Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > module 6c > Flashcards

module 6c Flashcards

1
Q

Antihypertensive Drugs

A 
BLOOD PRESSURE
Blood pressure = CO × SVR
 CO = cardiac output
 SVR = systemic vascular resistance
 Hypertension = high blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BP

A 
Four stages, based on BP measurements
 Normal
 Prehypertension
 Stage 1 hypertension
 Stage 2 hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

JNC-7: Significant Changes

Joint National Committee

A 
High diastolic BP (DBP) is no longer considered to be more dangerous than
high systolic BP (SBP)
 Studies have shown that elevated SBP is
strongly associated with heart failure,
stroke, and renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

JNC-7: Significant Changes

Joint National Committee

A

For those older than age 50, SBP is a more
important risk factor for cardiovascular
disease (CVD) than DBP
“Prehypertensive” BPs are no longer
considered “high normal” and require lifestyle
modifications to prevent CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

JNC-7: Significant Changes

Joint National Committee

A

Thiazide-type diuretics should be the initial
drug therapy for most patients with
hypertension (alone or with other drug
classes)
The previous labels of “mild,” “moderate,”
and “severe” have been dropped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cultural Considerations

A

B-blockers and ACE inhibitors have been
found to be more effective in white patients
than African American patients
CCBs and diuretics have been shown to be
more effective in African-American patients
than in white patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Classification of BP

A

Hypertension can also be defined by its cause
Unknown cause
Known as essential, idiopathic, or primary hypertension, 90% of the cases
Known cause
Secondary hypertension,10% of the cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antihypertensive Drugs:

Categories

A 
Adrenergic drugs
 Angiotensin converting enzyme (ACE)
inhibitors
 Angiotensin II receptor blockers (ARBs)
 Calcium channel blockers (CCBs)
 Diuretics
 Vasodilators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adrenergic Drugs:

Subcategories

A

Centrally acting A2-receptor agonists

Peripherally acting A1-receptor blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Adrenergic Drugs:

Subcategories

A 
Peripherally acting B-receptor blockers
(B-blockers)—both cardioselective
(B receptors) and nonselective (both B
and B2 receptors)
 Peripherally acting dual A1- and B-receptor
blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adrenergic Drugs:

Mechanism of Action

A

Centrally acting A2-receptor agonists
Stimulate A2-adrenergic receptors in the brain
Decrease sympathetic outflow from the CNS
Decrease norepinephrine production
Stimulate alpha2-adrenergic receptors, thus
reducing renin activity in the kidneys
 Result: decreased blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Adrenergic Drugs:
Centrally Acting
A2-Receptor Agonists

A

clonidine (Catapres)
methyldopa (Aldomet)
Can be used for hypertension in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adrenergic Drugs:

Mechanism of Action

A 
Peripheral A1-blockers/antagonists
 Block the A1-adrenergic receptors
 doxazosin Cardura)
 prazosin (Minipress)
 terazosin (Hytrin)
 Result: decreased blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adrenergic Drugs:

Mechanism of Action

A

Beta-blockers
Reduce BP by reducing heart rate through
beta1-blockade
Cause reduced secretion of renin
Long-term use causes reduced peripheral vascular resistance
Propranolol, atenolol
Newest: nebivolol (Bystolic)—beta1-selective
Result: decreased blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Adrenergic Drugs:

Mechanism of Action

A 
Dual-action A1- and B-receptor blockers
 Block A1-adrenergic receptors
• Reduction of heart rate 1-receptor blockade)
• Vasodilation (1-receptor blockade)
 carvedilol (Coreg) and labetalol
 Result in decreased blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adrenergic Drugs: Indications

A

Centrally acting A2-receptor agonists
Treatment of hypertension, either alone or
with other drugs
Usually used after other drugs have failed
because of adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Adrenergic Drugs: Indications

A

Centrally acting A2-receptor agonists
Also may be used for treatment of severe
dysmenorrhea, menopausal flushing, glaucoma
Clonidine is useful in the management of
withdrawal symptoms in opioid- or nicotinedependent
persons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Adrenergic Drugs: Indications

A 
Peripherally acting A1-receptor antagonists
 Treatment of hypertension
 Some used to relieve symptoms of BPH
• tamsulosin (Flomax)
 Management of severe HF when used
with cardiac glycosides and diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adrenergic Drugs:

Adverse Effects

A

High incidence of orthostatic hypotension
Most common: Dry mouth, Drowsiness, sedation,Constipation
Other:HA, Sleep disturbances, Nausea,
Rash, Cardiac disturbances (palpitations)

20
Q

Adrenergic Drugs

A 
B-blockers
 Act in the periphery
 Reduce heart rate due to B1-blockade
 Examples: nebivolol (bystolic), propranolol
(Inderal), atenolol (Tenormin)
21
Q

Adrenergic Drugs

A

Dual A1- and B-receptor blockers
Act in the periphery at heart and blood vessels
Reduce heart rate (B1-receptor blockade)
Cause vasodilation (A1-receptor blockade)
Examples: labetalol (Normodyne), carvedilol (Coreg)

22
Q

Angiotensin Converting
Enzyme (ACE) Inhibitors
(end in pril)

A 
Large group of safe and effective drugs
 Often used as first-line drugs for HF
and hypertension
 May be combined with a thiazide diuretic or
calcium channel blocker
23
Q

ACE Inhibitors:

