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44 Cards in this Set

  • Front
  • Back
What are the beta blockers?
-olol, propanolol, timolol, neviolol, pindolol, antenolol, labetalol, carvediol, metoprolol, nadaolol
What is the action of beta blockers?
decreases output and work on the heart, maintenance therapy in CHF, minimizes symptoms of hyperthyroidism, decreases renin production (decreases blood pressure)
How does angiotensin 2 promote increase in blood pressure?
induces increase in aldosterone (increases Na+ and water retention, vasoconstriction, inhibits bradykinin (vasodialation)
What are side effects of beta blockers?
fatigue, insomnia, impotence, decreased HDL, increased triglycerides
What patient population are non-selective beta blockers contraindicated in?
patients with COPD and asthma
What are beta one blockers?
ABEAM--acebutolol, bisoprolol, betaxolol, atenolol, metoprolol

*give to patients with COPD and asthma (no lung effects)
What is the MOA of thiazides?
block sodium uptake in the DCT-->increased Na+ excretion (and water follows)-->decreased blood volume-->decreased cardiac output
What are the side effects of thiazides?
hypokalemia, hypercalcemia, hyperuricemia,
What is the effect of calcium channel blockers?
vasculature and heart. Nifedipine (vasculature only) verapamil (heart and vasculature)
What are the side effects of Ca++ channel blockers?
constipation, vertigo, headache, fatigue and hypotension
What is the MOA of ACE inhibitors?
inhibit conversion of angiotensin 1 to 2, thus inhibiting the actions of angiotensin 2 (vasoconstriction, Na+ reabsorption, inhibits bradykinin)
What are the names of ACE inhibitors?
PRILS-->capto-pril, lisino-pril, enala-pril
What are the side effects of ACE inhibitors?
cough, rash, fever, altered taste, hypotension, hyperkalemia, and angioedema, first dose syncope, fetotoxic
What is the MOA of alpha blockers and drug names?
OSINS--praz-osin, teraz-osin

arteriolar vasodialation, decreased peripheral resistance and decreased arterial blood pressure
What is the MOA of angiotensin 2 antagonists and the names?
Losartan, cande-sartan, val-sartan

Block angiotensin 2 receptor-->vasodialationa and decreased aldosterone production
How are angiotensin 2 antagonists different from ACE inhibitors?
ACE-->inhibits ALL production of angiotensin 2

angiotensin 2-->inhibits angiotensin 2, decreases angiotensin 2 production, some is still there
What is the MOA of clonidine?
alpha 2 agonist, depresses sympathetic outflow-->decreases blood pressure by decreasing sympathetic effects on CV system
What is the MOA of hydralizine?
smooth muscle relaxant-->vasodialation
What is the MOA of alpha-methyldopa?
central alpha 2 agonist
What does alpha 2 normally do?
decreases neurotransmitter release from NE, thus if you antagonize you can decrease amt of epinephrine released
What is the MOA of sodium nitro-prusside?
vasodialator
What is the MOA of alpha-methylodpa?
central alpha 2 agonist
What is a side effect of minoxidil?
hair growth (hyper-trichosis)
Why is nitroprusside dangerous?
can be poisionous if given orally, hydrolyzes to cyanide
What is the DASH diet?
diet rich in potassium, calcium, low in sodium and fat, lots of fruits and veggies
What is the target blood pressure in someone with artery dz risk (excluding coronary artery dz) ex: stable agina, MI?
<120/80
What are the meds recommended for anyone with blood pressure >140/90?
1. Thiazide

2. Stage 2 HTN BP>160/100
2 drugs + thiazide
What is the target blood pressure for someone with high risk for coronary artery dz?
<130/80
What are the meds recommended for someone with high risk for coronary artery dz? **Excludes those with kidney dz or diabetics
1. Thiazides

2. Stage HTN BP >160/100
2 drugs + thiazide

3. Ca++ channel blocker or thiazide
What are the meds recommended for someone with high risk for coronary artery dz and has kidney dz or are diabetic?
1. ACE or ARBs
2. another drug (avoid thiazide)
What are the meds recommended for someone with artery dz risk (excluding coronary artery dz) ex: stable agina, MI?
1. beta blocker + ACE inhibitor or angiotensin 2 antag

2. Ca ++ channel blocker or thiazide

**if beta blocker is not tolerated do verapamil or diltiazam (Ca++ channel blockers that work on the heart)
What is the blood pressure recommended for people before medication (except those with coronary artery dz or heart problems like angina)?
<140/90
What is the target blood pressure for those with CHF?
<120/80
What are the meds recommeded for someone with CHF?
3 drug regimen
1. beta blocker + ACE inhibitor/ACE antag + loop diuretic/thiazide

2. African Americans, add hydralazine or issorbide dinitrate
What is the DOC for heart failure?
Digoxin--increases myocardial contractility, MOA is unknown
How do we define hypertensive emergency (BP)?
systolic >210, diastolic >150

**if patient has cerebral hemorrhage or CHF then diastolic >130
What is the treatment for hypertensive emergency?
sodium nitroprusside, diazoxide, or labetalol
What is the effect of nitro-prusside?
vasodialates BOTH arteries and veins, decreases cardiac preload

**if problems, give with sodium thiosulfate IV
What is diazoxide?
direct arterolar vasodialator (similar to hydralazine)
What are the drugs that are both alpha and beta blockers?
labetalol and carvediolol
What are the side effects of alpha blockers?
reflex tachy and first dose syncope
Do we use ARBs (Angiotensin 2 receptor blockers, end in -sartan) or ACE-inhibitors for people with respiratory issues?
**Give ARBs, because bradykinin levels are not increased, no cough associated
What is the MOA of spironolactone?
aldosterone antagonist, K+ sparing diuretic

inhibits aldosterone-->inhibits aldosterone mediate N+ and water uptake in the DCT and collecting duct

**sodium is not reabsorbed, potassium not exchanged-->don't lose K+
What are the side effects of spironolactone?
hyperkalemia, metabolic acidosis, hormone related side effects (mentraual irregularities and gynecomastia), structurally similar to sex hormones