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43 Cards in this Set
- Front
- Back
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define renin
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a proteolytic enzyme that is synthesized and stored in the juxtaglomerular cell of the kidney.
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What are some reasons renin is released
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*decrease in renal perfusion
(hemorrage, dehydration, chronic Na ion depletion, renal artery stenosis) *by Sympathetic nervous System stimulaton by activation of beta adrenergic receptors |
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What are the effects of Angiotensin II on the body
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1. *Aldosterone secretion from
adrenal cortex 2. Na & Cl reabsorption k excretion h20 retention 3. *Arteriolar vasoconst. 4. ADH secretion from pituitary gland which increases h20 reabsorption 5. Sympathetic activity - thirst |
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Where are the vasocontrictive effects from angiotensin II greatest in the body
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skin
splanchic vasculature kidneys |
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coronary artery vasoconstriction due to angiotensin II can lead to
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decreased coronary blood flow
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What factors alter plasma renin activity
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1.PEEP (inc renin)
2.Nitroprusside hypotension (inc. in ADH & renin)(propranolol will prevent inc.in renin) 3. Activation of SNS (stim. beta) |
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what drugs block the Renin-angiotensin-aldosterone system
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1.ARB's (angiotensin II receptor blockers)
2.Ace Inhibitors 3. Beta Blockers 4. Clonidine (sympatholytic) |
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What do you call a polypeptide that include kallidin and bradykinin
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Plasma kinins
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What are the most potent known endogenous vasodilator
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plasma kinins
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What do kinins do
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1. inc. capillary permeability
2. produce edema 3. Evoke intense burning pain by acting @ nerve endings. |
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Plasma kinins are 10 x's more potent than ? as a vasodilator
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histamine
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Diseases that may be associated with excess formation of plasma kinins such as bradykinin include
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1.Septic shock
2.Allergic Rx 3.Carcinoid syndrome |
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Essential hypertension may be a cause of inadquate amonts of
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bradykinins
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A naturally occuring polypeptide inhibitor of proteolytic enzyes that is isolated from bovine lung
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Aprotinin
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What does Aprotinin inhibit
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trypsin, plasmin, tissue and plasma kallikrein
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indicated for reduction or prevention of blood loss in pts undergoing CABG when a high risk of excessive bleeding exists
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AProtinin
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The ACT is prolonged in the presence of heparin plus aprotinin when ? is used as the surface activator
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celite (use kaolin instead)
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Adverse rx's for aprotinin
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-inc. risk for postop renal dys.
-phlebitis -dyspnea -bronchoconstriction -fever and mental confusion |
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What is the other name for serotonin
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5-HT
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A widely distributed endogenous vasocactive substance (autocoid) that evokes complex changes in the cardiovasculas system
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Serotonin
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Functions as a neurotransmitter in emesis and pain transmission
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Serotonin
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Where is seretonin found in the body
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90% GI tract
rest in CNS and platelets |
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Cerebral vasoconstriction is mediated by
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5-HT1 Receptors
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5-HT2 receptors effect
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Vasoconstrictionof coronary arteries and pulmonary vessels
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What has revolutionized the management of drug induced N/V
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Antagonism of 5-HT3 receptors
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5-HT4
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Gastrokinntic effects of metoclopromide
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Serotonin is synthesized from ?
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the amino acid precursor tryptohan
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Metabolism of serotonin
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monoamine oxidase
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A 5-HT1 receptor agonist that is used to tx migraine and cluster HA
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Sumatriptan
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Will a repeat injection of sumatriptan be needed and why
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yes, due to elimination half time of 2 hrs.
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What pts should you not use sumatripan and why
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CAD pts, due to potential coronary artery vasoconstriciton
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A 5-HT1b agonist that is indicated for tx of migraines with or without aura
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Rizatriptan
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What is Methsergide
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A congener of lysergic acid (LSD)but lacks Signi. CNS effect
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What is methsergide used for
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prophylaxis of migraine or other vascular HA
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other uses of methsergide
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tx of malabsorbtion and diarrhea in pts. w/ carcinoid syndrome
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Side effect with methsergide
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retroperitoneal fibrosis
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What is cyproheptadine
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resembles the structure of H1 receptor blockers and is able to block receptors for both histamine and serotonin
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What is used to tx seasonal and other allergic symptoms
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cyproheptadine
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Unlabeled uses include appetite stimulation, blepharospasm nelsons syndrome, cluser HA, schizophrenia, tardive dyskinesia, and spinal cord damage associated spacisity
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Cyproheptadine
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These agents help with N/V due to chemotherapy and radiation
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5-HT3 receptor Antagonist
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Name 2 drugs that are 5-HT3 antagonists
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Ondansetron (zofran)
dolansetron |
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Which drug do you always have to give a test dose to
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Aprotinin
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What is an impt warning/precation to remeber with dolasetron
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pts who have or develop prolongaton of QTI
pts with low k, mg, pts taking diuretis, antiarrhy, |
