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Pharmacology II > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

this is defined as sustained systolic bp of >140 mm Hg OR sustained diastolic BP of greater than 90 mm Hg

A

HTN

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2
Q

results from increased peripheral arteriolar resistance and reduced capacitance of the venous system

A

HTN

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3
Q

stroke, heart failure, heart disease/heart attack , and renal damage can be caused by

A

chronic HTN

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4
Q

what are the four classifications of blood pressure

A

normal, prehypertension, stage 1, and stage 2

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5
Q

90 % of pts. have what type of HTN

A

essential HTN ( unknown origin)

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6
Q

T or F: HTN has higher incidence in blacks, middle aged men, and it increases with age

A

True

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7
Q

arterial bp is directly proportional to what…

A

cardiac output and peripheral vascular resistance

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8
Q

which two systems control cardiac output and peripheral resistance

A

baroreflexes( heart, arterioles, and venules), and renin angiotensin -aldosterone system( kidney)

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9
Q

these act by changing the activity of the sympathetic nervous system ( rapid, moment to moment control)

A

baroreflexes

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10
Q

when there is a fall in bp, these ______ will send fewer impulses to cardiovascular centers in the spinal cord; reflex response of increased sympathetic and decreased parasympathetic output -> vasoconstriction and increased cardiac output

A

baroreflexes

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11
Q

what provides long term control of BP ( alters blood volume)

A

kidney

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12
Q

what in the kidney responds to reduced arterial pressure and sympathetic stimulation of B1 receptors

A

baroreceptors

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13
Q

low Na intake and greater Na loss increases what?

A

renin release

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14
Q

what converts angiotensinogen to angiotensin I

A

renin

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15
Q

what converts angiotensin I to angiotensin II

A

ACE

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16
Q

this is a potent circulating vasoconstrictor

A

angiotensin II

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17
Q

T or F, Angiotensin II stimulated aldosterone secretion

A

T ( leads to increased renal Na absorption and increased blood volume)

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18
Q

what is the goal of tx of antihypertensives

A

reduce cardiovascular and renal morbidity and mortality

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19
Q

these class of drugs lower bp by reducing cardiac output and/ or decreasing peripheral resistance

A

antihypertensives

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20
Q

what are the categories of Antihypertensive drugs

A

diuretics, sympathoplegic agents, direct vasodilators, angiotensin agents

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21
Q

which class of anti HTN drugs decrease Na and reduce blood volume

A

diuretics

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22
Q

which class of anti HTN drugs reduce peripheral resistance and decrease cardiac output

A

sympathoplegic agents

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23
Q

which class of anti HTN drugs relax vasodilator smooth muscle and decrease peripheral resistance

A

direct vasodilators

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24
Q

which class of anti HTN drugs reduce peripheral resistance and blood volume

A

angiotensin agents

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25
Q

T or F: BP = cardiac output x peripheral vascular resistance

A

T

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26
Q

what is the most common reason for therapy failure

A

lack of pt compliance

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27
Q

therapy is directed at preventing future or present disease?

A

future

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28
Q

these class of drugs are the first line in drug therapy ; safe, inexpensive and effective; better for tx in older adults

A

diuretics

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29
Q

side effects of this class of drugs includes: K depletion increased uric acid concentrations , impaired glucose tolerance

A

diuretics

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30
Q

this type of diuretic is the most commonly used ie. HCTZ; increases Na and water excretion ; chronic use leads to decreased peripheral vascular resistance

A

thiazide diuretics

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31
Q

therapeutic uses of this type of diuretic includes decreased bp, counteract Na and water retention seen with other anti HTN

A

thiazide diuretics

32
Q

adverse effects of this type of diuretic includes hypokalemia, hyperuricemia, hyperglycemia

A

thiazide diuretics

33
Q

these type of diuretics act quickly ; increase Ca content of urine-> decreased renal vascular resistance and increased renal bf

A

loop diuretics

34
Q

this type of diuretics reduce K loss in the urine

A

K sparing diuretics

35
Q

which drug of the K sparing diuretics decreases the cardiac remodeling that occurs in heart failure

A

spironolactone

36
Q

this drug is a centrally acting adrenergic drug ; its a central alpha 2 agonist ; used in HTN tx when 2 or more drugs have failed; useful in renal disease

A

clonidine

37
Q

this drug may cause Na and water retention ; adverse effects : sedation,dry mouth, constipation, rebound HTN

A

clonidine

38
Q

this drug is a centrally acting adrenergic drug; its a central alpha 2 agonist; its converted to methylnorepinephrine; does NOT decrease cardiac outout and bf to vital organs is not decreased ; can be used in pregnancy

A

methyldopa

39
Q

side effects of this drug include sedation/ drowsiness

A

methyldopa

40
Q

these produce competitive block of alpha 1 receptors-> relaxation of arterial and venous smooth muscle -> minimal changes in cardiac output , renal bf, and glomerular filtration rate ie. Prazosin, doxazosin, and terazosin

A

alpha Adrenoceptor blocking agents

41
Q

adverse effects of this drug include reflex tachycardia and first dose syncope ( loss of consciousness) ; seldom used as monotherapy

A

alpha Adrenoceptor blocking agents

42
Q

these drugs lower bp by decreasing cardiac output ; selective blockers are more commonly prescribed

