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Unit 4 > AntiHTN > Flashcards

AntiHTN Flashcards

1
Q

What are the 3 strategies to reduce BP?

A

Reduce CO
Reduce TPR
Reduce body fluid volume

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2
Q

What else does ACEI inhibit, which results in?

A

Inhibit breakdown of bradykinin—>dry cough

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3
Q

What receptors do ARB block?

A

AT-1 receptors

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4
Q

What are the drug endings for ACEI and ARB? and what does aliskiren do?

A

ACEI—>”pril”
ARB—>”sartan”
Aliskiren—>block renin

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5
Q

What else do ACEI and ARB used for besides HTN?

A

Diabetic nephropathy
CHF
chronic kidney disease

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6
Q

How does ACEI and ARB cause hyperkalemia?

A

ACEI and ARB decrease level of aldosterone—>aldosterone is K+ wasting—>thus hyperkalemia

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7
Q

What are the side effects of ACEI and ARB?

A

Angioedema (facial area)
Hyperkalemia
Dry cough (ACEI)
Acute renal failure with bilateral renal stenosis

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8
Q

Can you use ACEI and ARB for pregos?

A

No—->they are teratogen

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9
Q

How are ACEI and ARB renal protective and why can they cause acute renal failure with bilateral renal stenosis?

A

ACEI and ARB dilate efferent arterioles (constricted by aldosterone)—>decrease GFR—>protect kidneys from hyperfiltration
ACEI and ARB lower GFR significantly with bilateral renal stenosis—>renal failure

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10
Q

How can chronic use of NSIADs affect the kidneys?

A

Prevent production of PGE2—>afferent arteriole constriction—>renal failure

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11
Q

What is the mechanism of calcium channel blockers?

A

Block L type Ca2+ channel in blood vessels and heart—>lower Ca2+—>lower CO and TPR—>lower BP

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12
Q

What are the dihydropyridine and non-dihydropyridine? and what are their selectivity on Ca channel?

A

Calcium channel blocker:
Dihydropyridine—>nifedipine and amlodipine (“dipine”)—>traget Ca2+ channel in blood vessel
Non-hyhydropyridine—>verapamil and diltiazem—>target Ca2+ in the heart

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13
Q

Which Ca2+ channel blockers would increase HR?

A

Dihydropyridine (“dipine”)—>reflex tachycardia

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14
Q

What are the Ca2+ channel blockers that are antiarrthymia?

A

Verapamil and diltiazem

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15
Q

What are the 3 drugs that cause gingival hyperplasia?

A

Phenytoin/cyclosporine/dihydropyridine (“dipine”)

Gum swollen/bleed

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16
Q

What are some common drugs that cause constipation?

A

Opioid/antimuscarinic/verapamil

17
Q

What are some side effects of beta blockers?

A

Rebound HTN (if stop abruptly)/increase LDL and TGs/fatigue/sexual dysfuntion

18
Q

How can beta blocker affect diabetic pts?

A

Mask hypoglycemia

19
Q

What are the alpha 1 antagonists? they can cause what affect when giving for the first time?

A

“zosin”/first dose syncope—>titrate up

20
Q

Side effects of “zosin”?

A

Orthostatic HoTN/urinary incontinence (increase urination)/increase HDL and decrease LDL

21
Q

What are the 2 alpha 2 agonists? What is their mechanism?

A

Clonidine and methydopa/decrease symp

22
Q

What are the uses for clonidine and methydopa?

A

HTN
Clonidine—>opiate withdraw
Methydopa—>HTN in pregnancy

23
Q

Side effects of alpha 2 agonists?

A

Methydopa—>hemolytic anemia (positive Coombs test)

CNS depression—>fatigue

24
Q

What is hydralazine? and side effects?

A

Direct arteriole vasodilator via NO—>anti HTN
Used especially for preeclampsia HTN
Lupus like symptoms

25
Q

What drug is used to prevent and treat eclamptic seizure?

A

Magnesium sulfate

26
Q

What is nitroprusside? and side effects?

A

Vein and arteriole vasodilator via NO—>anti HTN (emergency)
Side effects—>long term use cause cyanide poisoning

27
Q

What drugs are used to treat cyanide poisoning?

A

Sodium or amyl nitrite—>convert Hb into MetHb—>CN binds to MetHb to form cyanomethemoglobin
Sodium thiosulfate—>enhance metabolism of CN via rhodanase
Hydroxycobalamin—>binds with CN—>B12

28
Q

What is used to treat MetHbnemia?

A

Methylene blue—>reduce MetHb

29
Q

What is HTN emergency and how do we treat it?

A

HTN severe enough to cause end organ damage—>lower BP slowly
Start with nitroprusside—>then change to labetalol or fenoldopam

30
Q

What are minoxidil and diazoxide? and what are their mechanism and side effects?

A

Open K channel—>hyperpolarization of smooth muscle—>arteriole dilator—>anti HTN
Diazoxide—>decrease insulin release—>insulinoma
Minoxidil—>baldness

31
Q

What else should be given with long term use of arteriole dilator for HTN?

A

Diuretics (for edema)/beta blocker (for reflex tachy)

32
Q

Which 2 kind of drugs are contraindicated for HTN with hihg lipid?

A

Beta blocker and thiazide

33
Q

What are drugs for pul HTN and what are their mechanism?

A

Bosentan—>block endothelin (vasoconstrict)A receptor—>no pregos
Epoprostenol—>PGI2 analog
Sidenafil—>PDE5 inhibitor—>increase cGMP—>pul artery relaxation

Unit 4 (28 decks)

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