Antihypertensive drugs Flashcards
(103 cards)
1
Q
What is the equation for CO?
A
SV*HR=CO
2
Q
What is stroke volume measure?
A
Force of contraction
3
Q
What is the biggest determinant of peripheral resistance (PR)?
A
Radius of the lumen or vessel
4
Q
What are the 2 equations for MAP?
A
MAP=(CO)(PR)
MAP=(SV)(HR)(PR)
5
Q
What drugs effect CO?
A
Beta blockers
6
Q
What drugs effect PR?
A
Alpha blockers
7
Q
What does inotrope mean?
A
Force of contraction
8
Q
What does chronotrope mean?
A
Effect on HR
9
Q
What is considered high BP?
A
Anything >120/80
10
Q
True or false: any drug or disease that increases the sympathetic system can cause HTN?
A
True
11
Q
True or false: aldosterone secreting tumor can cause hypotension?
A
False, it causes hypertension because Aldosterone increases blood volume
12
Q
How many cases of HTN are idiopathic?
A
90%
13
Q
What is two other name for idiopathetic HTN?
A
Essential HTN
primary HTN
14
Q
Why is HTN called a silent killer?
A
Because no Sx show until damage is done
15
Q
How can HTN damage your heart?
A
Increased BP causes heart to work harder to eject blood into peripheral
16
Q
How does HTN damage your vessels?
A
High BP in vessels damages endo cells and lead to atherosclerosis and thrombi
17
Q
How can an aneurysm in vessels be caused by HTN?
A
HTN weakens vessel walls
18
Q
How can HTN damage kidneys?
A
Increased pressure in glomerulus can damage its ability to filter blood
19
Q
What commonly seen in urine when the kidney glomerulus is damaged?
A
Protein in urine(proteinuria)
20
Q
How does HTN damage eyes?
A
HTN damages retinal vessels and causes them to leak into virtuous humor
21
Q
What gender is more likely to get HTN?
A
Males
22
Q
What ethnicity is more likely to get HTN?
A
African American
23
Q
How does genetics and aging effect HTN?
A
Increase age=risk
HTN runs in families
24
Q
How does smoking cause a risk for HTN?
A
Smoking increases the sympathetic system and damages endo cells
25
What does DASH diet stand for? What type of diet does it include?
Dietary Approached to Stop HTN
Low salt, sweets and fats
More fruit and veggies
26
What are 4 things that can decrease HTN risk?
Stop smoking
Exercise
Relaxation techniques
DASH diet
27
Why does a DASH diet help decrease BP?
DASH diet is high in K+ which hyperpolarizes SM which causes vasodilation
28
What happens to Na+ levels when body is hypokalemic?
Na+ retention increases
29
at what BP is lifestyle modifications used to Tx HTN?
120-140 systolic BP
30
What controls the long term regulation of BP?
RAAS
ADH mechanism
ANH mechanism
31
What 2 things being decreased will cause renin to be released?
Decreased BP
| Decreased Na+
32
What cells measure BP in glomerulus?
Juxtaglomerulosa cells
33
What cells in the glomerulus measure Na+ levels?
Macula densa cells
34
What part of the nephron is closely associated with the afferent arteriol?
DCT
35
What enzyme changes Angiotensinogen into angiotensin 1?
Renin
36
What enzyme changes AT-1 into AT-2?
ACE
37
What effect does ACE have on Bradykinin?
It breaks down bradykinin
38
What are the 4 things that AT-2 does?
Vasoconstriction
Increase ADH
Increase Aldosterone
Increase salt appetite and thirst
39
What is the receptor for AT-2? Where are they found?
AT-1 receptor
Kidneys and heart
40
What does ACEI stand for?
Angiotensin converting enzyme inhibitors
41
What does ARBs stand for?
Angiotensin receptor blocker
42
What are the 3 types of drugs used to inhibit the RAAS?
ACEI
ARBs
renin inhibitors
43
What are the 3 things that bradykinin causes?
Endothelial retraction
Vasodilation
Dry cough d/t bronchoconstriction
44
What DO ACEI drugs end in?
-pril
45
What do ACEI come from?
Venom of Pit vipers
46
What are the indications for ACEIs?
HTN
| Preserving kidney function
47
What is benazepril(Lotensin)?
ACEI
48
What is Captopril(Capten)?
ACEI
49
What is Enalapril(Vasotec)?
ACEI
50
What is Lisinopril(Prinivil)?
ACEI
51
What is Quinipril(Accupril)?
ACEI
52
What is Ramipril(Altace)?
ACEI
53
Where are the most amount of AT-1 receptor found?
Efferent arteriol
54
Why can having DM lead to glomerular damage and eventually proteinuria?
DM increases levels of AT-2 which binds to efferent arteriol and causes massive vasoconstriction. The blood gets backed up and eventually leaks protein into urine
55
What causes the posterior pituitary to release ADH?
Increase in osmolarity concentration
| Decrease in BP
56
What is the contraindication for ACEI and ARBs? What can they cause?
