Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MJ- Pharm exam 2 > HTN 5 > Flashcards

HTN 5 Flashcards

1
Q

Sympathoplegic drugs interfere with sympathetic (SANS) control of cardiovascular function. The result is a reduction of one or more of what 5 things?

A
  1. venous tone
  2. heart rate
  3. contractile force of the heart
  4. cardiac output
  5. total peripheral resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MOA of which group of meds:

  • Negative chronotropic and inotropic-results in decreased CO
  • Inhibit release of renin
A

Beta Blockers (“-olol”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The following are the main side effects of which group of meds?

–***Bradycardia, AV conduction abnormalities, development of acute heart failure

–***Acute exacerbations of asthma or COPD (bronchospasms)

A

Beta Blockers (“-olols”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the following are some side effects of what group of meds?

  1. Aggrevate intermittant claudication and Raynaud’s phenomenon (decreased peripheral blood flow)
  2. Increased sympathetic tone with Hypoglycema with increase in BP from unopposed alpha stimulation
  3. Transient increase in blood glucose and serum cholesterol
  4. Increase in TG and decrease in HDL
A

Beta Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How should you discontine use of Beta Blockers?

A

Avoid abrupt cessation—increase in BP, risk of unstable angina, MI

taper dose over 1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Efficacy/monitoring of what group of meds?

–**Differentiated based on cardioselectivity, ISA, and membrane-stabilizing effect.

  • Cardiolselective: atenolol, metoprolol*
    • ​dose dependent
  • ISA: acebutolol, pindolol
    • Maintains resting HR, CO and peripheral blood flow
    • Increase risk post MI- rarely used
  • Membrane stabilizing effect: all beta blockers
    • Important w/ the BB antiarrhythmics
A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The following should be monitored in which group of meds?

  1. HR, BP prior to first dose (possibly EKG)
  2. **Assess for CHF: edema, new cough, dyspnea, weight gain or unresolved fatigue
  3. **Monitor BS in DM
A

Beta Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 4 drug interactions of Beta Blockers?

A
  1. NSAIDs
  2. Other SNS and PNS agents
  3. CCB
  4. Digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which 2 Beta Blockers undergo extensive first pass effect?

A

Propanolol and metoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Atenolol has a relatively long half life and is ____ excreted

A

renally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

________beta blockers include propranolol causing more dizziness and drowsiness, but adding indications of migraine HA prevention, essential tremor, thyrotoxicosis, anger/rage management

A

Lipophillic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which Beta Blockers are Beta 1 blocker and Alpha 1 blockers?

A

Labetolol and Carvedilol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which beta blocker preferentially blocks Beta 1 (at doses <10) and also produces endothelium-derived nitric oxide-dependent vasodilation

A

Nebivolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In which patient should a nonselective Beta blocker be avoided?

A

pulmonary- Asthma, COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanism of which meds?

–**Selective alpha 1 blockers in the peripheral vasculature and inhibit the uptake of catecholamines in smooth muscle cells resulting in vasodilation

–**Cross blood brain barrier

A

Alpha 1 Blockers (prazosin, terazosin, doxazosin–> “-zosins”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which group of meds has the following side effects?

  1. **First dose phenomenon and an increase in dose: 1-3 hrs within first dose of dizziness or faintness, palpitations, and possibly syncope
    • Use cautiously in the elderly
  2. Take dose at bedtime
  3. Lassitude, vivid dreams and depression
  4. Priapism
  5. Sodium and water retention with higher doses
    • Give in combination with diuretic
A

Alpha 1 Blockers ( “-zosins”)

17
Q

What is the first dose phenomenon and which group of meds is this seen in?

A

–First dose phenomenon and an increase in dose: 1-3 hrs w/in first dose of dizziness or faintness, palpitations, and possibly syncope (so take at bedtime)

Alpha 1 blockers (“-zosins”)

18
Q

Efficacy of which group of meds?

