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Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Phentolamine is classified as a

A

alpha-adrenergic receptor antagonist

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2
Q

Is phentolamine competitive or noncompetitive

A

competetive (transient)

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3
Q

Is phentolamine selective or nonselective adrenergic blocker

A

nonselective

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4
Q

What effect does phentolamine have on vessels

A

vasodilation

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5
Q

As a consequence of blocking alpha receptors, what effect does this do to the heart rate when giving phentolamine

A

reflex tachycardia

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6
Q

Is Phenoxybenzamine a selective or nonselective alpha adrenergic blocker

A

nonselective

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7
Q

What are the two major differences between phentolamine and phenoxybenzamine

A

Onset slower than phentolamine

Elimination 1/2 time longer (24 hours) d/t irreversible noncompetitive blockade

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8
Q

Is Prazosin selective or nonselective

A

selective postsynaptic alpha 1 receptor blocker

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9
Q

Will prazosin evoke reflex tachycardia

A

No, bc no effect on alpha 2 receptors

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10
Q

What effect does prazosin have on arterioles and veins

A

dilates- decreases preload & afterload

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11
Q

What receptor (s) does Terazosin act upon

A

alpha 1 receptor blocker

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12
Q

What is terazosin used to treat

A

BPH

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13
Q

Beta-adrenergic blockers are classified as

A

nonselective and B1 selective (cardioselective)

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14
Q

What are the B1 selective blockers

A

Metoprolol
Atenolol
Acebutolol
Esmolol

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15
Q

Beta 1 receptor antagonists competively antagonizes the beta 1 receptors in the heart and what other cells

A

renin-secreting cells of the kidney

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16
Q

Between the B1 and B2 receptor antagonists, which is better for asthmatics or patient’s with RAD

A

Beta 1 receptor antagonist

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17
Q

Esmolol’s DOA is about 10 minutes because it is

A

rapidly hydrolyzed by plasma esterases

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18
Q

Name the two combined alpha/beta adrenergic antagonists

A

Labetalol

Carvedilol

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19
Q

what specific receptors does labetalol interact with

A

alpha1 and

nonselective beta adrenergic antagonist

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20
Q

What are the CV effects of labetolol administration

A

decreased systemic vascular resistance, decreased bp

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21
Q

What additional effect does labetalol have on beta 2 receptors

A

vasodilation (partial agonist)

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22
Q

Name the two centrally acting sympatholytic drugs discusses in class

A

Methyldopa

Clonidine

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23
Q

As an analog for L-dopa, Methyldopa is known as a

A

false transmitter

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24
Q

What is MOA of methyldopa

A

stored in adrenergic nerve vesicles, where is relplaces NE and is released by nerve stimulation to interact with postsynptic adrenorecptors

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25
Q

How is PVR reduced with methyldopa

A

via stimulation of central alpha adrenoreceptors

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26
Q

Methyldopa is primarily used for hypertension in which patient population

A

pregnant

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27
Q

Clonidine is classified as a

A

centrally acting alpha 2 adrenoreceptor agonist

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28
Q

What is clonidine’s MOA

A

stimulates alpha 2 adrenergic inhibitor neurons in the medullary vasomoter center

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29
Q

What principle effect does clonidine have

A

decreases SNS output from the CNS and increases ParaSNS tone

Decrease HR PVR and CO

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30
Q

What SE should you expect with centrally acting sympathomimetics

A

Sedation
Dry mouth
Withdrawl leading to HTN crisis

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31
Q

What are the Adrenergic Neuron-blocking agents

A

Trimethaphan
Reserpine
Guanethidine

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32
Q

What is the MOA of Guanethidine

A

Inhibits the release of NE from sympathetic nerve endings

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33
Q

What is reserpine’s MOA

A

blocks the ability of aminergic transmitter vesicles to take up and store biogenic amines

34
Q

What is the MOA of Trimethaphan

A

Comptetitvely blocks nicotinic cholinorecetors on Postganglionic neurons

35
Q

What does trimethaphan liberate

36
Q

What are SE associated with trimethaphan

A 
orthostatic hypotension
constipation
urinary retention
gluacoma
dry mouth
37
Q

what are the ACE inhibitors

A

“PRILS”

38
Q

What is the MOA of ACE inhibitors

A

blocks the conversion of angiotension 1 to angiotension II

39
Q

What effect does ACE inhibitors have

A

decreased vasoconstrictive effects and decreased circulating levels of aldosterone

40
Q

What other MOA does ACE inhibitors have

A

Blocks the breakdown of bradykinin

41
Q

What is bradykinin

A

an endogenous vasodilator substance, which contributes to the anti HTN effects of the PRILS

