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34 Cards in this Set

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1. direct peripheral vasodilators
2. ACE inhibitors
3. Angiotension receptor antagonists
4. Aldosterone receptor antagonists
5. Calcium channel blockers
What are the 5 subgroups of non-autonomic inhibitors of smooth muscle?
peripheral resistance
All 5 subgroups of non-autonomic inhibitors of smooth muscle affects what?
direct peripheral vasodilators
may cause Na+ fluid retention in some individuals

used with a diuretic
relaxes smooth muscle of vessels
What is the mechanism of action for direct peripheral vasodilators?
direct peripheral vasodilators
Side or toxic effects

1. reflex tachycardia due to decreased BP (given with beta blockers)

2. some CNS and GI effects - mechanism not understood
a. headach (common)
b. nausea and loss of apetite (probably why not prescribed more)
c. dizzines and sweating
direct peripheral vasodilators
Which non-autonomic inhibitor of smooth muscle drug does NOT get postural hypotension with the sympathetic system still functional?
Angina

Coronary artery disease (tachycardia)

Hypersensitive reaction to drug
What are the contraindication of direct peripheral vasodilators?
Low BP
What causes the release of renin from the kidneys?
angiotensinogen (plasma protein)
What does renin convert into?
angiotensin I
What does angiotensinogen convert into?
angiotensin II
What does angiotensin I convert to?
ACE
What converts angiotenin I to angiontensin II?
Angiotensin II
This is a vasoconstrictor and it stimulates ALDOSTERONE release from the adrenal cortex.
adrenal cortex
Where is aldosterone released from?
Aldosterone
_________ causes Na+ reabsorption and K+ secretion (increases volume) (increases BP)
Angiotensin Converting Enzyme Inhibitors
Mechanism of action

Less vasoconstriction and less aldosterone secretion so less fluid retention. Work well. Becoming more popular. Less effective in black patients.

What drug?
Angiotensin Converting Enzyme Inhibitors
Side or toxic effects

Persistant cough, rash, proteinuria, headache, myaglia, dyspepsia, diarrhea

Physicans less worriend about severe effects which include fatal bone marrow depression and renal damage (occurs chiefly in patients with renal disease.)
Angiotensin Converting Enzyme Inhibitors
Contraindications

Pregnancy: 2nd and 3rd trimester death or injury to fetus

Caution in volume depleted or hyperkalemic (high potassium ion) patients

This agent is especially effective with a small dose of hydrochlorothiazide.
Early stages of congestive heart failure

help with post MI

reduce diabetic nephronpathy
What are other therapeutic uses for ACE inhibitors beside antihypertensives?
other therapeutic uses for ACE inhibitors
Early stages of congestive heart failure

help with post MI

reduce diabetic nephronpathy
potassium
hypotension
cough

ACE inhibitors
Less likely to cause _________ depletion and cardiac arrythmias. More likely to cause first does _________ and dizziness, decreased renal function and severe persistant _______.

Which drug?
Angiotensin receptor antagonists
Mechanism of action

Prevents angiotensin II from constricting smooth muscle and stimulating adrenal cortex for aldosterone release.
Hypertension

Congestive heart failure
What are the therapeutic uses for Aldosterone receptor antagonists?
Aldosterone receptor antagonists
Side or toxic effects

Few so far. Diarrhea, rare increases in liver enzymes and kidney markers like BUN, creatinine and uric acid.
Aldosterone receptor antagonists
Contraindications

monitor potassium for hyperkalemia
Calcium channel blockers
All cause vasodilation

Usually a reflex tachycardia also occurs (though not always).

Direct action on blocking heart still make these useful to TREAT ATRIAL TACHYCARDIAS.
vasodilation

reflex

TREAT ATRIAL TACHYCARDIAS
Calcium channel blockers

All cause _________

Usually a ______ tachycardia also occurs (though not always).

Direct action on blocking heart still make these useful to treat ______ _________.
Calcium channel blockers
Therapeutic uses

Hypertension, supraventricular (atrial) tachycardia, angina. Better antihypertensive choice for black patients (along with diuretics.)
Peripheral edema
What is the side or toxic effect Calcium channel blockers that is different?
Aldosterone receptor antagonist
Mechanism of action

Blocks aldosterone receptors in epithelial (kidney) and non-epithelial (heart, BV, brain) tissues.

Which drug?
Angiotensin receptor antagonist
Blocks angiontensin

what drug?
Angiotensin receptor antagonist
Therapeutic uses

only recommended for hypertension control (NOT CONGESTIVE HEART FAILURE)
Angiotensin receptor antagonist
side or toxic effects

Essentially same as ACE inhibitors, except no persistant cough
Congestive heart failure patients
Who should not take ca++ channel blockers?