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49 Cards in this Set
- Front
- Back
Three groups of vasoactive peptides |
1) Vasoconstrictors 2) Vasodilators 3) Peptides with mixed effects |
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ACE Inhibitors |
1) Captopril 2) Enalapril 3) Lisinopril |
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Angiotensin II Receptor Blockers (ARBs) |
1) Saralasin 2) Losartan 3) Valsartan 4) Telmisartan |
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Renin Inhibitors |
Aliskiren |
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Drugs that block renin release |
1) Clonidine 2) Propranolol |
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ACE Inhibitors - Mechanism of Action |
1) Block angiotensin converting enzyme (ACE), resulting in decreased ANG II formation 2) Decrease systemic vascular resistance (arteriolar and venous); promote natriuresis 3) Prevents bradykinin degradation |
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Side effects of ACE Inhibitors |
1) Cough 2) Angioedema 3) Hyperkalemia NOTE: Contraindicated in pregnancy |
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Therapeutic use of ACE Inhibitors |
1) Mild to moderate hypertension 2) Diabetic renal failure 3) Congestive heart failure |
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Saralasin |
1) A partial AT receptor agonist that functions as a peptide angiontensin II receptor blocker (ARB) 2) used to treat renin-dependent hypertension |
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Nonpeptide ARBs |
1) Losartan 2) Valsartan 3) Telmisartan |
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Nonpeptide ARBs - Mechanism of action |
1) Competitive antagonists of AT1 receptor 2) Do not interfere with bradykinin degradation |
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Clinical Uses of Nonpeptide ARBs |
1) Hypertension 2) Congestive Heart Failure 3) Prevention of diabetic nephropathy |
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Side effects of Nonpeptide ARBs |
1) Lower incidence of cough 2) Contraindicated in pregnancy and patients with nondiabetic renal disease |
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Aliskiren - Mechanism of Action |
1) Inhibits action of renin, which results in decreased ANG I, ANG II, and aldosterone levels 2) Does not interfere with bradykinin degradation |
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Clinical Uses of Aliskiren |
Hypertension |
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Side effects of aliskiren |
1) Hyperkalemia 2) Renal impairment
3) Headache
4) Diarrhea 5) Contraindicated in pregnancy |
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Vasodilators |
1) Hydralazine 2) Minoxidil 3) Diazoxide 4) Sodium Nitroprusside |
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Hydralazine - Mechanism of Action |
1) Release of nitric oxide from endothelial cells 2) Relaxes smooth muscle (more effective on arterioles) |
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Clinical Uses of Hydralazine |
1) Severe hypertension (long term outpatient therapy) 2) Heart failure |
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Side effects of Hydralazine |
1) Headache 2) Nausea and anorexia 3) Palpitations 4) Sweating and flushing 5) Lupus like syndrome (high doses) 6) Peripheral neuropathy (not common) |
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Minoxidil- Mechanism of action |
1) Opens potassium channels, resulting in hyperpolarization of smooth muscle 2) Promotes arteriolar vasodilation |
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Clinical Uses of Minoxidil |
1) Severe hypertension 2) Baldness (topical application) |
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Side effects of Minoxidil |
1) Hypertrichosis 2) Headache 3) Sweating |
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Diazoxide - Mechanism of action |
1) Opens potassium channels, resulting in smooth muscle hyperpolarization 2) Produces arteriolar vasodilation 3) Reduces insulin release |
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Clinical Uses of Diazoxide |
Hypertensive emergencies |
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Side effects of Diazoxide |
1) Hypotension 2) Hyperglycemia 3) Edema 4) Reflex tachycardia |
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Sodium Nitroprusside - Mechanism of Action |
1) Stimulates release of nitric oxide and increases cGMP 2) Decreases total peripheral resistance by dilation of arterioles and venules |
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Clinical Uses of Sodium Nitroprusside |
1) Hypertensive emergencies 2) Severe heart failure |
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Side Effects of Sodium Nitroprusside |
1) Excessive hypotension 2) Shock 3) Cyanide toxicity |
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Drugs used to treat angina |
1) Nitrates 2) Beta blockers 3) Calcium channel blockers |
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Types of nitrates |
1) Nitroglycerin (prototype) 2) Isosorbide dinitrate 2) Isosorbide mononitrate |
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Nitrates - Mechanism of Action |
1) A prodrug of nitric oxide 2) Increases NO levels, resulting in smooth muscle relaxation and venodilation 3) primarily works on arteries and veins; no direct effects on cardiac muscle |
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Clinical Uses of Nitrates |
1) Acute angina episodes (given sublingual) 2) Prophylaxis of angina (given oral or transdermal) 3) Acute coronary syndrome (given IV) |
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Side effects of Nitrates |
1) Tachycardia 2) Orthostatic hypotension 3) Throbbing headache |
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Monday Disease |
1) Syndrome experienced by workers exposed to nitrate contaminants in the workplace 2) Workers develop tolerance to nitrates during the work week that disappears over the weekend |
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Amyl nitrate |
1) Rapid acting drug taken via inhalation 2) Acts by releasing NO, resulting in increased cGMP and vasodilation |
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Clinical Uses of Amyl Nitrate |
1) Rarely prescribed to prevent angina 2) Cyanide poisoning |
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Side effects of Amyl Nitrate |
Methemoglobinemia (at high concentrations) |
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Beta Blockers -Mechanism of Action |
1) Acts primarily on the heart 2) Inhibits beta adrenergic receptors 3) Decreases heart rate, cardiac force and pressure 4) Increases heart size and injection time |
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Clinical Uses of Beta Blockers |
Prevent effort angina |
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Side effects of Beta Blockers |
1) Cardiovascular effects (bradycardia, atrioventricular blockade, heart failure) 2) Severe asthma attacks 3) CNS effects (sedation, fatigue, sleep alterations) 4) Sexual dysfunction |
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Types of Calcium Channel Blockers |
1) Dihydropyridines (Nifedipine, Amlodipine) 2) Phenylalkylamines (Verapamil) 3) Benzothiazepines (Diltiazem) |
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Calcium Channel Blockers - Mechanism of Action |
Blocks L-type calcium channels in heart and blood vessels; results in decreased intracellular calcium |
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Clinical Uses of Calcium Channel Blockers |
1) Treatment of AV node arrythmias (verapamil and diltiazem only) 2) Hypertension 3) Prophylatic therapy for effort and vasospastic angina 4) Moderately effective in hypertrophic cardiomyopathy, migraine and Raynaud's phenomenon |
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Side Effects of Calcium Channel Blockers |
1) Constipation 2) Pretibial edema 3) Nausea 4) Flushing 5) Dizziness 6) Heart failure 7) AV blockade 8) Sinus node depression |
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Ranolazine - Mechanism of Action |
1) Blocks late inward sodium current in myocardial cells, resulting in decreased calcium accumulation 2) Decreases end diastolic pressure and improves diastolic coronary flow 3) Thought to inhibit fatty acid oxidase |
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Clinical Uses of Ranolazine |
Prevent angina |
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Side effects of Ranolazine |
1) Constipation 2) Nausea 3) Dizziness 4) Prolongs QT interval |
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Ivabradine |
1) Drug that inhibits If sodium channel in SA node; produces a reduction in heart rate and reduced myocardial O2 demand 2) Approved in U.S. for treatment of chronic heart failure 3) Also used in Europe to treat stable angina |