Antihypertensive Drugs

Question 1

Diuretics: Loop

Answer 1

Block transporter in loop of Henle = increase in Na excretion (water goes with it)

Question 2

Agents that affect the CNS:

Centrally Acting (effect and adverse)

Answer 2

Decrease SNS outflow, act at BP control center to reduce SNS activity, reduce BP

Adverse effects: Sedation

Question 3

Vasodilators

2 types

Answer 3

1. Ca channel blockers
   i. Nifedipine: acts on blood vessels only
   ii. Diltiazem and verapamil: act on heart and blood vessels
2. Other direct vasodilators: various mechanisms

Question 4

Agents that act on the Renin Angiotensin System:

ACE inhibitors

Answer 4

Inhibit formation of AII – get decreased BP (from decrease AII get vasodilation, decreased aldosterone - which decreases Na and H2O)

Adverse effects: Teratogenic - cause fetal malformations

Question 5

Diuretics: Thiazide

Answer 5

Block NaCl transporter in distal tubule = increase NaCl excretion

Deplete Na stores = decrease stiffness of VSM

Question 6

Diuretics: K-sparing

Answer 6

Block Na/K transporter = more Na in lumen, more K in body (dont lose K)

Deplete Na stores = decrease stiffness of VSM

Question 7

Agents that act on the Renin Angiotensin System:

All Antagonists

Answer 7

Block receptors for AII/VSM/or decrease aldosterone

Causes vasodilation, decreased BP, decrease in Na and H2O retention

Question 8

Agents that affect the CNS:

Beta-blockers

Answer 8

Decrease HR and FVC initially (reduces CO and BP)
Decrease renin release later (decrease renin, decrease AI and AII, get vasodilation and decrease in aldosterone - less Na and H2O retention) - decrease BP

Question 9

Agents that affect the CNS:

Alpha-blockers (action and adverse effect)

Answer 9

Block receptors on VSM = vasodilation and reduced BP

Adverse effects: orthostatic hypotension (fainting)

Question 10

What happens if you decrease Na stores?

Answer 10

You decrease the stiffness of the VSM