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Name the Ca Channel inhibitors?
What are their general effects?
Nifedipine, Diltiazem, Verapamil
- Smooth muscle relaxation
- Decreases HR, Conduction, and contraction force.
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What is a difference between Nitrates and Ca channel Blockers?
Nitrates-- are venous dilators
- Ca channel Blockers--- Arterial dilators
- (note: These can cause a reflex tachycardia)
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Which of the Ca channel blockers are DHP (dipine) and which are not?
What are their effects?
What are they used for?
- VERAPAMIL DILTIAZEM are NON-DHP
- - decrease HR
- - Used in Arrythmia and angina
- NIFEDIPINE is DHP
- -increased HR(due to Reflex)
- -Cause Vascular smooth muscle relaxation-- decrease afterload
- - used in HTN and angina
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Name the different Dipines (DHP drugs) and their special features.
Amlodipine ---------- no reflex tachycardia
Nicardipine---------- Used in HTN and angina
Nimodipine ---------- This is Cerebral vessel specific, it prevents cerebral vassospasm and ischemia
Nifedipine----- used to treat Raynauds phenonmenon (which is caused by Vasospasm)
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K CHANNEL OPENERS
What is their prominate action?
Name one
Smooth muscle relaxation of Vascular and Visceral tissues.
-Nicorandil
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What is Ranolazine? What is it used for?
What is Trimetazidine? What is it used for?
It is a Na channel inhibitor. Used for treatment of chronic angina pectoris.
- -Is a drug for angina pectoris.Trimetazidine is an anti-ischemic agent, that improves
- myocardial glucose utilization thus decreasing its O2 dependence.
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Conclusions of Antianginal agents
- -Nitrates and CCBs decrease myocardial wall tension whereas, beta blockers decrease the heart rate and
- contractility.
- -Nitrates and Nifedipine have the potential to
- cause reflex tachycardia, but this effect can be prevented by concurrent administration of beta blocker.
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What are the Classifications of the Antihypertensives?
- ACE inhibitors
- Angiotensin receptor blockers
- Renin inhibitors
- Beta adrenergic blockers
- Alpha adrenergic blockers
- Central alpha 2 agonists
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What are the diuretics that can be used as Antihypertensive agents? Name them
-Thiazides : Chlorothiazides, Metolazone, Indapamide.
-High ceiling diuretics : Furesomide, Bumetanide, Ethacrynic acid
-K sparing diuretics : Spironolactone, Triamterene, Amiloride
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What are the Antihypertensive agents that are Vasodilators?
- -Calcium channel blockers :
- - Amlodipine, Nicardipine, Nifedipine.
-Other vasodilators: Hydralazine, Minoxidil, Diazoxide, Nitroprusside, Fenoldopam
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Name the Angiotensin Converting Enzyme (ACE) Inhibitors
What is their effect?
Captopril, Lisinopril, Enalapril, Ramipril, Benazepril, Fosinopril
Decreases: Arterial resistance (afterload), Venous tension (preload) and aldosterone secretion.
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What are the effects of Angiotension II activation?
- -Increases sympathetic activity
- -Increases Tubular Na/Cl reabsorption
- -Increases Aldosterone secretion
- -Increases arterial vasoconstriction (increases BP)
- -Increases the pituitary release of ADH--> increases water retension
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What does ACE enzyme do?
It converts Angiotensin I to Angiotensin II.
It destroys bradykinin which is a Vasodilator
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What are the indications for ACE inhibitors?
- -Congestive heart failure (CHF)
- -Hypertension
- -Left ventricular dysfunction
- -Prevention of nephropathy in diabetes mellitus
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What are the Side effects with ACE INHIBITORS?
CHRONIC DRY COUGH**** -- due to increased Bradykinin
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