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Year 2 > Anti-hypertensive Drugs > Flashcards

Anti-hypertensive Drugs Flashcards

1
Q

What are the 4 causes of secondary hypertension?

A

Pheochromocytoma, hyperaldosteronism, preeclampsia, renal stenosis.

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2
Q

What are the 4 classes of drugs commonly used to treat hypertension?

A

Diuretics, Beta blockers, Angiotensin Converting Enzyme Inhibitors, Angiotensin receptor blockers.

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3
Q

How do Thiazide diuretics reduce hypertension?

A

They increase the excretion of Na and H2O in the DCT.

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4
Q

True or false: Thiazide diuretics are the first line therapy for hypertension.

A

True. They are effective, safe, and cost effective.

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5
Q

What are the common adverse effects of Thiazide diuretics?

A

Muscle weakness/fatigue, K loss, Hyperglycemia, Hyperlipidemia.

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6
Q

What is the normal K level?

A

4 mEq/L

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7
Q

True or false: Loop diuretics re more effect for curing serious fluid retention rather than BP.

A

True. Loop diuretics are used in fluid overload states, such as congestive failure.

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8
Q

What are the three angiotensin converting enzyme inhibitors?

A

Captopril, Enalapril, Lisinopril.

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9
Q

True or false: Captopril, Enalapril, and Lisinopril are used as a mono therapy for stage 1,2, and 3 hypertension.

A

True.

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10
Q

True or false. ACEI’s are used in combination with a thiazide diuretic, Ca channel blocker, or Beta blocker for stage 4 hypertension.

A

True.

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11
Q

What do ACEI’s prevent?

A

The conversion of angiotensin 1 to angiotensin 2.

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12
Q

True or false: Renin-angiotensin system inhibitors may cause renal damage in the fetus.

A

True. Contraindicated use with pregnancy.

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13
Q

What are the common side effects of ACEI’s?

A

Dry cough, hyperkalemia, first dose effect, loss of taste.

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14
Q

True or false: ACEI’s may increase fetal mortality during the third trimester of pregnancy.

A

True.

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15
Q

What are the angiotensin II receptor blockers?

A

Losartan, Valsartan, Telmisartan, Irbesartan. Eprosartan mesylate, Candesartan cilexitil, Olmesartan medoxomil.

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16
Q

There are two types of angiotensin II receptors. Which one mediates most of the effects of angiotensin II?

A

AT1.

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17
Q

True or false: AT2 is highly expressed in fetal and diseased tissues, but is silent in adult tissues.

A

True.

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18
Q

What are the major adverse effects of angiotensin II receptor blockers?

A

Dizziness.

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19
Q

What are the Beta adrenergic blockers?

A

Propanolol, Atenolol, Labetalol, Metoprolol, Nadolol, Timolol.

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20
Q

What is the action of beta blockers?

A

They compete for binding site of norepineprhine and epinephrine.

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21
Q

What do Prazosin and Terazosin block?

A

Alpha 1 adrenergic receptors.

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22
Q

Beta blockers are the only drugs that act by decreasing cardiac output.

A

True.

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23
Q

Which receptor do Beta blockers act on in the heart?

A

B1 receptor.

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24
Q

Which receptor do beta blockers act on in the peripheral circulation and bronchi?

A

B2 receptor.

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25
Q

True or false, Beta blockers are used as a mono therapy for stage 1 and 2 hypertension.

A

True.

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26
Q

What are the common problems associated with beta blockers?

A

Fatigue, bradycardia, myocardial depression, asthma, increase in plasma cholesterol, diabetics, impotence.

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27
Q

What are the 2 alpha adrenergic blockers?

A

Prazosin, Terazosin

28
Q

True or false: Alpha adrenergic blockers are used as a mono therapy for stage 1 hypertension.

A

True.

29
Q

True or false: Alpha adrenergic blockers are combined with diuretics to treat stage 2 hypertension.

A

True.

30
Q

True or false: Alpha adrenergic blockers are used for malignant prostatic hypertrophy.

