1what do thiazides do
diuretic
inhibit reabsorption of Na+ and Cl- in distal tubule
increase absorption of Ca
causes water retention
2most commonly used diuretic
thiazides
3hydrochlorothiazide
vasodilator, can tx kidney stones (*reduction of calcium in urine*)
4thiazide side effects
hypokalemia, hypercalcemia, gout, hyperglycemia, photosensitivity
5what do spironolactones do
potassium sparing diuretic
aldosterone receptor antagonist
inhibit Na and K channels > increased Na excretion and decreased K excr
good use with K+ depleting agents
6what do amilorides and triamterenes do
inhibit Na channels > inc excretion of Na, dec excr of K
NOT an aldosterone receptor antagonist like spironolactone
7spironolactone, amiloride and triamterenes can all
prevent loss of K+ from thiazide or loop diuretics
these are called potassium sparing diuretics
8angiotensin converting enzyme (ACE) inhibitors
captopril, lisinopril, ~prils
9what do captopril, lisinopril, ~prils do
ACE inhibitors!
inhibit angiotensin converting enzyme, dec production of angiotensin II
cause less vasoconstriction (dec sympathetic)
inc bradykinin levels (vasodilator)
less aldosterone production > less na/water retention
10ACE structure
peptidyl dipeptidase
11common adv effect of ACE inhibitors
dry cough due to inc bradykinin
angioedema
dry mouth
glossitis
oral ulceration and bleeding
12angiotensin II type 1 receptor blockers (ARBs)
losartan; ~sartan
13what do AT II type 1 receptors do
inc aldosterone, ADH, TPR, SNS
14losartan (~sartan) function
competitive antagonist of ATII type 1 receptors
for pts who cannot tolerate ACE inhibitors; less sfx
functions similar to ACEI
15calcium channel blockers function
bind to L-type ca ch's, inhibit Ca influx into cardiac and arterial sm m cells
INHIBITION OF MUSCLE CONTRACTION > dilation of art > dec BP
16non-dihydropyridine CCB
verapamil, diltiazem
17verapamil functions
non-dihydrophyridine calcium channel blocker!
significant cardiac depression
18diltiazem functions
non-dihydropyridine ccb!
similar to verapamil, depress cardiac and HR
actions on cardiac and vascular beds
19dihydropyridine CCBs
nifedipine, amlodipine
20nifedipine functions
dihydropyridine ccb!
arteriole vasodilation, little cardiac effect