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Clin phar > HTN part 1&2 > Flashcards

HTN part 1&2 Flashcards

1
Q

elevated blood pressure

A

Hypertension

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2
Q

Hypertension is when high force exerted by circulating blood against the ____________

A

arterial walls

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3
Q

guidelines in the classification of hypertension

A

jnc, aha/acc, esc/esh

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4
Q

Blood pressure is equals to

A

CO (Cardiac Output) x SVR (Systemic vascular Resistance)

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5
Q

To get the cardiac output you have to

A

multiply stroke value with heart rate

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6
Q

special nerve cells that keep blood pressure balanced

A

baroreceptors

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7
Q

Baroreceptors are controlled by

A

CNS

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8
Q

What acts on angiotensinogen to form angiotensin 1

A

renin

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9
Q

Renin combined with angiotensinogen forms

A

angiotensin 1

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10
Q

it is a weak vasoconstrictor

A

angiotensin

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11
Q

What acts on angiotensin I to form angiotensin II

A

ACE

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12
Q

ACE is released from

A

Lungs

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13
Q

Angiotensin II is a

A

potent vasoconstrictor

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14
Q

This also acts directly on blood vessels stimulating vasocontriction

A

Angiotensin II

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15
Q

This acts on the adrenal gland to stimulate the release of aldosterone

A

Angiotensin II

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16
Q

Angiotensin II acting on the adrenal gland will stimulate the release of

A

aldosterone

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17
Q

this is an antidiuretic hormone that reabsorbs water and salt

A

aldosterone

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18
Q

when salt and water are reabsorbed it will _________ SV and ____________ VR

A

increase; increase

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19
Q

Type of htn: 90-95% unkown etiology; essential htn

A

Primary

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20
Q

Type of htn: renal disease, endocrine diseases, vascular, drugs

A

Secondary

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21
Q

type of htn wherein patient’s bp is higher when it is measured with the presence of a doctor

A

White coat

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22
Q

type of htn wherein bp is elevated despite optimally dosed medications

A

resistant htn

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23
Q

it is a sudden, severe increase in blood pressure (180/120 millimeters of mercury (mm Hg) or greater

A

htn crisis

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24
Q

with target organ damage

A

htn emergency

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25
Q

with organ damage and SBP>210 ; DBP>130

A

accelerated

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26
Q

with organ damage and decrease by 20-25%

A

malignant

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27
Q

with no target organ damage

A

Hypertensive Urgency

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28
Q

In young and middle age __________ is more at risk than __________

A

male is more at risk than female

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29
Q

T/F: females experiencing menopause is at risk

A

true

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30
Q

T/F: Black communities have lower chance getting HTN

A

false

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31
Q

drugs used in htn

A

diuretics, sympathoplegics blockers, vasodilators, angiotensin antagonists, renin inhibitors, ccb

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32
Q

example of diuretics

A

carbonic anhydrase inhibitor, osmotic diuretic, loop diuretics, thiazide and related diuretics, k-sparring

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33
Q

example of CAI

A

acetazolamide

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34
Q

example of osmotic

A

mannitol

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35
Q

example of loop diuretics

A

bumetanide, furosemide, torasemide

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36
Q

example of thiazide

A

Bendroflumethiazide, chlortalidone, hydrochlorthiazide, indapamide, metolazone, clopamide

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37
Q

example of k-sparring

A

amiloride, eplerenone, spironolactone, traimterene

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38
Q

k-sparring diuretics that are also aldosterone antagonist

A

spironolactone and epleronone

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39
Q

this osmotic diuretic reduces intracrannial pressure and can be prescribed to patients with diabetes

A

mannitol

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40
Q

an a2 agonist that is converted centrally to methylnorepinephrine

A

Methyldopa

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41
Q

a2 agonists reduces ________

A

constriction

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42
Q

This reduces sympathetic outflow from CNS

A

methyldopa

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43
Q

decreases catecholamine release

A

methyldopa

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44
Q

reduces peripheral vascular resistance & cardiac output

A

methyldopa

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45
Q

Used primarily for hypertension of pregnancy

A

methyldopa

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46
Q

may cause guanabenz

A

methyldopa

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47
Q

may cause Little postural hypotension (orthostatic, dilated bv)

A

Methyldopa

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48
Q

htn drugs used in pregnancy together methyldopa

A

nifedipine, labetalol

49
Q

a direct agonist at central α2-adrenoceptors, decreases circulating catecholamine levels, & reduces blood pressure

50
Q

leads to a reduction of the TPVR and reduction of the sympathetic & increases parasympathetic tone, resulting in blood pressure lowering & bradycardia

51
Q

T/f: Clonidine does not decrease renal blood flow or glomerular filtration

52
Q

T/F: Clonidine is useful in the treatment of hypertension complicated by renal disease

53
Q

T/F: Clondine should not be given to patients who are at risk for mental depression

54
Q

nonselective b blockers (negative ISA)

A

Propranolol, sotalol, timolol

55
Q

nonselective b blockers (positive ISA)

A

pindolol, oxprenolol

56
Q

selective b blockers (negative isa)

A

atenolol, metoprolol, bisoprolol

57
Q

selective b blockers (positive ISA)

A

celiprolol, acebutolol

58
Q

b blockers with alpha blocking activity

A

carvedolol, labetolol

59
Q

T/F: you can give non selective b blockers to asthmatic patients

60
Q

b blockers recommended forpatients with heart failure

A

selective positive ISA (celiprolol, acebutolol)

