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Name the ANGIOTENSIN RECEPTOR BLOCKERS ARB (AT 1 BLOCKERS):
Losartan, Erbesartan, Candesartan
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Name the RENIN INHIBITORS
How does it work?
What are the adverse effects?
Aliskiren
-Aliskiren inhibits the activity of renin and thus prevents the conversion of angiotensinogen to angiotensin-I
-angioedema, hyperkalemia and hypotension
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Name the beta blockers.
What are their effects?
- Atenolol, Propranolol
- -Decrease in cardiac output
- -Inhibition of renin release
- -Inhibition of NE release from presynaptic adrenergic terminals
- -Reduction of central adrenergic tone
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What are the adverse effects of the Beta blockers?
- Bradycardia, which sometimes presents as coolness
- of hands and feet in winter.
worsening of preexisting asthma and other forms of airway obstruction.
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Name the Alpha2 recepter blockers
What do they do?
What happens when they are Withdrawn abruptly?
- Clonidine, Methyldopa
- -REDUCING SYMPATHETIC OUTFLOW FROM CNS
- -withdrawn abruptly leading to tachycardia, sweating, nausea, tremor,
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What is Nimodipine used for?
subarachnoid hemorrhage
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Hydralazine
What is it? How does it work?
Is there a reflex?
What are its adverse effects?
- Arteriolar vasodilator
- It releases NO
- There is a reflex tachycardia
- Its advese effects:
- Throbbing headache, palpitations
- SLE – in slow acetylators
- Precipitation of angina and myocardial infarction.
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What are the uses for Hydralazine?
- Hypertension
- Used in hypertension of pregnancy
- Hypertensive emergencies
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Minoxidil
What is it?
What happens if used chronically?
a vasodilator (K channel activator)
Chronic therapy –excess growth of hair on face, back and arms
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What is Sodium Nitroprusside (SNP)?
How does it work?
What is its toxicity?
- -In has potent vasodilating effects in arterioles and venules-Used in acute hypertensive emergency.
- -sensative to light (becomes metabolized)
- -Breaks down in circulation and releases NO
- -When it is metabolized it releases CN-. Which inhibits the Electron transport chain.--> can lead to Lactic acid production.
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What do you give in CN posining?
Concomitant administration of sodium thiosulfate or hydroxocobalamin
These prevent CN accumulation in patients on Nitroprusside.
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Diazoxide
What is it?
How does it work?
What is its toxicity?
- -it is a long acting arterial dilator.
- -Used in Hypertensive emergencies.
- -It acts by opening K channels--> leading to relaxation of the bloodvessels.
-Toxicity: Excessive Hypotension and hyperglycemia (because it inhibits Insulin release)
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What is Fenoldopam?
How does it work?
What are the major Toxicities?
-A drug that is via IV to treat hypertensive crisis.
-It acts as a selective peripheral dopamine D1 receptor weak partial agonist.
major toxicities: reflex tachycardia, headache, and flushing.
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In diabetes what are C.I and what are IN?
In Dyslipidemia ?
In Pregnancy?
- -Diuretics are CI and Ace inhibitors are IN
- -Diuretics are CI
- -Diurectis and Ace Inhibitors are CI
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Name the Endothelin receptor antagonists
What are they?
Bosentan, Sitaxentan
(vasoconstrictors)
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Name the Phosphodiesterase type 5 inhibitors
When is it used?
Sildenafil
Used in Pulmonary hypertension
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Name the Prostacyclin derivatives
- Epoprostenol (PGI2),
- Iloprost (PGI2)
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What are the DOC fort:
-uncomplicated HTN?
-patients with hypertension and diabetes mellitus
-hypertensive patient with history of CAD.
-HTN patient with history of bronchial asthma.
-treatment of HTN in pregnancy.
- -Diuretics
- -Ace inhibitors
- -Beta Blockers
- -Calcium channel blockers
- -Methyldopa
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