Pregnancy
Infant renal failure
Congenital malformations(cleft pallet)
Death
57
What are the ADR of ACEI and ARBs?
Dry cough
| Hyperkalemia
58
Why can ACEI and ARB cause a ADR of hyperkalemia?
Aldosterone gets blocked
| -aldosterone normally helps Na+ get reabsorbed back into the blood through a Na/K pump
59
What do ARB drugs usually end in?
-sartan
60
What is aliskiren(Tekturna)? What effects of the drug is it similar to?
A renin inhibitor
ACEIs and ARBs
61
What are the 3 different categories of diuretics?
Thiazides/thiazide-like drugs
K+ sparing drugs
Loop diuretics
62
What is hydrochlorothiazide(Hydrodiuril)? What does it cause?
Thiazide
Causes vasodilation of SM
63
What is chlorthalidone(Hygroton)? What does it cause?
Thiazide
Causes vasodilation of SM
64
When are K+ sparing drugs used?
When loss of K+ is a concern
65
When are loop diuretics used?
When there is reduced kidney function
66
What is the MOA of thiazides that causes vasodilation?
Thiazides open large conductance Ca2+ activated K+ channels, which hyperpolarizes the endo cells and cause vasodilation
67
What is clonidine(Catapress)? What receptor does it stimulate? What does it cause?
Central acting sympatholytic
Stimulates alpha 2 receptor
Decreases NE release which causes vasodilation
68
What do alpha blockers end in?
-osin
69
What part of MAP do alpha blockers effect?
Peripheral Resistance
70
What is doxazosin(Cardura)?
Alpha blocker
71
What is prazosin(Minipress)?
Alpha blocker
72
What is terazosin(Hytin)?
Alpha blocker
73
What organs do beta-blockers work on? What enzyme do they reduce the release of?
Act on heart and kidneys
Reduce release of renin
74
What is atenolol(Tenormin)?
Selective beta 1 blocker
75
What is metoprolol(Lopressor)?
Selective beta 1 blocker
76
What is esmolol(Brevibloc)?
Selective beta 1 blocker
77
What is bisoprolol(Morocor)?
Selective beta 1 blocker
78
What is propranolol(Inderal)? What is it contraindicated for?
beta 1 and 2 blocker
Contraindicated for asthmatic pt
79
What is carvedilol(Coreg)?
beta 1 and alpha 1 blocker
80
What is labetalol(Trandate)?
beta 1 and alpha 1 blocker
81
What are the 2 categories of Ca2+ channel blockers (CCB)? What do they cause?
Nondihydropyridine-
Decrease HR
negative inotrope effect
Vasodilation
Dihydropyridine-
Just vasodilation
82
What is diltiazem(Cardizem)?
Nondihyrdopyridine CCB
83
What is verapamil(Calan)?
Nondihyrdopyridine CCB
84
What is amlodipine(Notvasc)?
Dihyrdopyridine CCB
85
What is nicardipine(Cardene)?
Dihyrdopyridine CCB
86
What is nifedipine(Procardia)?
Dihyrdopyridine CCB
87
What effect does ANH have on blood volume? When is it released?
Released to kidneys to cause natriuresis to decrease BP
ANH is release when atria is stretch a lot
88
What is Nesiritide(Natrecor)? Route? Available in US?
Synthetic ANH
Given IV
no long available in USA
89
What is diazoxide(Hyperstat)? Route? When is it used?
Vaso and arteriolar dilator
Oral
Used in HTN emergencies
90
What is nitroprusside(Nitropress)? Route? When is it used?
Vaso and arteriolar dilator
IV infusion
Used in HTN emergencies
91
What is Epleronone(Inspra)? What does it block?
Selective aldosterone blocker
Blocks aldosterone receptor
92
What is endothelium? What does it cause?
Hormone released from endo cells that causes vasoconstriction
93
What is bosentan(Tracleer) MOA? Route? Indication?
Blocks receptors of hormone endothelin
Oral
Pulmonary HTN w/ severe HF
94
What are the lab values of a pt on an ACEI?
Increase serum creatinine levels
| Increased serum K+ levels
95
If a pt is <60yo and has a BP >140/90 on two occasions? What type of therapy should be used?
Pharmacotherapy
96
If a pt is >60yo and has a BP >150/90 on two occasions? What type of therapy should be used?
Pharmacotherapy
97
If a pt is African American w/ HTN what drug classes are commonly used?
Thiazides and CCB
98
If a pt is DM w/ HTN, what type of drug classes are they likely to use?
ACEI or ARB +/- CCB or thiazide
99
What is the goal of using Medications for HTN pt <60yo? >60yo? DM pt?
<60yo= <140/90
>60yo= <150/90
DM pt= <130
100
What Hx should a nurse get from pt of PMHx?
Medications
| Herbal medication Hx
101
What HR should HTN meds not be given?
<60HR
102
What can cause rebound HTN?
Abruptly discontinuing HTN medication
103
What is a ADR of antiHTN drugs?
Dizzinesss and syncope
