-
Fxn of Alpha 1:
"BEVAS"
- B: Bladder: contraction
- E: Eye: contriction of radial muscle = mydriasis
- V: Veins: constriction
- A: Arterioles: (skin, mucous memranes, viscera) constriction
- S: Sex Organs: (male) ejaculation, constricts prostate capsule
-
Fxn of Alpha 2:
- inhibition of trasmitter release
- reduces T release when too much accumulates in synaptic gap
-
Fxn of Beta 1:
- Heart:
- ↑ HR
- ↑ Contractility
- ↑ AV Conduction
-
Fxn of Beta 2:
"LABS"
- L: Liver: gylcogenolysis
- A: Arterioles: (heart, lung, skel. musc) dilation
- B: Bronchi: dilation
- S: Skeletal Muscle: ↑ contraction, glycogenolysis
- (plus uterus relaxation)
-
Fxn of Dopamine:
- Kidney:
- dilation of kidney vasculature
- enhances renal perfusion
-
Prazosin [Minipress]
- Alpha Adrenergic Blocker
- Selective Alpha-1
- Use: Hypertension
- A/E: Orthostatic Hypotension/First Dose Effect (also ↓ejaculation, nasal congestion)
- Take first dose @ bedtime to avoid first dose effect
-
Propanolol
- Nonselective Beta Blocker
- Beta-1 and Beta-2
- Use: Hypertension (angina, HF, dysrhythmia) Reduces CO
- A/E: Bradycardia, Heart Block, Rebound Excitation, Blocks Genolysis (↑BG)
- Diabetics! Masks Hypoglycemic Tachycardia
-
Metropolol
- Selective Beta Blocker
- Beta-1 only
- Use: Hypertension (angina, HF, MI) reduces CO
- A/E: Bradycardia, ↓CO, Rebound Excitation, Can Cause HF
- Diabetic! masks hypogylcemic tachycardia
-
Captopril [Capoten]
- ACE Inhibitor
- Blocks Production of AngioII in lungs
- Uses: Hypertension (Diabetic Nephropathy, HF, MI)
- AE: Cough (↑bradykinin), First Dose, Hyperkalemia, AngioEdema, Renal Failure)
- No K+ Supplements
-
Losartan [Cozaar]
- ARB
- Blocks Action of AngioII
- Use: Hypertension (Diabetic Nephropathy, Stroke Prevention, HF, MI, Migraine)
- AE: AngioEdema, Renal Failure
- Doesn't work in the lungs, so no bradykinin effect, so no Cough and no HyperKalemia like the ACE inhibitors
-
Verapamil & Diltiazem
- CCB: Calcium Channel Blockers (like BB's)
- works on VSM of both Heart and Arterioles
- Use: Hypertension, Angina, Cardiac Dysrhythmia
- AE: Constipation (dizzy, flush, HA, edema, bradycarda [SA], Heart Block [AV], ↓contr.)
- (think "calcium = contraction")
-
Nifedipine
- CCB: Calcium Channel Blockers (like BB's)
- works on VSM of only ArteriolesUse:Hypertension, Angina Pectoris
- AE: Reflex Tachycardia
- Little Constipation, unlike Verapamil
-
Lovastatin
- HMG-CoA Reductase Inhibitor
- Lowers Cholesterol (statins are most effective) by inhibiting cholesterol production, which stims ↑LDL receptors in liver (more LDL drawn from blood into liver)
- Use: Lower Colesterol, Prevent CV Events
- AE: Myopathy, Hepatotoxicity
- Take in the evening because endogenous absorption increases at nighttime.
-
Nicotinic Acid [Niacin]
- Lowers Cholesterol by targeting VLDLs, therefore ↓LDL
- Use: lowers cholesterol, DOC for Pancreatitis, best at ↓HDL
- AE: Flushing, GI, Hepatotoxicity, Hyperglycemia
- Don't take long-acting preparations because ↑risk hepatotoxicity. Take with food.
-
Cholestyramine
- Bile-Acid Sequestrant
- Lowers Cholesterol by preventing reabsorption of Bile Acids into Liver, leading to ↑LDL receptors in Liver
- Use: Reduce LDL (can pair w/statins)
- AE: Constipation (↓uptake of Vit ADEK, can form complexes w/other drugs)
- take other drugs 1 hr before or 4 hrs after
-
Ezetimibe
- Lowers Cholesterol, works on cells on small intestine to decrease absorption of cholesteral
- Use: Lower Cholesterol
- AE: generally well tolerated
- No constipation/GI effects like other cholesterol drugs.
- Newest for HyperCholestemia.
-
Where do Diuretics work?
the nephron of the kidney
-
Furosemide [Lasix]
- High Cieling (Loop) Diuretic
- works in Asceding Loop of Henle, where 20% water reabsorption takes place; blocks reabsorption so water is excreted
- use: Edema, Hypertension
- ae: Hypokalemia, Hypernatremia, Ototoxicity, Hyperglycemia, dehydration, ortho hypotn, hyperuricemia
- intrxn: Digoxin (↑dyrhythmia), Ototoxic Drugs (↑risk hearing loss), Potassium-Sparing Diuretics (help prevent hypokalemia)
- Greatest amount of Diuresis, very strong effect.
-
Hydrochlorothiazide [HydroDIRUIL, HCTZ]
- Thiazide Diuretic
- blocks reabsabsorption in early segment of DCT, where 10% water is reabsorbed
- use: Hypertension, Edema, CHF
- ae: all the same as Furosemide, but to a lesser degree
- intrxn: Digoxin (toxicity), NSAIDs (blunt fx), Antihypertensives (change fx), Lithium (↑ to toxic levels), Potassium-Sparing Diuretics (compensate K+ loss)
- Most Widely Used, more mild effects.
- Dependent on Renal Fxn, cannot use if Renal Impairment.
-
Spironolactone [Aldactone]
- Potassium-Sparing Diuretic
- blocks receptors for Aldosterone in DCT, so K+ is retained and Na, Cl, H2O are excreted (takes ~48hrs)
- use: (usually combined) Hypertension, Edema, CHF (also Hyperadolsteronism, PMS, PCOS, Acne)
- ae: Hyperkalemia (lethal dysrhythmia possibility)
- intrxn: Agents that ↑K+ (K+ suppl, salt subs, other K+ sparing diuretics), ACE/ARB/DRI, Thiazide/Loop Diuretics (counteracts K+ wasting)
-
Mannitol [Osmitrol]
- Osmotic Diuretic
- works in Lumen of Nephron to create Omotic Force to inhibit passive reabsorption of water, so urine flow increases
- use: prophy Renal Failure, ↓ICP, ↓IOP
- ae: Edema, CHF, F/E Imbalance, N/V, HA
- freely filtered in glomerulus
- minimal reabsorption, not majorly metabolized
- pharmacologically inert (no direct effects)
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