Hypertension

Question 1

What type of autonomic receptor does ACh act on?

Answer 1

Muscarinic (Parasympathetic effect)

Question 2

What type of autonomic receptor does Norepinephrine act on?

Answer 2

alpha1/2
beta1/2/3
(Sympathetic effect)

Question 3

True/False? Arterioles are more capacitive than veins, which are resistive

Answer 3

False

Question 4

Which is faster? Autonomic Nervous control of bp or Hormonal control?

Answer 4

Autonomic loop

Question 5

What is an average blood pressure?

How do you diagnose hypertension?

Answer 5

120/90 mmHg

3 repeated measurements above the average

Question 6

True/False? Blood Pressure tends to increase with age

Answer 6

True

Question 7

What are the four sites of blood pressure regulation?

Answer 7

Arterioles (resistance)
Venules (capacitance)
Heart (pump output)
Kidneys (volume)

Question 8

What are the 4 major drug groups for therapy?

Answer 8

Diuretics
Sympathoplegics
Vasodilators
Angiotensin antagonists

Question 9

What are the two main diuretic classes? What severity of HT would you need to prescribe each? What are their two main actions?

Answer 9

Thiazides (mild HT)
Loop Diuretics (severe HT)

Both reduce blood volume
Affect smooth muscle tone

Question 10

What is hydrochlorothiazide?

Answer 10

Diuretic (thiazide)
Block Na/Cl symporter in distal convoluted tubule (Ca reabsorbed)
TOXICITY: Hypokalemia

Question 11

What is furosemide?

Answer 11

Loop Diuretic
Block Na/K/2Cl symporter in thicc ascending loop (Ca excreted)
TOXICITY: hypokalemia

Question 12

How do Sympathoplegics work?

Answer 12

Decrease sympathetic discharge or its effects on Cardiovascular system

Question 13

What is Clonidine Methyldopa?

Answer 13

Sympathoplegic (Centrally acting agent), alpha2-selective agonist
Mechanism not known, minimal toxicity (sudden cessation causes severe HT)

Question 14

How does reserpine work in the context of hypertension?

Answer 14

Sympathoplegic (postganglionic sympathetic neuron blockers)
Rarely used
blocks uptake
TOXICITY: depression

Question 15

What is Prazosin?

Answer 15

Sympathoplegic (Adrenoceptor blocker)

Blocks alpha1 receptors (vessels)

Question 16

What is Propranolol?

Answer 16

Sympathoplegic (Adrenoceptor blocker)

Blocks beta1 receptors (heart)

Question 17

What is Nitroprusside?

Answer 17

Nitrovasodilator
Activates soluble guanylate cyclase, relaxing smooth muscle
TOXICITY: tachycardia

Question 18

What is Diazoxide?

Answer 18

K Channel Opener/Agonist
Hyperpolarizes cell, causing relaxation
TOXICITY: tachycardia

Question 19

True/False? if a patient doesn’t respond to monotherapy, there is nothing that can be done

Answer 19

False, polypharmacy

Question 20

Name a vasoselective Ca Channel blocker class and give an example

Answer 20

Dihydropyridines

e.g. Nifedipine

Question 21

Name two classes of Cardiac/Vascular acting Ca Channel blockers and give an example for each

Answer 21

Phenylalkylamines, e.g. Verapamil

Benzothiazines, e.g. Diltiazem

Question 22

ACE inhibitors such as captopril are a subtype of which class of antihypertensive? How do they work?

Answer 22

Angiotensin antagonists
Blocks synthesis of angiotensin II from angiotensin I
TOXICITY: prevents breakdown of bradykinin

Question 23

Angiotensin-receptor inhibitors such as losartan are a subtype of which class of antihypertensive? How do they work?

Answer 23

Angiotensin antagonists

Prevents angiotensin II from binding, reducing vasopressin release