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Pharmacology Exam 3 > Antihypertensives & Antianginals > Flashcards

Antihypertensives & Antianginals Flashcards

1
Q

best for variant angina

A

calcium channel blockers - dilate smooth muscle

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2
Q

best for unstable angina

A

anti platelet and statin (after PCI)

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3
Q

dihydropyridine Ca Channel Blockers

A

Nifedipine

Nimodipine

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4
Q

Non-dihydropyridine Ca Channel Blockers

A

Verapamil

Diltiazem

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5
Q

nitroglycerin MOA

A

decrease preload = decreases wall tension and increases pressure gradient (to increase coronary flow)

large artery dilation

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6
Q

compared to non-dihydropyridines, the dihydropyridines are more active on the vessels or the heart?

A

vessels

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7
Q

vasodilation in vessels will decrease BP, can cause reflex tachycardia and increase in contractility

this is caused by____________

A

SHORT- or FAST-acting dihydropyridines

use long-acting formulation to decrease risk

might be useful for someone with bradycardia

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8
Q

adverse effects of Ca channel blockers

A 
constipation
AV block
CHF
cardiac depression
cardiac arrest
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9
Q

contraindications for Ca channel blockers

A

heart failure

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10
Q

best option for treating variant angina

A

Ca channel blockers

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11
Q

may reduce vasospasm in SAH

A

Nimodipine

Ca channel blocker that targets CEREBRAL vessels

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12
Q

beta blockers decrease heart rate by _______

A

blocking sympathetic activity on the SA node!

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13
Q

beta blockers decrease contractility by _________

A

blocking beta 1 receptors on ventriculocytes

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14
Q

propranolol is contraindicated in patients with __________

A

asthma

blocking beta-2 leads to bronchoconstriction

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15
Q

Who gets beta blocker versus Ca channel blocker:

history of HTN or MI? _______

history of angina? _____

A

MI: beta blocker

angina: calcium channel blocker

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16
Q

beta blockers will ________ preload

A

increase

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17
Q

drugs that directly target TPR by direct vasodilation of arterioles

(BP = CO x TPR)

A

vasodilators (hydralazine, minoxidil, sodium nitroprusside)

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18
Q

antihypertensive drugs that target CO by decreasing contractility

(BP = CO x TPR)

A

beta blockers

Ca channel blockers

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19
Q

drugs that target TPR by blocking sympathetic activity (decreasing vasoconstriction)

(BP = CO x TPR)

A

alpha-1 receptors (prazosin)

guanethidine

reserpine

alpha-2 agonists (methyldopa, clonidine)

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20
Q

drugs that target CO by decreasing preload (decrease venous tone or blood volume)

(BP = CO x TPR)

A

diuretics
ACE inhibitors
Ang II Receptor Blockers

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21
Q

how do thiazide diuretics cause potassium excretion?

A

increase Na in the lumen, which depolarizes collecting duct cells, opening K channels (Na reabsorbed-K secreted)

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22
Q

how do K sparing diuretics spare K?

A

block Na channel in collecting duct (inhibits Na -K exchange)

offsets K-wasting effect of HZTZ

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23
Q

Losartin (class)

A

ARB

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24
Q

Captopril (class)

A

ACE-inhibitor

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25
Q

angiotensin II causes _________, _______, and__________ when acting on AT1 receptor

A

vasoconstriction
aldosterone secretion
Na retention

26
Q

adverse effect of ACE-inhibitors, due to build up of bradykinin

A

severe cough

does not occur with ARB (AT1 receptor blocker)

27
Q

drug that regresses LVH and delays/prevents HF and MI

A

ACE inhibitor

28
Q

angiotensin II causes _________, _______, and__________ when acting on AT1 receptor on the efferent arteriole

A

vasoconstriction
aldosterone secretion
Na retention

29
Q

adverse effect of ACE-inhibitors, due to build up of bradykinin

A

severe cough (in 20% of pts)

does not occur with ARB (AT1 receptor blocker)

30
Q

drug that slows progression of renal disease in diabetics

A

ACE inhibitor

decreases pressure at glomerulus, though that decreases flow/GFR

31
Q

contraindications to ACE-inhibitors and ARBs

A

pregnancy

renal artery stenosis (decreases GFR)

32
Q

adverse effect of ACE-inhibitors and we don’t know why

A

angioedema

33
Q

African Americans and elderly do not respond as well to ____________

A

beta blockers

34
Q

adverse effect of beta blockers

A

erectile dysfunction

depression and insomnia

asthma

35
Q

effective mono therapy in African Americans and elderly populations (low-renin populations)

A

Ca channel blockers

36
Q

adverse effects of vasodilators, related to increased baroreceptor reflex

A

increase HR, contractility, renin, fluid retention

increased cardiac oxygen demand can lead to ischemia

37
Q

prazosin (class)

A

alpha-1 blocker

38
Q

adverse effects of alpha-1 blocker

A

“first dose phenomenon” (drop in BP on first dose, give this in-office)

Na and water retention

39
Q

not great mono therapy, but useful for men with prostatic hyperplasia (bladder obstructive symptoms)

A

prazosin

40
Q

adverse effects of guanethidine

A

postural hypotension
sexual dysfunction (retrograde ejaculation)
diarrhea

41
Q

adverse effects of guanethidine

A

postural hypotension
sexual dysfunction (retrograde ejaculation)
diarrhea

42
Q

methyldopa, clonidine

A

alpha-2 agonists

43
Q

adverse effect of methyldopa (but not clonidine)

A

immunologic abnormalities

44
Q

useful antihypertensive during pregnancy

A

methyldopa

45
Q

adverse effect of methyldopa and clonidine

A

dizziness
reduced lipid
sedation and depression
withdrawal syndrome (even higher BP)

46
Q

adverse effects of reserpine, related to CNS MOA

A

sedation
poor concentration
depression

47
Q

depletes NE in CNS synapses

A

reserpine

48
Q

depletes NE in peripheral post-ganglionic adrenergic neurons

A

guanethidine

49
Q

block central sympathetic activity

A

methyldopa, clonidine

50
Q

aldosterone blockers

A

spironolactone

51
Q

asthma

don’t give________

A

beta blocker

52
Q

depression

don’t give _______

A

beta blocker

alpha-2 agonist

53
Q

pregnant

don’t give _______

A

ACE inhibitor

All receptor antagonists

54
Q

heart failure

don’t give _______

A

Ca antagonists

55
Q

bilateral renal stenosis

don’t give _______

A

ACE inhibitors / ARBs

56
Q

diabetes

try ________

A

ACE inhibitors

57
Q

heart failure

try _______

A

ACE inhibitor

58
Q

cardiac hypertrophy

try _______

A

ACE inhibitor

59
Q

MI

try _______

A

beta blocker + ACE inhibitoe

60
Q

Angina

try _______

A

beta blocker + Ca antagonist

61
Q

arrhythmia and fibrillation

try _______

A

beta blocker

non-DHP Ca antagonist

62
Q

need a second agent??

try _______

A

diuretic (it not already on it)

Pharmacology Exam 3 (10 decks)

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