Test 3 Flashcards
How does bradykinin produce vasodilation?
Stimulate the release of NO and prastacyclins for potent vasodilation
Which is the main mineralcorticoid?
Aldosterone
Which is the post potent vasocontrictor?
Angiotension II
Endogenous vasoconstrictor?
Endothelin 1
What does ADH cause?
Only H20 retention. No Na retention
How does spironolactone affect K and Na levels?
K retention and Na excretion
What does aldosterone do?
Na retention that leads to concomitant H20 retention
Also does K excretion
Explain how NO causes smooth muscle relaxation?
NO combines with the heme group of soluble gunaylyl cyclase which converts GTP to cGMP which leads to vasodilation
What two types of meds might you need to add with hydralazine?
beta blocker and diuretic (hydrochlorothiazide) to counteract the compensatory tachycardia and water retention.
clinical results of B2 stimulation?
smooth muscle relaxation. I.e. lungs and vascular smooth muscle
How do ACE-I affect renin levels?
increase it
What does Aliskiren (tekturna) do?
reduce plasma renin activity by 50-80%. Can increase renin levels up to 10x.
Are ACE-I safe in a pt with ischemic heart disease?
yes because they don’t cause reflex sympathetic activation.
How do ACE-I affect pt with CKD?
diminish proteinuria and stabilize renal function.
How do ACE-I affect DM incidence in patients with high cardiovascular risk?
reduce incidence of DM
Are ACE-I venous or arterial?
both
How much do ACE-I decrease BP?
less than 10mmHg
What meds should you avoid with ACE-I?
NSAIDs - block bradykinin mediated vasodilation
K supplements. Lead to hyperkalemia
K sparing diuretics.