1-Blood pressure drugs Flashcards
systolic blood pressure
pressure at peak ventricular contraction
diastolic blood pressure
minimum pressure during ventricular relaxation
BP fomula
BP=cardiac output x peripheral vascular resistant
sites to regulate BP
heart, vessels, RAAS
what is important to us with the nephron
what leaves and where
NaCl leaves the distal convoluted tubule
Thiazide Diuretics how do they work
inhibit NaCl reabsorption in the distal convoluted tubule
block the NaCl co transporter
Bendroflumethiazide what kind of drug
thiazide diuretics
what is Na role in the kidney normally
drives water reabsorption in the kidney
role of β1 receptors
accelerate heart
role of β2 receptors
dilation of bronchioles
what kind of G couple β1 and β2
Gs
targets for cardiac muscle in β1 activation
L-type Ca channels (increase intracellular Ca during heartbeat)
Ryanodrine receptors (increase intracellular Ca from intracellular stores)
SERCA pumps (take Ca into ER at end of heartbeat)
targets in vascular/bronchilar smooth muscle in β2 activation
myosin light chain kinase
phosphorylation causes relaxation of smooth muscle
how are adrenergic receptors inhibited? (antagonism, agonist)
competitive antagonism
inotropic
influences cardiac contractility
chronotropic
influences heart rate
how are β blocker antihypertensive?
reduce cardiac output
reduce sympathetic activity
reduce renin secretion
what causes bronchiospasm
β2 blocking prevents smooth muscle relaxation of bronchioles
carvediolol
beta and alpha inhibition
atenolol
beta1 selective
propranolol
beta inhibition (non selective between the two)
is β1 or β2 better theraputically
β1 , β2 not used at all
RAAS(renin angiotension aldosterone system) does what
controls blood volume, salt balance and blood pressure
works to keep fluid and raise blood pressure
what kind of drugs target RAAS
ARBs (angiotension receptor blockers)
ACE (angiotension converting enzyme inhibitors)
what does renin do
enzyme secreted by kidney that processes angiotensinogen to ATI
ACE what do
enzyme that processes ATI to ATII
ATII what do
powerful vasoactive peptide that causes smooth muscle control and aldosterone release
powerful vasoconstrictor
Aldosterone what do
steroid hormone that promotes reabsorption of Na and H2O in the kidney
preserved blood volume and increases blood pressure
what do beta blockers stop in the pathway
inhibit renin secretion
inhibiting RAAS does what to hypertension
anti-hypertensive
where are ACE enzymes
membrane bound protein in the pulmonary capillary endothelium
what do the Angiotension2 type 1 receptor do (At1)
mediate angiotension2
what G signalling cascade in the AT1 receptor
Gq
what does Ca signals trigger the release of in the adrenal cortex
aldosterone
what kind of hormone is aldosterone
steroid –> not prepackaged into vessicles, it is controlled at the level of synthesis
what does the mineralocorticoid receptor
steroid hormone receptor for aldosterone
where aldosterone effects and why
na/k pump
na leak channel
na/cl symporter (convoluted distal tubule)
because it increases sodium and water reabsorption
side effect of angiotension 1 inhibition and why
cough because bradykinin is not broken down
example of ace inhibitor
Captopril
how does captopril work
preents cleavage of angiotensin 1 into angiotensin 2
example of AT1 blocker/ ARBs
Losartan
how does losartan work
inhibits aldosterone secretion and vasoconstriction (AT1 blocker) receptor
are ACE inhibitors or ARBs better tolerated
ARBs
example of aldosterone antagonist
spironolactone
what does spironolactone do
diuretic because inhibits aldosterone effects
