Pharm Chapter 21 - Antihypertensives

Question 1

Diagnostic criteria for hypertension

Answer 1

Diastolic above 90 Systolic above 140

Question 2

BP formula

Answer 2

CO x TPR

Question 3

Essential Hypertension

Answer 3

5% of patients. No clear discernable cause.

Question 4

Secondary Hypertension

Answer 4

attributed to some specific abnormality

Examples: Renal artery stenosis, Cerebral damage, Endocrine disorders

Question 5

Categories of Antihypertensive

Answer 5

Diuretics
Vasodilators
ACE inhibitors and ARBs
Calcium channel blockers

Question 6

Diuretics

Answer 6

MOA- increase formation and excretion of urine. Decrease volume of fluid in vascular space. cause renal sodium and water excretion
Categories: Thiazides, Loop Diuretics, Potassium sparing diuretics
AE: Fluid depletion and electrolyte imbalance, Increased cardiac output in response to decrease in fluid volume, Orthostasis

Question 7

Beta Blockers

Answer 7

MOA- decrease HR and force myocardial contraction. Slow HR and reduce CO
Types of beta blockers are sorted by alpha 1, beta 1, and beta 2 selectivity and drive the patient specific selection of the agent
AE:Bronchoconstriction in asthmatic pts, Bradycardia, Impaired glucose and liquid metabolism, Fatigue
Examples: metoprolol, propranolol “olol”

Question 8

Alpha Blockers

Answer 8

MOA- block alpha 1 receptor on vascular smooth muscle to decrease vascular resistance
Advantages: Less hypotension
AE: Reflex tachycardia, Orthostasis

Question 9

Centrally acting agents

Answer 9

MOA- decrease sympathetic outflow
Adverse effects: dry mouth, dizziness, sedation
Examples: Clonidine

Question 10

Vasodialators

Answer 10

MOA: dilate the peripheral blood vessels to reduce pressures. Inhibit smooth muscle contraction, thus cause vasodilation
Adverse Effects: orthostasis, dizziness, tachycardia, headache, fluid retention
Examples: dinitrate, isosorbide, mononitrate, nitroprusside, minoxidil

Question 11

RAS Drugs (renin angiotension system)

Answer 11

When BP drops, kidneys release renin, which acts on angiotensinogen to convert to angiotensin I then angiotensin II which is a potent vasoconstrictor, which ensures perfusion of the body

Question 12

ACE inhibitors

Answer 12

“prils”

MOA: inhibit angiotensin converting enzyme

Question 13

ARBs

Answer 13

“artans”

MOA: angiotensin II receptor blockers

Question 14

Calcium Channel Blockers

Answer 14

MOA: block calcium entry into the vascular smooth muscle, thus block contraction, then relax the blood vessels and lower pressure
AE: peripheral edema in ankles

Question 15

Nonpharmacologic Management

Answer 15

DASH diet
Decreasing alcohol and tobacco use
Exercise Weight loss
Stress management