Mmc Pharmacology - Treatment Of Blood Vessel Disorders

Front 1

Three groups of vasoactive peptides

Back 1

1) Vasoconstrictors

2) Vasodilators

3) Peptides with mixed effects

Front 2

ACE Inhibitors

Back 2

1) Captopril

2) Enalapril

3) Lisinopril

Front 3

Angiotensin II Receptor Blockers (ARBs)

Back 3

1) Saralasin

2) Losartan

3) Valsartan

4) Telmisartan

Front 4

Renin Inhibitors

Back 4

Aliskiren

Front 5

Drugs that block renin release

Back 5

1) Clonidine

2) Propranolol

Front 6

ACE Inhibitors - Mechanism of Action

Back 6

1) Block angiotensin converting enzyme (ACE), resulting in decreased ANG II formation

2) Decrease systemic vascular resistance (arteriolar and venous); promote natriuresis

3) Prevents bradykinin degradation

Front 7

Side effects of ACE Inhibitors

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1) Cough

2) Angioedema

3) Hyperkalemia

NOTE: Contraindicated in pregnancy

Front 8

Therapeutic use of ACE Inhibitors

Back 8

1) Mild to moderate hypertension

2) Diabetic renal failure

3) Congestive heart failure

Front 9

Saralasin

Back 9

1) A partial AT receptor agonist that functions as a peptide angiontensin II receptor blocker (ARB)

2) used to treat renin-dependent hypertension

Front 10

Nonpeptide ARBs

Back 10

1) Losartan

2) Valsartan

3) Telmisartan

Front 11

Nonpeptide ARBs - Mechanism of action

Back 11

1) Competitive antagonists of AT1 receptor

2) Do not interfere with bradykinin degradation

Front 12

Clinical Uses of Nonpeptide ARBs

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1) Hypertension

2) Congestive Heart Failure

3) Prevention of diabetic nephropathy

Front 13

Side effects of Nonpeptide ARBs

Back 13

1) Lower incidence of cough

2) Contraindicated in pregnancy and patients with nondiabetic renal disease

Front 14

Aliskiren - Mechanism of Action

Back 14

1) Inhibits action of renin, which results in decreased ANG I, ANG II, and aldosterone levels

2) Does not interfere with bradykinin degradation

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Clinical Uses of Aliskiren

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Hypertension

Front 16

Side effects of aliskiren

Back 16

1) Hyperkalemia

2) Renal impairment

3) Headache

4) Diarrhea

5) Contraindicated in pregnancy

Front 17

Vasodilators

Back 17

1) Hydralazine

2) Minoxidil

3) Diazoxide

4) Sodium Nitroprusside

Front 18

Hydralazine - Mechanism of Action

Back 18

1) Release of nitric oxide from endothelial cells

2) Relaxes smooth muscle (more effective on arterioles)

Front 19

Clinical Uses of Hydralazine

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1) Severe hypertension (long term outpatient therapy)

2) Heart failure

Front 20

Side effects of Hydralazine

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1) Headache

2) Nausea and anorexia

3) Palpitations

4) Sweating and flushing

5) Lupus like syndrome (high doses)

6) Peripheral neuropathy (not common)

Front 21

Minoxidil- Mechanism of action

Back 21

1) Opens potassium channels, resulting in hyperpolarization of smooth muscle

2) Promotes arteriolar vasodilation

Front 22

Clinical Uses of Minoxidil

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1) Severe hypertension

2) Baldness (topical application)

Front 23

Side effects of Minoxidil

Back 23

1) Hypertrichosis

2) Headache

3) Sweating

Front 24

Diazoxide - Mechanism of action

Back 24

1) Opens potassium channels, resulting in smooth muscle hyperpolarization

2) Produces arteriolar vasodilation

3) Reduces insulin release

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Clinical Uses of Diazoxide

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Hypertensive emergencies

Front 26

Side effects of Diazoxide

Back 26

1) Hypotension

2) Hyperglycemia

3) Edema

4) Reflex tachycardia

Front 27

Sodium Nitroprusside - Mechanism of Action

Back 27

1) Stimulates release of nitric oxide and increases cGMP

2) Decreases total peripheral resistance by dilation of arterioles and venules

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Clinical Uses of Sodium Nitroprusside

