Mechanisms/Drug Class Flashcards by Melissa V | Brainscape

Q

What is the mechanism of action of renin inhibitors?

A

Inhibition of renin decreases conversion of angiotensinogen I, thereby reducing the substrate for ACE and decreasing subsequent arteriolar vasoconstriction, aldosterone synthesis, renal proximal tubule NaCl reabsorption, and ADH release

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Q

aliskiren

A

Renin inhibitor

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Q

What is the mechanism of action of ACE inhibitors?

A

Inhibition of ACE decreases conversion of angiotensin I to angiotensin II, thereby decreasing arteriolar vasoconstriction, aldosterone synthesis, renal proximal tubule NaCl reabsorption, and ADH release; ACE inhibitors also inhibit the degradation of bradykinin, and thereby increase vasodilation

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Q

captopril

A

ACE inhibitor

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Q

enalapril

A

ACE inhibitor

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Q

ramipril

A

ACE inhibitor

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Q

benazepril

A

ACE inhibitor

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Q

fosinopril

A

ACE inhibitor

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Q

moexipril

A

ACE inhibitor

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Q

perindopril

A

ACE inhibitor

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Q

quinapril

A

ACE inhibitor

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Q

trandolapril

A

ACE inhibitor

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Q

lisinopril

A

ACE inhibitor

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Q

What is the mechanism of action of angiotensin II receptor antagonists?

A

They antagonize action of angiotensin II at AT1 receptor, may also increase vasorelaxant AT2 activity

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Q

candesartan

A

angiotensin II receptor antagonist

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Q

irbesartan

A

angiotensin II receptor antagonist

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Q

losartan

A

angiotensin II receptor antagonist

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Q

telmisartan

A

angiotensin II receptor antagonist

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Q

valsartan

A

angiotensin II receptor antagonist

Q

What is the mechanism of action of B-type natriuretic peptide (BNP)?

A

BNP increases intracellular concentrations of cGMP by binding to the guanylyl cyclase receptor NPR-A of vascular smooth muscle and endothelial cells, resulting in smooth muscle relaxation

Q

nesiritide

A

B-type natriuretic peptide

Q

What is the mechanism of action of vasopressin receptor antagonists?

A

They have potent antagonist activity at V2 and weaker antagonist activity at V1, prevening vasopressin-stimulated water reabsorption via V2-coupled aquaporin channels in apical membrane of collecting duct cells

Q

conivaptan

A

vasopressin receptor 2 antagonist

Q

tolvaptan

A

vasopressin receptor 2 antagonist

Q

What is the mechanism of action of carbonic anhydrase inhibitors?

A

They inhibit sodium and bicarbonate reabsorption by noncompetitively and reversibly inhibiting proximal-tubule cytoplasmic carbonic anhydrase II and luminal carbonic anhydrase IV, leading to increased delivery of sodium bicarbonate to more distal segments of the nephron

Q

acetazolamide

A

carbonic anhydrase inhibitor

Q

What is the mechanism of action of osmotic diuretics?

A

They act as an osmole, filtered at the glomerulus but not subsequently reabsorbed in the nephron; exert an intraluminal osmotic force and limit reabsorption of water across water-permeable nephron segments

Q

mannitol

A

osmotic diuretic

Q

What is the mechanism of action of loop diuretics?

A

They inhibit sodium reabsorption by reversibly and competitively inhibiting sodium-potassium-chloride co-transporter NKCCS in apical (luminal) membrane of cells in thick ascending limp of loop of Henle; also reduce or abolish the lumen-positive transepithelial potential difference

Q

furosemide

A

loop diuretic

Q

bumetanide

A

loop diuretic

Q

torsemide

A

loop diuretic

Q

ethacrynic acid

A

loop diuretic

Q

What is the mechanism of action of thiazide diuretics?

A

They inhibit sodium chloride reabsorption by acting as competitive antagonists at NCC sodium-chloride co-transporter in apical (luminal) membrane of distal convoluted tubule cells; promote increased transcellular calcium reabsorption in distal convoluted tubule

Q

hydrochlorothiazide

A

thiazide diuretic

Q

bendroflumethiazide

A

thiazide diuretic

Q

hydroflumethiazide

A

thiazide diuretic

Q

polythiazide

A

thiazide diuretic

Q

chlorthalidone

A

thiazide diuretic

Q

metolazone

A

thiazide diuretic

Q

indapamide

A

thiazide diuretic

Q

What is the mechanism of action of collecting duct (potassium sparing) diuretics?

A

Spironolactone and eplerenone inhibit aldosterone action by binding to and preventing nuclear translocation of the mineralocorticoid receptor; amiloride and triamterene are competitive inhibitors of the principle cell membrane EnaC sodium channel

Q

spironolactone

A

collecting duct (potassium-sparing) diuretic

Q

eplerenone

A

collecting duct (potassium-sparing) diuretic

Q

amiloride

A

collecting duct (potassium-sparing) diuretic

Q

triamterene

A

collecting duct (potassium-sparing) diuretic