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38 Cards in this Set
- Front
- Back
drugs that enters the CNS and causing decreased SANS outflow resulting in lowered BP and HR
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a2 agonists:
Clonidine Methyldopa |
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Adverse effects of clonidine
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rebound HTN
sedation |
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adverse effects of methyldopa
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hemolytic anemia (positive Coomb's test)
sedation |
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a2 agonist DOC during pregnancy
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methyldopa
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irreversibly blocks the vesicular monoamine transporter (VMAT) that normally transports free norepinephrine, serotonin, and dopamine from the cytoplasm of the presynaptic nerve terminal into storage vesicles for subsequent release into the synaptic cleft
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reserpine
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blocks the reuptake of norepinephrine and depletes the stores
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Guanethidine
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adverse effects of postganglionic neuron blockers: resperine and guanethidine
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sedation, severe psychiatric depression
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a1 antagonist
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prazosin
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adverse effects of prazosin
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1st dose hypotension
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drug of choice in patients with HTN and BPH
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prazosin
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two effects associated with B blockers
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decrease cardiac output
decrease renin release |
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adverse effects of B blockers
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bronchospasm seen in propanolol
avoid use in patients with SA/AV nodal dysfunction raised risk of stroke in patients over 60 |
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Effects of ACE inhibitors
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blocks conversion of ATN I to ATN II
blocks inactivation of bradykinin which is also a vasodilators |
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Blocks ATN II receptor
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Losartan
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Adverse effects of ACE inhibitors
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Hyperkalemia (decreased ENaC usage in DCT)
Teratogen - contraindicated in pregnancy Cough and Angioedema - both due to increased bradykinin |
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Adverse effects of ATN II receptor blocker
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Hyperkalemia
teratogen |
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Ca channel blockerd with greater vasodilatory effect than cardiacdepressent effect
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Nifedipine
amlidopine finoldipine |
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Ca channel blockers with combined vasodilatory and cardiodepressent action
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Verapamil
Diltiazem |
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Which drugs should be avoided to use in combination with B-blockers
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Verapamil and Diltiazem
**Can result in extreme cardiac depression |
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Adverse effects of Verapamil/Diltiazem
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excessive cardiac depression
constipation avoid in patients with cardiac conduction disturbances |
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Opens K channel in smooth muscle resulting in decreased Ca entry and smooth muscle relaxation
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Minoxidil
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increaes eNOS release causing arteriolar dilation
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Hydralazine
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associated with lupus-like syndrome
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hydralazine
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associated with hirsutism
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Minoxidil
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why should hydralazine/minoxidil not be used as monotherapies
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because they trigger baroreceptor-mediated tachycardia and RAAS activation
*need to be used in combination with B-blockers and diuretics |
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Releases NO from drug molecule resulting in increased cGMP resulting in vasodilation of both arteries and veins
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Nitroprusside
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associated with cyanide toxicity
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Nitroprusside
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Drug of choice for HTN emergency
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nitroprusside
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First-line DOC for HTN always
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Thiazide diuretics
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physiologic axn of each:
a1, a2, B1, B2 |
a1 - increases IP3 and intracellular Ca leading to vasoconstriction
a2 - decreases cAMP leading to decreased NE release from presynaptic neurons or contracts vessels directly if postsynaptic B1 - increases cAMP and intracellular Ca leading to increased HR and contractility of the heart B2 - increased cAMP and intracellular Ca causing vasodilation |
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patient population that respond less well to ACE inhibitors
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Blacks
Elderly |
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selective B1 blockers
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atenolol
metoprolol acebutolol - can be B-agonist at high concentrations |
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nonselective B blockers
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propanolol
timolol pindolol - can be B agonists at high concentrations |
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3 drugs associated with increased vascular compliance
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thiazide diuretics
Nitrates ACE inhibitors |
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Why would ACE inhibitors still help in people with low renin levels
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because increase bradykinin availability
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differentiate cardiovascular effects of amlidopine vs. nifedipine
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amlidopine has no affect on contracility while nifedipine decreases contractility - both are good vasodilators
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vasodilator least likely to induce orthostatic hypotension
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hydralazine - only dilates arterioles, NOT veins
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combined alpha and Beta blockers
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carvedilol
labetalol |