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1) Hypertensive emergencies

2) Severe heart failure

Front 29

Side Effects of Sodium Nitroprusside

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1) Excessive hypotension

2) Shock

3) Cyanide toxicity

Front 30

Drugs used to treat angina

Back 30

1) Nitrates

2) Beta blockers

3) Calcium channel blockers

Front 31

Types of nitrates

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1) Nitroglycerin (prototype)

2) Isosorbide dinitrate

2) Isosorbide mononitrate

Front 32

Nitrates - Mechanism of Action

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1) A prodrug of nitric oxide

2) Increases NO levels, resulting in smooth muscle relaxation and venodilation

3) primarily works on arteries and veins; no direct effects on cardiac muscle

Front 33

Clinical Uses of Nitrates

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1) Acute angina episodes (given sublingual)

2) Prophylaxis of angina

(given oral or transdermal)

3) Acute coronary syndrome (given IV)

Front 34

Side effects of Nitrates

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1) Tachycardia

2) Orthostatic hypotension

3) Throbbing headache

Front 35

Monday Disease

Back 35

1) Syndrome experienced by workers exposed to nitrate contaminants in the workplace

2) Workers develop tolerance to nitrates during the work week that disappears over the weekend

Front 36

Amyl nitrate

Back 36

1) Rapid acting drug taken via inhalation

2) Acts by releasing NO, resulting in increased cGMP and vasodilation

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Clinical Uses of Amyl Nitrate

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1) Rarely prescribed to prevent angina

2) Cyanide poisoning

Front 38

Side effects of Amyl Nitrate

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Methemoglobinemia

(at high concentrations)

Front 39

Beta Blockers -Mechanism of Action

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1) Acts primarily on the heart

2) Inhibits beta adrenergic receptors

3) Decreases heart rate, cardiac force and pressure

4) Increases heart size and injection time

Front 40

Clinical Uses of Beta Blockers

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Prevent effort angina

Front 41

Side effects of Beta Blockers

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1) Cardiovascular effects

(bradycardia, atrioventricular blockade, heart failure)

2) Severe asthma attacks

3) CNS effects (sedation, fatigue, sleep alterations)

4) Sexual dysfunction

Front 42

Types of Calcium Channel Blockers

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1) Dihydropyridines (Nifedipine, Amlodipine)

2) Phenylalkylamines (Verapamil)

3) Benzothiazepines (Diltiazem)

Front 43

Calcium Channel Blockers - Mechanism of Action

Back 43

Blocks L-type calcium channels in heart and blood vessels; results in decreased intracellular calcium

Front 44

Clinical Uses of Calcium Channel Blockers

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1) Treatment of AV node arrythmias (verapamil and diltiazem only)

2) Hypertension

3) Prophylatic therapy for effort and vasospastic angina

4) Moderately effective in hypertrophic cardiomyopathy, migraine and Raynaud's phenomenon

Front 45

Side Effects of Calcium Channel Blockers

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1) Constipation

2) Pretibial edema

3) Nausea

4) Flushing

5) Dizziness

6) Heart failure

7) AV blockade

8) Sinus node depression

Front 46

Ranolazine - Mechanism of Action

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1) Blocks late inward sodium current in myocardial cells, resulting in decreased calcium accumulation

2) Decreases end diastolic pressure and improves diastolic coronary flow

3) Thought to inhibit fatty acid oxidase

Front 47

Clinical Uses of Ranolazine

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Prevent angina

Front 48

Side effects of Ranolazine

Back 48

1) Constipation

2) Nausea

3) Dizziness

4) Prolongs QT interval

Front 49

Ivabradine

Back 49

1) Drug that inhibits If sodium channel in SA node; produces a reduction in heart rate and reduced myocardial O2 demand

2) Approved in U.S. for treatment of chronic heart failure

3) Also used in Europe to treat stable angina