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Specialized Pharmacology MN650 > Blood Pressure Meds > Flashcards

Blood Pressure Meds Flashcards

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1
Q

Calcium has what effect on the myocardium?

A

a. Positive inotropic effects

b. increases force of contraction

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2
Q

Calcium is what effect on the sinoatrial node?

A

a. Increases spontaneous discharge, increasing HR

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3
Q

Calcium has what effect on the AV node/?

A

a. Causes firing

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4
Q

What effect do calcium channel blockers have on the myocardium?

A

a. Negative entropic effects

b. decreases the force of contraction

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5
Q

What effect do calcium channel blockers have on the SA and AV node?

A

a. Decreases excitability of the SA node

b. slows conductivity through AV node

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6
Q

What effects do calcium channel blockers have on the heart?

A

a. Reduces the force of contraction
b. slows heart rate
c. suppresses conduction through AV node

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7
Q

Name the calcium channel blocker drugs?

A

a. Verapamil
b. diltiazem
c. nifedipine

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8
Q

What is verapamil’s mechanism of action?

A

a. blocks calcium channels in blood vessels and in the heart

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9
Q

What is diltiazem mechanism of action?

A

a. blocks calcium channels in blood vessels and in the heart

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10
Q

What is nifedipine mechanism of action?

A

a. Blocks calcium channels in blood vessels

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11
Q

What are the indications for verapamil use?

A

a. angina pectoris
b. hypertension
c. cardiac dysrhythmias

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12
Q

Where is verapamil metabolized and excreted?

A

a. metabolized and eliminated by the liver

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13
Q

What are verapamil’s onset and peak times?

A

a. Onset : 30 minutes

b. Peak: within five hours

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14
Q

What are verapamil’s adverse effects?

A

a. Constipation
b. partial or complete AV block
c. Flushing
d. dizziness
e. gingival hyperplasia
f. peripheral edema

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15
Q

What are the negative effects of combining digoxin and verapamil?

A

a. Increased risk of AV block

b. digoxin toxicity

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16
Q

Why does digoxin toxicity occur when combed with verapamil?

A

a. Verapamil increases digoxin plasma levels

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17
Q

What drugs should not be given in combination with verapamil?

A

a. Digoxin and beta blockers

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18
Q

How does grapefruit juice affect calcium channel blockers?

A

a. It inhibits intestinal and hepatic metabolism , increasing their plasma levels

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19
Q

How does nifedipine cause an increase heart rate in contractility?

A

a. the immediate release form causes a rapid drop in BP, stimulating the sympathetic nervous system

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20
Q

Where is nifedipine metabolized and created?

A

a. By the kidneys in the urine

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21
Q

What are the indications for nifedipine use?

A

a. angina pectoris

b. hypertension

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22
Q

What are nifedipines adverse effects?

A

a. Constipation
b. Flushing
c. dizziness
d. gingival hyperplasia
e. peripheral edema

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23
Q

How to prevent reflex tachycardia caused by nifedipine use?

A

a. Combine with beta blocker

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24
Q

Hydralazine causes dilation of what vessels?

