Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics II > ANS Control of Blood Pressure > Flashcards

ANS Control of Blood Pressure Flashcards

1
Q

What is systolic blood pressure?

A

Pressure inside the arteries when the heart pumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is diastolic blood pressure?

A

Pressure when the heart relaxes between beats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Quantitative definitions of HTN

A

-Diastolic over 80
-Systolic over 130
-Resting blood pressure (SBP-DBP) over 65
-Two or more measurements of blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Consequences of HTN

A

-Heart failure
-Coronary artery disease
-Angina/ischemia
-MI
-Kidney disease/failure
-Stroke
-Vision loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors associated with HTN

A

-Aging
-Genetics
-Diabetes
-Obesity
-High sodium intake
-Low potassium intake
-Lack of exercise
-Excess alcohol intake
-Stress
-Reduced number of nephrons (age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What percent of HTN patients have primary/essential HTN?

A

~90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of secondary HTN

A

-Aldosteronism
-Bad kidneys
-Cushing’s/coarctation
-Drugs
-Endocrine disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are HTN and diabetes related?

A

-Lifestyles that lead to HTN can also lead to diabetes
-Diabetic nephropathy can cause HTN
-Glucose and fat can lead to vascular damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nonpharmacologic strategies to reduce the risk of HTN

A

-Weight loss
-Adopt DASH diet
-Salt reduction
-Exercise
-Reduce alcohol consumption
-Smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacologic strategies to reduce the risk of HTN

A

-Reduce the systolic blood pressure
-Reduce cardiac output
-Reduce vascular resistance through vasodilation of decreasing the blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which nonpharmacologic strategy has the greatest impact on the management of hypertension

A

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why are HTN medications generally harder to stay compliant with?

A

-Hypertension is asymptomatic
-Requires daily drug treatment
-Many of these drugs can have undesirable side effects such as ED in men, general sexual dysfunction and serious CNS effects such as depression or nighmares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does the baroreceptor reflex respond to a decrease in blood pressure?

A

Activates sympathetic fibers that:
-innervate the heart (beta 1) which increase heart rate
-Innervate the blood vessels (alpha 1) resulting in vasoconstriction
-Inhibits vagus (PSNS)
-Net result is an increase in blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the baroreceptor reflex respond to an increase in blood pressure?

A

-Inhibits sympathetic fibers
-Activates the vagus (PSNS) which decreases heart rate
-Net result is a decrease in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of action of phenylephrine?

A

-Activates the alpha 1 receptor which leads to vasoconstriction
-Baroreceptor reflex activates causing a decrease in heart rate
-Overall increase in systolic pressure and decrease in heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mechanism of action of epinephrine?

A

-Activates the alpha 1 receptor which leads to vasoconstriction
-Activates the beta 2 receptor which leads to vasodilation
-Activates the beta 1 receptor which causes a positive inotropic and chronotropic effects
-Activation of the baroreceptor reflex mitigates the direct effects
-Overall an increase in systolic pressure, pulse pressure, and heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the mechanism of action of isoproterenol?

A

-Activates the beta 2 receptor which causes vasodilation
-Activates the beta 1 receptor which leads to positive inotropic and chronotropic effects
-Activation of the baroreceptor reflex enhances the direct effects
-Overall there would be a decrease in diastolic pressure and an increase in pulse pressure and heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Targets for antihypertensive drugs

A

-Heart
-Resistance of arterioles
-Resistance of veins
-Kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Classes of antihypertensive medications

A

-Diuretics
-Sympatholytics
-Vasodilators
-Renin-angiotensin-aldosterone system antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Examples of diuretics

A

-Thiazides
-Potassium-sparing diuretics
-Loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Physiologic action of diuretics

A

Decreases circulating volume

22
Q

Examples of sympatholytics

A

-Beta blockers
-Combined alpha and beta blockers
-Central alpha 2 agonists
-Peripheral alpha 1 antagonists

