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43 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the mechanism of Diuretics? |
increase formation and secretion of urine increase renal excretion of water and sodium: reduce fluid volume |
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What are the three classification of Diuretics? |
Thiazide, Loop diuretics, potassium sparing |
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Mechanism of thiazides |
acts on early portions of dct and inhibit sodium resorption |
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examples of thiazide diuretics |
bendroflumethiazide chlorothiazide polythiazide quinethazone trichlomethiazide hydrochlorothiazide hydroflumethiazide |
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Mechanism of Loop diuretics |
Acts on ascending limb of loop of henle, inhibit reabsorption of sodium and chloride thus preventing the reabsorption of water |
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Example of Loop Diuretics |
Bumetanide Ethacrynic acid Furosemide |
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Mechanism of Potassium sparing diuretics |
prevents secretion into distal tubules |
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examples of Potassium sparing |
amilorid spironolactone triamterene |
AST |
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Adverse side effects of Diuretics |
Fluid depletion electrolyte imbalance- Hypokalemia, Hyponatremia GI disturbance Weakness Orthostatic Hypotension |
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4 theories on how beta blockers work |
Central inhibitory effect on sympathetic activity influence renin release from kidneys and within CNS Impair sympathetic activity in the ganglia or at presynaptic adrenergic terminals Combination of all of these |
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Examples of Beta blockers |
Acebutolol Betaxolol carteolol Esmolol Metoprolol Nebivolol Nadolol Pindolol propanolol Timolol Atenolol Bisoprolol Carvedilol Labetalol Penbutolol |
-Lol |
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What are the beta blockers that are relatively selective for beta 1 receptors |
Pindolol/Acebutolol Lebatolol/Propanolol |
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Adverse side effects of Beta blockers |
bronchoconstriction Excessive Depression of HR and contractility OH Depression, Fatigue, GI disturbance, Allergic reaction |
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Examples of Alpha blockers |
Doxazosin Prazosin Terazosin |
-Zosin |
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Adverse side effects of Alpha Blockers |
OH GI Disturbance |
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Examples of Centrally acting agents |
Clonidine Monoxidine Rilmenidin Guanabenz Guantacine Methyldopa |
3 dine 2 go 1 meth |
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Adverse effects of centrally acting agents |
Dry mouth dizziness drowsiness |
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Example of Ganglionic blockers |
Mecamylamine |
Most are no longer available d/t intolerable toxicities |
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Adverse side effects of Ganglionic blockers |
Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade Dry mouthGI DiscomfortUrinary retentionVisual DisturbancesExcessive Orthostatic hypotensionsympathoplegiaNeuromuscular blockade |
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MOA of CAA |
inhibits sympathetic discharge from brainstem |
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Mechanism of ganglionic blockers |
blocks the sympathetic transmission at autonomic ganglia |
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Mechanism of Presynaptic adrenergic inhibitors |
Prevent nprmal physiologic release of norepinephrine from postganglionic sympathetic neurons |
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example of PSETB |
Guanadrel guanethidine reserpine |
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examples of vasodilators |
Diazoxide fenoldopam hydralazine Minoxidil nitroprusside |
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adverse effects of vasodilators |
Reflex tachycardia dizziness postural hypotension weakness nausea fluid retention headache |
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MOA of ACE inhibitors |
Inhibits enzym that converts angiotensin 1 to angiotensin 2 (Renin angiotension-aldosterone system) |
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advantages of ACE inhibitorsq |
lowers incidence of CV side effects no reflex tachycardia and OH Prevents animal heart and vasculature hypertrophy |
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examples of ACE inhibitors |
Benazepril Captopril Enalapril Fosinopril Lisinopril Moexipiril Perindopril Quinapril Ramipril Trandolapril |
Pril |
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adverse effects of ACE inhibitors |
Allergic reaction GI discomfort Dizziness, Angina Persistent dry cough |
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Mechanism of action of angiotensin receptor blockers |
Blocks angiotensin II type 1 receptor |
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advantage of Angiotensin receptor blockers |
No effect on bradykinin metabolism-potential for more complete inhibition of angiotensin action No effect on bradykinin metabolism-potential for more complete inhibition of angiotensin action-provide benefits similar to those of ACE inhibitors in patients with heart failure and chronic kidney disease -provide benefits similar to those of ACE inhibitors in patients with heart failure and chronic kidney disease |
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Examples of Angiotensin receptor blockers |
Candesartan eprosartan ibesartan losartan olmesartan telmisartan valsartan |
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Adverse effects of Angiotensin receptor blockers |
same to ACE inhibitors |
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Mechanism of action of calcium channel blockers |
blocks calcium entry into vascular smooth muscle cell |
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example of Calcium channel blocker |
amlodipine diltiazem felodipine isradipine nicardipine nisoldipine nifedipine verapamil benidipine barnidipine lacidipine manidipine |
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adverse effects of calcium channel blockers |
OH Excessive vasodilation reflex tachycardia abnormal HR dizziness, headache, nausea |
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example of combination drugs |
Cilazapril/hydrochlorothiazide Enalapril/HydrochlorothiazideI midapril/hydrochlorothiazidem oexipril/Hydrochlorothiazide Perindoprile/ amlodipine besiliate Cilazapril/hydrochlorothiazideEnalapril/HydrochlorothiazideImidapril/hydrochlorothiazidemoexipril/HydrochlorothiazidePerindoprile/ amlodipine besiliate Cilazapril/hydrochlorothiazideEnalapril/HydrochlorothiazideImidapril/hydrochlorothiazidemoexipril/HydrochlorothiazidePerindoprile/ amlodipine besiliate Cilazapril/hydrochlorothiazideEnalapril/HydrochlorothiazideImidapril/hydrochlorothiazidemoexipril/HydrochlorothiazidePerindoprile/ amlodipine besiliate Cilazapril/hydrochlorothiazideEnalapril/HydrochlorothiazideImidapril/hydrochlorothiazidemoexipril/HydrochlorothiazidePerindoprile/ amlodipine besiliate |
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stepped care approach |
1. Diuretic, beta blocker, ace inhibitor, CA calcium blocker 2. second agent - Central acting, alpha 1, vasodilators, presynaptic inhibitor 3. 3 different agent from different classes. 4. fourth drug from another class |
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Nonpharmacologic treatment for HTN |
Sodium restriction low fat diet diet high in fish oil reduce weight reduce alcohol consumption quit smoking behavior modification |
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what is angina pectoris? |
sensation of intense compression and tightness in the retrosternal region |
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determinants of myocardial oxygen demant |
wall stress heart rate contractility |
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specific agents to treat angina |
nitroglycerine isosorbide dinitrate erythrityl tetranitrate pentaerythritol tetranitrate amyl nitrate |
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what calcium channel blockers can be used for treatment of angina pectoris |
Bepridil Diltiazem Nifedipine Verapamil |
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