Drugs unique properties, contraindications, test fodder Flashcards
Stress response, angiotensin II, increase osmolality, hypovolemia trigger release of?
ADH
side effect of av block and bradyarrhythmia
Propranolol (Inderal, Innopran)Metoprolol (Lopressor, Toprol); atenolol (Tenormin)
side effects include Hypocalcemia, hypomagnesemia, metabolic alkalosis, hypokalemia, ototoxicity
Furosemide (Lasix), Bumetanide (Bumex)
why is labetalol contraindicated for diabetics?
B2 blockade will prevent glycogenolysis and gluconeogenesis: important in diabetic and leads to hypoglycemia
aldosterone causes what effects on the kidney
Act on kidney to:
- Sodium retention
- Water retention
- Potassium excretion
- H+ excretion
Contraindicated: CHF, pulmonary edema, intracranial bleeding, severe renal disease with anuria
Mannitol, isosorbide
The Active metabolite is a full V1 agonist and half life is 4-6 hours?
Terlipressin
Therapeutic effects in the treatment of heart failure to reduce or reverse pathological cardiac hypertrophy and B receptor desensitization
Propranolol (Inderal, Innopran)Metoprolol (Lopressor, Toprol); atenolol (Tenormin)
used to treat Malignant hypertension, volume-based hypertension with chronic kidney disease
Furosemide (Lasix), Bumetanide (Bumex)
used to treat Hyperuricemia or gout, Acute mountain sickness (altitude sickness)
Acetazolamide (Diamox)
Released when low blood volume levels the ___________
Angiotensin II
side effects of Metabolic acidosis, urinary alkalinization, high levels of bicarbonate excreted
Acetazolamide (Diamox)
side effects include Electrolyte imbalance, pulmonary edema by increasing plasma oncotic pressure and increasing preload
Mannitol, isosorbide
side effects include Hyperglycemia (unclear mechanism), hypokalemia, metabolic alkalosis
Hydrochlorothiazide (HCTZ), chlorothiazide (Diuril)
Could be used to treat?
esophageal varies, portal hypertension
central (neurohypophyseal) diabetes insipidus- NOT nephrogenic, bleeding disorders
Vasopressin (AVP/pitressin
V1: esophageal varies, portal hypertension
V2: central (neurohypophyseal) diabetes insipidus- NOT nephrogenic, bleeding disorders
used to treat Secondary hypertension caused by hyperaldosteronism
Spironolactone (Aldactone), eplerenone (inspra)
What two CCB are dihydropyridines?
What channel conformation do they prefer?
What is the advantage?
nifedipine/Procardia
amlodipine/Norvasc
dihydropyridines prefer the inactivated L type channel
vasodilation
Angiotensin 2 causes what effects?
Thirst, ADH release, aldosterone secretion, Na+ reabsorption from PCT, renal vasoconstriction on efferent arteriole, release catecholamines, vasoconstriction
Inhibition of Na+ reabsorption in thick ascending Loop of Henle by blocking NKCC2 (Na+/K+/Cl-) transporter
Furosemide (Lasix), Bumetanide (Bumex)
diuretic Contraindicated: sulfa drug allergy
Furosemide (Lasix), Bumetanide (Bumex)
excess aldosterone would lead to?
Excess: hypokalemia, alkalosis, hypertension
does desmopressin have a long or short half life?
long
could be used to treat Post-lumbar puncture headache,
Central (neurohypophyseal) diabetes insipidus, bleeding disorders
Desmopressin (DDAVP)
Pharmacological blockage of ENaC Na+ channel (not synthesis of the channel like Spironolactone)
amiloride, triamterene,
used to treat Liddle’s syndrome: gain of function mutation of Na+ channels
amiloride, triamterene,
Synthesized in adrenal cortex response to elevated potassium and angiotensin II
aldosterone
B2 blockade for propranolol can cause?
bronchospasm/constriction, diabetics
used for treatment of Rapid treatment of increased intracranial pressure (trauma, cerebral edema, tumor)
Mannitol, isosorbide
insufficient aldosterone would lead to?
Insufficient: hyperkalemia, acidosis, hypotension
Contraindicated: ACE and ARBs (potassium sparing), chronic renal insufficiency susceptible to hyperkalemia
Spironolactone (Aldactone), eplerenone (inspra)amiloride, triamterene,
side effects of AV block, bradyarrhythmia, bronchospasm
Labetalol (Trandate)
CCB that prefer open confirmation L type calcium channel
verapamil/Covera-HS
diltiazem/Cardizem
Hypertension; preferred first line for African Americans
Hydrochlorothiazide (HCTZ), chlorothiazide (Diuril)
side effect of kidney stones
triamterene,
used to treat Preload reduction in the treatment of heart failure, SIADH
Conivaptan
a side effect of Desmopressin (DDAVP)
V2: water intoxication
side effects include Hyperkalemia, metabolic acidosis, impotence
Spironolactone (Aldactone),
the only endogenous diuretic
natriuretic peptides
side effect of ischemia, gangrene, anginal pain, myocardial ischemia, facial pallor
- Antidiuretic Hormone (ADH)
• Vasopressin (AVP/pitressin) - Terlipressin
V1: anginal pain, myocardial ischemia, facial pallor
osmotics like Acetazolamide (Diamox) and Mannitol, isosorbide are not used for?
long term treatment
