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Pharmacology II > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the goal when treating hypertension?

A

<140/90

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2
Q

What is the goal blood pressure of an individual with diabetes?

A

<140/80

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3
Q

What is the goal blood pressure of an individual with chronic kidney disease and proteinuria?

A

<130/80

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4
Q

What is used as initial drug therapy for hypertension by increasing sodium and water retention?

A

Thiazide diuretics

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5
Q

What conditions can Thiazide diuretics induce?

A

hypokalemia and hyperuricemia

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6
Q

What kind of diuretics act by blocking sodium and chloride reabsorption in the kidneys, even in patients with poor renal function or those who have not responded to thiazide diuretics?

A

Loop diuretics

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7
Q

What mineral increases in the urine with loop diuretics?

A

Calcium

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8
Q

Who would typically use a beta blocker?

A

Hypertensive patients with heart disease

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9
Q

What drug is a nonselective beta-blocker, reduces chronotropic, inotropic and vasodilator responses by competing for the receptor site, and B1 blockade of juxtaglomerular apparatus lead to decrease in renin release?

A

Propranolol

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10
Q

What are the adverse effects of Propranolol?

A
  • bronchoconstriction
  • hypotension
  • bradycardia
  • sexual dysfunction
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11
Q

What is the first line treatment of hypertension in patients with a variety of compelling indications, including high coronary disease risk or history of diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease?

A

ACE Inhibitors

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12
Q

What do ACE inhibitors decrease and what do they increase?

A

decrease angiotensin II

increase bradykinin

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13
Q

What condition do ACE inhibitors slow the progression of?

A

Diabetic nephropathy

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14
Q

What kind of patients are ACE inhibitors a first-line treatment with?

A

systolic dysfunction and following a myocardial infarction

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15
Q

What are the adverse effects of ACE Inhibitors?

A

Dry cough
rash
hypotension
hyperkalemia

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16
Q

What is the key ACE inhibitor decreases BP by inhibiting the enzyme responsible for production of angiotensin II, a potent vasoconstrictor and prevents breakdown of bradykinin, a vasodilator?

A

Captopril

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17
Q

What class of drugs are alternatives to ACE Inhibitors and are drugs that block the AT1 receptors, decreasing the activation of AT1 receptors by angiotensin II?

A

Angiotensin Receptor Blockers (ARBs)

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18
Q

What is the key difference in ARBs versus ACE Inhibitors?

A

ARBs do not increase bradykinin levels

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19
Q

What are the adverse effects of ARBS?

A

same as ACE Inhibitors

20
Q

T/F: ARBs should not be combined with an ACE inhibitor for the treatment of hypertension due to similar mechanisms and adverse effects

A

True

21
Q

What is an example of an ARB?

A

Losartan

22
Q

Do Selective Renin Inhibitors act earlier or later in the renin–angiotensin–aldosterone system than ACE inhibitors or ARBs ?

A

Earlier

23
Q

What is the contradiction with Selective Renin Inhibitors?

A

Pregnancy

24
Q

What is the adverse effects of Selective Renin Inhibitors?

A

Diarrhea, cough, and angioedema

25
Q

What is the recommended treatment option in hypertensive patients with diabetes or angina?

A

Calcium Channel Blockers

26
Q

What is the only member of Diphenylalkylamines class and is the least selective of any calcium channel blocker and has significant effects on both cardiac and vascular smooth muscle cells?

A

Verapamil

27
Q

What is Verapamil used to prevent?

A

migraine and cluster headaches

28
Q

What is the only member of Benzothiazepines class and affects both cardiac and vascular smooth muscle cells?

A

Diltiazem

29
Q

What do dihydropyridines have a much greater affinity for?

A

vascular calcium channels

30
Q

what is the main MOA of Calcium Channel Blockers?

A

causes vascular smooth muscle to relax, dilating arterioles

31
Q

What 2 drugs are used in the treatment of atrial fibrillation?

A

Diltiazem and verapamil

32
Q

What are 2 key adverse effects for Verapamil?

A

atrioventricular block and constipation

33
Q

What class of drugs produce a competitive block of α1-adrenoceptors and decrease peripheral vascular resistance and lower arterial blood pressure by causing relaxation of both arterial and venous smooth muscle?

A

Alpha-Blockers

34
Q

What can Alpha-blockers also treat in males?

A

Benign prostatic hyperplasia

35
Q

What alpha blocker is mainly used in the treatment of heart failure?

A

Carvedilol

36
Q

What alpha-blocker is used in the management of gestational hypertension and hypertensive emergencies?

A

Labetalol

37
Q

What centrally acting adrenergic drug stimulates alpha 2 adrenergic receptors in the brain reducing sympathetic outflow from the CNS and decrease peripheral resistance, renal vascular resistance, heart rate, and blood pressure?

A

Clonidine

38
Q

What are the adverse effects of Clonidine?

A
  • vasoconstriction and increased BP
  • Drowsiness, dizziness, and headache
  • Mild bradycardia
  • Xerostomia
  • Constipation
39
Q

What centrally acting adrenergic drug Acts as alpha 2 receptor agonist and acts centrally to stimulate alpha receptors decreasing sympathetic outflow and decreasing blood pressure?

A

Methyldopa

40
Q

What are the adverse effects of Methyldopa?

A
  • edema
  • sedation, dizziness, and headache
  • bradycardia
  • Lupus like syndrome
  • Positive Coomb’s test
41
Q

What act by producing relaxation of vascular smooth muscle, primarily in arteries and arterioles which results in decreased peripheral resistance and blood pressure?

A

Vasodilators

42
Q

What concentrations can vasodilators increase?

A

plasma renin concentrations

43
Q

What vasodilator is almost always administered in combination with a β-blocker and diuretic?

A

Hydralazine

44
Q

What do the three above drugs decrease?

A

cardiac output, plasma volume, and peripheral vascular resistance

45
Q

What drug is used for controlling blood pressure in pregnancy induced hypertension?

A

Hydralazine

46
Q

What vasodilator causes hypertrichosis (the growth of body hair) and is used topically to treat male pattern baldness?

A

Minoxidil

Pharmacology II (23 decks)

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