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Flashcards in Antihypertensives Deck (81):
1

Phentolamine is classified as a

alpha-adrenergic receptor antagonist

2

Is phentolamine competitive or noncompetitive

competetive (transient)

3

Is phentolamine selective or nonselective adrenergic blocker

nonselective

4

What effect does phentolamine have on vessels

vasodilation

5

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

reflex tachycardia

6

Is Phenoxybenzamine a selective or nonselective alpha adrenergic blocker

nonselective

7

What are the two major differences between phentolamine and phenoxybenzamine

Onset slower than phentolamine

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

8

Is Prazosin selective or nonselective

selective postsynaptic alpha 1 receptor blocker

9

Will prazosin evoke reflex tachycardia

No, bc no effect on alpha 2 receptors

10

What effect does prazosin have on arterioles and veins

dilates- decreases preload & afterload

11

What receptor (s) does Terazosin act upon

alpha 1 receptor blocker

12

What is terazosin used to treat

BPH

13

Beta-adrenergic blockers are classified as

nonselective and B1 selective (cardioselective)

14

What are the B1 selective blockers

Metoprolol
Atenolol
Acebutolol
Esmolol

15

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

renin-secreting cells of the kidney

16

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

Beta 1 receptor antagonist

17

Esmolol's DOA is about 10 minutes because it is

rapidly hydrolyzed by plasma esterases

18

Name the two combined alpha/beta adrenergic antagonists

Labetalol
Carvedilol

19

what specific receptors does labetalol interact with

alpha1 and
nonselective beta adrenergic antagonist

20

What are the CV effects of labetolol administration

decreased systemic vascular resistance, decreased bp

21

What additional effect does labetalol have on beta 2 receptors

vasodilation (partial agonist)

22

Name the two centrally acting sympatholytic drugs discusses in class

Methyldopa

Clonidine

23

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

false transmitter

24

What is MOA of methyldopa

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

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