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Cardiac > BP Drugs > Flashcards

BP Drugs Flashcards

1
Q

What are the elements that determine blood pressure?

A

Heart Rate
Stroke Volume
Total Peripheral Resistance

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2
Q

How is Total Peripheral Resistance described?

A

Resistance of the muscular arteries to the blood being pumped through.

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3
Q

How is Stroke Volume described?

A

Amount of blood pumped out of the ventricle with each heartbeat

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4
Q

What stimulates secretion of renin by the juxtaglomerular cells?

A

Decreased perfusion pressure in the afferent arteriole.

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5
Q

What produces angiotensinogen?

A

The liver

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6
Q

What does renin react with to form angiotensin 1?

A

Angiotensinogen

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7
Q

Where does the activation of angiotensin I to angiotensin II occur?

A

In the pulmonary capillary bed.

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8
Q

Where are the angiotensin II receptors located?

A

In the arterioles

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9
Q

What is angiotensin II

A

A powerful vasoconstrictor

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10
Q

When angiotensin II becomes angiotensin III: what releases?

A

Aldosterone from the adrenal cortex

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11
Q

What cause aldosterone cause?

A

Increased sodium and water reabsorption by the tubules of the kidney.

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12
Q

When the tubules of the kidney begin to increasingly reabsorb sodium and water what happens to the blood volume?

A

It increases

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13
Q

Where in the brain is blood pressure controlled?

A

The vasomotor center

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14
Q

The vasomotor center in the communicates with what in order to control blood pressure?

A

The sympathetic ganglia

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15
Q

The sympathetic ganglia communicates with what to receptors to control the blood pressure?

A

Alpha receptors of vasculature

Beta 1 receptors of the heart

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16
Q

What are the 3 risks for coronary artery disease that are related to hypertension?

A
  • Thickening of the heart muscle
  • Increased pressure generated by the muscle on contraction
  • Increased workload on the heart
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17
Q

What are the 4 conditions that are related to untreated hypertension?

A
  • CAD and Cardiac Death
  • Stroke
  • Renal failure
  • Loss of Vision
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18
Q

What could be classified as normal blood pressure?

A

Systolic less than 120

Diastolic less than 80

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19
Q

What is classified as prehypertension?

A

Systolic from 120-139

Diastolic from 80-89

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20
Q

What is classified as stage 1 hypertension?

A

Systolic from 140-159

Diastolic from 90-99

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21
Q

What is classified as stage 2 hypertension?

A

Systolic greater than or equal to 160

Diastolic greater than or equal to 100

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22
Q

What is the first step in the care approach for treating hypertension?

A

Lifestyle modifications are instituted

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23
Q

What is the second step in the care approach for treating hypertension?

A

If the measures in step 1 are not sufficient then drug therapy is added

24
Q

What is the third step in the care approach for treating hypertension?

A

If the patient’s response is inadequate, drug dose or class may be changed or another drug is added

25
Q

What is the fourth step in the care approach for treating hypertension?

A

Includes all of the above measures with the addition of more antihypertensive agents until blood pressure is controlled.

26
Q

What are the five classes of drugs that are used to treat hypertension?

A 
Diuretics
ACE inhibitors
Beta Blockers
Calcium Channel Blockers
Vasodilators
27
Q

What do diuretics do?

A

The decrease serum sodium levels and blood volume

28
Q

What do ACE inhibitors do?

A

Blocks the conversion of angiotensin I to angiotensin II
An angiotensin II receptor blocker
Blocking effects of angiotensin on blood vessels

29
Q

What do Beta-blockers do?

A

The lead to a decrease in heart rate and strength of contraction as well as vasodilation

30
Q

What do Calcium Channel Blockers do?

A

Relaxes muscle contration or other autonomic blockers

31
Q

What do vasodilators do?

A

They act directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation, and drop in blood pressure

32
Q

What are the indications that a patient needs to be placed on an ACE inhibitor?

A
  • Hypertension
  • Congestive Heart Failure
  • Diabetic nephropathy
  • Left ventricular dysfunction following an MI
33
Q

What are the contraindications for the use of ACE inhibitors?

A

Impaired renal function

Pregnancy and lactation

34
Q

What do you need to use caution with when using ACE inhibitors?

A

Congestive Heart Failure

35
Q

What drug can interact with ACE inhibitors?

A

Allopurinol

36
Q

What are the adverse effects for ACE inhibitors?

A
  • Related to the effects of vasodilation and alterations in blood flow
  • GI irritation
  • Renal insufficiency
  • Cough
37
Q

What is the prototype for ACE inhibitors?

A

Captopril

38
Q

What is the route, onset, and peak of Captopril?

A
  • Oral
  • 15 mins
  • 30-90 minutes
39
Q

What do ACE inhibitors increase?

A

Increased:
Cardiac Output
Cardiac Rate
Cardiac Contractility

40
Q

What are the contraindications for angiotensin II receptor blockers?

A
  • Allergies
  • Pregnancy
  • Lactation
41
Q

What is the caution that has to be used with angiotensin II receptor blockers?

A
  • Hepatic or renal dysfunction

- Hypovolemia

42
Q

What are the adverse effects when using angiotensin II receptor blockers?

A
  • Headache
  • Dizziness
  • Syncope
  • Weakness
  • GI complaints
  • Rash/dry skin
43
Q

What drug interacts with angiotensin II receptor blockers?

A

Phenobarbital

44
Q

What is the prototype for angiotensin II receptor blockers?

A

Losartan

45
Q

What is the route, peak, and duration of Losartan?

A
  • Oral
  • 1 to 3 hours
  • 24 hours
46
Q

What do renin inhibitors do?

A

They directly inhibit renin, leading to decreased plasma renin activity and inhibiting the conversion of angiotensinogen to angiotensin I

47
Q

What is the drug that belongs in the renin inhibitor class?

A

Aliskiren

48
Q

What are the contraindications for calcium channel blockers?

A

Heart block
Sick sinus syndrome
Renal or hepatic dysfunction
Pregnancy and lactation

49
Q

What are the adverse effects for calcium channel blockers?

A

Related to effects on cardiac output
GI symptoms
Cardiovascular symptoms

50
Q

What drug interacts with Calcium Channel blockers?

A

Cyclosporine

51
Q

What is the prototype drug for Calcium Channel Blockers?

A

Diltiazem

52
Q

What is the route, onset, peak, and duration for Diltiazem?

A
  • Oral & extended release
  • 30-60 minutes
  • 6 -11 hours
  • 12 hours
53
Q

What becomes decreased due to Calcium Channel Blockers?

A

Decreased:

  • Contractility
  • Conductivity of the heart
  • Demand for oxygen
54
Q

What should you not eat when taking Calcium Channel Blockers?

A

Grapefruit

55
Q

What is the prototype for vasodilators?

A

Nitroprusside

56
Q

What is the indication for Nitroprusside?

A

Severe hypertension

57
Q

What is the route, onset, peak, and duration for Nitroprusside?

A
  • IV
  • 1 - 2 minutes
  • Rapid
  • 1 - 10 minutes

Cardiac (13 decks)

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