Drugs with CV Actions Flashcards
1st Gen Nonselective BB
2nd Gen selcetive B1B
Propranolol/Nadolol
Atenolol/Meoprolol
3rd gen BB blockers
Blocks alpha receptors/antioxidants/reduces CH
Blocks Alpha receptors
Vasodilator actions
Carvedilol
Labetalol
Nebivolol
Dihydropyridine Ca Channel Blockers
Vasodilators with mixed mechanisms
Inhibitors of RAAS
Thiazide diuretics
Amlodipine/Nifedipine
Hydralazine/Minoxidil
Aliskerin/Lisinopril/Losartan
Hydrochlorothiazide/Chlorthalidone
Na Channel blocking diuretics
Aldosterone antagonists
Central Alpha 2A agonist
Amiloride/triameterine
Eplerenerone/spironolactone
clonidine
Beta Adrenergic receptor antagonists block
actions of endogenous NT and exogenous drugs
Beta 1 and B2
Physio consequences of the B1 receptor
BB effect
Partial _____ effect
Inc contractile force, HR, renin release/At2
dec force/rate of mycardial contraction and renin secretion
antiarrhthymic
Therapeutic indications for BB
HTN SVT IHD PMI HF
HTN- dec CO/HR/Renin
SVT- blocks SA/AV node
Ischemic HD- dec force/rate and decrease myocardial O2 consumption
MI= prevent reinfarction, dec O2 consumption, blocks arrhythmias
HF- reduces symp activity, hypertrophy, free radicals
SE of BB
B2B
Bradycardia/AV nodal blockade
Dec contractility
Hypotension
Sedation/fatigue/lassitude
Exacerbates airway dz (COPD/asthma) and PVD (Raynauds)
Dihydropyridine Ca Channel Blockers
Use
Effect
Amlodipine/nifedipine
1st line anti-HTN
Arterial vasodilators dec PVR
CCB MOAs
Block Ca channels in heart- slow HR, lower BP
Dilates arteries- lower pressure
Hydralazine (vasodilator)
Use
Toxicities- genetics and typical
Relax arterial SM
2nd line- moderate to severe HTN
G- inactivated by N-acetylation, can produce lupus like syndrome, inc with slow acetylators
HypoTN, headache, tachycardia
Minoxidil (VD) MOA
USE
SE
Arterial vasodilator that stimulates outward K+ channel, leading to repolarization of VSM
Treatment of M/S HTN
Hypotension/headache/tachycardia/hair growth
Aliskerin
Losartan
Lisinopril MOA
inhibits renin
blocks At1 receptor
Blocks ACE
Therapeutic indications for ACEI and ARBs
Caution
1st line for HTN and HF
Pregnancy
SE of ACEI
Persistent cough
ACE degrades bradykinin
Blockage leads to build up and cough
SE of ACEI/ARBs
Hyperkalemia bc dec aldo secretion (concern with other drugs)
Angioedema
Loss of taste
HypoTN
Aliskerin MOA
Use
Binds to active site of renin, blocks catalytic activity- dec AT2
Alone/combo to treat HTN
Thiazide diuretics use
Initial/LT effect
1st line for HTN- alone or in combo
Reduce plasma volum- hypoTN
LT= dec PVR
SE and toxicity of Thiazides
Interactions
HypoTN, volume depletion, impotence
Hypokalemia- inc risk of arrhythmias
HS rxns due to similarity to sulfonamides
NSAIDS can blunt effect
Inc Lithium levels- toxicity in therapy of BPD
K+ sparing diuretics
Na channel inhibitors
Aldo agonists
Amiloride and triamterine
Spironolactone/Eplerenerone
Uses of K+ sparing diuretics
Spironolactone and eplerenerone
Not alone for HTN
Minimize K+ loss by other diuretics (help other diuretics)
S/E= HF
K+ diuretics toxicity
hyperkalemia
S- gynecomastia and dec libido and impotence in men, menstrual irregularities in women
E has less effects
Clonidine
Can treat
Agonist of A2 receptors in BS CV center
Dec sympathetic outflow
Dec blood pressure
HN, ADHD, withdrawal, neuropathic pain, Tourette’s syndrome
