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Cardiovascular > HTN Pharm > Flashcards

HTN Pharm Flashcards

1
Q

adverse effects verapamil

A

flushing

headaches

negative ionotropes (worse of Ca blockers)

constipation (worse of Ca blockers)

reduced av conduction (worse of Ca blockers)

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1
Q

neronal and ganglionic blockers

A

guanethadine

guandadrel

reserpine

trimethapan (ganglionic)

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2
Q

adverse effects B blockers

A

glucose intolerance, masked hypoglycemia

bradycardia, dizziness,

increased TGs, decreased HDL

Depression, fatigue, sleep disturbance

reduced CO

impotence

exercise intolerance

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2
Q

direct renin inhibitor

A

aliskiren

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3
Q

adverse effects, aliskerin

A

orthostatic hypotension

hyperkalemia

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4
Q

combine reserpine and guanethidine wiht ___ to avoid water retention

A

thiazide diuretic

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5
Q

selective alpha 1 blockers

A

prozosin

terazosin

doxazosin

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6
Q

reflexive effect of direct arterial vasodilators that can be counteracted with beta blockers

A

reduced pressure > compensatory increaesed sympathetic flow - HR increase, renin increase

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7
Q

ACE inhibitors

A

Captopril

Elanopril

Lisinopril

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8
Q

Direct Arterial Vasodilators

A

Hydralazine

Minoxidil

diazoxide

nitroprusside

fenoldopam

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8
Q

Ca channel blockers

A

Nifedipine

Diltiazem

Verapamil

Amlodipine

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9
Q

action of a1/a2 blokcers (phenoxybenzamine, phentolamine)

A

inhibit smooth muscle catecholamine uptake in peripheral vasculature

vasodilation

lowered BP

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9
Q

central a2 agonists

A

clonidine

gunabenz

a-methyldopa

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10
Q

sympathetic impact on lung

A

bronchodilation (beta2)

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10
Q

ACE distribution

A

prmarily endothelial cells

blood vessels major site of angitotensin II production

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11
Q

monitor __ and ___ within 4 weeks of ACE inhibitor regiment

A

K and SCr

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12
Q

impact of selective alpha1 blockers (terasozin, dozazosin, prazosin)

A

smaller increase in heartrate than nonselective

do not stimulate renin release

do not block alpha 2 receptors - allows NE inhibition at autoreceptor

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13
Q

ACE inhibitors

A

captopril

enalapril

lisinopril

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14
Q

most effect demographics, beta blockers / mize blockers

A

better in young adults (older adults, combine with diuretics)

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14
Q

central a2 agonists

A

cliinidine

guanabenz

a metyhl dopa

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14
Q

JNC8 reccomentdation for AA

A

CCB or thiazide

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15
Q

symptoms hypertensive emergency

A

encepoaplopathy

intracranial hemorrhage

acute LV failure with pul edema

dissecting oartic aneurism

unstable angia

ecamplsia

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15
Q

Beta blocker action at B1 receptors

A

heart kidney

stimulate HR, contractility, renin release

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17
Q

adverse effects, diltiazem

A

flushing

headaches

negative ionotrope

edema

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18
Q

beta blocker efficacy is dependent upon ___ status

A

renin status (not effective for low renin HTN)

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19
Q

changes in JNC8

A

no lifestyle reccommendations

Racial, CKD, diabetic subgroups

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20
Q

side effect NO donors (nitroprusside)

A

cyanide buildup

(especially if Kidney failure

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21
Q

Ca channel blockers

A

Diltiazem (non-dihydro)

Verapamil (non-dihydro)

Amlodipine

Nifedipine

23
Q

beta 1 blockers

A

metropolol

atenonolol

25
Q

sympathetic impact on arterioles

A

constriction (skin, viscera) alpha 1

dilation (skeletal muscle, liver) beta 2

26
Q

beta 1 blockers

A

metropolol

atenolol

28
Q

alpha 1/2 blockers

A

phenoxybenzamine

phentolamine

28
Q

adverse effects reserpine and guanethidine (neuronal blockers)

A

sedation, depression increased gastric acid (reserpine

decreased CO

sodium water retntion

diarrhea

bradycardia

29
Q

sympathetic impact on heart

A

contractility and HR (beta 1)