42
Q

What are the most common SE associated with the PRILS

A

COUGH
upper respirator congestion
rhinoorhea
Allergic-like symptoms

43
Q

What is a potential life-threatening complication assoc. with ace-inhibitors

A

Laryngeal angioedema

44
Q

ACE-inhibitors have what effect on renal function

A

decreases GFR, use carefully in patient’s with renal dx

45
Q

What electrolyte dysfunction is likely with PRIL administration

A

hypekalemia

46
Q

Enalapri is a ——– that is metabolized in the liver to its —- —–

A

prodrug
active form

therefore, DOA is longer

47
Q

What are the Angiotesion II blockers

A

“SARTANS”

48
Q

What specific receptor does ‘SARTAN’s” block

A

angiotensin II type 1 receptors

49
Q

What are the calcium channel blockers

A 
VeraPaMIL
Ditiazem
AmloDIPINE
FeloDIPINE
IsraDIPINE
NicarDIPINE
"PINE"
50
Q

What effects do calcium channel blockers have

A

antianginal
antiarrhythmic
INHIBITION of calcium influx into arterial smooth muscle cells

51
Q

List the drugs that release NO or cause it to be released by endothelium

A

Nitroprusside

Hydralazine

52
Q

Name drugs that reduce calcium influx

A

Calcium channel blockers

53
Q

Name drugs that cause hyperpolorization of smooth muscle membrane through opening of potassium channels

A

Minoxidil

diazoxide

54
Q

Name the drug that activates dopamine receptors

A

Fenoldopam

55
Q

Hydralazine works by

A

dilating arterioles but not veins

56
Q

What is the consequence of hydralazine

A

causes reflex tachycardia

*bad for coronary dx patients or HF

57
Q

What does hydralazines SE resemble

A

Lupus

*Arthralgia, myalgia, skin rash, and fever

58
Q

What is minoxidil’s MOA

A

hyperpolorization of smooth muscle cells which leads to dilation of arterioles but not veins

59
Q

Minoxidil is associated with

A

greater reflex sympathetetic stimulation and sodium and fluid retention than hydralazine

*as a consequence, it mus be used with beta blocker and loop diuretic

60
Q

Nitroprusside works by

A

dilating both arterial and venous vessels

61
Q

Nitroprusside is rapidly metabolized by

A

uptake into RBC with liberation of cyanide

62
Q

Cyanide is converted to

A

thiocyanate, which is eliminated by the kidneys

63
Q

Name a carbonic anhydrase inhibitor

A

acetazolamide

64
Q

What is the MOA of acetazolamide

A

Blocks carbonic anhydrase activity at the proximal tubule of the kidney

65
Q

What component in the H+ + HCO3- is lost with acetazolamide

66
Q

What happens to the sodium when HC03- is filtered

A

Sodium follows and leads to diuresis

67
Q

What happens to the H+

A

It gets reabsorbed and combined with Cl- to offset the filtered HCO3-

*Leads to Hyperchloremic metabolic acidosis

68
Q

What is acetazolamide used to treat

69
Q

What diuretic works on the ascending loop of henle

A

Furosemide

70
Q

How does furosemide work

A

Inhibits Na/K/CL symporter resulting in lost of loss of sodium, potassium, and chloride ions. This leads to H20 loss and hypokalemia and hypocloremia

71
Q

What is the indication for loop diuretic use

A

Acute pulmonary edema

Edematous CHF

HyperKalemia

72
Q

Thiazide diuretics work on the

A

Distal Convoluted tubule by blocking the sodium chloride symporter.

73
Q

Loss of sodium within the cells of the DCT cells leads to increased absorption of what electrolyte

A

Calcium via sodium/calcium ATpase pump

74
Q

What is a common electrolyte abnormality of thiazide

A

HypoKalemic metabolic alkalosis

75
Q

Name three potassium-sparing diuretics

A

Triamterene
Amiloride
Spironolactone

76
Q

Potassium-Sparing diuretics work on

77
Q

Spironolactone is considered a

A

aldosterone antagonist

*binds to cytoplasmic mineralocrticoid receptors on collectiong duct

78
Q

Name a osmotic diuretic

79
Q

What is significant about how mannitol is filtered

A

Excreted without tubular reabsorption or secretion

80
Q

What effect does mannitol have

A

because it is not reabsorbed, the filtrate maintains its hyperosmolarity with prevents water reabsorption

81
Q

What is mannitol indicated for

A

Increased intracranial pressure
Increased intraocular pressure
Prophlaxis against acute renal failure

Pharmacology (27 decks)

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