–Not a first line agent

–Give in combination with diuretics to improve efficacy

–Useful when male patient has BPH

–Hypertension, PTSD related nightmares and sleep disruption, Raynaud’s, BPH

–No adverse effect on lipids-may increase HDL ??significance

A

Alpha 1 Blockers (-Zosins)

19
Q

If you have a patient suffering from HTN and BPH, what antihypertensive would be indicated?

A

Alpha 1 Blockers (ex: prazosin)

20
Q

What is important to monitor with Alpha 1 Blockers?

A

–First dose and increased dose effect-BP standing, sitting/supine

21
Q

Drug interactions of what group of meds?

–Decrease levels of dabigatran, linagliptin, vincristine

–Methylphenidate may diminish the antihypertensive effect of _______ (as well as other agents)

A

alpha-1 blockers

22
Q

Mechanism of which group of meds?

–Stimulate alpha 2 receptors in the brain which reduces sympathetic outflow from the vasomotor center in the brain and increased vagal tone.

–Reduces sympathetic activity,

–Together with enhanced parasympathetic activity can: decrease heart rate, cardiac output, total peripheral resistance, plasma renin activity and baroreceptor reflexes.

A

Central Alpha 2 Agonists (Clinidine, methyldopa)

23
Q

Which two meds are central alpha 2 agonists?

A

Clonidine

Methyldopa

24
Q

Side effects of which group of meds?

  1. Sodium and water retention (most prominent with methyldopa thus give with diuretic (except in pregnancy)
  2. Sedation, dry mouth, depression,
  3. Orthostatic hypotension, dizziness—caution in elderly
  4. Rebound hypertension with abrupt cessation—compensatory increase in NE
A

Central Alpha 2 Agonists

25
Q

Side effect of which central alpha 2 agonist?

high incidence of anticholinergic side effects such as sedation, dry mouth, constipation, urinary retention and blurred vision

A

Clonidine

26
Q

Side effects of which Central Alpha 2 agonist?

Can cause hepatitis or hemolytic anemia although rare—transient rise in LFTs can be noted

A

Methyldopa

  • Stop if persistent increases or alkaline phosphatase increases
  • May cause + direct Coombs test
27
Q

Efficacy of which group of meds?

–Effective as single agent but are second or third line agent because of side effects

–Dosage adjustment need in renal impairment—extend dosing interval

A

Central alpha 2 agonists (Clonidine, methyldopa)

28
Q

what med is first line in pregnancy HTN?

A

Methyldopa (Central alpha 2 agonist)

29
Q

T/F: Central alpha 2 agonists are contraindicated in pediatrics?

A

False. Central Alpha 2 agonists can be used in pediatrics

30
Q

Monitoring for which group of meds?

–Hepatic and renal status

–Hypotension, bradycardia or CNS changes on regular basis

A

Central alpha 2 agonists (Clonidine, methyldopa)

31
Q

–Consider converting patients desiring pregnancy well in advance to _______ or _________

A

Methyldopa or Labetolol

32
Q

why is there a need to add a thiazide diuretic to the central alpha 2 agonists?

A

–These agents can cause sodium and water retention because of vasodilation resulting in decreased blood flow through the kidneys which then activates the RAAS system

33
Q

Mechanism of which medication?

–>depletes NE from sympathetic nerve endings and blocking transport of NE into its storage granules.

—>Leads to decreased PVR

A

Reserpine (Peripheral Adrenergic Antagonist)

5th line (occasionally used for resistant HTN)

34
Q

Which medication causes significant sodium and water retention so it should be given with a thiazide diuretic

This is also an inexpensive treatment regimen

A

Reserpine (peripheral adrenergic antagonist)

5th line

35
Q

Which med?

Leads to reflex parasympathetic activity:

  1. nasal stuffiness
  2. increased gastric acid secretion
  3. diarrhea
  4. bradycardia
A

Reserpine (a peripheral adrenergic antagonist)

5th line med

36
Q

Which 2 group of meds are vasodilators?

A
  1. Calcium channel blockers
  2. Direct arteriole vasodilators
37
Q

What are 2 types of calcium channel blockers?

A
  1. Non-dihydropyridines (Verapamil, Diltiazem)
  2. Dihydropyridines (“-dipines”)

MJ- Pharm exam 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions