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Advanced Pharmacology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What are the JNC 8 Blood pressure goal for persons > 60 years?

A
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2
Q

What are the JNC 8 Blood pressure goal for persons > 60 years?

A
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3
Q

What are the JNC 8 Blood pressure goal for persons

A

The goal blood pressure for all others including African Americans or patients with diabetics or chronic kidney disease is

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4
Q

What should initial therapy for non-african american patients with HTN?

A

Initial therapy should be a thiazide-type diuretic, an ACEI, or a CCB

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5
Q

What should be the initial BP therapy for patients with CKD?

A

patients with chronic kidney disease, treatment should include an ACEI or angiotensin receptor blocker (ARB) to improve kidney outcomes regardless of race or diabetes status

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6
Q

What should be the initial BP therapy for patients with CKD?

A

patients with chronic kidney disease, treatment should include an ACEI or angiotensin receptor blocker (ARB) to improve kidney outcomes regardless of race or diabetes status

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7
Q

Hydrochlorothiazide

A

“Moderate Diuretic”
treatment of primary HTN
treatment of edema

HTN 12.5-25mg
diuresis 25-200mg
antihypertensive effect plateaus at 25mg

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8
Q

What effect does NSAIDS have on HTN medication?

A

increases BP in patients receiving BB, diuretics, and angiotensin blockers

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9
Q

Hydrochlorothiazide side effects

A 
hypokalemia
hyponatremia
hyperuricemia
increase calcium reabsorption
hyperglycemia
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10
Q

What should be the initial BP therapy for patients with CKD?

A

patients with chronic kidney disease, treatment should include an ACEI or angiotensin receptor blocker (ARB) to improve kidney outcomes regardless of race or diabetes status

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11
Q

Furosemide

A

management of chronic edema
treatment of HTN
20-80mg

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12
Q

Hydrochlorothiazide

A

“Moderate Diuretic”
initial dosing 12.5-25 target 25-50
antihypertensive effect plateaus at 25

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13
Q

Furosemide interactions

A 
Hypotensive drugs
Anti-inflammatory drugs
Anticoagulants
Lithium
Ototoxic & nephrotoxic drugs (Aminoglycosides) 
Administration of ACE inhibitors 
Digoxin
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14
Q

Hydrochlorothiazide side effects

A

potassium loss
hyperuricemia
increase calcium reabsorption

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15
Q

Hydrochlorothiazide interactions

A 
hypotensive agents
lithium
uricosuric agents
digoxin
NSAIDs
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16
Q

Side effects of potassium sparing diuretics

A

Hyperkalemia
impotence, gynecomastia, and decreased libido in 50% of males and menstrual abnormalities in females
cause GI upset

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17
Q

Furosemide side effects

A 
volume depletion
hyponatremia
hypochloremia
dehydration
hypotension
shock
ototoxic
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18
Q

Furosemide interactions

A 
Hypotensive drugs
Anti-inflammatory drugs
Anticoagulants
Lithium
Ototoxic & nephrotoxic drugs (Aminoglycosides) 
Administration of ACE inhibitors 
Digoxin
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19
Q

Triamterene

A

directly inhibit basal Na+/K+ exchange mechanism in distal and collecting tubules, independent of aldosterone, to inhibit access of sodium to the transport site
used alone in treatment of hypertension or for relieving edema
treatment of hypokalemia or mineralocorticoid excess.

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20
Q

Spironolactone

A

competitively blocks the effect of aldosterone on kidney tubules
used alone in treatment of hypertension or for relieving edema
treatment of hypokalemia or mineralocorticoid excess.
treatment of hyperaldosteronism

21
Q

Side effects of potassium sparing diuretics

A

Hyperkalemia
impotence, gynecomastia, and decreased libido in 50% of males and menstrual abnormalities in females
cause GI upset

22
Q

How much potassium is needed to prevent hypokalemia?

A

20mEq

23
Q

How much potassium is needed to restore normal potassium levels?

A

40-80mEq

24
Q

What effects do ACE and ARBs have on potassium?

