ANS control of BP Flashcards
1
Q
pressure inside arteries when the heart pumps
A
systolic
2
Q
pressure when the heart relaxes between beats
A
diastolic
3
Q
normal BP S/D
A
less than 120 and less than 80
4
Q
elevated BP S/D
A
120-129 and less than 80
5
Q
stage 1 htn S/D
A
130-139 or 80-89
6
Q
stage 2 htn S/D
A
140 or higher or 90 or higher
7
Q
htn crisis S/D
A
higher than 180 and/or higher than 120
8
Q
what pulse pressure value is a risk factor for heart disease
A
> 60mmHg
9
Q
what are some causes of secondary htn
A
kidney disease
tumors
endocrine disease
pregnancy
medication adverse effects
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
11
Q
If a pt has elevated bp, what is the first thing you should try
A
nonpharm therapy, monitor in 3-6 months
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
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
14
Q
if a pt is in stage 2 htn what is the first step of therapy?
A
BP lowering med with nonpharm changes
15
Q
BP is the product of what and what
A
cardiac output (CO) and total peripheral resistance (TPR)
16
Q
BP equation
A
CO x TPR
17
Q
CO is the product of what and what?
A
cardiac stroke volume (SV) and heart rate (HR)
18
Q
what is the equation for CO?
A
CO=SV x HR
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
20
Q
Parasymp or symp?
acetylcholine
A
p
21
Q
Parasymp or symp?
norepinephrine
A
s
22
Q
Parasymp or symp?
muscarine
A
p
23
Q
Parasymp or symp?
nicotine
A
p
24
Q
Parasymp or symp?
epinephrine
A
s
25
what are the two cholinoceptors (acetylcholine receptors)?
nicotine and muscarine
26
what are the two nicotinic receptors
Nm and Nn
27
what are the 3 muscarinic receptors
M1, M2, M3
28
What are the two adrenoceptors (norepinephrine and epinephrine receptors)
alpha and beta
29
what are the two alpha receptors
a1 and a2
30
what are the 3 beta receptors
B1, B2, B3
31
which receptor is Gq coupled
a. a1
b. a2
c. beta
d. M2
a. a1
32
which receptor is Gi coupled?
a. a1
b. a2
c. beta
d. M2
b. a2
33
which receptor is Gs coupled?
a. a1
b. a2
c. beta
d. M2
c. Beta
34
what 3 locations (broad) are the adrenergic receptors located in?
GI, pancreas, CNS)
35
what receptor makes you cum?
a1
36
which receptors deal with vasoconstriction?
a1 and a2
37
what receptors deal with cardiac stimulation?
B1 and B2
38
what receptor secretes renin
B1
39
what receptor vasodilates
B2
40
what receptor for bronchodilation
B2
41
T or F: Epinephrine is more selective for alpha than beta receptors
F, more selective for beta
42
what receptors innervate the heart
b1 receptors
43
what receptors innervate blood vessels
a1 receptors
44
what receptors does phenylephrine work on
alpha
45
what receptors does epinephrine work on
beta and alpha
46
what receptors do isoproterenol work on
beta receptors
47
what are the targets for anti htn drugs?
heart and kidneys
48
physiologic action of beta blockers (3)
decrease heart rate
cardiac contractility
decrease renin secretion
49
central a2-agonists physiologic action
decrease sympathetic tone
50
physiologic action of peripheral a1 antagonists
vascular smooth muscle relaxation
51
what class of drugs are calcium channel blockers in
vasodilators
52
what is the physiologic action of calcium channel blockers
decrease peripheral vascular resistance
53
physiologic action of ace inhibitors
decrease peripheral vascular resistance and?
