Pharmacology - Antihypertensive Drugs (Exam 3)

Question 1

What are the antihypertensive drug classes?

Answer 1

1. Diuretics
2. ACE Inhibitors
3. Angiotensin antagonists
4. Calcium channel blockers
5. Beta blockers
6. a1 blockers
7. Renin inhibitors

Question 2

What is the mechanism of diuretics?

Answer 2

Lose salt
Lose water

Question 3

What is the effect of diuretics?

Answer 3

Decrease BP and blood volume

Question 4

What do ACE inhibitors target?

Answer 4

Renin-Angiotensin-Alodersterone (RAA) system

Question 5

What is the mechanism of ACE inhibitors?

Answer 5

Inhibit angiotensin converting enzyme (ACE) from converting angiotensin I into angiotensin II

Question 6

What does angiotensin II do?

Answer 6

1. Increase aldosterone (leads to increased Na+ reabsorption, water retention, and blood volume)
2. Increase vasoconstriction and thirst (leads to increased resistance and water intake)

Question 7

What suffix do ACE inhibitors have?

Answer 7

“-pril”

(think: April)

Question 8

What is the other mechanism of ACE inhibitors?

Answer 8

Increase level of bradykinin, which makes ACE inactive

Question 9

What does increasing the level of bradykinin cause?

Answer 9

Vasodilation
Cough

Question 10

What are the main benefits of ACE inhibitors?

Answer 10

1. Decreased angiotensin II and aldosterone levels
2. Increased bradykinin levels
3. Increased vasodilation
4. Decreased BP and blood volume

Question 11

ACE inhibitors have ____________ effect even in patients without _________ activities

Answer 11

antihypertensive; high-renin

Question 12

T/F ACE inhibitors have little effect on cardiac output

Answer 12

True

Question 13

T/F ACE inhibitors cause orthostatic hypotension and tachycardia

Answer 13

FALSE

Question 14

T/F ACE inhibitors do not induce salt and water retention

Answer 14

True

Question 15

ACE inhibitors cause _________ mortality in patients following acute myocardial infarction and chronic systolic heart failure

Answer 15

decreased

Question 16

ACE inhibitors cause ________ chronic hypertension-induced ________ damage

Answer 16

decreased; renal

Question 17

ACE inhibitors have protective effects in __________ patients

Answer 17

diabetic

Question 18

T/F ACE inhibitors cause increased deterioration of renal function in diabetic nephropathy

Answer 18

FALSE, they cause decreased deterioration

Question 19

What are the adverse effects of ACE inhibitors? (VERY IMPORTANT FOR EXAM)

Answer 19

1. Dry cough
2. Reduced taste
3. Angioedema
4. Hyperkalemia

Question 20

ACE inhibitors are contraindicated in which patients?

Answer 20

Pregnant women

Question 21

What is the mechanism of Angiotensin Receptor Blockers/Antagonists (ARBs)?

Answer 21

Inhibit angiotensin II

Question 22

What suffix do Angiotensin Receptor Blockers/Antagonists (ARBs) have?

Answer 22

“-sartan”

(think: art = Angiotensin Receptor anTagonist)

Question 23

Angiotensin Receptor Blockers/Antagonists (ARBs) are selective for what receptor?

Answer 23

AT1 receptor

(angiotensin II receptor type 1)

Question 24

What do AT1 receptors do when activated?

Answer 24

Vasoconstriction (increase BP)

Question 25

What do AT2 receptors do when activated?

Answer 25

Vasodilation

Question 26

What drug is a renin inhibitor?

Answer 26

Aliskiren

Question 27

What is the mechanism of renin inhibitors? What does renin do?

Answer 27

Inhibits renin, which is the rate-limiting enzyme in the RAA system

Question 28

What are the 3 RAA system inhibitors?

Answer 28

1. ACE inhibitors 2. Angiotensin receptor blockers/antagonists 3. Renin inhibitor

Question 29

What can the RAA system inhibitors cause?

Answer 29

Hyperkalemia Hypotension

Question 30

What are the contraindications of RAA system inhibitors?

Answer 30

Bilateral renal artery stenosis Pregnancy

Question 31

What is the mechanism of calcium channel blockers (CCBs)?

Answer 31

Block calcium channels; causes relaxation and vasodilation

Question 32

What are the 2 main groups of calcium channel blockers (CCBs)?

Answer 32

1. Non-dihydropyridines 2. Dihydropyridines

Question 33

What drugs are non-dihydropyridines?

Answer 33

1. Verapamil 2. Diltiazem

Question 34

What suffix do dihydropyridines have?

Answer 34

"-dipine" (think: 2 pine trees on their side looks like a B, so they are CCBs)

Question 35

What do non-dihydropyridines do?

Answer 35

Decrease contractility

Question 36

What do dihydropyridines do?

Answer 36

Increase vasodilation

Question 37

What do CCBs cause in membrane potential?

Answer 37

Slow depolarization Increase length of phase 0 (causes decreased automaticity, conduction speed, HR)

Question 38

Which drugs are sympatholytic?

Answer 38

1. B blockers ("-lol") 2. Selective a1 blockers ("-osin") 3. Centrally acting a2 agonists (ex: clonidine)

Question 39

What do B blockers cause in membrane potential?

Answer 39

Block sympathetic stimulation; inhibits the steep sympathetic "slope"

Question 40

What drugs are direct acting vasodilators?

Answer 40

1. Hydralazine 2. Minoxidil

Question 41

T/F Controlling hypertension often requires multiple drug therapies

Answer 41

True

Question 42

What are the compensatory mechanisms your body has when taking direct acting vasodilators to decrease BP? What drug can be added to resist the compensatory mechanism?

Answer 42

1. Baroreceptor reflex and increased sympathetic discharge -> reflex tachycardia (increases HR); B blockers can resist this 2. Decreased renal artery perfusion pressure -> increased renin and fluid retention; ACEI and ARBs can resist this

Question 43

What is a non-pharmacological approach for hypertension?

Answer 43

Decreased Na+ intake

Question 44

Sudden and severe increase in BP

Answer 44

Hypertensive emergency

Question 44

Blood pressure drugs can cause __________ ___________

Answer 44

Orthostatic hypotension

Question 44

What is the formula for blood pressure?

Answer 44

BP = Flow x TPR (flow = cardiac output)

Question 44

Stress + __________ = hypertensive crisis (in uncontrolled hypertension)

Answer 44

Epinephrine

Question 45

What is hypertension defined as?

Answer 45

> than or = to 140/90

Question 46

What increases risk of cardiovascular disease, stroke, renal, and retinal damage?

Answer 46

Hypertension