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Pharm 2 > Hypertension Medications > Flashcards

Hypertension Medications Flashcards

1
Q

What are the long-term complications of hypertension?

A

Brain (stroke, TIA), Eye (blindness), Heart (angina, heart attack, heart failure), kidney failure, legs - peripheral artery disease

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2
Q

What is the target blood pressure for pts over 60 years old?

A

150/90mmHg with medication

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3
Q

What is the target blood pressure for pts under 60 years old?

A

140/90mmHg with medication

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4
Q

What are the 2 classes of diuretics?

A

Thiazides and Loops

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5
Q

What is the prototypical thiazide diuretic?

A

Hydroclorothiazide

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6
Q

What is the prototypical loop diuretic?

A

Type II Furosemide (Lasix)

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7
Q

How do diuretics work?

A

Cause renal excretion of excess NaCl from the blood stream. Water follows into the kidney and increases urination

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8
Q

This diuretic pulls off blood volume from vascular space (the blood stream)

A

Hydroclorothiazide

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9
Q

This diuretic pulls off blood volume from peripheral/pulmonary edema.

A

Loop diuretic

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10
Q

This diuretic works in the ascending Loop of Henle.

A

Loop Diuretic

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11
Q

This diuretic occurs in the distal convulated tubule.

A

Thiazide Diuretic

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12
Q

What are the 2 mechanisms of Thiazide diuretics?

A

Decreasing blood volume and decreasing peripheral resistance in the arms and legs

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13
Q

Peripheral resistance (vasodilation) takes how long to occur in the body?

A

3-4 weeks

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14
Q

Hydroclorothiazide _____ calcium excretion.

A

decreases.. acts as mini-osteoporosis drugs

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15
Q

Thiazide has a ____ diuretic effect

A

mild

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16
Q

It the thiazide is taken as needed.. urine excretion will ____

A

remain steady

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17
Q

If the thiazide is taken every day..urine excretion will ______

A

wear off and the main mechanism will be peripheral resistance

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18
Q

Thiazides ____ uric acid secretion. What disease does this increase the risk for?

A

decrease uric acid.

Gout

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19
Q

Furosemide (Lasix) ______ calcium excretion in the urine

A

increases

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20
Q

Loops inhibits the ____ pump to to inhibit reabsorption of NaCl

A

sodium-potassium pump

21
Q

Loops can pull of _____ volumes of fluid

A

large

22
Q

Loops are the DOC for reducing acute pulmonary edema in what disease?

A

Congestive Heart Failure

23
Q

Hypokalemia, Hyperuricemia, and hypercalcemia are caused by which diuretic

A

Thiazides

24
Q

Acute hypovolemia, hypokalemia, hyperuricemia, hearing loss are characteristics of what diuretic?

A

Loops

25
Q

Propranolol is a type of ________ beta-blocker

A

non-selective

26
Q

At low doses, cardiac selective beta blockers plug into B_ receptors.

A

B1 cardiac receptors

27
Q

Beta 2 receptors are found where?

A

in the lungs and periphery

28
Q

Beta 1 receptors are found where?

A

in the cardiac muscle

29
Q

What are the ADRs of beta blockers?

A

Fatigue, depression, nightmares, sexual dysfunction, bronchoconstriction, bradycardia

30
Q

Do not give pt a beta blocker when the HR is _____.

A

Less than or equal to 60 bpm

31
Q

What are the 3 prototypes for Ace-Inhibitors

A

Enalapril (Vasotec), Lisonopril (Prinivil, Zestril)

Ramipril (Altace)

32
Q

T or F: Ace inhibitors effect the renin-angiotensin-aldosterone system (RAAS)

A

True

33
Q

The basic MOA for ace-inhibitors is to decrease or completely inhibit ____.

A

Ang I from becoming Ang II

34
Q

Angiotensin II act as a…

A

vasoconstrictor which increases one’s blood pressure

35
Q

What is the main problem with ACE inhibitors?

A

ACE escape – some enzyme is still able to convert Ang I to Ang II

36
Q

What 5 things do Ace-inhibitors do?

A

Decreases prod. of Ang II, Decreases output of sympathetic nervous system, Increases vasodilation, decreases aldosterone, increases levels of bradykinin

37
Q

An accumulation in bradykinin causes the pt to ____.

A

cough

38
Q

ARB acts by what MOA?

A

Blocks/plugs the receptors of Ang II so Ang I cannot bind

39
Q

What percentage of patients experience the Ace cough?

A

10-30%

40
Q

What allergic rxn is unique to ACE and ARB that involves the mouth and lips?

A

Angioedemia

41
Q

Which Dihydropyridine CCB should be used?

A

Amlodipine

42
Q

Non-dihydropyridine CCB (are/aren’t) peripheral dilators

A

Are not

43
Q

Dihydropyridine CCBs (are/aren’t) peripheral dilators

A

Are

44
Q

What are the 2 non-dihydropyridine CCBs? Do they work directly on the heart?

A

Verapamil and Diltiazem

Yes, work on myocardium to decrease cardiac output

45
Q

Amlodipine and Nifedipine causes vasodilation by focusing on the ___ and ___.

A

arms and legs

46
Q

Constipation, gingival hyperplasia, worsening of CHF are all side effects of ?

A

Verapamil

47
Q

T or F: Using beta-blockers with verapamil can stop the heart from beating?

A

True

48
Q

Why don’t we use nifedipine anymore?

A

causes fast vasodilation in peripher. Pt will experience increased heart rate and palpitation

49
Q

Amlodipine (Norvasc) is better than Nifedipine, but still causes ____ edema

A

peripheral

Pharm 2 (4 decks)

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