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RENAL II Exam 3 > Vasodilators and Sympatholytics DSA II > Flashcards

Vasodilators and Sympatholytics DSA II Flashcards

1
Q

beta3 agonist

A

nebivolol

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2
Q

propranolol

A

non-selective beta blocker

-decreased BP and CO

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3
Q

beta1 in kidney

A

blockade inhibits renin release

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4
Q

esmolol

A

not available oral

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5
Q

lipophilic sympathplegics

A

propranolol and penbutolol

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6
Q

asthma/COPD

A

adverse effects of beta-2 blockade with sympatholytics

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7
Q

diabetes

A

glycogenolysis blocked after beta-2 blockade

-use sympatholytics w/ caution

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8
Q

cardiac arrhythmias

A

caution sympatholytic use

-cardiac decompensation

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9
Q

side effect of sympatholytics

A

fatigue, bradycardia, sexual dysfunction, depression

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10
Q

chronic sympatholytic use

A

high lipid plasma leels

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11
Q

sudden sympatholytic withdrawal

A

rebound hypertension, angina, possible MI

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12
Q

drug-drug interactions sympatholytics

A

with CCBs - verapamil and diltiazem

-heart block

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13
Q

HTN Tx

A

metoprolol and atenolol

-beta-1 selective antagonist

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14
Q

carvedilol and labetalol

A

non-selective beta blockers

alpha 1 blockers

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15
Q

heart failure Tx

A

carvedilol, bisopril, metoprolol
-reduce mortality

-may worse CHF - careful long term use

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16
Q

bisoprolol

A

beta1 selective antagonist

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17
Q

ISA

A

intrinsic sympathomimetic activity

-labetolol, acebutolol, nevibutolol

18
Q

non-ISA

A

no intrinsic sympathomimetic activity

-propranolol, carvedilol, metoprolol, atenolol

19
Q

ischemic heart disease Tx

A

beta blockers - reduce angina episodes

  • increased exercise tolerance
  • timolol, metoprolol, propranolol - prolong survival after MI
20
Q

cardiac arrhythmia Tx

A

beta blockers - supraventricular and ventricular arrhythmias

21
Q

glaucoma Tx

A

topical timolol, btaxolol, carteolol

22
Q

prazosin

A

alpha1 antagonist

  • prevent constriction of arteries and veins
  • BP reduced - decreased TPR
  • relaxes prostate smooth m
  • without diuretic - Na and water retention

does not effect alpha-2 receptor inhibition of NE release (decreased reflex tachycardia)

23
Q

men with HTN and BPH

A

prazosin

24
Q

central acting alpha-2 agonists

A

clonidine and methyldopa

-reduce sympathetic outflow from vasomotor centers of brainstem

rarely used today

25
Q

pregnancy HTN

A

methyldopa

26
Q

clonidine

A

decreases BP - via decreased CO and TPR

-sedation, dry month, depression, sexual dysfunction

27
Q

methyldopa

A

lower BP by reducing TPR

  • analog of L-dopa
  • converted to alpha-methylnorepinephrine

-sedation dry mouth, lack of concentration, sexual dysfunction

28
Q

HTN in pregnancy

A

stroke risk - SBP > 160 and DBP > 110

consider mother and fetus

29
Q

drugs for HTN in pregnancy

A

acute - labetalol, hydralazine, CCB, nitro

chronic - methyldopa, labetalol, nifedipine, hydralazine

30
Q

contraindicated for HTN in pregnancy

A

ACE (-), ARBs, direct renin inhibitors - fetal abnormalities

nitroprusside - CN poisoning

31
Q

hypertensive emergency

A

> 180/120 with acute end organ damage

goal - gradual reduction of BP without excessive hypotension

32
Q

most effective for hypertensive emergency

A

sodium nitroprusside

-long term - possible CN poisoning

33
Q

cardiac ischemia or after coronary bypass surgery with hypertensive emergency

A

nitroglycerin

34
Q

hypertensive emergency meds

A

nicardipine, clevidipine - DHP-CCB

fenoldopam - dilates renal arteries - good choice for pt with renal dysfunction

hydralazine - pregnancy related to eclampsia

35
Q

phentolamine

A

alpha-blocker

  • treat pts with HTN due to elevated catecholamines
  • cocaine intox, pheochromocytoma
36
Q

esmolol

A

rapid, short acting beta1 blocker

-treat aortic dissection or post-op HTN

37
Q

labetolol

A

alpha and beta blocker

-safe for patients with active coronary disease

38
Q

initial monotherapy in essential HTN

A 
thiazide
ACE (-)
ARB
CCB
**beta blockers NOT used unless specific indication
39
Q

black pt with essential HTN

A

better to thiazide diuretics and CCBS

-worse to ACE (-) and beta-blockers

40
Q

monotherapy vs. polytherapy in HTN

A

mono - pt compliance, decreased cost, less adverse effects

poly - each drug acts on one of set of interacting mutually compensatory mechanisms
-decreased toxicity (2-3 drugs at low dose as opposed to one at higher dose)

41
Q

example HTN combo drugs

A

ACE (-) and CCB
-trandolapril/verapamil

ACE (-) and diuretic
-benazepril/HCTZ

ARB and diuretic
-valsartan/HCTZ

beta-blocker and diuretic
-propranolol/HCTZ

central agent and diuretic
-reserpine/chlorothiazide

diuretic and diuretic
-spironolactone/HCTZ

42
Q

triple drug regimens

A

thiazide diuretic, DHP-CCB, and

-ACE (-), ARB, or renin (-)

RENAL II Exam 3 (17 decks)

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