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Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

maximum blood pressure during contraction of ventricles is called _______

A

systolic pressure

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2
Q

minimum pressure recorded just prior to next contraction is called _________

A

diastolic pressure

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3
Q

define stage 1 HTN

A

systolic BP from 140-159

diastolic BP in 90s

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4
Q

define stage 2 HTN

A

systolic BP from 160-179

diastolic BP in 100-109 range

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5
Q

define stage 3 HTN

A

systolic BP >180
diastolic BP >110
aka malignant HTN

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6
Q

what outcomes can you expect to improve by treating elevated BP

A

atherosclerosis ā€“> MI & stroke
HF
renal damage

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7
Q

non-pharmacologic tx to HTN

A

sodium restriction
weight loss
smoking cessation
stress management

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8
Q

four categories of antihypertensive drugs

A

Diuretics
Beta blockers
CCB
ACE/ARB

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9
Q

2014 BP guidelines, which 3 or 4 are recommended in general non-black population?

A

Diuretic, ACE/ARB, CCB

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10
Q

at which site do loop diuretics act?

A

thick ascending loop of henle

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11
Q

at which site to thiazides act?

A

distal convoluted tubule

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12
Q

name the 4 common thiazide diruetics

A

Chlorothiazide (prototype)
Hydrochlorothiazide
Chlorthalidone
Metolazone

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13
Q

what is the MOA of thiazide diuretics

A

inhibit Na and Cl transportere in distal convoluted tubule
increase NA and Cl excretion
increase K/Mg excretion
decrease Ca excretion
natriuretic effect on Na reduces circulating blood vol. and relaxes vascular SM in wall of arteries

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14
Q

Side effects of thiazide diuretics

A

*****hypokalemia (order CMP after 6 mo use)

hyponatremia

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15
Q

name the 4 loop diuretics

A

Furosemide (prototype)
Bumetanide
Torsemide
Ethacrynic acid

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16
Q

MOA loop diuretics

A

inhibits apical Na-K-Cl transporter in thick ascending loop of henle (these drugs really make you pee)
competes with Cl binding sites
enhances passive Mg and Ca excretion
inhibits reabsorption of 25% of glomerular filtrate

17
Q

which diuretic is preferred in patients with moderate-severe chronic kidney dz

A

loop

18
Q

side effect of loop diuretics

A

increase lithium toxicity
hypokalemia**
hyponatremia

19
Q

what are the best tolerated antihypertensives?

A

RAS: ACE/ARB*****

20
Q

T/F: dual RAS blockade either with an ACE-Iplus an ARB or with aliskiren plush ACE-I or ARB is contraindicated

A

true

21
Q

how do ACE-I, ARBs and aliskiren work?

A

blocking conversion of angiotensin I into angiotensin II and thus reducing effects of angiotensin II on blood vessels
they are basically vasodilators

22
Q

name the 4 ACE-Iā€™s

A

Lisinopril
Enalapril
Catopril
Ramipril

23
Q

name the 4 ARBs

A

Losartan
Irbesartan
Valsartan
Candesartan

24
Q

what are the side effects of RAS

A 
contraindicated in pregnancy --> birth defects
mc is dry cough
angioedema (mc in ACE-I)
hyperkalemia
small reductions in kidney function
25
Q

Three classes of CCB

A

Phenylalkylamines (Verapamil)
Benzothiazepines (Diltiazem)
1, 4-Dihydropyridines (nifedipine)

26
Q

which CCBs work thru decreasing CO

A

Phenylalkylamines and Benzothiazepines

27
Q

which CCB is a vasodilator

A

1,4-Dihydropyridines

28
Q

what is the principal side effect of dihydropyridines

A

ankle edema

can also cause gingival hyperplasia

29
Q

side effect of verapamil and diltiazem

A

impairment of cardiac conduction (esp. in older pts)

30
Q

Beta-1

A

tachycardia
increased lipolysis
increased myocardial contractility = increased cardiac output

31
Q

Beta-2

A

vasodilation
slightly decreased peripheral resistance
bronchodilation

32
Q

MOA beta blockers

A

all are competitive antagonists

antagonize effects of catecholamines on heart

33
Q

cardioselective BBs

A 
metoprolol
esmolol
acebutolol
atenolol (markedly hydrophilic --> can penetrate tissue less well, making it preferred in practice)
betaxolol
34
Q

non-cardioselective BBs

A

carvedilol

35
Q

what BB is contraindicated in pts with lung dz

A

carvedilol

36
Q

adverse side effects Beta blockers

A

CNS effects (sedation, depression, hallucinations)
precipitation or worsening of HF
hypoglycemia unawareness in diabetes
worsening of impotence

Pharmacology (6 decks)

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