Cardiovascular Pharmacology Part I

Question 1

What 3 physiological components are responsible for the RAPID control of blood pressure?

Answer 1

1. Baroreceptor reflex
2. Peripheral chemoreceptors
3. Adrenergic system

Question 2

What system is responsible for the LONG TERM control of blood pressure?

Answer 2

Renin-angiotensin-aldosterone system

Question 3

What is the most potent and powerful vasoconstrictor in the body?

Answer 3

Angiotensin II

Question 4

_____ serves as the catalyst that converts angiotensin into angiotensin I.

Answer 4

Renin

Question 5

____ serves as the catalyst to convert angiotensin I to angiotensin II.

Answer 5

Angiotensin Converting Enzyme (ACE)

Question 6

_____ is responsible for the reabsorption and excretion of sodium/water that increases plasma volume and cardiac output.

Answer 6

Aldosterone

Question 7

What is the purpose of a diuretic?

Answer 7

Antihypertensive drugs that BLOCK the reabsorption of sodium to promote water loss (decrease BP)

Question 8

List the 2 mechanisms of action of diuretics.

Answer 8

1. Inhibit sodium pumps

2. Induce renal PG (prostaglandin) synthesis

Question 9

____ make diuretics less effective.

Answer 9

NSAIDS

Question 10

_____ are powerful antihypertensive agents but moderate diuretics.

Answer 10

Thiazides

Question 11

_____ are mod anti-hypertensives-yet powerful diuretics.

Answer 11

Loop diuretics

Question 12

List the 2 mechanisms of action for K+ sparing diuretics.

Answer 12

1. Blocks aldosterone receptors

2. Inhibit Na flux through ion channels in luminal membrane (slow the release of potassium)

Question 13

List the 3 most important ADRs related to diuretic use.

Answer 13

Hyperglycemia (diabetes)
Increased LDL
DEHYDRATION (decreased turgor)

Question 14

What electrolyte should be closely monitored in patients with cardiac disease?

Answer 14

Potassium (k+)

Question 15

Which diuretic in particular can cause an ADR in the form of an arrhythmia?

Answer 15

K+ sparing diuretics

Question 16

What lab value will be elevated in patients experiencing dehydration secondary to diuretic use?

Answer 16

Blood urea nitrogen (BUN)

Question 17

What is contraindicated, in terms of exercise, for patients taking diuretics?

Answer 17

Prolonged exercise in the heat

Question 18

List 3 mechanisms of action for beta blockers.

Answer 18

1. Slows down the heart and reduces cardiac output
2. Central inhibitory effect on sympathetic activity
3. Inhibits renin release

Question 19

Beta blockers mask the symptoms of and delay recovery from ______ but cause _____ with long term use. Why?

Answer 19

1. Hypoglycemia
2. Hyperglycemia

Because beta receptors are involved with gluconeogenesis, so repressing that will decrease glucose production, but long term use of beta blocker results in diabetes

Question 20

An increase in ____ is an ADR associated with using a beta blocker.

Answer 20

LDL

Question 21

True or False: LE edema should be a clinical sign to watch for in patients on beta blockers who might be experiencing heart failure.

Answer 21

TRUE

Question 22

If patient has myocardial ischemia, beta blockers can _____ exercise performance but for uncomplicated hypertension, exercise performance ____.

Answer 22

Increases

Decreases

Question 23

What is the MOA for calcium channel blockers?

Answer 23

Interfere with calcium uptake in arteriole smooth muscle and in cardiac muscle

Question 24

List 5 ADRs associated with calcium channel blockers.

Answer 24

1. Low BP
2. Orthostatic hypotension
3. LE edema
4. Dizziness
5. AV block

Question 25

List 3 MOAs of ACE I drugs.

Answer 25

1. Inhibits ACE (enzyme) 2. Does not adversely affect lipids or glucose and preserves renal function 3. CO and HR do not change

Question 26

What is a hallmark ADR of ACE I drugs?

Answer 26

Chronic cough (affects 20% of population)

Question 27

What is the MOA of angiotensin receptor blockers (ARBs)?

Answer 27

Prevent angiotensin II from binding to their receptors on blood vessels

Question 28

What is the advantage of using Angiotensin receptor blockers (ARBs) over ACE I drugs?

Answer 28

ARBs have no effect on bradykinin metabolism so chronic cough is not an ADR.

Question 29

What antihypertensive ADR, relevant to vital signs, should warrant the PT to call the patient's prescriber?

Answer 29

Notify prescriber if BP<100 and HR<60

Question 30

What is the difference between a competitive and non competitive antagonist?

Answer 30

1. Competitive antagonists bind to the same receptors as the agonist, and make the agonist look less potent but their effect can be overcome by increasing the dose of the agonist. THEY HAVE NO EFFECT ON THEIR OWN. 2. Noncompetitive antagonists bind to a different site than the agonist and reduces the max response

Question 31

______ are useful in diabetics with renal disease.

Answer 31

ACE inhibitors

Question 32

______ and ______ antihypertensive agents are useful in treating angina.

Answer 32

Beta blockers | Calcium blockers

Question 33

_______ or _______ are good antihypertensive drugs in treating CHF.

Answer 33

ACE inhibitors | Diuretics

Question 34

If a patient taking a beta-blocker needs a second drug, add a _________ rather than a ________ to reduce the patient’s risk of developing diabetes.

Answer 34

Calcium-channel blocker | Thiazide-type diuretic