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Pharmacology > BP Lowering Medication > Flashcards

BP Lowering Medication Flashcards

1
Q

Adverse effects for DHP CCBs:

A

Flushing, headache, excessive hypotension, peripheral edema, and reflex tachycardia

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2
Q

MOA of direct renin inhibitor:

A

Inhibiting the activity of renin (vasodilation) which is responsible for stimulating angiotensin II formation

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3
Q

MOA of loop diuretics:

A

Inhibit Na-K-Chloride cotransporter in thick ascending limb leading to diuresis and natriuresis

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4
Q

Contraindications for NON-DHP CCBs:

A

Preexistent bradycardia, heart conduction defects, heart failure caused by systolic dysfunction

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5
Q

Common clinical uses of ACE inhibitors:

A

Heart failure
CAD
HTN
Chronic renal disease with proteinuria

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6
Q

Common clinical uses for BB:

A

Heart failure
CAD
Tachyarrhythmias
HTN

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7
Q

Common clinical uses for aldosterone antagonists:

A

Heart failure
CAD
HTN
Hyperaldosteronism

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8
Q

Adverse effects of alpha-1 blockers:

A 
Headache and dizziness 
Orthostatic hypotension
Nasal congestion 
Reflex tachycardia 
Fluid retention
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9
Q

Minoxidil adverse effect:

A

Hypertrichosis (extensive hair growth) and pericardial effusion (boxed warning)

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10
Q

MOA of nitrates:

A

Dilate both arteries and veins through venous dilation predominates when drugs are given at normal therapeutic doses

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11
Q

3 subclasses of beta-blockers:

A
  1. Nonselective BB
  2. Beta-1 BB
  3. Vasodilating BB
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12
Q

MOA of direct vasodilators:

A

Directly relaxing arteriolar SM (reduce SVR)

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13
Q

Which alpha-1 blockers are used in HTN emergencies caused by pheochromocytoma:

A

Phentolamine and phenoxybenzamine

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14
Q

MOA of ARBs:

A

Blocky type 1 angiotensin II (AT1) receptors on blood vessels and other tissues (heart) preventing angiotensin II induced vasoconstriction

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15
Q

Vasodilating BB have what vasodilating properties?

A

Alpha-1 with beta inhibition

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16
Q

4 classes of vasodilators:

A
  1. Non-dihydropyridine calcium channel blockers
  2. Dihydropyridine calcium channel blockers
  3. Direct vasodilators
  4. Nitrates
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17
Q

MOA of thiazide diuretics:

A

Inhibit Na-Chloride transporter in distal tubule of nephron increasing excretion of Na and water

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18
Q

Common clinical uses for thiazide diuretics:

A

HTN
Edema
Calcium nephrolithiasis (kidney stones)

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19
Q

Common clinical uses of central alpha-2 agonists:

A

HTN (NOT 1st line)

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20
Q

Hydralazine adverse effect:

A

Lupus-like syndrome

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21
Q

Adverse effects from BB:

A 
1 Exaggeration of cardiac therapeutic actions 
2 Smooth muscle spasm 
3 CNS penetration 
4 Worsened quality of life 
5 Adverse metabolic side effects 
6 Withdrawal phenomenon
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22
Q

IV vasodilator stimulates DI-like dopamine receptors:

A

Fenoldapam

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23
Q

MOA of central alpha-2 agonists:

A

Binding to and activating alpha-2 adrenoceptors:

  • reduces sympathetic outflow to heart (decrease CO, HR and contractility)
  • reduces sympathetic output to vasculature (decrease SVR)
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24
Q

2 classes of diuretics:

A
  1. Loop diuretics

2. Thiazide diuretics

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25
Q

Adverse effects of neprilysin inhibitor plus ARB:

A

Hyperkalemia
Angioedema
Renal function deterioration
Hypotension

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26
Q

Adverse effects of NON-DHP CCBs:

A

Flushing, headache, peripheral edema, excessive hypotension, excessive bradycardia, impaired electrical conduction, and depressed contractility

27
Q

Common clinical uses of nitrates:

A

HTN
Heart failure
Angina
MI

28
Q

MOA of aldosterone antagonists:

A

Block the aldosterone receptor in renal collecting tubule which increases sodium and water excretion while conserving K+ and hydrogen ions

29
Q

Adverse effects of thiazide diuretics:

A

Hypovolemia
Electrolyte disturbance (hypokalemia, hyponatremia, hypochloremia, hypomagnesemia)
Hypercalcemia, hyperuricemia
Alkalosis

30
Q

MOA beta-1:

A

Inhibit receptors and cause decrease HR, CO, renin release, and BP

31
Q

Aldosterone antagonists adverse effect risk of hyperkalemia:

A

Increased with declining renal function and with the concurrent use of ARBs and ACE inhibitors

32
Q

Adverse effects for direct renin inhibitor:

A

Diarrhea
Hyperkalemia
Angioedema

33
Q

Where are beta-2 receptors found?