23
Q

Physiologic action of beta blockers

A

-Decrease heart rate
-Cardiac contractility
-Renin secretion

24
Q

Physiologic action of combined alpha and beta blockers

A

-Decrease heart rate
-Cardiac contractility
-Renin secretion
-Smooth muscle relaxation

25
Q

Physiologic action of central alpha 2 agonists

A

Decrease in sympathetic tone

26
Q

Physiologic action of peripheral alpha 1 antagonists

A

Vascular smooth muscle relaxation

27
Q

Examples of vasodilators

A

-Calcium channel blockers
-Direct vasodilators

28
Q

Physiologic action of vasodilators

A

Decrease in peripheral vascular resistance

29
Q

Examples of RAAS antagonists

A

-Angiotensin-converting enzyme inhibitors
-Angiotensin 2 receptor blockers
-Direct renin inhibitors

30
Q

Physiologic action of RAAS antagonists

A

-Decrease in peripheral vascular resistance
-Decrease in sodium retention

31
Q

Beta-blocker concurrent indications

A

-Heart failure
-Postmyocardial infarction
-Angina
-Cardiac arrhythmia

32
Q

Diuretic concurrent indications

A

-Heart failure

33
Q

ACE inhibitor concurrent indications

A

-Heart failure
-Postmyocardial infarction
-Diabetes
-Chronic kidney disease

34
Q

Angiotensin 2 receptor blocker concurrent indications

A

-Heart failure
-Postmyocardial infarction
-Diabetes
-Chronic kidney disease

35
Q

Aldosterone antagonist concurrent indications

A

-Heart failure
-Postmyocardial infarction

36
Q

Calcium channel blocker concurrent indications

A

-Diabetes

37
Q

Examples of alpha 1 antagonists

A

-Prazosin
-Terazosin
-Doxazosin

38
Q

Metabolism of alpha 1 antagonists

A

metabolized extensively and excreted in yhe bile

39
Q

Therapeutic indications of alpha 1 antagonists

A

-Hypertension
-Benign prostatic hyperplasia

40
Q

Side effects of alpha 1 antagonists

A

-First-dose phenomenon
-Postural hypotension
-Syncope

41
Q

Examples of alpha 2 receptor agonists

A

-Clonidine
-Methyldopa
-Guanabenz
-Guanfacine
-Brimonidine
-Apraclonidine
-Tizanidine

42
Q

How do alpha 2 agonists work?

A

-Decreases norepinephrine release in the brain which leads to a decrease in heart rate, contractility, renin release, and vasoconstriction

43
Q

Which alpha 2 agonist is a prodrug?

A

Methyldopa

44
Q

Pharmacological effects of beta blockers

A

-Decreased cardiac output and heart rate
-Reduced renin release
-Increased VLDL, decrease HDL
-Inhibit lipolysis
-Inhibit compensatory glycogenolysis and glucose release in response to hypoglycemia
-Increase bronchia airway resistance

45
Q

What are the selective beta 1 adrenergic receptor antagonists?

A

-Metoprolol
-Bisoprolol
-Atenolol
-Esmolol
-Nebivolol

46
Q

Side effects of beta blockers

A

-Bradycardia
-AV block
-Sedation
-Mask symptoms of hypoglycemia
-Withdrawal symptoms

47
Q

Contraindications of beta blockers

A

-Asthma
-COPD
-Congestive heart failure

48
Q

Which type of beta blocker is preferred for HTN?

A

Beta 1 blocker

49
Q

Mixed beta adrenergic antagonists

A

-Carvedilol
-Labetolol

50
Q

Effect of mixed beta adrenergic antagonists

A

Decrease total peripheral resistance via decreasing alpha mediated vasoconstriction resulting in lower blood pressure; prevent reflex tachycardia

51
Q

Clinical use of labetolol

A

Hypertensive emergencies, pheochromocytoma

52
Q

Clinical use of carvedilol

A

Heart failure

Therapeutics II (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions