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Phar 505 > Classes of antihypertensives > Flashcards

Classes of antihypertensives Flashcards

1
Q

What class of drugs alters sodium and water balance

A

Diuretics

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2
Q

What class of drugs alters sympathetic function

A

CNS-acting sympathoplegic, adrenergic neuron blockers, adrenoreceptor antagonists

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3
Q

T/F: Calcium channel blockers cause vasoconstriction

A

False: Calcium channel blockers cause vasodilation

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4
Q

What two classes of drugs cause inhibition of angiotensin

A

ACE inhibitors and Angiotensin receptor blockers

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5
Q

What is the difference between natriuretic and diuretics

A

Diuretics increase urine volume while natriuretics increases renal Na excretion

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6
Q

What is the equation for Blood Pressure

A

BP= Cardiac Output x Peripheral Vascular Resistance

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7
Q

What is the equation for Cardiac Output

A

Co= Heart Rate x Stroke Volume

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8
Q

What aspect of blood pressure is initially reduced by diuretics, how

A

Cardiac output due to reduced volume

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9
Q

How do diuretics still lower blood pressure when cardiac output returns to normal, when does this take place

A

Na depletion leads to decreased peripheral vascular resistance, 6 to 8 weeks

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10
Q

What class of diuretics is used for hypertension

A

Thiazides, Potassium-sparing diuretics

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11
Q

T/F: Thiazide diuretics are the most prescribed class of diuretics and are effective in treatment of mild to moderate essential hypertension

A

True

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12
Q

T/F: Diuretic effect drastically increases with higher doses with a much higher diuretic effect and no effect on Na excretion

A

False: Lower doses produce similar antihypertensive action but there is more of a natriuretic effect at higher doses

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13
Q

Why thiazides are used in hypertension

A

Hydrochlorthiazide, chlorthalidone, indapamide, metolazone

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14
Q

T/F: Thiazides inhibit NaCL reabsorption in the DCT and enhance calcium reabsorption

A

True

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15
Q

What are adverse effects of thiazides

A

Hypokalemia, Hyperuricimeia (gout), Hyperglycemia in diabetic patients, hyperlipidemia

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16
Q

What are the potassium sparing diuretics

A

Spironolactone, Eplernone, Triamterne, Amiloride

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17
Q

What are the CNS-acting sympathoplegics

A

Methyldopa, clonidine

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18
Q

T/F: In the brain methyldopa has a net effect of decreasing sympathetic outflow but has no antihypertensive action peripherally

A

True

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19
Q

What is the MOA of clonidine

A

Direct agonist of alpha-2 adrenoceptors in medulla of the brain causing reduced BP, bradycardia and increased parasympathetic tones

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20
Q

Why is sudden withdrawal from CNS-acting sympathoplegics not recommended, how can this be avoided

A

severe hypertensive crisis due to rebound sympathetic activity, dose should be tapered to D/C

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21
Q

What is the adrenergic neuron blocker that blocks uptake of NE, dopamine and serotonin leading to inhibited NE release at effector blood sites causing vasodilation

A

Reserpine

22
Q

What is the MOA of alpha-1 adrenoreceptor antagonists

A

bind antagonistically to alpha-1 receptors at postganglionic sympathetic effect sites on blood vessels leading to vasodilation

23
Q

What are the alpha-1 adrenoceptor antagonists

A

Prazosin, Terazosin, Doxaszosin

24
Q

What are the non-selective Beta-blockers

A

Propanolol, naldolol, carteolol

25
Q

What are the selective Beta-blockers

A

metoprolol, atenolol, bisoprolol, betaxolol, esmolol (IV only)

26
Q

Which beta-blockers have mixed arendoreceptor activity but have greater agonist activity at beta-2 but are antagonists at beta-1

A

pindolol, acebutolol, penbutolol

27
Q

Which beta-blockers have mixed adrenoreceptor activity with selective beta activity and alpha antagonist activity

A

Lavetalol and Carvedilol

28
Q

What aspect of BP do beta-blockers effect, how

A

Decrease cardiac output, reduced peripheral vascular resistance

29
Q

T/F: Patients with angina should not receive beta-blockers

A

True

30
Q

What disease states are beta-blockers particularly useful in

A

Post myocardial infarction, high coronary risk , Heart failure

31
Q

What are adverse effects from using beta-blockers

A

bradycardia, decrease cardiac contractility and excitability, bronchoconstriction (non-selective beta-blockers)

32
Q

T/F: Symptoms of hypoglycemia may be masked by beta-blockers in diabetic patients

A

True

33
Q

T/F: Hydralazine is a vasodilator that vasodilates arterioles and veins and is usually used in monotherapy for severe hypertension

A

False: Hydralazine is a vasodilator that only vasodilates arterioles and is used in combination therapy for severe hypertension

34
Q

What is the MOA of minoxidil

A

Its metabolite opens potassium channels in smooth muscle membranes of arterioles leading to suppression of contraction

35
Q

What is the other use of minoxidil

A

Hair growth

36
Q

What are the parenteral vasodilators

A

Sodium nitroprusside, diazoxide, fenodopalm

37
Q

What is the general MOA of calcium channel antagonists when it comes to antihypertensive activity

A

inhibition of calcium influx into smooth muscle of arterioles thereby inhibiting contraction

38
Q

What do calcium channel blockers effect in the BP equation

A

reduced vascular resistance

39
Q

What are the two non-dihydropyridines calcium channel blockers

A

Verapamil and Diltiazem

40
Q

What are the dihydropyridines calcium channel blockers

A

Nifedipine, amlodipine, nicardipine, and felodipine

41
Q

T/F: Non-dihydropyridines have more potent vasodilator effect than dihydropyridines with verapmil having the greatest effect

A

True

42
Q

What are adverse effects of calcium channel blockers

A

Cardiac depression, dizziness, constipation, peripheral edema

43
Q

What was the prototype drug for ACEI, ARBs

A

captopril, losartan

44
Q

What causes stimulation of renin release from kidney cortex stimulation

A

decreased renal arterial pressure, sympathetic stimulation, increased Na concentration at renal distal tubule

45
Q

Why do ACEs have a slight advantage over ARBs in loweing blood pressure

A

While they both blunt angiotensin 2 activity, ACEIs also allow for Bradykinin buildup that leads to vasodilation

46
Q

What are the ACE inhibitors

A

enalapril, lisinopril, benazepril, fosinopril

47
Q

How do ACEIs effect the BP equation

A

Decrease peripheral vascular resistance

48
Q

What disease states have the most benefit from using ACEis

A

Post myocardial infacrcation, heart falure (with diuretics), chronic kidney disease, recent stroke, diabetes

49
Q

T/F: High dose aspirin and NSAIDS may diminish the hypotensive response of ACEI inhibiots while low ASA appears to pose no problem

A

True

50
Q

What disease states have the most benefit from using ARBs

A

Chronic Kidney Disease and Diabetes

Phar 505 (33 decks)

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