HTN part 1&2 Flashcards
1
Q
elevated blood pressure
A
Hypertension
2
Q
Hypertension is when high force exerted by circulating blood against the ____________
A
arterial walls
3
Q
guidelines in the classification of hypertension
A
jnc, aha/acc, esc/esh
4
Q
Blood pressure is equals to
A
CO (Cardiac Output) x SVR (Systemic vascular Resistance)
5
Q
To get the cardiac output you have to
A
multiply stroke value with heart rate
6
Q
special nerve cells that keep blood pressure balanced
A
baroreceptors
7
Q
Baroreceptors are controlled by
A
CNS
8
Q
What acts on angiotensinogen to form angiotensin 1
A
renin
9
Q
Renin combined with angiotensinogen forms
A
angiotensin 1
10
Q
it is a weak vasoconstrictor
A
angiotensin
11
Q
What acts on angiotensin I to form angiotensin II
A
ACE
12
Q
ACE is released from
A
Lungs
13
Q
Angiotensin II is a
A
potent vasoconstrictor
14
Q
This also acts directly on blood vessels stimulating vasocontriction
A
Angiotensin II
15
Q
This acts on the adrenal gland to stimulate the release of aldosterone
A
Angiotensin II
16
Q
Angiotensin II acting on the adrenal gland will stimulate the release of
A
aldosterone
17
Q
this is an antidiuretic hormone that reabsorbs water and salt
A
aldosterone
18
Q
when salt and water are reabsorbed it will _________ SV and ____________ VR
A
increase; increase
19
Q
Type of htn: 90-95% unkown etiology; essential htn
A
Primary
20
Q
Type of htn: renal disease, endocrine diseases, vascular, drugs
A
Secondary
21
Q
type of htn wherein patient’s bp is higher when it is measured with the presence of a doctor
A
White coat
22
Q
type of htn wherein bp is elevated despite optimally dosed medications
A
resistant htn
23
Q
it is a sudden, severe increase in blood pressure (180/120 millimeters of mercury (mm Hg) or greater
A
htn crisis
24
Q
with target organ damage
A
htn emergency
25
with organ damage and SBP>210 ; DBP>130
accelerated
26
with organ damage and decrease by 20-25%
malignant
27
with no target organ damage
Hypertensive Urgency
28
In young and middle age __________ is more at risk than __________
male is more at risk than female
29
T/F: females experiencing menopause is at risk
true
30
T/F: Black communities have lower chance getting HTN
false
31
drugs used in htn
diuretics, sympathoplegics blockers, vasodilators, angiotensin antagonists, renin inhibitors, ccb
32
example of diuretics
carbonic anhydrase inhibitor, osmotic diuretic, loop diuretics, thiazide and related diuretics, k-sparring
33
example of CAI
acetazolamide
34
example of osmotic
mannitol
35
example of loop diuretics
bumetanide, furosemide, torasemide
36
example of thiazide
Bendroflumethiazide, chlortalidone, hydrochlorthiazide, indapamide, metolazone, clopamide
37
example of k-sparring
amiloride, eplerenone, spironolactone, traimterene
38
k-sparring diuretics that are also aldosterone antagonist
spironolactone and epleronone
39
this osmotic diuretic reduces intracrannial pressure and can be prescribed to patients with diabetes
mannitol
40
an a2 agonist that is converted centrally to methylnorepinephrine
Methyldopa
41
a2 agonists reduces ________
constriction
42
This reduces sympathetic outflow from CNS
methyldopa
43
decreases catecholamine release
methyldopa
44
reduces peripheral vascular resistance & cardiac output
methyldopa
45
Used primarily for hypertension of pregnancy
methyldopa
46
may cause guanabenz
methyldopa
47
may cause Little postural hypotension (orthostatic, dilated bv)
Methyldopa
48
htn drugs used in pregnancy together methyldopa
nifedipine, labetalol
49
a direct agonist at central α2-adrenoceptors, decreases circulating catecholamine levels, & reduces blood pressure
clonidine
50
leads to a reduction of the TPVR and reduction of the sympathetic & increases parasympathetic tone, resulting in blood pressure lowering & bradycardia
clonidine
51
T/f: Clonidine does not decrease renal blood flow or glomerular filtration
True
52
T/F: Clonidine is useful in the treatment of hypertension complicated by renal disease
True
53
T/F: Clondine should not be given to patients who are at risk for mental depression
True
54
nonselective b blockers (negative ISA)
Propranolol, sotalol, timolol
55
nonselective b blockers (positive ISA)
pindolol, oxprenolol
56
selective b blockers (negative isa)
atenolol, metoprolol, bisoprolol
57
selective b blockers (positive ISA)
celiprolol, acebutolol
58
b blockers with alpha blocking activity
carvedolol, labetolol
59
T/F: you can give non selective b blockers to asthmatic patients
false
60
b blockers recommended forpatients with heart failure
selective positive ISA (celiprolol, acebutolol)
61
ADR of A blockers
retention of salt and water
62
Reversible Non selective alpha adrenorecept agonistt
Phentolamine, tolazoline
63
irreversible non selective alpha adrenorecept agonistt
phenoxybenzamine
64
selective alpha 1 blockers
prazosin, terazosin, doxazocin, alfuzosin, bunazosin, tamsulosin
65
selective alpha 2 blockers
yohimbine, idazoxan
66
miscellaneous alpha adrenorecept agonistt
ergot alkaloinds
67
direct vasodilators
hydralazine, minoxidil
68
acts mainly by releasing nitric oxide (NO), endothelium-derived relaxing factor (EDRF)
Hydralazine
69
Hydralazine dilates _______
arterioles, not veins
70
ADR of hydralazine
myocardial ischemia & precipitation of angina, lupus- like syndrome
71
T/f: hydralazine cannot cause renal damage
true
72
T/F: hydralazine's adr can still be reversed if drug is stopped
true
73
Metabolized in the liver to minoxidil sulfate, which is a K+- channel opener in SM MS→ hyperpolarization & relaxation of smooth muscle.
