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Cardiovascular III
Antihypertensives
| Term | Definition |
|---|---|
| Diuretics | Loop (high-ceiling), thiazide, potassium sparing |
| Loop (high-ceiling) | most potent natriuretic agents, rapid onset, intense diuresis, short duration, enhance Na, Cl, K, Ca, Mg excretion, acts on entire thick ascending limb Ex: Furosemide: reduce acute edema, |
| Loop (high-ceiling) SIDE FX | extracell fluid volume depletion, potassium depletion, hypochloremia, deafness, hypocalcemia, arrythmias, |
| Thiazide | weakly natriuretic, prolonged duration, increase excretion of Na, Cl, K |
| Hydrochlorothiazide (thiazide) | antihypertensive (after 3-7 days), stabilize BP at lower level without further major direutic effect. Reduce excretion of Ca++ in hypercalciuria (kidney stones) |
| Thiazide SIDE FX | Side effects: extracell fluid volume depletion, potassium depletion, hypochloremia. |
| Potassium-sparing | weakly natriuretic, potent anti-kaliuretic. Act on last half of distal tubule and cortical collectin duct. |
| Spironolactone (Potassium Sparing ) | effective if aldosterone is high, delayed onset, prolonged action (2-3 days), Side effects: gyno and menstrual abnomralities. |
| Triamterene(Potassium Sparing ) | effective regardless of aldosterone level, rapid onset, long duration (12-16 hours) |
| Potassium Sparing (Potassium Sparing ) | Protect against K+ loss. |
| Ace Inhibitors | Work by decreasing afterload, increasing cardiac output, lowering preload and heart rate. Work as arterial vasodilators. |
| Captopril (ACE INHIBITOR) | Rapidly absorbed, food reduces this. Maximum responde 2-4 hours, metabolized by liver, can cause rash, dry cough, reduced taste, severe hypotension on first dose, protein urea. |
| Enalapril (ACE INHIBITOR) | metabolized to active compound Enalaprilate. Long half life (10X more than captopril). |
| Diazoxide | Powerful arterial dilator (non-direutic thiazide). Side effects: reflex cardiac stimulation, sodium water retention, hyperglycemia. |
| Hydralazine | Arterial vasodilator, moderate effectiveness, for hypertensive crisis. Highly metabolized, unknown mechanism. Side effects include reflex cardiac stimulation, sodium and water retention, headaches, lupus syndromes. |
| Minoxidil | Powerful oral vasodilator, usually resered for refractory hypertension, activated by liver metab. Side effects: reflex cardiac stim, sodium water retention, hypertrichosis with prolonged use. |
| Nitroprusside | mixed vasodilator. i.v. for severe hypertension, first choice if life threatening. Rapid onset, consistent effects, low toxicity. Generates NO. Side effects: toxicity, excessive dilation, thiocyanate poisioning,. |
| Others | Diazoxide, hydralazine, minoxidil, nitroprusside |
| Prazosin | similar to nitroprusside, blocks a1 receptor (no a2 blockade). Development of tolerance. |
| Nitrates | same as in Ionotropes |
| Clonidine | alpha 2 agonist. Decreases central adrenergic outflow. Causes sodium water retention (combine with diuretic to fix this). |
| Clonidine SIDE FX and USE | Side effects: sedation, dry nasal mucosa. Use: test for pheochromocytoma, concomitant renal disease. |
| Alpha-methyl dopa | same as clonidine |
Created by:
vbukorovic
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