Pharmacology Flashcards
Mechanism of action and side effects of bosentan
- Endothelin receptor antagonist leading to pulmonary vasodilation
- Side effects: lower extremity edema
Mechanism of action of loop diuretics
Inhibit Na/2Cl/K transporter and blocks resorption of Na/Cl in ascending loop
Side effects with lasix
Ototoxicity
Drug fever/drug rash
Nephrocalcinosis with prolonged use in neonates
Mechanism of action of thiazide diuretics
Inhibits Na/Cl cotransporter and blocks Na resorption in distal tubule
Mechanism of action of K sparing diuretics
Competitive binding of aldosterone receptor for Na/K exchange in distal tubule
Mechanism of action of milrinone
- Type III phosphodiesterase inhibitor
- Inodilator - inotropy, lusitropy, vasodilation
- Blocks breakdown of cAMP, increases intracellular calcium and improves contractility, allows for vascular smooth muscle relaxation
Risk with nipride
Cyanide toxicity
Mechanism of action of nipride
Direct vasodilation - decreases SVR, PVR and preload
Mechanism of action of ACEi
- Inhibits ACE from converting AT1 to AT2
- Decreases SVR, BP and increases venous capacitance
Side effects of ACEi
- Cough d/t bradykinin
- Renal insufficiency, hyperkalemia
- NO in pregnancy
Mechanism of action of ARB
- Blocks binding of ATII to AT receptor
- Decreases SVR, BP and increases venous capacitance
- NO in pregnancy
Mechanism of action of calcium channel blockers
- Blocks Ca entry via slow channels or select voltage sensitive areas of vascular smooth muscle and myocardium
- Peripheral arterial and coronary vasodilation
Receptors and use of carvedilol
- NON selective B anatagonist and some alpha blocking too
- Improves NYHA class in adult HF - decreases afterload, LVEDp and increases LVEF
Receptors and use of propranolol
- NON selective B antagonist
- Half life 4-7 hours (increased with hepatic dysfunction)
- Can cause bronchospasm or hypoglycemia
Mechanism of action of digoxin
- Blocks membrane Na/K/ATPase leading to increased intracellular calcium
- Inotropy, vasodilation, decreased speed of AV conduction
Symptoms and treatment for dig toxicity
- Nausea, vomiting, vision changes, PVCs, change in ST/T segments, PR prolongation
- Tx; treat hypokalemia, atropine for bradycardia, esmolol for VT, digibind (monoclonal antibody)
Side effects of PGE
Platelet inhibition
Fever
Vasodilation
Apnea
Gastric outlet obstruction with prolonged use
Cortical hyperostosis
Cardiac receptors and effect
- B1: sinus node (increases HR), AV node (increases conduction velocity), myocardium (increases contractility)
- A1: coronary vasoconstrction
- DA1 - coronary vasodilation
Peripheral artery receptors and effect
- A1 - skin and pulm vasoconstrction
- B2 - mesenteric, splanchnic, skeletal muscle vasodilation
- DA1 - renal vasodilation
DA2 - mesenteric and splanchnic vasodilation
Effects of epinephrine
- B1 (HR and contractility), B2 (decreased SVR/vasodilation)
- Increased doses will get more A1 vasoconstriction
Effects of dopamine
- DA1 and DA2 (increased renal, mesenteric and coronary perfusion), B1 (increased HR and contractility)
- Medium dose mostly B1
- High dose transition to A1 vasoconstriction
Effects of norepinephrine
- A1 increase SVR and vasoconstriction
- Minimal B1 contractility
Effects of dobutamine
- B1 increase HR and contractility
- B2 vasodilation
Effects of isoproterenol
- B1 increase HR and contractility
- B2 vasodilation
Effects of vasopressin
- V1 vascular smooth muscle constriction
-V2 renal collecting ducts lead to increase water reuptake
Hi Kamel
<3 :)
Symptoms of flecainide toxicity
Flecainide is a Na channel blocker
Can cause PR prolongation and possible heart failure
Flec levels increase with less breastmilk or formula
