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Pharmacology Exam II > Anti-Hypertensives > Flashcards

Anti-Hypertensives Flashcards

1
Q

Stage 1 Hypertension

A

140-159/90-99

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2
Q

Stage 2 HTN

A

> 160/>100

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3
Q

Isolated systolic HTN

A

> 140/

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4
Q

Hypertensive Crisis

A

encompasses both hypertensive urgencies and emergencies

more reflective of high degree BP elevation

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5
Q

Hypertensive urgency

A

SBP >180 or DBP>120

NO ASSOCIATED END ORGAN DAMAGE

reduced over hours to days

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6
Q

Hypertensive emergency

A

markedly elevated BP’s

PRESENCE OF ACUTE END ORGAN DAMAGE

reduce BP within mins to hrs

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7
Q

Resistant HTN

A

uncontrolled despite optimal usage of three or more anti-hypertensive drugs

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8
Q

ACE Inhibitors (3 examples)

A

Captopril
Lisinopril
Fosinopril

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9
Q

ACE Inhibitor MOA

A

inhibits ACE to decrease AT II

also INCREASE bradykinin - serves as a vasodilator

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10
Q

Clinical Use of ACE-I’s

A

first line for uncomplicated HTN

first line for compelling indications of: diabetes, CKD, CAD, left ventricular dysfunction, ischemic stroke

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11
Q

Pharmacologic Aspects of ACE-I’s

A

reduce dose with kidney failure

elevated levels of renin causes hyperresponsiveness to ACE-I’s - need to decrease dose as well

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12
Q

Avoid ACE-I’s in

Potentially unfavorable effect in?

A

PREGNANCY

Hyperkalemia, Volume depletion

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13
Q

Adverse effects of ACE-I’s

A

Coughing - d/t bradykinin build up

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14
Q

Angiotensin Receptor 1-Blockers (3 examples)

A

Losartan, Valsartan, Candesartan

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15
Q

AR-1 Blockers MOA

A

block angiotensin receptor-1

does not cause build up of bradykinin

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16
Q

Dihydropyridine CCB’s (3)

A

Nifedipine
Amlodipine
Felodipine

17
Q

Avoid use of Dihydropyridine CCB’s in

also unfavorable effects with?

A

left-ventricular dysfunction

high-normal heart rate or tachycardia or peripheral edema

18
Q

Non-dihydropyridine CCB’s

A

Verapamil

Diltiazem

19
Q

Non-Dihydropyridine CCB’s Clinical use

Avoid use in

A

first line/add on for uncomplicated HTN

add on for diabetes

alternative to B-blockers

do not use in LV DYSFUNCTION

20
Q

Thiazide diuretics Role in HTN therapy

A

first line/add on for uncomplicated HTN

first line for LV dysfunction, previous ischemic stroke

21
Q

Alpha-1 Blockers

A

Prazosin
Doxazosin
Terazosin

22
Q

Central alpha-2 agonists

A

Clonidine

Alpha-methyldopa

23
Q

Central Alpha-2 Agonist important side effect

A

rebound HTN

24
Q

Alpha-methyldopa importantly used for

A

gestational HTN

chronic HTN management in pregnancy

25
Q

Hydralazine MOA

A

decreases Ca in smooth muscle - leads to vasodilation

also opens K channels - leads to hyperpolarization

26
Q

Hydralazine particularly useful in what two patient populations

A

severe chronic kidney disease

gestational HTN

27
Q

Adverse effects of Hydralazine

A

drug-induced lupus

compensatory tachycardia and Na retention

28
Q

Minoxidil MOA

A

opens K channels - relaxes arteriolar VSMC’s

increases blood flow to heart, skin, skeletal muscle, GI, CNS

29
Q

Clinical use of Minoxidil

A

only for severe refractory HTN

combo with Beta-blockers and diuretics

30
Q

Adverse effects of minoxidil

A

reflex increase in myocardial contractility

31
Q

Sodium nitroprusside MOA

Delivered how?

A

donates NO - causes cGMP-mediated Ca sequestration

decreases PRE-LOAD and AFTERLOAD

Intravenous - short term

32
Q

Sodium nitroprusside adverse effects

A

methemoglobinemia
cyanide poisoning
cell death

33
Q

Aliskiren MOA

A

directly inhibits renin

prevents formation of angiotensin I from angiotensinogen

34
Q

Aliskiren adverse effects/precautions

A

Hyperkalemia

NEVER USE IN PREGNANCY

35
Q

Reserpine MOA

A

inhibits vesicular storage of catecholamines

36
Q

Reserpine most effectively used in combo with what?

A

thiazide diuretic

37
Q

Resistant HTN Management considerations

What diuretic is preferred?

A

Excessive dietary Na - reduction should be integrated

Considering change in diuretics

Chlorthalidone

Pharmacology Exam II (5 decks)

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