PHARMACY Lecture Notes - Lecture 1: Vascular Smooth Muscle, Hematology, Ganglionic Blocker
Document Summary
Drugs that alter sodium and water balance (diuretics) Increase na excretion -> decrease blood volume -> decrease co. Effect on vascular resistance (vessel stiffness and neural reactivity) Decrease na of vessel wall -> decrease na-ca exchange -> decrease intracellular ca and concentration: thiazide diuretics. Initial monotherapy or in combination w/ other drugs. Blocks the nacl cotransporter in distal convoluted tubules: chlorothiazide, hydrochlothiazide. Benzothiadiazine: loop diuretics, furosemide, bumetamide, ethacrynic acid. Limp of loop of henle: k sparing diuretics. Aldosterone receptor agonist (dependent on circulating aldosterone: spirolonactone. Epithelium na channel blocker (enac) non steroidal: triamterene, amiloride, others, indapamide, metolazone, xipamide. Reduce sympathetic outflow from vasopressor centers in brainstem with increased sensitivity to baroreceptor control. L-dopa analog converted to alpha- methyldopamine and then alpha- methylnorepinephrine. Reduce pvr, variable effect on hr and co, reduce rvr. Treatment of hypertension, either alone or with other agents. Usually used after other agents have failed due to side effects.
