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Pharmacology II > HTN6 > Flashcards

Flashcards in HTN6 Deck (38)
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1
Q

what is clonidines effect on:

PVR, CO, HR, and SV

A

all decrease due to inhibition of NE binding a1, b1, and b2 receptors

2
Q

if alpha1 receptor is stimualated what occurs?

A

increased vasoconstriction, increased PVR

3
Q

beta blockade leads to what?

A

decreasaed HR

decreased SV

4
Q

which antihypertensive agent would be most appropriate to treat HTN crisis due to clonidine withdrawal:

a. lisonipril
b. labetalol
c. esmolol
d. prazosin

A

c. labetalol

5
Q

what are the 2 main groups of drugs for HTN considered vasodilators

A

Ca channel blockers

direct vasodilators

6
Q

what is activated by Nitric Oxide in a vascular smooth muscle cell

A

guanylyl cyclase

7
Q

what is the cascade stimulated by NO in vascular smooth muscle (3 steps after NO)

A
  1. guanylyl cyclase converts GTP to cGMP
  2. cGMP activates myosin-LC phosphatase
  3. myosin-LC phosphatase causes relaxation
8
Q

how does myosin-LC cause smooth muscle relaxation

A

by dephosphorylating myosin light chain

9
Q

what CCB’s have use dependent binding

A

nondihydropyrimidines

10
Q

what CCB’s have voltage dependent binding

A

dihydropyrimedines

11
Q

what class is diltiazem

A

benzothiazepine

12
Q

what class is verapamil

A

phenylalkilamine

13
Q

what is the MOA of verapamil

A

blocks P-glycoprotein transporter, decreasing HR and FOC

14
Q

dihydropyridines have what type of selectivity? what does it cause there

A

vasoselective, causing vasodilation

15
Q

what CCB interacts with digoxin

A

verapamil

16
Q

what dihydropyrimidine is available IV and can be used in HTN crisis

A

nifedipine

17
Q

what type of CCB is associated with GI intolerance

A

non-dihydropyridines

18
Q

what type of CCB is associated with tachycardia

A

dihydropyridines

19
Q

what activates MLCK cascade for smooth muscle contration to take place

A

calcium

20
Q

how is hydralazine metabolized

A

acetylation

21
Q

what does tachyphylaxis mean

A

with repeated use, need a higher dose to get therapeutic effect

22
Q

what is minoxidil’s MOA

A

hyperpolarization by activating ATP modulated K channels

23
Q

what are some adverse effects of minoxidil

A

hypotrichosis
salt and water retention
cardiac effects (increases HR, FOC, and O2 demand)

24
Q

what oral vasodilator is also found in rogaine

A

minoxidil

25
Q

what is the parenteral vasodilator that increases dephosphorylation of MLCK in smooth muscle

A

sodium nitroprusside

26
Q

what is the MOA of sodium nitroprusside

A

donates NO causing vasodilation

27
Q

what are 3 adverse effects of sodium nitroprusside

A
  1. cyanide toxicity
  2. flushing
  3. headache
28
Q

what is the MOA of diazoxide

A

activates K+ channels causing hyperpolarization

29
Q

what is another use of diazoxide?

how?

A

treats hypoglycemia

inhibits secretion of insulin

30
Q

what is the MOA of fenoldopam

A

activates dopamine receptors

31
Q

what is an adverse effect specific to fenoldopam

A

increase intraocular pressure

32
Q

how is fenoldopam generally dosed IV for HTN crisis?

A

low dose then titrate up

33
Q

list the parenteral vasodilators

A
  1. sodium nitroprusside
  2. diazoxide
  3. fenoldopam
34
Q

what are some symptoms of hypertensive urgency

A

headache
SOB
nosebleed
anxiety

35
Q

why not drop bp quickly in HTN treatment?

A

leads to end organ ischemia or infarction

36
Q

what are 3 parenteral HTN crisis treatments often used

A
  1. sodium nitroprusside
  2. fenoldopam
  3. labetalol
37
Q

what are 3 oral therapies for HTN treatment

A
  1. clonidine
  2. labatelol
  3. captopril
38
Q

what class of drug is not recommended for HTN with HF?

A

CCBs