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PHARMACOLOGY 2 > Whalen Chapter 17 > Flashcards

Whalen Chapter 17 Flashcards

1
Q

Have a higher incidence of hypertension than do both non-Hispanic whites and Hispanic white

A

Non-Hispanic Blacks

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2
Q

Defined as either a systolic BP greater than 140 mmHg or sustained Diastolic BP greater than 90 mmHg

A

Hypertension

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3
Q

Top 2 cause of death in the world

A

Heart disease
Stroke

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4
Q

Regulated within a narrow range to provide
adequate perfusion of the tissues without causing damage to the vascular system, particularly the arterial intima (endothelium).

A

Arterial Blood Pressure

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5
Q

Act by changing the activity of the sympathetic nervous
system and is responsible for the rapid, moment-to-
moment regulation of blood pressure.

A

Baroreflexes

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6
Q

Provides long-term control of blood pressure by altering
the blood volume

A

Kidney

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7
Q

Potent circulating vasoconstrictor, constricting both arterioles and veins, resulting in an increase in blood pressure.

A

Angiotensin ll

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8
Q

The goal of this therapy is to reduce cardiovascular and
renal morbidity and mortality

A

Antihypertensive therapy

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9
Q

Stimulates aldosterone secretion leading to increased renal sodium reabsorption

A

Angiotensin ll

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10
Q

Can sometimes be controlled by Monotherapy

A

Mild hypertension

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11
Q

Patients with Diabetes

A

140/80 mm Hg

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12
Q

Patients with Chronic Kidney Disease and Proteinuria

A

130/80 mm Hg

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13
Q

Elderly patients

A

< 150/90 mm Hg

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14
Q

Used as an initial drug therapy for HTN

A

Thiazide diuretics

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15
Q

Effective in preventing Stroke, Myocardial infarction, and Heart failure

A

Low-Dose Diuretic Therapy

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16
Q

Useful in combination therapy (Beta blockers, ACE inhibitors, ARBs, PSB with exception of Metolazone

A

Thiazides

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17
Q

Acts promptly by blocking Sodium and Chloride reabsorption in kidney

A

Loop diuretics

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18
Q

Rarely used alone to treat HTN, but is commonly used to manage symptoms of Heart failure and Edema

A

Loop Diuretics

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19
Q

Aldosterone receptor antagonist examples

A

Eplerenone
Spironolactone

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20
Q

Inhibitors of Epithelial Sodium Transport at late distal and collecting ducts

A

Triamterene
Amiloride

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21
Q

Reduces potassium loss in urine

A

Eplerenone
Spironolactone

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22
Q

Have additional benefit of diminishing cardiac remodeling

A

Aldosterone antagonist

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23
Q

Treatment option for hypertensive patients with concomitant heart disease or failure

A

Beta blockers

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24
Q

Decreases sympathetic outflow and formation of Angiotensin ll

A

Beta blockers

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25
Q

Prototype beta blocker

A

Propranolol

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26
Q

Selective blocker of B1 receptor examples that are most commonly prescribed beta blocker

A

Metoprolol
Atenolol

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27
Q

May be administered cautiously in hypertensive patients who also have asthma

A

Selective beta blockers

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28
Q

Examples of Non-Selective Beta blockers

A

Propranolol
Nadolol

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29
Q

Contraindicated in patients with asthma due to blockade of b2-mediated bronchodilation

A

Non-Selective Beta blockers

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30
Q

Orally active for the treatment of HTN

A

Beta blockers

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31
Q

Undergoes extensive and high variable first pass metabolism

A

Propranolol

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32
Q

Beta blockers available in intravenous formulations

A

Propranolol
Esmolol
Metoprolol

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33
Q

A/E of Beta blockers

A

Bradycardia
Hypotension
Decrease of Libido
CNS S/E - Fatigue, Insomnia, Lethargy

34
Q

Decreases High density lipoprotein cholesterol and Increases Triglycerides

A

Non-cardioselective Beta blockers

35
Q

May disturb lipid metabolism

A

Non-cardioselective Beta blockers

36
Q

1st line treatment of HTN in patient’s with High-coronary disease risk or History of Diabetes

A

Enalapril
Lisinopril

37
Q

Responsible for the breakdown of Bradykinin

A

ACE inhibitors

38
Q

Peptide that increases the production of Nitric oxide and Prostacyclin

A

Bradykinin

39
Q

ACE INHIBITORS
Bradykinin levels decreases, Angiotensin ll increases.

TRUE OR FALSE

A

False

40
Q

TRUE / FALSE

ACE inhibitors also slows the progression of Diabetic Nephropathy and decreases Albuminuria.

