Vasodilators and Sympatholytics DSA II Flashcards Preview

RENAL II Exam 3 > Vasodilators and Sympatholytics DSA II > Flashcards

Flashcards in Vasodilators and Sympatholytics DSA II Deck (42):
1

beta3 agonist

nebivolol

2

propranolol

non-selective beta blocker
-decreased BP and CO

3

beta1 in kidney

blockade inhibits renin release

4

esmolol

not available oral

5

lipophilic sympathplegics

propranolol and penbutolol

6

asthma/COPD

adverse effects of beta-2 blockade with sympatholytics

7

diabetes

glycogenolysis blocked after beta-2 blockade
-use sympatholytics w/ caution

8

cardiac arrhythmias

caution sympatholytic use
-cardiac decompensation

9

side effect of sympatholytics

fatigue, bradycardia, sexual dysfunction, depression

10

chronic sympatholytic use

high lipid plasma leels

11

sudden sympatholytic withdrawal

rebound hypertension, angina, possible MI

12

drug-drug interactions sympatholytics

with CCBs - verapamil and diltiazem
-heart block

13

HTN Tx

metoprolol and atenolol

-beta-1 selective antagonist

14

carvedilol and labetalol

non-selective beta blockers
alpha 1 blockers

15

heart failure Tx

carvedilol, bisopril, metoprolol
-reduce mortality

-may worse CHF - careful long term use

16

bisoprolol

beta1 selective antagonist

17

ISA

intrinsic sympathomimetic activity
-labetolol, acebutolol, nevibutolol

18

non-ISA

no intrinsic sympathomimetic activity
-propranolol, carvedilol, metoprolol, atenolol

19

ischemic heart disease Tx

beta blockers - reduce angina episodes
-increased exercise tolerance
-timolol, metoprolol, propranolol - prolong survival after MI

20

cardiac arrhythmia Tx

beta blockers - supraventricular and ventricular arrhythmias

21

glaucoma Tx

topical timolol, btaxolol, carteolol

22

prazosin

alpha1 antagonist
-prevent constriction of arteries and veins
-BP reduced - decreased TPR
-relaxes prostate smooth m
-without diuretic - Na and water retention

does not effect alpha-2 receptor inhibition of NE release (decreased reflex tachycardia)

23

men with HTN and BPH

prazosin

24

central acting alpha-2 agonists

clonidine and methyldopa

-reduce sympathetic outflow from vasomotor centers of brainstem

rarely used today

25

pregnancy HTN

methyldopa

26

clonidine

decreases BP - via decreased CO and TPR

-sedation, dry month, depression, sexual dysfunction

27

methyldopa

lower BP by reducing TPR
-analog of L-dopa
-converted to alpha-methylnorepinephrine

-sedation dry mouth, lack of concentration, sexual dysfunction

28

HTN in pregnancy

stroke risk - SBP > 160 and DBP > 110

consider mother and fetus

29

drugs for HTN in pregnancy

acute - labetalol, hydralazine, CCB, nitro
chronic - methyldopa, labetalol, nifedipine, hydralazine

30

contraindicated for HTN in pregnancy

ACE (-), ARBs, direct renin inhibitors - fetal abnormalities

nitroprusside - CN poisoning

31

hypertensive emergency

>180/120 with acute end organ damage

goal - gradual reduction of BP without excessive hypotension

32

most effective for hypertensive emergency

sodium nitroprusside
-long term - possible CN poisoning

33

cardiac ischemia or after coronary bypass surgery with hypertensive emergency

nitroglycerin

34

hypertensive emergency meds

nicardipine, clevidipine - DHP-CCB

fenoldopam - dilates renal arteries - good choice for pt with renal dysfunction

hydralazine - pregnancy related to eclampsia

35

phentolamine

alpha-blocker
-treat pts with HTN due to elevated catecholamines
-cocaine intox, pheochromocytoma

36

esmolol

rapid, short acting beta1 blocker
-treat aortic dissection or post-op HTN

37

labetolol

alpha and beta blocker
-safe for patients with active coronary disease

38

initial monotherapy in essential HTN

thiazide
ACE (-)
ARB
CCB
**beta blockers NOT used unless specific indication

39

black pt with essential HTN

better to thiazide diuretics and CCBS
-worse to ACE (-) and beta-blockers

40

monotherapy vs. polytherapy in HTN

mono - pt compliance, decreased cost, less adverse effects

poly - each drug acts on one of set of interacting mutually compensatory mechanisms
-decreased toxicity (2-3 drugs at low dose as opposed to one at higher dose)

41

example HTN combo drugs

ACE (-) and CCB
-trandolapril/verapamil

ACE (-) and diuretic
-benazepril/HCTZ

ARB and diuretic
-valsartan/HCTZ

beta-blocker and diuretic
-propranolol/HCTZ

central agent and diuretic
-reserpine/chlorothiazide

diuretic and diuretic
-spironolactone/HCTZ

42

triple drug regimens

thiazide diuretic, DHP-CCB, and
-ACE (-), ARB, or renin (-)