Exam 2 Drugs Flashcards
Phenoxybenzamine
Noncompetitive (meaning it will have a slow on set of action)
Administered orally
Irreversible antagonist b/c it has an active metabolite that forms a covalent bond
Decreases vascular resistance?
Decrease supine and BP?
Treats hypertension patients w/ pheochromocytoma (a tumor of the adrenal medulla that secretes huge amount of catecholamines)
Also used during surgery to control hypertension
Phentolamine
Competitive (immediate on set of action)
Administered intravenously = produces vasodilation (opens up the vessels) decreasing BP
Reversible antagonist
Treats acute hypertension by the alpha agonist
used to counter act localized ischemia (inadequate blood supply to an organ)
Increase HR block alpha 2 receptor
Prazosin
Selective alpha 1 antagonist
Calcium Channel Blocker
Relaxes the vascular and other SM (urethra, urinary bladder, and prostate)
Produces vasodilation (expands vessels) = decrease BP
Treat primary hypertension
Doesn’t increase HR it doesnt block alpha 2 receptor
Causes less tachycardia than phentolamine
Doxazosin
Selective alpha 1 antagonist
Treats lower urinary tract symptoms associated with benign prostatic (prostate alpha 1) hyperplasia
Drug blocks alpha 1 receptor on prostate which allow SM to relax and allows urination
Terazosin
Selective alpha 1 antagonist
Alfuzosin
Selective alpha 1 antagonist
Treats lower urinary tract symptoms associated with benign prostatic hyperplasia
Drug blocks alpha 1 receptor on prostate which allow SM to relax and allows urination
Tamsulosin
Selective alpha 1 antagonist
Treats lower urinary tract symptoms associated with benign prostatic hyperplasia
Drug blocks alpha 1 receptor on prostate which allow SM to relax and allows urination
Siiodosin
Selective alpha 1 antagonist
Nadolol
Beta nonselective antagonist
inhibits renin secretion?
Pinodolol
Beta nonselective antagonist
Inhibits renin secretion?
Propranolol
Beta 1 nonselective antagonist (block beta 1 and 2)
Administered orally or parentally
used for hypertension, cardiac dysrhythmias, migraines, and angina pectoris
Decrease HR and cardiac output
Timolol
Beta 1 nonselective antagonist (block beta 1 and 2)
Administered as an eye drop for glaucoma
Carteolol
Beta nonselective antagonist
Inhibits renin secretion?
Pilocarpine
Muscarinic receptor agonists (helps flow)
Site of action is the trabecular meshwork
Stimulates the contraction of meridional ciliary muscle fibers (the eye)
Atenolol
Selective beta 1 blocker (block beta 2)
Block beta 2 receptors in the lungs, liver, and vascular SM to avoid beta 2 adverse effects (bronchoconstriction, hypoglycemia, decrease in peripheral blood flow)
Treat hypertension, angina pectoris, and acute myocardial infarction
Decrease HR and cardiac output
Metroprolol
Selective beta 1 blocker (block beta 2)
Block beta 2 receptors in the lungs, liver, and vascular SM to avoid beta 2 adverse effects (bronchoconstriction, hypoglycemia, decrease in peripheral blood flow)
Treat hypertension, angina pectoris, and acute myocardial infarction
Decrease HR and cardiac output
Esmolol
Selective beta 1 blocker
Administered parentally
Decrease HR and cardiac output
Carvedilol
Beta 3 nonselective antagonists (block alpha 1, beta 1 and 2)
Calcium Channel Blocker
Administered orally
Reduce ventricular wall tension and oxygen demand
Labetalol
Beta 3 nonselective antagonists (block alpha 1, beta 1, and 2)
Administered orally
Verapamil
Direct acting vasodilators
Calcium channel blocker use for SM and heart
Affect cardio myocytes
Target both vascular and cardiac tissue, reduce HR and cardiac output
Reduces ventricular wall tension and oxygen demand
Decrease afterload
Reduces digoxin clearance and increases serum digoxin levels by inhibiting P-glycoprotein mediated renal excretion
Diltiazem
Direct acting vasodilators
Calcium channel blocker use for SM and heart
Affect cardio myocytes
Target both vascular and cardiac tissue, reduce HR and cardiac output
Reduces ventricular wall tension and oxygen demand
Decrease afterload
Reduces digoxin clearance
Increases serum digoxin levels by inhibiting P-glycoprotein mediated renal excretion
Hydralazine
Direct acting vasodilators
CCB
Inhibits IP3 induced calcium release from the sarcoplasmic reticulum
Favors relaxation
Decreases BP
Increases HR, SV, and CO
Dilate arterioles NOT veins (affects after load)
Reduces ventricular wall tension and oxygen demand
LosarTAN
Angiotensin 2 receptor antagonist
Block angiotensin 2 in SM and adrenal medulla
ValsarTAN
Angiotensin 2 receptor antagonist
Block angiotensin 2 in SM and adrenal medulla
CandesarTAN
Angiotensin receptor antagonist
Block angiotensin 2 in SM and adrenal medulla
Clonidine
Central acting sympatholytics
Methyldopa
Central acting sympatholytics
Guanfacine
Central acting sympatholytics
CaptoPRIL
ACE inhibitors
in the lungs
Block formation of angiotensin 2 and inhibits the breakdown of bradykinin (vasodilator)
