Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Test 4 > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Thiazide diuretics (2)

A

HYDROCHLOROTHIAZIDE, and CHLORTHALIDONE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Loop diuretic

A

Furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aldosterone Antagonists

A

Spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ACE inhibitor

A

Captopril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ARBs

A

Losartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Direct renin inhibitors

A

Aliskiren

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Calcium Channel Blockers

A

Dihydropyridine: Nifedipine

Non-Dihydropyridines: Verapamil, Diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vasodilators

A

Nitroprusside, hydralazine, minoxidil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sympatholytics

A

1) Clonidine, methyldopa: Centrally acting alpha-2 adrenergic agonists.
2) Beta blockers (Propranolol, metoprolol, atenolol).
3) Alpha Blockers (terazosin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First-line agents for HTN

A

Thiazide diuretics, ACE inhibitors or ARBs, CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Third-line agents for HTN

A

Loop diuretics, aliskiren, alpha-1 blockers, vasodilators, central alpha-2 aonists, reserpine, aldosterone antagonists, beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MOA of hydrochlorothiazide and chlorothalidone

A

1) Initially descreses vascular volume and CO via its direct diuresis effect (inhibits NA-Cl symporter in DCT)
2) Long term- indirectly decreases TPR- mechanism unclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

For thiazide diuretics, you only need a low dose (12.5-25 mg). Why is that?

A

Doses >25 mg provide no further benefit but increases risks and adverse effects. Low dose used as monotherapy for stage 1; lowers BP 10-15 mm in most patients 4-6 after onset of therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thiazide diuretics are used with other antihypertensives how?

A

In combination due to a synergistic effect and to reduce Na+/water retention caused by vasodilators and sympatholytics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hydrochlorothiazide vs. chlorothalidone: Which drug is less potent and has a shorter duration of action yielding lower efficacy in controlling nocturnal BP?

A

hydrochlorothiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hydrochlorothiazide vs. chlorothalidone: Which drug may be inferior in reducing the risk of CV events?

A

hydrochlorothiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Adverse effects of Thiazide diuretics?

A

1) Hypokalemia
2) Hyperuricemia (gout), hyperglycemia, hyperlipidemia
3) Erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drug and MOA for loop diuretics

A

Furosemide: decrease CO by reducing volume overload- blocks Na-Cl-K symporter in ascending limb of henle’s loop

19
Q

When is furosemide mostly used?

A

For malignant HTN and volume-dependent patients with renal disease.

20
Q

Name an Aldosterone Antagonist and its MOA:

A

Spironolactone: Decreases CO by reducing volume overload. 1) Blocks aldosterone receptors in collecting duct of epithelial cells. 2) Prevents cardiovascular remodeling.

21
Q

Adverse effects for Spironolactone:

A

Hyperkalemia, Gynecomastia, impotence, hirsutism

22
Q

Name an ACE inhibitor and the MOA:

A

Captopril: Decrease TPR

1) Inhibits enzymatic conversion of AngI to AngII (vasoconstrictor) and degradation of bradykinin (vasodilator).
2) Reduces stimulation of both AngII AT1 and AT2 receptors
3) Decreases AngII-mediated cardiovascular remodeling and renal dysfunction

23
Q

Anti-HTN uses for Captopril:

A

1) Monotherapy for stage 1; lowers BP even in patients with normal Plasma renin activity.
2) In combination with other anti-HTN; mitigates the risk of hypokalemia from thiazide diuretic therapy

24
Q

True/False: Ace inhibitors have no interference with cardiovascular reflexes- exercise capacity is not impaired and orthostatic Hypotension is minimal

A

TRUE- this is a clinical advantage over 2nd-line drugs

25
Q

True/False: Ace Inhibitors are associated with are associated with metabolic disturbances

A

False: Ace inhibitors are NOT associated with metabolic disturbances.- An advantage compared to 2nd line drugs

26
Q

True/False: Ace inhibitors can be used safely in patients with bronchial asthma and does not induce lethargy, weakness or sexual dysfunction.

A

TRUE- this is a clinical advantage over 2nd-line drugs

27
Q

True/False: Ace inhibitors reduce the risk of HTN-induced cardiovascular mortality?

A

TRUE- this is a clinical advantage over 2nd-line drugs

28
Q

Adverse Effects and Contraindications of Ace Inhibitors:

A

1) First-dose hypotension
2) Hyperkalemia, cough, angiodema
3) Contraindicated in pregnancy

29
Q

List an ARB and the MOA

A

Losartan: Selective antagonist of AngII AT1 receptors. Does NOT affect bradykinin levels.

30
Q

True/False: ARBs anti_HTN efficacy is roughly the same as ACE-Inhibitors

A

TRUE

31
Q

True/False: ARBs are not alternatives for patients who cannot tolerate ACE inhibitors (cough)?

A

False- they are alternatives

32
Q

True/False: Combining ARBs with ACE inhibitors has a beneficial effect?

A

False: Not beneficial and may be harmful

33
Q

Adverse effects of Losartan:

A

Similar to ACE inhibitors but cough and angiodema are less prevelant

34
Q

Name a direct renin inhibitor and the MOA:

A

Aliskiren: Decreases TPR; blocks rate-limiting step in enzymatic formation of AngII

35
Q

What type of calcium channel blockers are most frequently used?

A

Long acting DHPs. Heart rate lowering CCBs can be given for HR control in patients with IHD or Atrial fib.

36
Q

HRL-CCBs and Beta blockers are usually avoided because:

A

due to potential for bradyarrhythmias.

37
Q

MOA of Nitroprusside

A

Decomposes to release NO. Similar mechanism to nitroglycerin, but tolerance does NOT develop.

38
Q

Adverse effects of Nitroprusside

A

Excessive vasodilation and hypotension. Cyanide toxicity

39
Q

MOA of Hydralazine and what population is it used in?

A 
Produces arterolar (not venous) dilation. Mechanism unclear.
Used in AfricanAmerican patients in fixed -dose combination with BiDil
40
Q

Hydralazine Adverse Effects

A

Reflex Tachycardia and headache. Lupus-like syndrome (slow acetylators).

41
Q

Minoxidil kills people. What is the MOA and what is it used for?

A

Arterial dilation by opening K+ channels on VSM cells. Used as add-on in severe HTN and used to promote hair growth.

42
Q

Name centrally-acting alpha-2 adrenergic agonist and what it does.

A

Clonidine, methyldopa: Decreases sympathetic outflow by stimulating alpha-2 receptors resulting in decreased CO and TPR

43
Q

Name an alpha blocker

A

Terazosin: Block alpha1 receptors in VSM

Pharm Test 4 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions