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phrm 844 > ANS control of BP > Flashcards

ANS control of BP Flashcards

1
Q

pressure inside arteries when the heart pumps

A

systolic

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2
Q

pressure when the heart relaxes between beats

A

diastolic

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3
Q

normal BP S/D

A

less than 120 and less than 80

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4
Q

elevated BP S/D

A

120-129 and less than 80

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5
Q

stage 1 htn S/D

A

130-139 or 80-89

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6
Q

stage 2 htn S/D

A

140 or higher or 90 or higher

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7
Q

htn crisis S/D

A

higher than 180 and/or higher than 120

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8
Q

what pulse pressure value is a risk factor for heart disease

A

> 60mmHg

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9
Q

what are some causes of secondary htn

A

kidney disease
tumors
endocrine disease
pregnancy
medication adverse effects

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10
Q

Fill in the acronym for causes of secondary htn
A
B
C
D
E

A

Aldosteronism
Bad kidneys
Cushings/coarctation
Drugs
Endocrine disorders

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11
Q

If a pt has elevated bp, what is the first thing you should try

A

nonpharm therapy, monitor in 3-6 months

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12
Q

if a pt is in stage 1 htn AND has a clinical ASCVD or estimated 10 year CVD risk >10% what do you do?

A

nonpharm therapy + BP-lowering medication, reaccess in 1 month

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13
Q

if a pt in stage 1 htn has attempted a BP lowering med and the goal is not met after 1 month, what is the next step?

A

assess and optimize adherence to therapy

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14
Q

if a pt is in stage 2 htn what is the first step of therapy?

A

BP lowering med with nonpharm changes

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15
Q

BP is the product of what and what

A

cardiac output (CO) and total peripheral resistance (TPR)

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16
Q

BP equation

A

CO x TPR

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17
Q

CO is the product of what and what?

A

cardiac stroke volume (SV) and heart rate (HR)

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18
Q

what is the equation for CO?

A

CO=SV x HR

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19
Q

SV is determined by what 3 things?

A

cardiac contractility
venous return to the heart
resistance the left ventricle must overcome to eject blood into the aorta

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20
Q

Parasymp or symp?
acetylcholine

A

p

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21
Q

Parasymp or symp?
norepinephrine

A

s

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22
Q

Parasymp or symp?
muscarine

A

p

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23
Q

Parasymp or symp?
nicotine

A

p

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24
Q

Parasymp or symp?
epinephrine

A

s

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25
Q

what are the two cholinoceptors (acetylcholine receptors)?

A

nicotine and muscarine

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26
Q

what are the two nicotinic receptors

A

Nm and Nn

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27
Q

what are the 3 muscarinic receptors

A

M1, M2, M3

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28
Q

What are the two adrenoceptors (norepinephrine and epinephrine receptors)

A

alpha and beta

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29
Q

what are the two alpha receptors

A

a1 and a2

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30
Q

what are the 3 beta receptors

A

B1, B2, B3

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31
Q

which receptor is Gq coupled
a. a1
b. a2
c. beta
d. M2

A

a. a1

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32
Q

which receptor is Gi coupled?
a. a1
b. a2
c. beta
d. M2

A

b. a2

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33
Q

which receptor is Gs coupled?
a. a1
b. a2
c. beta
d. M2

A

c. Beta

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34
Q

what 3 locations (broad) are the adrenergic receptors located in?

A

GI, pancreas, CNS)

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35
Q

what receptor makes you cum?

A

a1

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36
Q

which receptors deal with vasoconstriction?

A

a1 and a2

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37
Q

what receptors deal with cardiac stimulation?

A

B1 and B2

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38
Q

what receptor secretes renin

A

B1

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39
Q

what receptor vasodilates

A

B2

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40
Q

what receptor for bronchodilation

A

B2

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41
Q

T or F: Epinephrine is more selective for alpha than beta receptors

A

F, more selective for beta

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42
Q

what receptors innervate the heart

A

b1 receptors

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43
Q

what receptors innervate blood vessels

A

a1 receptors

44
Q

what receptors does phenylephrine work on

A

alpha

45
Q

what receptors does epinephrine work on

A

beta and alpha

46
Q

what receptors do isoproterenol work on

A

beta receptors

47
Q

what are the targets for anti htn drugs?

A

heart and kidneys

48
Q

physiologic action of beta blockers (3)

A

decrease heart rate
cardiac contractility
decrease renin secretion

49
Q

central a2-agonists physiologic action

A

decrease sympathetic tone

50
Q

physiologic action of peripheral a1 antagonists

A

vascular smooth muscle relaxation

51
Q

what class of drugs are calcium channel blockers in

A

vasodilators

52
Q

what is the physiologic action of calcium channel blockers

A

decrease peripheral vascular resistance

53
Q

physiologic action of ace inhibitors

A

decrease peripheral vascular resistance and?

