lecture 8

Question 1

What is the definition of hypertension?

Answer 1

Hypertension (HTN) is characterized by an increase in the systolic and/or diastolic blood pressure caused by arteriosclerosis, kidney disease, other diseases, or may have no identified cause (essential hypertension).

Hypertension can lead to damage of the heart, blood vessels, kidneys, and other organs if untreated.

Question 2

What is considered normal blood pressure?

Answer 2

Lower than 120/80 mm Hg.

Question 3

What is ‘white-coat’ hypertension?

Answer 3

An elevated blood pressure that occurs when a person is being seen by a healthcare provider and may be anxious.

Question 4

Name the drug classes used to treat hypertension.

Answer 4

• Diuretic drugs
• Beta-blockers
• Alpha-/beta-blockers
• Alpha 1 blockers
• Alpha 2 receptor agonist drugs
• Calcium channel blockers
• ACE inhibitors
• Angiotensin II receptor blockers
• Renin inhibitors
• Aldosterone receptor inhibitors
• Peripheral vasodilators

Question 5

What is the mechanism of action of diuretic drugs in treating hypertension?

Answer 5

Promote the excretion of sodium and water in the urine, decreasing total blood volume which lowers blood pressure.

Question 6

What are the classes of diuretic drugs?

Answer 6

• Loop diuretics
• Thiazide diuretics
• Potassium-sparing diuretics
• Osmotic drugs
• Carbonic anhydrase inhibitor drugs

Question 7

What is the function of loop diuretics?

Answer 7

Block reabsorption of sodium and potassium in the proximal convoluted tubule and loop of Henle.

Question 8

Fill in the blank: Beta-blocker drugs primarily decrease the _______.

Answer 8

heart rate.

Question 9

What is the therapeutic effect of beta-blocker drugs?

Answer 9

Block action of epinephrine on beta receptors decreasing blood pressure.

Question 10

What are examples of beta-blocker drugs?

Answer 10

• nadolol (Corgard)
• pindolol (Visken)
• propranolol (Inderal)
• timolol (Blocadren)

Question 11

What do alpha 1 receptors do when stimulated?

Answer 11

Cause smooth muscle cells of blood vessels to constrict.

Question 12

True or False: Alpha 2 receptors promote norepinephrine release.

Answer 12

False.

Question 13

What is the role of calcium channel blockers in hypertension treatment?

Answer 13

Block the movement of calcium ions into the heart muscle and smooth muscles in the blood vessels, decreasing heart rate and dilating the arteries.

Question 14

What is the renin-angiotensin system’s role in blood pressure control?

Answer 14

It regulates blood pressure through the release of renin, conversion of angiotensinogen to angiotensin I, and then to angiotensin II, which is a potent vasoconstrictor.

Question 15

What is the mechanism of action of ACE inhibitors?

Answer 15

They reduce angiotensin II levels, leading to less vasoconstriction.

Question 16

Name some ACE inhibitor drugs.

Answer 16

• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• lisinopril (Prinivil, Zestril)
• ramipril (Altace)

Question 17

What do angiotensin II receptor blockers do?

Answer 17

Prevent angiotensin II from binding to receptors, allowing smooth muscle to dilate and lowering blood pressure.

Question 18

What are examples of angiotensin II receptor blockers?

Answer 18

• losartan (Cozaar)
• valsartan (Diovan)
• irbesartan (Avapro)
• telmisartan (Micardis)

Question 19

What are the effects of beta 2 receptor stimulation?

Answer 19

Cause relaxation of blood vessels and bronchi, increasing lung air flow.

Question 20

What is a common side effect of potassium-sparing diuretics?

Answer 20

Conservation of potassium, which can lead to hyperkalemia if dietary intake is excessive.

Question 21

Fill in the blank: The renin-angiotensin mechanism is initiated by a decrease in _______.

Answer 21

arterial blood pressure.

Question 22

What is the function of peripheral vasodilators?

Answer 22

Relax the smooth muscle in blood vessels and cause them to dilate, decreasing blood pressure.

Question 23

What are examples of peripheral vasodilators?

Answer 23

• hydralazine (Apresoline)
• minoxidil (Rogaine)

Question 24

What is the significance of beta-blockers in treating migraines?

Answer 24

They are used for prevention, although the exact mechanism is not entirely understood.

Question 25

What is hyperlipidemia?

Answer 25

A condition characterized by elevated levels of lipids in the blood.

Question 26

What are the therapeutic effects of calcium channel blockers?

Answer 26

Decrease heart rate and dilate arteries to lower blood pressure.

Question 27

What is losartan prescribed to treat?

Answer 27

Hypertension ## Footnote Losartan can cause harm or death to an unborn fetus.

Question 28

What is the mechanism of action of aliskiren?

