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Cardiovascular > 04.16 - Antihypertensives (Bahouth) > Flashcards

04.16 - Antihypertensives (Bahouth) Flashcards

1
Q

2 additional actions of Losartan

A

Competitive antagonist of TXA2 receptor; Increase Uric Acid excretion

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2
Q

2 third gen beta blockers

A

Bisoprolol, Nebivolol

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3
Q

A poor response to Thiazides may reflect

A

Either overwhelming load of dietary Na, or impaired renal capacity to excrete the Na

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4
Q

A1-blockers end in

A

azocin

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5
Q

ACEi’s and ARBs are superior in HTN pt’s with

A

High renin levels (young people, middle-aged caucasians)

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6
Q

ACEi’s end in

A

pril

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7
Q

ACEi’s/ARBs should be avoided in any condition that causes

A

Hyperkalemia

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8
Q

Action of Aliskerin

A

Renin inhibitor

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9
Q

Action of Nebivolol

A

Highly B1 selective, with NO-mediated vasodilation

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10
Q

Advantage of secretion of renal prostaglandins

A

Catopril –> Delays progression of renal disease in diabetics

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11
Q

AE’s of ACEi’s besides dry cough

A

Hypotension; Hyperkalemia; Angioedema; Fetotoxicity

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12
Q

Anti-oxididant BB

A

Carvedilol, Nebivolol

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13
Q

ARB’s end in

A

sartan

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14
Q

BB that prevents LDL oxidation and decreases LDL uptake into coronaries

A

Carvedilol

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15
Q

BB with Significant ISA

A

Pindolol (also Timolol)

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16
Q

BB with significant membrane stabilizing activity

A

Propanolol (also Metoprolol, Pindolol)

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17
Q

BB without Lipid Solubility

A

Atenolol

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18
Q

BB’s are highly preferred in HTN patients with

A

MI, IHD, CHF

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19
Q

BB’s are moderately preferred in HTN patients with

A

Hyperthyroidism, Migraines

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20
Q

Best tolerated drugs for monotx of HTN

A

Diuertics and ACEi’s

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21
Q

Can a1 blockers be given as monotherapy

A

No

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22
Q

Can CCB’s be used in diabetics

A

Yes

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23
Q

CCB’s should be reserved for what patients

A

do not tolerate diuretics, BB’s, ACEi’s

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24
Q

Clinical uses of Hydralazine

A

IV in HTN emergency from eclampsia

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25
Q

Clinical uses of Nitroprusside

A

IV for HTN emergencies in patients with ventricular failure

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26
Q

Clonidine withdrawal

A

HTN

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27
Q

Common side effect of Sedation

A

Alpha2 agonists

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28
Q

Competitive antagonist of TXA2 receptor; Increase Uric Acid excretion

A

2 additional actions of Losartan

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29
Q

Dihydropyridines end in

A

dipine

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30
Q

Do ACEi’s have positive impact on mortality in CHF

A

yes

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31
Q

Do ARB’s affect CYP metabolism

A

No

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32
Q

Do BB’s cause retention of salt and water?

A

No, can be administered without diuretic

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33
Q

Effect of ARBs on TPR, PV, CO, BP

A

Decrease all

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34
Q

Effects of alpha2 agonists

A

Dec PVR, Dec HR

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35
Q

Effects of ARB’s

A

Vasodilation and Na excretion –> Dec TPR, BV, CO, BP

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36
Q

First and second drugs administered to diabetic patient with HTN

A

ACEi/ARBs first, then CCB

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37
Q

Hemodynamic effects of alpha1 blockers

A

Decrease TPR and Reduce BP

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38
Q

Hemodynamic effects of Nebivolol

A

Significant increase SV, maintains CO and systemic blood flow

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39
Q

Hemodynamic effects of Nitroprusside

A

Dec TPR; Dec CO in normal, but inc CO in patients with ventricular failure (afterload reduced)

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40
Q

Highly B1 selective, with NO-mediated vasodilation

A

Action of Nebivolol

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41
Q

How do Dihydro-CCB’s affect BP, Sympathetic discharge, and HR

A

Dec BP, No change in sympathetics or HR

42
Q

How does Nitroprusside decrease preload

A

Venous pooling - less blood goes to heart

43
Q

In whom are BB’s not as effective

A

AA and Elderly

44
Q

In whom are CCB’s used (HTN)

