Bp & Antihypertensive Agents

Front 1

aortic valve pressure

Back 1

80

Front 2

AV valve

Back 2

tricuspid valve

Front 3

Mitral valve

Back 3

bicuspid valve

Front 4

Sa node is the start of electrical current, also known as the

Back 4

pacemaker

Front 5

Na+ in cell

Back 5

10mEq/L

Front 6

K+ in cell

Back 6

140mEq/L

Front 7

Ca++ in cell

Back 7

0.0001mEq/L

Front 8

Na+ out of cell

Back 8

142 mEq/L

Front 9

K+ out of cell

Back 9

4mEq/L

Front 10

Ca++ out of cell

Back 10

2.4mEq/L

Front 11

spontaneous depolarization occurs in the

Back 11

SA node

Front 12

main ion in SA node

Back 12

Ca++

Front 13

repolarization occurs when

Back 13

K+ leaves

Front 14

normal resting HR

Back 14

72-74 bpm

Front 15

normal HR

Back 15

60-100 bpm

Front 16

PR interval is the __________ on EKG

Back 16

AV node

Front 17

AV node allows a pause for ______ ___________ (emptying) before transmission to ventricles

Back 17

atrial contraction

Front 18

ventricular depolarization while artia repolarizes

Back 18

systole

Front 19

ventricles depend on which ion

Back 19

Na+

Front 20

ventricular phase 0 (rapid depolarization)

Back 20

inflow of Na+

Front 21

ventricular phase 1 (partial repolarization)

Back 21

inward Na+ flow deactivated, outflow of K+, Cl- inflow

Front 22

ventricular phase 2 (plateau)

Back 22

slow Ca+ current

Front 23

ventricular phase 3 (repolarization)

Back 23

inactivated Ca+ current, K+ outflow

Front 24

ventricular phase 4 (pacemaker potential)

Back 24

slow Na+ inflow, slow K+ outflow

Front 25

ventricular refractory period

Back 25

phases 1-3

Front 26

time interval that a 2nd contraction cannot occur (phases 0,1,2 and half of 3)

Back 26

absolute refractory period

Front 27

which ion causes parasymathetic activity (M2) SA node

Back 27

K+ (leaving cell)

Front 28

which ion causes sympathetic activity (B1) SA node

Back 28

Ca++ (leaks into cell)

Front 29

network atrial & ventricular cells to contractions as functional units

Back 29

intercalated discs

Front 30

MI diagnostic tests

Back 30

troponin and CPK

Front 31

BP =

Back 31

CO X PVR

Front 32

volume of blood pumped per min

Back 32

CO

Front 33

CO =

Back 33

SV (stroke volume: volume of blood pumped) X HR

Front 34

mean arterial pressure =

Back 34

P(diast) + 1/3(Psyst - Pdiast)

Front 35

systemic vascular resistance

Back 35

MAP/CO

Front 36

P1 X V1 = P2 X V2

Back 36

Boyle's Law

Front 37

blood flow

Back 37

change in pressure from to ends

Front 38

change in P / R

Back 38

flow

Front 39

length of the vessel and viscosity of blood / radius of vessel to the fourth power

Back 39

Resistance (R)

Front 40

biggest factor that effects blood flow

Back 40

vessel radius

Front 41

systolic pressure - diastolic pressure =

Back 41

pulse pressure

Front 42

diastolic pressure + 1/3 pulse pressure =

Back 42

MAP

Front 43

_________ is regulated by blood volume, HR, and PVR.

Back 43

peripheral arterial blood

Front 44

3 most important variables of BP are____,____, &_______. (increases in these results in incr. BP)

Back 44

HR, SV, and PVR

Front 45

THE most common CVD

Back 45

HTN

Front 46

major risk factor for CAD & retinopathy

Back 46

HTN

Front 47

Stage 1 HTN

Back 47

140-159/90-99

Front 48

pre-HTN

Back 48

120-139/80-89

Front 49

Stage 2 HTN

Back 49

>160/>100

Front 50

Stage 3 HTN

Back 50

>/=180/>/=110

Front 51

principle cause of stroke

Back 51

HTN

Front 52

universal characteristic of essential HTN

Back 52

increase in PVR

Front 53

major RF for HTN

Back 53

smoking, diabetes, age, family hx of CVD/hyperlipidemia

Front 54

1st line BP tx (least ADR)

Back 54

thiazides

Front 55

can cause hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, hypercalcemia, erectile dysfunction

