Antihypertensives Flashcards
1
Q
What regulates Blood pressure
A
- barorerceptor reflex
- kidneys
- adrenal gland
- hypothalamus and pituitary glands
2
Q
What is the baroreceptor reflex
A
- as blood pressure increases heart rate decreases
or - as blood pressure decreases heart rate increases
3
Q
How can blood pressure by modified
A
- lifestyle
- stress
- diet
- fluid and electrolyte levels
- organ function (heart failure means you have a harder time maintaining BP)
4
Q
What is normal blood pressure
A
- <120/<80 mmHg
5
Q
What is pre-hypertensive BP?
A
- 120-139/80-89mmHg
6
Q
What is hypertensive BP
A
- > 140/>90 mmHg
7
Q
What is BP a product of
A
- total peripheral resistance and cardiac output
- BP (HRxSV)xTPR
8
Q
what makes up cardiac output
A
- heart rate and stroke volume
9
Q
what are the classes of drugs for hypertension
A
- diuretics
- sympatholytics
- vasodilators
- ACE inhibitors
- calcium channel blockers
10
Q
Diuretics:
A
- 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
11
Q
Types of diuretics
A
- Thiazide
- loop
- potassium-sparing
12
Q
Thiazide diuretics:
A
- proximal tubule of the kidney
- inhibit rreabsorption of sodium into vasculature
- Na and water retained in nephron and excreted from body
13
Q
Loop diuretics
A
- 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
14
Q
Potassium-sparing diuretics
A
- 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
15
Q
What are the side effects of diuretics
A
- 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
16
Q
What are examples of sympatholytics and when are they used
A
- 2nd line of defense
- beta blockers (B1)
- alpha-1 blockers to reduce constriction
17
Q
vasodilators:
A
- reduce peripheral vascular resistance using second-messenger system
- cause a change within the cell to increase vasodilation
18
Q
side effects of vasodilators
A
- dizziness
- orthostatic hypotension
- reflex tachycardia due to the drop in BP
- weakness
- nausea, headache
- hair growth
19
Q
Renin-angiotension system inhibitors
A
- next step and affect the kidneys and adrenal gland
- ACE inhibitors
- Angiotensin II receptor blockers
20
Q
ACE inhibitors
A
- block conversion of angiotensin 1 to angiotensin II
- example: end in =pril
21
Q
Angiotensin II receptor blockers
A
- bind so that angiotensin II cannot bind
- decrease vasooconstriction
- decrease aldosterone release and retention of salt and water
- decrease the affects of angiotensin
22
Q
ACE inhibitor side effects
A
- dry cough (angiotensin is also in the lungs)
- rash
23
Q
Angiotensin II blockers as a BP medication
A
- very few side effects
- not as affective as other BP medications and usually taken with other BP meds
24
Q
Calcium-channel blockers
A
- 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
25
Q
Calcium-channel blockers side effects
A
- orthostatic hypotension
- reflex tachycardia
- these are reduced with extended release forms which have different layers that when digested it releases small doses over time
