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Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

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1
Q

Phentolamine is classified as a

A

alpha-adrenergic receptor antagonist

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2
Q

Is phentolamine competitive or noncompetitive

A

competetive (transient)

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3
Q

Is phentolamine selective or nonselective adrenergic blocker

A

nonselective

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4
Q

What effect does phentolamine have on vessels

A

vasodilation

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5
Q

As a consequence of blocking alpha receptors, what effect does this do to the heart rate when giving phentolamine

A

reflex tachycardia

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6
Q

Is Phenoxybenzamine a selective or nonselective alpha adrenergic blocker

A

nonselective

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7
Q

What are the two major differences between phentolamine and phenoxybenzamine

A

Onset slower than phentolamine

Elimination 1/2 time longer (24 hours) d/t irreversible noncompetitive blockade

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8
Q

Is Prazosin selective or nonselective

A

selective postsynaptic alpha 1 receptor blocker

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9
Q

Will prazosin evoke reflex tachycardia

A

No, bc no effect on alpha 2 receptors

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10
Q

What effect does prazosin have on arterioles and veins

A

dilates- decreases preload & afterload

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11
Q

What receptor (s) does Terazosin act upon

A

alpha 1 receptor blocker

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12
Q

What is terazosin used to treat

A

BPH

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13
Q

Beta-adrenergic blockers are classified as

A

nonselective and B1 selective (cardioselective)

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14
Q

What are the B1 selective blockers

A

Metoprolol
Atenolol
Acebutolol
Esmolol

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15
Q

Beta 1 receptor antagonists competively antagonizes the beta 1 receptors in the heart and what other cells

A

renin-secreting cells of the kidney

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16
Q

Between the B1 and B2 receptor antagonists, which is better for asthmatics or patient’s with RAD

A

Beta 1 receptor antagonist

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17
Q

Esmolol’s DOA is about 10 minutes because it is

A

rapidly hydrolyzed by plasma esterases

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18
Q

Name the two combined alpha/beta adrenergic antagonists

A

Labetalol

Carvedilol

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19
Q

what specific receptors does labetalol interact with

A

alpha1 and

nonselective beta adrenergic antagonist

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20
Q

What are the CV effects of labetolol administration

A

decreased systemic vascular resistance, decreased bp

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21
Q

What additional effect does labetalol have on beta 2 receptors

A

vasodilation (partial agonist)

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22
Q

Name the two centrally acting sympatholytic drugs discusses in class

A

Methyldopa

Clonidine

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23
Q

As an analog for L-dopa, Methyldopa is known as a

A

false transmitter

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24
Q

What is MOA of methyldopa

A

stored in adrenergic nerve vesicles, where is relplaces NE and is released by nerve stimulation to interact with postsynptic adrenorecptors