Adverse effects: fetal injury during 2nd & 3rd trimester/ dry cough & angioedema (swelling of skin) due to bradykinin accumulation
EnalaPRIL
ACE inhibitors
in the lungs
Block formation of angiotensin 2 and inhibits the breakdown of bradykinin (vasodilator)
Adverse effects: fetal injury during 2nd & 3rd trimester/ dry cough & angioedema (swelling of skin) due to bradykinin accumulation
LisinoPRIL
ACE inhibitors
in the lungs
Block formation of angiotensin 2 and inhibits the breakdown of bradykinin (vasodilator)
Adverse effects: fetal injury during 2nd & 3rd trimester/ dry cough & angioedema (swelling of skin) due to bradykinin accumulation
Aliskiren
Direct renin inhibitors
inhibits formation of angiotensin 1
HydrochlorothiaziDE
Diuretics Increase sodium excretion Decrease blood volume Treat high blood pressure and edema Has side effects Increase blood sugar levels Precipitate or worsen diabetes Patients allergic to sulfa drugs might be allergic to this drug
IndapamiDE
Diuretics
Increase sodium excretion
Decrease blood volume
AmiloriDE
Diuretics
Increase sodium excretion
Decrease blood volume
Inward diffusion of Na+ through the sodium channel
Drives reabsorption of Cl- and efflux of K+
AmlodiPINE
Calcium channel blocker (Dihydropyridines only target SM)
Cause reflex tachycardia
Reduces ventricular wall tension and oxygen demand
Reduce afterload
NifediPINE
Calcium channel blocker (Dihydropyridines only target SM)
Cause reflex tachycardia
Reduces ventricular wall tension and oxygen demand
Reduce afterload
Minoxidil
A potent direct acting peripheral vasodilator
Reduces peripheral resistance and lowers BP
Dilate arterioles NOT veins (affects after load)
Active metabolite Minoxidil Sulfate increase membrane permeability when the potassium channels open contracting the muscles less.
Improves hair follicles
No phase 1 rxn
Preload
Veins (to heart)
Dilation of veins
Decrease venous pressure, cardiac filing pressure, and ventricular DIASTOLIC pressure
Afterload
Arteries (away from heart) Dilation of arteries Decrease arterial and aortic pressure Reduces ventricular SYSTOLIC pressure CCB and nitrates reduce afterload = no contractions
Nitroglycerin
Organic nitrate/nitrate (acts on venous tissue in the heart)
Administered sublingual
Nitrate tolerance
Undergoes 1st pass inactivation
Amyl nitrate
Organic nitrate/nitrate (acts on venous tissue in the heart)
Potent vasodilator
Nitrate tolerance
Undergoes 1st pass inactivation
Isosorbide dinitrate
Organic nitrate/nitrate (acts on venous tissue in the heart)
Administered sublingual
Nitrate tolerance
Undergoes 1st pass inactivation
Doxorubicin
Anti-cancer drug
The use of this drug could cause heart failure
Digoxin
Positive inotropic drug
Treatment for heart failure
Increase cardiac contractility by increasing calcium in cardiac myoctyes
Digoxin inhibits ATpase (sodium pump) = increase in sodium in the SR
Sodium allows for more calcium in enter the cell = increase in contractility by shortening muscle fibers
Increase SV and CO = increase preload
Long half life
Low therapeutic index
P-glycoprotein pumps digoxin into the urine
Increases parasympathetic activity
Decreases sympathetic activity
Dobutamine
Positive inotropic drug
Beta 1 agonist
Treatment for heart failure
Increase cardiac contractility by increasing calcium in cardiac myocytes
Increase calcium influx by increasing cAMP
Short half life
Milrinone
Positive inotropic drug
Phosphodiesterase inhibitor
“inodilators”
Treatment for heart failure
Increase cardiac contractility by increasing calcium in cardiac myocytes
Increase calcium influx by increasing cAMP
Hockey stick configuration
ST segment depression
Anatacids
Can reduce the absorption of digoxin and decrease its therapeutic effect
Administer separately by 2 hours
Cholestryamine
Can reduce the absorption of digoxin and decrease its therapeutic effect
Administer separately by 2 hours
Quinidine
Reduce digoxin clearance and increase serum digoxin levels by inhibiting P-glycoprotein mediated renal excretion
Acetazolamide
Diuretics
Used for altitude sickness
Carbonic Anhydrase inhibitor
Sodium bicarbonate is inhibited in the proximal tubule
Canagliflozin
Diuretics
Mannitol
Diuretics
Osmotic agent
Urearetics
Diuretics
Osmotic agent
Furosemide
Diuretics
Loop agent
Inhibits reabsorption of sodium in the thick ascending limb = produces a greater diuresis
Thiazides
Diuretics
Aldosterone antagonists
Diuretics
Anti-Diuretic Hormone antagonists
Attracts water from adjacent collecting duct
Increases urine concentration
Adenosine
Diuretics
Loop of Henle
Reabsorption of filtered sodium chloride
Calcium and Magnesium are reabsorbed
Enables urine to be concentrated by transporting sodium chloride into surrounding interstitium
Triamterene
Diuretic Treat high blood and edema Side effects Increase blood sugar levels Precipitate or worsens diabetes
Spironolactone
Potassium Sparing Diuretic
Acts by antagonism of aldosterone in the distal renal tubules
