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Pharmacology II > HTN4 > Flashcards

HTN4 Flashcards

1
Q

what are the 4 classes of sympathoplegic agents for HTN?

A
  1. Beta-Blockers
  2. Alpha-1 Blockers
  3. Alpha-2 Agonists
  4. Adrenergic blocking agents
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2
Q

ACE-I’s are eliminated where, except for which one is hepatically eliminated

A

all renally eliminated

except fosinopril has some hepatic elimination

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3
Q

nitric oxide has what effect on PVR

A

decreases PVR

nitric oxide is a vasodilator

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4
Q

what catecholamine receptors are found on the presynaptic cell?

A

alpha2

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5
Q

what receptors are on post synaptic vascular smooth muscle cells

A

alpha1 receptors

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6
Q

what receptors are responsible for chronotropic action

A

beta1

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7
Q

what receptor activation increases liver’s release of renin

A

beta 1

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8
Q

what are beta blockers effect on chronotropic and inotropic effects?

A

decrease both

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9
Q

chronotropic effects refers to what specifically?

A

heart reate

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10
Q

inotropic effects refer to what specifically

A

stroke volume

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11
Q

list the adverse effects of beta blockers

A 
HBBEEF
hypoglycemia
bradycardia
exacerbate heart failure
bronchoconstriction (B2 rec)
depression
ED
fatigue
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12
Q

how do BB’s worsen HF?

A

by decreasing CO

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13
Q

which BB’s are B1 selective

A 
NEVER BE BAMA
Nebivolol
Bisoprolol
Betaxolol
Acebutolol
Metroprolol
Atenolol
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14
Q

why should BB’s not be stopped abruptly

A

receptor upregulation leads to rebound hypertension

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15
Q

who should use BB’s with caution

A

CHAD

COPD
Heart Failure
Asthma
Diabetes

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16
Q

what was the 1st BB?

A

propranolol

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17
Q

what drugs can interact with metoprolol

A

SSRI’s
Bupropion
H2-antagonists

18
Q

what is metoprolol’s extended release form

A

metoprolol succinate

19
Q

what is metoprolol’s immediate release form

A

metoprolol tartrate

20
Q

what type of metabolism does metoprolol go through?

A

hepatic metabolism

CYP2D6

21
Q

how is atenolol primarily excreted

A

unchanged in urine

22
Q

what 2 nonselective BB’s are excreted in urine unchanged

A

nadolol and carteolol

23
Q

name 2 cardioselective BB’s other than metoprolol metabolized by CYP2D6

A

betaxolol and bisoprolol

24
Q

name 2 cardioslective BB’s dosed once daily due to long half life

A

betaxolol and bisoprolol

25
Q

name 3 partial agonist BB’s?

A

pindolol
acebutolol
penbutolol

26
Q

define B-receptor partial agonist

A

binds to B receptor but produces little effect,
very little side effects
intrinsic sympathomoimetic activity

27
Q

name a cardioselective partial agonist BB

A

acebutolol

28
Q

what are the 2 inactive isomers of labetalol

A

SS and RS are inactive

29
Q

what is the potent alpha-blocker isomer of labetalol

A

SR = potent alpha

30
Q

what is the potent non-selective beta blocking isomer of latetalol

A

RR

31
Q

list the 4 isomers mixed in laetalol

A 
SS = inactive
RS = inactive
SR = potent alpha blocker
RR = poten non-selective B-blocker
32
Q

what are the two ismomers mixed for Carvedilol and there effects

A 
S(-) = nonselective B-blocker and alpha-blocker
R(+) = alpha-blocker
33
Q

how is carvedilol metabolized?

A

hepatic metabolism

2C9 and 2D6

34
Q

what 2 isomers are mixed racemically for Nebivolol and there effects

A 
D- = beta1 selective
L- = increased NO production
35
Q

what is the half life of Nebbivolol

A

10 hours

36
Q

what are 3 racemically mixed vasodilating BBs

A
  1. labetolol
  2. carvedilol
  3. nebivolol
37
Q

name a cardioselective, rapidly metabolized BB

A

esmolol

38
Q

what is esmolol’s half life?

how is it metsabolized

A

9-10 minutes

RBC esteraces

39
Q

how is esmolol administered?

for what?

A

continuous IV infusion

intraoperative HTN or HTN emergency with tachycardia

40
Q

BB’s are used concomitantly with HTN and what other diseases?

A

Supraventricular tachycardia
heart failure
angina pectoris
previous MI

Pharmacology II (15 decks)

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