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AU14 Pharmacology > Exam 1; Antihypertensive Agents > Flashcards

Exam 1; Antihypertensive Agents Flashcards

1
Q

What is the definition of hypertension

A

any prolonged elevation in blood pressure
most common cardiovascular disease
most are untreated

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2
Q

What is the desirable blood pressure

A

115/75

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3
Q

What category of blood pressure is pre-hypertensive

A

120/80-139/89

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4
Q

What category of blood pressure is stage 1 hypertension

A

140/90

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5
Q

What category of blood pressure is stage 2 hypertension

A

180/110

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6
Q

What category of blood pressure is hypertensive urgency

A

220/120

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7
Q

Every increase in blood pressure of what increases likelihood of cardiovascular incident by two fold

A

20/10

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8
Q

What is the result if 220/120 blood pressure is untreated for the long term

A

60% die within 6 months

80% dies within the year

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9
Q

What is it about hypertension that makes it so dangerous

A

it is generally asymptomatic until its final stages; can cause stroke, heart attack, aneurysms, and renal failure

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10
Q

True or False

There is a clear treatment option for hypertension

A

True

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11
Q

What is secondary hypertension (5-10%)

A

Know exactly what the problem/cause is (renal, tumor, etc.)

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12
Q

What is primary or essential hypertension

A

the cause is unknown

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13
Q

What is malignant hypertension

A

220/120+

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14
Q

A baroreceptor on the blood vessel stimulates what center of the brain

A

vasomotor center

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15
Q

In the vasomotor center of the brain, what occurs upon receiving a signal from the baroreceptor

A

NE is released to an α1 receptor which increases sympathetic flow
NE also autostimulates an α2 receptor which decreases sympathetic flow

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16
Q

The synapse from the vasomotor center relays to what

A

a paravertebral ganglia

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17
Q

From the paravertebral ganglia, what two places does the signal from the vasomotor center go

A

β1 receptors on the heart to increase cardiovascular output

α1 receptors on the blood vessel to stimulate vasoconstriction

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18
Q

A calcium influx into the blood vessel causes what to occur

A

constriction

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19
Q

A potassium efflux out of the blood vessel causes what to occur

A

relaxation

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20
Q

An increase cyclicGMP activity in the blood vessel causes what to occur

A

relaxation

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21
Q

Stimulation of an endothelium receptor on a blood vessel causes what to occur

A

constriction

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22
Q

Stimulation of a DA (dopamine) receptor on a blood vessel causes what to occur

A

relaxation

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23
Q

Stimulation of the angiotension II receptor by angiotension II on a blood vessel causes what to occur

A

constriction

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24
Q

The neuronal-vascular control loop is what kind of response to blood pressure changes

A

extremely rapid response (sudden dizziness upon sitting up quickly)
reflex blood pressure control

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25
Q

The kidney control loop system is what kind of response to blood pressure changes

A

long term regulation of blood pressure

renin-angiotension-aldesterone system

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26
Q

A decrease in renal blood pressure or decrease in Na in the kidney stimulates what

A

increases renin secretion by the kidney

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27
Q

Renin from the kidney is a precursor to what, via angiotensionogen

A

angiotension I

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28
Q

Angiotension 1 is converted to what via angiotension converting enzyme

A

angiotension II

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29
Q

Angiotension II has what three effects

A

vasoconstriction
Na retention in the kidney
secretion of aldesterone

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30
Q

This is converted to an inactive product by angiotension converting enzyme

A

bradykinin

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31
Q

What three effects does bradykinin have

A

dilates arteries - decreasing blood pressure
causes capillary leakage (edema)
activates sensory nerves (pain/itching)

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32
Q

What is the main treatment for hypertension

A

behavorial modification; stress, diet, weight management, smoking

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33
Q

Drugs like diuretics (thiazides) or a low Na diet cause this to occur, which can treat hypertension

A

decrease fluid volume

34
Q

What are three characteristics of hypertension drugs

A

interrupt “normal” BP control
do not “cure” hypertension
must be taken for life

35
Q

What is the one side effect that is common for all anti-hypertensives

A

risk of hypotension

36
Q

Any drug that can enter the CNS can have what kind of effects

A

behavioral effects

37
Q

This is a pro-drug metabolized to α-methyl NE which activates/stimulates α2 receptors

A

α-methyl DOPA

38
Q

What are the 5 side effects of α-methyl DOPA

A 
depression
drowsiness
dry mouth
impaired ejaculation
hepatic dysfunction
39
Q

This drug is an α2 agonist which has unlabeled uses

A

clonidine

40
Q

What are the four unlabeled uses of clonidine

A

fibromyalgia
insomnia
Tourette’s
opiate withdrawal

41
Q

What are the 4 side effects of clonidine

A

depression
drowsiness
dry mouth
impaired ejaculate

42
Q

This is a β blocker drug that has central and peripheral effects

A

propranolol

43
Q

This is a drug that inhibits the enzyme tyrosine hydroxyls which prevents the synthesis of E and NE; used to treat tumor of adrenal gland (pheochromoctyoma)

A

α-methyl tyrosine

44
Q

This drug causes depletion of post-ganglionic neuron neurotransmitter

A

reserpine

45
Q

What are the side effects of reserpine

A

depression
drowsiness
diarrhea

46
Q

Which family of drugs block the α1 receptor on vascular smooth muscle

A

-osin’s

prazosin, terazosin, etc.

