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Pharmacology > Antihypertensive drugs > Flashcards

Antihypertensive drugs Flashcards

1
Q

What is the equation for CO?

A

SV*HR=CO

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2
Q

What is stroke volume measure?

A

Force of contraction

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3
Q

What is the biggest determinant of peripheral resistance (PR)?

A

Radius of the lumen or vessel

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4
Q

What are the 2 equations for MAP?

A

MAP=(CO)(PR)

MAP=(SV)(HR)(PR)

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5
Q

What drugs effect CO?

A

Beta blockers

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6
Q

What drugs effect PR?

A

Alpha blockers

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7
Q

What does inotrope mean?

A

Force of contraction

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8
Q

What does chronotrope mean?

A

Effect on HR

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9
Q

What is considered high BP?

A

Anything >120/80

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10
Q

True or false: any drug or disease that increases the sympathetic system can cause HTN?

A

True

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11
Q

True or false: aldosterone secreting tumor can cause hypotension?

A

False, it causes hypertension because Aldosterone increases blood volume

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12
Q

How many cases of HTN are idiopathic?

A

90%

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13
Q

What is two other name for idiopathetic HTN?

A

Essential HTN

primary HTN

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14
Q

Why is HTN called a silent killer?

A

Because no Sx show until damage is done

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15
Q

How can HTN damage your heart?

A

Increased BP causes heart to work harder to eject blood into peripheral

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16
Q

How does HTN damage your vessels?

A

High BP in vessels damages endo cells and lead to atherosclerosis and thrombi

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17
Q

How can an aneurysm in vessels be caused by HTN?

A

HTN weakens vessel walls

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18
Q

How can HTN damage kidneys?

A

Increased pressure in glomerulus can damage its ability to filter blood

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19
Q

What commonly seen in urine when the kidney glomerulus is damaged?

A

Protein in urine(proteinuria)

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20
Q

How does HTN damage eyes?

A

HTN damages retinal vessels and causes them to leak into virtuous humor

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21
Q

What gender is more likely to get HTN?

A

Males

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22
Q

What ethnicity is more likely to get HTN?

A

African American

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23
Q

How does genetics and aging effect HTN?

A

Increase age=risk

HTN runs in families

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24
Q

How does smoking cause a risk for HTN?

A

Smoking increases the sympathetic system and damages endo cells

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25
Q

What does DASH diet stand for? What type of diet does it include?

A

Dietary Approached to Stop HTN

Low salt, sweets and fats
More fruit and veggies

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26
Q

What are 4 things that can decrease HTN risk?

A

Stop smoking
Exercise
Relaxation techniques
DASH diet

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27
Q

Why does a DASH diet help decrease BP?

A

DASH diet is high in K+ which hyperpolarizes SM which causes vasodilation

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28
Q

What happens to Na+ levels when body is hypokalemic?

A

Na+ retention increases

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29
Q

at what BP is lifestyle modifications used to Tx HTN?

A

120-140 systolic BP

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30
Q

What controls the long term regulation of BP?

A

RAAS
ADH mechanism
ANH mechanism

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31
Q

What 2 things being decreased will cause renin to be released?

A

Decreased BP

Decreased Na+

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32
Q

What cells measure BP in glomerulus?

A

Juxtaglomerulosa cells

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33
Q

What cells in the glomerulus measure Na+ levels?

A

Macula densa cells

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34
Q

What part of the nephron is closely associated with the afferent arteriol?

A

DCT

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35
Q

What enzyme changes Angiotensinogen into angiotensin 1?

A

Renin

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36
Q

What enzyme changes AT-1 into AT-2?

A

ACE

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37
Q

What effect does ACE have on Bradykinin?

A

It breaks down bradykinin

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38
Q

What are the 4 things that AT-2 does?

A

Vasoconstriction
Increase ADH
Increase Aldosterone
Increase salt appetite and thirst

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39
Q

What is the receptor for AT-2? Where are they found?

A

AT-1 receptor

Kidneys and heart

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40
Q

What does ACEI stand for?

A

Angiotensin converting enzyme inhibitors

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41
Q

What does ARBs stand for?

A

Angiotensin receptor blocker

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42
Q

What are the 3 types of drugs used to inhibit the RAAS?

A

ACEI
ARBs
renin inhibitors

43
Q

What are the 3 things that bradykinin causes?

A

Endothelial retraction
Vasodilation
Dry cough d/t bronchoconstriction

44
Q

What DO ACEI drugs end in?

A

-pril

45
Q

What do ACEI come from?

A

Venom of Pit vipers

46
Q

What are the indications for ACEIs?

A

HTN

Preserving kidney function

47
Q

What is benazepril(Lotensin)?

A

ACEI

48
Q

What is Captopril(Capten)?

A

ACEI

49
Q

What is Enalapril(Vasotec)?

A

ACEI

50
Q

What is Lisinopril(Prinivil)?

A

ACEI

51
Q

What is Quinipril(Accupril)?

A

ACEI

52
Q

What is Ramipril(Altace)?

A

ACEI

53
Q

Where are the most amount of AT-1 receptor found?

A

Efferent arteriol

54
Q

Why can having DM lead to glomerular damage and eventually proteinuria?

A

DM increases levels of AT-2 which binds to efferent arteriol and causes massive vasoconstriction. The blood gets backed up and eventually leaks protein into urine

55
Q

What causes the posterior pituitary to release ADH?

A

Increase in osmolarity concentration

Decrease in BP

56
Q

What is the contraindication for ACEI and ARBs? What can they cause?

