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Pharmacology Unit 4 > Hypertension Pharmacology I and II > Flashcards

Hypertension Pharmacology I and II Flashcards

1
Q

Define Stage I HTN

A

BP: 140-159/90-99

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2
Q

Define Stage II HTN

A

Systolic BP >160; or diastolic BP >100

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3
Q

What is essential HTN

A

no known secondary cause for HTN; accounts for 95% of cases

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4
Q

Causes of Secondary HTN

A

Renal disease, drugs (EtOH, oral contraceptives, NSAIDS, MAOIs), Endocrine (pheochromocytoma, Cushings, hyperaldosteronism, hyper/hypothyroidism), Pulmonary (Obstructive Sleep Apnea)

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5
Q

Clinical Features of Secondary HTN

A

Severe/resistant HTN, onset before puberty, onset before 30 with no fam history or obesity, electrolyte disturbances

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6
Q

Modifiable Risk Factors for HTN

A

sodium intake, obesity, EtOH intake, meds, sedentary lifestyle, stress

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7
Q

Risk factors for aggressive treatment of HTN

A

young age at onset, hyperlipidemia, diabetes, smoking, family history of vascular disease

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8
Q

What is end-organ disease related to?

A

extent of BP elevation and duration of HTN

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9
Q

What are some manifestations of end-organ disease?

A

stroke, CAD, LV hypertrophy, atherosclerosis, nephrosclerosis, aneurysms

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10
Q

Who is more likely to benefit from lowering BP: a 45 y/o male with obesity and BP 145/95, or a 45 y/o female smoker with obesity, diabetes, LV hypertrophy, and BP 145/95

A

45 y/o female-the benefit of lowering BP increases in the setting of end-organ disease

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11
Q

General MOA: Diuretics

A

decrease intravascular volume

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12
Q

General MOA: Angiotensin Blockers

A

inhibit production/action of angiotenisin II->decrease PVR

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13
Q

General MOA: Direct Vasodilators

A

relax smooth muscle to decrease PVR

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14
Q

General MOA: Sympathoplegic agents

A

decrease sympathetic tone -> decrease PVR (ex. beta blockers, alpha blockers)

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15
Q

Which drug classes have no effect on heart rate and cardiac output (5)

A

diuretics, ISA beta blockers, ACEI, ARB, renin inhibitors

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16
Q

Which drug classes have no effect on plasma volume (3)

A

ACEI, ARB, Renin inhibitors

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17
Q

Which type of diuretic is high potency and what is its MOA

A

Loop diuretic; competitively inhibit Na-K-Cl transporter in proximal ascending tubule

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18
Q

Which type of diuretic is medium potency and what is its MOA

A

Thiazides; inhibits exchange of Na-Cl in the distal ascending loop

19
Q

Which type of diuretic is low potency and what is its MOA

A

Potassium sparing; inhibits Na reabsorption in the distal tubule

20
Q

When would you use a loop diuretic

A

severe HTN, CHF, cirrhosis, renal insufficiency (GFR < 30-40 ml/min)

21
Q

Side effects of loop and thiazide diuretics

A

hypokalemia, hypomagnesemia, impaired glucose tolerance, increased lipids, increased uric acid, erectile dysfunction, volume depletion

22
Q

Side effects of potassium sparing drugs

A

gynecomastia, menstrual irregularities, hyperkalemia

23
Q

Most famous loop diuretic

A

Furosemide

24
Q

MOA of ARBs

A

competitive receptor binding of angiotensin II to vascular endothelium

25
Q

Ending associated with ACEIs

A

-pril (ex. lisinopril)

26
Q

Ending associated with ARBs

A

-sartan (ex. losartan)

27
Q

Short acting ACEI

A

captopril

28
Q

Unique side effect to ACEIs

A

cough

29
Q

Contraindications to ACEIs and ARBs

A

renal artery stenosis, hyperkalemia, pregnancy

30
Q

ACEIs/ARBs benefit:

A

chronic kidney disease and proteinuria, CHF, LV remodeling post-MI, LV hypertrophy

31
Q

Calcium Channel Blockers

A

Dihydropyridines: Amlopidine, nifedipine

Non-dihydropyridines: Verapamil, diltiazem

32
Q

Which class of Calcium channel blockers has anti-anginal effects

A

non-dihydropyridines

33
Q

Calcium channel blocker MOA

A

inhibits contraction of smooth muscle by blocking entry of calcium into cell->decreases PVR

34
Q

Side effects of CCBs

A

heart failure, block, bradycardia for non-dihydropyridines. reflex tachycardia and angina for dihydropyirdines

35
Q

How do you minimize the side effects of CCBs

A

use a long-lasting CCB

36
Q

How do beta blockers decrease BP

A

reduce CO

37
Q

Which beta blocker is used for a hypertensive emergency in the ICU setting

A

labetolol

38
Q

Which beta blocker is used for acute coronary syndromes or CHF

A

carvedilol

39
Q

Which beta blocker is administered IV and has a short half life used for AV nodal blocking in unstable patients

A

Esmolol

40
Q

Ending associated with alpha 1 antagonists

A

-azosin (terazosin) (doxazosin)

41
Q

Vasodilators (2)

A

hydralazine, minoxidil

42
Q

Central acting sympathoplegic drugs MOA

A

stimulate alpha 2 receptors to reduce sympathetic output

43
Q

Only alpha 2 agonist routinely used

A

clonidine

44
Q

ganglion blocking agents (2) + MOA

A

Guanethidine: blocks release of NE from post-ganglionic nerve terminals
Reserpine: depletes NE, DA, and serotonin; decreases CO and PVR

Pharmacology Unit 4 (9 decks)

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