Mechanism of Action

A

Renin-Angiotensin-Aldosterone System
Inhibit angiotensin-converting enzyme, which is responsible for converting angiotensin I to
angiotensin II
Angiotensin II is a potent vasoconstrictor and
causes aldosterone secretion from the
adrenals

24
Q

ACE Inhibitors:

Mechanism of Action

A

Aldosterone stimulates water and sodium
resorption
Result: increased blood volume, increased
preload and increased BP

25
ACE Inhibitors: | Mechanism of Action
Block angiotensin-converting enzyme, thus preventing the formation of angiotensin II Prevent the breakdown of the vasodilating substance, bradykinin Result in decreased systemic vascular resistance (afterload), vasodilation, and therefore decreased blood pressure
26
ACE Inhibitors: | Indications
Hypertension HF (either alone or in combination with diuretics or other drugs) To slow progression of left ventricular hypertrophy after an MI (cardioprotective) Renal protective effects in patients with diabetes
27
ACE Inhibitors: Indications
Drugs of choice in hypertensive patients with HF Drugs of choice for diabetic patients
28
ACE Inhibitors
captopril (Capoten) enalapril (Vasotec) moexipril perindopril trandolapril benazepril, fosinopril, lisinopril (Prinivil and Zestril), quinapril (Accupril) and ramipril Newer drugs, long half-lives, once-a-day dosing
29
ACE Inhibitors
Captopril and lisinopril are NOT prodrugs Prodrugs are inactive in their administered form and must be metabolized by the liver to an active form in order to be effective Captopril and lisinopril can be used if a patient has liver dysfunction, unlike other ACE inhibitors that are prodrugs
30
ACE Inhibitors: Adverse Effects
``` Fatigue Dizziness Headache Mood changes Impaired taste Possible hyperkalemia Dry, nonproductive cough, which reverses when therapy is stopped Angioedema: rare but potentially fatal NOTE: First-dose hypotensive effect may occur! ```
31
Angiotensin II Receptor Blockers | end in artan
ARBs Newer class Well tolerated Do not cause a dry cough
32
Angiotensin II Receptor Blockers: | Mechanism of Action
``` Allow angiotensin I to be converted to angiotensin II, but block angiotensin II receptors Block vasoconstriction and release of aldosterone ```
33
Angiotensin II Receptor Blockers
``` losartan (Cozaar, Hyzaar) candesartan eprosartan valsartan (Diovan) irbesartan olmesartan telmisartan ```
34
Angiotensin II Receptor | Blockers: Indications
Hypertension Adjunct drugs for the treatment of HF May be used alone or with other drugs such as diuretics Used primarily in patients who cannot tolerate ACE inhibitors
35
Angiotensin II Receptor Blockers: | Adverse Effects
Upper respiratory infections Headache May cause occasional dizziness, inability to sleep, diarrhea, dyspnea, heartburn, nasal congestion, back pain, fatigue Hyperkalemia less likely to occur compared to ACE inhibitors
36
Calcium Channel Blockers: | Mechanism of Action
``` Cause smooth muscle relaxation by blocking calcium channels preventing muscle contraction Results in Decreased peripheral smooth muscle tone Decreased systemic vascular resistance Decreased blood pressure ```
37
Calcium Channel Blockers | most in in pine or ine
``` Benzothiazepines diltiazem (Cardizem, Dilacor) Phenylalkamines verapamil (Calan, Isoptin) Dihydropyridines amlodipine (Norvasc), bepridil (Vascor), nicardipine (Cardene) nifedipine (Procardia), nimodipine (Nimotop) ```
38
Calcium Channel Blockers: | Indications
``` Angina Hypertension Dysrhythmias Migraine headaches Raynaud’s disease ```
39
Calcium Channel Blockers: | Adverse Effects
``` Cardiovascular Hypotension, palpitations, tachycardia Gastrointestinal Constipation, nausea Other Rash, flushing, peripheral edema, dermatitis ```
40
Diuretics
``` Decrease plasma and extracellular fluid volumes Results Decreased preload Decreased cardiac output Decreased total peripheral resistance Overall effect Decreased workload of the heart, and decreased blood pressure ```
41
Thiazide Diuretics
Thiazide diuretics are the most commonly used diuretics for hypertension Listed as first-line antihypertensives in the JNC-7 guidelines
42
Vasodilators: | Mechanism of Action
``` Directly relax arteriolar and/or venous smooth muscle Results in: Decreased systemic vascular response Decreased afterload Peripheral vasodilation ```
43
Antihypertensive Drugs | Vasodilators
diazoxide (Hyperstat) hydralazine Apresoline) minoxidil (Loniten) sodium nitroprusside (Nipride, Nitropress)
44
Vasodilators: | Indications
Treatment of hypertension May be used in combination with other drugs Oral diazoxide may be used as an antihypoglycemic Sodium nitroprusside and intravenous diazoxide are reserved for the management of hypertensive emergencies
45
Vasodilators: Adverse Effects
Hydralazine Dizziness, headache, anxiety, tachycardia, nausea and vomiting, diarrhea, anemia, dyspnea, edema, nasal congestion Sodium nitroprusside Bradycardia, hypotension, possible cyanide toxicity (rare)
46
Vasodilators: Adverse Effects
Diazoxide Dizziness, headache, anxiety, orthostatic hypotension dysrhythmias sodium and water, retention, nausea, vomiting, hyperglycemia in diabetic patients

Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions