antihypertensive drugs

Question 1

What is the physiological control of blood pressure?

Answer 1

cardiac output
contractile state of resistance arterioles
volume

Question 2

What controls the cardiac output?

Answer 2

heart rate (sympathetic)
stroke volume - filling pressure and contractility (sympathetic)

Question 3

What controls the contractile state?

Answer 3

neural (para + symp ns)
hormonal (renin-angiotensin-aldosterone system)
local transmitters (NO)

Question 4

What controls the volume of blood pressure?

Answer 4

hormonal (RAS, ADH, ANP)

Question 5

What are the antihypertensive drug strategies?

Answer 5

reduce cardiac output
dilate resistance vessels
reduce vascular volume

Question 6

How can we reduce cardiac output?

Answer 6

β-adrenergic blockers: not 1st line

calcium channel blockers

Question 7

How can we dilate resistance vessels?

Answer 7

calcium channel blockers
renin-angiotensin system blockers
α1 adrenoceptor blockers
nitrates**

Question 8

How can we reduce vascular volume?

Answer 8

diuretics. RAS blockers

Question 9

What organ does the angiotensin precursor come from?

Answer 9

liver

Question 10

What does the angiotensin precursor become once in contact with renin?

Answer 10

angiotensin I

Question 11

What converts angiotensin I to angiotensin II?

Answer 11

angiotensin converting enzyme

Question 12

What does angiotensin II target?

Answer 12

AT1 receptor

Question 13

What does a stimulation at the AT1 receptor cause?

Answer 13

vasoconstriction

Question 14

What causes the release of renin?

Answer 14

aldosterone
decrease renal blood flow
increase sympathetic

Question 15

What are some ACE inhibitors?

Answer 15

perinodpril
ramipril
anything ending in -pril

Question 16

What are some angiotensin receptor blocker (ARB)?

Answer 16

candesartan
irbesartan
anything else ending in -sartan

Question 17

How does the ANs regulate blood pressure?

Answer 17

effects on both pump output and resistance in the circulation

Question 18

What is the autonomic baroreceptor reflexes in BP control?

Answer 18

1. decrease BP
2. carotid sinus senses
3. vasomotor center respond (increase sns and decrease pns)
4. increase PVR at α1 + increase heart rate + contractility at β1

= increase BP

Question 19

What are some β1 adrenoceptor antagonists?

Answer 19

Metoprolol, atenolol, other -olol’s

Question 20

What is an α1 adrenoceptor blocker?

Answer 20

Prazosin

Question 21

What is the role of Prazosin?

Answer 21

relaxes peripheral resistance vessels

Question 22

What occurs when calcium enters a muscle cell?

Answer 22

muscle contraction (myocardial or vascular) caused by the sarcoplasmic reticulum

Question 23

What are the two types of calcium channel blockers?

Answer 23

cardioselective

vascular smooth muscle selective

Question 24

What are the main roles of cardioselective calcium channel blockers?

Answer 24

reduce cardiac contractility

reduce automaticity

Question 25

What are some cardioselective calciumi channel blocker drugs?

Answer 25

Verapamil

Diltiazem

Question 26

What is the role of the vascular smooth muscle selective calcium channel blockers?

Answer 26

reduce vascular resistance

Question 27

What are some examples of vascular smooth muscle selective calcium channel blocker drugs?

Answer 27

Dihydropyridines (nifedipine, felodipine, amlodipine)

Diltiazem