PHRM30003 Study Guide - Final Guide: Aldosterone, Losartan, Proximal Tubule
5 Jun 2018
School
Department
Course
Professor
Drug name
Drug class
Molecular target(s)
Mechanism/Function
Contradiction/AE/Notes
Hypertension
(
5
)
–
triple therapy
Prop
ranolol
Alprenolol
Oxprenolol
Non
-
selective
Beta AR antagonist
Beta
1 & 2
AR
-
Decrease HR via SA node
- Decrease SV via contractility/cardiac
muscle
decrease CO decrease BP
- Kidney: decrease renin secretion
from juxtaglomerular cells
decrease blood vol and vascular
tone
Lipidphilic
Cross BBB
AE
AE:
Bronchoconstriction
Contraindicated with asthma or COPD
Hypoglycaemia
Glucose inhibition due to lack of ADR
Bad for diabetes
Causes tachycardia
Contraindicated with diabetes
Other AE:
- Cold extremities
- Fatigue – skeletal vessels
- Dreams and insomnia
- Cardiac depression in elderly
- Bradycardia
Drug withdrawal: rebound hypertension
Atenolol
Metoprolol
Beta1 selective
Beta AR antagonist
Beta 1 AR
-
Decrease HR via SA node
- Decrease SV via contractility/cardiac
muscle
decrease CO decrease BP
- Kidney: decrease renin secretion
from juxtaglomerular cells
decrease blood vol and vascular tone
Atenolol: hydrophilic
Do not cross BBB
Less AE
Chlorthalidone
Hydrochlorothiazide
Thiazide
Diuretics
C1 cotransporter
Affect
SV and TPR
Net loss of Na+ and H2O
in distal convoluted tubule (DCL)
- Decrease reabsorption of Na+ & Cl-
- Increase water loss
- Decreases blood vol/VR BP
Thiazide inhibits C1 so Na remains in lumen
and excreted
Initial
therapy
for uncomplicated
hypertension
High oral bioavailability and long duration
Effective in elderly
Another class of diuretics, loop diuretics, use
when emergency
AE:
- K+ loss (hypokalaemia)