Back 55

thiazides

Front 56

ototoxicity

Back 56

loop-diuretic (ethacrynic acid)

Front 57

prevent hypokalemia induced by thiazides and loop diuretics

Back 57

K+ sparing diuretics

Front 58

may cause hyperkalemia

Back 58

K+ sparing diuretics

Front 59

folic acid antagonist, may cause megaloblastic anemia

Back 59

tiamterene

Front 60

androgen R antagonist, may cause gynecomastia, impotence, menstral irregularities

Back 60

spironolactone

Front 61

proven effects in decreasing mortality

Back 61

B-blockers

Front 62

1st line for post-MI tx

Back 62

B-blockers

Front 63

w/ISA: stimulate alpha-2 R and decr. PVR

Back 63

B-blockers w/ISA

Front 64

alpha-1 blocking activity

Back 64

B-blockers

Front 65

tx stable angina, atrial tachy, essential tremor, hyperthyroidism, migraine, anxiety

Back 65

B-blockers

Front 66

avoid in asthma & bronchospams

Back 66

B-blockers

Front 67

decreased myocardial contractility (AVOID in acute CHF)

Back 67

B-blockers

Front 68

ADR: decr. HDL, incr. TG, hypoglycemia, sexual dysfunction

Back 68

B-blockers

Front 69

cardioselective agents advantageous in which diseases

Back 69

diabetes and asthma

Front 70

B-blockers with alpha-1 blocking activity

Back 70

Labetolol, carvedilol

Front 71

DDI: severe decrease in HR and CO

Back 71

verapamil, diltiazem

Front 72

alpha-2 agonist for HTN in pregnancy

Back 72

a-methyldopa

Front 73

stimulates a-2 and reduces sympathetic putflow and increases vagal tone

Back 73

clonidine, guanfacine

Front 74

ADR: depression, postural Hypotension, sexual dysfunction, dry eyes, dry mouth, contact dermatitis

Back 74

Centrally acting a-2 agonists (clonidine, guanfacine)

Front 75

structural analog to L-tyrosine, binds to and inhibits tyrosine hydroxylase, used in patients with pheochromocytoma

Back 75

metyrosine (Demser)

Front 76

ADR: crysatalluria (kidney stones), orthostatic hypotension, EPS, Gi disturbances

Back 76

metyrosine (Demser)

Front 77

binds to adrenergic storage vesicles in neurons and inhibits vesicular MA-VMAT-2 preventing vesicular turnover, depletes NE

Back 77

resperpine (adrenergic Neuronal blockers)

Front 78

selective a-1 R antagonists

Back 78

prazosin, terazosin, doxazosin

Front 79

dilate arteries and decr. PVR, short term: incr. HR & renin, long term: HR & renin normal, postural hypotension (1st dose), sexual dysfunction

Back 79

a-1 R antagonists (prazosin, terazosin, doxazosin)

Front 80

favorable effects in hyperlipidemia & BPH

Back 80

a-1 R antagonists (prazosin, terazosin, doxazosin)

Front 81

identical to kininase II that inactivates bradykinin & other potent vasodilator peptides

Back 81

ACE (Angiotensin Converting Enzyme)

Front 82

activate PLC-IP3/DAG-Ca++ pathway

Back 82

AT1 Receptors

Front 83

only ACEI with a sulfhydryl grp

Back 83

captopril (capoten)

Front 84

only ACEI with a phosphinate group

Back 84

fosinopril (monopril)

Front 85

effective in mild to moderate HTN, left ventricle systolic dysfunction, acute MI, not to be used in hyperaldosteronism

Back 85

ACEIs

Front 86

renal and retinal protection in diabetes, reduction in ischemic CV events

Back 86

ACEIs

Front 87

ADR: cough in 1-6 wks, hypotension, proteinuria, hyperkalemia,skin rash, neutropenia, glycosuria, hepatotoxicity, angioedema

Back 87

ACEIs

Front 88

increase bradykinin levels (reason for switching to ARBs)

Back 88

ACEI

Front 89

ARB for stroke prevention

Back 89

losartan (Cozaar)

Front 90

ARB for Diabetic Neuropathy

Back 90

Ibesartan (Avapro) & losartan(Cozaar)

Front 91

ARB for Heart failure

Back 91

Valsartan or candesartan

Front 92

-ipines

Back 92

dihydropyridines (DHPs) CCBs

Front 93

Class of Diltiazem (Cardizem) & verapamil (Isopten)

