Antihypertensive drugs, tx of angina pectoris, arrhythmias and CHF Flashcards
How do antihypertensive drugs work?
work by affecting cardiac output, total peripheral resistance or both
Which category of hypertension is attributed to an abnormality in the body and treatment focuses on correcting the abnormality, and which one has no clear cause? Which one is more common?
secondary, primary, primary is more common
What are the possible causes of essential HTN?
diet, stress, genetic predisposition, cigarette smoking, alcohol abuse, obesity
What happens as BP increases with HTN?
changes in peripheral vasculature lead to vessels becoming less compliant and resistance increases
HTN is associated with metabolic abnormalities that are known together as metabolic syndrome, what are the characteristics? (4)
impaired glucose metabolism, hyperinsulinemia, dyslipidemia, abdominal obesity
What are the drugs used to treat HTN? (5)
diuretics, sympatholytics, vasodilators, drugs that inhibit renin-angiotensin system, calcium-channel blockers
Which drugs are used to treat HTN because they increase renal excretion of water and sodium which decreased fluid volume in the vascular system?
diuretics
What is something you have to be aware of when a patient is on diuretics?
it gets rid of sodium and potassium so pt needs to be taking potassium supplements or checking potassium levels to make sure they aren’t too low-> lead to arrhythmias and no energy
What are the diuretics (3) and which one is the most potent, least
thiazide (needs good kidney function), loop (most potent), potassium sparing (least potent)
What problem can fluid depletion cause in diuretics in response to decreased blood volume?
decrease in blood volume may cause an increase in cardiac output and peripheral vascular resistance due to activation of the baroreceptor reflex
Beta blockers, alpha blockers, presynaptic adrenergic inhibitors, and centrally acting agonists are all types of which drug?
sympatholytic
Which sympatholytic drug help decrease HR and myocardial contraction force and reduce HTN because they decrease cardiac output and slow down the HR?
beta blockers
What do most beta blockers tend to end with?
-lol
What are side effects to be aware of in beta blockers?
nonselective can cause bronchoconstriction in pts with asthma, orthostatic hypotension, excessive HR depression
What sympatholytic drugs block the alpha-1 adrenergic receptors on smooth mm which promotes a decrease in vascular resistance, and these drugs also improve blood lipid profiles (decreased trigylcerides and total cholesterol)?
alpha blockers
What are some adverse effects of alpha blockers to be aware of?
reflex tachycardia (lead to compensatory increase in HR), orthostatic hypotension, increase in cardiac disease and CHF
Which sympatholytics inhibit the release of norepinephrine from the presynaptic terminals which decreases sympathetic excitation of the heart and peripheral vasculature resulting in decreased BP?
presynaptic adrenergic inhibitors
Which sympatholytics inhibit sympathetic discharge from the brainstem by acting on central receptors which causes a decrease in cardiovascular stimulation and BP?
centrally acting agents
Which antihypertensive drug inhibit the enzyme that allows angiotensin I to convert to angiotensin II which causes vasodilation and decrease in BP, what do they tend to end with?
ACE inhibitors. -pril (part of the renin-angiotensin system inhibitors)
Which antihypertensive drug block the actual recept where angiotensin II would bind to allow vasoconstriction to occur, leading to end result of vasodilation and decrease in BP, what do they tend to end with?
ARBs (angiotensin II receptor blockers), -tan
Why might someone opt to use an ARB rather than an ACE inhibitor?
to avoid the persistent dry cough side effect of ace inhibitors
What drugs block calcium entry into the vascular smooth mm cells which blocks contractile process leading to vasodilation and decreased vascular resistance? What were they developed to treat?
calcium channel blockers, treat angina pectoris, cardiac arrhythmias and hypertension
Which drugs are recommended for pts in stage I hypertension (140-159/90-99)?
thiazide diuretic, calcium channel blocker, ACE inhibitor or ARB
How many drugs are recommended for treating stage II hypertension (>159/>99)?
2 drugs, so thiazide diuretic or calcium channel blocker is combined with either an ACE inhibitor or an ARB
