Term
|
Definition
Tx: HTN first choice drug!, edema, CHF, hypocalcemia, diabetes insipidus
Ax: Thiazide diuretic - inital phase: ↑Na+ loss, ↓plasma volume, ↓CO,
Chronic Phase:
↓Peripheral vascular resistance
SE: Hypokalemia→U wave+long QT→vent. arrhythmias
Ms: countermeasures - K+-sparing diuretic, K+ supplements, or combo w/ ACE-I/ARBs
|
|
|
Term
Verapamil
Diltiazem
Nifedipine
|
|
Definition
Tx: HTN (esp for pts w/ angina), ischemic heart disease, arrhythmias (slow AV)
Ax: Ca2+ Channel Blockers - directly inhibit L-type Ca2+ channels,
↓Ca2+ influx into mm cells (vascular, cardiomyocytes),
↓periph vascular resistance
SE: verapamil (9%) & diltiazem: AV Block, Bradycardia, CHF, nausea; nifedipine (17%): ankle edema, hypotension, tinnitus
Ms: Type I (V&D): "balanced" heart & vasc. effects
Type II (N): mainly vasc. effects (↓PVR)
|
|
|
Term
|
Definition
Tx: HTN- okay alone, but better in combo therapies
Ax: Nonpeptide Renin inhibitor - specific renin inhibitor, dose-dependent effects, possibly more complete inhib of renin-angio-aldost system
Ms: no kinin meta.→no cough or angioneurotic edema
t½=20-45hrs |
|
|
Term
|
Definition
Tx: HTN in pts w/ comorbidities (CHF, CAD, chronic renal disease EXCEPT renal artery stenosis)
Ax: ACE-Inhibitor - ↓angiotensin II, ↓aldost,
↑renin, ↑bradykinin (PGs vasodiolation), ↓BP + heart remodeling
SE: risk of renal failure in pts w./ renal art. stenosis (massive ↓renal urine flow), cough (5-20%, due to bradykinin), angioneurotic edema, teratogenic, hyperkalemia
|
|
|
Term
|
Definition
Tx: HTN - can use in pts with cough or angioneurotic edema w/ ACE-I
Ax: ARB (AII R Antag.), competitive AT1 inhib.,
dose-dependent ↓ in periph vascular resistance,
more complete inhibition of renin-angio-aldost system
SE: risk of renal failure in pts w/ renal art. stenosis, teratogenic, hyperkalemia
Ms: no ↑ kinin levels, 10,000x higher affinity for AT1 than AT2 |
|
|
