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Pharmacology - Final - Part 6

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davidwurbel7's version from 2016-08-14 05:39

Anti adrenergic drugs

Question Answer
Phenoxybenzamine and Phentolamine are this class of drugsNon-Selective Alpha Blocker
Prazosin, Terazosin, Doxazosin and Tamsulosin are this class of drugsAlpha-1 Selective Blocker
Arterial and venous vasodilation leading to hypotension. Increase in heart rate due to reflex sympathetic stimulation. Increased release of NE by α2 blockade (only true for Nonselective blockers)Alpha Blockers
This alpha blocker drug forms a covalent bond with receptors. Because of this, it results in irreversible alpha-blockadePhenoxybenzamine
Postural hypotension is a common side effect of this drugPhenoxybenzamine
This class of drug can be used to treat BPH and hypertensionAlpha Blockers
Phenoxybenzamine or Phentolamine is used to treat thisPheochromocytoma
Prazosin is used to treat thisEssential Hypertension
Phentolamine or Prazosin is used to treat thisHT due to clonidine withdrawal, cheese reaction
Prazosin is used to treat thisRaynaud’s Phenomenon
Tamsulosin is preferred. Prazosin, terazosin and Doxazosin are alternatives for treating thisBenign Prostatic Hyperplasia
This type of blocker is the best to use for BPHα1a
Side effects of these drugs include postural hypotension (Orthostatic hypotension). “first-dose phenomenon" - Marked postural hypotension and syncope with the first dose of selective agents. Reflex Tachycardia, palpitationsAlpha Blockers
The effects of "first-dose phenomenon" (Orthostatic hypotension) can be reduced by thisTaking Drug Before Bed-Time
Propranolol, Timolol, Pindolol and Sotolol are this class of drugsNon-Selective Beta Blocker
Atenolol, Betaxolol, Esmolol, Acebutalol, Metoprolol are this class of drugsBeta-1 Selective Blocker
The adverse effects of these drugs are bradycardia, Bronchospasm, Precipitation of peripheral vascular disorders and Vasospastic angina. Should be cautiously used in patients with Congestive Heart Failure as they depresses myocardial contractility and excitability. Mask the premonitory symptoms of hypoglycemia. Chronic use associated with increase lipid levels. Sudden stoppage of beta blocker therapy leads to rebound hypertension due to “up regulation” of beta receptorsBeta Blocker
A beta blocker with partial agonist activity, also called intrinsic sympathomimetic activity may minimize the bradycardia frequently found in elderly patientsBeta Blockers with ISA
A beta blocker with relatively high affinity for beta-1 with less blockade of Beta-2.Therefore preferred over other non-selective beta blockers in patients with Bronchial asthma, Peripheral vascular disorders (Raynaud's Phenomenon) and Vasospastic angina (Prinzmetal's Angina)Beta-1 Selective Beta Blocker
A beta blocker with a "membrane-stabilizing" action. A disadvantage of such beta blockers when used topically in the eye is that it decreases protective reflexes and increases the risk of corneal ulcerationBeta Blockers with Local Anesthetic Action
This class of drugs is cautiously used in patients with Congestive Heart Failure as they depresses myocardial contractility and excitabilityBeta Blockers
This class of drugs mask the premonitory symptoms of hypoglycemiaBeta Blockers
Sudden stoppage of beta blocker therapy leads to this due to “up regulation” of beta receptorsRebound Hypertension
Pindolol and Acebutalol are this type of beta blockersBeta Blocker with ISA
This effects is absent in Timolol, hence preferred in glaucomaBeta Blockers with Local Anesthetic Action
Beta blocker used in the treatment of glaucomaTimolol
Beta blocker used in the treatment of heart failure by reduce mortality in chronic heart failureCarvedilol
Beta blocker used in the treatment of PheochromocytomaLabetalol
This drug is an antagonist at alpha-1, beta-1, and beta-2 receptorsCarvedilol
This drug is an antagonist at alpha-1 receptors and a partial agonist at beta-1 and beta-2 receptorsLabetalol
Mechanism of action of this drug is the inhibition of tyrosine hydroxylase, the rate-limiting enzyme in catecholamine biosynthesisMetyrosine
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Anti-Hypertension Drugs

Question Answer
For thiazides, maximum antihypertensive action is at this doseLower than Diuretic Dose
