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N216 A/B > Perfusion Part 1 - Hypertension > Flashcards

Perfusion Part 1 - Hypertension Flashcards

1
Q

What do baroreceptors do?

A

Detect changes in BP

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2
Q

The adrenal gland secretes ____ to stimulate the kidney

A

aldosterone

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3
Q

Renin + _____ –> _____ I + ____ –> ____ II

A

angiotensinogen, angiotensin I, ACE, angiotensin II

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4
Q

What are the 3 factors that influence blood pressure?

A
  1. Blood volume
  2. Diameter of arterioles
  3. Cardiac output
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5
Q

Blood is composed of 55% ____ and 45% ____ ____

A

plasma, formed elements

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6
Q

What are 4 actions the CDV system does to counter high BP?

A
  1. Vasodilation
  2. Decrease stroke volume
  3. Decrease heart rate
  4. Decrease cardiac output
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7
Q

What are 2 actions the kidneys do to counter high BP?

A
  1. Increase urine output

2. Decrease blood volume

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8
Q

Hypertension is ____ systolic or diastolic BP

A

high

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9
Q

What are 6 potential causes of a sudden change in BP?

A
  1. Pain
  2. Infection
  3. Compensation
  4. Hypervolemia
  5. Drug induced
  6. Malignant hypertension
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10
Q

What are the 3 types of hypertension?

A
  1. Essential (idiopathic)
  2. Secondary
  3. Sudden onset
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11
Q

What are some potential causes for essential hypertension?

A
  • Age
  • Race
  • Family history
  • Lifestyle
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12
Q

What are some potential causes for secondary hypertension?

A
  • Renal disease

- Congenital

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13
Q

What is a potential cause for sudden onset hypertension?

A

Drugs

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14
Q

What is gestational HTN (preeclampsia)?

A

A new onset of hypertension in pregnant women after 20 weeks of gestation

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15
Q

What are 2 potential complications of gestational HTN?

A
  1. DIC (clotting)

2. Thrombocytopenia (platelet deficiency)

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16
Q

What are 2 treatments for gestational HTN?

A
  1. Sodium restriction

2. Antihypertensive medications

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17
Q

What are 3 age related changes that can affect BP?

A

Decreased:

  1. Elasticity of vessels
  2. Renal blood flow
  3. Sensitivity to baroreceptors
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18
Q

What would be considered orthostatic hypotension?

A

A drop of 20mmHg in SBP or 10 in DBP

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19
Q

Orthostatic hypotension is caused by venous ____ in lower extremities

A

pooling

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20
Q

What are 2 signs and symptoms of orthostatic hypotension due to decreased CNS perfusion?

A
  1. Faintness

2. Dizziness

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21
Q

What 3 categories of patients are at risk of orthostatic hypotension?

A
  1. Elderly
  2. Dehydrated patients
  3. Antihypertensive med. patients
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22
Q

What is the treatment for orthostatic hypotension in emergencies?

A

Adrenergic agonists

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23
Q 
Expected findings for adults are:
BP = \_\_/\_\_ mmHg
MAP = \_\_-\_\_ Hg
HR: \_\_-\_\_ bpm
CO: \_\_-\_\_ L/min
A

120/80
70-100
60-100
4-8

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24
Q

What is the emergency treatment for hypertension?

A

Direct Acting Vasodilators (DAV)