A

False. Used for BENIGN prostatic hypertrophy.

31
Q

What are the adverse effects of alpha blockers?

A

First dose effect, edema, orthostatic hypotension, nasal stuffiness, delayed ejaculation, tachycardia, dizziness, headache, incontinence.

32
Q

What are the two classes of Ca channel blockers?

A

Dihydropyridines and non-dihydropyridines.

33
Q

What is Nifedipine?

A

A dihydropyridine Ca channel blocker.

34
Q

What are Verapamil and Diltiazem?

A

Non-dihydropyridine Ca channel blockers.

35
Q

True or false: Ca channel blockers are used as mono therapy for stage 1 hypertension only.

A

False. Used as mono therapy for stage 1,2 and 3 hypertension.

36
Q

True or false: Dihydropyridines have a greater effect on vascular smooth muscle.

A

True.

37
Q

True or false: Non-dihyropyridines have a greater effect on the heart.

A

True.

38
Q

What are the effects of dihydropyridines on BP and HR?

A

Decrease BP, Increase HR.

39
Q

What are the effects of non-dihydropyridines on BP and HR?

A

Decrease BP, Decrease HR, and Decrease contractility.

40
Q

What are the adverse effects of dihydropyridines?

A

Headache, digital dysethesia, tachycardia, ankle edema.

41
Q

What are the adverse effects of non-dihydropyridines?

A

Bradycardia, myocardial depression, constipation.

42
Q

True or false: Short duration nifedipine may aggravate myocardial ischemia.

A

True.

43
Q

What is Aliskiren?

A

A renin inhibitor.

44
Q

What is the action of Aliskiren?

A

Binds to renin and prevents angiotensinogen conversion to angiotensin 1.

45
Q

What are the two centrally acting anti-hypertensive agents?

A

Clonidine and Methyldopa.

46
Q

What place in therapy do centrally acting anti-hypertensive drugs have?

A

They are used in combination with diuretics to treat ALL stages of hypertension.

47
Q

What are the adverse effects of Methyldopa?

A

Decreased liver function, mental lassitude, impaired concentration.

48
Q

What are the adverse effects of Clonidine and Methlydopa?

A

Sedation, dry mouth, bradycardia, constipation, sexual disfunction, fluid retention, postural hypotension, mental depression.

49
Q

How long does it take for the full therapeutic effects of Reserpine to develop?

A

2-3 weeks.

50
Q

True or false: Reserpine can cause psychic depression.

A

True.

51
Q

What is Guanethidine?

A

A rarely used agent to treat severe hypertension.

52
Q

True or false: The therapeutic effectiveness of Guanethidine is preceded by a brief period of hypertension.

A

True.

53
Q

What are hydralazine and minoxidil?

A

Vasodilators.

54
Q

True or false: Minoxidil is used to grow hair.

A

True.

55
Q

What is the use for vasodilators?

A

They are used with diuretics and Beta blockers for treating hypertension no controlled with other drugs.

56
Q

What is the action of hydralazine?

A

It interferes with the availability of calcium.

57
Q

What is the action of minoxidil?

A

It opens K channels.

58
Q

What are the common side effects of vasodilators?

A

Na and water retention, Tachycardia, Increased myocardial work.

59
Q

What are side effects specific to minoxidil?

A

Hypertricosis and hair growth.

60
Q

What are side effects specific to hydralazine?

A

Rheumatoid state that may process to SLE.

61
Q

What are the 2 drugs used in hypertensive emergencies?

A

Diazoxide and Trimethaphan.

62
Q

What are the actions of diazoxide?

A

Arterial vasodilator; Opens K channels.

63
Q

How is diazoxide administered?

A

IV

64
Q

What are the contraindications of diazoxide?

A

Angina pectoris, myocardial infarction, dissecting aneurism, pulmonary edema, and diabetes.

65
Q

What is the action of Trimethaphan?

A

Ganglion blocking agent; Arterial and venous vasodilator

66
Q

How is Trimethaphan administered?

A

IV

67
Q
A

Year 2 (9 decks)

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