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Pharmacology > HTN 1 > Flashcards

HTN 1 Flashcards

1
Q

What is the formula for MAP?

A

MAP= (SBPX 1/3) + (DBP X 2/3)

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2
Q

What is a normal MAP?

A

70-100 mmHg

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3
Q

What does an elevated MAP indicate?

A

cardiac overload/works harder

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4
Q

CO formula

A

CO= SV X HR

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5
Q

BP formula

A

BP= SV X TPR X HR

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6
Q

Where does most Na absorption occur?

A

PCT

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7
Q

-osmotic diuretic -freely filtered at glomerulus but
poorly reabsorbed in the tubule
-given IV -reduced brain volume/ICP and
IOP
-acts on PCT -remains in lumen and holds
water by osmotic effects

A

Mannitol

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8
Q

What are the clinical applications of mannitol?

A
  • Acute closed angle glaucoma
  • Brain edema
  • solute overload in Rhabdomyolysis
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9
Q

What are ADE with use of Mannitol?

A
  • hyponatremia followed by hypernatremia

- headache, nausea, vomiting

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10
Q

What is MOA of carbonic anhydrase inhibitors?

A
  • bicarbonate break down into CO2 and H2O in lumen is stopped by blocking carbonic anhydrase
  • NHE3 transporter pumps Na into PCT with use of H ion from bicarbonate
  • without H ion the Na cant enter the PCT cell and the Na/K ATPase cannot pump Na into the blood
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11
Q

where does most Na, Cl, and bicarbonate get reabsorbed?

A

PCT

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12
Q

What class of diuretic is acetazolamide?

A

-carbonic anhydrase inhibitor

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13
Q

What are the clinical applications for carbonic anhydrase inhibitors?

A
  • glaucoma

- mountain sickness

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14
Q

What is ADE for acetazolamide?

A

-metabolic acidosis

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15
Q

What are site of action for diuretics (4)

A
  • PCT
  • DCT
  • Thick ascending limb
  • collecting tubule
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16
Q

T/F Diuretics decrease plasma volume and SV

A

TRUE

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17
Q

T/F The overall mechanism of diuretics is decreased Na and Cl reabsorption

A

TRUE

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18
Q

T/F Effects of diuretics are predictable

A

TRUE

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19
Q

Which part of the nephron is responsible for 60-70% of Na reabsorption?

A

PCT

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20
Q

Which part of the nephron is responsible for 20-30% of the Na reabsorption?

A

Thick Ascending Limb of Henle

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21
Q

Which ions are pumped back into the blood in TAL (5)? Which transporter is utilized?

A
  • Na, K, Cl, the NKCC2 transporter is utilized

- Mg and Ca

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22
Q

Which diuretics act on the TAL?

A

loop diuretics

-Furosemide, Torsemide

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23
Q

What is MOA of loop diuretics?

A
  • they block the NKCC2 transporter at TAL
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24
Q

What are the clinical uses of loop diuretics (4)?

A
  • heart failure
  • renal function eGFR less than 50-60%
  • peripheral/pulmonary edema
  • hypercalcemia
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25
Q

T/F Loop diuretics are less likely to cause hyperglycemia

A

TRUE

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26
Q

TO NSAIDS retain water and Na can can cause peripheral edema

A

TRUE

27
Q

Which is better at reducing BP loop diuretics or thiazides?

A

Thiazides, better at reducing PVR and increasing vasodilation
- loop diuretics are more potent diuretics but they are less effective reducing PVR and vasodilation

28
Q

What are ADE for loop diuretics (7)?

A
  • hypocalcemia
  • hypokalemia
  • hyponatremia
  • hypomagnesemia
  • OTOTOXICITY
  • hypovolemia
  • sulfonamide allergy
29
Q

What are drug interactions with loop diuretics?

A

-NSAIDS

30
Q

Where does 5-8% of Na reabsorption occur?

A

-DCT

31
Q

What is the MOA of thiazides?

A
  • they block the active transporter NCC (Na/Cl carrier)

- NCC contransports Na and Cl from the lumen into the blood

32
Q

In what part of the nephron is Ca reabsorbed through control of PTH?

A

DCT

33
Q

What is the first clinical sign of thiazides (2)?

A
  • increased diuresis

- decreases SV and plasma volume

34
Q

What is the clinical value of thiazides?

A

-chronic sustained decrease in peripheral vascular resistance and smooth muscle relaxation

35
Q

What are ADE?

A
  • hypokalemia
  • Hyperuricemia
  • Hypercalcemia
  • Hypomagnesemia
36
Q

T/F Hypomagnesemia causes Troussads

A

TRUE

37
Q

T/F Chlorthalidone is a thiazide

A

False-it is not a thiazide

-but is acts just like a thiazide

38
Q

What are drug interaction with thiazides (2)?

A

-NSAIDS and anti-diabetics reduce the effects of HCTZ

39
Q

T/F Chlorthalidone has a longer duration of action than thiazides?

A

-True

40
Q

What medication can you give to treat someone with low calcium levels?

A
  • thiazide
41
Q

What is half life of chlorthalidone vs thiazide?

A

-Chlorthalidone: 45-60 hrs

Thiazides: 8-15 hrs

42
Q

When should Thiazides not be used?

A
  • EGFR <30

- unrestricted salt intake

43
Q

What are the effects of thiazides on SBP and DBP (in mmHg)?

A
  • SBP: 15-20 mmHg

- DBP:8-15mmHg

44
Q

What labs should be monitored when using thiazides?

A
  • uric acid levels
  • Ca, K, Na, Mg
  • BUN creatinine
45
Q

Name three thiazides?

A
  • Metolazone,
  • Indapamide
  • HCTZ
46
Q

Which thiazide does not elevate lipid levels?

A

-Indapamide

47
Q

Which thiazide is more effective with concurrent kidney disease?

A

-metolazone

48
Q

Which drugs increase the effects of HCTZ?

A

-licorice, beta-2 agonist, corticosteroids

49
Q

What part of the nephron reabsorbs 2-5% of Na?

A

-CCT Cortical collecting tubule

50
Q

What hormone acts on the CCT?

A
  • Aldosterone
51
Q

What does aldosterone do?

A

-reabsorbs Na into blood and excretes K in urine

52
Q

What do aldosterone antagonists do (2)?

A
  • they block aldosterone receptor so Na is not reabsorbed and K is retained in the blood
  • they stop vasoconstriction
53
Q

Name two aldosterone antagonist (2)?

A
  • Spironolactone

- Eplerenone

54
Q

What are some side effects of aldosterone antagonists (5)?

A
  • Hyperkalemia
  • hyponatremia
  • gynecomastia
  • menstrual irregularities
  • decreased libido
55
Q

Which tubule is responsible for acidification of urine and the last site of K excretion?

A

CCT

56
Q

Where do K sparing diuretics act?

A
  • aldosterone receptor

- Na channels (ENaC)

57
Q

T/F Spironolactone is used in combination with HCTZ to counteract the low K levels

A

TRUE

58
Q

What are other clinical uses of spirnolactone?

A
  • pediatric HTN

- female acne and hirsutism

59
Q

Which K sparing diuretic does not induce gynecomastia?

A

-amiloride

60
Q

T/F K sparing diuretics have a moderate diuretic effect

A

true

61
Q

When should you not use K sparing diuretics?

A

when creatinine clearance is < than 10 mL/min

62
Q

What are drug interactions of amiloride and triamterene (2)?

A
  • decrease effect of cardiac glycosides

- NSAIDS decrease effects of K sparing diuretic

63
Q

Which diuretic has the most sodium loss?

A

-loop diuretics

Pharmacology (47 decks)

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