Ch 21/22 DRUGS Blood Vessel Volume & Tone Regulation

Ramipril

Class: ACE Inhibitor

• Inhibits RAAS pathway

  • Prevents conversion of Angiotensin I → Angiotensin II, therefore preventing vasoconstriction due to Angiotensin II signaling

Treats:

• Hypertension

• Congestive Heart Failure

• Acute Myocardial Infarction

• Chronic Kidney DIsease

****NOT USED for patients with liver damage

Losartan

Class: AT₁ Receptor Antagonist

• Inhibits RAAS pathway

  • Prevents vasoconstriction due to Angiotensin II signaling

Treats:

• Hypertension

• Protection against stroke

Nesiritide

Class: Recombinant BNP

• Prevents water retention

Treats:

• Heart failure

***Excretes more water than Na+

***May cause hypotension in high concentrations (difficult to reverse)

***Orally ineffective

Tolvaptan

Class: ADH V₂ Receptor Antagonist

• Prevents water retention

Treats:

• Cirrhosis

• Heart failure

Acetazolamide

Class: Na+ Reabsorption Inhibitor

• Carbonic Anhydrase Inhibitor

• Proximal tubule

Treats:

• Gout

• Glaucoma

• Mountain sickness

Mannitol

Class: Na+ Reabsorption Inhibitor

• Osmotic Diuretic

  • Pulls water, does not bind

• Glomerulus

Treats:

• Increased intracranial pressure

Furosemide

Class: Na+ Reabsorption Inhibitor

• Loop Diuretic

  • Prevents divalent Ca2+ reabsorption

  • Loss of Ca2+ & Mg2+

• Loop of Henle

Treats:

• Hypercalcemia

***Sulfa drug- can cause kidney stones

***NOT GOOD for patients with osteoporosis

Hydrochlorothiazide

Class: Na+ Reabsorption Inhibitor

• Thiazide

  • Prevents Ca2+ excretion

• Distal tubule

Treats:

• Hypertension

• Osteoporosis

***GOOD for elderly patients (weak bones)

Spironolactone

Class: Na+ Reabsorption Inhibitor

• Collecting Duct Diuretic

• Inhibits Aldosterone (RAAS pathway) binding

Treats:

• Hypokalemia

• Heart failure

• Edema

Amiloride

Class: Na+ Reabsorption Inhibitor

• Collecting Duct Diuretic

• Inhibits Na+ channels in collecting ducts

Treats:

• Hypokalemia

• Heart failure

• Edema

Nitroglycerin

Class: Diuretic

• Organic Nitrate

• Converted to Nitric Oxide for VASODILATION

Treats:

• Angina

• Myocardial Infarction

• Hypertension

• Heart Failure

***MOST EFFECT IN VEINS, not arteries

Sodium Nitroprusside

Class: Diuretic

• Organic Nitrate

• Converted to Nitric Oxide for VASODILATION

Treats:

• EMERGENCY hypertension

• Cardiac Failure

***QUICK response

***BAD for patients with liver issues (cyanide buildup cannot be filtered by liver)

***MOST EFFECT IN VEINS, not arteries

Inamrinone

Class: Diuretic

• Phosphodiesterase (PDE)₃ Inhibitor

• Selective → Cardiac

Treats:

• Hypertension

• Congestive Heart Failure

Sildenafil

Class: Diuretic

• Phosphodiesterase (PDE)₅ Inhibitor

Treats:

• Pulmonary Hypertension (in high concentration)

• Erectile Dysfunction (ED)

Nifedipine

Class: Diuretic

• Hydropyridine

• Ca2+ channel blocker

  • MOST effect in arteries, less in veins

Treats:

• Hypertension

***BEST FOR vascular smooth muscle

Diltiazem

Class: Diuretic

• Benzothiazepine

• Ca2+ channel blocker

  • MOST effect in arteries, less in veins

Treats:

• Arrhythmias

• Angina

***BEST FOR cardiac myocytes

Verapamil

Class: Diuretic

• Phenylalkylamine

• Ca2+ channel blocker

  • MOST effect in arteries, less in veins

Treats:

• Hypertension

• Arrhythmias

• Angina

***BEST FOR cardiac myocytes, good effect on vascular smooth muscle

Minoxidil

Class: Diuretic

• K+ Channel Opener

  • Causes hyperpolarization

  • Causes VASODILATION

Treats:

• Hypertension

• Balding (increases hair production in topical form)

Sitaxsentan

Class: Diuretic

• Endothelin_A Receptor Antagonist

  • Inhibits contraction due to endothelin

Treats:

• Hypertension

Prazosin

Class: Diuretic

• Alpha-1-Adrenergic Antagonist

  • Blocks Ca2+ mobilization

• Causes water & salt retention

Treats:

• Hypertension