Perfusion 2 Flashcards
S/E of Diuretics
Dehydration Hyponatremia Hypokalemia (thiazide, loop diuretics) Hyperkalemia (potassium sparing) Nocturia (if taken in evening)
Effect of Loop diuretics
Increase urine volume
Thiazides
inhibit reabsorption of Na and K
Drugs: Hydrochlorothiazide, chlorothiazide, metazolone
SE-Hypokalemia and natremia.
GOES UNCHANGED
Loop Diuretics
increased sodium, potassium and chloride out in urine Drugs: Furosemide (lasix) tx-hypertension se-hypokalemia
Potassium Sparing/Aldosterone Antagonists
blocks renal aldosterone (causes Na to leave, keeps K)
Drugs: Spironolactone (aldactone)
SE-hyperkalemia.
HAS LONG HALF LIFE
Effect of high or low potassium
Myocardial infarction
watch ECG
Combination Diuretics
Thiazide and k sparing.
-Aldactazide
balances out K. Good for long term HTN tx.
Osmotic Diuretics
CROSS THE BBB
Drugs:
Mannitol
Isosorbide
inhibits renin release. (renin causes retention of fluid in kidneys)
tx-cerebral edema, intraocular HTN.
DO NOT USE FOR CARDIO
Why would there not be drug-drug interactions when using thiazides?
They travel unchanged
Effect of Renin
meets angiotensin in the blood. ACE changes renin-angiotensin 1 into 2. Renin-angiotensin 2 causes blood vessels to constrict and BP to increase
What happens when we prevent angiotensin 2 from binding to receptors?
vasodilation. Will also decrease afterload and preload so the heart can pump more effectively. in turn BV also decreases
Where are Angiotensin 2 receptors found?
heart, blood vessels, adrenal cortex, kidneys.
When stimulated they: vasoconstrict. cause increased renal sodium reuptake.
ACE inhibitors
Vasodilate
tx-heart failure (with high efficacy)
Drugs: -prils Enalapril (vasotec) Captopril (common) Monopril Ramipril (altace) se-hypotension. Cannot use these if renals are not good.
Angiotensin 2 receptor Blockers
ARBs
less potent than ACE inhibitors. still vasodilate
-act on smooth muscle, cardiac, kidneys and adrenal gland.
Drugs: losartan (cozaar)
Ibesartan (Avapro)
se-hypotension. Also take a few weeks to work
Calcium Channel Blockers
AFIB
Muscle contraction is regulated by calcium, without it smooth muscle relaxes.
Acts on: cardiac, arterial, coronary artery muscle.
tx-angina and arrythmias.
Drugs:
Vascular selective smooth muscle:
-Nifedipine (adalat), Amlodipine (norvasc)
Cardio selective
-Verapamil (isoptin)
-Dilatiazem (cardizem)
tx-afib.
