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antihypertensive agents
n/a
67
Pharmacology
Undergraduate 2
01/17/2011

Additional Pharmacology Flashcards

 


 

Cards

Term

 

 

Normal blood pressure

Definition

 

 <120 and <80

Term

 

Prehypertension

Definition

 

 120-139  or  80-89

Term

 

 

Stage 1 hypertension

Definition

 

 

140-159   or  90-99

Term

 

 

Stage 2 hypertension

Definition

 

 >160  or  >100

Term

 

 essential or primary hypertension

Definition

 

 90 to 95% of cases where cause is unknown

Term

 

 Ethnicity with highest rates of hypertension

Definition

 

african american

Term

 

 Chronic hypertension can lead to damage of....

Definition

 

The cardiovascular system

CNS

Renal system

Retinal damage

Term

 

Contributing Factors

Definition

 -Obesity

-Stress

-Lack of exercise

-Diet (excess salt)

-Alcohol Intake

-Cigarette Smoking

Term

 

 percentage of adults with hypertension

Definition

 

 50% of people over the age of 60

Term
Lifestyle Modifications
Definition

-reduce weight to normal BMI

-DASH eating plan

-Dietary Sodium reduction

-Increase Physical activity

-Reduce alcohol consumption

Term
most common drug choice for stage 1 hypertention
Definition
Thiazide-Type Diuretic
Term
Most common drug choice for Stage 2 hypertension
Definition

2 drug combination

 

-usually Thiazide-type diuretic and either an Ace inhibitor, Angiotensin receptor blocker, Ca channel blocker or a Beta blocker

Term
are used to reduce blood volume, which reduces venous return, which reduces stroke volume, which reduces CO, which decreases MAP
Definition
diuretics
Term
drugs that block myocardial contractility, which decreases SV, then CO, then MAP
Definition
beta blockers
Term
Adverse effect of Diuretics
Definition
Due to volume and sodium depletion, renin is secreted which will elevate the BP
Term
First choice diuretic for noncomplicated cases
Definition
thiazides
Term
2 types of thiazides
Definition
chlorothiazide & hydrochorothiazide
Term
loop diuretic
Definition
furosemide
Term
furosemide
Definition

-loop diuretic

-Has high ceiling

-used to get rid of edema fast

Term
potassium sparing diuretics
Definition

1. Spironolactone

 

2.Triamterene

 

3. Amiloride

Term
Sympatholytics
Definition

1. Selective Alpha-1 recep blockers (prazosin)

2.Beta-Adrenergic blockers(Propranolol)

3. Agents that act on CNS (methyldopa, clonidine)

Term
how do Selective Alpha-1 Antagonists decrease BP?
Definition
by decreasing PVR
Term
Adverse effect of using alpha-1 antagonist
Definition
1st dose phenomenon (orthostatic hypotension), fluid retention, dizziness, headache
Term
When and how are selective Alpha-1 antagonist used to treat hypertension?
Definition

-used in refractory HT

-used in stage 1 and 2 in combination with a diuretic and a beta blocker

Term
Selective alpha-1 antagonist
Definition
prazosin
Term
non-selective beta blocker (1st generation)
Definition
Propranolol
Term
Selective B1 blocker (2nd generation)
Definition
metoprolol
Term

B-blocker with intrinsic sympathomimetric activity (ISA)

3rd generation

Definition
Labetalol
Term
ways that beta blockers lower BP
Definition

1. block cardiac beta-1 receptors & lower CO

 

2. Block renal Beta-1 recepors & lower renin which lowers PVR

Term
Metoprolol
Definition
used to treat diabetes and asthma
Term
Labetalol
Definition
used to treat Reynaud's
Term
mechanism by which Propanolol works
Definition

blocks cardiac B1 to lower co

&

blocks renal B1 to lower renin & PVR

Term
propanolol main effects
Definition
decreases HR and PVR
Term
Adverse effecct Propranolol
Definition
bradycardia, blocks B2 receptors in airways
Term
Pharmacokinetics of Propranolol
Definition

heavily metabolized by first pass

30 to 50%

 

t1/2- 3-5 hrs

Term
prapanolol uses
Definition
Used for stage 1 and stage 2 alone or with a diuretic and/or vasodilator 
Term
propranolol drug interactions
Definition
cant be used with verapamil, diltiazem (Ca channel blockers) or Digitalis b/c they slow A/V node conduction
Term
Labetalol
Definition

