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Exam 3 > Anti-Hypertensive Agents > Flashcards

Anti-Hypertensive Agents Flashcards

1
Q

Most common cardiovascular disease.

A

Hypertension

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2
Q

The risk of developing cardiovascular diseases such as stroke or heart failure ______ with each increment of 20/10 mm Hg.

A

doubles

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3
Q

Systole

A

Ventricular contraction

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4
Q

Diastole

A

Ventricular relaxation

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5
Q

Mean arterial pressure equation

A

(CO)(Peripheral Resistance)

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6
Q

Normal BP

A

<120/<80

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7
Q

Stage I Hypertension

A

140-159/90-99

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8
Q

Stage II Hypertension

A

> 160/>100

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9
Q

4 Regulatory Mechanisms for the Control of Blood Pressure

A

1) Kidney- Renal control of blood volume (Renin-Angiotensin- Aldosterone)
2) Neural - activity of the sympathetic NS.
3) Renin/Angiotensin/Aldosterone system
4) Vascular smooth muscle activity.

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10
Q

First line agents to treat Hypertension

A

1) ACE Inhibitors
2) Calcium channel blockers
3) Thiazide diuretics

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11
Q

These drugs are NOT used in black people with Hypertension

A

ACE Inhibitors

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12
Q

What kind of diuretic is Furosemide?

A

Loop Diuretic

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13
Q

These diuretics are used to treat mild to moderate HTN.

A

Thiazides

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14
Q

These diuretics are used to treat severe HTN.

A

Loop diuretics

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15
Q

When BP drops, peripheral resistance _______.

A

Increases

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16
Q

Hyponatremia

A

Low Na levels.

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17
Q

Side effects of Thiazide and Loop Diuretics

A 
Hypokalemia
Hyponatremia
Dehydration
Electrolyte Imbalance
Hypotension
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18
Q

Interaction of Thiazide diuretics with other drugs.

A

They potentiate the BP LOWERING effects of other anti-hypertensive agents.

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19
Q

Natriuresis

A

Na is in the urine

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20
Q

Pressure Natriuresis

A

When arterial pressure is high, renal perfusion pressure increases and this is a sign that we need to lower BP, so Na is excreted into the urine.

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21
Q

These anti-hypertensives inhibit the sympathetic effects of Renin release in the kidney and increased CO in the heart.

A

Beta 1-adrenergic blockers

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22
Q

Example of a beta-adrenergic blocker that acts on the kidney to prevent Renin release, and acts on the heart to decrease cardiac output.

A

Propanolol (non-selective)

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23
Q

How long does it take for propanolol to affect the BP and the Renin release?

A

It decreases Renin levels within hours.

It decreases BP in days-week

24
Q

Propanolol’s effects on hypertension are __________.

A

Time-dependent.

25
Q

Beta blockers reduce the clearance of _________.

A

Lidocaine.

26
Q

Adverse effects of beta adrenergic blockers.

A

CARDIODEPRESSION: Bradycardia, heart failure.

Decreased clearance of Lidocaine

27
Q

Interactions of Beta Adrenergic Blockers

A

Potentiate the effects of blood pressure-lowering drugs like vasodilators.

28
Q

These drugs end in “azosin.”

A

Alpha adrenergic blockers.

29
Q

Example of an alpha blocker that’s specific for alpha 1 receptors.

A

Prazosin

30
Q

Where are alpha 1 receptors located?

A

On the vascular smooth muscle to control peripheral resistance.

31
Q

Effect of Prazosin on resistance and arterial pressure.

A

Decreases vascular resistance so that it can decrease arterial pressure.

32
Q

(1) __________ has alpha 1 receptors and is blocked by ________.
(2) _________ has beta 1 receptors and is blocked by ___________.

A

(1) Vascular smooth muscle; Prazosin

(2) Kidney and heart; Propanolol

33
Q

How do the use of alpha blockers affect epinephrine in local anesthetics?

A

Epinephrine causes vasoconstriction so that the LA can last longer.

Alpha blockers reverse this vasoconstriction, so the LA doesn’t last as long.

34
Q

Alpha blockers are more effective when used with __________ and _________.

A

Beta blockers; Diuretics

35
Q

These two drugs are NE antagonists.

A

Reserpine and Guanethidine

36
Q

Interferes with intravesicular storage of NE

A

Reserpine

37
Q

Function of Guanethidine

A

Prevents NE release from the sympathetic nerve.

38
Q

Reserpine has adverse effects on the _____, Guanethidine does not.

A

CNS

Reserpine can cause sedation at high enough doses.

39
Q

This adverse effect is common with Guanethidine, which is why it’s not a first choice drug to treat hypertension.

A

Postural hypotension (same as orthostatic hypotension).

40
Q

These drugs reduce sympathetic outflow from the brainstem (CNS)

A

Clonidine and Methyldopa

41
Q

Bind to alpha 2 receptors on the brainstem to inhibit sympathetic outflow.

A

Clonidine and Methyldopa

42
Q

Adverse effects of Clonidine and MethylDopa

A

Sedation and mental depression.

43
Q

Occurs with sudden withdrawal of Clonidine.

A

Rebound hypertension.

44
Q

Ends in “pril”

A

ACE Inhibitor

45
Q

Ends in “sartan”

A

Angiotensin Receptor Blocker

46
Q

Function of Renin

A

Converts Angtiotensinogen to Angiotensin

47
Q

A Renin inhibitor

A

Aliskiren

48
Q

What causes Renin to be secreted by the kidneys?

A

1) Low Na+ going through the distal nephron.
2) Low renal perfusion pressure.
3) Stimulation of Beta 1 adrenergic receptors.

49
Q

Function of Angiotensin Converting Enzyme

A

Converts Angiotensin I to Angiotensin II

50
Q

A potent vasoconstrictor in the kidney.

A

Aldosterone

51
Q

Direct vasodilators in the treatment of hypertension.

A

Calcium-channel blockers

52
Q

How do Calcium-channel blockers work?

A

Prevent Ca2+ from entering into the smooth muscle, thus preventing contraction.

53
Q

Examples of Calcium channel blockers.

A

Verapamil
Diltiazam
Nifedipine

54
Q

Examples of non-calcium channel blocking anti-hypertensives:

A

Hydralazine, Minoxidil, Diazoxide, Nitroprusside

55
Q

Nitroprusside causes the release of ____.

A

NO, a potent vasodilator.

56
Q

Minoxidil and Diazoxide mechanism of action.

A

Allow K+ ions to enter the cell, causing hyperpolarization of the smooth muscle cell- doesn’t contract.

57
Q

Vasoconstrictors are __________ in patients with hypertension.

A

contraindicated

Exam 3 (9 decks)

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