A

a. Arterioles

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25
Minoxidil causes dilation of what vessels?
a. Arterioles
26
Nitroprussides cause dilation of what vessels?
a. Arterioles and veins
27
Hydralazine onset and duration after oral administration?
a. Onset: 45 minutes | b. Duration: 6 hrs
28
Hydralazine onset and duration after IV administration?
a. Onset: within 10 minutes | b. Duration: 2-4 hrs
29
How is hydralazine metabolized?
a. inactivated by a metabolic process known as acetylation | b. will be inactivated quicker in some than others
30
What are the indications for hydralazine use?
a. Hypertension | b. short term tx of heart failure (reduces afterload)
31
What are the adverse effects of Hydralazine?
a. Reflex tachycardia b. increased blood volume c. systemic lupus erythematosus like syndrome
32
What are the symptoms of systemic lupus erythematosus like syndrome?
a. Muscle and joint pain b. fever c. pericarditis
33
What is the indication for Minoxidil ues?
a. Severe HTN unresponsive to other drugs
34
What is the definition of primary hypertension?
a. Hypertension with no identifiable cause
35
Systolic BP of 130 - 139 or diastolic of 80 - 89 is what type of hypertension?
a. Stage one hypertension
36
Systolic BP ≥ 140 or diastolic ≥ 90 is what type of hypertension?
a. Stage two hypertension
37
What factors influence cardiac output?
a. Heart rate b. myocardial contractility c. blood volume d. venous return
38
What are the three blood pressure regulatory systems?
a. Sympathetic nervous system b. renin angiotensin aldosterone system c. the kidneys
39
Where are baroreceptors located?
a. The aortic arch and carotid sinus
40
Where is renin released from?
a. Juxtaglomerular cells in the kidneys
41
What is the action of renin?
a. Converts angiotensinogen to angiotensin I
42
Describe the RAAS step wise process?
a. Kidney senses high BP b. Renin released from kidneys c. Renin converts Angiotensinogen to angiotensin I d. Angiotensin converted ACE to angiotensin II e. Angiotensin trigges aldosterone release
43
What are the triggers for renin release?
a. Reduced renal blood flow b. Reduced blood volume c. Reduced BP d. Activation of B1 receptors on kidneys
44
What are the actions of angiontensin II?
a. Vasoconstriction = inc BP | b. Triggers aldosterone release
45
Where is aldosterone released from?
a. Adrenal cortex
46
What are the actions of aldosterone?
a. Na retention, water follows | b. Increases BP
47
Where and how does Clonidine act to lower BP?
a. Acts in the brain stem | b. Suppresses sympathetic outflow
48
What are the CV effects of Clonidine?
a. Decreased HR b. Decreased myocardial contractility c. Decreased BP (vasodilation)
49
What is the mechanism of action of propranolol?
a. Non-selective B-adrenergic agonist
50
Where are beta1 receptors located?
a. Heart b. Kidneys c. Fat cells
51
What occurs with B1 receptor activation in the heart?
a. Increases SA, AV and ventricular muscle firing
52
What occurs with B1 receptor activation kidneys?
a. Renin release, activating the RAAS
53
What occurs with B1 receptor activation in Fat Cells?
a. Upregulates lipolysis
54
What is metoprolol MOA?
a. Selective Beta-1 blocker
55
What is metoprolol brand name?
a. Lopressor
56
What is prazosin MOA?
a. Postsynaptic Alpha-1 adrenergic blocker
57
Where are Alpha-1 receptors located?
a. Vascular smooth muscle
58
What does Alpha-1 receptor activation cause?
a. Vasoconstriction
59
Where and how does hydralazine reduce BP?
a. Vascular smooth muscle causing vasodilation
60
What is clonidine MOA?
a. Alpha-2 blocker | b. Works in brain stem
61
What is the preferred drug class for the initial treatment of HTN for a patient without any CI’s to other drugs?
a. Thiazide diuretic (HCTZ) | b. Works in brain stem
62
What is the preferred drug class for the initial treatment of HTN for a patient with Heart Failure?
a. Diuretic b. B-Blocker c. ACEi d. ARB e. Aldosterone antagonist
63
What is the preferred drug class for the initial treatment of HTN for a post MI patient?
a. B-blocker b. ACEi c. Aldosterone antagonist
64
What is the preferred drug class for the initial treatment of HTN for a patient with high risk coronary disease?
a. Diuretic b. B-blocker c. ACEi d. CCB
65
What is the preferred drug class for the initial treatment of HTN for a patient with diabetes?
a. Diuretic b. B-blocker c. ACEi d. ARB e. CCB
66
What is the preferred drug class for the initial treatment of HTN for a patient with chronic kidney disease?
a. ACEi | b. ARB
67
What is the preferred drug class for the initial treatment of HTN for the prevention of recurrent stroke?
a. Diuretic | b. ACEi
68
Which type of diuretic should be used in a patient with renal insufficiency?
a. Loop diuretics
69
What class of drug is enalapril?
a. ACEi

Specialized Pharmacology MN650 (28 decks)

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