A

Lung and vasculature

34
Q

Common clinical uses for loop diuretics:

A

Edema
Hyperkalemia
HTN

35
Q

Common clinical uses for neprilysin inhibitor plus ARB:

A

Heart failure

36
Q

MOA of neprilysin inhibitor plus ARB:

A

Inhibition of neprilysin increases the concentration of bradykinin which leads to vasodilation and natriuresis

37
Q

Contraindication for ARBs:

A

Pregnancy

Bilateral renal artery stenosis

38
Q

Adverse effects of nitrates:

A

Headache
Postural hypotension and reflex tachycardia
Lose efficacy with sustained use (tolerance)
Risk of thiocyanante toxicity
Interact with phosphodiesterase inhibitors to treat erectile dysfunction

39
Q

Common clinical uses for direct renin inhibitor:

A

HTN

40
Q

Common clinical uses for DHP CCBs:

A

HTN

Angina

41
Q

Adverse effects of only ACE inhibitors:

A

Dry cough

42
Q

Adverse effects of central alpha-2 agonists:

A
  • Sedation, dry mouth and nasal mucosa, bradycardia, orthostatic hypotension, impotence
  • Constipation, nausea and GI upset
  • Rebound HTN if stopped suddenly bc excessive sympathetic activity
43
Q

MOA of NON-DHP Ca channel blockers:

A

CCBs bind to L-type calcium channels located on vascular SM, cardiac myocytes, and cardiac nodal tissue

44
Q

Adverse effects of loop diuretics:

A

Na/volume depletion
Hypokalemia, hypocalcemia, hypomagnesemia, alkalosis
Ototoxicity
Hyperuricemia with chronic therapy

45
Q

5 different classes of renin angiotensin aldosterone system antagonists

A
  1. ACE inhibitors (angiotensin-converting enzyme)
  2. ARBs (angiotensin-II receptor blockers)
  3. Neprilysin inhibitors Plus angiotensin-II receptor blocker
  4. Aldosterone antagonists
  5. Direct renin inhibitor
46
Q

Adverse effects of direct vasodilators:

A

Headaches, flushing
Baroreceptor-mediated reflex tachycardia
Salt and water retention (edema)

47
Q

Common clinical uses for ARBs:

A

Heart failure
CAD
HTN
Chronic renal disease with proteinuria

48
Q

What can concomitant use or use within 36hrs of ACE inhibitors cause adverse effect?

A

Increase risk of angioedema and is contraindicated

49
Q

Contraindication for ACE inhibitors:

A

Pregnancy

Bilateral renal artery stenosis

50
Q

MOA of ACE inhibitors:

A

Reduces the synthesis of angiotensin II and prevents bradykinin breakdown
-bradykinin»angiotensin II = vasodilation (reduction in PVR and BP)

51
Q

Common clinical uses for NON-DHP CCBs:

A

HTN
Tachyarrhythmias
Angina

52
Q

Where is beta-1 receptors found?

A

Heart and kidney

53
Q

Common clinical uses of alpha-1 blockers:

A

HTN

Benign prostatic hypertrophy

54
Q

MOA of alpha-1 blockers:

A

Block binding of Epi and NE to alpha-1 adrenoceptors located on the vascular SM causing vasodilation

55
Q

3 classes of sympatholytics:

A
  1. Alpha-1 blockers
  2. Beta-blockers
  3. Central alpha-2 agonists
56
Q

Adverse effects of aldosterone antagonists:

A

Hyperkalemia
Renal function deterioration
Gynecomastia

57
Q

MOA of beta-2:

A

Inhibition of receptors cause bronchospasm and vasoconstriction

58
Q

Common clinical uses for direct vasodilators:

A

HTN (resistant HTN and emergency)

Heart failure

59
Q

Adverse effects of ACE inhibitors:

A

Hyperkalemia
Acute renal failure
Angioedema

60
Q

Contraindication for neprilysin inhibitor plus ARB:

A

Pregnancy

Bilateral renal artery stenosis

61
Q

Contraindication for direct renin inhibitor:

A

Pregnancy

62
Q

MOA of DHP CCBs:

A

Prevent flow of calcium through L-type calcium channels located on vascular SM (reduce SVR and BP)

63
Q

Adverse effects of ARBs:

A

Hyperkalemia

Acute renal failure

Pharmacology (14 decks)

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