Antihypertensives

Question 1

What regulates Blood pressure

Answer 1

• barorerceptor reflex
• kidneys
• adrenal gland
• hypothalamus and pituitary glands

Question 2

What is the baroreceptor reflex

Answer 2

• as blood pressure increases heart rate decreases
  or
• as blood pressure decreases heart rate increases

Question 3

How can blood pressure by modified

Answer 3

• lifestyle
• stress
• diet
• fluid and electrolyte levels
• organ function (heart failure means you have a harder time maintaining BP)

Question 4

What is normal blood pressure

Answer 4

• <120/<80 mmHg

Question 5

What is pre-hypertensive BP?

Answer 5

• 120-139/80-89mmHg

Question 6

What is hypertensive BP

Answer 6

• > 140/>90 mmHg

Question 7

What is BP a product of

Answer 7

• total peripheral resistance and cardiac output
• BP (HRxSV)xTPR

Question 8

what makes up cardiac output

Answer 8

• heart rate and stroke volume

Question 9

what are the classes of drugs for hypertension

Answer 9

• diuretics
• sympatholytics
• vasodilators
• ACE inhibitors
• calcium channel blockers

Question 10

Diuretics:

Answer 10

• often the first drug used to reduce hypertension if lifestyle changes do not work
• reduce fluid load in the vascular system
• reduced fluid reduces the Total peripheral resistance

Question 11

Types of diuretics

Answer 11

• Thiazide
• loop
• potassium-sparing

Question 12

Thiazide diuretics:

Answer 12

• proximal tubule of the kidney
• inhibit rreabsorption of sodium into vasculature
• Na and water retained in nephron and excreted from body

Question 13

Loop diuretics

Answer 13

• work on the loop of henle
• inhibit reabsorption of Na and Cl into circulation
• retains water in the nephron and excretes it from the body
• stronger than thiazide - loses the most water
• can be used long/short term

Question 14

Potassium-sparing diuretics

Answer 14

• distal tubule
• prevent secretion of K+ into the distal tubule
• Na and water are retained and excreted
• less diuretic effect but reduces potassium loss
• does not reduce peripheral resistance as much

Question 15

What are the side effects of diuretics

Answer 15

• electrolyte imbalance:
  1. hypokalemia: can cause heart arrhythmia
  2. hyponatremia: can cause muscle cramping
• dizziness, orthostatic hypotension
• muscle weakness
• may cause reflex increase in cardiac output due to reduced BP

Question 16

What are examples of sympatholytics and when are they used

Answer 16

• 2nd line of defense
• beta blockers (B1)
• alpha-1 blockers to reduce constriction

Question 17

vasodilators:

Answer 17

• reduce peripheral vascular resistance using second-messenger system
• cause a change within the cell to increase vasodilation

Question 18

side effects of vasodilators

Answer 18

• dizziness
• orthostatic hypotension
• reflex tachycardia due to the drop in BP
• weakness
• nausea, headache
• hair growth

Question 19

Renin-angiotension system inhibitors

Answer 19

• next step and affect the kidneys and adrenal gland
• ACE inhibitors
• Angiotensin II receptor blockers

Question 20

ACE inhibitors

Answer 20

• block conversion of angiotensin 1 to angiotensin II
• example: end in =pril

Question 21

Angiotensin II receptor blockers

Answer 21

• bind so that angiotensin II cannot bind
• decrease vasooconstriction
• decrease aldosterone release and retention of salt and water
• decrease the affects of angiotensin

Question 22

ACE inhibitor side effects

Answer 22

• dry cough (angiotensin is also in the lungs)
• rash

Question 23

Angiotensin II blockers as a BP medication

Answer 23

• very few side effects
• not as affective as other BP medications and usually taken with other BP meds

Question 24

Calcium-channel blockers

Answer 24

• reduce contractile process in smooth vasculature and causes vasodilation
• also used to teat angina due to myocardia ischemia
• used with caution due to possible increase risk of heart attack and cancer

Question 25

Calcium-channel blockers side effects

Answer 25

• orthostatic hypotension
• reflex tachycardia
• these are reduced with extended release forms which have different layers that when digested it releases small doses over time