Anti-Hypertension Drug Therapy Deck 2

Question 1

Beta blocker types

Answer 1

Cardio-Selective
Nonselective
Combined

Question 2

Cardio-Selective example

Answer 2

atenolol, metoprolol

Question 3

nonselective example

Answer 3

propranolol block B1 and B2

Question 4

combined example

Answer 4

Carvedilol: blocks alpha 1 and beta 1 and beta 2
Labetalol: block alpha 1 and beta 1

Question 5

beta blocker indication

Answer 5

Use to manage HTN in patients with: angina, tachyarrhythmias, MI, and glaucoma

Question 6

beta blocker are not to be used as f

Answer 6

first line therapy, especially in patients over age 60

Question 7

BB Action

Answer 7

Impedes the action of catecholamines at adrenergic receptors
Reduces heart rate
Reduces force of myocardial contraction
Reduces the velocity of impulse conduction through AV node
Reduces the automaticity of ectopic pacemakers
Reduces the release of renin in the kidneys

Question 8

BB net effect

Answer 8

Net effect: decreased cardiac output, sympathetic outflow; reduce cardiac morbidity and mortality

Question 9

BB SE

Answer 9

Side effects: may cause – bronchospasm, depression, bradyarrhythmia, insomnia, mask hypoglycemia

Question 10

BB are

Answer 10

Lipid soluble, adjust dosage with advancing age

Question 11

BB are bio transofred in the

Answer 11

Bio-transformed in the liver, rest eliminated in kidney

Question 12

Metoprolol is easier

Answer 12

easier on kidneys than atenolol

Question 13

BB Contraindications

Answer 13

Do not use in patients with a history of sick sinus syndrome, heart failure, or 2nd or 3rd degree AV block

Question 14

BB precautions

Answer 14

not stop abruptly in patient with CVD

Question 15

BB do not

Answer 15

not stop abruptly in patient with CVD

Question 16

BB not specific recomend

Answer 16

Net effect: decreased cardiac output, sympathetic outflow; reduce cardiac morbidity and mortality

Question 17

Supplemental Drug Classes

Answer 17

Centrally Acting Alpha2 Agonists
Peripherally Acting Adrenergic Antagonists
Direct-Acting Peripheral Vasodilators
Alpha 1 Receptor Blockers

Question 18

Centrally Acting Alpha 2 Agonists example

Answer 18

Clonidine, methyldopa

Question 19

Centrally Acting Alpha 2 Agonists MOA

Answer 19

Stimulates alpha 2 receptors in the brainstem
Subdues sympathetic outflow to heart, kidneys, and peripheral vasculature
Reduces renin activity

Question 20

Centrally Acting Alpha 2 Agonists net effect

Answer 20

Not considered first line treatment except in Pregnancy (methyldopa)

Question 21

Centrally Acting Alpha 2 Agonists not considered

Answer 21

Not considered first line treatment except in Pregnancy (methyldopa)

Question 22

Centrally Acting Alpha 2 Agonists are

Answer 22

2nd or 3rd adjunct therapy.

Question 23

Centrally Acting Alpha 2 Agonists often adminstered with a

Answer 23

diuretic because of tendency to cause fluid rention

Question 24

Centrally Acting Alpha2 Agonists SE

Answer 24

Side effects: Na retention with weight gain, drowsiness, sedation, dizziness, orthostatic hypotension, restlessness and nervousness, depression, dry mouth

Question 25

Centrally Acting Alpha2 Agonists SE GI

Answer 25

SE GI: constipation, abdominal pain, hepatitis

Question 26

Centrally Acting Alpha2 Agonists first dose

Answer 26

severe coronary insufficiency, renal failure

Question 27

Centrally Acting Alpha2 Agonists abrupt

Answer 27

severe coronary insufficiency, renal failure

Question 28

Centrally Acting Alpha2 Agonists precations

Answer 28

severe coronary insufficiency, renal failure

Question 29

Peripherally Acting Adrenergic Antagonists example

Answer 29

reserpine

Question 30

Peripherally Acting Adrenergic Antagonists MOA

Answer 30

Inhibits the sympathetic nervous system by depleting norepinephrine stores in the vesicles of adrenergic nerve endings Depletes dopamine, precursor to norepinephrine

Question 31

Peripherally Acting Adrenergic Antagonists net effect

Answer 31

Net effect: Decrease in peripheral vascular resistance (PVR) and decrease in BP

Question 32

Peripherally Acting Adrenergic Antagonists only availible

Answer 32

Only available agent is reserpine

Question 33

Peripherally Acting Adrenergic Antagonists now widely

Answer 33

Not widely used due to side effects

Question 34

Peripherally Acting Adrenergic Antagonists less

Answer 34

effective over time

Question 35

Peripherally Acting Adrenergic Antagonists SE

Answer 35

multiple psycho-emotional and neurological; weight gain and fluid retention over time, orthostatic hypotension, arrhythmias, angina, impaired sexual functioning

Question 36

Peripherally Acting Adrenergic Antagonists precautions

Answer 36

cardiac, cerebrovascular or renal insufficiency

Question 37

Peripherally Acting Adrenergic Antagonists contraindications

Answer 37

Depression, PUD, ulcerative colitis, gallstones, ECT

Question 38

Selective dilation of arteriolies example

Answer 38

Hydralazine

Question 39

Selective dilation of veins | example

Answer 39

Nitroglycerin

Question 40

Dilation of arterioles and veins example

Answer 40

Prazosin

Question 41

Hydralazine for vasodialaotrs

Answer 41

``` Essential hypertension Hypertensive crisis Angina pectoris Heart failure Myocardial infarction Pheochromocytoma Peripheral vascular disease Pulmonary arterial hypertension Production of controlled hypotension during surgery ```

Question 42

Adverse effects related to vasodilation

Answer 42

Postural hypotension Reflex tachycardia Expansion of blood volume

Question 43

Postural hypotension | Teach patients about symptoms of

Answer 43

hypotension (lightheadedness, dizziness) and advise them to sit or lie down if these occur. Avoid abrupt transitions from a supine or seated position to an upright position.

Question 44

Hydralazine does what

Answer 44

Selective dilation of arterioles | Mechanism unknown

Question 45

Hydralazine postural hypotension is

Answer 45

minimal

Question 46

Hydralazine uses

Answer 46

Essential hypertension Hypertensive crisis Heart failure

Question 47

Hydralazine ADR

Answer 47

Reflex tachycardia Increased blood volume Systemic lupus erythematosus–like syndrome Headache, dizziness, weakness, and fatigue

Question 48

Interactions

Answer 48

Other antihypertensive agents Avoid excessive hypotension Combined with beta blocker to protect against reflex tachycardia and with diuretics to prevent sodium and water retention and expansion of blood volume