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QUICK PHARM HINTS if all else fails…

QUICK PHARM HINTS if all else fails…. If it sounds like… “-zosin” “-olol” “-pril” “-sartan”. Then it’s a…. Alpha-1 antagonist Beta blocker ACE Inhibitor ARB. Some MOAs. Diuretics: decrease Na + reabsorption

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QUICK PHARM HINTS if all else fails…

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  1. QUICK PHARM HINTSif all else fails…

  2. If it sounds like… “-zosin” “-olol” “-pril” “-sartan” Then it’s a…. Alpha-1 antagonist Beta blocker ACE Inhibitor ARB

  3. Some MOAs • Diuretics: decrease Na+ reabsorption • So less water is reabsorbed, so ECF volume decreases, decreasing MAP (lowering BP) • Alpha 2 agonists: inhibit symp outflow • So less sympathetic tone means less vasocontriction and less CO, lower HR (all of these lower BP) • Alpha 1 antagonists: blocks alpha 1 in arterioles and veins • Remember alpha 1 receptors, when stimulated, cause vasoconstriction, so if we block them this leads to vasodilation—which decreases TPR thus decreasing MAP

  4. Beta Blockers: decrease HR, contractility, CO, and O2 demand • Beta 1 is in the heart and causes increased CO/HR/contractility when stimulated, so blocking it will decrease these. Beta 2 is in the vessels and causes vasodilation when stimulated, so blocking this is actually decreasing the amount of vasodilation. Well no drug is perfect so we use these due to the Beta 1 effects. • Know which drugs are Beta 1 selective, and know that you must use beta 1 selective drugs in asthmatics/COPD patients because blocking beta 2 will also cause bronchoconstriction, which can kill them. • Ca++ blockers: block L type channel, relax arterial muscle which decreases afterload • ACE I: inhibit conversion of AngI to AngII, so less Ang II available • So less vasoconstriction, less aldosterone release, less ADH release, less NE, less remodeling of vasc smooth muscle. These are less effective in AAs.

  5. Interesting Side Effects • Clonidine (an alpha-2 agonist): sexual dysfunction in males, problem with ejaculation, NOT erection • Alpha-1 antagonists (“-zosin”): 1st dose phenomenon of postural hypotension and syncope • Ca++ channel blockers: constipation (watch out! Valsalva maneuver can cause decreased VR) • ACE Inhibitors (“-pril”): dry cough (vs ARBS which do not cause cough) • Diazoxide: hypertrichosis

  6. My advice for Pharm: • MEMORIZE! • MEMORIZE! • MEMORIZE! • MEMORIZE! • MEMORIZE! • MEMORIZE! • Good Luck!

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