HEART MEDS Flashcards
Antagonizes both B1 and B2 receptors thus inhibiting the effects of catecholamines on these receptors
adrenergic modulating meds
non selective beta blockers
Antagonizes B1 receptors to a greater extent than B2 receptors in typical doses
adrenergic modulating meds selective beta blockers
- These agents are considered third-generation beta-blockers
- They posses non-selective beta blocking activity like propranolol and alpha blocking activity like prazosin.
- Effects seen:
a) Decrease heart rate
b) Decrease contractility
c) Vasodilation
alpha/beta adrenergic receptor antagonists
- labetalol
- carvedilol
- Block peripheral A1 - receptors thus causing vasodilation secondary to inhibiting catecholamine mediated vasoconstriction. These agents block both arterial and venous A1 - receptors.
- decrease afterload of the heart
- decrease peripheral vascular resistance
selective alpha1 adrenergic blockers
- doxazosin
- prazosin
- terazosin
- tamsulosin
- Alpha2 – receptors are located in the central nervous system. They are pre-synaptic receptors thus stimulation will result in a decrease in sympathetic out flow.
- The resulting effect is a lowering of blood pressure and to a lesser degree heart rate.
Central Acting A2 – Adrenergic Receptor Agonist
- clonidine
- guanabenz
- guanfacine
- methyldopa
located throughout the body
needed for cardiac contraction, smooth muscle contraction, and is required for pacemaker activity in the heart (sino-atrial (SA) node depolarization) and atrio-ventricular (AV) node conductance.
L-type channels
T-type channels
Calcium Channel Blockers
freely filtered into the lumen of the nephron and not reabsorbed. This causes an increase in solutes in the nephron and thus water will follow this high solute concentration
Osmotic Diuretics: Mannitol
bind to the Na+/K+/2Cl- transport system blocking the reabsorption of Cl- thus sodium and water will follow
Loop diuretics
Bumetanide (Bumex)
Ethacrynic acid (Edecrin)
Furosemide (Lasix)
Torsemide (Demadex)
Inhibits aldosterone effects in the cortical collecting tubule and late distal tubule
Potassium Sparing diuretics
Spironolactone/Eplerenone
Inhibits sodium transport through ion channels in the cortical collecting tubule and late distal tubule
Potassium Sparing diuretics
Amiloride and Triamterene
a) are found in the brush border cells in the lumen of the nephron
b) Inhibition of this enzyme decreases sodium bicarbonate reabsorption in the proximal tubule thus water follows.
c) This may cause a metabolic acidosis which decrease the effectiveness for diuresis.
Carbonic Anhydrase Inhibitors
Inhibit ADH antagonists in the collecting ducts of the nephron to promote free water excretion
Antidiuretic Hormone (ADH) Antagonists (vasopressin antagonists)
Conivaptan - Vaprisol®
Tolvaptan - Samsca®
inhibit conversion of angiotensin I to angiotensin II
Angiotensin Inhibitors
– Blocks angiotensin II (ATII) from binding to angiotensin type 1 receptors (AT1), therefore blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II
– Blocks the effect of ATII regardless of whether ATII is generated by ACE, or some other enzymatic route (non-ACE pathway)
– Does not interfere with metabolism of kinins or
neuropeptides
Angiotensin II Receptor
Blockers (ARBs)
Blocks conversion of angiotensinogen to angiotensin I, therefore decreasing formation of angiotensin II
Direct Renin Inhibitor
-Aliskiren (Tekturna®)