A

increase serum potassium levels

25
Q

Methyldopa

A

lower arterial pressure by the stimulation of central inhibitory α2-adrenergic receptors
drug of choice in treating hypertension in pregnant wome

26
Q

Clonidine

A

lower arterial pressure by the stimulation of central inhibitory α2-adrenergic receptors

27
Q

Labetalol

A

nonselective beta-blockers that also block alpha-receptors
does not affect serum lipids
indicated for the treatment of hypertension and CHF

28
Q

Carvedilol

A

nonselective beta-blockers that also block alpha-receptors

29
Q

What happens if Methyldopa or Clonidine is discontinued abruptly?

A

is rebound hypertension that may occur if the drug is suddenly discontinued

30
Q

propranolol

A

nonselective

31
Q

metoprolol

A

cardioselective

32
Q

Labetalol

A

nonselective beta-blockers that also block alpha-receptors

33
Q

carvedilol

A

nonselective beta-blockers that also block alpha-receptors

34
Q

What is the “first does effect” in alpha 1 blockers?

A

marked hypotension and syncope with first few doses or with rapid increase in dose
give at bedtime to reduce effect

35
Q

What are side effects of beta blockers?

A

Nonselective agents may cause bronchoconstriction.
Other adverse effects include slow heart rate, fatigue, sleep disturbances, and male sexual dysfunction
Decreased cardiac output may lead to reduction in exercise tolerance.
Contraindicated in sinus bradycardia.

36
Q

Prazosin

A

Alpha1 Adrenergic Blocker

Treatment of hypertension

37
Q

Terazosin

A

Alpha1 Adrenergic Blocker

Treatment of hypertension and symptoms associated with benign prostatic hyperplasia

38
Q

Doxazosin

A

Alpha1 Adrenergic Blocker

Treatment of hypertension and symptoms associated with benign prostatic hyperplasia

39
Q

What is 5-alpha-reductase is an enzyme?

A

5-alpha-reductase is an enzyme that converts testosterone to dihydrotestosterone in the prostate gland. DHT increases growth of prostate epithelial tissue.

40
Q

Do alpha 1 antagonists shrink the prostate?

A

no

41
Q

Phentolamine [Regitine]

A

blocks both presynaptic (α2) and postsynaptic (α1) adrenergic receptors
Prevention or control of hypertensive episodes that occur in patients with pheochromocytoma (given IV by controlled infusion) and for prevention and treatment of dermal necrosis and sloughing following extravasation of intravenous norepinephrine or dopamine

42
Q

Do 5-alpha-reductatase inhibitors shrink the prostate?

A

yes

43
Q

Finasteride

A

is a specific inhibitor of 5-alpha-reductase
treatment of benign prostatic hypertrophy and male pattern hair loss
Pregnancy Category X
(tablets should not be handled by a woman who is pregnant or may become pregnant and men should not donate blood for 6 months after stopping the drug to avoid transmission to a pregnant woman.)

44
Q

What is 5-alpha-reductase is an enzyme?

A

5-alpha-reductase is an enzyme that converts testosterone to dihydrotestosterone in the prostate gland. DHT increases growth of prostate epithelial tissue.

45
Q

Dutasteride [Avodart]

A

2nd generation 5α-reductase (both type 1 and type 2) inhibitor for treatment of BPH
extensively metabolized by CYP3A4 but has a terminal half-life of 5 weeks

46
Q

Phentolamine [Regitine]

A

blocks both presynaptic (α2) and postsynaptic (α1) adrenergic receptors
Prevention or control of hypertensive episodes that occur in patients with pheochromocytoma (given IV by controlled infusion) and for prevention and treatment of dermal necrosis and sloughing following extravasation of intravenous norepinephrine or dopamine

47
Q

Hydralazine [Apresoline]

A

Vasodilator
mechanism is not clear
homeostatic mechanism including an increase in renin secretion, increased cardiac rate and output, and salt and water retention

48
Q

What are Hydralazine [Apresoline] indications?

A

Indications: Hydralazine is indicated for the treatment of primary hypertension (usually considered a 3rd step drug because of reflex tachycardia & salt & water retention.)
indicated to produce afterload reduction in patients with CHF

Advanced Pharmacology (4 decks)

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