minoxidil
74
Minoxidil adr
myocardial ischemia, Growth of body hair
75
CCB examples
diphenylalkylamines, benzothiazepines, dihydropyridines
76
diiphenylalkylamines
verapamil
77
benzothiazepines
diltiazem
78
1st gen dihydropyridines
nifedipine
79
2nd gen dihydropyridines
isradipine, nicardipine, felodipine
80
3rd gen dihydropyridines
amlodipine
81
T or F: CCB are useful in treating HTN patients who also have asthma, diabetes, and/or peripheral vascular disease
True
82
T/F: CCBs are not useful in angina
False
83
CCBs that are used in the treatment of atrial fibrillation
Diltiazem and verapamil
84
ADR of CCB
cardiac depression
85
INHIBITORS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
1. β-Adrenoceptor blockers.
2. Renin antagonist: Aliskiren
3. Angiotensin converting enzyme inhibitors (ACEs).
4. Angiotensin receptor blockers.
5. Aldosterone antagonists: Spironolactone
86
T/f: Ace inhibitors can cause Severe hypotension especially in hypovolemia
true
87
T/F: Ace can cause Chronic renal failure particularly in patients with bilateral renal artery stenosis or renal artery stenosis of a solitary kidney
False; acute
88
T/F: Ace can cause Hyperkalemia
true
89
due to bradykinin or susbtance P, Ace inhibitors can cause
Dry cough, wheezing, angioedema
90
may cause proteinuria & neutropenia at high doses, especially in patients with renal insufficiency.
Captopril
91
Ace inhibitors can be prescribed to pregnant patients
False, can cause fetal malformations
92
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.
ARBs
93
ARBs examples
Losartan
Valsartan
Candesartan
Eprosartan
Irbesartan
Telmisartan
Olmesartan
94
ADRs of ARBs are similar to ACEs including wheezing, angioedema & cough
false; except wheezing, angioedema & cough
95
Renin Antagonist
Aliskiren
96
directly inhibits renin &, thus, acts earlier in the renin–angiotensin–aldosterone system than ACEIs or ARBs.
Renin antagonists
97
Renin antagonist should not be routinely combined with an
ACE or Arbs
98
T/F: Aliskiren is contraindicated during pregnancy.
True
99
is metabolized by CYP 3A4 & is subject to many drug interactions.
Aliskiren
100
Treatment of choice for heart failure
ACEI/ARB + BB + diuretic + spironolactone
101
Treatment of choice for Post-MI/Clinical CAD
ACEI/ARB, BB
102
Treatment of choice for CAD
ACEI/ARB, CCB, diu, bb
103
Treatment of choice for diabetes
ACEI/ARB, CCB, diuretic
104
Treatment of choice for CKD
ACEI/ARB
105
Treatment of choice for rcuurent stroke prevention
ACEI,diureitc
106
Treatment of choice for pregnancy
Labetolol, nifedipine, methyldopa
107
Possibly safer in patients with COPD, asthma, diabetes, and peripheral vascular disease
Beta-1 Selective Blockers
108
When you administer Diuretics to your patients, you must monitor for __________
hypokalemia
109
Diuretitcs is most effective when combine with
ACEI
110
T/F: ACEI/ARBs may also cause hyperkalemia
True
111
T/F: Losartan prevent migrain headaches
False. Losartan lowers uric acid levels; candesartan prevent migraine headaches
112
What drug class can mask hypoglycemic awareness
Beta blockers
113
What drug class may cause orthostatic hypotension
Vasodilators
114
This is available in weekly patch formulation for resistant hypertension
Clonidine (Centrally Acting Agents)
115
HTN drugs for Elderly
Thiazides, CCB, ACEI, ARBs
116
HTN drugs for Diabetic
ARBs, ACEI, CCB, Diu
117
HTN drugs for patients with renal disease
ARBs, ACEI
118
HTN drugs for Pregnant women
methyldopa, labetalol, nifedipine, hydralazine, hydrocholorthiazide
