Anti Htn Drugs

Front 1

hydraulic equation for BP?

Back 1

CO x TPR = BP

drugs should reduce either CO or TPR

Front 2

Major classes of anti-HTN?

Back 2

ABCD

ACE inhibitor
Blockers
Calcium Channel Blocker
Diuretics

Front 3

Targets of anti-hypertensives?

Back 3

Vasomotor Center
Sympathetic nerve terminals
Beta receptors of heart
Sympathetic ganglia
Angiotensin receptors of vessels
alpha-receptors of vessels
Vascular smooth muscle
Kidney tubules
beta-receptors of JGA that release renin
Angiotensin converting enzyme

Front 4

methyldopa

Back 4

acts on vasomotor center: stimulates presynaptic a2-receptors to inhibit NE release

lower TPR and some CO

indication: moderate HTN and often combined with thiazide diuretic

Front 5

methyldopa toxicities?

Back 5

- drug-induced positive Coombs' test associated with hemolytic anemia
- lactation and prolactin release
- edema
- sedation
- impotence
- dry mouth
- hepatitis

Front 6

clonidine

Back 6

stimulates central a2-adrenergic receptors

lower TPR and some CO decrease

for mild to moderate HTN

Front 7

clonidine toxicities?

Back 7

- sedation
- dizziness
- dry mouth
- rebound HTN after sudden withdrawal from high doses

Front 8

clonidine should not be combined with which drugs?

Back 8

tricyclics; they inhibit clonidine's actions

Front 9

guanfacine

Back 9

centrally acting anti-HTN with mxn of action and side effect similar to clonidine

Front 10

what drug do you give to old men with HTN and BPH?

Back 10

a1 blockers:
- prazosin
- terazosin
- doxazosin

Front 11

prazosin, terazosin and doxazosin

Back 11

a1 blockers to treat moderate HTN

Front 12

toxicities of prazosin, terazosin and doxazosin?

Back 12

- dizziness
- orthostatic hypotension (after 1st dose)
- headache

Front 13

what do you risk when giving beta-blockers to pts with essential HTN over age of 60yrs?

Back 13

stroke

Front 14

in what part of the body do a1 blockers work?

Back 14

decrease peripheral vascular resistance; minimal decrease in CO

Front 15

what anti HTN drugs reduce renin release?

Back 15

beta blockers

Front 16

bronchoconstriction and reduced HDL and increased plasma tracylglycerol is a side effect in what anti-HTN drugs?

Back 16

beta blockers

Front 17

reserpine and guanethedine mxn?

Back 17

block the release of stored NE

Front 18

what effect do diuretics have on plasma lipid conc.?

Back 18

increases

Front 19

hydralazine

Back 19

- dilate arteriolar smooth muscle to decrease PVR
- in moderate HTN and CHF

Front 20

hydralazine better for african americans or whites?

Back 20

african americans; use ACE-inhibitors for whites

Front 21

what is flomax (tamsulosin)?

Back 21

alpha 1 blocker - acts on BPH withouth the anti HTN effects

Front 22

what kind of alpha1 receptors are in the prostate?

Back 22

75% are alpha1A (tamsulosin)

Front 23

minoxidil

Back 23

arteriolar vasodilator used for severe HTN; blocks K+ channels, resulting in hyperpolarization and relaxation of smooth muscle cells

Front 24

sodium nitroprusside

Back 24

release NO -> stimulate guanylyl cyclase -->
increase production of cGMP --> decrease Ca++ ions
--> relaxation of smooth muscle in both arteries and veins

Front 25

sodium nitroprusside side effects?

Back 25

- cyanide toxicity (cyanide ions made during metabolism of sodium nitroprusside)

Front 26

how do you treat cyanide toxicity?

Back 26

infusion of rhodanese

Front 27

where is ACE located?

Back 27

lungs; convert ATI to ATII

Front 28

what does ATII do?

Back 28

potent vasoconstrictor and stimulates release of aldosterone

Front 29

what does aldosterone do?

Back 29

increase Na and water retention

Front 30

what do ACE inhibitors do?

Back 30

block conversion of ATI to ATII and boosts bradykinin levels (potent vasodilator)

Front 31

what are 4 ACE inhibitors?

Back 31

captopril
lisinopril
enalapril
benazepril

Front 32

what drug interaxn should you watch for in ACE inhibitors?

Back 32

NSAIDs can reduce vasodilatory effects; NSAIDs block bradykinin

Front 33

how is bradykinin formed?

Back 33

kininogen is converted to bradykinin by kallikrein

Front 34

what effect does bradykinin have on prostaglandin synthesis?

Back 34

increases prostaglanding synthesis

Front 35

name two ARBs (angiotensin receptor blockers)

Back 35

losartan and valsartan

Front 36

what are 3 adverse effects of losartan and valsartan?

Back 36

1. headache
2. hyperkalemia - especially in pts taking potassium-sparing diuretics
3. hypotension

Front 37

what 2 anti-HTN meds are contraindicated in pregnancy?

Back 37

ACE inhibitors and ARBs