Pharm 7- Antihypertensives

Question 1

HTN Definition

Answer 1

Sustained systolic BP > 140 or sustained DBP > 90

Question 2

“Staged” HTN

Answer 2

Pre-HTN: 120-130 / 80-90 mmHg
Stage 1 HTN: 140-160 / 90-100 mmHg
Stage 2 HTN: >160/100mmHg

Question 3

Primary (Essential) HTN

Answer 3

caused by a blend of nurture and nature, is generally idiopathic and is the most common form (90%)

Question 4

Idiopathic

Answer 4

relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown.

Question 5

Secondary HTN

Answer 5

is caused by a specific etiology and is less common 10%

Question 6

Etiology

Answer 6

the cause, set of causes, or manner of causation of a disease or condition.

Question 7

7 aspects of BP Control

Answer 7

1. Arterioles
2. Venules
3. The Heart
4. Renin/angiotensin
5. The “Pump”
6. Anesthetic Depth
7. Drugs

Question 8

What two aspects mainly control CO and SVR?

Answer 8

The SNS and baroreceptor feedback

The Renin/Angiotensin System

Question 9

What is often the first-line Rx for HTN?

Answer 9

Diuretics

Question 10

Bystolic

Answer 10

Generic: Nebivolol

B1-selective and potent vasodilator

Question 11

What are commonly used as a first line drug post-MI for HTN?

Answer 11

ACE Inhibitors

Question 12

ACE Inhibitors

Answer 12

1. Captopril (Capoten)
2. Enalapril (Vasotec)
3. Lisinopril (Prinivil, Zestril)
4. Benzapril (Lotensin)
5. Fosinopril (Monopril)
6. Moexipril (univasc)
7. Quinapril (Accupril)
8. Ramipril (Altace)
9. Trandolapril (mavik)

Question 13

Angiotensin II-Receptor Blockers (ARBS)

Answer 13

1. Losartin (Cozaar)
2. Valsartin (diovan)
3. Candesartan (Atacand)
4. Eprosartan (Teveten)
5. Irbesartan (Avapro)
6. Telmisartan (Micardis)
7. Olmesartan (Benicar)

Question 14

Renin Inhibitors

Answer 14

Aliskirin (tekturna)

*Used in combination with other drugs

Question 15

Alpha 2 Agonists

Answer 15

Clonidine (Catapres, Duraclon)

Alpha-Methyldopa (Aldomet)

Question 16

Alpha 1 Blockers

Answer 16

Prazosin (minipres)
Doxazoin (cardura)
Terazosin (Hytrin)

Question 17

Hydralazine

Answer 17

Trade name: Apresoline

Causes endothelial cells to release nitric oxide- a potent vasodilator causing smooth muscle relaxation

Question 18

Hydralazine Dose

Answer 18

Adult bolus: 2.5-5.0 mg q15 min (max 20-40mg)

Acute HTN: 10-20 mg slow IV

Question 19

Nitroglycerin Dose

Answer 19

Adults:
50-100 ug bolus
0.1-7.0 ug/kg/min

Pediatric Infusion: 0.1-0.5 ug/kg/min

Question 20

Nitroprusside

Answer 20

Nipride or Nitropress; parentally; T1/2= 1-2 min

Potent arterial and capactiance dilator; decreases both preload and afterload which helps increase CO in patients with heart failure

Question 21

What is the toxic metabolite of nitroprusside and what is its half life?

Answer 21

Thiocyanate

Half life is many days.

Question 22

Nitroprusside Dose

Answer 22

Adult: 0.5 - 10.0 ug/kg/min (peds low end of this dose)