Renal IX: Hypertension Flashcards
ACEIs and ARBS ________ decrease TPR/decrease CO
decrease TPR
Beta-Blockers ________ decrease TPR/decrease CO
decrease CO
Causes of primary hyperaldosteronism
Adrenal adenoma, adrenal gland hyperplasia
Causes of renal parenchymal hypertension (3)
Glomerulonephritis, Hereditary kidney disease, diabetic nephropathy
Causes of renovascular hypertension
Fibromuscular dysplasia, atherosclerosis
Causes of Secondary Hypertension (4)
Renovascular hypertension, Renal parenchymal hypertension, Hyperaldosteronism, Pheochromocytoma
Dihydropyridine calcium channel blockers ________ decrease TPR/decrease CO
decrease TPR
High intracellular Na in VSMCs increases activity of the _______.
Na/Ca exchanger
In the ____ hypothesis, there is an inability to excrete sodium
Guyton’s
In the _____ hypothesis, there is inhibition of the Na/K ATPase in VSMCs
Cellular
Increased sodium results in volume expansion; autoregulation is responsible for ______ PVR
increased
Loop diuretics cause ____calcemia.
Hypo-
Name the drug class for each part of the tubule: proximal tubule, loop of Henle, distal tubule, collecting duct
Acetazolamide; loop diuretics; thiazide diuretics; aldosterone antagonists/sodium channel blockers
Non dihydropyridine calcium channel blockers ________ decrease TPR/decrease CO
decrease CO and TPR
Pheochromocytoma is a tumor of the ______ resulting from excess _______.
adrenal medulla; catecholamines
Prevalence of hypertension in US
50 million
Renovascular hypertension results in _______ angiotensin II levels and _______ renal blood flow
increased, decreased
Renovascular hypertension results in inappropriate activation of _______ and release of _____.
baroreceptors; renin
Thiazide diuretics cause ____calcemia.
Hyper-
Treatment of Renovascular hypertension
fibromuscular dysplasia: percutaneous balloon dilatation, atherosclerosis: surgical repair
What drug? Cough, hyperkalemia, angioedema, anemia
ACEIs
What drug? decreases urethral resistance and may improve urine flow and BPH symptoms
alpha-1-adrenergic blockers
What drug? hyperkalemia, amenorrhea, gynecomastia
Spironolactone
What drug? hyperkalemia, anemia
ARBs
What drug? hyperkalemia, hyperuricemia, glucose intolerance in diabetic patients
Na Channel Blockers
What drug? hypokalemia, hypomagnesemia, uric acid retention, hyponatremia, hypochloremia, hyperglycemia, hypercalcemia
Thiazide diuretics
What drug? Improved bioavailability over furosemide
Torsemide
What drug? interferes with calcium movements within the vascular smooth muscle to cause vasodilation
Hydralazine
What drug? Longer half-life thiazide diuretic
Chlorthalidone
What drug? metabolic acidosis, drowsiness, fatigue, CNS depression
Carbonic anhydrase inhibitors
What drug? nausea, headache, constipation, gingival hyperplasia, cardiac conduction defects
Non-Dihydropyridines
What drug? nausea, headache, severe water loss and hypernatremia with prolonged use
Osmotic diuretics
What drug? Only non-sulfa loop or thiazide diuretic
ethacrynic acid
What drug? ototoxicity, hypokalemia, metabolic alkalosis, hyponatremia, hypocalcemia, uric acid retention
Loop diuretics
What drug? peripheral edema, headache, reflex tachycardia, flushing, gingival hyperplasia
Dihydropyridines
What drug? potassium channel opener, causing hyperpolarization of cell membranes
Minoxidil
What drug? stimulates α2-adrenergic receptors in the CNS and periphery, which reduces sympathetic nerve impulses and decreases peripheral vascular resistance
Clonidine/Methyldopa
Which drug class? Inhibit Na/Cl cotransporter
Thiazide diuretics
Which drug class? Inhibit Na/K/2Cl cotransporter
Loop diuretics
Which drug? Aldosterone antagonist
spironolactone, eplerenone
Which drug? Carbonic anhydrase inhibitor
Acetazolamide
Which drug? Sodium channel inhibitor
Amiloride, triamterene
