Term
| What are the major risks of untreated hypertension? |
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Definition
1) coronary thrombosis (MI)
2) heart failure
3) stroke
4) renal failure |
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Term
Describe Loop diuretics
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) thick ascending limb of the loop of henle
2) inhibition of Na/K/2Cl contransporter
3) increased distal tubular Na, dec. hypertonicity of interstitium, and less water reabsorption in collecting duct (i.e. diuresis and natriuresis). Induction of prostaglandins (i.e. dilation of afferent arteriole)
4) hypokalemia, hypocalcemia, hypomagnesia, metabolic alkalosis
5) furosemide, ethacrynic acid, bumetamide, torsemide |
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Term
Describe thiazides diuretics
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) distal tubule
2) inhibition of Na/Cl transporter; antihypertensive activity
3) diuresis; natriuresis (less powerful than loop-diuretics)
4) hypokalemia, metabolic alkalosis, hypercalcemia, hyponatremia
5) HCTZ; metolazone; chlorthalidone |
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Term
Describe potassium-sparing diuretics
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) distal segment of distal tubule
2) spironolactone: antagonizes aldosterone; triamterene, amiloride: inhibits sodium channels
3) decreased sodium reabsorption, and decreased potassium and acid loss
4) spironolactone, triamterene, amiloride |
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Term
Describe nitrates
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) vascular smooth muscle
2) stimulation of intracellular cyclic guanosine monophosphate production (venous > arterial)
3) reduce systolic, diastolic, and MAP
4) reflex tachycardia, flushing, headache *made up*, impractical due to short t1/2
5) nitroglycerin |
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Term
Describe Ca-CBs
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) vascular smooth muscle; cardiac myocytes, cardiac nodal tissue (SA, AV)
2) inhibition of L-type calcium channels, causing vasodilation (a>v), negative inotropy, negative chronotropy, negative dromotropy (esp @ AV node)
4)
5) dihydropyridines (smooth muscle selective): amlodipine, nifedipine; phenylalkylamine (myocardium): verapamil; benzothiazepine (intermediate): diltiazem |
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Term
Describe beta-blockers
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) cardiac nodal tissue, conducting system, contracting myocytes, vascular smooth muscle
2) beta-2 inhibition, causes decreased activation of adenylyl cyclase, and decreased activity of L-type Ca-Channels. This leads to negative chronotropy, inotropy, dromotropy, and lusitropy, and vasoconstriction
4) acute treatment is not very effective due to compensatory increase in systemic vascular resistance
5) propaanolol, metoprolol, atenolol |
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Term
Describe sympatholytics agents
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) peripheral at effector organ; ganglionic blockers at sympathetic gaanglia; centrally-acting sympatholytics drugs within the brain
2) centrally: activation of alpha-2 adrenoceptors; peripherally: competitive antagonists for alpha adrenoceptors (alpha1)
3) central: decrease HR and contractility and decrease SNA on vasculature; peripheral: dilate both arteries and veins (a>v)
4)
5) central: clinidine, methyldopa; peripheral: prazocin, doxazocin, terazocin |
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Term
Describe ACEi
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) vascular smooth muscle
2) inhibition of the formation of angiotensin II; inhibit bradykinin breakdown
3) decrease AII vasoconstriction; increase bradykinin levels; dilate arteries and veins; down regulate sympathetic adrenergic activity; promote urinary excretion of sodium and water (aldosterone release block); inhibit cardiac and vascular remodeling
4) dry cough
5) captopril; lisinopril; enalapril |
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Term
Describe angiotensin II receptor antagonist (ARBs)
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) vascular smooth muscle
2) block AII receptors
3) "vasodilation"; do not cause an increase in bradykinin
4) decreased cough, decreased angioedema
5) losartan; valsartan; irbesartan |
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Term
Describe Direct-Acting Vasodilators
site of action
mechanism
major actions
major side-effects
examples |
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Definition
1) arterial vessels
2) hyperpolarization w/ K channels; inhibit release of Ca; formation of NO
3) arterial vasodilation
4) reflex tachycardia
5) hydralazine |
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