Antihypertensives1 Flashcards
What stage hypertension is someone with a systolic pressure of 150?
stage I HTN. 140-159/90-99
What stage hypertension is a person with diastolic 88?
prehypertension. 120-139/80-89
What are the three mechanisms used to regulate normal BP?
- sympathetic control via barometric reflex: increase in HR and vasoconstriction
- RAAS system: vasoconstriction and hypervolemia
- Local release of hormones (endothelin, NO, kinins)
Where do alpha1 adrenergic responses predominantly have an effect and how do they achieve it?
sympathetic response primarily in the blood vessels. They increase intracellular Ca and cause vasoconstriction.
Where do Beta adrenergic responses have a major effect and how do they achieve it?
heart and lungs primarily by cAMP
What does reserpine do? what is its mechanism?
It depletes NE stores by inhibiting VMAT. Reduces sympathetic tone.
What is the mechanism of a drug ending in ‘azosin’?
they are alpha blockers
What effect do alpha blockers have on cholesterol levels?
they increase HDL and decrease LDL. Also have beneficial effects on insulin resistance
What is prazosin used to treat?
hypertension
What are terazosin and doxazosin used to treat?
BPH and difficulty urinating. Can also lower BP but not primarily used for it alone.
What is the mechansim of a drug ending in ‘olol’?
it is a beta blocker. (antagonist)
What is propranolol? What is special about it?
it is a beta blocker. It is membrane stabilizing and highly lipid soluble, but not cardioselective
What is pindolol? What is special about it?
It is a non-specific beta blocker with high ISA and some lipid solubiilty. It is not cardioselective and slighlty membrane stabilizing
What is the mechanism of beta1 blocking drugs?
block b1 receptors to decrease HR, contractility, and cardiac output. Also reduce renin secretion
Why would a B blocker be preferred in the treatment of some HTN?
it is very effective if renin levels are high. It is also useful in patients with CHF, MI, or ischemic heart disease
What effect do B blockers have on heart rate in patients with CHF?
normally B blockers decrease HR, but in patients with CHF they increase HR. They reduce mortality and recurrence of MI.
What is bisoprolol? What is its mechanism and what receptors is it specific for?
long acting B1-selective blocker that significantly reduces HTN mortality. Can also be used to treat glaucoma as eyedrops
What is metoprolol? What is its mechanism and what receptors is it specific for?
B1-selective blocker. Cardioselective. Somewhat lipid soluble
What is propranolol? What is its mechanism and what receptors is it specific for?
Non-selective BB that produces resting bradycardia and hypotension. Useful antiarrhythmic. Has membrane stabilizing activity, produces bronchospasm, and is highly lipid soluble
What is pindolol? What is its mechanism and what receptors is it specific for?
non-selective BB with high ISA. High doses raise HR, BP, and bronchodilation. Memrane stabilizing. Lipid soluble. ISA.
What is esmolol? What is its mechanism and what receptors is it specific for?
very short half-life, selective BB. given during IV management to stabilize arrhythmias
What is timolol? What is its mechanism and what receptors is it specific for?
nonselective BB used as eyedrops for treatment of open angle glaucoma
What are the main adverse effects of BB?
cold extremities, bradycardia, bronchospasm, CNS side effects
What is labetalol? What is its mechanism and what receptors is it specific for?
nonselective B blocker and A1 antagonist. Given IV for hypertensive emergencies. 3rd generation. Good for treating pre-eclampsia
What is carvedilol? What is its mechanism and what receptors is it specific for?
nonselective BB and A1 antagonist. Lipid soluble. TPR, BP, HR, and contractility reduced but CO maintained. Antioxidant, prevents LDL oxidation. Useful for HTN and CHF
What is celiprolol? What is its mechanism and what receptors is it specific for?
selective B blocker, and B2 agonist. Directly vasodilates BV. used for HTN and angina
What is nebivolol? What is its mechanism and what receptors is it specific for?
highly selective B1 blocker, with NO-mediated vasodilation. devoid of ISA. Membrane stabilizing. Decreases BP, HR and TPR, but signficantly increases stroke volume to maintain CO. Drug of choice for HTN with metabolic syndrome
Which drug is useful for treating HTN in patients with DM?
captopril because it will help prevent diabetic neprhopathy
Which drug is a balanced vasodilator, reducing both preload and afterload?
nitroprusside
T or F: digoxin decrease vagal stimulation of the heart at therapeutic doses.
False.
