Drugs for Hypertension: Part 2

Question 1

What is the most common drug that we start hypertensive patients on?

Answer 1

Thiazide diuretics

Question 2

Hydrochlorothiazide works by what two mechanisms?

Answer 2

Reduces blood volume

Reduces arterial resistance

Question 3

_____ _____ ______ is responsible for initial antihypertensive side effects

Answer 3

Reduced blood volume

Question 4

______ ______ ______ develops over time and is responsible for long term antihypertensive effects

Answer 4

Reduced arterial resistance

Question 5

Adverse effects of hydrochlorothiazide

Answer 5

Hypokalemia, dehydration, hyperglycemia, hyperuricemia, hypovolemia

Question 6

Hyperuricemia

Answer 6

Increased uric acid problem for people with gout

Question 7

The closer to the beginning of the nephron that a drug works, the….

Answer 7

Stronger the effects

Question 8

What drugs are the best diuretics that we have (closest to the glomerulus)?

Answer 8

Loops (but can cause profound dehydration)

Question 9

High ceiling (loop) diuretics name

Answer 9

Furosemide (Lasix)

Question 10

Lasix

Answer 10

Reduces BP by reducing blood volume and promoting vasodilation

Question 11

Lasix is used for patients who…

Answer 11

Need greater diuresis than thiazides provide

Have renal insufficiency (Thiazides don’t work with low GFR)

Question 12

Adverse effects of loop diuretics

Answer 12

Hypokalemia, dehydration, hyperglycemia, hyperuricemia, ototoxicity (hearing loss)

Question 13

Loop diuretics should not be used with..

Answer 13

Any other atotoxic frug (Aminoglycosides - antibiotic = vancomycin)

Question 14

Potassium sparing diuretics name

Answer 14

Spironolactone (Aldactone)

Question 15

Potassium sparing diuretics

Answer 15

Diuresis is minimal, therefore there is modest hypotensive effects
Potassium sparing diuretics balance potassium loss caused by thiazides or loop diuretics

Question 16

Adverse effects of potassium sparing diuretics

Answer 16

Hyperkalemia

*Do not use with another potassium sparing diuretic or potassium supplements

Question 17

What else should not be taken in conjunction with potassium sparing diuretics?

Answer 17

ACE inhibitors or angiotensin II receptor blockers - both promote hyperkalemia b/c of effect on aldosterone

Question 18

Beta adrenergic blockers names

Answer 18

Propranolol (Inderal)

Metoprolol (Lopressor)

Question 19

Lol =

Answer 19

Beta blocker

Question 20

Metoprolol (Lopressor) is…

Answer 20

Cardioselective

Question 21

Beta adrenergic blockers actions

Answer 21

Decreases HR & Contractility = decreased CO

Decreases renin release from the kidneys

Question 22

Adverse effects of beta-adrenergic blockers

Answer 22

Bradycardia, decreased AV conduction, reduced contractility

Question 23

Do not use beta-adrenergic blockers in patients with…

Answer 23

2nd or 3rd degree heart block

Asthma

Question 24

Use care with beta blockers in patients with

Answer 24

Heart failure

Question 25

How do beta blockers work?

Answer 25

Show electrical conduction from atria to ventricles

Question 26

You would watch a patient with CHF and a beta blocker for...

Answer 26

Edema, puffiness, difficulty breathing

Question 27

Propranolol blocks..

Answer 27

Beta 1 and 2 receptors (nonselective) Also causes bronchoconstriction Could exacerbate asthma or COPD

Question 28

Metropolol blocks,,,

Answer 28

Beta 1 only More expensive Should be safe for asthma and COPD

Question 29

Alpha 1 Blockers names

Answer 29

Doxazosin (Cardura), Terazosin (Hytrin)

Question 30

Apha 1 blockers

Answer 30

Prevent vasoconstriction by preventing stimulation of alpha 1 receptors on arterioles and veins (VASODULATION)

Question 31

Alpha 1 blockers reduce...

Answer 31

Peripheral resistance and venous return

Question 32

Zosin =

Answer 32

Alpha blockers

Question 33

Adverse effects of alpha 1 blockers

Answer 33

Orthostatic hypotension | Reflex tachycardia

Question 34

Are alpha 1 blockers recommended as a first-line therapy?

Answer 34

No b/c of side effects

Question 35

What causes reflex tachycardia?

Answer 35

Pressure receptors

Question 36

Alpha1-Beta1 Blockers names | Not on test

Answer 36

Carvedilol (Coreg), Labetalol (Trandate)

Question 37

Alpha1-Beta1 Blockers works by... (Not on test)

Answer 37

Promotes vasodilation (Alpha 1) Reduces HR and contractility (Beta 1) Suppresses release of renin (Beta 1 on juxtaglomerular cells)

Question 38

Adverse effects of Alpha1-Beta1 Blockers (not on test)

Answer 38

Orthostatic hypotension