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Pharmacology wk 1-4

QuestionAnswer
ACE-I action suppresses aldolsterone and inhibits conversion of angiotensin I to II, useful w/diabetic
ACE-I uses HTN, CHF, post MI status, diabetic/nondiabetic nephropath, prevention of MI, stroke and death in pts w/high CV risk, reduces risk of CV morbidity and mortality
ACE-I SE chronic cough, decrease BP, rash (w/d tx), dysguesia (w/d) tx, angiodema (life threatening), neutropenia (rare), proteinura
ACE-I contraindication renal failure pts, hyperkalemia, pregnancy (categ D death to fetus in 2nd/3rd tri)
ACE I prototype enalpril (vasotec)
AT-2 (ARBS)-angiotensin receptor blocker- action block antiotension II where it is formed
ARB protoype Losartan (Cozaar)
ARB- SE similar to ACE I w/no cough, HA, dizziness, nasal congestion, hypotension, fatigue, hepatitis, renal failure, hyperkalemia (rare)
combo ARB and diuretic HTZ diovan HCT & Atacand HCT
ARB contraindication pregnancy Categ. D
Beta adrenergic blockers-action blocks sympathetic nervous system, decreases hr, AV conduction, contracitlity, and cardiac output, reduces renin long term use reduces peripheral vascular resistance
beta blocker -action affect the force and frequency of heart beats, slow metabolic processes, ease workload of heart, effective in reducing BP
beta blocker-action slower heart rate, reduces O2 consumption during myocardial contraction
beta blocker problems used alone, question mortality, Type 2 DM, do not use asthma, emphysema and chronic bronchitis (COPD), due to bronchoconstriction
beta blocker -SE masks hypglycemia, fatigue, lethargy, vivid dreams, sexual dysfunction decreased HDL, bradycardia
beta blocker pt. teaching if SE call MD, must not be stopped abruptly can cause angina, heart attack, death
Alpha blocker action blocks norepinephrine,peripheral vasoliator, relaxes blood vessels and BP loweres, widen arterioles and veins, reduces peripheral resistance and venous return to heart
Alpha blocker -use lowers BP, also BPH, glaucoma and raynaud's disease (higher risk of CP, stroke and CHF only use if no other agents)
Alpha blocker SE severe orthostatic hypotension (1st dose), increase in cardiovascular events, reflex tachycardia, inhibition ejaculation, nasal congestion, palpitations, weakness
Alpha blocker prototype doxazosin (cardura)
Alpha/beta blocker-action combo of alpha and beta blockers, produces decrease in BP w/o reflex tachycardia or bradycardia
Alpha/beta blocker prototype carveilol (Coreg)
Alpha/Beta blocker-SE exacerbate bradycardia, AV heart block, asthma, and postural hypertension, HF, orthostatic hypotension
Alpha/Beta blocker contraindication HF, heart block, COPD
Centrally acting alpha agonist-action decrease BP by stimulating central alpha receptors, decreases sympathetic outlflow from brain, resulting in vasodilation and reduced cardiac output
Central alpha antagaonist prototype catapres
Adrenergic neuron blockers-action deplete the stores of norepinephrine ro interfere w/release, last resort drug (ICU, ER), cause depression, orthostatic hypotension
Direct Acting vasodilator acts on arterioles, veins or both
Direct Acting vasodilator-use HTN, angina pectoris, HF
Direct Acting vasodilator-SE orthostatic hypotension, reflex tachycardia, increase in blod volume
Direct acting vasodilator- Hyralazine(Apresoline) and Minoxidil (Loniten) relax arterioles, decrease in peripheral resistance and lowe BP, minimal venous dilation, thus no hypotension, used w/beta blocker or diuretic
Hydralazine-use HTN, hypertensive crisis, HF
Hydralazine SE systemic lupus erytheatosus-like syndrome characterized by muscle pain, joint pain, fever, nephritis, and pericarditis; discontinue drug; may take 6 mo. to resolve
Minoxidel (Loniten)-use severe HTN, hypertichosis (Rogaine), pericardial effusion, possible cardiac tamponade
Sodium nitroprusside (Nitropress) used for HTN, causes arterial and venous dilation, caution: cyanide poisoning; avoid w/slow IV infusion: w/d if poisoning
Calcium Channel Blockers action has greatest effect on heart and blood vessels, lowers blood pressure by reg. strength and rate of heart, prevent ca ions from entering cells, decreases SA/AV node, reduce force of contraction, slow heart rate and suppress conduction of AV node
CCB-use IMMEDIATE effect on reducing BP, HTN, angina pectoris, and cardiac dysfunction (inferior to other agents in preventing strokes, heart events, kidney comp)
CCB-SE dizziness, headache, peripheral edema due to vasodilation effects
Created by: kaylie9
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