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58 Cards in this Set

  • Front
  • Back
Blood pressure is a product of what two things?
Bp=CO x PR
Heart rate, contractility, and filling pressure make up what?
cardiac output
Perpherial resistance depends on what?
arteriolar volume
Short term control of BP is accomplished by...
the baroreceptor reflex
Long term control of BP occurs in hours to several days and is accomplished by what?
Systolic/diastolic =
Blood pressure measurement
A sustained reporducible increase in BP
The normal range of BP =
Optimal BP
<120 / <80
High Normal BP
130-139 / 85-89
Hypertension Stage 1
Hypertension Stage 2
160-179 / 100-109
Hypertension Stage 3
> or = 180 / > or = 110
Why treat Hypertension?
Congestive heart failure
Kidney Failure
Myocardial infarction
No symptoms may go undetected
What are environment risks of acquiring hypertension?
Cigarette Smoking
Alcohol Abuse
Lack of exercise/obesity
What is secondary hypertension due to?
Some specific abnormality (ex. catecholamine producing tumors)
Name four types of drugs that are used in the tx of hypertension
Drugs affecting the Sympathetic system
Angiotensin converting enzyme (ACE) inhibitors
Ca+ channel blockers
Non-pharmacological treatment
How is mild hypertension treated?
With a single drug - any of the four Diuretics - angiotensin Converting emzyme - Ca channel blocker
Which drugs are recommended for first time use?
Diuretics and/or beta adrenoceptor blockers
What population responds better to diuretics and Ca+ channel blockers but poorly to beta-blockers and ACE-inhibitors?
Blacks and older people
What are nonpharamological ways in which one can treat hypertension?
Na restriction
Alcohol restriction
Weight control
This drug reduces CO by reducing volume
What are three classes of diuretic drugs?
Thiazide diuretics
Loop diuretics
Potassium sparing diuretics
This diuretic inhibits Na, Cl adn h2o absorption in the distal tube of the nephron.
Thiazide diuretics
Prototype of Thiazide diuretics
Inhibits reabsorption of NA, Cl, K and h2o in the ascending loop of Henle of the nephron
Loop Diuretics
Prototype of Loop Diuretics
Interefere with K/Na exchange so that K is spared while Na remains in the tubule for excretion
Potassium sparing diuretics
Prototype for K+ sparing diuretics
What are the adverse effects of diuretics?
Fluid depletion (orthostatic hypotension)
Sodium depletion
Potassium depletion (-except K+ sparing diuretics)
GI disturbance - weakness - fatigue
What are the theraputic uses of diuretics?
Tx hypotension
-first line therapy
-avoid in hypertensive diabetics
Drugs affecting the Sympathetic System
Beta-adrenoceptor blockers
Alpha1 adrenoceptor blockers
Alpha2 adrenoceptor agonists
What do Beta-adrenoceptor blockers do?
-Reduce HR
-Reduce force of contraction
-Decrease CO
-Decrease sympathetic outflow in CNS and inhibit renin secretion from kidneys to reduce PR
What is the prototype for Beta-adrenoceptor blockers
What adverse effects to Beta adrenoceptor blockers have?
CNS- fatifue, lethargy, hallucinations
Orthostatic hypotension dizziness
Drug w/drawl - rebound hypertension
These drugs are effective in treating hypertention - more effective in white and young people - Should not use with asthma, congestive heart failure, peripheral vascular disease
Beta-adrenoceptor blockers
Block Alpha1 adrenergic receptor on vascular smooth muscle to cause vasodilation and decrease in PR
Alpha1 adrenoceptor blockers
Prototype is Phenoxybenzamine
Alpha1 adrenoceptor blockers
What are the effects of Alpha1 adrenoceptors blockers?
Orthostatic Hypotension
Reflex tachycardia
Uses of this drug include: tx of mild to mod. hypertension, can improve blood lipid profiles
Alpha1 adrenoceptor blockers
This drug causes a decrease in CO and PR
Alpha2 adrenoceptor agonists
What is the prototype of Alph2 adrenoceptor agonists?
These drugs cause sedation and dizziness
Alpha2 adrenoceptor agonists
Used in the treatment of mild to mod. hypertension not responding to diuretics and complicated by renal disease
Alpha2 adrenoceptor agonists
These drugs
-reduce PR (block angiotensin converts angiotensin I to the potent vasoconstrictor, angiotensin II
-decrease in angiotensin II decreases aldosterone = decrease Na, h2o, therefore a decrease in blood volume and CO
Angiotensin converting enzyme inhibitors
What is the prototype for Angiotensin Converting Enzyme inhibitors?
Adverse affects include: Persistant dry cough, GIT disturbance, Allergic reactions, Hyperkalemia
Angiotensin converting enzyme inhibitors
These drugs do not cause orthostatic hypotension
But are effective in pts. with chronic congestive heart failure and young white pts. (like Beta blockers)
Angiotensin converting enzyme inhibitors
Block Ca by binding to L-type Ca2+ channels of heart and smooth muscle of coronary and peripheral vasculature

Decrease PR
Calcium Channel Blockers
Averse effects of these drugs are GIT disturbance, dizziness, headache, fatigue
-in elderly, diabetics with unstable agina
-increase risk for myocaridal infarction and cancer
Calcium Channel Blockers
What drug is useful in tx of hypertensive with asthma, diabetes, and PR disease
Calcium Channel Blockers
Inhibit smooth muscle contraction by increasing intracellular production of second messengers (Cyclic GMP)

Decrease PR
Hydralazine and Minoxidil are what type of drug?
What are the adverse effects of vasodilators?
-Reflex tachycardia
-Dizziness, postural hypotension, weakness, nausea
-Fluid retention
-Increases hair growth
The drug is not a first line therapy but added if others prove inadequate
This occurs when mean arterial pressure is an immediate threat the life
Hypertensive Emergency
This drug is administered by IV to cause vasodialation
Sodium nitropruside
Name non-pharmalogical tx of hypertension
-Dietary mod. (Na restriction, low fat, high fish oils)
-Decrease alcohol, tobacco
-Decrease body wt./exercise
-Psychological -(relaxation, meditation, prayer)