A1, B1 and B2 blocker

Beta blocking is more prominent.

some ISA property

Term
When and how is Labetalol used?
Definition
Used in hypertensive emergencies and can be given both orally or by IV
Term
Drugs that act on CNS
Definition
Methyldopa & Clonidine
Term
Methyldopa
Definition
an A2 agonist that suppresses SNS output from the CNS
Term
Clonidine
Definition
a2 agonist that decreases SNS activity
Term
Methyldopa & Clonidine main effects
Definition
decrease PVR and HR
Term
Methyldopa & Clonidine Adverse effects
Definition
sedation, bradycardia, rebound hypertension, postural hypotension
Term
types of vasodilator drugs 
Definition

1. CA entry blockers

 

2. Potassium channel openers

 

3. direct acting vasodilators

Term
Names of Ca entry blockers
Definition

Verapamil

 

Diltiazem

 

Nifedipine

Term
Mechanism of action for Ca blockers
Definition
inhibit Ca entry through L-type voltage gated channels
Term
Nifedipine
Definition
Only blocks vascular Ca channel, no effect on the heart
Term
Nifedipine main effect
Definition
vasodilation, which lower PVR, which lower BP
Term
Nifedipine (Procardia) adverse effects
Definition
ankle edema, reflex tachycardia with short acting version (now have aProcardia SR)
Term
Nifedipine (Procardia)
Definition

Hypertension (most effective in african americans)

Not useful as Antiarrhythmic drug

Term
Verapamil & Diltiazem Mechanism for action
Definition
Block Ca channels in the vascuature and in the heart and A/V node
Term
Verapamil & Diltiazem Main effects
Definition
Vasodialate which leads to lower BP
Term
Verapamil & Diltiazem Adverse effects
Definition
ankle edema & others similar to nifedipine, but no reflex tachycardia
Term
Verapamil & Diltiazem Drug interactions
Definition
caution for AV block when used with beta blockers or digitalis
Term
Verapamil & Diltiazem Use
Definition
to treat hypertension, angina and arrhythmias
Term
Minoxidil
Definition

K channel opener

 opens Ca channels on smooth muscle, K leaves cell, cell hyperpolarizes, leads to vasodialation, which lowers PVR, which lower BP

Term
Minoxidil
Definition
relex tachycardia, Na and fluid retention
Term
Na-Nitroprusside
Definition

Vasodilator

 

-metabolite is NO, which activate cGMP, which vasodialates arteries and veins, which lower PVR, which lowers BP

 

Term
Na-Nitroprusside Adverse Effects
Definition
Reflex tachycardia, can lead to severe hypotension
Term
When is Na-Nitroprusside used?
Definition

In hypertensive emergencies

 

Its very fast acting and has a short half life

Term
Drugs that effect RAS (renin Angiotensis system)
Definition

ACE inhibitors (captopril)

 

Angiotensin II receptor blockers (Losartan)

Term
Captopril
Definition

ACE inhibitor

 

-inhibits ACE, which decreaces Ang II, which decreaces PVR, which decreaces BP

Term
Captopril adverse effects
Definition
cough, hyperkalemia
Term
Captopril Uses
Definition
used in stage 1 and 2 hypertension, Congestive heart failure
Term
Losartan
Definition

Angiotensin II receptor blocker

 

-selectively blocks Ang II AT-1 receptor, which decreases PVR, which decreases BP

Term
Losartan Adverse Effects
Definition
some Hyperkalemia as in ACE inhibitors, but no cough
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