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Flashcards in lecture 12 to 22 all drugs Deck (84)
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1

drugs used to treat hypertension

ACE inhibitors - pril
angiotensin II antagonists - artan
calcium channel antagonists - ipine
beta blovkers - olol
diuretics

2

calcium antagonists in hypertension

diltiazem, amlodipine, verapamil
blocks l type calcium channels
reduce contractility and AV conduction
headache and constipation

3

diuretics in hypertension

decrease plasma volume by increasing urine output
can also treat oedema
increase excretion of NaCl and water
loop thiazide and potassium sparing

4

loop diuretics

frusemide and bumetanide
inhibits cotransporter that transports 1Na+, 1K+ and 2Cl-
used in heart failure and renal failure
used in hypertension when the kidneys are not working well
more powerful than thiazide diuretics

5

thiazide diuretics

eg bendroflumethazide
chlortalidone is a thiazide related drug
it inhibits the NaCl transporter
found in the distal convoluted tubule
used in oedema (from heart failure) and hypertension

6

potassium sparing diuretics

decrease the movement of sodium across principal cells
spironolactone is a competitive antagonist of aldosterone and used in hyperaldosteronism
amiloride inhibits sodium channels in the luminal membrane

7

RAAS

renin angiotensin aldosterone system
renin to angiotensin to aldosterone and vasoconstriction
aldosterone causes salt and water retention and combined with the vasoconstriction this increses blood pressure

8

aldosterone

is a mineralocorticoid ie a nuclear hormone receptor
increases the transcription of the gene for Na+ channels so increases the number of Na+K+ATPases
can also bind to a protein mediator and non genomicallt stimulate the Na+ channels directly

9

renin

is an enzyme secreted into the blood by cells of the glomerular apparatus, shows global control
its releases can be stimulated dby adrenaline prostacyclines and decreased Na+ conc in DCT
cleaves angiotensinogen into inactive decamer angiotenin I

10

ACE inhibitors

pril - captopril , lisinopril
cause initial dose hypotension and cough
(as bradykinin is not broken down we get vasodilation)

11

angiotensin II antagonists

losartan candesartan
compete for angiotensin II type 1 receptors
hypotension is a side effect

12

angiotensin receptors

are g coupled protein receptors
Angiotensin II type I recetpros have vascular effects/ aldosterone release

13

alpha 1 adrenceptors

vasoconstriction and contraction of smooth muscle
coupled to phospholipase C and Gq

14

alpha 2 adrenoceptor

compled to adenylate cyclase and Gi
neurotransmitter release and decreases the release of insulin

15

beta 1 adrenergic recetpro

aneylate cyclase and gs
heart rate and force
renin release

16

doxazosin

alpha 1 antagonist
dilates arterioles and veins by blocking alpha 1 adrenocetpros
side effevts are postural hypotension and urinary incontinence

17

propranolol

connected wutg vasodilation
competitive antagonist that is non selective so wroks at both beta 1 and 2 adrenoceptors
lipid soluble so penetrates CNS

18

atenolol and bisprolol

competitive antagonists at the beta 1 receptor
water soluble so poor penetration of CNS
bisoprolol then atenolol then propranololl

19

beta adrenoceptor antagonists

decrease heart rate and stroke volume and decrease blood pressure
they decrease the release of renin (beta 1)
decrease sympathetic tone
decrease anxiety

20

unwanted effects of beta adrenoceptor antagonists

bronchoconstriction
precipitation of heart block or heart failure
hypoglycaemia
vivid dreams
cold extremities

21

hypertension guidelines

black and over 55 use calcium channel blocker first
if over 55 and not black use ace inhibitor
then ace and calcium
then ace and calcium and diuretics
then ace and calcium nd diuretic and beta blcoker

22

vLDLs and LDls

increase the formation of fatty deposits
decrease fibrinolysis
activate platelets
increase the risk of atherosclerosis

23

HDLs

increase fibrinolysis
increase prostacyclin formation

24

lipid lowering drugs

statins ezetimibe fibrates nicotinic acids anion exchange resins
reduce LDL increase HDL

25

fibrates

lipid lowering drug
agonst at PPARalpha receptor

26

anion exchange resins

lipid lowering drug
sequester the bile acids in the gut

27

Statins

lipid lowering drug
inhibit rate limiting ezyme HMG CoA reductase in the production of cholesterol
decreases the cholesterol in the liver and increases LDL receptors on hepatocytes increasing LDL removal and increasing HDL conc
side effects are myocitis and rhabdomyolysis which causes renal failure due to release of toxic substances

28

ezetimibe

lipid lowering drug
inhibits a cholesterol transporter in enterocytes
dual inhibition of cholesterol absorption and LDL synthesis
can be used in place of statins

29

drug types used for angina pectoris

aspirin (prevents thrombosis)
beta blocker
calcium antagonist verapamil
statin eg atorvastatin
organic nitrate GTN, isosorbide dinitrate
k+ activator (vasodilator)

30

organic nitrates in angina

GTN and isosorbide dinitrate
headaches (caused by nitric acid dilating brin blood vessels)
dilate coronary arterie, decrease cardiac workload by decreasinf preload and afterload . heart doenst push so hard, less nlood returned, decreased contractile force, less peripheral resistance
dilates collateral vessels