Drugs Flashcards
DIURETICS
= substance/drugs that promote diuresis
Target PCT 1. Osmotic diuretics - Mannitol, 2. Carbonic anhydrase inhibitors
Target Loop of Henle 1. Loop diuretics - furosemide, bumetanide
Target Early DCT 1. Thiazide like diuretics - bendroflumethazide, indapamide
Late DCT/Collecting duct 1. K+ sparing diuretics - amiloride, 2. Aldosterone antagonist - spirinolactone
Mannitol
Osmotic diuretic - small molecules filtered into glomerulus but not reabsorbed. They increase osmolarity of the tubular fluid therefore decreasing Na+ and water reabsorption.
Uses: reduces swelling and pressure in the eyes or around the brain in eg glaucoma, in patients with acute kidney failure
S/e: pulmonary congestion, fluid and electrolyte imbalance, headache, blurred vision
Acetazolamide
Carbonic anhydrase inhibitor - interferes with Na+ and HCO3- reabsorption
Uses:
S/e: dizziness/lightheadedness
Bumetanide, Furosemide
Loop diuretic - blocks NKCC2 channel.
Uses: in heart failure and renal failure to treat fluid retention and oedema
S/e: nausea, dizziness, electrolyte imbalance, fatigue, muscle spasms
Bendroflumethazide, Indapamide
Thiazide like diuretic - blocks NCC channel
Uses: in hypertension
S/e: constipation, diarrhoea, nausea, dizziness, electrolyte imbalance, headache, postural hypotension, urticaria, hyperuricemia (–> gout)
Amiloride
K+ sparing diuretic - blocks ENaC
Uses: in heart failure and renal failure to treat fluid retention and oedema
S/e: hyperkalemia (–> asystole)
Spironolactone
Aldosterone antagonist - preventing aldosterone stimulated expression of more ENaC channels thereby reducing Na+ and water retention. it is also k+ sparing
Uses: in heart failure for oedema, ascites in cirrhosis of the liver, hyperaldosteronism, hypertension?
S/e: hyperkalemia (–> asystole)
Drugs used for hypertension
Typically: ACE inhibitors, Calcium channel blockers, Thiazide like diuretics
Atypically: alpha adrenoreceptor blockers, beta blockers
Drugs used for myocardial infarction
ACEi and beta blockers - to lower BP and decrease strain on the heart Anticoagulants Antiplatelets Statins Analgesics
Bisoprolol, Labetalol, Propranolol, Atenolol
Beta blockers - bind to beta-adrenoceptors and thereby block the binding of NA and A to these receptors. This inhibits normal sympathetic effects that act through these receptors. Therefore, beta-blockers are sympatholytic drugs. negative inotropy, negative chronotropy and vasodilation
Uses: hypertension, angina, myocardial infarction, arrhythmias and heart failure.
S/e: nightmares, weight gain, abdominal discomfort, bradycardia, confusion, depression, N+V, fatigue, dry eye, hypotension
Propranolol
Beta blocker
Uses: Arrhythmias, angina, HTN
S/e: abdominal discomfort, bradycardia, confusion, depression, N+V, fatigue, dry eye, hypotension
Doxazosin
Alpha adrenreceoptor blocker - often add ons/when other drugs poorly tolerated in HTN, block at peripheral alpha1 receptors leads to vasodilation therefore decrease in BP. In BPH they help to relax the muscle of the prostate and bladder neck, which allows urine to flow more easily.
Uses: add on hypertension, benign prostatic hyperplasia
S/e: arrhythmias, chest pain, cough, dizziness, drowsiness, N+V, urinary disorders, hypotension
Lisinopril, Ramipril
ACE inhibitor - lower your blood pressure by reducing angiotensin II in your body therefore decreasing sympathetic activity - allowing blood vessels to vasodilate. It also lowers the amount of water your body retains, which lowers your blood pressure/strain on the heart.
Uses: hypertension, adjunct in MI/heart failure
S/e: alopecia, arrhythmias, chest pain, GI discomfort, dizziness, headache, hypotension
GTN spray, Isosorbide mononitrate
Nitrates - dilate the arteries and the veins not only in the heart but also elsewhere in the body. By dilating the blood vessels of the heart, nitrates can reduce the stress on the heart by improving blood flow to the heart muscle. This will relieve angina symptoms.
Uses: angina
S/e: arrhythmias, cerebral ischaemia, dizziness, drowsiness, flushing, headache, hypotension
Amlodipine, Diltiazem, Verapamil
Calcium channel blockers - inhibition of L type calcium channels - negatively inotropic - works on the heart muscle to decrease the force of contraction therefore decreasing cardiac output
Uses: hypertension, prophylaxis of angina
S/e: abdominal pain, dizziness, drowsiness, N+V
