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Pharma hypertension
Pharma hypertension
20
Pharmacology
Graduate
04/03/2010

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Term
Defined or seondary causes of hypertension
Definition
Coarctation of the aorta
REnal artery constriction
Cushing's disease
Term
Diuretics
sympatholytics
vasodilators
Anti Renin-ang
Definition
Treatment targets of Hypertension
Term
Cap=
PVR=
Definition
Capacitance venules
Peripheral vascular Resistance
Term
Mild-disease=
Definition
Monotherapy
Term
Moderate/severe HTN(hypertension)
what type of therapy?
Definition
Polytherapy
Term
First class of Anti Hypertensives:
Definition
Diuretics
Term
Thiazide Diuretics: Molecular Target
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
Term
Thiazide Diruetics:
What is the electolyte effects.
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.
Term
Thiazide Diuretics:/
Toxicities/Interactions
Definition
Hypokalemia: due to indirect consequence on electrolyte balance through prinicpal cells in collecting tubule.
Sulfonamide dependent allergic responses.
Term
Class 1: Hydrochlorothiazide (Thiazide) summary
Class
Max effect on BP lowering
MOA
Side effects
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
Term
First-step antihypertensive therapy for CVD
Definition
Thiazide-type diuretics are superior
Term
Sympatholytic Drugs in the CNS
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
Term
Sympatholytics acting in CNS
Class
Max effect on BP lowering
MOA
Side effects
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
Term
Sympatholytics
targets B1 and B2 acting in Nerve ending
Definition
Reserpine
Max BP-down effect
Useful at low doses
Toxicities-depression
Term
Inotropy?
Chronotropy?
Dromotropy?
Definition
Inotropy-Strength of each heart beat
Chronotropy-Rate of heart beat
Dromotropy-Conduction velocity with
Term
Prazosin alpha 1
MOA
Adverse effects
Definition
Vessel relaxation; PVR down
Adverse effects-postural or orthostatic
1st dose effect
little compensatory tachycardia
Term
Summary Prazosin
Class:
MAx effect on BP lowering
MOA
Side effects
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
Term
Propranolol(B1=B2)Beta blockers)
2 MOA what are they
Adverse effects
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
Term
Class 2 sympatholytics
Summary: Propranolol
Max effect on BP lowering: Approx. Systolic 10 mm HG
MOA
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
Term
HTN
Definition
>130systolic or >90 diastolic
Tx 4 classes of drugs
Diureteics-Thiazides
Sympatholytics-Clonidine,Prazosin,propranolol, Me dopa
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