Hypertension Flashcards
What type of autonomic receptor does ACh act on?
Muscarinic (Parasympathetic effect)
What type of autonomic receptor does Norepinephrine act on?
alpha1/2
beta1/2/3
(Sympathetic effect)
True/False? Arterioles are more capacitive than veins, which are resistive
False
Which is faster? Autonomic Nervous control of bp or Hormonal control?
Autonomic loop
What is an average blood pressure?
How do you diagnose hypertension?
120/90 mmHg
3 repeated measurements above the average
True/False? Blood Pressure tends to increase with age
True
What are the four sites of blood pressure regulation?
Arterioles (resistance)
Venules (capacitance)
Heart (pump output)
Kidneys (volume)
What are the 4 major drug groups for therapy?
Diuretics
Sympathoplegics
Vasodilators
Angiotensin antagonists
What are the two main diuretic classes? What severity of HT would you need to prescribe each? What are their two main actions?
Thiazides (mild HT) Loop Diuretics (severe HT)
Both reduce blood volume
Affect smooth muscle tone
What is hydrochlorothiazide?
Diuretic (thiazide)
Block Na/Cl symporter in distal convoluted tubule (Ca reabsorbed)
TOXICITY: Hypokalemia
What is furosemide?
Loop Diuretic
Block Na/K/2Cl symporter in thicc ascending loop (Ca excreted)
TOXICITY: hypokalemia
How do Sympathoplegics work?
Decrease sympathetic discharge or its effects on Cardiovascular system
What is Clonidine Methyldopa?
Sympathoplegic (Centrally acting agent), alpha2-selective agonist
Mechanism not known, minimal toxicity (sudden cessation causes severe HT)
How does reserpine work in the context of hypertension?
Sympathoplegic (postganglionic sympathetic neuron blockers)
Rarely used
blocks uptake
TOXICITY: depression
What is Prazosin?
Sympathoplegic (Adrenoceptor blocker)
Blocks alpha1 receptors (vessels)
What is Propranolol?
Sympathoplegic (Adrenoceptor blocker)
Blocks beta1 receptors (heart)
What is Nitroprusside?
Nitrovasodilator
Activates soluble guanylate cyclase, relaxing smooth muscle
TOXICITY: tachycardia
What is Diazoxide?
K Channel Opener/Agonist
Hyperpolarizes cell, causing relaxation
TOXICITY: tachycardia
True/False? if a patient doesn’t respond to monotherapy, there is nothing that can be done
False, polypharmacy
Name a vasoselective Ca Channel blocker class and give an example
Dihydropyridines
e.g. Nifedipine
Name two classes of Cardiac/Vascular acting Ca Channel blockers and give an example for each
Phenylalkylamines, e.g. Verapamil
Benzothiazines, e.g. Diltiazem
ACE inhibitors such as captopril are a subtype of which class of antihypertensive? How do they work?
Angiotensin antagonists
Blocks synthesis of angiotensin II from angiotensin I
TOXICITY: prevents breakdown of bradykinin
Angiotensin-receptor inhibitors such as losartan are a subtype of which class of antihypertensive? How do they work?
Angiotensin antagonists
Prevents angiotensin II from binding, reducing vasopressin release