A

True

41
Q

Standard of patient following a myocardial infarction

A

ACE inhibitors

42
Q

1st line drugs for treating HTN, Hypertensive patients with Chronic Kidney disease

A

ACE inhibitors

43
Q

True or False

All ACE inhibitors are orally bioavailable as a drug or produg

A

True

44
Q

Undergoes hepatic conversion to active metabolites and is preferred in patients with severe hepatic impairment.

A

Captopril
Lisinopril

45
Q

Only ACE inhibitors not eliminated primarily by Kidney and does not require dose adjustment

A

Fosinopril

46
Q

Only drug under this classification available intravenously

A

Enalaprilat

47
Q

Thought to be due to the increase levels of Bradykinin and Substance P in the pulmonary tree

A

Dry cough

48
Q

Rare but is a potentially life threatening reaction

A

Angioedema

49
Q

An alternative to ACE inhibitors

A

Losartan
Irbesartan

50
Q

Decreases salt and water retention

A

ARBs

51
Q

1st line agents for trt of hypertension especially in patients with compelling indication of diabetes

A

ARBs

52
Q

These agents are teratogenic and should not be used by pregnant women

A

ARBs

53
Q

Acts earlier in renin-angiotensin-aldosterone system and should not be routinely combined with ACE inhibitors or ARBs

A

Aliskiren

54
Q

Aliskiren is metabolized by what?

A

CYP3A4

55
Q

Recommended treatment option for Hypertensive patients with Diabetes and angina

A

Calcium channel blocker

56
Q

3 chemical classes of CCB

A

Diphenylalkylamine
Benzothiazepines
Dihydropyridine

57
Q

Drug under diphenylalkylamine that is the only drug available in US

A

Verapamil

58
Q

Used to treat angina and supraventricular Tachyarrthmia and prevent migraines and cluster headache

A

Verapamil

59
Q

Only drug under Benzothiazepines that is currently available in US

A

Diltiazem

60
Q

Has a less pronounced negative inotropic effect and has favorable s/e profile

A

Diltiazem

61
Q

Drugs under Dihydropyridine

A

Nifedipine
Amlodipine
Isradipine
Felodipine
Nicardipine
Nisoldipine

62
Q

Have a greater affinity with vascular cc than cc in the heart

A

Dihydropyridine

63
Q

Blocks the inward movement of calcium by binding to L-type calcium channel

A

Calcium channel antagonist

64
Q

Used in the treatment of Atrial fibrillation and should be avoided in patients with atrioventricular block

A

Diltiazem and Verapamil

65
Q

Have a very long half-life and does not require sustained release formulations

A

Amlodipine

66
Q

The S/E of Verapamil is Atrioventricular block and Constipation. True or False

A

True

67
Q

May cause gingival hyperplasia

A

Nifedipine

68
Q

Shown to reduce morbidity and mortality associated with heart failure

A

CARVEDILOL, Metoprolol succinate, Bisoprolol

69
Q

Used in management of Gestational hypertension and Hypertensive emery

A

Labetalol

70
Q

Produce a competitive block of a1 adrenoceptors

A

Prazosin, Doxazosin, Terazosin

71
Q

Example of Centrally acting adrenergic drugs

A

Clonidine
Methyldopa

72
Q

Used primarily for trt of HTN that has not responded adequately to treatment with 2 or more drugs. And is available as a transdermal patch

A

Clonidine

73
Q

Occurs following the abrupt withdrawal of CLONIDINE

A

Rebound HTN

74
Q

Mainly used to manage HTN in pregnancy and is an a2 agonist that is converted to methylepinephrine

A

Methyldopa

75
Q

Cause Hypertrichosis and is used topically to treat male pattern baldness

A

Minoxidil

76
Q

Rare but a life threatening situation characterized by severe elevation of BP

Systolic > 180 mm Hg
Diastolic > 120 mm Hg

A

Hypertensive emergency

77
Q

BP remains elevated (above goal) despite administration of 3-drug regimen

A

Resistant HTN

78
Q

Medications used in Hypertensive emergency:

CCB

A

Nifedipine
Clevidipine

79
Q

Medications used in Hypertensive emergency:

Nitric oxide vasodilator

A

Nitroprusside
Nitroglycerin

80
Q

Medications used in Hypertensive emergency:

Adrenergic Receptor antagonist

A

Phentolamine, Esmolol, Labetalol

81
Q

Not effective in patients with inadequate kidney function

A

Thiazide diuretic

PHARMACOLOGY 2 (2 decks)

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