54
Q

physiologic action of arbs

A

decrease sodium retention

55
Q

physiologic action of direct renin inhibitors

A

decrease sodium retention

56
Q

which of the following drug classes can be used in pts with diabetes?
a. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists
f. calcium channel blockers

A

a. ACE i
b. arbs
f. calcium channel blockers

57
Q

which of the following drug classes can be used in pts with CKD?
a. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists
f. calcium channel blockers

A

a. ACE i
b. Arbs

58
Q

which of the following drug classes can be used in pts with postmyocardial infarction?
a. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists
f. calcium channel blockers

A

a. ACE i
b. ARB
c. beta blockers
e. aldosterone antagonists

59
Q

which of the following drug classes can be used in pts with heart failure?
a. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists
f. calcium channel blockers

A

a. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists

60
Q

which receptor is found on:
vascular sm
genitourinary sm
intestinal sm
heart
liver

A

a1

61
Q

which receptor mobilizes Ca++ from intracellular stores?

A

a1

62
Q

which pathway (also receptor) does something with dag to activate PKC?

A

gq pathway, a1

63
Q

which receptor antagonist class has medications that end in “osin”

A

a1 antagonist

64
Q

give the following half lives
prazosin
terazosin
doxazosin

A

prazosin - 3 hrs
terazosin - 12 hrs
doxazosin - 20 hrs

65
Q

action of a1 antagonist is in ______ and ______

A

arterioles and venules

66
Q

what are the two compensatory effects of a1 antagonists?

A

tachycardia and renin release

67
Q

which receptor and pathway does the following:
inhibit adenylyl cyclase
activate certain K+ channels
inhibit neuronal Ca++ channels

A

a2, gi

68
Q

which receptor is found presynaptically and function as autoreceptors to inhibit sympathetic output?

A

a2

69
Q

which of the following is not an a2 agonist?
a. clonidine
b. prazosin
c. methlydopa
d. brimonidine

A

b. prazosin

70
Q

how do a2 agonist reduce blood pressure?

A

reducing sympathetic output from the brain

71
Q

what are the 2 indications for clonidine

A

antihypertensive and antiglaucoma

72
Q

a2 agonists indirectly inhibit the release of ____

A

norepinephrine

73
Q

side effects of direct acting a2 agonists

A

hypotension, sedation, dry mouth

74
Q

T or F: methyldopa is a prodrug

A

true

75
Q

where does the a2 agonist methyldopa act?

A

at CNS a2 receptors to decrease sympathetic outflow

76
Q

water soluble, ester hydrochloride salt methyldopate is used for ____ solutions

A

parenteral

77
Q

uses of methyldopa

A

hypertension, especially during pregnancy

78
Q

which receptor subtypes
activate adenylyl cyclase
increase camp leading to pkc activation
result in phosphorylation of ion channels and other proteins

A

b1,b2,b3

79
Q

what are the 5 beta blocker indications?

A

angina
cardiac arrhythmia
post-MI
htn
congestive HF

80
Q

beta receptor antagonists- also known as beta blockers, end with what?

A

-lol

81
Q

T or F: Beta blockers increase cardiac output and heart rate

A

F, they decreaes

82
Q

Beta blockers _____ VLDL and ______ HDL
a. increase increase
b. increase decrease
c. decrease increase
d. decrease decrease

A

b. increase decrease

83
Q

Nadolol is (less/more) lipophilic than propranolol

A

less

84
Q

T or F: Propranolol and Timolol block B1 AND B2

A

True

85
Q

clinical uses of propranolol (5)

A

htn
angina
cardiac arrhythmias
ischemic heart disease
prophylaxis for migraines (weird)

86
Q

clinical use of timolol

A

open-angle glaucoma (decreases production of aqueous humor)

87
Q

what type of medications do you need to be cautious using in asthma patients?

A

Beta blockers

88
Q

what are the four selective B1 blockers?

A

metoprolol, bisoprolol, atenolol, esmolol, nebivolol

89
Q

what is the moiety in the structure of B1 selective blockers

A

para-substituted phenyl derivatives (whatever tf this means)

90
Q

T or F: Selective b1 blockers have less bronchoconstriction

A

True

91
Q

action of metoprolol

A

selective antagonist at beta 1 receptor

92
Q

4 clinical uses of metoprolol

A

htn
angina
cardiac arrhythmias
ischemic heart disease

93
Q

which beta blocker is considered “cardioselective”

A

atenolol

94
Q

what is considered “water-soluble” metoprolol

A

atenolol

95
Q

2 uses of atenolol

A

htn and angina

96
Q

what is the “very short acting” selective beta blocker

A

esmolol

97
Q

what is the B1 selective 3rd generation beta blocker

A

nebivolol

98
Q

nitric oxide production would lead to what?

A

vasodilation

99
Q

what are the side effects of beta blockers?(5)

A

Bradycardia, av block, sedation, mask symptoms of hypoglycemia, withdrawal symtpoms

100
Q

contraindications of beta blockers (3)

A

asthma, copd, congestive heart failure(type IV)

101
Q

what are the 2 mixed adrenergic receptor antagonist from the slide

A

labetalol and carvedilol

102
Q

clinical use of carvedilol

A

heart failure

103
Q

clinical uses of labetalol (2)

A

hypertensive emergencies, and pheochomocytoma

104
Q

action of labetalol and carvedilol

A

a1 antagonism and nonselective B1 and B2 antagonism

105
Q

what is the dopamine receptor agonist

A

fenoldopam

106
Q

clinical use for fenoldopam

A

severe htn

107
Q

fenoldopam should not be used in pts with what

A

glaucoma

phrm 844 (12 decks)

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