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PHARM/MHD - Exam #4 > Pharm- Lec#5 - Vasoactive Peptides > Flashcards

Pharm- Lec#5 - Vasoactive Peptides Flashcards

1
Q

Captopril

  • MOA
  • Route
A
  • ACE inhibitor

- oral

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2
Q

Captopril

  • indications
  • SE
A

ACE inhibitor

  • HTN

Adverse Effects

  • severe stomach pain
  • chest pain
  • allergic reaction
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3
Q

Enalapril

  • MOA
  • route
  • indications
A

ACE inhibitor

oral

  • HTN
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4
Q

Enalapril

  • Adverse effects
A
  • HYPOTENSION

- severe stomach pain

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5
Q

Losartan

  • MOA
  • route
  • indication
A

Angiotensin Receptor Inhibitor

  • oral
  • hypertension
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6
Q

Losartan

  • adverse effects
A

Diarrhea
Insomnia
Nasal Congestion

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7
Q

Valsartan

  • MOA
  • route
  • indication
A
  • angiotensin receptor inhibitor

oral

HTN

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8
Q

Icatibant

MOA
Route

A
  • Bradykinin receptor inhibitor
    (DO NOT USE FOR SEPSIS)

-oral

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9
Q

Icatibant

Indication
Adverse Effects

A

-inflammatory response

AE:
stomach pain
nausea
same as valsartan

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10
Q

Aprotonin (tresolol)

MOA
route

A

Kallikrein inhibitor

  • IV
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11
Q

Aprotonin

indication
adverse effect

A

Inflammation

SE:
heart attack
stroke
kidney failure

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12
Q

Desmopressin

MOA
route

A

Vasopressin Analogue

  • IV
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13
Q

Desmopressin

indication
adverse effect

A

Bleeding

Headache
Nausea
stomach pain

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14
Q

Bosentan

  • MOA
  • route
A

endothelin receptor inhibitor

ORAL

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15
Q

Bosentan

indication
adverse effect

A

PULMONARY HYPERTENSION

  • liver problems
  • stomach pain
  • nausea
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16
Q

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

A

Desmopressin

17
Q

The following are vasoconstrictors or vasodilators:

Angiotensin II
Endothelins
Neuropeptide Y

A

Vasoconstrictors

18
Q

The following are vasoconstrictors or vasodilators:

bradykinin
BNP/ANP
CGRP (calcitonin)
VIP

A

vasodilators

19
Q

What drugs is liberated when kallikrein is active?

What activates kallikrein

A

Bradykinin

  • Hageman factor (XII) activates kallikrein in the intrinsic contact pathway
  • normally degraded by ACE
20
Q

What is another name for ACE?

A

Kininase-II

21
Q

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

A

ANGIOTENSINOGEN

  • also increased in pregnancy related hypertension
22
Q

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

A

Kininase II

or

Peptidyl Dipeptidase

23
Q

What is the half life of AT II

A

short

about 60 seconds

24
Q

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

A

NE and EPI

  • aldosterone production
  • glucocorticoid
  • may also contribute to cardiac hypertrophy since it is a potent mitogenic agent
25
Q

What is the MOA of ATII

A

vasoconstriction

- inhibit the mitogenic response of AT II

26
Q

Name 2 ACE inhibitors

  • what else do ace inhibitors inhibit?
A

Captopril, Enalapril

  • inhibit the degradation of bradykinin, substance P, enkephalin
27
Q

How are ACE inhibitors and bradykinin interact

A

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

SHOCK

28
Q

What are the angiotensin antagonists? (2)

A

Losartan

Valsartan

29
Q

What activates prekallikrein (fletcher factor)?

A
  • Hageman Factor( factor 12a )
  • also via trypsin

active kallikrein makes KININ which causes hypotension

** patients with DIC develop hypotension due to increased kallikrein production

30
Q

How is bradykinin made?

A

Plasma kallikrein cleaves fitzegrald factor (HMWK) to make BRADYKININ

  • kinins generate redness, local heat, swelling, and pain
31
Q

What receptors do kinins target?

Which receptors do inhibitors of bradykinin target?

A

B1

B2!!!

32
Q

What is capable of inactivating bradykinin?

How is this related to hypotension related to certain drugs?

A

Kininase II (ACE)

  • related to ACE INHIBITORS –> block the degradation of bradykinin leading to increased vasodilation and hypotensive shock
33
Q

What receptor does Ictibant inhibit?

A

B2 inhibitor

  • no clinical trials
  • may be useful for hypotension treatment and myocardial hypertrophy
34
Q

What are the Natriuretic peptide drugs?

A
  1. Omapatrilat
  2. Sampartilat
  3. Fasidotrilat
  • enhance vasodilation, reduce vasoconstriction, and increase sodium extortion
35
Q

Define sensitivity & specificity

A

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.

36
Q

Define positive predictive value

define negative predictive value

A

PPV
- positive test results that are true positive
TP/(TP+FP)

NPV
- negative test results that are true negative
TN/ (TN+FN)

37
Q

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

A

used as an ANTI-FIBRINOLYTIC
- for bleeding

but adverse affect is GRAFT THROMBOSIS

PHARM/MHD - Exam #4 (20 decks)

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