Winter Pharm Quiz #2 Flashcards
What severity of hypertension are thiazides primarily used to treat?
Mild hypertension
Name 6 classes of anti hypertensive drugs
Beta blockers Alpha blockers ACE inhibitors ARB's (angiotensin II receptor blockers) Calcium channel blockers Aldosterone antagonists
Explain the MOA of clonidine.
Clonidine stimulates inhibitory alpha 2 receptors in the medulla oblongata. This reduces sympathetic nerve activity to the heart, kidneys, and blood vessels.
Explain the MOA of prazosin.
Prazosin selectively blocks alpha 1 receptors causing peripheral vasodilation.
Name 2 actions of beta blockers which help to control hypertension.
- Reduced cardiac output
2. Blocks the release of renin from the kidneys
What are the 3 functions of the nephron?
Filtration
Reabsorption
Secretion
Regarding kidney function, which products fall under “active reabsorption”? How is this movement controlled?
Amino acids Lactate Vitamins Ions *movement is linked to sodium by way of sodium/potassium pumps
Regarding kidney function, which products fall under “passive reabsorption”? What drives this movement?
Cl-
Water
*movement is dictated by concentration gradients established by sodium/potassium pumps.
Regarding kidney function: when substances are secreted which way do they move? Blood to filtrate Or Filtrate to blood? What is the purpose of this secretion?
Blood to filtrate.
This secretion is for the purpose of disposing of certain substances not yet in the filtrate including: drugs, excess potassium, urea, uric acid.
This also helps to control PH.
Which part of the kidney is the most active reabsorber?
What is reabsorbed?
Proximal convoluted tubule.
- glucose
- amino acids
- sodium (in exchange for H+)
How much is the filtrate volume reduced due to reabsorption in the proximal convoluted tubule?
65%
Which part of the kidney is where H2O is reabsorbed?
Descending Loop of Henle
Which part of the kidney are Na+ and Cl- actively reabsorbed?
Ascending loop of Henle
Describe the affects of aldosterone on the kidneys.
Aldosterone stimulates the kidneys to secrete K+ into the urine in exchange for Na+ in the distal convoluted tubule.
What are the 3 chemical movements initiated by aldosterone?
Increase of sodium reabsorption
Increase of potassium secretion
Increase in H2O reabsorption (secondary to sodium reabsorption)
Explain the mechanism of ADH in regards to kidney function.
ADH causes the pores of the collecting duct to open, causing H2O to rush out, thereby concentrating the urine.
What are the 2 types of chronic hypertension?
Primary (no identifiable cause)
Secondary (identifiable cause)
List 3 consequences of chronic hypertension.
Heart disease
Disney disease
Stroke
List the 3 mechanisms the body uses to regulate BP
- Baroreceptors in the aortic arch and carotid sinus (sympathetic response)
- Renal regulation - through filtrate and sodium reabsorption
- Renin-angiotensin-aldosterone system (RAAS) (plays a more significant role in hypovolemia as opposed to someone who is normotensive)
* RAAS is a slow system (hours to days)
What are the effects of angiotensin II?
Vasoconstriction
Renal retention of water and sodium (aldosterone)
What are the 3 types of diuretics? How do they work?
Loop diuretic
Thiazides
Potassium sparing diuretics
They work by blocking reabsorption of Na+ and Cl-
Where do loop diuretics have their effect?
Ascending loop of Henle
List 4 adverse effects of loop diuretics.
Dehydration
Hyponatremia
Hypokalemia
Reflex tachycardia
Why are beta blockers commonly prescribed with loop diuretics?
Because reflex tachycardia is a common reaction due to the sudden lowering of blood pressure.
