drugs affecting vasculature and blood Flashcards
nitrates use
angina
acute coronary syndrome
nitrates main effect
venorelaxation but arterial dilation at higher doses
nitrates mechanism
formation of NO, which inc intracellular cGMP, which activates PKG causing relaxation
nitrates AE
headache hypotension fainting reflex tachycardia tolerance
nitrates - control side effect of reflex tachycardia
prescribe with beta blockers
antagonists of endothelia
bosentan and ambrisentan
what are endothelia antagonists used in
pulmonary hypertension
renin inhibitor
aliskiren
ACE inhibitor
lisinoPRIL
what do ACE inhibitors block
conversion of AGT1 to AGT2
ARB
loSARTAN
ACE effect
cause venous dilation - dec preload
and cause arteriolar dilation - dec afterload
ACE - what can happen on first dose
steep fall in BP
ACE - specific AE
dry cough - inc in bradykinin
ACE - AE
renal failure
angioedema
hyperkalaemia
ARB effect
similar to ACE but don’t cause dry cough
ACE and ARB contraindicated in
pregnancy - where hypertension is common
clinical use of ACE and ARB
hypertension
heart failure following MI
Ca channel blocker action
inhibit L type Ca channels in SM causing relaxation and vasodilation by blocking entry of Ca into cell
in the myocardium they also produce a negative inotropic effect b reducing calcium influx in phase 2 of the actin potential