HTN - Chap 10 Flashcards
to what class of drugs do clonidine and methyldopa belong?
alpha 2 selective agonists
what are the two ways you can manage rebound increase in bp due to cessation of clonidine?
reinstitute clonidine therapy OR administer alpha blockers such as phentolamine
true or false: clonidine and methyldopa can cause sedation.
true
hexamethonium and trimethaphan are members of which class of drugs?
ganglion-blocking drugs
what is the most common example of a drug that depletes the adrenergic nerve terminals of its NE stores?
reserpine
what are the two most common examples of drugs that deplete and block release of the stores of NE? (and thus can lower BP)
guanethidine, and guanadrel; note that these drugs are POSTGANGLIONIC SYMPATHETIC nerve terminal blockers
in the simplest of terms, what does tyramine do?
causes the release of stored NE - remember that this along with MAOi can lead to hypertensive crisis - also remember that tyramine is eaten up by MAO so with the MAOi it is given an extra “life support”
to what class of drugs do prazosin, doxazin, and terazosin belong to?
alpha 1 selective antagonist
to what class of drugs do phentolamine and phenoxybenzamine belong to?
nonselective alpha blockers
true or false: non selective alpha blockers are of no value in htn treatment
true
which class of drugs is really known to cause orthostatic hypotension?
alpha 1 blockers
which class of drugs is useful to treat benign prostatic hyperplasia?
alpha 1 blockers
metoprolol, atenolol, both belong to what specific group of beta blockers?
selective beta 1 blockers
which class of drugs reduces angiotensin levels by reducing renin release from the kidneys?
beta blockers
v/d can act by what 4 mechanisms? release of _______; opening of ____ channels (effectively causing what?), blockade of ____ channels, and activation of _____ receptors.
nitric oxide; potassium (hyperpolarization); calcium; dopamine (d1)
what is special about the use of the drug minoxidil?
the compensatory responses require concomitant use of diuretics and beta blockers
what is the common side effect of minoxidil?
hirsutism
what is THE prototype dihydropyridine?
nifedipine
to what class of drugs do the following belong? amlodipine, felodipine, and isradipine.
dihydropyridine ccbs
how does the ccb diazoxide work?
it opens K+ channels thus causing hyperpolarization and relaxation of the smooth muscle.
what is the only vasodilator that works by activation of d1 (dopamine) receptors?
fenoldopam.
ACE inhibitors do what to angiotensin II blood concentration levels? to endogenous v/d of the kinin family?
decrease; increase
what is the most common side effect of taking an ACE inhibitor?
cough - to avoid this, choose an ARB
which two drugs are absolutely contraindicated during pregnancy?
ACE inhibitor and ARB
what is the newest anti htn drug that works by inhibiting renin’s action on angiotensinogen called?
aliskiren - it reduces the formation of angiotensin 1
what are two of the toxicities of aliskiren?
HA and diarrhea
remember the usual steps (of stepped cared) for treatment of htn: 1. lifestyle changes 2. diuretics (thiazide) 3. ? 4. ?
- sympatholegic (beta blocker) 4. ace inhibitors 5. v/d
what is typically the first v/d chosen in terms of treatment for htn?
ccb
true or false: polypharmacy minimizes toxicities while producing additive or supra-additive therapeutic effects
true
older pts tend to do better on what class of meds?
diuretics and beta blockers
african americans tend to respond best to which two classes of anti htn meds?
diuretics and ccb
what is the main concern with htn emergency?
end organ damage
