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Cardiovascular > 04.16 - Antihypertensives (Bahouth) > Flashcards

04.16 - Antihypertensives (Bahouth) Flashcards

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1
Q

2 additional actions of Losartan

A

Competitive antagonist of TXA2 receptor; Increase Uric Acid excretion

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2
Q

2 third gen beta blockers

A

Bisoprolol, Nebivolol

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3
Q

A poor response to Thiazides may reflect

A

Either overwhelming load of dietary Na, or impaired renal capacity to excrete the Na

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4
Q

A1-blockers end in

A

azocin

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5
Q

ACEi’s and ARBs are superior in HTN pt’s with

A

High renin levels (young people, middle-aged caucasians)

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6
Q

ACEi’s end in

A

pril

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7
Q

ACEi’s/ARBs should be avoided in any condition that causes

A

Hyperkalemia

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8
Q

Action of Aliskerin

A

Renin inhibitor

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9
Q

Action of Nebivolol

A

Highly B1 selective, with NO-mediated vasodilation

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10
Q

Advantage of secretion of renal prostaglandins

A

Catopril –> Delays progression of renal disease in diabetics

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11
Q

AE’s of ACEi’s besides dry cough

A

Hypotension; Hyperkalemia; Angioedema; Fetotoxicity

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12
Q

Anti-oxididant BB

A

Carvedilol, Nebivolol

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13
Q

ARB’s end in

A

sartan

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14
Q

BB that prevents LDL oxidation and decreases LDL uptake into coronaries

A

Carvedilol

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15
Q

BB with Significant ISA

A

Pindolol (also Timolol)

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16
Q

BB with significant membrane stabilizing activity

A

Propanolol (also Metoprolol, Pindolol)

