Pharm- Lec#5 - Vasoactive Peptides Flashcards Preview

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

Flashcards in Pharm- Lec#5 - Vasoactive Peptides Deck (37):
1


Captopril

- MOA
- Route

- ACE inhibitor

- oral

2

Captopril

- indications
- SE

ACE inhibitor

- HTN

Adverse Effects
- severe stomach pain
-chest pain
- allergic reaction

3

Enalapril

- MOA
- route
- indications

ACE inhibitor

oral

- HTN

4

Enalapril

- Adverse effects

- HYPOTENSION
- severe stomach pain

5

Losartan

- MOA
- route
- indication

Angiotensin Receptor Inhibitor

- oral
-hypertension

6

Losartan

- adverse effects

Diarrhea
Insomnia
Nasal Congestion

7

Valsartan

- MOA
- route
- indication

- angiotensin receptor inhibitor

oral

HTN

8

Icatibant

MOA
Route

- Bradykinin receptor inhibitor
(DO NOT USE FOR SEPSIS)

-oral

9

Icatibant

Indication
Adverse Effects

-inflammatory response

AE:
stomach pain
nausea
(same as valsartan)

10

Aprotonin (tresolol)

MOA
route

Kallikrein inhibitor

- IV

11

Aprotonin

indication
adverse effect

Inflammation

SE:
heart attack
stroke
kidney failure

12

Desmopressin

MOA
route

Vasopressin Analogue

- IV

13

Desmopressin

indication
adverse effect

Bleeding

Headache
Nausea
stomach pain

14

Bosentan

- MOA
- route

endothelin receptor inhibitor

ORAL

15

Bosentan

indication
adverse effect

PULMONARY HYPERTENSION

- liver problems
- stomach pain
- nausea

16

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

Desmopressin

17

The following are vasoconstrictors or vasodilators:

Angiotensin II
Endothelins
Neuropeptide Y

Vasoconstrictors

18

The following are vasoconstrictors or vasodilators:

bradykinin
BNP/ANP
CGRP (calcitonin)
VIP

vasodilators

19

What drugs is liberated when kallikrein is active?

What activates kallikrein

Bradykinin

- Hageman factor (XII) activates kallikrein in the intrinsic contact pathway

- normally degraded by ACE

20

What is another name for ACE?

Kininase-II

21

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

ANGIOTENSINOGEN

- also increased in pregnancy related hypertension

22

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

Kininase II

or

Peptidyl Dipeptidase

23

What is the half life of AT II

short
about 60 seconds

24

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

NE and EPI

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

25

What is the MOA of ATII

vasoconstriction
- inhibit the mitogenic response of AT II

26

Name 2 ACE inhibitors

- what else do ace inhibitors inhibit?

Captopril, Enalapril

- inhibit the degradation of bradykinin, substance P, enkephalin

27

How are ACE inhibitors and bradykinin interact

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

SHOCK

28

What are the angiotensin antagonists? (2)

Losartan
Valsartan

29

What activates prekallikrein (fletcher factor)?


- 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

How is bradykinin made?

Plasma kallikrein cleaves fitzegrald factor (HMWK) to make BRADYKININ

- kinins generate redness, local heat, swelling, and pain

31

What receptors do kinins target?

Which receptors do inhibitors of bradykinin target?

B1

B2!!!

32

What is capable of inactivating bradykinin?

How is this related to hypotension related to certain drugs?

Kininase II (ACE)

- related to ACE INHIBITORS --> block the degradation of bradykinin leading to increased vasodilation and hypotensive shock

33

What receptor does Ictibant inhibit?

B2 inhibitor

- no clinical trials
- may be useful for hypotension treatment and myocardial hypertrophy

34

What are the Natriuretic peptide drugs?

1. Omapatrilat
2. Sampartilat
3. Fasidotrilat

- enhance vasodilation, reduce vasoconstriction, and increase sodium extortion

35

Define sensitivity & specificity

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

Define positive predictive value

define negative predictive value

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

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

37

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

used as an ANTI-FIBRINOLYTIC
- for bleeding

but adverse affect is GRAFT THROMBOSIS