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MOD 2 > Hypertension and pharmacotherapy > Flashcards

Hypertension and pharmacotherapy Flashcards

1
Q

Spironolocatone

A

aldosterone receptor blocker

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2
Q

Eplerenone

A

aldosterone receptor blocker

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3
Q

“zosin” drugs: prazosin, terazosin, doxazosin

A

alpha-1 adrenergic blockers

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4
Q

alpha-methyldopa

A

alpha-2 agonists

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5
Q

Clonidine

A

alpha-2 agonists

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6
Q

Guanfacine

A

alpha-2 agonists

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7
Q

acebutolol, betaxolol, esmolol, atenolol, metorpolol

A

beta-1 selective blockers

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8
Q

carvedilol, labetalol

A

B1B2a1 blockers

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9
Q

diltiazem

A

benzothiazepines - Calcium channel blocker

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10
Q

Amlodipine, felodipine, nicardipine, nifedipine

A

dihydropyridines: Calcium channel blocker

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11
Q

Verapamil

A

phenylalkylamines: Calcium channel blocker

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12
Q

Furosemide

A

loop diuretic

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13
Q

Ethyacrynic acid

A

loop diuretic for sulfa allergies

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14
Q

hydrochlorothiazide

A

thiazide diuretics

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15
Q

indapamide, chlorthalidone

A

thiazide like agents

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16
Q

amiloride, triameterene

A

K-sparing diuretics

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17
Q

Captopril, enalapril, lisinopril, benazepril, quinapril, meoxipril, perindopril, foesnopril

A

ACE inhibitors

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18
Q

Losartan, valsartan, irbesartan, candesartan, telmisartan

A

Angiotensin receptor blockers (ARBs)

19
Q

medoxomil

A

angiotensin receptor blocker

20
Q

Hydralazine, nitroprusside

A

vasodilator drugs -open K+ channels in vascular smooth muscle (similar to Ca channel blockers)

21
Q

Aliskiren

A

Blocks renin (renin converts angiotensinogen to AI)

22
Q

List the 6 classes of anti-hypertensive drugs

A
  1. Beta/alpha blockers
  2. Calcium channel blockers
  3. ARBs
  4. ACE inhibitors
  5. Diuretics
  6. Unique drugs
23
Q

action of blocking B1, B2, a1, and a2 receptors. Which are helpful to block in hypertension?

A
  • B1- blocking will decrease HR and contractility, and will lower BP = helpful!
  • B2- blocking will vasocontrict blood vessels = not helpful! and may worsen asthma symptoms
  • a1- blocking this will vasodilate blood vessels = helpful
  • a2-by stimulating alpha 2 receptor you decrease NE release in the CNS, and helpful in lowering BP, so blocking thsi will cause more NE release and will increase BP
24
Q

Beta blocker side effects (3)

A

fatigue, erectile dysfunction, hyperlipidemia

25
Q

propranolol

A

B1B2 nonselective blockers

26
Q

timolol

A

B1B2 nonselective blockers

27
Q

nadolol

A

B1B2 nonselective blockers

28
Q

this drug causes postural hypotension

A

alpha blockers

  • when you stand up, your venous return drops, so body responds by triggering alpha receptors to vasoconstrict
  • if blocked, you can get dizzy
29
Q

Nifedipine, dilitazem, verapamil

explain dominant effect

A

Calcium channel blockers

vasodilator vascular smooth muscle effects: nifedpine > diltiazem > verapamil

Negative inotropes, HR/contractility effects: verapamil > diltiazem > nifedipine

30
Q

Side effects of calcium channel blockers

A
  • nifedipine: edema (vasculature becomes more permeable, fluids leak out into interstitial space, diuretics cant get rid of this edema)
  • verapamil, dilitiazem: can precipitate heart failure, constipation, flushing
31
Q

5 effects of RAAS system and net results (4)

A
  1. SNS
  2. Arterioral vasoconstriction
  3. Renal Na/Cl resoprtion
  4. Adrenal aldosterone secretion
  5. Pituitary ADH secretion

Net results:

  1. increase salt/water retention
  2. increase BP
  3. increase preload
  4. increase afterload
32
Q

ACE inhibitor side effects (4)

A
  1. Hyperkalemia (less Na resorption so K stays in)
  2. Angioedema - swelling of face and tongue
  3. renal failure
  4. cough
33
Q

Mechanism for why ACE inhibitors cause cough

A

ACE usually breaks bradykinin down into inactive metabolites. Bradykinin causes cough and angioedema

34
Q

bumetanide

A

Loop diuretic

35
Q

torsemide

A

loop diuretic

36
Q

loop diuretic effects on:

  • calcium levels
  • K levels
A
  • hypocalcemia
  • hypokalemia

(the pump is Na, K, 2Cl pump)

need positive drive to bring in Ca

37
Q

Side effects of Thiazide diuretics:

A

hyperGLUC

elevated levels of:

  • glucose
  • lipids
  • uric acid
  • calcium (because calcium and Na compete to get inside)
38
Q

hydralazine

  • action
  • side efect
  • combinations of drugs
  • alarm
A
  • direct vasodilator (smooth muscle hyperpolarization), generates NO, increases cGMP in smooth muscle
  • causes reflex tachycardia, co-administered with B-blocker
  • combined with nitrates for CHF
  • dont use for angina-exacerbates problem
39
Q

three drugs that causes drug-induced lupus

A
  1. hydralazine
  2. isoniazid
  3. Procainamide (anti-arrythmic, Class IA Na blocker, increases QRS, QT, AP)
40
Q

Clonidine

  • action
  • use
  • side effect
A

agonists to CNS a2 receptor (tricks nervous system into thinking theres too much NE, so drops NE levels)

decreases sympathetic tone

  • used for HTN in renal patients, believed to have less decrease in renal blood flow
  • rebound hypertension
41
Q

methyldopa

  • action
  • use
  • side effect
A
  • agonist to CNS alpha-2 receptor
  • drug of choice in pregnancy
  • hemolytic anemia
42
Q

Which regulatory ssytems are the major target of antihypertensive drugs?

A
  1. SNS (seconds to minutes)
  2. RAAS (minutes to hours)
  3. kidney salt and water balance (hours to days)
43
Q

What receptors are in the kidneys and what are their actions?

A

B1- renin release

B2- vasodilation

a1-vasoconstriction

44
Q

Renin is released by the juxtaglomerular cells of the kidney in response to these 4 cases:

A
  1. increased SNS activity (B1 activity)
  2. decreased renal perfusion pressure
  3. reduced urinary [Na]
  4. increased urinary [K]

MOD 2 (13 decks)

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