61
Q

ADR of A blockers

A

retention of salt and water

62
Q

Reversible Non selective alpha adrenorecept agonistt

A

Phentolamine, tolazoline

63
Q

irreversible non selective alpha adrenorecept agonistt

A

phenoxybenzamine

64
Q

selective alpha 1 blockers

A

prazosin, terazosin, doxazocin, alfuzosin, bunazosin, tamsulosin

65
Q

selective alpha 2 blockers

A

yohimbine, idazoxan

66
Q

miscellaneous alpha adrenorecept agonistt

A

ergot alkaloinds

67
Q

direct vasodilators

A

hydralazine, minoxidil

68
Q

acts mainly by releasing nitric oxide (NO), endothelium-derived relaxing factor (EDRF)

A

Hydralazine

69
Q

Hydralazine dilates _______

A

arterioles, not veins

70
Q

ADR of hydralazine

A

myocardial ischemia & precipitation of angina, lupus- like syndrome

71
Q

T/f: hydralazine cannot cause renal damage

72
Q

T/F: hydralazine’s adr can still be reversed if drug is stopped

73
Q

Metabolized in the liver to minoxidil sulfate, which is a K+- channel opener in SM MS→ hyperpolarization & relaxation of smooth muscle.

74
Q

Minoxidil adr

A

myocardial ischemia, Growth of body hair

75
Q

CCB examples

A

diphenylalkylamines, benzothiazepines, dihydropyridines

76
Q

diiphenylalkylamines

77
Q

benzothiazepines

78
Q

1st gen dihydropyridines

A

nifedipine

79
Q

2nd gen dihydropyridines

A

isradipine, nicardipine, felodipine

80
Q

3rd gen dihydropyridines

A

amlodipine

81
Q

T or F: CCB are useful in treating HTN patients who also have asthma, diabetes, and/or peripheral vascular disease

82
Q

T/F: CCBs are not useful in angina

83
Q

CCBs that are used in the treatment of atrial fibrillation

A

Diltiazem and verapamil

84
Q

ADR of CCB

A

cardiac depression

85
Q

INHIBITORS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM

A
  1. β-Adrenoceptor blockers.
  2. Renin antagonist: Aliskiren
  3. Angiotensin converting enzyme inhibitors (ACEs).
  4. Angiotensin receptor blockers.
  5. Aldosterone antagonists: Spironolactone
86
Q

T/f: Ace inhibitors can cause Severe hypotension especially in hypovolemia

87
Q

T/F: Ace can cause Chronic renal failure particularly in patients with bilateral renal artery stenosis or renal artery stenosis of a solitary kidney

A

False; acute

88
Q

T/F: Ace can cause Hyperkalemia

89
Q

due to bradykinin or susbtance P, Ace inhibitors can cause

A

Dry cough, wheezing, angioedema

90
Q

may cause proteinuria & neutropenia at high doses, especially in patients with renal insufficiency.

91
Q

Ace inhibitors can be prescribed to pregnant patients

A

False, can cause fetal malformations

92
Q

may be used as first-line agents for treating HTN, especially in patients with a compelling indication of diabetes, heart failure, or chronic kidney disease.

93
Q

ARBs examples

A

Losartan
Valsartan
Candesartan
Eprosartan
Irbesartan
Telmisartan
Olmesartan

94
Q

ADRs of ARBs are similar to ACEs including wheezing, angioedema & cough

A

false; except wheezing, angioedema & cough

95
Q

Renin Antagonist

96
Q

directly inhibits renin &, thus, acts earlier in the renin–angiotensin–aldosterone system than ACEIs or ARBs.

A

Renin antagonists

97
Q

Renin antagonist should not be routinely combined with an

A

ACE or Arbs

98
Q

T/F: Aliskiren is contraindicated during pregnancy.

99
Q

is metabolized by CYP 3A4 & is subject to many drug interactions.

100
Q

Treatment of choice for heart failure

A

ACEI/ARB + BB + diuretic + spironolactone

101
Q

Treatment of choice for Post-MI/Clinical CAD

A

ACEI/ARB, BB

102
Q

Treatment of choice for CAD

A

ACEI/ARB, CCB, diu, bb

103
Q

Treatment of choice for diabetes

A

ACEI/ARB, CCB, diuretic

104
Q

Treatment of choice for CKD

105
Q

Treatment of choice for rcuurent stroke prevention

A

ACEI,diureitc

106
Q

Treatment of choice for pregnancy

A

Labetolol, nifedipine, methyldopa

107
Q

Possibly safer in patients with COPD, asthma, diabetes, and peripheral vascular disease

A

Beta-1 Selective Blockers

108
Q

When you administer Diuretics to your patients, you must monitor for __________

A

hypokalemia

109
Q

Diuretitcs is most effective when combine with

110
Q

T/F: ACEI/ARBs may also cause hyperkalemia

111
Q

T/F: Losartan prevent migrain headaches

A

False. Losartan lowers uric acid levels; candesartan prevent migraine headaches

112
Q

What drug class can mask hypoglycemic awareness

A

Beta blockers

113
Q

What drug class may cause orthostatic hypotension

A

Vasodilators

114
Q

This is available in weekly patch formulation for resistant hypertension

A

Clonidine (Centrally Acting Agents)

115
Q

HTN drugs for Elderly

A

Thiazides, CCB, ACEI, ARBs

116
Q

HTN drugs for Diabetic

A

ARBs, ACEI, CCB, Diu

117
Q

HTN drugs for patients with renal disease

A

ARBs, ACEI

118
Q

HTN drugs for Pregnant women

A

methyldopa, labetalol, nifedipine, hydralazine, hydrocholorthiazide

Clin phar (3 decks)

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