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PHARMACOLOGY 2 > Whalen Chapter 17 > Flashcards

Whalen Chapter 17 Flashcards

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1
Q

Have a higher incidence of hypertension than do both non-Hispanic whites and Hispanic white

A

Non-Hispanic Blacks

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2
Q

Defined as either a systolic BP greater than 140 mmHg or sustained Diastolic BP greater than 90 mmHg

A

Hypertension

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3
Q

Top 2 cause of death in the world

A

Heart disease
Stroke

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4
Q

Regulated within a narrow range to provide
adequate perfusion of the tissues without causing damage to the vascular system, particularly the arterial intima (endothelium).

A

Arterial Blood Pressure

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5
Q

Act by changing the activity of the sympathetic nervous
system and is responsible for the rapid, moment-to-
moment regulation of blood pressure.

A

Baroreflexes

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6
Q

Provides long-term control of blood pressure by altering
the blood volume

A

Kidney

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7
Q

Potent circulating vasoconstrictor, constricting both arterioles and veins, resulting in an increase in blood pressure.

A

Angiotensin ll

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8
Q

The goal of this therapy is to reduce cardiovascular and
renal morbidity and mortality

A

Antihypertensive therapy

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9
Q

Stimulates aldosterone secretion leading to increased renal sodium reabsorption

A

Angiotensin ll

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10
Q

Can sometimes be controlled by Monotherapy

A

Mild hypertension

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11
Q

Patients with Diabetes

A

140/80 mm Hg

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12
Q

Patients with Chronic Kidney Disease and Proteinuria

A

130/80 mm Hg

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13
Q

Elderly patients

A

< 150/90 mm Hg

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14
Q

Used as an initial drug therapy for HTN

A

Thiazide diuretics

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15
Q

Effective in preventing Stroke, Myocardial infarction, and Heart failure

A

Low-Dose Diuretic Therapy

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16
Q

Useful in combination therapy (Beta blockers, ACE inhibitors, ARBs, PSB with exception of Metolazone

A

Thiazides

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17
Q

Acts promptly by blocking Sodium and Chloride reabsorption in kidney

A

Loop diuretics

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18
Q

Rarely used alone to treat HTN, but is commonly used to manage symptoms of Heart failure and Edema

A

Loop Diuretics

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19
Q

Aldosterone receptor antagonist examples

A

Eplerenone
Spironolactone

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20
Q

Inhibitors of Epithelial Sodium Transport at late distal and collecting ducts

A

Triamterene
Amiloride

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21
Q

Reduces potassium loss in urine

A

Eplerenone
Spironolactone

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22
Q

Have additional benefit of diminishing cardiac remodeling

A

Aldosterone antagonist

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23
Q

Treatment option for hypertensive patients with concomitant heart disease or failure

