CV I Flashcards
Exam I
What is the goal of HTN tx?
reduce mortality & morbidity
<120/80
Healthy BP
> /= 160/100
Stage II HTN
> /= 180/120
HTN crisis
ways to reduce cardiac output
decrease HR, contraction, venous return
How to reduce PVR?
vasodilation via direct, central, and ganglionic action
How does angiotensin II work?
direct vasconstriction, increased sympathetic tone, causes release of aldosterone
How does aldosterone work?
alters renal fx, alters cardiac structure
What are the 4 components of the R-A-A targets for HTN tx?
inhibit renin, block ACE, block A2 receptors, block aldosterone
HTN drug groups
diuretics, sympathetic drugs, vasodilators, R-A-A blockers
these drug names end in -sin
alpha blocker
these drug names end in -pine
calcium channel blocker
What is are adverse side effects of thiazide diuretics
hypokalemia, hyperglycemia, ED, hyperuricemia, increased lipids, rash
What diuretic do you not give renal failure pt for HTN?
thiazide
What are the adverse side effects of furosemide?
hypokalemia, ototoxicity, hyperuricemia, hypomagnesemia
What are the two classes of potassium sparing diuretics?
luminal membrane agents, mineralocorticoid antagonists
Luminal Agent toxicities include (4)
Hyperkalemia, increased urinary calcium stones, GI upset, don’t use in renal failure
What meds do you not combine luminal agents with?
ACE inhibitors, NSAIDS
mineralcortacoid receptor antagonist
blocks effects of aldosterone
What are the adverse effects of mineralcortacoid receptor antagonists?
Anti-androgenic effects, hyperkalemia
What are the 4 types of beta blockers?
non-selective, selective, combined beta and alpha 1, blocker/partial agonist
Which beta receptors are metoprolol and atenolol more specific to?
B1>B2
What receptors are present in carvedilol and Labetalol?
beta 1&2, alpha 1
ISA beta blockers have less issues with ___ and ___.
bradycardia and metabolic effects
When do you use ISA beta blockers?
diabetics or pt with slow HR
Strongly selective beta blockers work to cause ____ by _______.
vasodilation by increasing nitric oxide
What node does beta blockers effect?
AV node
What needs to be avoided in beta blocker therapy?
abrupt cessation
What kinds of pts should/must be on beta blockers?
CHF or recent MI
alpha adrenergic blocking agents do what?
decrease vessel resistance, relax bladder
reflex tachy, postural syncope when taking alpha blocker is called ____.
1st dose phenomenon
What are the four classes of centrally acting agents?
Clonidine, Methyldopa, ganglionic blockers, postganglionic blockers
Centrally acting symp agent, Clonidine, helps with what?
used in renal disease and is effective against vasomotor flushes
What drug is considered to be a vasodilator?
calcium channel blocker
T/F, for the most part, diuretics needed with calcium channel blockers
FALSE
Calcium chaneel blockers are especially useful in these patients (3)?
diabetes, asthma, angina
What is the side effect of Ca Channel blockers that is complained about the most?
constipation
Additive to beta blockers utilized for HTN management in pregnancy, may cause lupus like syndrome
Hydralazine
adjunct to diuretic and beta blockers in severe HTN
minoxidil
Renin inhibitor with renoprotective effects when combined with an ARB
Aliskiren
What are the dose dependent adverse side effects of ACEIs?
hyperkalemia, cough, angioedema, teratogenic
What two adverse effects are less in ARBs versus ACEIs?
cough and angioedema are less prevelant
What are the primary single drug choices for HTN?
diuretic, ACE, ARB, calcium channel blocker
multi-drug HTN strategy
ACEI or ARB + diuretic (+ vasodilator)
Diabetes get these HTN drugs
ACE/ARB/Ca Chan B
ACEI, Beta blockers are used in which pt disease group?
Coronary Heart disease
HTN therapy for renal disease
ACEI, Ca Chan Block, renin inhibitor, ARB
BPH medication for HTN
alpha blocker
Medical tx of HTN emergency
Vasodilators, alpha and betas, dopamine agonist