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Pharmacology part B > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

examples of thiazides

A

hydrochlorothiazide

chlorthalidone

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2
Q

examples of loop diuretics

A

furosemide

ethacrynic acid

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3
Q

example of potassium sparing

A

spironolactone

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4
Q

examples of ACEIs

A

enalapril

fosinopril

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5
Q

example of ARBs

A

losartan

cansesartan

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6
Q

examples of CCBs vascular

A

nifedipine - longacting

amlodipine

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7
Q

examples CCBs cardiac

A

verapamil

diltiazem

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8
Q

examples beta receptors blockers

A

propranolol

metoprolol

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9
Q

example of alpha 1 receptor antagonist

A

prazosin

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10
Q

example of alpha 2 receptor agonist

A

clonidine

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11
Q

examples of vasodilators

A

hydralazine
minoxidil
nitroprusside

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12
Q

what is BP regulated by

A

cardiac output and total peripheral resistance

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13
Q

what does cardiac output depends on

A

venous return
heart rate
contractility

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14
Q

what does total peripheral resistance depend on

A

resistance vessel diameter

arterial tone

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15
Q

potential drugs that cause hypertension

A

estrogens
NSAIDS
antidepreesents, amphetamines

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16
Q

conditions that may cause hypertension

A

renal artery stenosis
coarctation of the aorta
phaeochromocytoma
hyperaldosteronism

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17
Q

what are the 3 major compensatory responses to a decrease in blood pressure

A

RAAS system
activate sympathetic NS
increase RAAS
decrease renal perfusion pressure

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18
Q

what is the result of decreased renal perfusion pressure

A

increase sodium retention causing increased blood volume

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19
Q

result of increased RAAS

A

aldosterone increases sodium retention

angiotensin 2 increases afterload and preload

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20
Q

result of increased SNA

A

increased afterload and preload, decreased inotropy and increase heart rate

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21
Q

non pharms for hypertension

A 
sodium restriction 
weight loss
exercise
reduced alcohol intake
smoking cessation 
relaxation
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22
Q

problems with increasing the dose

A

causes little improvement in effect
hypokalemia
glucose intolerance
increased LDL

23
Q

when are loop diuretics most useful

A

in renal impairment (GFR<50ml/min) and edematous states

24
Q

side effects of thiazides

A 
decreased insulin release 
increased LDL levels
erectile dysfunction 
decrease blood volume 
hypokalemia, hypercalcemia
25
Q

side effects of loop diuretics

A

deafness if given with aminoglycoside antibiotic
vascular volume contraction
hypokalemia
hypocalcemia

26
Q

side effects of potassium sparing diuretics

A

hyperkalemia
impotence
gynecomastia

27
Q

how do aceis inhibit the raas

A

decrease angiotensin 2 causing a decrease in TPR and aldosterone

28
Q

how do arms inhibit the ras

A

block all angiotensin 2 receptors resulting in decreases TPR and decreased aldosterone

29
Q

problems with raas inhibitors

A

rash
hyperkalemia
proteinuria angioedema
cough (ACEI)

30
Q

why do you use RAAS inhibitors in people with CHF and diabetic nephropathy

A

it is metabolically neutral so doesnt affect glucose and prevents remodelling

31
Q

what is there little reflex tachycardia in RAAS inhibitors

A

baroreceptors reset so there is no NE release

32
Q

can you use RAAS inhibitors in pregnancy

A

no

33
Q

which type of channels do calcium channel blockers block

A

L type

34
Q

which clacium channel blockers work primarily in vascular

A

dihydropyridines

increase TPR

35
Q

which calcium channel blockers work predominantly on the cardiac

A

non-dihydropyrinidines

increase cardiac output

36
Q

what are dihydropyridines used for

A

angina
raynauds (decreased perfusion of blood to extremeties)
secondary for hypertension
hypertensive crisis

37
Q

what are non-dihydropyridines used for

A

hypertension if also a concern about heart rate control in atrial fibrillation
angina

38
Q

calcium channel blockers useful where beta blockers are contraindicated which is when

A 
asthma 
diabetes bc cant sense hypo/hyperglycemia 
COPD
peripheral vascular disease 
elderly 
african americans
39
Q

when should beta blockers be used and for how long

A

post MI
heart failure
6 months

40
Q

problems with betablockers

A

not metabolically neutral
erectile dysfunction
may cause type 2 diabetes

41
Q

what does prazosin do

A

vasodilates arteries adn veins
decreases insulin resistance
useful for prostatic hyperplasia

42
Q

problems with prazosin

A

fluid retention with long term
initial large decrease in BP
orthostatic hypotension

43
Q

clonidine mechanism of action

A

acts on central vasomotor centers to decrease sympathetic nerve activity from CNS

44
Q

why does clonidine have to be tapered

A

rebound hypertension upon rapid cessation of the drug

45
Q

what is clonidine commone use

A

adjunct to general anesthetic

46
Q

what is used to lower blood pressure in pregnancy

A

hydralazine

47
Q

what are vasodilators taken with

A

beta blocker and diuretic

48
Q

problems with hydralazine

A 
lupus like syndrome
increase SNA 
headache 
nausea
hypotension 
tachycardia 
angina pectoris
49
Q

new use for minoxidil

A

topical for baldness

50
Q

problems with minoxidil

A 
headahce 
nausea
hypotension 
tachycardia 
pericardial effusion
51
Q

key difference of sodium nitroprusside compared to other vasodilators

A

dilates veins and arterioles

52
Q

what is sodium nitroprusside used for and why

A

hypertensive encephalopathy
surgery(sudden onset)
because it works in 1 min and is offset in 5

53
Q

why can you only use sodium nitroprusside for short term

A

potential for cyanide toxicity as that is the metabolite

54
Q

target blood pressure

A

140/90

Pharmacology part B (17 decks)

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