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PMCOL 200 - Introduction to Pharmacology > Lecture 7 - Drugs to treat high blood pressure I > Flashcards

Lecture 7 - Drugs to treat high blood pressure I Flashcards

1
Q

What is blood pressure?

A
  • is it generated by the beating of the heart and the resistance of the circulatory system.
  • it changes during the cardiac cycle.
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2
Q

When is our systolic pressure measured?

A

Pressure at the peak of ventricular contraction

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3
Q

When is our diastolic pressure measured?

A
  • minimum pressure during ventricular relaxation/dialation
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4
Q

Hypertension increases the risk for which diseases?

A
  • Renal failure
  • coronary disease
  • heart failure
  • stroke
  • dementia
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5
Q

Blood pressure is the calculation of?

A
  • Cardiac output x peripheral vascular resistance
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6
Q

The more your cardiac output, the ____ your blood pressure

A

higher

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7
Q

The stiffer your blood vessels are, the more ____ they are to blood flow leading to ____ blood pressure

A

ressitant; higher

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8
Q

What does RAAS stand for?

A
  • Renin-Angiotensin-Aldosterone System
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9
Q

What is the most commonly used drug on the kidney?

A

Thiazide diuretics

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10
Q

What is the function of sodium chloride co-transporter?

A
  • reabsorbs sodium and chloride and co-transports them into the cell and then sodium is transported again back into the interstitium-blood via the sodium potassium pump
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11
Q

What is the function of thiazides?

A

inhibit NaCl reabsorption in the distal convoluted tubule by blocking Na+/Cl- transporter.

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12
Q

What is the function of thiazides?

A

inhibit NaCl reabsorption in the distal convoluted tubule by blocking Na+/Cl- transporter.

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13
Q

Why is blocking reabsorption of Na+ bad?

A
  • reabsorption of Na+ = reabsorption of water; keeping sodium inside the tubule also blocks the ater from being reabsorbed, leading to peeing causing a loss of water = reduced blood volume and decreased blood pressure
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14
Q

What is a commonly used thiazide?

A

Bendroflumethaizide

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15
Q

Which receptors are G-protein coupled receptors that are activated by catecholamines like adrenaline and noradrenaline?

A

Adrenergic receptors

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16
Q

Why are adrenergic receptors important?

A

They regulate blood pressure.

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17
Q

Which subtypes of adrenergic receptors are present in the heart?

A
  • Beta 1 (only 1 heart)
  • receptors are responsible for acceleration of heart rate and causing the heart to pump harder during a flight or fight response
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18
Q

Which receptor does calcium bind to on the sarcoplasm particulum to allow calcium to tbe released from the sarcoplasm?

A

ryanodine receptor

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19
Q

When calcium is released, it triggers the ____ filaments in our cardiac muscle to ____.

A

myofibrils; contract

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20
Q

The stimulation of adrenergic receptors activates the ____ type calcium channels so more calcium comes in by ____ the type ____ channels. It accelerates the rate of calcium re-uptake causing the heartbeat to get ____ and leads to your heart beating/pumping ____ blood. It also phosphorylates a protein known as phospholamban which ____ the circuit pump.

A
  • L-type
  • autophosphorylation
  • L-type
  • smaller
  • more
  • inhibits
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21
Q

Which adrenergic receptors are present in the lungs?

A

Beta 2 receptors (2 lungs in the body)

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22
Q

Beta 2 receptors in the lungs cause bronchioles to ____ and enhanced perfusion of skeletal muscle during a fight or flight response

A

dilate

23
Q

In cardiac muscle, what are the 3 key targets of PKA?

A
  • voltage-gated Ca2+ channels (L-type)
  • Ryanodine receptors
  • serca pumps
24
Q

Voltage-gated Ca2+ channels (L-type) ____ intracellular Ca2+ during a heart beat

A

increase

25
Q

Ryanodine receptors ____ Ca2+ release from intracellular stores during a heartbeat.

A

increase

26
Q

What pumps clean up Ca2+ by taking it up into ER stores during the termination of a heartbeat?

A

SERCA pumps

27
Q

What is the key target in vascular/bronchiolar smooth muscle?

Hint: MLCK

A

Myosin Light Chain Kinase

28
Q

Myosin Light Chain Kinase is a protein which enables ____ of smooth muscle. Phosphorylation by PKA causes smooth muscle to ____ (dilate bronchioloes, dilate vessels).

A

constriction; relax

29
Q

Protein Kinase in smooth muscle will phosphorylate myosin light chain kinase by ____ its activity and making the ____ of muscle weaker.

