HTN6

Question 1

what is clonidines effect on:

PVR, CO, HR, and SV

Answer 1

all decrease due to inhibition of NE binding a1, b1, and b2 receptors

Question 2

if alpha1 receptor is stimualated what occurs?

Answer 2

increased vasoconstriction, increased PVR

Question 3

beta blockade leads to what?

Answer 3

decreasaed HR

decreased SV

Question 4

which antihypertensive agent would be most appropriate to treat HTN crisis due to clonidine withdrawal:

a. lisonipril
b. labetalol
c. esmolol
d. prazosin

Answer 4

c. labetalol

Question 5

what are the 2 main groups of drugs for HTN considered vasodilators

Answer 5

Ca channel blockers

direct vasodilators

Question 6

what is activated by Nitric Oxide in a vascular smooth muscle cell

Answer 6

guanylyl cyclase

Question 7

what is the cascade stimulated by NO in vascular smooth muscle (3 steps after NO)

Answer 7

1. guanylyl cyclase converts GTP to cGMP
2. cGMP activates myosin-LC phosphatase
3. myosin-LC phosphatase causes relaxation

Question 8

how does myosin-LC cause smooth muscle relaxation

Answer 8

by dephosphorylating myosin light chain

Question 9

what CCB’s have use dependent binding

Answer 9

nondihydropyrimidines

Question 10

what CCB’s have voltage dependent binding

Answer 10

dihydropyrimedines

Question 11

what class is diltiazem

Answer 11

benzothiazepine

Question 12

what class is verapamil

Answer 12

phenylalkilamine

Question 13

what is the MOA of verapamil

Answer 13

blocks P-glycoprotein transporter, decreasing HR and FOC

Question 14

dihydropyridines have what type of selectivity? what does it cause there

Answer 14

vasoselective, causing vasodilation

Question 15

what CCB interacts with digoxin

Answer 15

verapamil

Question 16

what dihydropyrimidine is available IV and can be used in HTN crisis

Answer 16

nifedipine

Question 17

what type of CCB is associated with GI intolerance

Answer 17

non-dihydropyridines

Question 18

what type of CCB is associated with tachycardia

Answer 18

dihydropyridines

Question 19

what activates MLCK cascade for smooth muscle contration to take place

Answer 19

calcium

Question 20

how is hydralazine metabolized

Answer 20

acetylation

Question 21

what does tachyphylaxis mean

Answer 21

with repeated use, need a higher dose to get therapeutic effect

Question 22

what is minoxidil’s MOA

Answer 22

hyperpolarization by activating ATP modulated K channels

Question 23

what are some adverse effects of minoxidil

Answer 23

hypotrichosis
salt and water retention
cardiac effects (increases HR, FOC, and O2 demand)

Question 24

what oral vasodilator is also found in rogaine

Answer 24

minoxidil

Question 25

what is the parenteral vasodilator that increases dephosphorylation of MLCK in smooth muscle

Answer 25

sodium nitroprusside

Question 26

what is the MOA of sodium nitroprusside

Answer 26

donates NO causing vasodilation

Question 27

what are 3 adverse effects of sodium nitroprusside

Answer 27

1. cyanide toxicity
2. flushing
3. headache

Question 28

what is the MOA of diazoxide

Answer 28

activates K+ channels causing hyperpolarization

Question 29

what is another use of diazoxide?

how?

Answer 29

treats hypoglycemia

inhibits secretion of insulin

Question 30

what is the MOA of fenoldopam

Answer 30

activates dopamine receptors

Question 31

what is an adverse effect specific to fenoldopam

Answer 31

increase intraocular pressure

Question 32

how is fenoldopam generally dosed IV for HTN crisis?

Answer 32

low dose then titrate up

Question 33

list the parenteral vasodilators

Answer 33

1. sodium nitroprusside
2. diazoxide
3. fenoldopam

Question 34

what are some symptoms of hypertensive urgency

Answer 34

headache
SOB
nosebleed
anxiety

Question 35

why not drop bp quickly in HTN treatment?

Answer 35

leads to end organ ischemia or infarction

Question 36

what are 3 parenteral HTN crisis treatments often used

Answer 36

1. sodium nitroprusside
2. fenoldopam
3. labetalol

Question 37

what are 3 oral therapies for HTN treatment

Answer 37

1. clonidine
2. labatelol
3. captopril

Question 38

what class of drug is not recommended for HTN with HF?

Answer 38

CCBs