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25
How is PVR reduced with methyldopa
via stimulation of central alpha adrenoreceptors
26
Methyldopa is primarily used for hypertension in which patient population
pregnant
27
Clonidine is classified as a
centrally acting alpha 2 adrenoreceptor agonist
28
What is clonidine's MOA
stimulates alpha 2 adrenergic inhibitor neurons in the medullary vasomoter center
29
What principle effect does clonidine have
decreases SNS output from the CNS and increases ParaSNS tone Decrease HR PVR and CO
30
What SE should you expect with centrally acting sympathomimetics
Sedation Dry mouth Withdrawl leading to HTN crisis
31
What are the Adrenergic Neuron-blocking agents
Trimethaphan Reserpine Guanethidine
32
What is the MOA of Guanethidine
Inhibits the release of NE from sympathetic nerve endings
33
What is reserpine's MOA
blocks the ability of aminergic transmitter vesicles to take up and store biogenic amines
34
What is the MOA of Trimethaphan
Comptetitvely blocks nicotinic cholinorecetors on Postganglionic neurons
35
What does trimethaphan liberate
histamine
36
What are SE associated with trimethaphan
``` orthostatic hypotension constipation urinary retention gluacoma dry mouth ```
37
what are the ACE inhibitors
"PRILS"
38
What is the MOA of ACE inhibitors
blocks the conversion of angiotension 1 to angiotension II
39
What effect does ACE inhibitors have
decreased vasoconstrictive effects and decreased circulating levels of aldosterone
40
What other MOA does ACE inhibitors have
Blocks the breakdown of bradykinin
41
What is bradykinin
an endogenous vasodilator substance, which contributes to the anti HTN effects of the PRILS
42
What are the most common SE associated with the PRILS
COUGH upper respirator congestion rhinoorhea Allergic-like symptoms
43
What is a potential life-threatening complication assoc. with ace-inhibitors
Laryngeal angioedema
44
ACE-inhibitors have what effect on renal function
decreases GFR, use carefully in patient's with renal dx
45
What electrolyte dysfunction is likely with PRIL administration
hypekalemia
46
Enalapri is a -------- that is metabolized in the liver to its ---- -----
prodrug active form therefore, DOA is longer
47
What are the Angiotesion II blockers
"SARTANS"
48
What specific receptor does 'SARTAN's" block
angiotensin II type 1 receptors
49
What are the calcium channel blockers
``` VeraPaMIL Ditiazem AmloDIPINE FeloDIPINE IsraDIPINE NicarDIPINE "PINE" ```
50
What effects do calcium channel blockers have
antianginal antiarrhythmic INHIBITION of calcium influx into arterial smooth muscle cells
51
List the drugs that release NO or cause it to be released by endothelium
Nitroprusside | Hydralazine
52
Name drugs that reduce calcium influx
Calcium channel blockers
53
Name drugs that cause hyperpolorization of smooth muscle membrane through opening of potassium channels
Minoxidil diazoxide
54
Name the drug that activates dopamine receptors
Fenoldopam
55
Hydralazine works by
dilating arterioles but not veins
56
What is the consequence of hydralazine
causes reflex tachycardia *bad for coronary dx patients or HF
57
What does hydralazines SE resemble
Lupus *Arthralgia, myalgia, skin rash, and fever
58
What is minoxidil's MOA
hyperpolorization of smooth muscle cells which leads to dilation of arterioles but not veins
59
Minoxidil is associated with
greater reflex sympathetetic stimulation and sodium and fluid retention than hydralazine *as a consequence, it mus be used with beta blocker and loop diuretic
60
Nitroprusside works by
dilating both arterial and venous vessels
61
Nitroprusside is rapidly metabolized by
uptake into RBC with liberation of cyanide
62
Cyanide is converted to
thiocyanate, which is eliminated by the kidneys
63
Name a carbonic anhydrase inhibitor
acetazolamide
64
What is the MOA of acetazolamide
Blocks carbonic anhydrase activity at the proximal tubule of the kidney
65
What component in the H+ + HCO3- is lost with acetazolamide
HC03-
66
What happens to the sodium when HC03- is filtered
Sodium follows and leads to diuresis
67
What happens to the H+
It gets reabsorbed and combined with Cl- to offset the filtered HCO3- *Leads to Hyperchloremic metabolic acidosis
68
What is acetazolamide used to treat
Glaucoma
69
What diuretic works on the ascending loop of henle
Furosemide
70
How does furosemide work
Inhibits Na/K/CL symporter resulting in lost of loss of sodium, potassium, and chloride ions. This leads to H20 loss and hypokalemia and hypocloremia
71
What is the indication for loop diuretic use
Acute pulmonary edema Edematous CHF HyperKalemia
72
Thiazide diuretics work on the
Distal Convoluted tubule by blocking the sodium chloride symporter.
73
Loss of sodium within the cells of the DCT cells leads to increased absorption of what electrolyte
Calcium via sodium/calcium ATpase pump
74
What is a common electrolyte abnormality of thiazide
HypoKalemic metabolic alkalosis
75
Name three potassium-sparing diuretics
Triamterene Amiloride Spironolactone
76
Potassium-Sparing diuretics work on
DCT
77
Spironolactone is considered a
aldosterone antagonist *binds to cytoplasmic mineralocrticoid receptors on collectiong duct
78
Name a osmotic diuretic
Mannitol
79
What is significant about how mannitol is filtered
Excreted without tubular reabsorption or secretion
80
What effect does mannitol have
because it is not reabsorbed, the filtrate maintains its hyperosmolarity with prevents water reabsorption
81
What is mannitol indicated for
Increased intracranial pressure Increased intraocular pressure Prophlaxis against acute renal failure

Pharmacology (27 decks)

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