Term
| vascular relaxation agents released by endothelium |
|
Definition
- nitric oxide
- Prostacyclin (PGI2)
- Endothelium-derived hyperpolarizing factor |
|
|
Term
| vascular contraction - agents released by endothelium |
|
Definition
- endothelin 1
- Thromboxane A2
- Prostaglandin H2 |
|
|
Term
| How does PGI2 exert its effects? |
|
Definition
| - by action of cAMP --> relaxation of VSM by inaction of Myosin-light chain kinase |
|
|
Term
|
Definition
-orally active; vasodilator
-used in severe hypertension with b-blockers and diuretics
-Toxicity (lupus-like, reflex tachycardia, headache, nausea, palpitations) |
|
|
Term
|
Definition
- orally active; vasodilator
- drug metabolite is active form.
- toxicity (tachycardia, edema, palpitations, hair growth) |
|
|
Term
|
Definition
vasodilator; IV-admin
hypertensive emergency
hyperpolarizes VSM
can cause severe hypotension, salt and water retention
hyperglycemia by inhibition of insulin secretion
reflex tachycardia + increased CO
relaxes uterine smooth muscle and may stop labor |
|
|
Term
|
Definition
- vasodilator; dilates both arteries and veins (unlike others talked about)
reduces BP by reducing total peripheral resistance
release NO
toxicity: (nausea, headache, cyanide toxocity, hypotension) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Ca antagonists - what they do and how they are used |
|
Definition
- first-line for hypertension
- may be used alone for mild HT, or with diuretics or ACE inhibitors for severe HT.
- have a mild diuretic effect of their own |
|
|
Term
| Why not use ca antagonists? |
|
Definition
- with b-blockers
- verapamil may increase [digitalis]
- cardiac pts
- depressant effect on A-V conduction and on contractility.
- adverse effects: dizziness, flushing, headache, fatigue, rhinitis, constipation, edema. |
|
|
Term
| renin release is mediated by....... |
|
Definition
| arterial and cardiopulmonary baroreceptor afferents to the nucleus of the solitary tract, VLM, IML cell column of the spinal cord sympathetic preganglionic nerves, post-sympathetic nerves, innervation of juxtaglomerular apparatus. |
|
|
Term
|
Definition
| dopa decarboxylase inhibitor; Me-NE formed and stimulates alpha2 adrenergic receptors -- reduce sympathetic outflow and vascular resistance. |
|
|
Term
|
Definition
Has catechol and imidazoline groups.
alpha 2 agonist (decreases sympathetic outflow). |
|
|
Term
alpha1 antagonists
Prazosin |
|
Definition
block NE-mediated vasoconstriction on arterioles and veins.
Does not interfere with NE inhibition of its own release mediated by presynaptic alpha2 adrenoreceptors.
frequently used for mild-moderate HP |
|
|
Term
|
Definition
lower CO, renin secretion, SNS outflow, NE release.
some have intrisic sympathomimetic activity. - reduce BP by causing vasodilation in line skeletal muscle bed.
hybrid b-blockers combines non-selective b-receptor blockage with alpha1-receptor blockade. |
|
|
Term
| toxicity/adverse effects of beta-blockers. |
|
Definition
can increase asthma, angina, peripheral vascular disease.
SNS effects
metabolic effects (incrase TG, decreases HDL, mask some diabetic symptoms. |
|
|
Term
|
Definition
acute effect - blocks release of NE
chronic effect - replaces NE in terminals.
Toxicity: GI uspset, postural hypotension. |
|
|
Term
|
Definition
blocks storage of NE
toxicity similar to guanethedine. |
|
|
Term
|
Definition
the only ganglionic blocker used to treat Hypertension.
inhibit acetylcholine activation of nicotinic receptors on both post-ganglionic sympathetic and parasympathetic neurons.
used IV in Hypertensive emergencies. |
|
|
Term
| ACE inhibitors - captopril, enalapril, lisinopril |
|
Definition
reduces vasoconstriction and BV.
CO and HR benerally unaffected.
do not cause baroreceptor reflex-mediated sympathetic actionva and can be used in pts with ischemic heart disease.
common adverse effect: cough. |
|
|
Term
| Angiotensisn II receptor antagonists - Losartan |
|
Definition
non-peptide angiotensin type 1 receptor (AT1) antagonist.
adverse effects: hypotension, hyperkalemia, reduced renal fxn.
may take 3-6 weeks for full effect.
other ANG II antagonists: valsartan, candesartan, irbesartan. |
|
|
