Flashcards in Meds Deck (46)
Thiazide Diuretics (3)
Inhibit sodium and chloride reabsorption in the THICK LOOP OF HENLE and EARLY DISTAL TUBULE
--> this increases urine volume causing a decrease in plasma volume
Thiazide- how does it affect the heart?
Decreases cardiac output and lowers stroke volume and lowers BP
Adverse effects of Thiazides (5)
MOA of ACE
block the enzyme that converts ANgiotensin I to angiotensin II.
What is angiotensin II?
principal pressor in the RAAS responsible for vasoconstriction, synthesis, and release of aldosterone cardiac stimulation and renal absorption of sodium
What happens when Angiotensin II is blocked by ACE?
Vascular resistance is decreased and the secretion of aldosterone is decreased-- decreased water and sodium retention
Adverse effects of ACE?
Contraindication fo ACE?
PTs with renal artery stenosis d/t risk of renal failure
ACE inhibitors Clinical use?
First-line drug for HTN
slow progression of neuropathy
good for HTN CHF or HTN and DM
MOA of ARBS
INHIBITS/BLOCKS angiotensin II RECEPTOR!
MOA difference between ARBS And ACE?
ARB- block receptor
Ace- blocks enzyme
Adverse effcts of ARBs
ARBs are contraindicated for which patients?
PT with renal artery stenosis
Why do some patients need ARB over ACE?
PT cannot tolerate ACE cough s/e
Indication of ARBS
HTN and CHF but not approved for post MI
Calcium Channel ANTAGONISTS
MOA of Calcium Channel ANTAGONISTS
Block L type calcium channels and decrease calcium entry into vascular and cardiac cells this results in reduced CONTRACTILITY in CARDIAC AND VASCULAR MUSCLE
Calcium Channel ANTAGONISTS decrease...
Arteriolar dilation and decreased BP
Why are CCB contraindicated with HF PT?
bc they also inhibit calcium in cardciac tissue and SLOW conduction of AV node this can decrease contractility and make HF worse
clinical use of CCB?
PT with Angina and HTN
Why should Nifedipine not be used for HTN Txt?
BC short-acting Nifedipine can cause increased risk of MI bc of reflex tachycardia
What are the three classes of Calcium channel ANTAGONISTS?
Verapamil belongs to which class of CCB?
Diphenyalkylamines --> vascular and cardiac activity
Txt- HTN Angina and SVT
Diltiazem belongs to which class of CCB?
Benzothiazepines-->vascular and cardiac activity
Txt- HTN Angina and SVT
Nifedipine belongs to which class of CCB?
greater affinity for calcium channels in the VASCULAR system than in the heart and they provide vasodilation BUT ARE NOT effective in decreasing AV node conduction
TXT ANGINA AND HTN