Anti-HTN

Question 1

what is BP

Answer 1

CO x SVR

Question 2

what is CO

Answer 2

amount of blood pumped in 1 min

SV x HR

Question 3

what is SV

Answer 3

amount of blood pumped per beat

Question 4

what is SVR

Answer 4

how much blood vessels resist BF

Question 5

pathophysiology of HTN

Answer 5

inc sympathetic activation: inc CO and vasoconstriction

inc SV = inc CO = in BP

plasma volume inc = inc SV

dec plasma or dehydration = activation of RAA = inc BP

Question 6

discuss renin-angiotensin-aldosterone system

Answer 6

continously controls BP: renin-A1-A2

liver releases angiotensin: causes kidney to release renin

renin: turns to A1

ACE from lungs: turns to A2

Question 7

effects of angiotensin 2

Answer 7

kidney: constricts efferent arteriole and inc Na and H

post pituitary: inc ADH; less water secretion

hypothalamus: induces thirst to drink water

smooth muscle: HTN

adrenal cortex: inc aldosterone; inc Na reabsorption and excretion of K

Question 8

manual BP taking

Answer 8

using sphygmomanometer: cover 2/3 of distal arm

too tight = inc BP
too loose = low BP

Question 9

automatic BP taking

Answer 9

can be lowbatt or prone to malfunction

Question 10

arterial line for BP

Answer 10

measures beat-to-beat variablity

every heart beat

Question 11

discuss diuretics

Answer 11

site of action: sodium

effect: dec blood volume

Question 12

what is diuresis

Answer 12

excrete plasma through urine

water will follow sodium

Question 13

thiazide diuretics

Answer 13

at distal convoluted tubules

Question 14

loop diuretics

Answer 14

loop of henle

acts quickly esp if IV

Question 15

potassium sparing diuretics

Answer 15

antagonize aldosterone at cortical collecting tubules

lose Na = lose K

spares potassium para di mag muscle weakness

Question 16

adverse effects of diuretics

Answer 16

fluid depletion

electrolyte imbalance

weakness - loss of K

fatigue

OH

Question 17

sympatholytics

Answer 17

site of action: heart and BV

effect: dec sympathetics stim and dec resistance and pooling

a1, a2, B1, B2

Question 18

a1 receptors

Answer 18

site: peripheral BV

effect: vasoconstriction or inc BP

Question 19

a2 receptors

Answer 19

site: presynaptic neuron

effect: regulates NT
- dec tone, motility and secretions of GIT

Question 20

B1 receptors

Answer 20

site: myocardium

effect: inc HR and force of contraction

Question 21

B2 receptors

Answer 21

site: peripheral BV and bronchial SM

effect: bronchodilation and vasolidation of lung peripheral vessesl

Question 22

beta blockers

Answer 22

dec myocardial contractility

dec HR

Question 23

adverse effects of beta blockers

Answer 23

bronchoconstriction

OH

bradycardia

Question 24

alpha blockers

Answer 24

alpha blockers are g-coupled
- stim: vasoconstriction
- block: vasodilation

Question 25

adverse effects of alpha blockers

Answer 25

reflex tachy OH d/t vasodilation

Question 26

what are adrenergic nuerons

Answer 26

releases norepi either pre or post synaptic effector organ

Question 27

presynaptic adrenergic inhibitors

Answer 27

inhibits presynaptic transmission of epi and nor epi

Question 28

adverse effects of presynaptic adrenergic inhibitors

Answer 28

dry mouth dizzy drowsy

Question 29

ganglionic blockers

Answer 29

target area for drugs autonomic ganglion - relays station to effector organ blocked = cant transmit catecholamines to post synaptic nueron

Question 30

adverse effect of ganglionic blockers

Answer 30

GI discomfort urinary retention visual disturbance OH

Question 31

where is the cardiovascular center

Answer 31

medulla - master control

Question 32

dicuss baroreceptors

Answer 32

detect stretch or pressure in BV elderly - less intact = more senstive to postural changes = IH

Question 33

centrally acting anti HTN

Answer 33

acts on CNS - medulla

Question 34

adverse effects centrally acting anti HTN

Answer 34

sedation - RAS impaired concentration depression lactation vertigo dry mouth HTN crises

Question 35

adverse effects of vasodilators

Answer 35

reflex tachy dizziness OH weakness nausea fluid retention hair growth

Question 36

discuss ACE inhibitors

Answer 36

not allow conversion of A1 to A2

Question 37

adverse effect of ACE inhibitors

Answer 37

allergic reax GI discomfort dizziness chest pain

Question 38

discuss ARBs and adverse effect

Answer 38

angiotensin receptor blockers adverse: OH

Question 39

what are calcium channels

Answer 39

for skeletal and smooth muscle contraction pathologic: - HTN - arryhtmia - angina pectoris

Question 40

side effects of Ca channel blockers

Answer 40

lightheaded fatigue nausea flushed face reflex tachy headache

Question 41

non-pharma tx for HTN

Answer 41

low fat and low sodium exercise - mod intensity 3x/wk dec stress

Question 42

risk factors for MI

Answer 42

HTN DM hyperlipedeimia tobbaco male and femal p menopause family hx

Question 43

antiplatelet agents for MI

Answer 43

aspirin: inhibits cyclooxygenase and thromboxane A2 clopidogrel: inhibits adenosine diphosphate; no aggregation

Question 44

nitrates for MI

Answer 44

converted to nitric oxide - potent vasodilator vasodilates coronary arteries for good BF should be ready during PT sessions or inumin na

Question 45

beta-blockers for MI

Answer 45

dec HR and demand from heart