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  • R-A-A System, Heart Failure Drugs, Mechanisms of Action

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    nizam_ghani
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    This document discusses various cardiovascular drugs and their mechanisms and effects. It covers topics like: 1. The renin-angiotensin-aldosterone system and how drugs like ACE inhibitors, ARBs, and aldosterone antagonists work to block it. 2. Diuretics like loop diuretics and thiazide diuretics that reduce blood volume and fluid retention. 3. Vasodilators like nitroglycerin, nitroprusside, and hydralazine that dilate blood vessels to reduce workload on the heart. 4. Beta blockers that slow the heart rate and relax arteries to improve blood flow. 5. Digoxin and

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    Heart failure

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    Heart Failure

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    This document discusses various cardiovascular drugs and their mechanisms and effects. It covers topics like: 1. The renin-angiotensin-aldosterone system and how drugs like ACE inhibitors, ARBs, and aldosterone antagonists work to block it. 2. Diuretics like loop diuretics and thiazide diuretics that reduce blood volume and fluid retention. 3. Vasodilators like nitroglycerin, nitroprusside, and hydralazine that dilate blood vessels to reduce workload on the heart. 4. Beta blockers that slow the heart rate and relax arteries to improve blood flow. 5. Digoxin and

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    © All Rights Reserved
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    51 views1 page

    R-A-A System, Heart Failure Drugs, Mechanisms of Action

    Uploaded by

    nizam_ghani
    This document discusses various cardiovascular drugs and their mechanisms and effects. It covers topics like: 1. The renin-angiotensin-aldosterone system and how drugs like ACE inhibitors, ARBs, and aldosterone antagonists work to block it. 2. Diuretics like loop diuretics and thiazide diuretics that reduce blood volume and fluid retention. 3. Vasodilators like nitroglycerin, nitroprusside, and hydralazine that dilate blood vessels to reduce workload on the heart. 4. Beta blockers that slow the heart rate and relax arteries to improve blood flow. 5. Digoxin and

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    © All Rights Reserved
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    of 1

    Pressure= Force/Area

    Angiotensinogen Angiotensin I Angiotensin II Aldosterone



    VASOCONSTICTION
    renin
    ACE
    R-A-A System
    reduced
    digoxin
    dosage
    Heart
    Failure
    Workload
    myocardial
    Contractility
    Vasodilators
    Fluid Retention
    Nitroglicerine
    Nitropruside/ Hydralazine
    venous tone
    Dilate coronary artery
    Enhance blood O2 delivery to the heart
    Relax arterioles
    Diuretics(blood Vol)
    ACE i
    ARB
    Aldosterone Antagonist
    Aldosterone Antagonist
    Beta blocker
    B-type Natriuretic Peptide
    Anticoagulants
    MoA
    slow the heart rate to improve myocardial perfusion by activating potassium
    channels to relax the smooth muscle and dilate the arteries
    A/E
    Nightmare, tiredness
    C/I
    Asthma
    decrease blood pressure by decreasing the cardiac output, also decreased
    renin by affecting the JGAB1 receptor
    increased TGs and decreases HDL (add a statin to reduce this effect)
    Indication
    hypertension
    +ve Inotropic
    Agent
    Type
    B1 selective
    Alpha/Beta
    Atenolol
    Metoprolol
    Carvedilol
    Direct Vasodilator
    Hydralzine
    Sod Nitroprusside
    Type
    Loop Diuretic
    Thiazide
    Furosemide
    Bumetanide
    Hydrochlorothiazide
    Metolazone
    Spironolactone
    Renin-Angiotensin
    Sysytem blockers
    ACE i

    Mortality
    Morbidity
    Side effect
    Skin rash
    Persistent cough
    Hyperkalemia
    Angioedema possibly
    Neotropenia
    ARBs
    eg
    Fosinopril
    Captopril
    Enalapril
    Lisinopril
    Advice
    Take in morning to prevent interrupted sleep
    Cardiac
    Glycosides
    (Digitalis)
    Digoxin
    MoA
    heart contractility, by blocking the sodium/potassium ATPase
    channel, the sodium available which in turn the sodium/cal
    cium exchange the calcium, it also the storage of calcium in
    the cell. Ca2+ influx into myocardial cell an in
    contractility of the muscle
    Adverse Effect
    Visual "yellow vision"
    V tachiarrithmia
    Hyper K+
    Anti-digoxin antibody fragment
    Nausea, Vomiting
    C/I: myocarditis
    Risk for
    toxicity
    Client at risk
    elderly
    with advanced heart disease
    with severe dysrhythmias
    with acute MI
    Drug
    Interaction
    Quinidine
    Verapamil
    Amiodarone
    Serum condition
    digoxin > 2mcg/L
    potassium < 3 mEq/L
    low magnesium
    Change in pulse rate / rhythm
    Manifestation
    Nausea, vomiting, diarrhea
    bradycardia & junctional tachycardia
    Confusion
    Visual change
    b1-agonist
    Dobutamine
    MoA
    cAMP productionB1 receptor
    Phosphodiesterase inhibitors
    Amrinone
    MoA
    Block cAMP degredation in the heart
    Advice
    Renal failure's progression retarded
    BP maybe by NSAIDs
    eg.
    Advice
    Does not have cough & angioedema
    Recommending for patients unable to tolerate ACEi
    Cautious for renal insufficiency patients
    Side effects:
    Hyperkalemia
    myalgia
    dizziness
    insomnia
    Candersartan
    Irbesartan
    Losartan
    Telmisartan
    Valsartan
    angina
    myocardial infarct
    arrhythmias
    reduced
    digoxin
    dosage
    Heart
    Failure
    Pressure= Force/Area
    reduced
    digoxin
    dosage

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