A

beta Adrenoceptor blocking agents

43
Q

which beta Adrenoceptor blocking agent increases production of NO

A

nebivolol

44
Q

what is contraindicated in pts with asthma

A

beta Adrenoceptor blocking agents non selective ie. propranolol and nadolol

45
Q

therapeutic uses of these drugs includes: subsets of the HTN population, Hypertensive pts with concomitant diseases

A

beta Adrenoceptor blocking agents

46
Q

adverse effects of this drug include bradycardia, fatigue, lethargy, insomnia, hypotension, decreased libido, can disturb lipid metabolism, and drug withdrawal

A

beta Adrenoceptor blocking agents

47
Q

these produce relaxation of vascular smooth muscle ; release NO ( hydralazine) and hyperpolarize smooth muscle by opening K channels ( minoxidil); produce reflex stimulation of the heart;increase plasma renin concentration

A

vasodilators

48
Q

this type of vasodilator is always given with a beta blocker and a diuretic; can be used as monotherapy in pregnant pts; adverse effects : HA , tachycardia, nausea, sweating, arrthymias, angina

A

hydralazine ( vasodilator)

49
Q

this type of vasodilator is admin. orally for tx of sever to malignant HTN that doesn’t respond to other drugs ; causes hypertrichosis

A

minoxidil

50
Q

which drug is used to treat male pattern baldness

A

minoxidil

51
Q

these drugs are recommended when preferred first line agents are contraindicated / ineffective; effective in treating HTN in pts with angina or diabetes

A

Ca channel blockers

52
Q

what are the three chemical classes of Ca channel blockers

A

diphenylalkamines, benzothiazepines, dihydropyridines

53
Q

these drugs block inward movement of Ca -> causes muscles to relax; stronger dilation of arteries than veins

A

Ca channel blockers

54
Q

some therapeutic uses of these drugs includes : natural diuretic effect, useful in HTN pts with asthma, diabetes, angina, and /or peripheral vascular disease

A

Ca channel blockers

55
Q

some adverse effects of these drugs includes: flushing, constipation, dizziness, HA, fatigue, and hypotension

A

Ca channel blockers

56
Q

this is a system for controlling bp and electrolyte levels ; monitors Na, K, vascular volume, and bp

A

renin-angiotensin- aldosterone system

57
Q

what results in a release of renin from the kidney

A

reduction in bp or a fall in the delivery of Na to the nephron

58
Q

T or F: Angiotensin I is biologically active

A

F: its biologically inactive

59
Q

this molecule has multiple actions that increase bp including : vasoconstrictor, enhances release of catecholamines, increases synthesis of aldosterone, also induces cardiac hypertrophy

A

angiotensin II

60
Q

these drugs reduce peripheral vascular resistance; decrease angiotensin II and increases bradykinin ( vasodilator ) -> vasodilation and decreased Na and water retention

A

ACE inhibitors

61
Q

therapeutic uses of these drugs include : slows progression of diabetic nephropathy, used in the care of pts following a heart attack; first line therapy for treating hf, HTN pts with chronic renal disease , and pts with increased risk for coronary artery disease

A

ACE inhibitors

62
Q

some adverse effects of this drug include :dry COUGH, hyperkalemia, skin rash, hypotension, fever, fetotoxic

A

ACE inhibitors

63
Q

these drugs are alternatives to ACE inhibitors; do not increase bradykinin levels, decrease nephrotoxicity ; fetotoxic

A

Angiotensin II receptor Blockers

64
Q

these drugs inhibit renin; metabolized by P450 System; adverse effects include cough, hyperkalemia, CI in pregnancy

A

renin inhibitor

65
Q

tis type of emergency is rare but life threatening ; diastolic BP over 150 mm Hg ( systolic over 210) in a health person ; or over 130 in a pt with preexisting conditions

A

HTN emergency

66
Q

symptoms of this emergency include: severe HA, mental confusion, and apprehension , blurred vision

A

HTN emergency

67
Q

tx of hypertension emergencies are

A

ICU with monitoring of BP, parenteral meds

68
Q

which drug is used during hypertensive emergency that is admin. IV; causes release of NO with results of increased ic cGMP; works regardless of cause; metabolized rapidly; poisonous if given orally

A

nitroprusside

69
Q

which drug is used during hypertensive emergency hat has peripheral dopamine 1 receptor agonist; given IV infusion; relaxes the renal and mesenteric arterial vessels and increases renal bf ; increases IOP

A

fenoldopam; CI in pts with glaucoma

70
Q

which drug is used during hypertensive emergency that is a Ca channel blocker and is given as IV infusion

A

nicardipine

71
Q

this is high blood pressure that does not respond to Tx

A

resistant HTN

72
Q

most common causes of this type of HTN include : poor compliance, excessive ethanol intake, concomitant conditions, used of sympathomimetics, NSAIDS, or antidepressants, insufficient dose

A

resistant HTN

73
Q

severe HTN during pregnancy treated with

A

labetalol

74
Q

which drugs are CI during pregnancy for HTN

A

ACE inhibitors, ARBs, and Aliskiren

75
Q

which drugs is CI during pregnancy for HTN due to possible cyanide poisoning

A

Nitroprusside

76
Q

what type of therapy will lower bp quickly

A

combination therapy

77
Q

what controls bp in up to 85% of pts

A

thiazide diuretics with beta blocker, ACE inhibitor, or ARB

Pharmacology II (31 decks)

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