Pharm Unit 5-7

Front 1

1. direct peripheral vasodilators
2. ACE inhibitors
3. Angiotension receptor antagonists
4. Aldosterone receptor antagonists
5. Calcium channel blockers

Back 1

What are the 5 subgroups of non-autonomic inhibitors of smooth muscle?

Front 2

peripheral resistance

Back 2

All 5 subgroups of non-autonomic inhibitors of smooth muscle affects what?

Front 3

direct peripheral vasodilators

Back 3

may cause Na+ fluid retention in some individuals

used with a diuretic

Front 4

relaxes smooth muscle of vessels

Back 4

What is the mechanism of action for direct peripheral vasodilators?

Front 5

direct peripheral vasodilators

Back 5

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

Front 6

direct peripheral vasodilators

Back 6

Which non-autonomic inhibitor of smooth muscle drug does NOT get postural hypotension with the sympathetic system still functional?

Front 7

Angina

Coronary artery disease (tachycardia)

Hypersensitive reaction to drug

Back 7

What are the contraindication of direct peripheral vasodilators?

Front 8

Low BP

Back 8

What causes the release of renin from the kidneys?

Front 9

angiotensinogen (plasma protein)

Back 9

What does renin convert into?

Front 10

angiotensin I

Back 10

What does angiotensinogen convert into?

Front 11

angiotensin II

Back 11

What does angiotensin I convert to?

Front 12

ACE

Back 12

What converts angiotenin I to angiontensin II?

Front 13

Angiotensin II

Back 13

This is a vasoconstrictor and it stimulates ALDOSTERONE release from the adrenal cortex.

Front 14

adrenal cortex

Back 14

Where is aldosterone released from?

Front 15

Aldosterone

Back 15

_________ causes Na+ reabsorption and K+ secretion (increases volume) (increases BP)

Front 16

Angiotensin Converting Enzyme Inhibitors

Back 16

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?

Front 17

Angiotensin Converting Enzyme Inhibitors

Back 17

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.)

Front 18

Angiotensin Converting Enzyme Inhibitors

Back 18

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.

Front 19

Early stages of congestive heart failure

help with post MI

reduce diabetic nephronpathy

Back 19

What are other therapeutic uses for ACE inhibitors beside antihypertensives?

Front 20

other therapeutic uses for ACE inhibitors

Back 20

Early stages of congestive heart failure

help with post MI

reduce diabetic nephronpathy

Front 21

potassium
hypotension
cough

ACE inhibitors

Back 21

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

Which drug?

Front 22

Angiotensin receptor antagonists

Back 22

Mechanism of action

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

Front 23

Hypertension

Congestive heart failure

Back 23

What are the therapeutic uses for Aldosterone receptor antagonists?

Front 24

Aldosterone receptor antagonists

Back 24

Side or toxic effects

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

Front 25

Aldosterone receptor antagonists

Back 25

Contraindications

monitor potassium for hyperkalemia

Front 26

Calcium channel blockers

Back 26

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.

Front 27

vasodilation

reflex

TREAT ATRIAL TACHYCARDIAS

Back 27

Calcium channel blockers

All cause _________

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

Direct action on blocking heart still make these useful to treat ______ _________.

Front 28

Calcium channel blockers

Back 28

Therapeutic uses

Hypertension, supraventricular (atrial) tachycardia, angina. Better antihypertensive choice for black patients (along with diuretics.)

Front 29

Peripheral edema

Back 29

What is the side or toxic effect Calcium channel blockers that is different?

Front 30

Aldosterone receptor antagonist

Back 30

Mechanism of action

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

Which drug?

Front 31

Angiotensin receptor antagonist

Back 31

Blocks angiontensin

what drug?

Front 32

Angiotensin receptor antagonist

Back 32

Therapeutic uses

only recommended for hypertension control (NOT CONGESTIVE HEART FAILURE)

Front 33

Angiotensin receptor antagonist

Back 33

side or toxic effects

Essentially same as ACE inhibitors, except no persistant cough

Front 34

Congestive heart failure patients

Back 34

Who should not take ca++ channel blockers?