drugs for hypertension Flashcards
what is associated with the risk of hypertenion
obesity, and diabetes
is there a known cause for primary essentail hypertension
no none cause
what is associated with primary hypertension
genetic predispostition, dietary salts, adrenergic tone
causes of secondary hypertension
pheochromocytoma, adrenal cortical tumors, drugs
pheochromocytoma, adrenal cortical tumors, drugs
secondary hypertension
what makes secondary hypersion worse
sympathetic input
what is high blood pressure a significant risk factor for
cerebrovascular disease, coronary artery disease. congestive heart failure, cardiac death, renal failure, PVD. dementia
cerebrovascular disease, coronary artery disease. congestive heart failure, cardiac death, renal failure, PVD. dementia are risk factors of wha
high blood pressure
whats the effcet of the heart consistantly working harder to expell blood against a greater force
the thickening of the left ventricle
what does increased force affect
they damage the arteries making someone more susceptible to atherosclerosis
what happens wen tiny blood vessels are damaged
leads to losses in vision, kidney function, and cerebral function
what leads to losses in vision, kidney function, and cerebral function
damaged tiny vessels
what are some factors that control blood pressure
blood volume, peripheral resistance, diameterof arteriole, HR, CO
what is considered high bp to be at for normal people
135/85
what is considered to be hypertension to be at for ppl with diabetes
130/80
if blood pressure remains equal to, or above 140/80mmhg wuht lifestyle modifactions what is recommended
pharmacotherapy
should you give diabetes pt medication for hypertension
yes
what is idenified as a high risk pt - bp
if their blood pressure is equal to or above 130/80 mmhg
what is a low risk patient
if there are no organ damage and CV risk factors
thiazide and thiazide like diuretics
reduce the storke volume by blocking the sodium chloride trsnsporter in the distal tubule faicltaing the urinary excretion of electrolytes, thereby reducing blood volume
reduce the stroke volume by blocking the sodium chloride transporter in the distal tubule facilitating the urinary excretion of electrolytes, thereby reducing blood volume
thiazide and thiazide-like diuretics
what is the first line therpay for hypertension
thiazide and thiazide-like diuretics
when should thiazide and thiazide like diuretics be contraindicted?
pregannacy
why must you administer thiazide and thiazide like diuretics during the day
to prevent nocturia
adverse effects of thiazide and thiazide like diuretics
gi upset, orthostatic hypertension, hyperglycemia, fluid and electrolyte imbalance
gi upset, orthostatic hypertension, hyperglycemia, fluid and electrolyte imbalance are adverse effects of wha
thiazide and thiazide like diuretics
what drug drug interactions should you look out for with patients taking thiazide and thiazide like diuretics
lithium, NSAIDS, antidiabetic drugs
lithium, NSAIDS and antidiabetic drugs should be stopped when taking what
thiazide and thiazide like diuretics
what should you monitor when a patient is taking thiazide and thiazide-like diuretics
fluid output, weight gain/loss, dizzness and lightheaded ness
fluid output, weight gain/loss, dizzness and lightheaded ness are symptoms of too much of what
thiazide and thiazide like diuretics
renin-angiotesin-aldosterone system
reduced total peripheral resistance
what is released in response to decreased blood pressure
renin
renin
released in response to decreased bp
how does angiotesin ii work - what is its effect in blood pressure, how does it do this, and what does it stimulate the secretion of
elevates blood pressure by increasing peripheral resistance, and stimulating the secretion of aldosterone and ADH
elevates blood pressure by increasing peripheral resistance, and stimulating the secretion of aldosterone and ADH
angiotesin II
what does pharmacological inhibition of RAAS do
it decreases the tpr, and blood volume, reducing BP
ACE inhibitors
block the conversion of angiotesin I to angiotesin II –> decreasing tpr and BV
what decreases TPR and BV through inhibition of the conversion of angiotesin i to ii
ace inhibitors
when are ace inhibitors contraindicated
pregnancy
what inhibits aldosterone secretion
ace inhibitors
what is the first dose phenomena associated with ACE inhibitors
sudden drop in blood pressire and tachycardia
when are angiotesin II receptor blockers used?
they are used when people develop the adverse effect of a cough
how to angiotesin II receptor blockers work
they block angiotesin II receptors in arteriolar smooth muscle and in adrenal cortex - inhibtiing the release of aldosterone
calcium channel blockers
block the calcium ion channels, relaxing smooth muscle, decreasing peripheral resistance
block the calcium ion channels, relaxing smooth muscle, decreasing peripheral resistance
calcium channel blockers
when should you use calcium channel blockers with caution
in those with liver and kidney impairment
adverse effects of calcium channel blockers
dizziness, lightheadedness, fatigue, flushing, nausea
alpha and beta adrenergic antagonists - blokc the action of what on the arterioles, what do they reduce, and what do they decrease
block adrenergic effect on arterioles, block action of NE and E on cardiac muscle reducing speed and force of contraction, decreasing renin secretion by kidneys
what block adrenergic effect on arterioles, block action of NE and E on cardiac muscle reducing speed and force of contraction, decreasing renin secretion by kidneys
alpha and beta adrenergic antagonists
beta adrenergic antagonists should be contriadicted in people with
diabetes, depression, asthma, or COPD
when are beta blockers most effective in what patients
in patients under the age of 60
