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Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

RAAS System

A
  1. low BP –> renin secretion
  2. renin converts angiotensinogen –> angiotensin I (inactive)
  3. angiotensin-converting enzyme (ACE) turns angiotensin I –> angiotensin II (active)
  4. angiotensin II –> vasoconstriction, release of aldosterone & ADH
  5. aldosterone & ADH –> Na & H2O retention (& K excretion)
  6. increased BP
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2
Q

How is BP regulated by body?

A

Kidneys via RAAS

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3
Q

What hormones are involved with BP?

A

ADH, ANP, BNP, RAAS hormones

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4
Q

Risk factors for HTN

A
  • excess saturated fat & carbs in diet
  • alcohol use
  • obesity
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5
Q

How do African Americans vs Asian Americans respond to BP meds?

A

African Americans hyposensitive
Asian Americans hypersensitive

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6
Q

Non-pharmacologic methods of HTN control

A
  • stress reduction
  • exercise
  • salt reduction
  • decrease alcohol consumption
  • smoking cessation
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7
Q

Define inotrope, chronotrope, & dromotrope

A
  • inotrope - contractility
  • chronotrope - rate/rhythm
  • dromotrope - speed of electricity conduction through AV node
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8
Q

Types of antihypertensives?

seven

A
  • Diuretics
  • Alpha blockers
  • Angiotensin converting enzyme (ACE) Inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Anti-anginals (NTG)
  • Beta blockers (BB)
  • Calcium chanel blockers (CCB)
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9
Q

Beta Blockers for HTN

A
  • -lol
  • vasodilation –> decreased HR, BP
  • can cause bronchospasms, rebound HTN
  • antidote is glucagon
  • monitor kidney labs (& liver)
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10
Q

Selective HTN beta blockers

B1 receptors

A

metoprolol, atenolol, esmolol

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11
Q

Non-selective HTN beta blockers

B1 & B2 receptors

A

labetalol, carvedilol, prapanolol

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12
Q

Central-acting alpha 2 agonists for HTN

A
  • sympatholytic
  • good for non-cardiac HTN
  • stimulates alpha receptors in CNS to inhibit vasoconstriction
  • decreases cardiac output, epi/norepi, and renin release
  • don’t use w/ impaired liver or HF
  • rebound HTN, Na & H2O retention

methyldopa, clonidine (patch for 7 days), guanfacine

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13
Q

Alpha adrenergic blockers for HTN

A
  • -sin
  • decrease sympathetic vasoconstriction –> decreased afterload, increase renal blood flow
  • ortho. hypo., edema, nasal congestion

doxazosin, prazosin, terazosin

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14
Q

Adrenergic neuron blockers for HTN

A
  • block & decrease norepi release –> lower BP
  • most potent, last drug of choice
  • ortho. hypo., pseudoparkinsonism

reserpine

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15
Q

Alpha 1 & Beta 1 adrenergic blockers for HTN

A
  • -alol/-olol
  • blocks A1 & B1 receptors
  • effect on A1 > than B1 –> greater decrease in BP, less incidence of bradycardia
  • hypotension, bradycardia, large doses can block B2 (bronchoconstriction)
  • monitor for fluid retention/weight gain

labetalol, carteolol

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16
Q

Direct-acting arteriolar vasodilators for HTN

A
  • relax smooth muscles of blood vessels, esp arteries –> vasodilation & decreased BP
  • hydralazine –> IV PRN for periodic HTN (mod to severe HTN)
  • minoxidil –> kidney pts (mod to severe HTN)
  • nitroprusside –> acute HTN emergency
  • tachycardia, palpitations
17
Q

Angiotensin-converting enzyme (ACE) inhibitors

A
  • -pril
  • inhibits formation of angiotensin II & blocks release of aldosterone
  • Dry cough, hyperkalemia, hyponatremia, angioedema (vascular tissue swelling)
  • African Americans & older adults don’t respond to ACEIs alone
  • don’t use salt substitutes w/ potassium
18
Q

Angiotensin II receptor blockers (ARBs)

A
  • -tan
  • prevent release of aldosterone by blocking angiotensin II
  • hyperkalemia, hyperglycemia, heartburn

losartan, valsartan, irbesartan

19
Q

Direct renin inhibitor

A
  • binds with renin –> reduction of angiotensin I & II, aldosterone levels
  • hyperkalemia, Stevens-Johnson syndrome
  • not proven effective in African American population
20
Q

Calcium channel blockers

A
  • -pine
  • slow calcium channels in myocardium & vascular smooth muscle cells –> vasodilation
  • dizziness, peripheral (dependent) edema, bradycardia, hypotension, palpitations

amlodipine, verapamil & diltiazem only two w/ different endings

21
Q

Antianginals/Nitrates

A
  • produce vasodilation, decrease pre/afterload, reduce myocardial O2 use
  • dilate arterial & venous vessels, specifically coronary arteries
  • used for angina, MIs too
  • hypotension, headache

sublingual nitroglycerin

Pharmacology (15 decks)

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