Download Pharm 1 Mechanisms of Diuretics as an Antihypertensive Direct

Pharm 1
Mechanisms of Diuretics as an Antihypertensive
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Direct vasodilator effect.
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↓ vascular receptor sensitivity to Vaso active substance
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↑ Increase synthesize of the vasodilator PGs.
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↓ cardiac output due to ↓ blood volume by the diuretic action.
Alphametyldopa can be used in hypertensive pregnant ladies
Mechanism of Action of ACEIs
1.
Inhibition of ACE (Angiotensin converting enzyme )
2.
Prevent inactivation of kinins= marked vasodilator
Absolute contraindication of ACEI
1. Bilateral renal artery stenosis or stenosis in a solitary kidney.
2. Pregnancy and breast-feeding
Give example of Dihydropyridines group = nifedipine
C.C.B.with cardiac effects ? = verapamil and diltiazem.
nifedipine is absolute contraindicated in Hypertrophic obstructive cardiomyopathy
Mention 2 carvidalol effect ?
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It blocks  and  receptors.
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It has dircet V.D. effect.
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It has anti oxidant effect.
Cytoprotective drugs ? (trimetazidine)
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Pharm 2
Mechanism of action of NITRITES
(NO) increase level of cGMP = V.D on vein > artery
Nitroglycerine tablets should not be put in sunlight, or with cotton.? Cus sunlight and cotton will reduce
it effect
pharm3- H.Faliur
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CARDIAC GLYCOSIDES\ Digitalis \Digoxin
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↑ force of contraction
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↓ the heart rate
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Diuresis on kidney
Assessment of Response to Digitalis
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Relief of dyspnea and orthopnea.
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Disappearance of tachycardia.
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Increase urine volume.
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Disappearance of edema, congested neck veins and basal lung crepitations.
What increase activity of digitalis ? = decrease K+ = diuretics
What decrees effect of digitalis ? Pectin, kaolin, cholestyramine
Amrinone, Milrinone INHIBIT PHOSPHODIESTERASE = ↑level of cAMP
RATIONAL FOR USE OF BETA-BLOCKERS IN HEART FAILURE
We will give Carvedilol?
1- vasodilator activity
Vasodilator cus it has alpha and beta blocking activity .
2-Antioxidant properties.
3-Up-regulation of beta-receptors
Mention 2 drugs used in treatment of ACUTE PULMONARY EDEMA\ Acute heart failure \ Cardiac
asthma?
1.
2.
3.
4.
5.
6.
7.
8.
Morphine
Oxygen
Diuretics
Vasodilators
Hospitalization.
Semisitting or sitting position.
Rapid digitalization:
Aminophylline
Pharm 4
Quinidine is an :
1- Class Ia antiarrhythmic
2- Class Ib antiarrhythmic
Or Quinidine is an :
SODIUM CHANNEL BLOCKERS
Amiodarone is an :
POTASSIUM CHANNEL BLOCKERS
The following drug is an ideal \ the best for treatment of Ventricular arrhythmias ?
Lidocaine
AMIODARONE is
POTASSIUM CHANNEL BLOCKERS
Adverse Effects of AMIODARONE?
1. Corneal microdeposists
2. disturb of thyroid function,
3. photosensitivity,
4. pulmonary fibrosis
5. myopathy,
6.
peripheral neuropathy,
7.
hepatotoxicity