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Human disease and therapeutics 2020 > Hypertension TEST 2 > Flashcards

Hypertension TEST 2 Flashcards

1
Q

What are the major classes of antihypertensives?

A
  • Diuretics
  • Sympathoplegics
  • Direct Vasodilators
  • Anti-Angiotensin Agents
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2
Q

Where do diuretics act?

A

-Kidney Tubules

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3
Q

What do diuretics do?

A
  • Deplete sodium

- Reduce blood volume

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4
Q

What do sympathoplegics do?

A

-Reduce peripheral vascular resistance

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5
Q

How many different classes of diuretics do you have?

A
  • Acetazolamide
  • Osmotic agents
  • Loop agents
  • Thiazides
  • Aldosterone antagonists
  • ADH antagonists
  • Adenosine
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6
Q

What is Mannitol?

A

-An osmotic diuretic agent

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7
Q

Where is mannitol used at?

A

-Thin descending limb

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8
Q

What are Carbonic anhydrase inhibitors?

A

-Acetazolamide diuretics

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9
Q

Where do Carbonic anhydrase inhibitors work?

A

-Proximal tubules

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10
Q

What does Acetazolamide do?

A

-Shut down reabsorption of H2CO3 into the interstitial space and thus less Na+ reabsorption thus more Na+ in lumen and thus diuresis

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11
Q

What are two loop diuretics?

A
  • Furosemide (Lasix)

- Bumetanide (Bumex)

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12
Q

What do loop diuretics do?

A

-Inhibit the luminal Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle thus reducing NaCl reabsorption

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13
Q

What is a side effect of Loop diuretics?

A

-Hypokalemia (should eat bananas)

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14
Q

What can keep loop diuretics from working?

A

-NSAIDs

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15
Q

Where do Thiazides work?

A

-Distal convoluted tubule

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16
Q

What are examples of Thiazide diuretics?

A
  • Hydrochlorothiazide

- CHlorthalindone

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17
Q

What do thiazides do?

A

-Inhibit NaCl reabsorption from the luminal side of epithelial cells in the DCT by clocking the NA+/Cl- transporter

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18
Q

What can keep thiazides from working?

A

-NSAIDs

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19
Q

What is a side effect from Thiazides?

A

-Hypokalemia

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20
Q

What can Hypokalemia can lead to decreased insulin secretion and thus hyperglycemia?

A
  • Thiazides

- Loop diuretics

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21
Q

What are potassium-sparing diuretics?

A

-Aldosterone antagonists

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22
Q

What are some examples of Aldosterone antagonists/K+ sparing diuretics?

A
  • Spironolactone (Aldactone)

- Amiloride

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23
Q

What should you watch for when giving aldosterone antagonists?

A
  • Headache
  • Diarrhea
  • Hyperkalemia
  • Electrolyte imbalance
  • Fatigue
  • GI disturbance
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24
Q

What do you use in combination with loop diuretics to offset hypokalemia?

A

-Potassium-sparing

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25
What do you not use potassium sparing drugs with and why?
ACE-I because you can worsen hyperkalemia
26
What does spironolactone do?
-Prevent K+ secretion by antagonizing effects of aldosterone in collecting tubules
27
What does angiotension lead to?
- Vasoconstriction | - Aldosterone secretion
28
What occurs if you use an angiotensin inhibitors?
-You won't get vasoconstriction or aldosterone secretion
29
What are ACE inhibitors?
-Captopril (Capoten)
30
What do ACE inhibitors do?
- Inhibit the converting enzyme (peptidyl dipeptidase) that hydrolyzes angiotensin I to angiotensin II - Increase bradykinin levels (potent vasodilator)
31
What are some side effects from ACE inhibitors?
- Dry cough from increased bradykinin | - Hyperkalemia because little aldosterone
32
What are Angiotensin II inhibitors?
-Losartan (Cozaar)
33
What does Angiotensin II inhibitors do?
- Decrease peripheral vascular resistance | - No effect on bradykinin
34
What are some side effects of Angiotensin II inhibitors?
-Hyperkalemia
35
What direct vasodilators release of nitric oxide from drug or endothelium?
- Nitroprusside - Hydralazine (Apresoline) - Nitroglycerin (Nitrostat)
36
What direct vasodilators cause a reduction of calcium influx?
- Verapamil - Diltiazem - Nifedipine
37
What direct vasodilators cause hyperpolarization of smooth muscle membrane through opening of potassium channels?
- Minoxidil | - Diazoxide
38
What direct vasodilators cause activation of dopamine receptors (D1)?
-Fenoldopam
39
What do all the vasodilators that are useful in hypertension do?
-Relax muscle of arterioles that decreases systemic vascular resistance
40
What does Sodium nitroprusside do?
-Relax vein
41
What is Clonidine?
-Alpha 2 agonist (centrally mediated)
42
What does Clonidine do?
-Reduce sympathetic tone resulting in decreased blood pressure
43
What are side effects of Clonidine?
- Dry mouth | - Sedation
44
What is mecamylamine?
-Ganglionic blocker
45
What are side effects of ganglionic blockers such as mecamylamine?
- Orthostatic hypotension - parasympathoplegia - constipation - urinary retention - Precipitation of glaucoma - dry mouth - blurred vision
46
What are some adrenergic blocking agents?
-Guanethidine (Ismelin)
47
What does Guanethidine do?
-Inhibit the release of norepinephrine from sympathetic nerve endings
48
What is a side effect of Guanethidine?
- Orthostatic hypotension | - Diarrhea
49
What are cardioselective beta blockers (B1 in the heart)?
- Atenolol (Tenormin) | - Metoprolol (Lopressor)
50
What are non-cardioselective (B1 and B2 ) beta blockers?
- Propranolol | - Nadolol
51
What drugs are Beta and Alpha 1 blockers?
- Labetalol (Trandate) | - Carvedilol (Coreg)
52
What are the effects of Beta blockers in the cardiac area?
-Decreased HR and contractility
53
What are the effects of Beta blocker on the vasculature?
-Increased TPR
54
What are the effects of Beta blockers on the renal system?
-Decreased Renin release
55
What are the effects of Beta blockers on the respiratory system?
-Bronchial constriction
56
What are the effects of Beta blockers on the metabolic system?
-Decreased Glycogenolysis in response to hypoglycemia
57
What are the effects of Beta blockers on aqueous humor production?
-Decreases it
58
What are cardioselective Alpha 1 blockers?
- Prazosin (Minipress) - Terazosin (Hytrin) - Doxazosin (Cardura)
59
what are non-cardioselective (alpha1 and alpha 2 blockers)?
- Phentolamine (Regitine) | - Phenoxybenzamine (Dibenzyline)
60
What are the side effects of alpha 1 blockers?
- orthostatic hypotension | - Nasal congestion

Human disease and therapeutics 2020 (60 decks)

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