A

Low renin HTN: AA’s, elderly

45
Q

Indications for Labetalol

A

IV for HTN emergencies

46
Q

Infrequent but potentially fatal AE of ACEi’s

A

Angioedema

47
Q

Is there a survival benefit with CCB’s for HTN

48
Q

IV for HTN emergencies

A

Indications for Labetalol

49
Q

IV for HTN emergencies in patients with ventricular failure

A

Clinical uses of Nitroprusside

50
Q

Main side effect of ARB’s

A

Fetotoxicity

51
Q

Major Advantage of Beta Blockers

A

Secondary protection in CAD

52
Q

Metabolic effects of BB’s

A

Nonselective: block glycogenolysis; LDL up, HDL down, TG up

53
Q

MOA of ARB’s

A

Selectively block ATII receptors

54
Q

MOA of BB w/ no ISA

A

Block B1 in heart; Block B1 in JGA (inhibit renin release)

55
Q

MOA of Hydralazine

A

Selective arteriolar SM relaxer

56
Q

MOA of Labetalol

A

Nonselective B + a1 receptor antagonist

57
Q

MOA of Minoxidil

A

Relaxes arteriolar SM by opening K channels

58
Q

Most selective CCB for myocardium

59
Q

Non-hemodynamic effects of alpha1 blockers

A

Relieve symptoms of BPH; Increase HDL, Lower LDL; Insulin resistance improvement

60
Q

Non-selective BB in A-N

A

Carvedilol (Labetelol?)

61
Q

Nonselective B + a1 receptor antagonist

A

Labetalol, Carvedilol

62
Q

Other uses of Clonidine

A

Releases endogenous opiates; ADHD also

63
Q

Palpitations; Tachycardia; AI - Hemolytic Anemia

A

Side effects of Hydralazine

64
Q

Peripheral side effects of BB’s

A

Cold extremities

65
Q

Reflex Tach, Renin; Hirsutism (rogaine)

A

Side effects of Minoxidil

66
Q

Reflexive effect of Hydralazine

A

Reflex SNS stimulation –> Catecholamine/Renin secretion –> Na retention

67
Q

Relaxes arteriolar SM by opening K channels

A

MOA of Minoxidil

68
Q

Releases endogenous opiates; ADHD also

A

Other uses of Clonidine

69
Q

Relieve symptoms of BPH; Increase HDL, Lower LDL; Insulin resistance improvement

A

a1-receptor blockers

70
Q

Renin inhibitor

71
Q

Secondary protection in CAD

A

Major Advantage of Beta Blockers

72
Q

Selective arteriolar SM relaxer

A

MOA of Hydralazine

73
Q

Side effect of a1 blockers

A

First-dose hypotension (give at bedtime)

74
Q

Side effects of alpha2-agonists

A

Sedation (less with Guanfacine)

75
Q

Side effects of Hydralazine

A

Palpitations; Tachycardia; AI - Hemolytic Anemia

76
Q

Side effects of Minoxidil

A

Reflex Tach, Renin; Hirsutism (rogaine)

77
Q

T/F: All ARB’s increase Uric Acid excretion

A

False, Losartan

78
Q

The b1 blocker ___ is considered standard tx with ACEi’s and Diuretics

A

Bisoprolol

79
Q

What are contraindicated in Renal Artery Stenosis

A

ACEi’s and ARB’s - Kidney needs vasodilatory effects of AT2

80
Q

What do Hydralazine and Minoxidil have in common besides arteriolar SM relexation

A

Increase Renin

81
Q

What do you want to use with Hydralazine

A

BB and diuretics

82
Q

What ends in -azocin

A

A1-blockers

83
Q

What ends in -dipine

A

Dihydropyridines

84
Q

What ends in -sartan

85
Q

What ends in pril

86
Q

What may preserve renal function in HTN patients with non-diabetic nephropathies

87
Q

What should be chosen as initial Anti-HTN in pateints prone to CHF

A

ACEi’s/ARB’s

88
Q

What should be the initial Anti-HTN in diabetic patients with HTN

89
Q

When are BB’s particularly useful

A

HTN’s with Tachycardia, High CO, and/or high renin

90
Q

When do Diuretics improve mortality in HTN

A

Alone or with BB’s

91
Q

When is Carvedilol used

A

CHF and HTN (decreased mortality with mild-moderate CHF)

92
Q

Which ACEi increases synthesis of renal prostaglandins

93
Q

Which ACEi is renoprotective

A

Catopril –> Delays progression of renal disease in diabetics

94
Q

Which CCB’s are used for HTN

A

Dihydropyridines: Selective for L-type Ca channels on vessels

95
Q

Which drug increases uric acid urinary excretion

96
Q

Which drug is a competitive antagonist to TXA2 receptor

97
Q

Which other drugs do Diuretics augment activity of

98
Q

Which patients show better responses to diuretics

A

Volume dependent HTN (low renin levels)

99
Q

Why are third gen BB’s preferred over older

A

Fewer side effects

100
Q

What is used in HTN with metabolic syndrome

Cardiovascular (18 decks)

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