47
Q

These three drugs are α1 blockers and used only to treat benign prostatic hypertrophy (BPH)

A

tamsulosin
alfuzosin
silodosin

48
Q

What is the main side effect of the α1 site inhibitors (-osin’s)

A

first dose effect; rapid dose in BP

orthostatic or postural hypotension

49
Q

This drug blocks all β blockers (β1 and β2)

A

propranolol

50
Q

Propranolol blocks β1 receptors on the heart and cause what

A

prevents any increase in heart rate and contraction force; decreases renin secretion

51
Q

What are the four “lesser” side effects of propranolol

A

gets into the CNS; depression
bradycardia; fatigue
impotence
decreases HDL and increases triglycerides

52
Q

What is the main side effect of propranolol

A

worsens asthma (β2 = bronchodilators)

53
Q

How many specific β1 blockers are there on the market

A

13

the -olol’s

54
Q

What are the side effects of the β1 blockers, the -olol’s

A

fewer CNS effects
bradycardia
fatigue (with exercise)

55
Q

Labetalol and carvedilol block which receptors

A

α1, β1, β2

56
Q

What are the side effects of labetalol andcarvedilol

A

postural hypotension

dry mouth

57
Q

Which family of drugs are angiotension receptor blockers (ARBs)

A

-artans

Angiotension RecepTor ANtagonists

58
Q

What effect does the antiogention receptor blockers induce (-artans)

A

block the angiotension II receptor

decreasing secretion of aldosterone

59
Q

*What is the main side effect of ARBs

A 
can cause fetal abnormalities; like all agents that alter the angiotension system
class X pregnancy drugs
60
Q

Which family of drugs are the endothelian blockers

A

-entan’s

61
Q

What are -entan’s the treatment for specifically

A

pulmonary artery hypertension

62
Q

What are the three side effects of endothelin blockers

A

fetal damage
hepatic toxicity
testicular atrophy

63
Q

This drug is a prodrug which is involved with opening potassium channels in arterial smooth muscle;
efflux leads to hyper polarization
for very refractory patients

A

minoxidil

64
Q

What are two side effects of minoxidil

A

hypertichosis (hair growth); discontinuation = hair loss

edema - pericardial effusion; leads to cardiac tamponade

65
Q

This is a vasodilator which increases cGMP which causes smooth muscle relaxation

A

hydralazine

66
Q

What is the side effect of hydralazine

A

in slow acetylators - lupus like syndrome

67
Q

This drug acts by opening potassium channels decreasing insulin secretion from β cells

A

diazoxide

68
Q

This is the drug of choice in hypertensive emergencies

A

nitroprusside

69
Q

Nitroprusside acts within seconds via an IV to do what

A

dilate both arteries and veins equaling a rapid drop in blood pressure

70
Q

Why must nitroprusside be stored in powder form

A

because it degrades in solution (saline) into other molecules including cyanide

71
Q

What is the meaning behind “Minnie Hid the Diamonds in the Nitro” because she was KG KG

A 
Minoxidil = potassium
hydralazine = cGMP
diazoxide = potassium
mitroprusside = cGMP
72
Q

What family of drugs are calcium channel blockers

A

-ipine’s

73
Q

The calcium channel blockers have what effect

A

inhibit Ca++ influx into vascular smooth muscle; prevents vasoconstriction

74
Q

What are two side effects of calcium channel blockers

A

can cause heart burn

may worsen heart failure

75
Q

This family of drugs are angiotension converting enzyme inhibitors (ACE)

A

-pril’s

76
Q

ACE inhibiting drugs have what three effects

A

inhibits ACE that is required for conversion of angiotension I to II
prevents breakdown of bradykinin (vasodilation)
decreases aldosterone secretion

77
Q

What are the five side effects of ACE inhibitors

A 
rash
dry cough
angioneurotic edema (swelling of URT)
taste alteration
fetal damage
78
Q

This is a renin inhibitor (directly inhibits renin)

A

aliskiren

79
Q

What are the four side effects of aliskerin

A

fetal damage
cough
angioedema
diarrhea

80
Q

This agent activates D1 receptors; given in IV for hypertensive emergencies

A

fenoldpam

AU14 Pharmacology (29 decks)

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