Midterm

• Alpha 1 contracts vascular smooth muscle and relaxes intestinal smooth muscle
• Alpha 2 decreases GI motility and insulin secretion
• Beta 1 increases HR and kidney function
• Beta 2 - bronchodilation, vasodilation, and reduces GI motility
• Beta 3 decreases heart contractility and reduces bladder contraction
• HTN Drugs

  • Vasodilators
  • Diuretics
  • Renin-angiotensin inhibitors
  • Sympatholytics
• Diuretics = IDE

  • thiazide
  • loop
  • Potassium sparing
• Diuretics adverse effects

  • OH
  • Hypokalemia
  • Increased urinary frequency
• Sympatholytics

  • beta blockers
  • alpha blockers
  • ganglionic blockers
  • Centrally acting drugs
  • presynaptic adrenergic NT depleters
• Beta Blockers = LOL

  • blocks beta 1
• Alpha blockers = SIN

  • blocks alpha 1 receptors to reduce peripheral vascular tone
  • may cause tachycardia and trigger baroreceptor reflex
• Presynaptic Adrenergic Inhibitors

  • inhibit the release of norepi
  • reduces heart excitation
  • relaxes peripheral vasculature
  • Bradycardia, arrhythmias, drowsiness
• Centrally acting agents

  • inhibit sympathetic discharge from BS
  • dry mouth, dizziness, sedation
• Ganglionic blockers are used in emergencies to reduce BP because they are vasodilators

  • OH, urinary retention, visual disturbances
• Vasodilators adverse effects

  • OH
  • Tachycardia
  • dizziness
• Renin-angiotensin inhibitor regulates sodium and water balance to maintain BP

  • ACE = pril
  • ARB = sartan
• ACE inhibits the conversion of I to II so BP will drop
• Side effects of renin-angiotensin inhibitors

  • Dry mouth
  • Angiodemia = medical emergency
• Calcium Channel Blockers = PINE

  • safe for those with kidney disease
  • causes vasodilation and reduced vascular resistance
• Side effects of CCB:

  • excessive vasodilation
  • OH
  • HR abnormalities
  • Reflex tachycardia
• Organic nitrates

  • cause global vasodilation
  • reduces cardiac workload, it does not increase oxygen supply
  • nitroglycerin
  • Adverse effects: HA, Dizziness, OH, Nausea
• For stable angina = nitroglycerin sublingually
• Variant angina = CCB
• CHF

  • positive inotropic agents - to increase myocardial contraction force
  • Digoxin increases CO
  • can be fatal
• CHF

  • positive inotropic agents
  • dopamine
  • stimulates beta 1 receptors
• Anticoagulants prevents clots in the venous system
• antiplatelets prevents thrombus in the arterial system
• Fibrinolytic agents are used to reopen occluded vessels in arterial and venous thrombosis
• Anticoagulants

  • Low molecular weight heparin = no monitoring
  • replaces heparin for DVT
• Heparin is used for initial treatment for venous thrombosis
• aPTT

  • normal 21-35 seconds
  • therapeutic 2-2.5 times normal (60-109 seconds)
• Warfarin (Coumadin)

  • primary drug for LONG TERM prevention of DVT
  • used for a-fib too
  • interferes with vitamin K
  • need INR testing
• INR measures how quickly a person clots

  • normal 0.8-1.2
  • for stroke 2-2.5
  • a-fib, PE, VTE 2-3
  • prosthetic heart valve 2.5-3.5
• Direct thrombin inhibitors and factor Xa inhibitors are anticoagulants that have reversal effects
• Direct thrombin inhibitors (Pradaxa) inhibit specific components of the clotting mechanisms and is an alternative to heparin
• Factor Xa inhibitors (Eliquis and Xarelto) inhibit factor Xa to reduce clotting
• Adverse effects of Anticoagulants

  • bleeding
  • thrombocytopenia
  • GI upset
• Antiplatelets

  • COX inhibitor - ASA
  • ADP receptor blockers (Plavix)
  • more effective than ASA and prevent thrombosis from MI
  • Glycoprotein lib-IIIa receptor blockers
  • inhibit fibrinogen to activate platelets
  • most powerful
• Adverse effects of antiplatelets

  • bleeding
  • GI upset
  • Liver/kidney toxicity
• Thrombolytics = dynamite for clots

  • converts plasminogen to plasmin
  • for MI