Hypertension Flashcards

1
Q

Alpha-2 receptors inhibit….

A

Norepinephrine release

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2
Q

Stimulation of alpha-1 receptors located on arterioles and venules causes….

A

Vasoconstriction

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3
Q

Activation of beta-2 receptors causes….

A

Vasodilation

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4
Q

Beta-1 receptors are located on

A

The heart and kidneys

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5
Q

Beta-1 receptors regulate…

A

HR and contractility impacting cardiac output

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6
Q

Blocking beta-1 receptors….

A

Decreases CO, peripheral resistance and BP

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7
Q

BP rises as a result of

A

Sodium and water elimination by kidney,
In turn plasma volume, CO and BP decrease

Dysfunction of this raises BP and plasma volume

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8
Q

Renin is released in response to….

A

Changes in BP, caused by reduced renal perfusion, decreased intravascular volume or increased circulation of catecholamines

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9
Q

Angiotensin I is converted into

A

The vasoconstrictor angiotensin II by angiotensin-converting enzyme (ACE)

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10
Q

Angiotensin II causes

A

Vasoconstriction and stimulation of the sympathetic nervous system and the release of aldosterone from the adrenal gland resulting in water and salt retention

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11
Q

Thiazides

Mechanism of action

A

Increasing urinary excretion of sodium and chloride in equal amounts and inhibit reabsorption

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12
Q

Thiazides

Contraindications

A

Not recommended in pts with creatinine clearance of <30mL/min
Renal decompensation
Hypersensitive to thiazides or Sulfonamides

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13
Q

Thiazides

Adverse events

A
Hypokalemia
Hypomagnesemia
Hypercalcemia
Hyperuricemia
Hyperglycemia 
GI upset
Tinnitus
Paresthesia
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14
Q

K+ sparing diuretics have the potential for causing ….

A

Hyperkalemia and hyponatremia, especially in pts with renal insufficiency or diabetes. Pts with concurrent tx with an acei, nsaids, or k+ supplements

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15
Q

Beta-1 receptors (heart and kidneys) regulate….

A

Heart rate
Renin release
Cardiac contractility

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16
Q

Beta-2 receptors (lungs, liver, pancreas, and arteriolar smooth muscle) regulate ….

A

Bronchodilation and vasodilation

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17
Q

Beta-blockers reduce BP by….

A

Blocking central and peripheral beta receptors, resulting in decreased CO and sympathetic outflow

18
Q

Beta-1 receptors are referred to as..,,,

A

Cardioselective because they do not significantly block beta-2 receptors

Better for asthmatics, CPOD, and peripheral vascular disease

19
Q

BB that possess sympathomimetic activity (ISA)

A

Partial beta-receptor agonist that reduce HR and contractility during excessive sympathetic outflow

20
Q

In diabetics, BB ….

A

Can mask all symptoms of hypoglycemia with the exception of sweating

21
Q

ACE

Mechanism of action

A

Inhibiting ACE enzyme, converting angiotensin I to angiotensin II a potent vasoconstrictor
CHF, post MI, systolic dysfunction

22
Q

ACE

Contraindications

A

Avoid with renal issues
Don’t use with ARBs
Past angioedema during pregnancy

23
Q

ACE

Adverse Events

A
Chronic dry cough
Rashes
Dizziness 
Angioedema is rare most frequently in blacks, reversible with discontinuation 
Laryngeal edema 
Hyperkalemia
24
Q

ARBs mechanism of action

A

Block vasoconstriction and aldosterone-secreting effects

Indicated for HTN, nephropathy in type II diabetes, HF and those that can’t tolerate ACE

25
Q

ARBs more effective

A

Losartan more effective than atenolol in reducing cardiovascular morbidity and mortality in DM with HTN and LVH

26
Q

ARBs and cough and hyperkalemia….

A

Lower than with ACEs

27
Q

Angioedema with ARBS vs ACEs

A

ARBs less common

28
Q

CCB

Mechanism of action

A

Inhibit the movement of Ca+ ions across the cell membranes

Relaxing and vasodilation, decreases HR and slows cardiac conduction at the AV node

Effective with black pts

Tx HTN associated with ischemic heart disease

Recommended for Prinzmetal angina

29
Q

CCB

Contraindications

A

Not first line for HF
Dilt and verapamil should be avoided in HB and with EF <45%
Causes reflex tachycardia

30
Q

CCB

Adverse Events

A
Produce symptoms of vasodilation, such as headaches, flushing, palpitations, and peripheral edema
Dizziness 
Gingival hyperplasia
Mood changes
GI upset
Peripheral edema
Bradycardia 
AV block
CHF
Verapimil causes constipation in elderly
31
Q

Peripheral Alpha-1 receptor blockers

A

Cadura or minipress
Effective in pts with benign prostatic hypertrophy

Dilate both arterioles and veins, causing relaxation of smooth muscle

32
Q

Diuretics work by…..

A

Increasing urine output therefore decreasing fluid volume

33
Q

Beta blockers work by…..

A

Blocking the SNS and inhibit HR

34
Q

CCB work by….

A

Causing vasodilation, affect preload and afterload

35
Q

ACE inhibitors work by….

A

Stopping conversion of angiotensin I to angiotensin II in RAAS

36
Q

ARBs work by…..

A

Blocking the action of angiotensin II in RAAS

37
Q

Adrenergic inhibitors….

A

Cause vasodilation, centrally acting

38
Q

Vasodilators work by….

A

Causing vasodilation

39
Q

JNC 8 algorithm

All ages CKD present with or without DM

A

Initiate ACEI or ARB alone or in combo with another drug class

40
Q

JNC 8 algorithms
All ages
DM present no CKD
Black

A

Initiate thiazide type diuretic or CCB, alone or in combination

41
Q

JNC 8 algorithms
All ages
DM present no CKD
Nonblack

A

Initiate thiazide type diuretic or ACEI or ARB or CCB, alone or in combination