Pharm- Lec#5 - Vasoactive Peptides

Question 1

Captopril

• MOA
• Route

Answer 1

• ACE inhibitor

- oral

Question 2

Captopril

• indications
• SE

Answer 2

ACE inhibitor

• HTN

Adverse Effects

• severe stomach pain
• chest pain
• allergic reaction

Question 3

Enalapril

• MOA
• route
• indications

Answer 3

ACE inhibitor

oral

• HTN

Question 4

Enalapril

• Adverse effects

Answer 4

• HYPOTENSION

- severe stomach pain

Question 5

Losartan

• MOA
• route
• indication

Answer 5

Angiotensin Receptor Inhibitor

• oral
• hypertension

Question 6

Losartan

• adverse effects

Answer 6

Diarrhea
Insomnia
Nasal Congestion

Question 7

Valsartan

• MOA
• route
• indication

Answer 7

• angiotensin receptor inhibitor

oral

HTN

Question 8

Icatibant

MOA
Route

Answer 8

• Bradykinin receptor inhibitor
  (DO NOT USE FOR SEPSIS)

-oral

Question 9

Icatibant

Indication
Adverse Effects

Answer 9

-inflammatory response

AE:
stomach pain
nausea
same as valsartan

Question 10

Aprotonin (tresolol)

MOA
route

Answer 10

Kallikrein inhibitor

• IV

Question 11

Aprotonin

indication
adverse effect

Answer 11

Inflammation

SE:
heart attack
stroke
kidney failure

Question 12

Desmopressin

MOA
route

Answer 12

Vasopressin Analogue

• IV

Question 13

Desmopressin

indication
adverse effect

Answer 13

Bleeding

Headache
Nausea
stomach pain

Question 14

Bosentan

• MOA
• route

Answer 14

endothelin receptor inhibitor

ORAL

Question 15

Bosentan

indication
adverse effect

Answer 15

PULMONARY HYPERTENSION

• liver problems
• stomach pain
• nausea

Question 16

What drug increases plasma levels of wf, factor 8 and tPA?

Answer 16

Desmopressin

Question 17

The following are vasoconstrictors or vasodilators:

Angiotensin II
Endothelins
Neuropeptide Y

Answer 17

Vasoconstrictors

Question 18

The following are vasoconstrictors or vasodilators:

bradykinin
BNP/ANP
CGRP (calcitonin)
VIP

Answer 18

vasodilators

Question 19

What drugs is liberated when kallikrein is active?

What activates kallikrein

Answer 19

Bradykinin

• Hageman factor (XII) activates kallikrein in the intrinsic contact pathway
• normally degraded by ACE

Question 20

What is another name for ACE?

Answer 20

Kininase-II

Question 21

Corticosteroids, estrogens, thyroid hormones, and ATII all increase plasma levels of what?

Answer 21

ANGIOTENSINOGEN

• also increased in pregnancy related hypertension

Question 22

ACE (angiotensin converting enzyme) is also known as what?

Answer 22

Kininase II

or

Peptidyl Dipeptidase

Question 23

What is the half life of AT II

Answer 23

short

about 60 seconds

Question 24

AT II is extremely potent vasoconstrictor that stimulates the release of what from the adrenal medulla?

Answer 24

NE and EPI

• aldosterone production
• glucocorticoid
• may also contribute to cardiac hypertrophy since it is a potent mitogenic agent

Question 25

What is the MOA of ATII

Answer 25

vasoconstriction | - inhibit the mitogenic response of AT II

Question 26

Name 2 ACE inhibitors - what else do ace inhibitors inhibit?

Answer 26

Captopril, Enalapril - inhibit the degradation of bradykinin, substance P, enkephalin

Question 27

How are ACE inhibitors and bradykinin interact

Answer 27

ACE inhibitors prevent the metabolism of bradykinin, thus leading to increased hypotension SHOCK

Question 28

What are the angiotensin antagonists? (2)

Answer 28

Losartan | Valsartan

Question 29

What activates prekallikrein (fletcher factor)?

Answer 29

- Hageman Factor( factor 12a ) - also via trypsin active kallikrein makes KININ which causes hypotension ** patients with DIC develop hypotension due to increased kallikrein production

Question 30

How is bradykinin made?

Answer 30

Plasma kallikrein cleaves fitzegrald factor (HMWK) to make BRADYKININ - kinins generate redness, local heat, swelling, and pain

Question 31

What receptors do kinins target? Which receptors do inhibitors of bradykinin target?

Answer 31

B1 B2!!!

Question 32

What is capable of inactivating bradykinin? How is this related to hypotension related to certain drugs?

Answer 32

Kininase II (ACE) - related to ACE INHIBITORS --> block the degradation of bradykinin leading to increased vasodilation and hypotensive shock

Question 33

What receptor does Ictibant inhibit?

Answer 33

B2 inhibitor - no clinical trials - may be useful for hypotension treatment and myocardial hypertrophy

Question 34

What are the Natriuretic peptide drugs?

Answer 34

1. Omapatrilat 2. Sampartilat 3. Fasidotrilat - enhance vasodilation, reduce vasoconstriction, and increase sodium extortion

Question 35

Define sensitivity & specificity

Answer 35

sensitivity: SNOUT - sensitive test: when negative, rules OUT disease TP/(TP+FN) Specificity: SPIN - when positive rules IN disease TN/ (TN+ FP) Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as classification function: Sensitivity (also called the true positive rate, or the recall in some fields) measures the proportion of positives that are correctly identified as such (e.g., the percentage of sick people who are correctly identified as having the condition). Specificity (also called the true negative rate) measures the proportion of negatives that are correctly identified as such (e.g., the percentage of healthy people who are correctly identified as not having the condition). Thus sensitivity quantifies the avoiding of false negatives, as specificity does for false positives.

Question 36

# Define positive predictive value define negative predictive value

Answer 36

PPV - positive test results that are true positive TP/(TP+FP) NPV - negative test results that are true negative TN/ (TN+FN)

Question 37

Aprotonin is also used as what besides a kallikrein inhibitor for inflammation?

Answer 37

used as an ANTI-FIBRINOLYTIC - for bleeding but adverse affect is GRAFT THROMBOSIS