Toxicity is this class of drugs include hypokalemia, ↓ glucose tolerance and may unmask latent diabetes mellitus, ↑ plasma LDL, cholesterol, and triglycerides and ↑ increased levels of plasma uric acid and precipitate acute goutThiazides
This class of drug mechanisms of action are decrease in cardiac output and inhibition of renin releaseBeta Blockers
The hemodynamic effect of this class of drug are Heart rate: decreased, Cardiac output: decreased, Venous tone: unchanged, Peripheral vascular resistance: decreased and Postural hypotension: negligibleBeta Blockers
Dihydropyridines, Verapamil, diltiazem belong to this class of drugsCalcium Channel Blockers
Amlodipine, felodipine, isradipine, nicardipine, nifedipine, and nisoldipine belong to this class of drugsDihydropyridines
Captopril, Enalapril, Ramipril, Benazepril, Fosinopril, Lisinopril, Quinapril belong to this class of drugsACE Inhibitors
Losartan, Valsartan, Candesartan, eprosartan, irbesartan, telmisartan, and olmesartan belong to this class of drugsAngiotensin Receptor Blockers (ARBs)
This class of anti-hypertensive drugs and this drug should be tapered when coming off of the drugBeta Blockers and Clonidine
This class of drugs are the drug of choice for hypertension with diabetic nephropathyACE Inhibitors
These beta blockers also have an alpha blocking ability as wellLabetelol and Carvedilol
Labetelol is used to treat this conditionPheochromocytoma
Carvedilol is used to treat this conditionCHF
In severe hypertension, this class of drugs is useful in preventing the reflex tachycardia that often results from treatment with direct vasodilatorsBeta Blockers
This class of calcium channel blocker drugs has a preferred site of action in the blood vesselsDihydropyridines (DHPs)
This class of calcium channel blocker drugs has a preferred site of action in the heartNon-Dihydropyridines (Verapamil, Diltiazem)
Mechanism of action is to decrease cardiac output. May cause hypokalemia, hyperglycemia, hyperlipidemia and hyperuricemiaHydrochlorothiazide
Mechanism of action is to decrease both cardiac output and renin systemBeta Blockers
Calcium channel blocker with a preference for peripheral arteriesAmlodipine
Calcium channel blocker with a preference of coronary bloodNicardipine
Calcium channel blocker with a preference for cerebral blood vesselNimodipine
This calcium channel blocker is used in treatment of subarachnoid hemorrhageNimodipine
Nimodipine is used to treat this conditionSubarachnoid Hemorrhage
Long term exposure to angiotensin II will cause this in both the heart and kidneysRemodelng
Mechanism of action is to decrease peripheral arterial resistance and cardiac output. May cause dry cough and severe hypotension (initial dose in hypovalemic patients). This class is the drug of choice for diabetic nephropathy. This class is contraindicated for bilateral renal artery stenosis, angioedema and pregnancy (category D). Drug interactions - Hyperkalemia- if K+ sparing diuretics and ACE inhibitors concurrently usedACE Inhibitors
Mechanism of action is to decrease peripheral arterial resistance by blocking the AT-1 and AT- 2 receptors. They have no effect on bradykinin metabolism and are therefore more selective blockers of angiotensin. Provide benefits similar to those of ACEI in patients with heart failure and chronic kidney disease. This drug is contraindicated in bilateral renal artery stenosis, angioedema and pregnancy (category D). Drug interactions - Hyperkalemia- if K+ sparing diuretics and ACE inhibitors concurrently usedAngiotensin Receptor Blockers (ARBs)
Adverse effects of this class of drugs include Severe hypotension, dry cough, Acute renal failure, Angioedema, Pregnancy category D. Drug interactionsACE Inhibitors
The most common adverse effect of ACE Inhibitors is thisDry Cough
The dry cough adverse effect of ACE Inhibitors is due to high levels of thisBradykinin
ACE Inhibitors are contraindicated in patients with this condition due to reduction of blood flow to kidneysBilateral Renal Artery Stenosis
Hyperkalemia is seen if ACE inhibitors are used concurrently with this a drug from the is class of drugsK+ Sparing Diuretics
They block the angiotensin II type 1 (AT1) receptor. They have no effect on bradykinin metabolism. Provide benefits similar to those of ACE inhibitors in patients with heart failure and chronic kidney diseaseAngiotensin Receptor Blockers (ARBs)
