Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM Exam 2 > Antihypertensives 2 > Flashcards

Antihypertensives 2 Flashcards

1
Q

What are the β blocker drugs?

A
  • propranolol
  • atenolol
  • metoprolol
  • pindolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When would you give someone a beta blocker as a first line of treatment for HTN?

A
  • when patients have comorbidities of: coronary artery disease, HF or post MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What comoboridies must be associated with HTN for you to prescribe the patient ________ blockers as first line treatment?

A

Beta blockers;

  • post MI
  • coronary artery disease
  • Heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metoprolol and atenolol are _____ β blockers

A

Selective: beta 1 blockers (most widely used)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What beta blocker is given during pregnancy?

A

Pindolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the selective β-1 blockers?

A
  • metoprolol

- atenolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which β blocker drug is a partial agonist?

A

Pindolol (given for HTN in pregnant women)

Non selective β1 and β2 partial agonist with intrinsic sympathomimetic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

________ receptor is important in the release of renin for the RAAS.

A

β1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

β blockers inhibits the release of _____ and______

A

NE and renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long does it take to see the effects of beta blockers?

A

Several weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient with coronary syndrome and HTN is prescribed metoprolol, what is one of the major adverse effects of this drug class?

A
  • ↓ libido and impotence
  • bradycardia
  • CNS effects: fatigue, lethargy, insomnia and hallucinations

Metorprolol = β blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

↓ libido and impotence is an AE of taking _________ drugs

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____ HDL and ______ TAGs levels is an AE of β blockers

A

↓ HDL and ↑ TAG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When giving a β blocker to a patient with HTN, what should you advise them?

A

Closely monitor glucose levels because β blockers can mask the tachycardia that is associated with a hypoglycemic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Propranolol is contraindicated in ______

A

Asthmatics and COPD patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What kind of drug is prazosin?

A

It is an α1 BLOCKER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the α1 blockers:

A

Prazosin and doxazosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

-zosin is the suffix for what drugs

A

For α1 BLOCKERS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Minimal changes are seen in ______, _____ and _____ when using prazosin

A

Prazosin = α1 blocker

CO, renal blood flow, GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Would you expect to see reflex tachycardia when administering doxazosin?

A

Doxazosin = α1 blocker

This is counterintuitive and so this is where you WOULD NOT see any reflex tachycardia when giving an α1 blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Reflex tachycardia is seen when you use a ___________ α blocker such as ___________ BUT NOT with a _____________ α blocker

A

NON SELECTIVE: phenoxybenzamine/ phentolamine (will see reflex tachycardia)

SELECTIVE = NO REFLEX TACHYCARDIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In treating HTN, when you give _______ blockers you DO NOT get Na/water retention but with ______ blockers you do.

A

β blockers = no Na/water retention because blocks β1 receptor for the RAAS

α blockers - WILL SEE Na/water retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What drug would be best to prescribe to an holder male patient with benign prostatic hyperplasia for HTN?

A

α1 blocker

Important to note that α1 blockers are rarely used to treat HTN except for unique situations like this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a specific adverse effect of doxazosin?

A

It is a α1 blocker and is show tin ↑ rate of CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What kind of drug is labetalol?

A

Mixed α and β blocker (α1 and β)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What drug is useful to treat patient in hypertensive emergencies?

A

Give labetalol IV because it causes rapid reduction in BP (mixed α1 and β blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the effect of α2 agonist and name a drug that is an α2 agonist

A
  • central α2 agonists cause ↓ sympathetic outflow by acting on presynaptica α2 receptors → ↓ resistance and CO → ↓ BP

CLONIDINE = α2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the effect of clonidine on renal blood flow?

A

Clonidine = α2 agonist

DOES NOT ↓ renal blood flow OR GFR (would expect to ↑ but does NOT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the two central α2 agonists?

A
  • clonidine

- methyldopa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the drug of choice for pregnancy induced HTN? What kind of drug is it?

A

METHYLDOPA is a central α2 agonist

31
Q

What is the difference in the effects of the two central α2 agonists?

A

A2 agonists: clonidine and methyldopa

Both ↓ resistance and BP and both DO NOT ↓ renal blood flow or GFR

Clonidine: ↓ CO
Methyldopa: does NOT ↓ CO

32
Q

A positive Coombs test is an AE seen in long term treatment with ____________ (antihypertensive)

A

Methyldopa

33
Q

A positive Coombs test can result in ________, _______., and _______ in someone taking __________

A
  • hemolytic anemia
  • hepatitis
  • drug fever

= methyldopa

34
Q

What kind of drug is hydralazine?

A

Direct vasodilator (NOT used as 1st line of treatment for HTN but usually 3rd line and given with drugs that manage their AE’s)

35
Q

What kind of drug is minoxidil?

A

Direct vasodilator

36
Q

What are the two direct vasodilator and what kinds of drugs are they usually given with?

A
  • hydralazine and minoxidil
  • given with: diuretic (vasodilation and ↓ in BP will cause ↑ water and sodium retention) AND β blocker (counteract the reflex tachycardia)
37
Q

Hydralazine acts mainly on _______

A

Arterioles

38
Q

What drug would you give for a patient who is pregnant and is in a hypertensive crisis?

A

Direct vasodilator: hydralazine

39
Q

Reversible lupus like syndrome is an adverse effect of what drug?

A

Hydralazine (direct vasodilator)

40
Q

What re some common adverse effects of hydralazine?

