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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
What is the fourth step in the care approach for treating hypertension?
Includes all of the above measures with the addition of more antihypertensive agents until blood pressure is controlled.
26
What are the five classes of drugs that are used to treat hypertension?
``` Diuretics ACE inhibitors Beta Blockers Calcium Channel Blockers Vasodilators ```
27
What do diuretics do?
The decrease serum sodium levels and blood volume
28
What do ACE inhibitors do?
Blocks the conversion of angiotensin I to angiotensin II An angiotensin II receptor blocker Blocking effects of angiotensin on blood vessels
29
What do Beta-blockers do?
The lead to a decrease in heart rate and strength of contraction as well as vasodilation
30
What do Calcium Channel Blockers do?
Relaxes muscle contration or other autonomic blockers
31
What do vasodilators do?
They act directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation, and drop in blood pressure
32
What are the indications that a patient needs to be placed on an ACE inhibitor?
- Hypertension - Congestive Heart Failure - Diabetic nephropathy - Left ventricular dysfunction following an MI
33
What are the contraindications for the use of ACE inhibitors?
Impaired renal function | Pregnancy and lactation
34
What do you need to use caution with when using ACE inhibitors?
Congestive Heart Failure
35
What drug can interact with ACE inhibitors?
Allopurinol
36
What are the adverse effects for ACE inhibitors?
- Related to the effects of vasodilation and alterations in blood flow - GI irritation - Renal insufficiency - Cough
37
What is the prototype for ACE inhibitors?
Captopril
38
What is the route, onset, and peak of Captopril?
- Oral - 15 mins - 30-90 minutes
39
What do ACE inhibitors increase?
Increased: Cardiac Output Cardiac Rate Cardiac Contractility
40
What are the contraindications for angiotensin II receptor blockers?
- Allergies - Pregnancy - Lactation
41
What is the caution that has to be used with angiotensin II receptor blockers?
- Hepatic or renal dysfunction | - Hypovolemia
42
What are the adverse effects when using angiotensin II receptor blockers?
- Headache - Dizziness - Syncope - Weakness - GI complaints - Rash/dry skin
43
What drug interacts with angiotensin II receptor blockers?
Phenobarbital
44
What is the prototype for angiotensin II receptor blockers?
Losartan
45
What is the route, peak, and duration of Losartan?
- Oral - 1 to 3 hours - 24 hours
46
What do renin inhibitors do?
They directly inhibit renin, leading to decreased plasma renin activity and inhibiting the conversion of angiotensinogen to angiotensin I
47
What is the drug that belongs in the renin inhibitor class?
Aliskiren
48
What are the contraindications for calcium channel blockers?
Heart block Sick sinus syndrome Renal or hepatic dysfunction Pregnancy and lactation
49
What are the adverse effects for calcium channel blockers?
Related to effects on cardiac output GI symptoms Cardiovascular symptoms
50
What drug interacts with Calcium Channel blockers?
Cyclosporine
51
What is the prototype drug for Calcium Channel Blockers?
Diltiazem
52
What is the route, onset, peak, and duration for Diltiazem?
- Oral & extended release - 30-60 minutes - 6 -11 hours - 12 hours
53
What becomes decreased due to Calcium Channel Blockers?
Decreased: - Contractility - Conductivity of the heart - Demand for oxygen
54
What should you not eat when taking Calcium Channel Blockers?
Grapefruit
55
What is the prototype for vasodilators?
Nitroprusside
56
What is the indication for Nitroprusside?
Severe hypertension
57
What is the route, onset, peak, and duration for Nitroprusside?
- IV - 1 - 2 minutes - Rapid - 1 - 10 minutes

Cardiac (13 decks)

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