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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
Q

What do you not use potassium sparing drugs with and why?

A

ACE-I because you can worsen hyperkalemia

26
Q

What does spironolactone do?

A

-Prevent K+ secretion by antagonizing effects of aldosterone in collecting tubules

27
Q

What does angiotension lead to?

A
  • Vasoconstriction

- Aldosterone secretion

28
Q

What occurs if you use an angiotensin inhibitors?

A

-You won’t get vasoconstriction or aldosterone secretion

29
Q

What are ACE inhibitors?

A

-Captopril (Capoten)

30
Q

What do ACE inhibitors do?

A
  • Inhibit the converting enzyme (peptidyl dipeptidase) that hydrolyzes angiotensin I to angiotensin II
  • Increase bradykinin levels (potent vasodilator)
31
Q

What are some side effects from ACE inhibitors?

A
  • Dry cough from increased bradykinin

- Hyperkalemia because little aldosterone

32
Q

What are Angiotensin II inhibitors?

A

-Losartan (Cozaar)

33
Q

What does Angiotensin II inhibitors do?

A
  • Decrease peripheral vascular resistance

- No effect on bradykinin

34
Q

What are some side effects of Angiotensin II inhibitors?

A

-Hyperkalemia

35
Q

What direct vasodilators release of nitric oxide from drug or endothelium?

A
  • Nitroprusside
  • Hydralazine (Apresoline)
  • Nitroglycerin (Nitrostat)
36
Q

What direct vasodilators cause a reduction of calcium influx?

A
  • Verapamil
  • Diltiazem
  • Nifedipine
37
Q

What direct vasodilators cause hyperpolarization of smooth muscle membrane through opening of potassium channels?

A
  • Minoxidil

- Diazoxide

38
Q

What direct vasodilators cause activation of dopamine receptors (D1)?

A

-Fenoldopam

39
Q

What do all the vasodilators that are useful in hypertension do?

A

-Relax muscle of arterioles that decreases systemic vascular resistance

40
Q

What does Sodium nitroprusside do?

A

-Relax vein

41
Q

What is Clonidine?

A

-Alpha 2 agonist (centrally mediated)

42
Q

What does Clonidine do?

A

-Reduce sympathetic tone resulting in decreased blood pressure

43
Q

What are side effects of Clonidine?

A
  • Dry mouth

- Sedation

44
Q

What is mecamylamine?

A

-Ganglionic blocker

45
Q

What are side effects of ganglionic blockers such as mecamylamine?

A
  • Orthostatic hypotension
  • parasympathoplegia
  • constipation
  • urinary retention
  • Precipitation of glaucoma
  • dry mouth
  • blurred vision
46
Q

What are some adrenergic blocking agents?

A

-Guanethidine (Ismelin)

47
Q

What does Guanethidine do?

A

-Inhibit the release of norepinephrine from sympathetic nerve endings

48
Q

What is a side effect of Guanethidine?

A
  • Orthostatic hypotension

- Diarrhea

49
Q

What are cardioselective beta blockers (B1 in the heart)?

A
  • Atenolol (Tenormin)

- Metoprolol (Lopressor)

50
Q

What are non-cardioselective (B1 and B2 ) beta blockers?

A
  • Propranolol

- Nadolol

51
Q

What drugs are Beta and Alpha 1 blockers?

A
  • Labetalol (Trandate)

- Carvedilol (Coreg)

52
Q

What are the effects of Beta blockers in the cardiac area?

A

-Decreased HR and contractility

53
Q

What are the effects of Beta blocker on the vasculature?

A

-Increased TPR

54
Q

What are the effects of Beta blockers on the renal system?

A

-Decreased Renin release

55
Q

What are the effects of Beta blockers on the respiratory system?

A

-Bronchial constriction

56
Q

What are the effects of Beta blockers on the metabolic system?

A

-Decreased Glycogenolysis in response to hypoglycemia

57
Q

What are the effects of Beta blockers on aqueous humor production?

A

-Decreases it

58
Q

What are cardioselective Alpha 1 blockers?

A
  • Prazosin (Minipress)
  • Terazosin (Hytrin)
  • Doxazosin (Cardura)
59
Q

what are non-cardioselective (alpha1 and alpha 2 blockers)?

A
  • Phentolamine (Regitine)

- Phenoxybenzamine (Dibenzyline)

60
Q

What are the side effects of alpha 1 blockers?

A
  • orthostatic hypotension

- Nasal congestion

Human disease and therapeutics 2020 (60 decks)

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