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Flashcards in HTN2 Deck (28)
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1

what are the 4 main physiological categories of drugs that regulate BP

1. diuretics
2. RAA agents
3. sympathoplegic agents
4. vasodilators

2

what are the 4 classes of diuretics

1. thiazides
2. loop diuretics
3. K-Sparing
4. Aldosterone Agonists

3

the first 6-8 weeks of thiazide tx what happens to CO and TVR

1. decrease in CO
2. initial increase in SVR

4

when are aldosterone agonists used for HTN

for pt's with heart failure or post MI

5

What pt's do not have much of a response to thiazides for HTN

CrCl< 30 ml/min

6

what diuretic shows a response that increases with an increase in dosing?

loop diuretics

7

what type of patients is HTN tx with loop diuretics appropriate for

pt's with heart failure and cirrhosis (sodium retention)

8

when are K sparing diuretics used for HTN

to avoid K depletion and
in combo to enhance natriuretic effect

9

what are 3 classes of drugs that treat RAA system for HTN

1. direct renin inhibitors
2. ACE inhibitors
3. ARB's

10

True/ False:
angiotensinogen is produced continously by the liver

True

11

True/ False:
Renin is continuously released by the kidneys

false
release in response to stress (diet, emtion, or physiologic)

12

what is formed by renin reacting with angiotensinogen

angiotensin I

13

what are the 3 pathways of renin release?

macula densa pathway
intrarenal baroreceptor pathway
beta-adrenergic receptor pathway

14

where is renin stored

juxtaglomerular cells in kidney

15

what is the macula densa

cell that signals for renin release if Na levels are low

16

what activates renin release with a decrease in renal blood flow

intrarenal baroreceptors

17

ACE has what effect on what other substance other than Angio I?

breaks down bradykinin (a vasodilator)

18

angiotensin II has what 3 major effects?

1. rapid pressor effect
2. slow pressor response
3. vascualr and cardiac hypertrophy

19

what is the MOA of angio II's rapid pressor response

direct vasoconstriction and increased NE release leads to altered peripheral resistance

20

what is the MOA of angio II's slow pressor response

1. increases sodium reabsorption in proximal tubule
2. increases aldosterone release from adrenal cortex
3. direct alteration of hemodynamics (renal vasoconstriction)

21

what is the MOA of angio II's vascular and cardiac hypertophy and remodeling effect

1. encreased expression of proto-oncogenes and growth factors
2. increases afterload and vascular wall tension

22

what bioreaction is stopped by direct renin inhibitors

angiotensinegin to angio I

23

what type of bioavailability does aliskiren have

very low bioavailability (2.5-3%)

24

what type of affinity does aliskiren have for renin?

very high affinity

25

what greatly decreases aliskiren absorption

high fat meals

26

what is dosing form and interval of aliskiren

PO once daily (usually adjunct)

27

what are the adverse effects of aliskiren

(similar to ACEI's)
GI upset
hyperkalemia
angioedema
dry cough (less than ACEI's)

28

what is the contraindication for aliskiren

pregnancy