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Year 2 Pharmacology > Cardiovascular pharmacology VII > Flashcards

Cardiovascular pharmacology VII Flashcards

1
Q

what are the ACE inhibitor agents?

A
  1. captopril
  2. lisinopril
  3. fosinopril
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2
Q

what is the mechanism of action for the ACE inhibitors?

A
  1. decreases amount of circulating angiotensin II

2. bradykinin concentration builds up (vasodilation)

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3
Q

the ACEI effect may be very potent in which populations?

A

patients with high plasma renin levels

  1. heart failure
  2. sodium depleted patients
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4
Q

ACEIs should be avoided in which population?

A

pregnant women

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5
Q

ACEIs have potentially favorable effects in which population?

A

prediabetes

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6
Q

what are the potentially unfavorable effects of ACEIs?

A
  1. hyperkalemia

2. volume depression

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7
Q

what are the adverse effects of ACEIs?

A
  1. hypotension

2. coughing

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8
Q

what are the angiotensin I blockers?

A
  1. losartan
  2. valsartan
  3. candesartan
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9
Q

what is the mechanism of action for the angiotensin I blockers?

A

block binding of angiotensin II to AT1 receptor

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10
Q

what is the role of calcium channel blockers for hypertension?

A

add on therapy for diabetes and coronary artery disease

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11
Q

which calcium channel blocker class has more of a vascular action?

A

dihydropyridine (10:1 action compared to NDHP)

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12
Q

what are the calcium channel blocker drugs for hypertension?

A
  1. nifedipine
  2. amlodipine
  3. felodipine
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13
Q

calcium channel blockers used for hypertension should be avoided in which population?

A

LV dysfunction

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14
Q

what are the favorable effects of calcium channel blockers for hypertension?

A

elderly patients with isolated systolic HTN

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15
Q

what are the unfavorable effects of calcium channel blockers for HTN?

A

high-normal HR or tachycardia

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16
Q

what is the role of NDHP calcium channel blockers in HTN?

A

alternative to beta blockers in coronary artery disease - block decreased cardiac contraction

17
Q

what are the indications for NDHP calcium channel blockers for HTN?

A
  1. migraine
  2. arrhythmias
  3. high-normal HR or tachycardia
18
Q

what is the role of thiazide diuretics for HTN?

A
  1. uncomplicated HTN
  2. LV dysfunction (first line)
  3. previous ischemic stroke (first line)
  4. patients with osteoporosis (increases calcium reuptake)
19
Q

what are the adverse effects of using thiazide drugs for HTN?

A
  1. gout
  2. hyponatremia
  3. hypokalemia
20
Q

what are the indications for beta blockers for HTN?

A
  1. coronary artery disease

2. LV dysfunction

21
Q

what are the indications for aldosterone blockers for HTN?

A
  1. add on for resistant HTN

2. add on for coronary artery disease and LV dysfunction

22
Q

what are the favorable effects of aldosterone blockers for HTN?

A
  1. low-normal potassium

2. chronic kidney disease

23
Q

what are the adverse effects of aldosterone blockers for HTN?

A

high-normal potassium

24
Q

what is the role of a1 receptor blockers in HTN (prazosin, doxazosin, terazosin)?

A
  1. very effective especially with diuretic

2. added benefits of lowered LDL, TG, and total cholesterol

25
Q

a-methyldopa (a2 agonist) is good for what condition?

A
  1. gestational hypertension

2. chronic hypertension in pregnancy

26
Q

what is the MOA of hydralazine?

A
  1. arterial vasodilator
  2. decreases IP3 induced calcium release from smooth muscle SR - decreased contraction
  3. opens calcium activated potassium channels in smooth muscle - relaxation
  4. relaxes arterioles
27
Q

what is the role of hydralazine in HTN?

A
  1. resistant HTN add on
  2. severe chronic kidney disease
  3. gestational HTN
28
Q

what are the adverse effects of hydralazine?

A
  1. drug induced lupus (long use)
  2. compensatory tachycardia and sodium retention

should be used in combination with diuretic and beta blocker or NDHP CCB

29
Q

what is the MOA of minoxidil?

A
  1. arterial vasodilator - direct

2. potassium channel opener - relaxes arteriolar VSMCs

30
Q

what is the role of minoxidil in HTN?

A
  1. only used for severe refractory HTN

2. used in combination with beta blockers and diuretics

31
Q

what is the MOA of sodium nitroprusside?

A
  1. arterial vasodilator
  2. donates NO - cGMP mediated calcium sequestration
  3. decreases preload and afterload
32
Q

sodium nitroprusside is good for what condition?

A

acute MI

33
Q

what is the MOA of aliskiren?

A
  1. direct renin inhibitor

2. binds directly to catalytic site of renin - prevents cleavage of angiotensinogen to generate angiotensin I

34
Q

what is the contraindication for aliskiren?

A

pregnancy

35
Q

what is the MOA of reserpine?

A
  1. rauwolfia alkaloid
  2. blocks transport of NE into storage vesicles
  3. depletes NE from sympathetic nerve endings
  4. decreases sympathetic tone, PVR, BP
  5. depletes catecholamines in brain and myocardium - sedation, depression, decreased CO
36
Q

what is the role of reserpine in HTN?

A

combination with a thiazide diuretic

37
Q

what is the preferred thiazide agent for resistant HTN?

A

chlorthalidone

38
Q

what is idea behind renal sympathetic denervation in treating resistant HTN?

A

decrease sympathetic outflow to kidney to ultimately decrease renin output

Year 2 Pharmacology (70 decks)

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