🖋️ Interactive Notes: BP Pharm | Y2 Pharm

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Use the A-->B-->C-->D approach:

A

ACE Inhibitors
  • – “-pril”. 

  • captopril, ramipril.
  • blocks Angiotensin Converting Enzyme, so angiotensin I cannot be converted to angiotenin II.
  • side effects: dry cough due to bradykinin

Angiotensin Receptor Blockers (ARBs) “-sartan“

losartan blocks angiotensin I receptor so angiotensin II cannot bind. 

B

B Blockers

  • “-olol”
  • propranolol, atenolol
  • Labetolol is safe for pregnancy- think labour
  • reduces cardiac output
  • (not for asthmatics as they block B2 receptors in lungs causing smooth muscle constriction )

C

Calcium Channel Blockers CCB

 

Dihydropyridines

  • “-dipine”
  • amlodipine, nifedipine (Raynaud’s)
  • blood vessels vasodilate

Non-Dihydropyridines

  • verapamil, diltiazem
  • blood vessels vasodilate and reduces heart rat

D

Diuretics (kidney drugs)

See below

Blood pressure

= cardiac output x total peripheral resistance

 

Cardiac output

= stroke volume x heart rate

 

mean arterial pressure =

1/3 systolic BP + 2/3 diastolic BP

Resting Membrane Potential

On the island:
🍌 bananas:
K+ = 135mM

Outside of the island:
🌊 salty water:
Na+ = 140mM
Cl- = 130mM

RAAS System

Diuretics

Dilute Urine

Click on parts of nephron to see different diuretics

Bowman's Capsule

  • Osmotic Diuretics
  • Mannitol

Proximal Convoluted Tubule PCT

  • Carbonic Anhydrase Inhibitor
    • Acetazolamide
      • Inhibits Carbonic Acid
      • Sodium & Bicarbonate Loss
      • Used for glaucoma and altitude sickness
      • Side effects: kidney stones

Loop of Henle

  • Loop diuretics (are the strongest type of diuretic)
    • Furosemide, bumetanide
      • Inhibits NKCC2 channel
      •  Loss of Na+, Cl-, K+, Ca2+, Mg2+
      • Used to reduce sodium retention, oedema hypertension, hyperkalaemia, hypercalcaemia
      • Side effects:ototoxic - can cause permenant deafness (especially in combination with gentamicin antibiotic) 

Loop of Henle

  • Loop diuretics (are the strongest type of diuretic)
    • Furosemide, bumetanide
      • Inhibits NKCC2 channel
      •  Loss of Na+, Cl-, K+, Ca2+, Mg2+
      • Used to reduce sodium retention, oedema hypertension, hyperkalaemia, hypercalcaemia
      • Side effects:ototoxic - can cause permenant deafness (especially in combination with gentamicin antibiotic) 

Collecting Duct

Potassium Sparing Diuretics:

  • antihypertensives
  • side effects: hyperkalaemia

Amiloride

  1. blocks ENaC
  2. Na+ and Cl- excretion

Spironolactone

    • aldosterone antagonist
    • Na+ excretion

Distal Convoluted Tubule

    • Thiazides
    • Hydrochlorothiazide
      • inhibits Na/Cl cotransporter
      • more Na+, Cl- excretion and more Ca2+ reabsorption
      • reduces oedema, hypertension, osteoporosis
      • side effects: erectile dysfunction
    •  

Asthma Drugs

A S T H M A acronym

Beta-2 Agonist (bronchodilator)

salbutamol – short-acting
salmeterol – long-acting

 

Glucocorticoids

beclamethazone, prednisolone

anti-inflammatory

 

Relaxes smooth muscle around the bronchioles + reduces sensitivity to histamines

 

Given IV for life threatening Asthma

Antagonist of leukotriene receptor 

Anti-inflammatory & also a bronchodilator

End in ‘-lukast’ 

Ipatropium bromide

inhibits Ach bronchoconstriction

Anti-dysrhythmic drugs
Class 1 Antiarrhythmic Drugs (Sodium Channel Blockers) | Concise Medical Knowledge

  • Class 1:
    • Sodium Channel Blockers
      • 1a) disopyramide (intermediate dissociation)
      • 1b) lidocaine (fast dissociation)
      • 1c) flecainide (slow dissociation)
    •  

 

  • Class 2:
    • Beta Blocker
      • Propranolol

 

 

  • Potassium Channel Blocker
    amiodarone, sotalol
    amiodarone -> Wolff-Parkinson-White ( congenital heart condition that causes the heart to beat abnormally fast for periods of time – causing sudden SVT)
  • Potassium Channel Blocker
    amiodarone, sotalol
    amiodarone -> Wolff-Parkinson-White ( congenital heart condition that causes the heart to beat abnormally fast for periods of time – causing sudden SVT)

hypertension

  • “-dil”

    minoxidil, nicorandil

    • Potassium in cells leaves via open channels, so cell is too negative (hyperpolarised) to have an action potential.
    • vsaodilation (angina pectoris)
    • lowers blood pressure
    • Minoxidil causes excessive hair growth (hypertrichosis) 
  •  
  •  

 

digoxin, digitoxin, ouabain

  • blocks Sodium/Potassium ATPase (Na+/K+ exchanger)
  • stimulates vagus nerve
  • slows down AV node conduction
    • (digoxin- stronger contractions of heart, slows heart rate down = used for atrial fibrillation).

Glyceryl trinitrate (GTN), sodium nitroprusside

  • nitric oxide (NO) is a vasodilator
  • GTN used for angina pectoris
  • Dobutamine– Beta-1 agonist, heart pumps more
  • Phospodiesterase III inhibitor– milrinone- reduces work of the heart
  • ivabradine– Funny current inhibitor (If)
  • Hydralazine– vasodilator
  • Desmopressin– ADH analogue (cranial diabetes insipidus)
  • Aliskiren– renin inhibitor
  • nicotinic Acetylcholine receptor:
    • agonist- acetylcholine, nicotine
    • antagonist- hexamethonium (‘hexamethonium man’)

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