, preventing strokes, and preventing kidney damage in people with hypertension or diabetes. They also improve survival after heart attacks.
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Describe the triple wammy effect of ACE inhibitors...
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Renal blood flow may be affected by angiotensin II because it vasoconstricts the efferent arterioles of the glomeruli of the kidney, there by increasing glomerular filtration rate(GFR). Hence, by reducing angiotensin II levels, ACE inhibitors may reduce GFR, a marker of renal function. This is especially a problem if the patient is concomitantly takingan NSAID and a diuretic.When the three drugs are taken together, there is a very high risk of developing renal failure.
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