30
Q

beta blocker actiona t beta 2 receptors

A

lugn liver pancreas, arterolal smooth muscle

bronchodilation and vasodilation

mediate insulin secretion and glycogenolysis

31
Q

JNC8 reccommendation for DM

A

Thiazide

CCB

ACEi

ARB

33
Q

new JNC BP goals for under 60 years, over 60

A

>60 150/90

34
Q

aldosterone antagonists

A

sprinolactone

eplerenone

35
Q

RAS system inhibitors

A

aliskiren

losartan

captopril

enalapril

lisinopril

36
Q

impact aldosterone antagonists

A

inhibit renal effect of aldosterone (Na and water retention)

and extra renal effects (fibrosis, inflammation)

36
Q

At1 receptor action

A

vasoconstriction

vascular prolif

aldosterone secretion

cardiac myocyte proliferation

increased sympathetic tone

37
Q

first line drugs JNC8(vs 7)

A

7 = Thiazide diuretics

8 = Thiazide

CCB

ACE inhibitor

ARB

38
Q

adverse effects direct arterial dilators

A

sodium/water retention

tachycardia, angina

Hyrdralazine - lupus like syndrome

minoxidil - hair growth

39
Q

when beta1 selectivity is lost at high doses of B1 blockers antenolol and metropolol, may exacerpate

A

bronchospastic disease

40
Q

action ACE inhibitiors

A

block bradykinin degredations

stimulate sythesis of vasodilation substances like prostaglandin E2 and prostacyclin

prevent or reggress LVH

42
Q

dihydropyridines vs non-dihyrdropyridines

A

dihydropyidines don’t alter av conduction (no HR depression)

so no baroreceptor mediated reflex tachycardia

43
Q

adverse effects central a2 agonsits

A

na/water retention

discontinued = rebound HTN

depression, dizziness

clonidine - anticholinergic

methyldopa - hepatitis, hemolytic anemia

44
Q

alpha 1/2 blockers

A

phenoxybenzamine

phentolamine

45
Q

ARB

46
Q

Cardioselective beta blockers

receptor effects

A

metropolol and atenolol

inhibit b1 receptors at low to moderate dose

inhibit beta2 at higher dose (selective, not specific)

47
Q

adverse effects nifedipine

A

flushing

headaches

edema

refractoryness

48
Q

neuronal ganglionic blockers

A

guanethidine

guandadrel

reserpine

trimethapan (ganglionic)

49
Q

alpha 1 blocker first dose effect

A

orthostatic hypotension

tranisent dizziness, fainteness, palpitations, syncope withing 1-3 hours of first dose

reflex tachy

1st dose before sleep to minimize

50
Q

impact aliskerin

A

renin inhibition

does not black bradykinin breakdown - less cough than ace inhibition

52
Q

impact central a2 agonists (clonidine, guanabenz, amethyldopa)

A

reduce sympathetic outflow from vasomotor center

increasse vagal tone

53
Q

aldosterone antagonists

A

spironolactone

eplerenone

55
Q

sympathetic action on the kidney

A

increased renin (alpha-1, beta-1)

56
Q

diuretics

A

hydrochlorothiazide

fursemide

amiloride

57
Q

hypertesnive crisis level

58
Q

ACE / ARB precautions

A

acute kidney failure if:

severe bilateral artery stenosis (or solitary kindey stenosis)

contraindicated in pregnancy

60
Q

mixed Beta blockers

A

Propanolol (B1/B2)

Labetalol (B1/B2/a1)

61
Q

adverse effects diuretics

A

Electrolyte distubance

hyperglycemia

hypotension/orthstasis

lipid abnromalities

phosensitivity

ototoxicity

hyperuriciemia, gout flare

62
Q

JNC8 reccommendation for CKD

A

ACEi

or ARB

63
Q

AT2 receptor action

A

vasodilation

antiproliferation

apoptosis

64
Q

adverse effects ACE inhibitors

A

cough

angioedema

hyperkalemia (esp if CKD or DM)

neurropenia, agrnulocytosis, proteinuria, glomerulonephritis, acute renal fialure

65
Q

RAS inhibitors

A

aliskiren

losartan

captopril

enalpril

lisinopril

66
Q

selective alpha 1 blockers

A

prazosin

terzosin

doxazosin

67
Q

Direct Arterial Vasodilators

A

Hydralazine

Minoxidil

diazoxide

nitroprusside

fenoldopam

68
Q

adverse effects angiotensin II receptor blocker ARBs

A

orthostatic hypotension

renal insufficiency

hyperkalemia

Cardiovascular (39 decks)

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