CV-Renal Drugs Flashcards
Doxazosin (Cardura)
Selective a1-blocker resulting in decreased arterial tone.
Secondarily, blood pressure would drop.
Tx:
Hypertension
Clonidine (Catapres)
a2-receptor agonist which acts to reduce sympathetic tone to peripheral structures, resulting in decreased PVR & HR.
Also acts to reduce Renin activity Thereby further lowering PVR and reducing SV (and thus CO).
Tx: Hypertension
Dobutamine
a-receptor agonist which increases cellular cAMP levels in the heart resulting in Positive Inotropic Effects (increased Cardiac contractility & output).
Tx: Heart Failure
Metoprolol (Lopressor)
Selective B1-receptor inhibitor which reduces;
Cardiac contractility & HR-> Decreased Cardiac Output
Renin Release -> Reduced PVR & CO
Tx: Angina, Arrhythmias, & HTN
Atenolol (Tenormin)
Selective B1-receptor inhibitor which reduces;
Cardiac contractility & HR-> Decreased Cardiac Output
Renin Release -> Reduced PVR & CO
Tx: Angina & HTN
Carvedilol (Coreg)
Non selective B-receptor inhibitor which decreases HR & plasma renin activity
Tx: Heart failure & HTN
Nitroglycerin
Vasodilator
Converted to NO Intracellularly which activates Guanylyl cyclase, causing and increase in i[cGMP] which causes depohosphorylation of MLC and promoting relaxation of vascular smooth muscle and vasodilation.
Tx: Angina, OCAD
Amyl Nitrate
Vasodilator
Converted to NO Intracellularly which activates Guanylyl cyclase, causing and increase in i[cGMP] which causes depohosphorylation of MLC and promoting relaxation of vascular smooth muscle and vasodilation.
Vasodilation leads to decreased preload & increased blood flow to the myocardium
Tx: Angina
Hydralazine
Vasodilator
Promotes arteriole smooth m. relaxation & Vasodilation
Tx: Hypertension
Verapamil (Calan)
Vasodilator: Calcium Channel Blocker
Blocks voltage calcium channels located primarily in cardiac muscle & vascular smooth muscle, leading to decreased i[Ca2+] and promoting muscle relaxation & dilation of peripheral vasculature.
Also causes a decrease in myocardial contractile force
*Cardiac Suppression
Tx: Antiarrhythmia, HTN, Angina
Diltiazem (Cardizem)
Vasodilator: Calcium Channel Blocker
Blocks voltage calcium channels located primarily in cardiac muscle & vascular smooth muscle, leading to decreased i[Ca2+] and promoting muscle relaxation & dilation of peripheral vasculature.
Also causes a decrease in myocardial contractile force
*Cardiac Suppression
Tx: Antiarrhythmia, HTN, Angina
Amiodipine (Norvasc)
Vasodilator: Calcium Channel Blocker
Block voltage sensitive calcium channels located primarily in the cardiac muscle & in vascular smooth muscle, causing decreased intracellular Calcium and leading to muscle relaxation
Block Cyclic nucleotide PDE which increases cGMP & decreases Calcium influx
Results in dilation of peripheral arterioles and venules
TX: Hypertension & Angina
Nifedipine (Procardia)
Vasodilator: Calcium Channel Blocker
Block voltage sensitive calcium channels located primarily in the cardiac muscle & in vascular smooth muscle, causing decreased intracellular Calcium and leading to muscle relaxation
Block Cyclic nucleotide PDE which increases cGMP & decreases Calcium influx
Results in dilation of peripheral arterioles and venules
TX: Hypertension & Angina
Lisinopril (Prinivil)
Angiotensin/Renin Agents: ACE-inhibitor
Inhibit the formation of Angiotensin II from Angiotensin I via ACE
Resulting in:
• Decrease PVR & Blood volume -> CO
Tx: Hypertension & Heart Failure
Enalapril (Vasotec)
Angiotensin/Renin Agents: ACE-inhibitor
Inhibit the formation of Angiotensin II from Angiotensin I via ACE
Resulting in:
• Decrease PVR & Blood volume -> CO
Tx: Heart Failure & Hypertension
Losartan (Cozaar)
Angiotensin/Renin Agents: Angiotensin Receptor Blocker (ARB)
Blocks Angiotensin II receptors preventing vasoconstriction (& thus promoting vasodilation)
Tx: Hypertension
Valsartan (Diovan)
Angiotensin/Renin Agents: Angiotensin Receptor Blocker (ARB)
Blocks Angiotensin II receptors preventing vasoconstriction (& thus promoting vasodilation)
Tx: Heart Failure & Hypertension
Hydrochlorothiazide
Diuretics: Thiazides
Increase urinary & salt excretion by inhibiting Na+ & Cl- Reabsorption in the Distal Tubule (DCT) and causing net excretion of H2O (Diuresis)
Tx: Hypertension & Edema
Chlorthalidone (Thalitone)
Diuretics: Thiazides
Increase urinary & salt excretion by inhibiting Na+ & Cl- Reabsorption in the Distal Tubule (DCT) and causing net excretion of H2O (Diuresis)
Tx: Hypertension & Edema
Furosemide (Lasix)
Diuretics: Loop
Inhibition of Na+ & Cl- reabsorption in the TAL (cortical & medullary), resulting in increased NaCl excretion & Diuresis.
Also Promotes Ca2+ excretion*
Tx: Heart Failure associated Edema, HTN
Spironolactone (Aldactone)
Diuretics: K+ Sparing
Inhibition of aldosterone effects in the CCT, resulting in Na+ excretion, while retaining K+.
Tx: HF, HTN, Hypokalemia, Edema
Acetazolamide (Diamox)
Diuretics: Carbonic Anhydrase Inhibitior
Reversible inhibition of CA results in decreased H+ secretion at the Renal Tubule
*Also decreases Aqueous Humor Secretion
Tx: Edema, Glaucoma
Conivaptan (Vaprisol)
Diuretics: Vasopressin-Receptor (ADH) Inhibitor
Inhibition of the V2 vasopressin receptor, resulting in excretion of free water
Tx: Hyponatremia
Mannitol (Osmitrol)
Osmotic Diuretics
Increases osmotic pressure of glomerular filtrate, thus increasing urine output by decreasing fluid & electrolyte reabsorption
Tx: Hypernatremia* & Headache
Lidocaine (Xylocaine)
Na+ Channel blocker: Class I Anti-Arr
• Inhibit Both inactive & active Na+ channels
• Act preferentially on depolarized arrhythmogenic tissue
• Shorten AP duration
Tx: Anti-Arr
Amiodarone (Cordarone)
K+ Channel blockers: Class III Anti-Arr • Prolongs AP duration by blocking K+ channels • Does not affect conduction velocity • Blocks calcium channels • Some B-blocker activity • Coronary & peripheral vasodilator
Tx: Anti-Arr
Digoxin (Lanoxin)
Cardiac Glycoside:
• Inhibit Na/K ATPase, leading to increased i[Na+]
• Increased i[Na+] leads to a decrease in activity for the Na/Ca exchanger, resulting in an increased in i[Ca2+]
• Increased i[Ca2+] leads for increased contractile force
• Direct electrical effects on the heart include decrease in AP duration, Ectopic beats, and arrhythmias
Tx: Heart Failure & Anti-Arr
Milrinone
PDE inhibitor: Vasodilator?
• Inhibition of PDE leads to elevated cAMP
• Selective for Cardiac isoform of PDE
• Results in vasodilation and inotropic effects
Tx: Acute Chronic Heart Failure
