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What is an ARB?
Angiontensin II Receptor Blocker
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What receptor does ARB drugs block?
AT1 receptor
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Why are ARBs not assosiated as much with cough side effects as the ACE inhibitors are?
They do not effect break down of bradykinin
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What patients are reccomended to take ARBs?
Ones who are having good results with their ACE inhibitors but are getting the cough side effect from it?
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What is the crossover Angioedema Risk?
3-8%
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What is the ARB mechanism of action?
they block the action of angiotensin II
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What is the drug class and the brand name for losartan?
Cozaar; angiotensin II receptor blocker
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What is the drug class and the brand name for valsartan?
Diovan; angiotensin II receptor blocker
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What is the drug class and the brand name for Irbesartan?
Avapro; angiotensin II receptor blocker
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What is the drug class and the brand name for Candesartan?
Atacand; angiotensin II receptor blocker
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What is the drug class and the brand name for Olmesartan?
Benicar; angiotensin II receptor blocker
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Who are Alpha 1-Receptor Blockers primarily used for and What is their purpose?
Primarily used in men and they are for the treatment of high blood pressure and the treatment of BPH
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Alpha 1-receptor blockers are not used first line unless treating...
...patients with high blood pressure and BPH
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What is BPH?
Benign prostatic hyperplasia
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What is the mechanism for alpha 1-receptor blockers?
they block the alpha 1-receptors of vascular smooth muscle, thus preventing the reuptake of catecholamines by the smooth muscle cells
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Where are alpha-1 receptors mainly found?
prostate
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What does blocking the catecholines cause?
vasodilation and allows blood to flow more easily
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what are catecholamines, where are derived from, and where are they found?
chemical compounds, derived from amino acids, and found circulating in the blood
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What are catecholines assosiated with?
stress
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what do catecholines do to BP and HR?
increase blood pressure and increase heart rate
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What are some examples of catecholamines?
epinephrine, nor-epinephrine, and dopamine
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What is the drug class and the brand name for doxazosin?
alpha 1-receptor blocker; cardura
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What is the drug class and the brand name for terazosin?
alpha 1-receptor blocker; hytrin
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Why are alpha 1-receptor blockers normally used in combination?
there is difficulty in lowering blood pressure (not very effective by itself)
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What are some of the adverse side effects of alpha 1-receptor blockers and what is some patient education for this medication?
adverse effect: palpitations, nausea, and headache; patient education: take first dose at bedtime
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What are some of the adverse side effects of doxazosin and what is some patient education for this medication?
adverse effect: palpitations, nausea, and headache; patient education: take first dose at bedtime
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What are some of the adverse side effects of terazosin and what is some patient education for this medication?
adverse effect: palpitations, nausea, and headache; patient education: take first dose at bedtime. do not take if pregnant (woman)
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What are some of the adverse side effects of valsartan and what is some patient education for this medication?
adverse effect: dizziness, increase in renal failure; patient education: do not take if pregnant (woman)
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What are some of the adverse side effects of irbesartan and what is some patient education for this medication?
adverse effect: dizziness, hyperkalemia; patient education: first dose to be taken at bedtime
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What are some of the adverse side effects of candesartan and what is some patient education for this medication?
adverse effect: hypotension, dizziness, lightheadedness, headache; patient education: take preferably on empty stomach (1 hour before or 2 hours after)
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What are some of the adverse side effects of olmesartan and what is some patient education for this medication?
adverse effect: dizziness, headache, back pain; patient education: do not use potassium supplement or salt subsitutes
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What is the drug class and the brand name for clonidine?
aplha-2 agonist; Catapres
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What's the mechanism for clonidine?
crosses the blood brain barrier and selectively stimulates receptors in the brain that monitor catecholamine levels in the blood
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How does clonidine work? What does it do?
it activates an inhibitory neuron and decreases sympathetic outflow therefore there is a decrease in catecholamine production, decrease in HR and decrease in BP.
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What are some of the side effects associated with clonidine? What is the patient education?
dry mouth, drowsiness, dizziness, headache; edu: take with food or milk, change transdermal skin sites with each application of patch
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What can clonidine be used for?
migraine headache, symptoms associated with menopause or menstrual discomfort, symptoms of withdrawal associated with alcohol, nicotine, or narcotics, ADHD, high blood pressure
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