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N216 A/B > Perfusion Part 1 - Hypertension > Flashcards

Perfusion Part 1 - Hypertension Flashcards

1
Q

What do baroreceptors do?

A

Detect changes in BP

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2
Q

The adrenal gland secretes ____ to stimulate the kidney

A

aldosterone

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3
Q

Renin + _____ –> _____ I + ____ –> ____ II

A

angiotensinogen, angiotensin I, ACE, angiotensin II

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4
Q

What are the 3 factors that influence blood pressure?

A
  1. Blood volume
  2. Diameter of arterioles
  3. Cardiac output
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5
Q

Blood is composed of 55% ____ and 45% ____ ____

A

plasma, formed elements

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6
Q

What are 4 actions the CDV system does to counter high BP?

A
  1. Vasodilation
  2. Decrease stroke volume
  3. Decrease heart rate
  4. Decrease cardiac output
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7
Q

What are 2 actions the kidneys do to counter high BP?

A
  1. Increase urine output

2. Decrease blood volume

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8
Q

Hypertension is ____ systolic or diastolic BP

A

high

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9
Q

What are 6 potential causes of a sudden change in BP?

A
  1. Pain
  2. Infection
  3. Compensation
  4. Hypervolemia
  5. Drug induced
  6. Malignant hypertension
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10
Q

What are the 3 types of hypertension?

A
  1. Essential (idiopathic)
  2. Secondary
  3. Sudden onset
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11
Q

What are some potential causes for essential hypertension?

A
  • Age
  • Race
  • Family history
  • Lifestyle
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12
Q

What are some potential causes for secondary hypertension?

A
  • Renal disease

- Congenital

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13
Q

What is a potential cause for sudden onset hypertension?

A

Drugs

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14
Q

What is gestational HTN (preeclampsia)?

A

A new onset of hypertension in pregnant women after 20 weeks of gestation

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15
Q

What are 2 potential complications of gestational HTN?

A
  1. DIC (clotting)

2. Thrombocytopenia (platelet deficiency)

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16
Q

What are 2 treatments for gestational HTN?

A
  1. Sodium restriction

2. Antihypertensive medications

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17
Q

What are 3 age related changes that can affect BP?

A

Decreased:

  1. Elasticity of vessels
  2. Renal blood flow
  3. Sensitivity to baroreceptors
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18
Q

What would be considered orthostatic hypotension?

A

A drop of 20mmHg in SBP or 10 in DBP

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19
Q

Orthostatic hypotension is caused by venous ____ in lower extremities

A

pooling

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20
Q

What are 2 signs and symptoms of orthostatic hypotension due to decreased CNS perfusion?

A
  1. Faintness

2. Dizziness

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21
Q

What 3 categories of patients are at risk of orthostatic hypotension?

A
  1. Elderly
  2. Dehydrated patients
  3. Antihypertensive med. patients
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22
Q

What is the treatment for orthostatic hypotension in emergencies?

A

Adrenergic agonists

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23
Q 
Expected findings for adults are:
BP = \_\_/\_\_ mmHg
MAP = \_\_-\_\_ Hg
HR: \_\_-\_\_ bpm
CO: \_\_-\_\_ L/min
A

120/80
70-100
60-100
4-8

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24
Q

What is the emergency treatment for hypertension?

A

Direct Acting Vasodilators (DAV)

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25
Q

How do DAVs work?

A
  1. Stimulates L-Arginine in endothelial cells
  2. L-Arginine stimulates nitric oxide production
  3. Nitric oxide results in vasodilation
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26
Q

What are 2 examples of DAVs?

A
  1. Nipride (Nitroprusside)

2. Hydralazine

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27
Q

What are some side effects of DAVs?

A
  • Reflex tachycardia
  • Hypotension
  • Syncope
  • Headache
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28
Q

What are 4 drug classes used to treat hypertension normally?

A
  1. Diuretics
  2. Renin-Angiotensin
  3. Calcium channel blockers
  4. Adrenergic agents
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29
Q

What are the effects of diuretics?

A
  • Decrease blood volume
  • Decrease re-absorption of H2O + electrolytes
  • Increase urine output
30
Q

What are the 2 types of Renin-Angiotensin drugs?

A
  1. ACE inhibitors

2. Angiotensin II receptor blockers (ARBs)

31
Q

What are the effects of ACE inhibitors?

A
  • Vasodilate by inhibiting ACE

- Decrease blood volume

32
Q

What are the effects of ARBs?

A
  • Vasodilate

- Decrease blood volume

33
Q

What are the effects of calcium channel blockers?

A
  • Block calcium influx (muscle relaxation)
  • Decrease CO + HR
  • Optimize cardiac contractions
34
Q

What are the effects of adrenergic antagonists?

A
  • Vasodilation

- Decrease HR, conduction rate + contractility

35
Q

What are the 4 types of diuretics?

