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Systemic Pharm II > Hypertension > Flashcards

Hypertension Flashcards

1
Q

-PRIL Drugs

A

Ace Inhibitors; they inhibit Angiotensin II from forming

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2
Q
  • SARTAN Drugs
A

Angiotensin Receptor Blockers; they inhibit angiotensin II from binding to its receptor

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3
Q

Aliskiren

A

Renin Inhibitor

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4
Q

Chlorthalidone

A

Thiazide Diuretic which works in the Distal Tubule

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5
Q

Hydrochlorothiazide

A

Thiazide Diuretic which works in the Distal Tubule

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6
Q

Metolazone

A

Thiazide Diuretic which works in the Distal Tubule

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7
Q

Furosemide

A

Loop Diuretic which works in the Ascending LOH

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8
Q

Torsemide

A

Loop Diuretic which works in the Ascending LOH

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9
Q

Bumetanide

A

Loop Diuretic which works in the Ascending LOH

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10
Q

Mannitol

A

Osmotic Diuretic which works in the Descending LOH

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11
Q

Eplerenone

A

Potassium Sparing Diuretic

Aldosterone Antagonist

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12
Q

Spironolactone

A

Potassium Sparing Diuretic

Aldosterone Antagonist

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13
Q

Amiloride

A

Potassium Sparing Diuretic

Sodium Channel Blocker

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14
Q

Triamterene

A

Potassium Sparing Diuretic

Sodium Channel Blocker

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15
Q

Hydralazine

A

Vasodilator

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16
Q

Minoxidil

A

Vasodilator

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17
Q

Nifedipine

A

Calcium Channel Blocker

Dihydropyridine

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18
Q

Isradipine

A

Calcium Channel Blocker

Dihydropyridine

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19
Q

Felodipine

A

Calcium Channel Blocker

Dihydropyridine

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20
Q

Amlodipine

A

Calcium Channel Blocker

Dihydropyridine

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21
Q

Diltiazem

A

Calcium Channel Blocker

Non-Dihydropyridine

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22
Q

Verapamil

A

Calcium Channel Blocker

Non-Dihydropyridine

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23
Q

Acetazolamide

A

CAI which works in the Proximal Tubule

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24
Q

Methazolamide

A

CAI which works in the Proximal Tubule

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25
Q

Clonidine

A

Alpha 2 Agonist

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26
Q

Methyldopa

A

Alpha 2 Agonist

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27
Q

Prazosin

A

Alpha Blocker

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28
Q

Doxazosin

A

Alpha Blocker

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29
Q

Terazosin

A

Alpha Blocker

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30
Q

Fenoldopam

A

HTN ER

Dopamine and Alpha 2 Agonist

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31
Q

Nitroprusside

A

Vasodilator

HTN ER

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32
Q

Digoxin

A

Inhibits sodium pump and increases calcium concentration (contractility)

Positive Inotropic Agent

33
Q

Milrinone

A

phosphodiesterase inhibitor which increases calcium

34
Q

Dopamine

A

Beta Agonist for HF

35
Q

Dobutamine

A

Beta Agonist for HF

36
Q

Isosorbide Nitrate / Dinitrate

A

Vasodilator for HF

37
Q

what factors control arterial BP

A

CO and peripheral resistance

38
Q

How does the RAAS system work to control BP

A

a fall in BP stimulates release of renin from kidney

renin converts angiotensinogen to ATI (inactive)

ACE converts ATI to ATII (active)

ATII: vasoconstriction, release aldosterone (increases BV), release catecholamines (sym), and induce cardiac hypertrophy

39
Q

What are the effects of ACE inhibitors

A

less ATII + more bradykinin (VD and decrease Na/H20 retention which decreases BV)

40
Q

What are ACE inhibitors used for

A

diabetic nephropathy + patients with MI

1st line for HTN

41
Q

What are the contraindications for ACE inhibitors

A

fetotoxic !! don’t use with k-sparing diuretics

42
Q

What are the AE of ACE inhibitors?