Back 93

Non-dihydropyridines CCBs

Front 94

inhibit voltage-gated L-type Ca++ channels, decreasing Ca++ influx in vascular and cardiac cells

Back 94

CCBs

Front 95

decrease HR and contractility, relaxes vascular smooth muscle cells (precapillary smooth muscle)

Back 95

CCBs

Front 96

effects of blocking Ca++ channels (arteries>veins)

Back 96

vasodilation, decr. PVR, incr. coronary blood flow (diltiazem)

Front 97

L-type Ca++ channels are expressed in the _________, ________, and ____________

Back 97

SA node, AV node, and Myocardium

Front 98

inhibition of L-type Ca++ channels causes

Back 98

decr. firing of SA node = decr. HR & CO, decr. contractility of atrial & ventricular muscles = decr. CO

Front 99

CCB that work on heart most (decr. AV nodal conduction & controls ventricular rate in atrial flutter and fibrillation)

Back 99

verapamil

Front 100

CCBs that works on periphery most

Back 100

DHPs

Front 101

used for supraventricular tachyarrhymias, subarachnoid hemorrhage (cerebral vasodilation)

Back 101

CCBs (cerebral dilation = nimodipine)

Front 102

very effective when combined with a-blockers or diuretics

Back 102

CCBs

Front 103

hypotension, CHF, AV block, edema, HA, constipation are ADRs of

Back 103

Verapamil (CCB)

Front 104

significantly more hypotension, edema, and HA

Back 104

DHPs

Front 105

CCB that interacts with Digoxin

Back 105

Verapamil

Front 106

blocks both voltage & receptor-gated CA++ channels AND voltage-gated Na+ channels, used mostly in resistant chronic stable exertional angina

Back 106

Bepridil

Front 107

arterial dilation =

Back 107

decr. PVR

Front 108

venous dilation =

Back 108

decr. CO

Front 109

direct vasodilator that causes direct, rapid relaxation of arteriole SMCs that can cause NA+ retention

Back 109

Hydralazine (Apresoline)

Front 110

ADR: hypotension, tachy, palp, arthralgia, Lupus-like syndrome of arthritis (arthralgia, pleuritis, pericarditis), fluid retention, HA, flushing

Back 110

Hydralazine

Front 111

does NOT dilate epicardial coronary artery

Back 111

Hydralazine

Front 112

treatment of HTN emergencies in pregnancy (preeclampsia)

Back 112

Hydralazine

Front 113

K+ channel opener, incr. K+ efflux from VSM causing relaxation and hyperpolarization, decreasing PVR

Back 113

Minoxidil

Front 114

very effective in severe resistant HTN

Back 114

Minoxidil

Front 115

hypertrichosis, fluid retention (must use diuretic), tachy

Back 115

Minoxidil (Loniten)

Front 116

increases blood flow to skin, muscle, GI and heart more than CNS (good for Raynaud's syndrome)

Back 116

Minoxidil

Front 117

directly inhibits Renin. ADR: hypotension, angioedema, diarrhea, no pregnancy/children, decr. effects of furosemide, incr. K+, CK, URIC ACID

Back 117

Aliskiren (Tekturna)

Front 118

HTN Urgency

Back 118

upper level Stage 2 (>160-180)

Front 119

DOC for HTN Urgency

Back 119

Labetolol (mixed B-blocker) or Captopril (ACEI)

Front 120

HTN Emergency

Back 120

>200-210/>130-140 BP

Front 121

HA, blurred vision, malignant HTN w/papilledema (swollen back of eye - incr. ICP)

Back 121

HTN emergency

Front 122

IV only for HTN emergency, n on-selective vasodilator, unstable, light sensitivity, produces cyanide

Back 122

Na+ Nitroprusside (Nipride)

Front 123

Long-acting nitrates (venodilation):

Back 123

isosorbide dinitrate, isosorbide mononitrate

Front 124

ADR: excessive hypotension: HA (dilation), tachy, ortho hypotension, angina, tolerance

Back 124

Organic Nitrates

Front 125

K+ channel activator, arterial dilation, decreases contractility = dilation = decr. PVR, hyperglycemia

Back 125

Diazoxide (Hyperstat IV)

Front 126

Dopamine-1 agonist used for HTN emergency accompanied by acute/chronic renal failure

Back 126

Fenoldopam (Corlopam)

Front 127

withdrawl rebound HTN (hypertensive crisis)

Back 127

Clonidine