A
  1. Loop
  2. Thiazides
  3. Potassium sparing / Aldosterone antagonists
  4. Osmotic
36
Q

What are 5 potential side effects of diuretics?

A
  1. Dehydration
  2. Hyponatremia
  3. Hypokalemia (loop, thiazide)
  4. Hyperkalemia (potassium)
  5. Nocturia
37
Q

What is an example of a loop diuretic?

A

Furosemide (Lasix)

38
Q

What are 2 examples of thiazides?

A
  1. Hydrochlorothiazide (HZTZ)

2. Chlorothiazide (Diuril)

39
Q

What is an example of a K+ sparing drug?

A

Spironolactone (Aldactone)

40
Q

What is an example of a thiazide + potassium sparing combo med?

A

Aldactazide

  • Balances potassium
  • PO
41
Q

What are osmotic diuretics used to treat?

A
  • Cerebral edema
  • Intraocular hypertension
  • Move fluid from brain –> body
42
Q

What are 2 examples of osmotic diuretics?

A
  1. Mannitol (Osmitrol)

2. Isosorbide

43
Q 
The part of the nephron these drugs work on:
Loop = \_\_\_\_ \_\_ \_\_\_\_
Thiazides = \_\_\_\_ \_\_\_\_ \_\_\_\_
K+ sparing = \_\_\_\_ \_\_\_\_
Osmotic = \_\_\_\_ \_\_\_\_ and \_\_\_\_ \_\_ \_\_\_\_
A

Loop of Henle
Distal convoluted tubule
Distal tubule
Proximal tubule, Loop of Henle

44
Q

Where can angiotensin II receptors be found? (3 places)

A
  • Blood vessels + heart
  • Adrenal cortex
  • Kidneys
45
Q

Angiotensin II causes vaso____

A

constriction

46
Q

What are 2 examples of ARBs?

A
  1. Losartan (Cozaar)

2. Ibesartan (Avapro)

47
Q

What is a side effect of ARBs?

A

Hypotension

48
Q

What is the 1st line of therapy for heart failure?

A

ACE inhibitors

49
Q

What are 4 examples of ACE inhibitors?

A
  1. Enalapril (Vasotec)
  2. Captopril
  3. Monopril
  4. Ramipril (Altace)
50
Q

What are 2 examples of thiazide diuretic + ARB combo drugs?

A
  1. Hyazaar HCT

2. Cosart-H

51
Q

What are calcium channel blockers use to treat?

A
  • Angina

- Some arrhythmias

52
Q

What are 2 types of calcium channel blockers?

A
  1. Vascular-selective

2. Cardio-selective

53
Q

Vascular-selective calcium channel blockers target ____ muscle meanwhile cardio-selective calcium channel blockers target ____ muscle

A

smooth, cardiac

54
Q

What are 2 examples of vascular-selective drugs?

A
  1. Nifedipine (Adalat)

2. Amlopidine (Norvasc)

55
Q

What are 2 examples of cardiac-selective drugs?

A
  1. Verapamil (Isoptin)

2. Diltiazem (Cardizem)

56
Q

What are some side effects of calcium channel blockers?

A
  • Dizziness, flushing, hypotension
  • Reflex tachycardia
  • Peripheral edema (pooling)
  • Dysrhythmias
  • Exacerbation of heart failure
57
Q

Ginseng is a NHP and a calcium channel ____

A

antagonist

58
Q

What are the 2 drugs used to treat atrial fibrillation?

A
  1. Calcium channel blockers

2. Beta blockers

59
Q

What are 2 examples of beta blockers?

A
  1. Propanolol

2. Metoprolol

60
Q

What are 2 examples of antiarrhythmic meds?

A
  1. Digitoxin
  2. Amiodarone
    * Narrow therapeutic indexes
61
Q

Alpha 1 & 2 cause vaso____

A

constriction

62
Q

Beta 1 receptors ____ heart rate and beta 2 receptors cause vaso/broncho____

A

increase, dilation

63
Q

What are 2 endogenous catecholamines?

A

Norepinephrine (NE) & Epinephrine (E)

64
Q

NE & E cause vaso____

A

constriction

65
Q

How do adrenergic antagonists work?

A

Block adrenergic receptors –> block endogenous catecholamine activity
ie) inhibit NE release

66
Q

What are 3 examples of adrenergic antagonists and which receptors do they act on?

A
  1. Antenolol (B1)
  2. Propanolol (B1&2)
  3. Metoprolol (B1)
67
Q

What is an example of a thiazide diuretic + adrenergic antagonist combo med?

A

Lopressor HCT

68
Q

What are centrally acting alpha 2 adrenergic agonists used to treat?

A

Resistant hypertension

69
Q

What are some side effects of alpha 2 agonists?

A
  • Hypotension

- Headache

70
Q

What are 2 examples of alpha 2 agonists?

A
  1. Clonidine (A2)
  2. Methyldopa (A2)*
    * Prodrug

N216 A/B (26 decks)

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