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25
How do DAVs work?
1. Stimulates L-Arginine in endothelial cells 2. L-Arginine stimulates nitric oxide production 3. Nitric oxide results in vasodilation
26
What are 2 examples of DAVs?
1. Nipride (Nitroprusside) | 2. Hydralazine
27
What are some side effects of DAVs?
- Reflex tachycardia - Hypotension - Syncope - Headache
28
What are 4 drug classes used to treat hypertension normally?
1. Diuretics 2. Renin-Angiotensin 3. Calcium channel blockers 4. Adrenergic agents
29
What are the effects of diuretics?
- Decrease blood volume - Decrease re-absorption of H2O + electrolytes - Increase urine output
30
What are the 2 types of Renin-Angiotensin drugs?
1. ACE inhibitors | 2. Angiotensin II receptor blockers (ARBs)
31
What are the effects of ACE inhibitors?
- Vasodilate by inhibiting ACE | - Decrease blood volume
32
What are the effects of ARBs?
- Vasodilate | - Decrease blood volume
33
What are the effects of calcium channel blockers?
- Block calcium influx (muscle relaxation) - Decrease CO + HR - Optimize cardiac contractions
34
What are the effects of adrenergic antagonists?
- Vasodilation | - Decrease HR, conduction rate + contractility
35
What are the 4 types of diuretics?
1. Loop 2. Thiazides 3. Potassium sparing / Aldosterone antagonists 4. Osmotic
36
What are 5 potential side effects of diuretics?
1. Dehydration 2. Hyponatremia 3. Hypokalemia (loop, thiazide) 4. Hyperkalemia (potassium) 5. Nocturia
37
What is an example of a loop diuretic?
Furosemide (Lasix)
38
What are 2 examples of thiazides?
1. Hydrochlorothiazide (HZTZ) | 2. Chlorothiazide (Diuril)
39
What is an example of a K+ sparing drug?
Spironolactone (Aldactone)
40
What is an example of a thiazide + potassium sparing combo med?
Aldactazide * Balances potassium * PO
41
What are osmotic diuretics used to treat?
- Cerebral edema - Intraocular hypertension * Move fluid from brain --> body
42
What are 2 examples of osmotic diuretics?
1. Mannitol (Osmitrol) | 2. Isosorbide
43
``` The part of the nephron these drugs work on: Loop = ____ __ ____ Thiazides = ____ ____ ____ K+ sparing = ____ ____ Osmotic = ____ ____ and ____ __ ____ ```
Loop of Henle Distal convoluted tubule Distal tubule Proximal tubule, Loop of Henle
44
Where can angiotensin II receptors be found? (3 places)
- Blood vessels + heart - Adrenal cortex - Kidneys
45
Angiotensin II causes vaso____
constriction
46
What are 2 examples of ARBs?
1. Losartan (Cozaar) | 2. Ibesartan (Avapro)
47
What is a side effect of ARBs?
Hypotension
48
What is the 1st line of therapy for heart failure?
ACE inhibitors
49
What are 4 examples of ACE inhibitors?
1. Enalapril (Vasotec) 2. Captopril 3. Monopril 4. Ramipril (Altace)
50
What are 2 examples of thiazide diuretic + ARB combo drugs?
1. Hyazaar HCT | 2. Cosart-H
51
What are calcium channel blockers use to treat?
- Angina | - Some arrhythmias
52
What are 2 types of calcium channel blockers?
1. Vascular-selective | 2. Cardio-selective
53
Vascular-selective calcium channel blockers target ____ muscle meanwhile cardio-selective calcium channel blockers target ____ muscle
smooth, cardiac
54
What are 2 examples of vascular-selective drugs?
1. Nifedipine (Adalat) | 2. Amlopidine (Norvasc)
55
What are 2 examples of cardiac-selective drugs?
1. Verapamil (Isoptin) | 2. Diltiazem (Cardizem)
56
What are some side effects of calcium channel blockers?
- Dizziness, flushing, hypotension - Reflex tachycardia - Peripheral edema (pooling) - Dysrhythmias - Exacerbation of heart failure
57
Ginseng is a NHP and a calcium channel ____
antagonist
58
What are the 2 drugs used to treat atrial fibrillation?
1. Calcium channel blockers | 2. Beta blockers
59
What are 2 examples of beta blockers?
1. Propanolol | 2. Metoprolol
60
What are 2 examples of antiarrhythmic meds?
1. Digitoxin 2. Amiodarone * Narrow therapeutic indexes
61
Alpha 1 & 2 cause vaso____
constriction
62
Beta 1 receptors ____ heart rate and beta 2 receptors cause vaso/broncho____
increase, dilation
63
What are 2 endogenous catecholamines?
Norepinephrine (NE) & Epinephrine (E)
64
NE & E cause vaso____
constriction
65
How do adrenergic antagonists work?
Block adrenergic receptors --> block endogenous catecholamine activity ie) inhibit NE release
66
What are 3 examples of adrenergic antagonists and which receptors do they act on?
1. Antenolol (B1) 2. Propanolol (B1&2) 3. Metoprolol (B1)
67
What is an example of a thiazide diuretic + adrenergic antagonist combo med?
Lopressor HCT
68
What are centrally acting alpha 2 adrenergic agonists used to treat?
Resistant hypertension
69
What are some side effects of alpha 2 agonists?
- Hypotension | - Headache
70
What are 2 examples of alpha 2 agonists?
1. Clonidine (A2) 2. Methyldopa (A2)* * Prodrug

N216 A/B (26 decks)

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