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Pharmacology -- Test #3 > Hypertension I > Flashcards

Hypertension I Flashcards

1
Q

BP=

A

CO X PVR

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2
Q

Risk factors for hypertension

A

Family History, Sex, Diet, Smoking, Diabetes, Hyperlipidemia

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3
Q

What is diuresis?

A

An increase in urine volume

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4
Q

What is Natriuresis?

A

An increase in renal sodium excretion

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5
Q

Clinical uses of diuretics?

A

HTN, Edema, CHF, Kidney Disease, Cirrhosis, Hypercalcemia, Diabetes Insipidus

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6
Q

Site of Acetazolamide activity?

A

Proximal Tubule

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7
Q

What does Acetazolamide do?

A

It is a carbonic anhydrase inhibitor. This prevents the H+/Na+ antiporter from absorbing Na

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8
Q

Why is Acetazolamide not super effective?

A

Na still absorbed in the loop

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9
Q

Potential side effect of Acetazolamide to watch for?

A

Metabolic Acidosis

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10
Q

Hemodynamic Effects of long-term diuretic administration

A

Peripheral resistance decrease
Plasma Volume decreased or unchanged
HR+CO don’t change
Plasma renin activity is increased

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11
Q

Name the important loop diuretics

A

Furosemide
Bumetanide
Ethacrynic Acid

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12
Q

Loop diuretics act by…

A

Inhibiting the Na+-K+2Cl- symporter

Inhibits reabs of Na, Cl, Mg, Ca

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13
Q

Clinical use of Loop Diuretics

A

Edematous Conditions

Acute Pulmonary Edema

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14
Q

Loop diuretic toxicities?

A 
Dehydration
Hypokalemic metabolic alkalosis
Ototoxicity
Hyperuricemia
Hypomagnesemia
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15
Q

Contraindications for Loop Diuretics?

A

Sulfa Allergy

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16
Q

Thiazides + Loops – who is best for HTN in patients with normal renal fxn

A

Thiazides

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17
Q

How do thiazides work?

A

Inhibit Na/Cl cotransporters in the distal tubule

18
Q

Thiazide diuretic names

A

Things that end in thiazide
Chlorthalidone
Indapamide
Metolazone

19
Q

Actions of Thiazide diuretics

A

Inhibit NaCl reabsorption in DCT
Enhance Ca reabs in the kidney
May open Ca channels –> Vasodilation
Decrease in peripheral resistance from neg. Na balance

20
Q

Clinical uses of Thiazides

A

Hypertension

Congestive Heart Failure

21
Q

Influence of Thiazides on Ca

A

Loss of Na in the DCT leads to activtion of the Ca/Na antiporter, causing increase Ca absorption

22
Q

Thiazide toxicities

A 
Hypokalemia/Hypokalemic metabolic alkalosis
Hyperuricemia
Hypercalcemia
Impaired Carb. tolerance
Hyperlipidemia
ED
23
Q

Contraindications for Thiazides?

A

Sulfa allergies

24
Q

Major type of drugs that act in the collecting tubule…

A

Na Channel Inhibitors

25
Q

Whats the wording commonly used for Na Channel inhibitors in the collecting tubule?

A

Potassium Sparing Diuretics

Without NA coming in, no Na/K antiporter action, so K is spared

26
Q

Two examples of Potassium sparing diuretics

A

Amiloride

Triamterene

27
Q

Clinical uses for Amiloride?

A

Adjunctive treatment with thiazide or loop diuretic in CHF or HTN

Can reduce BP

28
Q

Toxicities of Amiloride and Triamterene?

A

Hyperkalemia

Hyperchloremic metabolic acidosis

29
Q

Contraindications for prescribing Amiloride?

A

K+ Supplements

ACE inhibitors

30
Q

Clinical uses for Triamterene?

A

Edema assoc. with CHF, hepatic cirrhosis, nephrotic syndrome, or hyperaldosteronism

Can’t lower BP alone

31
Q

Contraindications for Triamterene?

A

Kidney Stones
K+ Supplements
ACE Inhibitors

32
Q

How do aldosterone antagonists work

A

Control Aldosterone expression

Modifies # of Na channels via transcription of proteins and channels that put them in

33
Q

Main aldosterone antagonists to know?

A

Spironlactone

Eplerenone

34
Q

Actions of Spironlactone

A

Blocks Aldosterone

Inhibits 5-alpha reductase

35
Q

Clinical uses for Spironlactone in CV Disease

A

Hypertension or CHF w/ other diuretics

36
Q

Toxicities of Spironlactone?

A

Hyperkalemia
Hyperchloremic metabolic acidosis
Gynecomastia + Impotence
Benign Prostatic Hyperplasia

37
Q

Contraindications for Spironlactone?

A

K+ Supplements
ACE Inhibitors (Promotes K+ Retention)
Chronic Renal Insufficiency

38
Q

Actions of Eplerenone

A

Selective antagonism of mineralocorticoid receptor in kidney, heart, BV, and brain

39
Q

Clinical use of Eplerenone

A

Hypertension

Full therapeutic effect within 4 weeks

40
Q

Toxicities and adverse reactions to Eplerenone?

A

Hyperkalemia

Hypertriglyceridemia

41
Q

Contraindications for Eplerenone?

A 
K+ supplements/K+ sparing diuretics
ACE inhibitors
Chronic Renal Insufficiency
Diabetes+microalbuinuria
CYP450 3A4 inhibitors (ex. ketoconazole)

Pharmacology -- Test #3 (13 decks)

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