A

chronic dry cough, skin rash, fever, hyperkalemia (do NOT use with k-sparing diuretics)

43
Q

What are the AE of aliskiren

A

fetotoxic and hyperkalemia

44
Q

What do diuretics do in general

A

induce urine production by decreasing reabsorption of sodium in nephron so that the ions will enter urine and water follows

45
Q

which diuretics are most likely for treating HTN

A

thiazide diuretics and k-sparing diuretics + calcium channel blockers

46
Q

What are the contraindications for thiazide diuretics

A

digoxin users

47
Q

What are the contraindications for CAI

A

Avoid in cirrhosis (liver issues)

48
Q

What are the contraindications for fenoldopam

A

glaucoma patients because it increases IOP

49
Q

what are the contraindications for digoxin

A

increase risk of toxicity with amiodarone, erythromycin, quinidine, tetracycline, verapamil

Corticosteroids, thiazide and loop diuretics all decrease K levels as well

50
Q

What are the effects of Thiazide Diuretics (sulfa)

A

inhibits the Na/Cl co-transporter: Na, K, and Mg OUT while Ca stays in

decreases peripheral resistance (decrease BP)

Takes 1-3 weeks for effects

51
Q

What are the effects of loop diuretics

A

inhibit the nacl and K+ co transport so EVERYTHING LEAVES (Na, K, Ca, and Mg)

increases prostaglandin synthesis

RAPID ONSET (ER USE) ~ highest efficacy in diuretics

52
Q

What are the uses of loop diuretics

A

reduce acute pulmonary edema of HF, treat hypercalcemia and hyperkalemia

53
Q

What are the AE of loop diuretics

A

ototoxicity (aminoglycosides), hyperuricemia, acute hypovolemia (bc so many things leaving nephron)

54
Q

What are the effects of potassium-sparing diuretics

A

inhibit Na reabsorption(decrease BV) and K excretion

55
Q

What are the effects of aldosterone antagonists

A

aldosterone is high in edematous states – can relieve edema

56
Q

What are the AE of aldosterone antagonists

A

GI upset, peptic ulcers, induce gynecomastia, menstrual irregularities

57
Q

What are the effects of sodium channel blockers

A

increase uric acid, renal stones

58
Q

What are the effects of CAIs

A

inhibits bicarbonate production and increases Na excretion

59
Q

What are the therapeutic uses for CAIs

A

treat glaucoma by decreasing AH production and for Acute Angle Closure Glaucoma with Acetazolamide

Treat mountain sickness and pseudotumor cerebri

60
Q

what are the AE of CAIs

A

metabolic acidosis, drowsy, k depletion, renal stones, paresthesia

61
Q

What is mannitol used for

A

increase water retention, prevent acute renal failure, and increase intracranial pressure

62
Q

What are the effects of vasodilators

A

relax vascular smooth muscle, decrease BP from nitric oxide, which results in release of renin and reflex tachycardia

63
Q

What are the uses for hydralazine

A

monotherapy in pregnant women

64
Q

What are the uses for Minoxidil

A

treats severe HTN + causes hypertrichosis

65
Q

What are the uses for calcium channel blockers

A

negative inotropic agents (decrease calcium and contractility) + increases dilation of coronary and periphery arteries (decrease BP)

66
Q

what are the AE of calcium channel blockers

A

the decreased contraction leads to peripheral edema, reflex tachycardia, flushing, constipation, dizzy, HA, fatigue

67
Q

what are the compensatory mechanisms of heart failure

A

when heart failure occurs the body increases the SYM NS and RAAS which leads to hypertrophy and stiffness which ultimately decreases contraction of the heart (long-term no good)

68
Q

what are the symptoms of heart failure

A

fatigue, fluid retention and dyspnea (SOB) due to abnormal blood volume and interstitial fluid

69
Q

what happens in systolic failure

A

reduced contractility leading to reduced CO

70
Q

what happens in diastolic failure

A

reduced filling and relaxation leading to reduced CO and hypertrophy (stiffness)

71
Q

what are the most common causes of HF

A

CHD and HTN

MI, valvular disease, congenital

72
Q

How do you treat HF

A

decrease physical activity, sodium intake, avoid NSAIDs, AVOID alcohol, AVOID calcium channel blockers and AVOID high dose BB

You want to decrease the workload of the heart and increase CO by slowing the cardiac remodeling and improve contractility

73
Q

What are the AE of digoxin

A

low levels of K can lead to arryhthmia, angina, N, V, CNS effects, BLUR + COLOR VISION + HALOS

74
Q

What are the inpatient treatments of HF

A

Milrinone + Beta Agonists

IV only

75
Q

How do diuretics help HF

A

relieve the pulmonary congestion and peripheral edema by decreasing the cardiac workload

Loop Diuretics = most common for HF

76
Q

How do aldosterone antagonists help HF

A

heart failure patients have a lot of aldosterone because of the increased activation of sym system

prevents salt retention, myocardial hypertrophy, and hypokalemia

77
Q

How do ACE or ARB help HF

A

Heart failure patients have more RAAS bc of the sym system and so by blocking those molecules (ATII) it can decrease workload of heart

78
Q

what are the effects of BB

A

decrease chronic activation of sym system to decrease renin, HT and remodeling

ONLY FOR CHRONIC HF

initial worsening of symptoms

Systemic Pharm II (17 decks)

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