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Pharmacology II > HTN2 > Flashcards

Flashcards in HTN2 Deck (28)
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1
Q

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

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

what are the 4 classes of diuretics

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

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

A
  1. decrease in CO

2. initial increase in SVR

4
Q

when are aldosterone agonists used for HTN

A

for pt’s with heart failure or post MI

5
Q

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

A

CrCl< 30 ml/min

6
Q

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

A

loop diuretics

7
Q

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

A

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

8
Q

when are K sparing diuretics used for HTN

A

to avoid K depletion and

in combo to enhance natriuretic effect

9
Q

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

A
  1. direct renin inhibitors
  2. ACE inhibitors
  3. ARB’s
10
Q

True/ False:

angiotensinogen is produced continously by the liver

A

True

11
Q

True/ False:

Renin is continuously released by the kidneys

A

false

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

12
Q

what is formed by renin reacting with angiotensinogen

A

angiotensin I

13
Q

what are the 3 pathways of renin release?

A

macula densa pathway
intrarenal baroreceptor pathway
beta-adrenergic receptor pathway

14
Q

where is renin stored

A

juxtaglomerular cells in kidney

15
Q

what is the macula densa

A

cell that signals for renin release if Na levels are low

16
Q

what activates renin release with a decrease in renal blood flow

A

intrarenal baroreceptors

17
Q

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

A

breaks down bradykinin (a vasodilator)

18
Q

angiotensin II has what 3 major effects?

A
  1. rapid pressor effect
  2. slow pressor response
  3. vascualr and cardiac hypertrophy
19
Q

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

A

direct vasoconstriction and increased NE release leads to altered peripheral resistance

20
Q

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

A
  1. increases sodium reabsorption in proximal tubule
  2. increases aldosterone release from adrenal cortex
  3. direct alteration of hemodynamics (renal vasoconstriction)
21
Q

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

A
  1. encreased expression of proto-oncogenes and growth factors
  2. increases afterload and vascular wall tension
22
Q

what bioreaction is stopped by direct renin inhibitors

A

angiotensinegin to angio I

23
Q

what type of bioavailability does aliskiren have

A

very low bioavailability (2.5-3%)

24
Q

what type of affinity does aliskiren have for renin?

A

very high affinity

25
Q

what greatly decreases aliskiren absorption

A

high fat meals

26
Q

what is dosing form and interval of aliskiren

A

PO once daily (usually adjunct)

27
Q

what are the adverse effects of aliskiren

A
(similar to ACEI's)
GI upset 
hyperkalemia
angioedema
dry cough (less than ACEI's)
28
Q

what is the contraindication for aliskiren

A

pregnancy