Anti-Hypertensive Agents

Question 1

Most common cardiovascular disease.

Answer 1

Hypertension

Question 2

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

Answer 2

doubles

Question 3

Systole

Answer 3

Ventricular contraction

Question 4

Diastole

Answer 4

Ventricular relaxation

Question 5

Mean arterial pressure equation

Answer 5

(CO)(Peripheral Resistance)

Question 6

Normal BP

Answer 6

<120/<80

Question 7

Stage I Hypertension

Answer 7

140-159/90-99

Question 8

Stage II Hypertension

Answer 8

> 160/>100

Question 9

4 Regulatory Mechanisms for the Control of Blood Pressure

Answer 9

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.

Question 10

First line agents to treat Hypertension

Answer 10

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

Question 11

These drugs are NOT used in black people with Hypertension

Answer 11

ACE Inhibitors

Question 12

What kind of diuretic is Furosemide?

Answer 12

Loop Diuretic

Question 13

These diuretics are used to treat mild to moderate HTN.

Answer 13

Thiazides

Question 14

These diuretics are used to treat severe HTN.

Answer 14

Loop diuretics

Question 15

When BP drops, peripheral resistance _______.

Answer 15

Increases

Question 16

Hyponatremia

Answer 16

Low Na levels.

Question 17

Side effects of Thiazide and Loop Diuretics

Answer 17

Hypokalemia
Hyponatremia
Dehydration
Electrolyte Imbalance
Hypotension

Question 18

Interaction of Thiazide diuretics with other drugs.

Answer 18

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

Question 19

Natriuresis

Answer 19

Na is in the urine

Question 20

Pressure Natriuresis

Answer 20

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.

Question 21

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

Answer 21

Beta 1-adrenergic blockers

Question 22

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

Answer 22

Propanolol (non-selective)

Question 23

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

Answer 23

It decreases Renin levels within hours.

It decreases BP in days-week

Question 24

Propanolol’s effects on hypertension are __________.

Answer 24

Time-dependent.

Question 25

Beta blockers reduce the clearance of _________.

Answer 25

Lidocaine.

Question 26

Adverse effects of beta adrenergic blockers.

Answer 26

CARDIODEPRESSION: Bradycardia, heart failure. Decreased clearance of Lidocaine

Question 27

Interactions of Beta Adrenergic Blockers

Answer 27

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

Question 28

These drugs end in "azosin."

Answer 28

Alpha adrenergic blockers.

Question 29

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

Answer 29

Prazosin

Question 30

Where are alpha 1 receptors located?

Answer 30

On the vascular smooth muscle to control peripheral resistance.

Question 31

Effect of Prazosin on resistance and arterial pressure.

Answer 31

Decreases vascular resistance so that it can decrease arterial pressure.

Question 32

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

Answer 32

(1) Vascular smooth muscle; Prazosin | (2) Kidney and heart; Propanolol

Question 33

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

Answer 33

Epinephrine causes vasoconstriction so that the LA can last longer. Alpha blockers reverse this vasoconstriction, so the LA doesn't last as long.

Question 34

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

Answer 34

Beta blockers; Diuretics

Question 35

These two drugs are NE antagonists.

Answer 35

Reserpine and Guanethidine

Question 36

Interferes with intravesicular storage of NE

Answer 36

Reserpine

Question 37

Function of Guanethidine

Answer 37

Prevents NE release from the sympathetic nerve.

Question 38

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

Answer 38

CNS Reserpine can cause sedation at high enough doses.

Question 39

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

Answer 39

Postural hypotension (same as orthostatic hypotension).

Question 40

These drugs reduce sympathetic outflow from the brainstem (CNS)

Answer 40

Clonidine and Methyldopa

Question 41

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

Answer 41

Clonidine and Methyldopa

Question 42

Adverse effects of Clonidine and MethylDopa

Answer 42

Sedation and mental depression.

Question 43

Occurs with sudden withdrawal of Clonidine.

Answer 43

Rebound hypertension.

Question 44

Ends in "pril"

Answer 44

ACE Inhibitor

Question 45

Ends in "sartan"

Answer 45

Angiotensin Receptor Blocker

Question 46

Function of Renin

Answer 46

Converts Angtiotensinogen to Angiotensin

Question 47

A Renin inhibitor

Answer 47

Aliskiren

Question 48

What causes Renin to be secreted by the kidneys?

Answer 48

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

Question 49

Function of Angiotensin Converting Enzyme

Answer 49

Converts Angiotensin I to Angiotensin II

Question 50

A potent vasoconstrictor in the kidney.

Answer 50

Aldosterone

Question 51

Direct vasodilators in the treatment of hypertension.

Answer 51

Calcium-channel blockers

Question 52

How do Calcium-channel blockers work?

Answer 52

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

Question 53

Examples of Calcium channel blockers.

Answer 53

Verapamil Diltiazam Nifedipine

Question 54

Examples of non-calcium channel blocking anti-hypertensives:

Answer 54

Hydralazine, Minoxidil, Diazoxide, Nitroprusside

Question 55

Nitroprusside causes the release of ____.

Answer 55

NO, a potent vasodilator.

Question 56

Minoxidil and Diazoxide mechanism of action.

Answer 56

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

Question 57

Vasoconstrictors are __________ in patients with hypertension.

Answer 57

contraindicated