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What is the mechanism of action of spironolactone and eperenone?
What is the mechanism of action of spironolactone and eperenone?
What is a common side-effect of spironolactone?
What is a common side-effect of spironolactone?
What is an indication for the usage of propranolol?
What is an indication for the usage of propranolol?
What is the mechanism of action of propranolol?
What is the mechanism of action of propranolol?
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Which medications are known to lower mortality in congestive heart failure?
Which medications are known to lower mortality in congestive heart failure?
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What is an indication for the usage of spironolactone?
What is an indication for the usage of spironolactone?
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What is a difference between spironolactone and eperenone?
What is a difference between spironolactone and eperenone?
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What is an indication for the usage of hydralazine and nitrates?
What is an indication for the usage of hydralazine and nitrates?
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How does adenosine relieve supra ventricular tachycardia?
How does adenosine relieve supra ventricular tachycardia?
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What is the mechanism of action of aspirin in preventing clot formation?
What is the mechanism of action of aspirin in preventing clot formation?
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When is aspirin indicated?
When is aspirin indicated?
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What are the adverse effects of aspirin?
What are the adverse effects of aspirin?
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What is the mechanism of action of dipyridamole?
What is the mechanism of action of dipyridamole?
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When is dipyridamole indicated?
When is dipyridamole indicated?
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What are the Thienopyridines?
What are the Thienopyridines?
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When are Thienopyridines indicated?
When are Thienopyridines indicated?
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Study Notes
Spironolactone and Eperenone
- Indicated for congestive heart failure, ascites, adrenal hyperplasia, or small cell carcinoma of the lung
- Also used for acne, hypertension, and amnorrhea
Mechanism of Action
- Both are aldosterone antagonists
- Spironolactone is also anti-androgenic
Side-Effects
- Spironolactone: hyperkalemia, gynecomastia due to anti-androgenic effects
- Eperenone: only hyperkalemia, no effects on testosterone receptor
Medications Known to Lower Mortality in CHF
- ACE Inhibitors
- Angiotensin Receptor Blockers
- Spironolactone and eperenone
- Beta Blockers
- Hydralazine and Nitrates in combination
Propranolol
Mechanism of Action
- Nonspecific blocker of both Beta-1 and Beta-2 receptors
Indications
- Migraine headaches
- Portal hypertension
- Thyroid storm
- Essential tremor
- Pheochromocytoma (adrenal tumor)
Side-Effects
- Bronchospasm, depression, bradycardia, hypotension, erectile dysfunction
- Hyperkalemia by inhibiting Sodium/Potassium ATPase
- Adverse effects on glucose and peripheral arterial disease
Adenosine
Indication
- Supra ventricular tachycardia that does not respond to sinus massage
Mechanism of Action
- Reduces calcium currents and is anti-arrhythmic by increasing AV nodal refractoriness
- Transiently slows sinus rate and AV nodal conduction velocity
- Opens potassium channels, hyperpolarizing nodal tissue and making them less likely to fire
Aspirin
Mechanism of Action
- Irreversibly inhibits COX, decreasing TXA2 production and preventing clot formation
Indications
- Acute coronary syndromes (MI, unstable angina)
- Stroke or TIA
- Peripheral artery disease
- Kawasaki's Disease
- Essential Thrombocythemia
- Fever, RA, Gout
Adverse Effects
- Bleeding
- Peptic ulcers, asthma, renal insufficiency, rash
Toxic Overdose
- Metabolic acidosis
- Tinnitus
- Encephalopathy
- Renal insufficiency
- Increased anion gap
Dipyridamole
Indications
- Thinning blood in patients with stroke, heart valve embolism, or peripheral artery disease
- Diagnostic tool in myocardial perfusion studies
Mechanism of Action
- Inhibits adenosine deaminase and phosphodiesterase
- Increases cAMP, inhibiting platelets
Adverse Effects
- Dizziness, headache
- GI bleeds
Thienopyridines
Examples
- Clopidogrel
- Prasugrel
- Ticlopidine
Mechanism of Action
- Act as blood thinners by inhibiting platelet aggregation
Indications
- Combination with aspirin is standard treatment for acute MI
- Strongest indication is early coronary intervention (angioplasty) with stenting
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Description
This quiz covers the indications of spironolactone and eperenone, as well as medications that lower mortality in congestive heart failure. It's a high-yield topic for medical students.
