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