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AFN Pharm I > Antihypertensives Part II > Flashcards

Antihypertensives Part II Flashcards

1
Q

What is the mechanism of clonidine?

A

A2 agonist

*A2 receptor is a negative feedback mechanism for NE concentrations in the synapse. Clonidine works centrally, acting on the sympathetic inhibitory neuron(s) in the CNS

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2
Q

Is clonidine a 1st line tx for HTN?

A

No

*It is more commonly used for withdrawal with alcohol & benzos to prevent surg of NE is synapse (d/t upregulation) caused from withdrawal

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3
Q

What is mechanism of action for alpha-methyl-dopa?

A

Inhibits synthesis of NE

*think about how NE needs dopa, derived from tyrosine, to be made, so from the name of this drug its easy to remember that it interferes with dopa, therefore interfering with the synthesis of NE

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4
Q

Is alpha-methyl-dopa centrally acting?

A

Yes

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5
Q

What pt population are Beta blockers contraindicated in?

A

-Decompensated HF

-Asthma

-Watch out for masking of hypoglycemia in DM pts

*if you have poor contractility as it is, then you give a BB, then ur gonna throw them in cardiogenic shock, so don’t do that, thanks

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6
Q

BB can mask s/s of ____________

A

hypoglycemia

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7
Q

Tamsulosin is what kind of drug?

A

A1 blocker

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8
Q

What drug is used in pregnacy induced HTN?

*aka PIH

A

Methyldopa

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9
Q

With _________, a centrally acting anti-HTN agent, you can get rebound HTN if you hold it periop

A

Clonidine

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10
Q

Do you give clonidine DOS?

A

Yessssssssss

*will get rebound HTN due to upregulation because clonidine is an A2 agonist which acts as negative feedback to NE in synapse

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11
Q

How exactly do A2 receptors limit NE release into the synapse when the A2 receptors are bound by an agonist?

A

The A2 receptors inhibit adenylyl cyclase which decreases Ca++ influx into the presyaptic neuron which prevents the vescicle containing NE from releasing NE into the synapse

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12
Q

Dexmedetomidine is a ______ A2 agonist unlike clonidine which is a ______ A2 agonist

A

-Full

-partial

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13
Q

Reserpine depletes NE, dopamine and serotonin

A

Just a fact bro, ur welcome

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14
Q

Labetolol and carvedilol block what receptors?

*in a general sense

A

Beta and alpha

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15
Q

Phentolamine and phenoxybenzamine block what receptors?

A

A1 & A2

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16
Q

What drugs for pheochromocytoma?

A

-phenoxybenzamine

OR

-phentolamine

17
Q

What drug name ending is for A1 blockers?

A

“zosin”

ex. Prazosin, Doxazosin, etc.

18
Q

What 2 diseases are the “zosins” aka A1 blockers used for?

A

-BPH (most common)

-HTN

19
Q

A1 blockers have _________ reflex tachycardia than nonselective alpha blockers

A

less

20
Q

Prazosin is 50% _____ potent than Doxazosin

A

more

21
Q

When blocking for pheochromocytoma, block ___ receptors before ____ receptors

A

A before B

*alpha before beta

22
Q

Which alpha blockers have more extreme reflex tachycardia?

A

Non-selective

*because they block A2 receptors as well, which would act as ur negative feedback, but now you blocked them so ur HR is unopposed

23
Q

Alpha blockers shouldn’t be used in ______ ______ or angina

A

Heart failure

24
Q

What are the cardioselective BBs?

*meaning they are more selective to B1 receptors

*FYI according to nagelhout, there is no such thing as true cardioselective BBs because at the doses we are giving patients, the B1 selectivity is gone and they effect both B1 & B2. These drugs are only cardioselective at very small doses, smaller than what we give patients. This is scewed info from marketing these so called “cardioselective” drugs

A

-metoprolol

-esmolol

-atenolol

25
Q

What are the mixed BBs?

*meaning they block alpha and beta receptors

A

-labetalol

-carvedilol

26
Q

What is the most common non-selective BB?

A

-Propranolol

27
Q

Do BB decreases activation of RAAS?

A

Yep

*remember B1 receptor activation in the JGA causes renin release

28
Q

Don’t give any BBs to ______ patients

A

Asthma pts

29
Q

Don’t stop BB after long term use why?

A

Can have withdrawal symptoms (tachycardia, angina, HTN, nervousness) d/t upregulated Beta receptors

30
Q

If you start a BB DOS with a pt, they are at increased risk of ________. If you don’t give BB DOS and they are taking it long term then they will have an increased risk of ________

A

-stroke

-CV event (MI)

31
Q

Don’t give a BB in pts with greater than a ___ degree heart block or complete heart block

A

1st degree HB

32
Q

BBs can increase effects of __________ and _________

*anesthesia drug classes

A

-sedatives

-NDNMBs

33
Q

BBs may cause significant _______ during NMB reversal

A

Bradycardia

34
Q

Whats the short acting BB for HR that we will use in OR?

A

Esmolol

35
Q

What is the short acting BB for BP that we can use in OR?

A

Labetalol

AFN Pharm I (7 decks)

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