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42 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What systolic and diastolic values constitute hypertension?
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- sustained diastolic greater than 90 mmHg
- sustained systolic greater than 140 mmHg *generally greater than 140/90 |
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What drugs are used to treat hypertension?
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- Diuretics
- Vasodilators - Beta blockers - ACE inhibitors - Angiotensin II antagonists - Calcium Channel Blockers - Alpha blockers - Centrally-acting adrenergics |
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what systolic and diastolic values constitute a hypertensive emergency?
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- diastolic greater than 150 mmHg in healthy patients
- diastolic greater than 130 mmHg in complicated patients |
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What antihypertensive drug can be used to treat preeclampsia and HTN encephalopathy?
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Diazoxide
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What IV drug can be used in hypertensive emergency
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Sodium nitroprusside (lowers BP in all patients)
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What vasodilators are used to treat hypertension?
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- Hydralazine
- Minoxidil |
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Which vasodilator can be used in severe or malignant hypertension?
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Minoxidil
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What other conditions can Diuretics treat or prevent besides hypertension?
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- cardiovascular accidents
- myocardial infarction - congestive heart failure |
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How do Thiazide diuretics work?
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1) act on DISTAL tubule
2) inhibit Na/Cl co-transport 3) increase Na/H2O excretion 4) decrease blood volume 5) decrease cariac output 6) decrease BP |
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Thiazide diuretics are not effective in lowering BP in which type of patient?
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Patients with poor kidney function.
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Thiazide diuretics can be used in combination with which other types of antihypertensive drugs?
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ACE inhibitors and Beta blockers
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For what conditions are Thiazide diuretics contraindicated?
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- diabetes (ketoacidosis)
- hyperlipidemia |
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What are the most powerful diuretics?
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Loop diuretics
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What are the types of diuretics used to treat hypertension?
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1) Thiazide diuretics
2) Loop diuretics *end in 'ide' |
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How do Loop diuretics work?
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1) Decrease Na, K, and Cl reabsorption in the ASCENDING loop
2) increase renal blood flow |
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Where do Loop diuretics work?
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the ASCENDING loop
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Where do Thiazide diuretics work?
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the DISTAL tubule
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How do Beta blockers work?
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1) decrease cariac output (B1 receptor inhibition)
2) decrease release of Renin |
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Nonselective Beta blockers are contraindicated for which conditions?
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Patient with pulmonary disease (asthma, COPD, etc)
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Why are nonselective Beta blockers contraindicated in patients with pulmonary disease?
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Blockade of B2 receptors causes bronchoconstriction.
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What are some examples of Beta blockers used to treat hypertension?
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Propranolol, acebutolol, atenolol, metaprolol, esmolol, pindolol, labetolol
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all end in 'olol'
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What are some side effects of Beta blockers?
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- impotence
- rebound hypertension with abrupt withdrawal - fatigue |
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How do ACE inhibitors work to treat hypertension?
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1) decrease sympathetic output
2) decrease angiotensin II and aldosterone 3) increase vasodilation 4) increase bradykinin |
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ACE inhibitors are best for what types of patients?
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1) White, young patients
2) pts with CHF |
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What are some examples of ACE inhibitors?
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catopril, enalapril, fosinopril, quinapril, lisinopril
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all end in 'pril'
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Which antihypertensive drug is a standard in care after a myocardial infarction?
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ACE inhibitor
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What are some side effects of ACE inhibitors?
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1) dry cough
2) metallic taste 3) hyperkalemia 4) rash 5) fever |
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Which agents are contraindicated when taking ACE inhibitors?
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Potassium supplements and spironolactone.
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ACE inhibitors can cause hyperkalemia
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Angiotensin II antagonists are contraindicated in what type of patient?
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Pregnancy
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Angiotensin II antagonists are fetotoxic
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What are some examples of Angiotensin II antagonists?
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Losartan, candesartan, telmisartan, valsartan, irvesartan
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all end in 'tan'
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How do Calcium channel blockers work to treat hypertension?
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1) block Ca channels of peripheral blood vessels
2) vasodilation * also act on cardiac muscle |
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What conditions can Calcium channel blockers treat?
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- hypertension
- angina - arrhythmias |
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What are some side effects of Calcium channel blockers?
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- headache
- dizziness - constipation |
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What is the least selective (acts on both cardiac and vascular muscles) Calcium channel blocker?
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Verapramil
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What type of Calcium channel blockers have the greatest affinity for vascular smooth muscle?
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Dihydropyridines: Nifedipine, felodipine, nicardipine, nislodipine, almodipine, isradipine
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all end in 'pine'
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What are some examples of Calcium channel blockers?
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- Verapramil
- Diltiazem - Dihydropyridines (ex Nifedipine) |
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How do selective Alpha 1 blockers work to treat hypertension?
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decrease peripheral resistance
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What are some examples of Alpha 1 blockers?
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prazosin, oxazosin, terazosin
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all end in 'sin'
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What are the centrally-acting adrenergics used to treat hypertension?
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- Clonidine
- Alpha-methyldopa - Aproclonidine |
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Which centrally-acting adrenergics also decreases IOP?
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Aproclonidine
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Which centrally-acting adrenergic is used in pre and post cataract surgery?
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Aproclonidine
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How does Clonidine work to treat hypertension?
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Alpha 2 AGONIST
*usually used with diuretic |
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