Answer 28

Blocks renin production, leading to decreased angiotensin I and dilation of blood vessels ## Footnote Aliskiren is a renin inhibitor drug for hypertension.

Question 29

What hormone does aldosterone increase the reabsorption of?

Answer 29

Sodium ## Footnote Aldosterone is produced by the cortex of the adrenal gland.

Question 30

What is the effect of eplerenone?

Answer 30

Blocks the action of aldosterone ## Footnote Eplerenone is used as an aldosterone receptor inhibitor drug for hypertension.

Question 31

What are combination drugs for hypertension typically composed of?

Answer 31

Antihypertensive drug combined with a diuretic drug, beta-blocker, ACE inhibitor, calcium channel blocker, renin inhibitor, or angiotensin II receptor blocker ## Footnote Examples include Accuretic and Hyzaar.

Question 32

What is endothelin-1?

Answer 32

A potent vasoconstrictor peptide released by endothelial and vascular smooth muscle cells ## Footnote It targets ETA and ETB receptors.

Question 33

What condition does Tryvio (aprocitentan) treat?

Answer 33

Resistant hypertension ## Footnote Approved in 2024, it has a boxed warning for embryo-fetal toxicity.

Question 34

What is atheroma?

Answer 34

Atheromatous plaque causing thickening of the tunica intima and narrowing of arterial lumen ## Footnote It is associated with atherosclerosis.

Question 35

What is hyperlipidemia?

Answer 35

Hypercholesterolemia and hypertriglyceridemia ## Footnote It is a risk factor for atherosclerosis.

Question 36

What is the primary function of cholesterol in the body?

Answer 36

Production of hormones and bile, component of skin and nerve fibers ## Footnote Cholesterol is produced by the liver.

Question 37

What role do high-density lipoproteins (HDLs) play?

Answer 37

Carry cholesterol to the liver ## Footnote They are important for cholesterol transport.

Question 38

What do bile acid sequestrant drugs do?

Answer 38

Bind with bile, forming an insoluble complex that lowers blood cholesterol levels ## Footnote Examples include cholestyramine, colesevelam, and colestipol.

Question 39

What do HMG-CoA reductase inhibitors do?

Answer 39

Block the HMG-CoA reductase enzyme, increasing HDL levels ## Footnote Statin drugs like atorvastatin and simvastatin are examples.

Question 40

What is the effect of fibric acid drugs?

Answer 40

Decrease triglyceride production in the liver ## Footnote Examples include fenofibrate and gemfibrozil.

Question 41

What do ACL inhibitors do?

Answer 41

Decrease production of cholesterol and levels of LDL in blood ## Footnote Bempedoic acid is an example.

Question 42

What is the purpose of niacin drugs?

Answer 42

Remove chylomicrons from blood ## Footnote Niacin is also known as Vitamin B3.

Question 43

What is the role of omega-3 fatty acids in hyperlipidemia?

Answer 43

Reduce VLDL and triglyceride production ## Footnote Examples include Lovaza and Vascepa.

Question 44

What condition does congestive heart failure (CHF) describe?

Answer 44

Heart muscle is weakened and unable to pump blood adequately ## Footnote CHF can lead to right or left side heart failure.

Question 45

What effect does digoxin have?

Answer 45

Negative chronotropic effect and positive inotropic effect ## Footnote It helps the heart beat more efficiently.

Question 46

What are diuretic drugs used for in CHF?

Answer 46

Help the body excrete excess fluid from edema ## Footnote Spironolactone is an example.

Question 47

What is angina pectoris?

Answer 47

Insufficient oxygenated blood to myocardium ## Footnote It can lead to cellular ischemia and death if untreated.

Question 48

What do nitrates do in angina pectoris treatment?

Answer 48

Dilate the coronary arteries ## Footnote Nitroglycerin is the most frequently prescribed nitrate.

Question 49

What is a myocardial infarction?

Answer 49

Myocardial cellular death ## Footnote Drugs can limit the extent of dead tissue.

Question 50

What are cardiac arrhythmias?

Answer 50

Abnormalities in the electrical impulses conduction of the heart ## Footnote They include bradycardia, tachycardia, and fibrillation.

Question 51

What is the treatment for ventricular fibrillation?

Answer 51

Lidocaine and Amiodarone ## Footnote These drugs help restore normal heart rhythm.

Question 52

What is the purpose of epinephrine in cardiac arrest?

Answer 52

Stimulates contractions of the myocardium ## Footnote It helps maintain blood pressure and blood flow.

Question 53

What types of drugs are used to treat hypertensive crisis?

Answer 53

Beta-blocker drugs, calcium channel blocker drugs, peripheral vasodilator drugs ## Footnote These can be given intravenously to quickly lower blood pressure.