Cardiovascular Flashcards
AcetaZOLAMIDE
Inhibits carbonic anhydrase in the cells of the PCT of the nephron. Loss of Bicarb leads to loss of Na and consequently water. Causes metabolic acidosis, and alkalinizes the urine. Causes hypokalemia. Used to tx glaucoma, and also for high altitude sickness prophylaxis.
Mannitol
Osmotic diuretic that acts in proximal tubule and the descending loop of Henle. Decreases intracranial & intraocular pressure (glaucoma & cerebral edema) via volume depletion.
Furosemide/Bumetanide/Torsemide
Loop diuretics are sulfonamides that block the Na/K/2 Cl channel in the thick ascending loop. Used for volume overload states in CHF, Liver & Renal failure. Used for hypertension and hypercalcemia as well. Also causes ototoxicity, hyperuricemia, & Sulfa Allergies
Ethacrynic Acid
Non-sulfonamide Loop Diuretic. Used in pt’s with sulfa allergies or gout.
Thiazides/Chlorthalidone
Diuretic that inhibits Na/Cl co-transporter in Early DCT. Used for hypertension, nephrogenic DI (reduces polyuria), and recurrent kidney Ca stones. Causes Hypokalemia and hyperuricemia. Also impairs glucose tolerance.
Spirolactone
Competitive aldosterone receptor antagonist. Works in CCT and LDT of nephron. Decreases potassium excretion. Causes hyperkalemia and gynecomastia. Treats Primary Hyperaldosteronism and volume overload in CHF (improves survival rates). Also used in hypertension.
Eplerenone
Very similar to Spirolactone, aldosterone receptor antagonist. Doesn’t cause gynecomastia. Improves survival rates in CHF
Triamterene/Amiloride
Blocks Sodium reabsorption in distal cortical collecting tubule. Decreases potassium excretion( causes hyperkalemia). Used for CHF (volume overload), and hypertension. Amiloride is used to treat Li-induced Nephrogenic DI.
Desmopressin
Analog of ADH. Increases permeability of water in the collecting duct, therefore causing reabsorption of water and concentration of urine. Used in Central DI, also in Septic Shock and Cardiac Arrest. ALso increases Factor VIII activity. Can cause hyponatremia
Caramazepine/Chlorpropamide
Enhances the action of ADH.
Demeclocycline
Antibiotic that inhibits ADH. Used in SIADH (Small Cell Carcinoma). Also can causes nephrogenic DI.
ConiVAPTAN
V2 antagonist of ADH. Tx for SIADH
Clonidine
Alpha-2 agonist, that decreases central adrenergic activity (reduces NE release from medulla) and results in less vasoconstriction, as well as a drop in CO & HR. Used in Hypertension, cessation results in rebound hypertension. Contraindicated in pregnancy. Useful in renal disease (does not affect RBF). Can lower REM sleep.
Methyldopa
Alpha-2 agonist, that decreases central adrenergic activity (reduces NE release from medulla) and results in less vasoconstriction. Used in pregnancy for moderate HT. Causes a positive Coombs test and orthostatic hypotension. Useful in renal disease (does not affect RBF)
Guanethidine
Inhibits NE release from Symp. neurons, and causes gradual depletion. Not used anymore because it causes severe orthostatic hypotension –> shock
PrAZOSIN
Selective Alpha-1 blocker. Dilates both resistance & capacitance vessels (used to treat HT). Causes “First dose syncope”. Attenuates over time, can increase ECF/Plasma volume over time.
Tamulosin
Selective Alpha-1 blocker used to treat BPH. DOES NOT lower blood pressure.
PropanOLOL
Beta blockers depress CO through HR & Contractility. This lowers MAP, thus how it is used in treating HT. Can cause Bronchoconstriction (blocking Beta-2).
Timolol
Beta blocker used in wide-angle glaucoma
Pindolol
Beta blocker that is a weaker in action. Used to tx pt’s with bradycardia & Hypertension
Metoprolol
Selective Beta-1 blocker. Decreases HR & Contractility. Used to tx Hypertension, Tachycardia, & CAD, especially in pt’s with diabetes.
Esmolol
Short-acting Beta-1 blocker, used for treating arrhythmia, HT, & MI.
Carvedilol
Blocks Alpha-1 & Beta. Decreases HR & contractility. Used to treat hypertension. Used to treat CCHF with ACE inhibitors & diuretics. Can cause bronchoconstriction.
Aliskiren
Renin inhibitor. Blocks renin, also causes an increase in renin (that doesn’t matter as long as you take the drug). Not used anymore.
ACE inhibitors (-PRIL)
Inhibit Angiotension Converting Enzyme (AT1 –> AT2). Prevents AT2-induced vasoconstriction and Aldosterone production. Used to treat HT & CHF. Also used to tx & prevent diabetic neuropathy. Improves survival in post-MI pt’s. Causes a COUGH, and can cause angioedema