A

Pregnancy

Infant renal failure
Congenital malformations(cleft pallet)
Death

57
Q

What are the ADR of ACEI and ARBs?

A

Dry cough

Hyperkalemia

58
Q

Why can ACEI and ARB cause a ADR of hyperkalemia?

A

Aldosterone gets blocked

-aldosterone normally helps Na+ get reabsorbed back into the blood through a Na/K pump

59
Q

What do ARB drugs usually end in?

A

-sartan

60
Q

What is aliskiren(Tekturna)? What effects of the drug is it similar to?

A

A renin inhibitor

ACEIs and ARBs

61
Q

What are the 3 different categories of diuretics?

A

Thiazides/thiazide-like drugs
K+ sparing drugs
Loop diuretics

62
Q

What is hydrochlorothiazide(Hydrodiuril)? What does it cause?

A

Thiazide

Causes vasodilation of SM

63
Q

What is chlorthalidone(Hygroton)? What does it cause?

A

Thiazide

Causes vasodilation of SM

64
Q

When are K+ sparing drugs used?

A

When loss of K+ is a concern

65
Q

When are loop diuretics used?

A

When there is reduced kidney function

66
Q

What is the MOA of thiazides that causes vasodilation?

A

Thiazides open large conductance Ca2+ activated K+ channels, which hyperpolarizes the endo cells and cause vasodilation

67
Q

What is clonidine(Catapress)? What receptor does it stimulate? What does it cause?

A

Central acting sympatholytic

Stimulates alpha 2 receptor

Decreases NE release which causes vasodilation

68
Q

What do alpha blockers end in?

A

-osin

69
Q

What part of MAP do alpha blockers effect?

A

Peripheral Resistance

70
Q

What is doxazosin(Cardura)?

A

Alpha blocker

71
Q

What is prazosin(Minipress)?

A

Alpha blocker

72
Q

What is terazosin(Hytin)?

A

Alpha blocker

73
Q

What organs do beta-blockers work on? What enzyme do they reduce the release of?

A

Act on heart and kidneys

Reduce release of renin

74
Q

What is atenolol(Tenormin)?

A

Selective beta 1 blocker

75
Q

What is metoprolol(Lopressor)?

A

Selective beta 1 blocker

76
Q

What is esmolol(Brevibloc)?

A

Selective beta 1 blocker

77
Q

What is bisoprolol(Morocor)?

A

Selective beta 1 blocker

78
Q

What is propranolol(Inderal)? What is it contraindicated for?

A

beta 1 and 2 blocker

Contraindicated for asthmatic pt

79
Q

What is carvedilol(Coreg)?

A

beta 1 and alpha 1 blocker

80
Q

What is labetalol(Trandate)?

A

beta 1 and alpha 1 blocker

81
Q

What are the 2 categories of Ca2+ channel blockers (CCB)? What do they cause?

A

Nondihydropyridine-
Decrease HR
negative inotrope effect
Vasodilation

Dihydropyridine-
Just vasodilation

82
Q

What is diltiazem(Cardizem)?

A

Nondihyrdopyridine CCB

83
Q

What is verapamil(Calan)?

A

Nondihyrdopyridine CCB

84
Q

What is amlodipine(Notvasc)?

A

Dihyrdopyridine CCB

85
Q

What is nicardipine(Cardene)?

A

Dihyrdopyridine CCB

86
Q

What is nifedipine(Procardia)?

A

Dihyrdopyridine CCB

87
Q

What effect does ANH have on blood volume? When is it released?

A

Released to kidneys to cause natriuresis to decrease BP

ANH is release when atria is stretch a lot

88
Q

What is Nesiritide(Natrecor)? Route? Available in US?

A

Synthetic ANH

Given IV

no long available in USA

89
Q

What is diazoxide(Hyperstat)? Route? When is it used?

A

Vaso and arteriolar dilator

Oral

Used in HTN emergencies

90
Q

What is nitroprusside(Nitropress)? Route? When is it used?

A

Vaso and arteriolar dilator

IV infusion

Used in HTN emergencies

91
Q

What is Epleronone(Inspra)? What does it block?

A

Selective aldosterone blocker

Blocks aldosterone receptor

92
Q

What is endothelium? What does it cause?

A

Hormone released from endo cells that causes vasoconstriction

93
Q

What is bosentan(Tracleer) MOA? Route? Indication?

A

Blocks receptors of hormone endothelin

Oral

Pulmonary HTN w/ severe HF

94
Q

What are the lab values of a pt on an ACEI?

A

Increase serum creatinine levels

Increased serum K+ levels

95
Q

If a pt is <60yo and has a BP >140/90 on two occasions? What type of therapy should be used?

A

Pharmacotherapy

96
Q

If a pt is >60yo and has a BP >150/90 on two occasions? What type of therapy should be used?

A

Pharmacotherapy

97
Q

If a pt is African American w/ HTN what drug classes are commonly used?

A

Thiazides and CCB

98
Q

If a pt is DM w/ HTN, what type of drug classes are they likely to use?

A

ACEI or ARB +/- CCB or thiazide

99
Q

What is the goal of using Medications for HTN pt <60yo? >60yo? DM pt?

A

<60yo= <140/90
>60yo= <150/90
DM pt= <130

100
Q

What Hx should a nurse get from pt of PMHx?

A

Medications

Herbal medication Hx

101
Q

What HR should HTN meds not be given?

A

<60HR

102
Q

What can cause rebound HTN?

A

Abruptly discontinuing HTN medication

103
Q

What is a ADR of antiHTN drugs?

A

Dizzinesss and syncope

Pharmacology (27 decks)

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