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17
Q

BB without Lipid Solubility

A

Atenolol

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18
Q

BB’s are highly preferred in HTN patients with

A

MI, IHD, CHF

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19
Q

BB’s are moderately preferred in HTN patients with

A

Hyperthyroidism, Migraines

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20
Q

Best tolerated drugs for monotx of HTN

A

Diuertics and ACEi’s

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21
Q

Can a1 blockers be given as monotherapy

A

No

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22
Q

Can CCB’s be used in diabetics

A

Yes

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23
Q

CCB’s should be reserved for what patients

A

do not tolerate diuretics, BB’s, ACEi’s

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24
Q

Clinical uses of Hydralazine

A

IV in HTN emergency from eclampsia

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25
Clinical uses of Nitroprusside
IV for HTN emergencies in patients with ventricular failure
26
Clonidine withdrawal
HTN
27
Common side effect of Sedation
Alpha2 agonists
28
Competitive antagonist of TXA2 receptor; Increase Uric Acid excretion
2 additional actions of Losartan
29
Dihydropyridines end in
dipine
30
Do ACEi's have positive impact on mortality in CHF
yes
31
Do ARB's affect CYP metabolism
No
32
Do BB's cause retention of salt and water?
No, can be administered without diuretic
33
Effect of ARBs on TPR, PV, CO, BP
Decrease all
34
Effects of alpha2 agonists
Dec PVR, Dec HR
35
Effects of ARB's
Vasodilation and Na excretion --> Dec TPR, BV, CO, BP
36
First and second drugs administered to diabetic patient with HTN
ACEi/ARBs first, then CCB
37
Hemodynamic effects of alpha1 blockers
Decrease TPR and Reduce BP
38
Hemodynamic effects of Nebivolol
Significant increase SV, maintains CO and systemic blood flow
39
Hemodynamic effects of Nitroprusside
Dec TPR; Dec CO in normal, but inc CO in patients with ventricular failure (afterload reduced)
40
Highly B1 selective, with NO-mediated vasodilation
Action of Nebivolol
41
How do Dihydro-CCB's affect BP, Sympathetic discharge, and HR
Dec BP, No change in sympathetics or HR
42
How does Nitroprusside decrease preload
Venous pooling - less blood goes to heart
43
In whom are BB's not as effective
AA and Elderly
44
In whom are CCB's used (HTN)
Low renin HTN: AA's, elderly
45
Indications for Labetalol
IV for HTN emergencies
46
Infrequent but potentially fatal AE of ACEi's
Angioedema
47
Is there a survival benefit with CCB's for HTN
no
48
IV for HTN emergencies
Indications for Labetalol
49
IV for HTN emergencies in patients with ventricular failure
Clinical uses of Nitroprusside
50
Main side effect of ARB's
Fetotoxicity
51
Major Advantage of Beta Blockers
Secondary protection in CAD
52
Metabolic effects of BB's
Nonselective: block glycogenolysis; LDL up, HDL down, TG up
53
MOA of ARB's
Selectively block ATII receptors
54
MOA of BB w/ no ISA
Block B1 in heart; Block B1 in JGA (inhibit renin release)
55
MOA of Hydralazine
Selective arteriolar SM relaxer
56
MOA of Labetalol
Nonselective B + a1 receptor antagonist
57
MOA of Minoxidil
Relaxes arteriolar SM by opening K channels
58
Most selective CCB for myocardium
Verapamil
59
Non-hemodynamic effects of alpha1 blockers
Relieve symptoms of BPH; Increase HDL, Lower LDL; Insulin resistance improvement
60
Non-selective BB in A-N
Carvedilol (Labetelol?)
61
Nonselective B + a1 receptor antagonist
Labetalol, Carvedilol
62
Other uses of Clonidine
Releases endogenous opiates; ADHD also
63
Palpitations; Tachycardia; AI - Hemolytic Anemia
Side effects of Hydralazine
64
Peripheral side effects of BB's
Cold extremities
65
Reflex Tach, Renin; Hirsutism (rogaine)
Side effects of Minoxidil
66
Reflexive effect of Hydralazine
Reflex SNS stimulation --> Catecholamine/Renin secretion --> Na retention
67
Relaxes arteriolar SM by opening K channels
MOA of Minoxidil
68
Releases endogenous opiates; ADHD also
Other uses of Clonidine
69
Relieve symptoms of BPH; Increase HDL, Lower LDL; Insulin resistance improvement
a1-receptor blockers
70
Renin inhibitor
Aliskerin
71
Secondary protection in CAD
Major Advantage of Beta Blockers
72
Selective arteriolar SM relaxer
MOA of Hydralazine
73
Side effect of a1 blockers
First-dose hypotension (give at bedtime)
74
Side effects of alpha2-agonists
Sedation (less with Guanfacine)
75
Side effects of Hydralazine
Palpitations; Tachycardia; AI - Hemolytic Anemia
76
Side effects of Minoxidil
Reflex Tach, Renin; Hirsutism (rogaine)
77
T/F: All ARB's increase Uric Acid excretion
False, Losartan
78
The b1 blocker ___ is considered standard tx with ACEi's and Diuretics
Bisoprolol
79
What are contraindicated in Renal Artery Stenosis
ACEi's and ARB's - Kidney needs vasodilatory effects of AT2
80
What do Hydralazine and Minoxidil have in common besides arteriolar SM relexation
Increase Renin
81
What do you want to use with Hydralazine
BB and diuretics
82
What ends in -azocin
A1-blockers
83
What ends in -dipine
Dihydropyridines
84
What ends in -sartan
ARB's
85
What ends in pril
ACEi's
86
What may preserve renal function in HTN patients with non-diabetic nephropathies
Catopril
87
What should be chosen as initial Anti-HTN in pateints prone to CHF
ACEi's/ARB's
88
What should be the initial Anti-HTN in diabetic patients with HTN
ACEi/ARBs
89
When are BB's particularly useful
HTN's with Tachycardia, High CO, and/or high renin
90
When do Diuretics improve mortality in HTN
Alone or with BB's
91
When is Carvedilol used
CHF and HTN (decreased mortality with mild-moderate CHF)
92
Which ACEi increases synthesis of renal prostaglandins
Catopril
93
Which ACEi is renoprotective
Catopril --> Delays progression of renal disease in diabetics
94
Which CCB's are used for HTN
Dihydropyridines: Selective for L-type Ca channels on vessels
95
Which drug increases uric acid urinary excretion
Losartan
96
Which drug is a competitive antagonist to TXA2 receptor
Losartan
97
Which other drugs do Diuretics augment activity of
All
98
Which patients show better responses to diuretics
Volume dependent HTN (low renin levels)
99
Why are third gen BB's preferred over older
Fewer side effects
100
What is used in HTN with metabolic syndrome
Nebivolol

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