BP meds

Question 1

BP intro

Answer 1

surrogate marker for CV risk
can be primary or secondary HTN
norm BP <120/80

Question 2

MAP =

Answer 2

CO x TPR

Question 3

hormonal factors in HTN

Answer 3

renin, angiotensin, aldosterone, bradykinin (RAAS)

Question 4

pre HTN guidelines

Answer 4

<120-139/80-89

Question 5

stage I HTN guidelines

Answer 5

<140-159/90-99

Question 6

stage II HTN guidelines

Answer 6

> 160/>100

Question 7

when to begin pharm therapy for BP

Answer 7

SBP >130 or DBP >80
130 is new 140
results in many more individuals requiring therapy

Question 8

Thiazides

Answer 8

hypotensive effect > half-life (extra renal factors involved?)

Question 9

ACEI-Is

Answer 9

block RAAS-mediated conversion of angiotensin I to angiotensin II
first line in compelling indications (CKD, LV dysfunction, DM)!!!
all but captopril can be dosed once daily

Question 10

ARBs

Answer 10

do not block bradykinin mech so little bradykinin-induced cough
beneficial effects of bradykinin not present with ARBs (myocardial remodeling and regression of myocyte hypertrophy/fibrosis)

Question 11

CCB

Answer 11

dihydropyridines - vasodilators

non-dihydropyridines - rate controllers

Question 12

combo therapy

Answer 12

strongly encouraged for pt’s with stage II HTN

usually provides better BP control with fewer SE’s

Question 13

BB med pneumonic

Answer 13

“All Americans Eat Better Meat”

Question 14

BB’s

Answer 14

cardioselective (B1>B2)

noncardioselective (B1=B2, can be beneficial in asthmatics)

Question 15

Nitroprusside

Answer 15

metabolized to cyanide
accelerates enz depredation of cyanide to thiocyanide (much less toxic)
add Na thiosulfate to IVPB (starting 2nd bag)

Question 16

Dobutamine

Answer 16

mainly B1 activity-little B2 or a activity
inc CO with little vasoconstriction
an isotrope with vasodilation properties

Question 17

Phenylepherine

Answer 17

potent a-agonist with weak B-agonist activity

vasoconstrictive in arterioles and nasal mucosa

Question 18

Vasopressin

Answer 18

inc water perm of renal tubules
inc water resorption from tubular lumen
results in dec urine vol and inc osmolality

Question 19

dopamine

Answer 19

low dose is no longer renal dose (its mainly DA effects)
intermediate dose (DA + B effects)
high dose (mainly a effects)