54
physiologic action of arbs
decrease sodium retention
55
physiologic action of direct renin inhibitors
decrease sodium retention
56
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. ACE i
b. arbs
f. calcium channel blockers
57
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. ACE i
b. Arbs
58
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. ACE i
b. ARB
c. beta blockers
e. aldosterone antagonists
59
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. ACE I
b. ARB
c. B-blockers
d. diuretics
e. aldosterone antagonists
60
which receptor is found on:
vascular sm
genitourinary sm
intestinal sm
heart
liver
a1
61
which receptor mobilizes Ca++ from intracellular stores?
a1
62
which pathway (also receptor) does something with dag to activate PKC?
gq pathway, a1
63
which receptor antagonist class has medications that end in "osin"
a1 antagonist
64
give the following half lives
prazosin
terazosin
doxazosin
prazosin - 3 hrs
terazosin - 12 hrs
doxazosin - 20 hrs
65
action of a1 antagonist is in ______ and ______
arterioles and venules
66
what are the two compensatory effects of a1 antagonists?
tachycardia and renin release
67
which receptor and pathway does the following:
inhibit adenylyl cyclase
activate certain K+ channels
inhibit neuronal Ca++ channels
a2, gi
68
which receptor is found presynaptically and function as autoreceptors to inhibit sympathetic output?
a2
69
which of the following is not an a2 agonist?
a. clonidine
b. prazosin
c. methlydopa
d. brimonidine
b. prazosin
70
how do a2 agonist reduce blood pressure?
reducing sympathetic output from the brain
71
what are the 2 indications for clonidine
antihypertensive and antiglaucoma
72
a2 agonists indirectly inhibit the release of ____
norepinephrine
73
side effects of direct acting a2 agonists
hypotension, sedation, dry mouth
74
T or F: methyldopa is a prodrug
true
75
where does the a2 agonist methyldopa act?
at CNS a2 receptors to decrease sympathetic outflow
76
water soluble, ester hydrochloride salt methyldopate is used for ____ solutions
parenteral
77
uses of methyldopa
hypertension, especially during pregnancy
78
which receptor subtypes
activate adenylyl cyclase
increase camp leading to pkc activation
result in phosphorylation of ion channels and other proteins
b1,b2,b3
79
what are the 5 beta blocker indications?
angina
cardiac arrhythmia
post-MI
htn
congestive HF
80
beta receptor antagonists- also known as beta blockers, end with what?
-lol
81
T or F: Beta blockers increase cardiac output and heart rate
F, they decreaes
82
Beta blockers _____ VLDL and ______ HDL
a. increase increase
b. increase decrease
c. decrease increase
d. decrease decrease
b. increase decrease
83
Nadolol is (less/more) lipophilic than propranolol
less
84
T or F: Propranolol and Timolol block B1 AND B2
True
85
clinical uses of propranolol (5)
htn
angina
cardiac arrhythmias
ischemic heart disease
prophylaxis for migraines (weird)
86
clinical use of timolol
open-angle glaucoma (decreases production of aqueous humor)
87
what type of medications do you need to be cautious using in asthma patients?
Beta blockers
88
what are the four selective B1 blockers?
metoprolol, bisoprolol, atenolol, esmolol, nebivolol
89
what is the moiety in the structure of B1 selective blockers
para-substituted phenyl derivatives (whatever tf this means)
90
T or F: Selective b1 blockers have less bronchoconstriction
True
91
action of metoprolol
selective antagonist at beta 1 receptor
92
4 clinical uses of metoprolol
htn
angina
cardiac arrhythmias
ischemic heart disease
93
which beta blocker is considered "cardioselective"
atenolol
94
what is considered "water-soluble" metoprolol
atenolol
95
2 uses of atenolol
htn and angina
96
what is the "very short acting" selective beta blocker
esmolol
97
what is the B1 selective 3rd generation beta blocker
nebivolol
98
nitric oxide production would lead to what?
vasodilation
99
what are the side effects of beta blockers?(5)
Bradycardia, av block, sedation, mask symptoms of hypoglycemia, withdrawal symtpoms
100
contraindications of beta blockers (3)
asthma, copd, congestive heart failure(type IV)
101
what are the 2 mixed adrenergic receptor antagonist from the slide
labetalol and carvedilol
102
clinical use of carvedilol
heart failure
103
clinical uses of labetalol (2)
hypertensive emergencies, and pheochomocytoma
104
action of labetalol and carvedilol
a1 antagonism and nonselective B1 and B2 antagonism
105
what is the dopamine receptor agonist
fenoldopam
106
clinical use for fenoldopam
severe htn
107
fenoldopam should not be used in pts with what
glaucoma
