Anti-Hypertensives

Front 1

Difference between labile hypertensive and well established hypertensive

Back 1

labile = increase CO but normal TPR
well est. = normal CO but increase TPR

labile can => well est. because overperfusion of tissues can lead to autoregulatory decrease in flow (vasoconstriction)

Front 2

Early vs late phase of reduction of BP by diuretics

Back 2

early phase - decrease in CO and no change TPR

late phase - return of CO to normal values and decrease TPR

Front 3

What is the cause of early reduction of CO w/ diuretics?

Back 3

loss of fluid and electrolytes which lowers mean circulatory pressure and therefore venous return and CO

Front 4

cause of progression from early phase to late phase w/ diuretics

Back 4

autoregulatory changes in resistance to flow and local control mechanisms

Front 5

Diuretics are adequate to control BP in...

Back 5

mild hypertensive patients
- often used in combination with other antihypertensives in moderate to severe hypertension

Front 6

What is the relationship between beta blockers and plasma renin activity in terms of BP lowering effect?

Back 6

patients with normal and high plasma activity have more dramatic BP lowering effect

hypertensive patients with low renin activity will benefit from beta blocker + diuretic

Front 7

hydralazine

Back 7

- weak antihypertensive agent
- dilates only resistance vessels.. this increases venous return, which increases CO
- can be used with diuretic and b-blocker to block these compensatory changes

Front 8

Best antihypertensives for the elderly

Back 8

Ca2+ channel blockers
diuretics

Front 9

mechanism of enalipril

Back 9

ACE inhibitor
- prevent formation of angiotension II, may also potentiate bradykinin

Front 10

adverse effect of ACE inhibitor

Back 10

- may cause severe hypotension in hypovolemic patients.. caution when using with diuretic
- acute renal failure
- hyperkalemia
- cough

Front 11

losartan

Back 11

angiotension II antagonist
- similar effects to ACE inhibitor, not associated with cough