antihypertensive

Question 1

alpha 2 agonists

Answer 1

work on the presynaptic receptor that is Gi coupled. this causes a decrease in sympathetic outflow and thus decreased alpha and beta stimulation. this decreases TPR, HR -vasodilates and bradycardia.

Question 2

indications for the alpha 2 agonists

Answer 2

mild-to-moderate HTN. management in pregnancy

Question 3

what are the agents for alpha 2 agonists

Answer 3

clonidine and methyldopa.

Question 4

SE of the alpha 2 agonists

Answer 4

positive coombs test (methyldopa) CNS depression, edema

Question 5

what are the interactions with the alpha 2 agonists

Answer 5

TCA will decrease the antihypertensive effects of the alpha 2

Question 6

reserpine mechanism

Answer 6

destroys the vesicles that contain NE. thus decrease the outflow. decreases the CO and TPR. decreases the NE, dop, and serotonin in the CNS.

Question 7

SE of reserpine

Answer 7

severe depression. edema. there is increase in GI secretions

Question 8

contraindications for reserpine

Answer 8

peptic ulcer disease, depression.

Question 9

guanethidine mechanism

Answer 9

accumulates in the nerve terminal and inhibits the release of NE.

Question 10

SE of guanethidine

Answer 10

edema, diarrhea,

Question 11

what class cannot be taken with guanethidine

Answer 11

TCA. they will abolish the effects because they block the uptake pump.

Question 12

alpha 1 blockers agents

Answer 12

prazosin, terazosin, doxazosin

Question 13

alpha 1 blockers effects

Answer 13

decrease arteriolar and venous resistance, reflex tachycardia due to the drastic lowering of the BP.

Question 14

uses of alpha 1 blockers

Answer 14

HTN, BPH

Question 15

SE alpha 1 blockers

Answer 15

first dose syncope, orthostatic hypertension, urinary incontinence.

Question 16

what is the positive about using alpha 1 blockers

Answer 16

there is a good effect on lipid profile. decreases LDL and increases HDL.

Question 17

beta blockers effects

Answer 17

they actually work by decreasing the RAAS. although they also cause cardiodepression

Question 18

beta blockers se

Answer 18

fatigue, sexual dysfunction, metabolic perturbations. increase LDL and TG. they can cause DM.

Question 19

when should beta blocker use be cautioned

Answer 19

in asthmatics and vasospastic disorders.

Question 20

hydralazine action

Answer 20

decreases the TPR via arteriolar dilation

Question 21

uses of hydralazine

Answer 21

moderate to severe HTN. pregnancy management

Question 22

SE of hydralazine

Answer 22

SLE-like syndrome. edema. reflex tachycardia.

Question 23

nitroprusside action

Answer 23

decreases TPR via arterioles and venules.

Question 24

what are the uses for nitroprusside

Answer 24

DOC for hypertensive emergencies.

Question 25

what should be given with nitroprusside

Answer 25

nitrites and thiosulfate. this forms met-Hb and protects the electron transport chain from the CN- toxicity of nitroprusside.

Question 26

what are the SE for nitroprusside

Answer 26

cyanide toxicity when used for more than 24-48 hrs.

Question 27

minoxidil/diazoxide mechanism

Answer 27

opens ATP-dependent potassium channels and causes hyperpolarization of SM resulting in arteriolar vasodilation.

Question 28

uses of minoxidil

Answer 28

hypertensive emergencies, severe hypertension, baldness.

Question 29

SE of minoxidil

Answer 29

hypertrichosis, hyperglycemia, edema, reflex tachycardia.

Question 30

calcium channel blockers mechanism

Answer 30

block L-type channels in the heart and the blood vessels. this decreases CO and TPR.

Question 31

CCB agents

Answer 31

verapamil, diltiazem, nifedipine (and the other dipines)

Question 32

which of the CCB acts on the blood vessels

Answer 32

the dipine class acts more on the blood vessels than the heart.

Question 33

what is the use of the CCB

Answer 33

HTN, angina (esp. vasospastic), antiarrhythmic.

Question 34

SE of the CCB

Answer 34

reflex tachycardia, gingival hyperplasia, constipation

Question 35

which of the CCB works on the heart

Answer 35

verapamil is more specific for the heart. f

Question 36

ACEi mechanism

Answer 36

block the formation of angiotensin II and thus the stimulation of the AT-1 receptor. this decreases aldosterone and vasodilation.

Question 37

what effect does the ACEi have on bradkinin

Answer 37

inhibits its degradation.

Question 38

SE of ACEi

Answer 38

cough. hyperkalemia. acute renal failure, angioedema.

Question 39

uses of the ACEi

Answer 39

mild to moderate HTN. protective of diabetic nephropathy. CHF.

Question 40

ARBs mechanism

Answer 40

blocks the angiotensin AT-1 receptor. same result as ACEi but no bradykinin accumulation.

Question 41

what are the contraindications of the ACEi/ARBs

Answer 41

pregnancy and renal artery stenosis

Question 42

bosentin uses?

Answer 42

pulmonary HTN.

Question 43

mechanism for bosentin

Answer 43

ETA receptor antagonist.

Question 44

SE of bosentin

Answer 44

HA, flushing, hypotension. -all do to the vasodilatory effects

Question 45

sildenafil mechanism

Answer 45

inhibits PDE V. causes pulmonary artery relaxation and decreases pulmonary HTN.