Term
| Defined or seondary causes of hypertension |
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Definition
Coarctation of the aorta
REnal artery constriction
Cushing's disease |
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Term
Diuretics
sympatholytics
vasodilators
Anti Renin-ang |
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Definition
| Treatment targets of Hypertension |
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Term
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Definition
Capacitance venules
Peripheral vascular Resistance |
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Term
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Definition
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Term
Moderate/severe HTN(hypertension)
what type of therapy? |
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Definition
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Term
| First class of Anti Hypertensives: |
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Definition
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Term
| Thiazide Diuretics: Molecular Target |
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Definition
Bind to the electroneutral NaCl cotransporter
Thiazides impair Na and CL reabsorption in the early distal tubule (section responsible for 8-10% absirption)
Low ceiling |
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Term
Thiazide Diruetics:
What is the electolyte effects. |
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Definition
Increase in NA,Cl excretion through direct action on the elctroneutral NA/CL cotransporter.
Increase in K excretion thhrough indirect effect on principal cells of collecting tubule. |
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Term
Thiazide Diuretics:/
Toxicities/Interactions |
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Definition
Hypokalemia: due to indirect consequence on electrolyte balance through prinicpal cells in collecting tubule.
Sulfonamide dependent allergic responses. |
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Term
Class 1: Hydrochlorothiazide (Thiazide) summary
Class
Max effect on BP lowering
MOA
Side effects |
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Definition
Diuretic
Max effect on BP lowering
MOA-Blocks Na/Cl Absorption by Transporter in DCT of Kidney causing decrease in blood volume
Side effects: Hypokalemia, sulfonamide dependent allergic responses |
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Term
| First-step antihypertensive therapy for CVD |
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Definition
| Thiazide-type diuretics are superior |
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Term
| Sympatholytic Drugs in the CNS |
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Definition
Clonidine-upon cessation Rebound SPIKE in BP with risks-caused by down regulation
Methyldopa-no spike in BP upon cessation Renal flow preserved
FDA approved |
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Term
Sympatholytics acting in CNS
Class
Max effect on BP lowering
MOA
Side effects |
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Definition
Alpha MEDOPA, Clonidine
Max effect on BP lowering Systolic 30mm HG
MOA: Activates alpha-2 receptors in CNS causing a decrease in release of NE
Side effects: Dry mouth,sedation depression,rebound hypertension if clonidine therapy is stopped suddenly, no rebound spike with alpha-MeDOPA |
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Term
Sympatholytics
targets B1 and B2 acting in Nerve ending |
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Definition
Reserpine
Max BP-down effect
Useful at low doses
Toxicities-depression |
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Term
Inotropy?
Chronotropy?
Dromotropy? |
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Definition
Inotropy-Strength of each heart beat
Chronotropy-Rate of heart beat
Dromotropy-Conduction velocity with |
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Term
Prazosin alpha 1
MOA
Adverse effects |
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Definition
Vessel relaxation; PVR down
Adverse effects-postural or orthostatic
1st dose effect
little compensatory tachycardia |
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Term
Summary Prazosin
Class:
MAx effect on BP lowering
MOA
Side effects |
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Definition
Class: Sympathetic Receptor Blocker
Max effect on BP lowering:Approx Systolic 20mmHG
MOA: Inhibits alpha 1 receptors in arterioles and venules, decreases PVR (BP=COxPVR)
Side effects: first-dose hypotension in upright position, relatively mild other side effects,dizziness,palpitations, headache, and lassitude |
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Term
Propranolol(B1=B2)Beta blockers)
2 MOA what are they
Adverse effects |
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Definition
Cardiac output-down (rate and force)down
Renin release (Down)
B2 block ASTHMA!!! B1 selective
Heart block (AV node)
Sleep alterations, Depression
Alterations in lipids (VLDL up, HDL down |
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Term
Class 2 sympatholytics
Summary: Propranolol
Max effect on BP lowering: Approx. Systolic 10 mm HG
MOA |
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Definition
MOA inhibits B1 B2 in heart decreases CO (BP=COxPVR)
2. Inhibits Renin release (mediated by B1 receptors in kidney) decreasing both CO and PVR.
Side eggects |
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Term
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Definition
>130systolic or >90 diastolic
Tx 4 classes of drugs
Diureteics-Thiazides
Sympatholytics-Clonidine,Prazosin,propranolol, Me dopa |
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