A
  • fluid retention and reflex tachycardia
  • REVERSIBLE LUPUS LIKE SYNDROME
  • headache, nausea, sweating, flushing
41
Q

What is a unique adverse effect of minoxidil that is not seen in the other drug that acts similarly (________)

A

(Hydralazine; both are direct vasodilators)

  • hypertrichosis: regrowth of hair
42
Q

_______ can be given topically to treat male pattern baldness

A

Minoxidil (direct vasodilator) has a AE of hypertrichosis so using this AE to regrow hair

43
Q

What are the 3 different types of treatments for pulmonary HTN?

A
  • prostaglandins (epoprostenol)
  • inhibitors of endothelin synthesis and action (bosentan)
  • vasodilators (sildenafil)
44
Q

What kind of drug is epoprostenol, route of administration and effect

A

It is a synthetic PGI2 given via continuous infusion

↓ peripheral, pulmonary and coronary resistance (used to treat pulmonary HTN)

45
Q

What are some adverse effects of epoprostenol?

A

Epoprostenol is a synthetic PGI2 given to treat pulmonary HTN

  • flushing, headache, jaw pain, diarrhea and arthralgias
46
Q

Bosentan is used to treat _______________ and its MOA is ________

A

Pulmonary HTN;

Blocks the initial transient depressor (ETA) and prolonged pressor responses to endothelin

47
Q

Which drug should NEVER be given to treat pulmonary HTN in pregnant patients or someone who wants to become pregnant

A

Bosentan (nonselective endothelin receptor blocker)

48
Q

_________ is a drug for pulmonary HTN that is contraindicated with the use of nitrates

A

Sildenafil; will result in extreme hypotension

49
Q

What is the MOA of sildenafil and what is it used to treat?

A
  • inhibits phosphodiesterase 5 → ↑ cGMP → SM relaxation
50
Q

What are the first line treatment in treating HTN in someone with a previous MI?

A

β blocker and then add ACEI/ARB

51
Q

What is the first line treatment for HTN in patients with heart failure?

A
  • ACEI/ARB + thiazide (or loop) diuretic + β blocker
52
Q

What is the difference between a hypertensive emergency and a hypertensive urgency:

A

Emergency: severe HTN with signs of damage to target organs (brain, CV, kidneys)

Urgency: very high BP WITHOUT target organ damage

53
Q

How is the treatment different for hypertensive emergency vs. hypertensive urgency

A

Emergency must be treated with IV drugs for immediate action but urgency can be given an oral drug combination

54
Q

What specific BP’s categorizes a patient having a hypertensive emergency?

A
  • in a healthy pt: DBP > 150 w/ SBP > 210

- in a patient with pre existing complications such as cerebral hemorrhage or aortic stenosis : DBP > 120

55
Q

BP in managing hypertensive emergency should be progressively reduced in order to avoid:

A

MI, stroke or visual changes

Monitor via arterial line and give a short acting titratable IV drug

56
Q

What it is the first step in managing a hypterneisve crisis?

A
  • first lower BP by no more than 25% within minutes to an hour (want to get near 100-110 DBP)
57
Q

In managing a hypertensive emergency, after the first lowering, you want to reduce the BP to a goal (______/_______) within __-__ hours and then gradual reduction to normal over the next _____ hours

A

160/100;
2-6 hours;
8-24 hours

58
Q

If a patient is in a hypertensive crisis due to preeclampsia, what drug would you give to ↓ HTN?

A

Hydralazine

59
Q

What a clinical use of sodium nitropusside

A

Used to ↓ BP in hypertensive emergency and must be given via IV and requires a continuous infusion and given with β blocker to counteract the reflex tachycardia

60
Q

Sodium nitroprusside causes vasodilation by acting on _________

A

Arterial and venous smooth muscle

61
Q

Cyanide poisoning is an adverse effect of ______________

A

Sodium nitroprusside;

Metabolism of nitroprusside → cyanide ion

62
Q

What would you give to a patient suffering from cyanide poisoning?

A
  • sodium thiosulfate
63
Q

Which mixed α and β blocker can be used to manage hypertensive emergency?

A

Labetalol

64
Q

What kind of drug is fenoldopam and what does it act on?

A
  • it is a peripheral Dopamine 1 receptor agonist

- ARTERIOLAR dilation

65
Q

In a patient who is in a hypertensive emergency and has history of renal insuffiency, what is the best drug to give?

A

Fenoldopam; it maintains or increases renal perfusion and lowers BP

66
Q

Contraindications of fenoldopam

A

Don’t give to patients with glaucoma

67
Q

Which calcium channel blocker can be used to treat hypertensive emergencies?

A
  • Nicardipine (causes reflex tachycardia so give a β blocker with it)
68
Q

what is the drug of choice in hypertensive emergencies in patients with cardiac ischemia or angina or after a cardiac bypass surgery?

A

NITROGLYCERIN

69
Q

What is the MOA of nitroglycerin and when would you give it?

A
  • vasodilator that acts more on the veins than arteries

- DOC for patients with MI/angina or after cardiac bypass surgery and are in hypertensive emergency

70
Q

MOA of diazoxide

A
  • artierolar dilator that prevents SM contraction by opening K channels
71
Q

Which drug causes arteriolar dilation by opening K+ channels?

A

Diazoxide

72
Q

What is a unique adverse effect of diazoxide?

A
  • inhibits insulin release → treat hypoglycemia due to insulinoma
73
Q

__________ or ________ would be chosen over ARB’s or ACEI to treat HTN in black patients with no other comorbidities

A

Thiazides or calcium channel blockers

74
Q

What drugs are used for HTN emergency treatment? (9)

A
  • sodium nitroprusside
  • labetalol
  • fenoldopam
  • nicardipine
  • nitroglycerin
  • diazoxide
  • phentolamine
  • esmolol
  • hydralazine

PCM Exam 2 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions