antihypertensive drugs Flashcards

(27 cards)

1
Q

What is the physiological control of blood pressure?

A

cardiac output
contractile state of resistance arterioles
volume

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2
Q

What controls the cardiac output?

A
heart rate (sympathetic)
stroke volume - filling pressure and contractility (sympathetic)
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3
Q

What controls the contractile state?

A
neural (para + symp ns)
hormonal (renin-angiotensin-aldosterone system)
local transmitters (NO)
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4
Q

What controls the volume of blood pressure?

A

hormonal (RAS, ADH, ANP)

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5
Q

What are the antihypertensive drug strategies?

A

reduce cardiac output
dilate resistance vessels
reduce vascular volume

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6
Q

How can we reduce cardiac output?

A

β-adrenergic blockers: not 1st line

calcium channel blockers

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7
Q

How can we dilate resistance vessels?

A

calcium channel blockers
renin-angiotensin system blockers
α1 adrenoceptor blockers
nitrates**

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8
Q

How can we reduce vascular volume?

A

diuretics. RAS blockers

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9
Q

What organ does the angiotensin precursor come from?

A

liver

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10
Q

What does the angiotensin precursor become once in contact with renin?

A

angiotensin I

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11
Q

What converts angiotensin I to angiotensin II?

A

angiotensin converting enzyme

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12
Q

What does angiotensin II target?

A

AT1 receptor

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13
Q

What does a stimulation at the AT1 receptor cause?

A

vasoconstriction

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14
Q

What causes the release of renin?

A

aldosterone
decrease renal blood flow
increase sympathetic

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15
Q

What are some ACE inhibitors?

A

perinodpril
ramipril
anything ending in -pril

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16
Q

What are some angiotensin receptor blocker (ARB)?

A

candesartan
irbesartan
anything else ending in -sartan

17
Q

How does the ANs regulate blood pressure?

A

effects on both pump output and resistance in the circulation

18
Q

What is the autonomic baroreceptor reflexes in BP control?

A
  1. decrease BP
  2. carotid sinus senses
  3. vasomotor center respond (increase sns and decrease pns)
  4. increase PVR at α1 + increase heart rate + contractility at β1

= increase BP

19
Q

What are some β1 adrenoceptor antagonists?

A

Metoprolol, atenolol, other -olol’s

20
Q

What is an α1 adrenoceptor blocker?

21
Q

What is the role of Prazosin?

A

relaxes peripheral resistance vessels

22
Q

What occurs when calcium enters a muscle cell?

A

muscle contraction (myocardial or vascular) caused by the sarcoplasmic reticulum

23
Q

What are the two types of calcium channel blockers?

A

cardioselective

vascular smooth muscle selective

24
Q

What are the main roles of cardioselective calcium channel blockers?

A

reduce cardiac contractility

reduce automaticity

25
What are some cardioselective calciumi channel blocker drugs?
Verapamil | Diltiazem
26
What is the role of the vascular smooth muscle selective calcium channel blockers?
reduce vascular resistance
27
What are some examples of vascular smooth muscle selective calcium channel blocker drugs?
Dihydropyridines (nifedipine, felodipine, amlodipine) | Diltiazem