A

inhibiting; contraction

30
Q

Phosphorylation of Myosin Light Chain kinase promotes ____ (contraction/dilation)

A

contraction

31
Q

Gq signaling cascade releases IP3 which causes the release of calcium from calcium channels in vascular muscle or bronchioles. Calcium acts through ____ which binds to MLCK. When ____ is activated, it phosphorylates the MLC allowing smooth muslce ____ to occur.

A

calmodulin; calmodulin; contraction

32
Q

MLCK is a ____ dependent protein kinase

A

Ca2+ - calmodulin

33
Q

MLCK activity is ____ by B2-adrenoceptor activation

A

inhibited

34
Q
  • Beta 1 receptors ____ contraction in the heart
  • Beta 2 receotors ____ contraction in smooth muscle (bronchioles and lungs) and in blood vessels during a flight or fight reaction
A

promote; inhibit

35
Q

Beta blockers are ____ antagonists of adrenergic receptors
Some examples include adrenaline, noradrenaline, propranolol (non-selective), atenolol (B1 selective), carvedilol (B and a inhibition) and prazosin (alpha 1 selective)

A

competitive

36
Q

Anti-hypertensive effects of beta-blockers are mediated primarily by a ____ in cardiac output and ____ of renin secretrion

A

decrease;inhibition

37
Q

True or False: Inotropic effects the strength of contraction of the Heart

A

True

38
Q

True or False: Chronotropic influences the rate at which your heart beats.

A

True

39
Q

Some beta blockers such as carvedilol have non-specific inhibition of alpha receptors, which leads to an additional effect on ____ resistance (due to vasodilation).

A

peripheral

40
Q

Some beta blockers such as carvedilol have non-specific inhibition of alpha receptors, which leads to an additional effect on ____ resistance (due to vasodilation).

A

peripheral

41
Q

What is the side effect of non-specific beta blockers in bronchial smooth muscle?

A

bronchospasm

42
Q

Why are beta blockers with acitivy on beta 2 receptors to be avoided in patients with asthma or other respiratory issues?

A
  • If you take beta 2 receptors, it causes your bronchioles to relax/dilate so by taking a beta blocker your are inhibiting the relaxation and bronchioles become constricted, making it harder to breathe.
  • If someone is taking a beta blocker to treat high blood pressure and they also have asthma, a negative outcome is that you inhibit beta 2 receptors causing an astham exacerbation.
43
Q

Inhibition of ____ receptors would cause dilation, while the inhibition of ____ 2 would cause constriction

A

alpha;beta

44
Q

Why do we not use Beta 2 blockers to treat high blood pressure?

A

beta2 blockade can trigger blood vessel constriction

45
Q

Why do we use a non-specific beta blocker to treat high blood pressure?

A

they block beta1 and reduce blood presure by reducing cardiac output and reducing renin release

46
Q

Explain the signaling cascade for alpha1- receptor

A

->GDP - GTP exchange on Galpha,q subunit and dissociation of Galpha and Gbeta/gamma
->Galpha,q activates PLC
-> PLC cleaves PIP2, releasing IP3 and DAG
-> IP3 triggers Ca2+ release from ER, via IP3 receptor
-> Ca2+ is sensed by Calmodulin
->Ca2-Calmodulin binds and activates Myosin Light Chain Kinase
-> Myosin Light Chain Kinase phosphorylates Myosin Light Chain
-> This allows for muscle contraction.

47
Q

In tissues that don’t require increased blood flow during a fight or flight response, ____ receptors are the primacy adrenergic receptors.

A

alpha 1

48
Q

Stimulation of alpha1 receptors triggers smooth muscle ____. ____ causes vasodiliation.

A

contraction; inhibition

49
Q

Alpha 1 receptors signal through ____ cascade.

A

Gq

50
Q

Protein kinase C can promote ____ of vascular muscle by phosphorylating a protein called the ____ kinase which then inhibits a MLCP (myosin light chain phosphatase). If MLCP is inhibited, muscle ____ is longer and more efective.

A

constriction; Rho; contraction

51
Q

is Propranolol selective or non-selective?

A

non-selective

52
Q

Is atenolol Alpha1 selective or beta1 selective?

A

Beta1 selective

53
Q

Is carvedilol beta inhibition or alpha inhibition?

A

alpha and beta inhibition

54
Q

Is prazosin alpha1 selective or beta1 selective?

A

alpha 1

PMCOL 200 - Introduction to Pharmacology (12 decks)

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