The dry cough seen with ACE inhibitors is reduced if patient is given this class of drug insteadAngiotensin Receptor Blockers (ARBs)
Prazosin, terazosin, and doxazosin are examples are this class of drugsAlpha-1 Selective Alpha Adrenergic Blockers
Primarily used in men with concurrent HTN and benign prostatic hyperplasia (BPH)Alpha Adrenergic Blockers
Phentolamine, phenoxybenzamine are examples are this class of drugsNonselective Alpha Blockers
Mechanism of action is to directly act on smooth muscle cells through nonautonomic mechanisms to release of nitric oxide. Has equal effect on arteries and vein. Used in hypertensive emergencies. Toxicity can lead to cyanide toxicitySodium Nitroprusside
Major route metabolism is acetylation for this drugHydralazine
This drug acts by release of nitric oxide acting as an arteriolar vasodilatorHydralazine
Adverse effects of this drug is compensatory responses-tachycardia, salt and water retention. Drug induced reversible lupus erythematosus like syndrome – syndrome characterized by arthralgia, myalgia, skin rashes, and fever (in slow acetylators)Hydralazine
Amylnitrite/sodium nitrite followed by sodium thiosulfate or hydroxocobalamine is used to treat thisCyanide Toxicity
This manifests as lethargy, disorientation, muscle spasms & convulsionsCyanide Toxicity
Mechanism of action is by opening up K+ channels (hyperpolarization)-prevents/reduces smooth muscle contraction. Has a duration of action of several hours. Also reduces insulin release (used to treat hypoglycemia produced by insulinomas). Adverse effects hypotension, hyperglycemia, salt and water retentionDiazoxide
Can be used to treat hypoglycemia seen in insulinomasDiazoxide
Mechanism of action is to directly act on smooth muscle cells through nonautonomic mechanisms to release of nitric oxide. Has greater action on arteries. Major route of metabolism is acetylation. Used as a second line drug for HT in pregnancy. Toxicity may cause lupus like symptoms, compensatory responses - tachycardia, salt and water retentionHydralazine
Combination of this these drugs are approved for patients with both hypertension and heart failure, especially in African-American patientsHydralazine and Nitrates
Mechanism of action is to directly act on smooth muscle cells through nonautonomic mechanisms by activating D1 receptors. Used for hypertension emergenciesFenoldopam
Mechanism of action acts as a K+ channel opener-causes hyperpolarization and relaxes vascular smooth muscle. Used for severe HTN and topically to stimulant of hair growth for correction of baldnessMinoxidil
Mechanism of action reduces BP by reduction of cardiac output due to decreased heart rate and relaxation of capacitance vessels, with a reduction in peripheral vascular resistance. Toxicity - Dry mouth and sedation. Sudden withdrawal causes rebound hypertension. This rebound HTN is treated with α-blockersClonidine
It is a prodrug which stimulates central α2 adrenoceptors. It was widely used in the past but is now used primarily for HTN during pregnancy. Toxicity includes sedation and may cause hemotologic immune toxicity (+ve Coomb’s test) which may progress to hemolytic anemiaMethyldopa
First line drug use to treat pre-eclampsiaMethyldopa
Toxicity of this drug shows sedation and may cause hemotologic immune toxicity (+ve Coomb’s test). May progress to hemolytic anemiaMethyldopa
One among the 1st drugs to be used as antihypertensives. These are nicotinic blockers(Nn) acting in the ganglia. Cause severe reduction in BP. No longer used clinically due to toxicityHexamethonium and Trimethaphan
No longer used clinically due to toxicity. Depleting NE stores in the adrenergic nerve terminal. Side effect mental depressionReserpine
No longer used clinically due to toxicity. Depleting and blocking the release of stored NE. Side effect orthostatic hypotension and sexual dysfunctionGuanethidine
Hypertensive emergencies 1st choiceNicardipine/Clevidipine plus Labetalol/Esmolol
This drug is no longer 1st drug of choice for hypertensive emergenciesSodium Nitroprusside
Diuretics, beta blockers and ACE inhibitors have this as a minimal side effectCompensatory Response
Drug of choice for BPH with hypertensionPrazosin
Drug of choice for BPHTerazosin
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