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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
T/F Loop diuretics are less likely to cause hyperglycemia
TRUE
26
TO NSAIDS retain water and Na can can cause peripheral edema
TRUE
27
Which is better at reducing BP loop diuretics or thiazides?
Thiazides, better at reducing PVR and increasing vasodilation - loop diuretics are more potent diuretics but they are less effective reducing PVR and vasodilation
28
What are ADE for loop diuretics (7)?
- hypocalcemia - hypokalemia - hyponatremia - hypomagnesemia - OTOTOXICITY - hypovolemia - sulfonamide allergy
29
What are drug interactions with loop diuretics?
-NSAIDS
30
Where does 5-8% of Na reabsorption occur?
-DCT
31
What is the MOA of thiazides?
- they block the active transporter NCC (Na/Cl carrier) | - NCC contransports Na and Cl from the lumen into the blood
32
In what part of the nephron is Ca reabsorbed through control of PTH?
DCT
33
What is the first clinical sign of thiazides (2)?
- increased diuresis | - decreases SV and plasma volume
34
What is the clinical value of thiazides?
-chronic sustained decrease in peripheral vascular resistance and smooth muscle relaxation
35
What are ADE?
- hypokalemia - Hyperuricemia - Hypercalcemia - Hypomagnesemia
36
T/F Hypomagnesemia causes Troussads
TRUE
37
T/F Chlorthalidone is a thiazide
False-it is not a thiazide | -but is acts just like a thiazide
38
What are drug interaction with thiazides (2)?
-NSAIDS and anti-diabetics reduce the effects of HCTZ
39
T/F Chlorthalidone has a longer duration of action than thiazides?
-True
40
What medication can you give to treat someone with low calcium levels?
- thiazide
41
What is half life of chlorthalidone vs thiazide?
-Chlorthalidone: 45-60 hrs | Thiazides: 8-15 hrs
42
When should Thiazides not be used?
- EGFR <30 | - unrestricted salt intake
43
What are the effects of thiazides on SBP and DBP (in mmHg)?
- SBP: 15-20 mmHg | - DBP:8-15mmHg
44
What labs should be monitored when using thiazides?
- uric acid levels - Ca, K, Na, Mg - BUN creatinine
45
Name three thiazides?
- Metolazone, - Indapamide - HCTZ
46
Which thiazide does not elevate lipid levels?
-Indapamide
47
Which thiazide is more effective with concurrent kidney disease?
-metolazone
48
Which drugs increase the effects of HCTZ?
-licorice, beta-2 agonist, corticosteroids
49
What part of the nephron reabsorbs 2-5% of Na?
-CCT Cortical collecting tubule
50
What hormone acts on the CCT?
- Aldosterone
51
What does aldosterone do?
-reabsorbs Na into blood and excretes K in urine
52
What do aldosterone antagonists do (2)?
- they block aldosterone receptor so Na is not reabsorbed and K is retained in the blood - they stop vasoconstriction
53
Name two aldosterone antagonist (2)?
- Spironolactone | - Eplerenone
54
What are some side effects of aldosterone antagonists (5)?
- Hyperkalemia - hyponatremia - gynecomastia - menstrual irregularities - decreased libido
55
Which tubule is responsible for acidification of urine and the last site of K excretion?
CCT
56
Where do K sparing diuretics act?
- aldosterone receptor | - Na channels (ENaC)
57
T/F Spironolactone is used in combination with HCTZ to counteract the low K levels
TRUE
58
What are other clinical uses of spirnolactone?
- pediatric HTN | - female acne and hirsutism
59
Which K sparing diuretic does not induce gynecomastia?
-amiloride
60
T/F K sparing diuretics have a moderate diuretic effect
true
61
When should you not use K sparing diuretics?
when creatinine clearance is < than 10 mL/min
62
What are drug interactions of amiloride and triamterene (2)?
- decrease effect of cardiac glycosides | - NSAIDS decrease effects of K sparing diuretic
63
Which diuretic has the most sodium loss?
-loop diuretics

Pharmacology (47 decks)

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