A

Beta blockers

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24
Q

Decreases sympathetic outflow and formation of Angiotensin ll

A

Beta blockers

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25
Prototype beta blocker
Propranolol
26
Selective blocker of B1 receptor examples that are most commonly prescribed beta blocker
Metoprolol Atenolol
27
May be administered cautiously in hypertensive patients who also have asthma
Selective beta blockers
28
Examples of Non-Selective Beta blockers
Propranolol Nadolol
29
Contraindicated in patients with asthma due to blockade of b2-mediated bronchodilation
Non-Selective Beta blockers
30
Orally active for the treatment of HTN
Beta blockers
31
Undergoes extensive and high variable first pass metabolism
Propranolol
32
Beta blockers available in intravenous formulations
Propranolol Esmolol Metoprolol
33
A/E of Beta blockers
Bradycardia Hypotension Decrease of Libido CNS S/E - Fatigue, Insomnia, Lethargy
34
Decreases High density lipoprotein cholesterol and Increases Triglycerides
Non-cardioselective Beta blockers
35
May disturb lipid metabolism
Non-cardioselective Beta blockers
36
1st line treatment of HTN in patient's with High-coronary disease risk or History of Diabetes
Enalapril Lisinopril
37
Responsible for the breakdown of Bradykinin
ACE inhibitors
38
Peptide that increases the production of Nitric oxide and Prostacyclin
Bradykinin
39
ACE INHIBITORS Bradykinin levels decreases, Angiotensin ll increases. TRUE OR FALSE
False
40
TRUE / FALSE ACE inhibitors also slows the progression of Diabetic Nephropathy and decreases Albuminuria.
True
41
Standard of patient following a myocardial infarction
ACE inhibitors
42
1st line drugs for treating HTN, Hypertensive patients with Chronic Kidney disease
ACE inhibitors
43
True or False All ACE inhibitors are orally bioavailable as a drug or produg
True
44
Undergoes hepatic conversion to active metabolites and is preferred in patients with severe hepatic impairment.
Captopril Lisinopril
45
Only ACE inhibitors not eliminated primarily by Kidney and does not require dose adjustment
Fosinopril
46
Only drug under this classification available intravenously
Enalaprilat
47
Thought to be due to the increase levels of Bradykinin and Substance P in the pulmonary tree
Dry cough
48
Rare but is a potentially life threatening reaction
Angioedema
49
An alternative to ACE inhibitors
Losartan Irbesartan
50
Decreases salt and water retention
ARBs
51
1st line agents for trt of hypertension especially in patients with compelling indication of diabetes
ARBs
52
These agents are teratogenic and should not be used by pregnant women
ARBs
53
Acts earlier in renin-angiotensin-aldosterone system and should not be routinely combined with ACE inhibitors or ARBs
Aliskiren
54
Aliskiren is metabolized by what?
CYP3A4
55
Recommended treatment option for Hypertensive patients with Diabetes and angina
Calcium channel blocker
56
3 chemical classes of CCB
Diphenylalkylamine Benzothiazepines Dihydropyridine
57
Drug under diphenylalkylamine that is the only drug available in US
Verapamil
58
Used to treat angina and supraventricular Tachyarrthmia and prevent migraines and cluster headache
Verapamil
59
Only drug under Benzothiazepines that is currently available in US
Diltiazem
60
Has a less pronounced negative inotropic effect and has favorable s/e profile
Diltiazem
61
Drugs under Dihydropyridine
Nifedipine Amlodipine Isradipine Felodipine Nicardipine Nisoldipine
62
Have a greater affinity with vascular cc than cc in the heart
Dihydropyridine
63
Blocks the inward movement of calcium by binding to L-type calcium channel
Calcium channel antagonist
64
Used in the treatment of Atrial fibrillation and should be avoided in patients with atrioventricular block
Diltiazem and Verapamil
65
Have a very long half-life and does not require sustained release formulations
Amlodipine
66
The S/E of Verapamil is Atrioventricular block and Constipation. True or False
True
67
May cause gingival hyperplasia
Nifedipine
68
Shown to reduce morbidity and mortality associated with heart failure
CARVEDILOL, Metoprolol succinate, Bisoprolol
69
Used in management of Gestational hypertension and Hypertensive emery
Labetalol
70
Produce a competitive block of a1 adrenoceptors
Prazosin, Doxazosin, Terazosin
71
Example of Centrally acting adrenergic drugs
Clonidine Methyldopa
72
Used primarily for trt of HTN that has not responded adequately to treatment with 2 or more drugs. And is available as a transdermal patch
Clonidine
73
Occurs following the abrupt withdrawal of CLONIDINE
Rebound HTN
74
Mainly used to manage HTN in pregnancy and is an a2 agonist that is converted to methylepinephrine
Methyldopa
75
Cause Hypertrichosis and is used topically to treat male pattern baldness
Minoxidil
76
Rare but a life threatening situation characterized by severe elevation of BP Systolic > 180 mm Hg Diastolic > 120 mm Hg
Hypertensive emergency
77
BP remains elevated (above goal) despite administration of 3-drug regimen
Resistant HTN
78
Medications used in Hypertensive emergency: CCB
Nifedipine Clevidipine
79
Medications used in Hypertensive emergency: Nitric oxide vasodilator
Nitroprusside Nitroglycerin
80
Medications used in Hypertensive emergency: Adrenergic Receptor antagonist
Phentolamine, Esmolol, Labetalol
81
Not effective in patients with inadequate kidney function
Thiazide diuretic

PHARMACOLOGY 2 (2 decks)

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