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32 Cards in this Set

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hydrochlorothiazide
thiazide diuretic
furosemide
loop diuretic
spironolactone
K sparing
Lisinopril
ACE inhibitor
Losartan
Angiotensin Receptor Blocker
nitroprusside
direct vasodilator
hydralazine
direct vasodilator
verapamil
Ca+ entry blockers
nifedipine
Ca+ entry blocker
clonidine
sympathetic agents working w/in the CNS
trimethaphan
sympathetic agent that works on autonomic ganglia
reserpine
sympathetic agents that work on the post ganglionic neurons
atenolol
blocks peripheral adrenergic receptors
prazosin
blocks peripheral adrenergic receptors
labetolol
blocks peripheral adrenergic receptors
the mechanism of hyrdochlorothiazide
blocks Na and CL reabsorption after glomerular filtration

also decreases SVR
side effects / toxicity for hydrocholorothiazide
Na,CL depletion
hypokalemia, hypomagnesi
hyperuricemia

doesnt work in pts with renal disease (would use loop diuretic instead)
mechanism of ACE inhibitor
decreases aldosterone (decreasing Na retention)
decreases vasoconstriction otherwise caused by angiotensin II
increases bradykinin (which is normally broken down by angiotensin II)
onset, duration and peak of lisinopril
ACE Inhibitor

onset 1 hour
peak 6 hours
duration 24 hours
major uses of lisinopril
ACE inhibitor

used in managing pts with CHF and pts after MI
ACE inhibitors are contraindicated in pts already on
diuretics

hypotension! also they cause hyperkalemia so you would not want to use an ACE inhibtor if a pt is on spironolactone
why might Losartan be a good choice for a diabetic
Losartan is a ARB (angiotensin II Receptor Blocker) it preserves renal function and decreases the nephrotoxicity of diabetes
why would you probably use a vasodilator in conjunction with a Beta Blocker and a diuretic
when vasodilation occurs you get reflex stimulation of the heart which increases M. contractility, HR etc. It also causes an increase in plasma renin. This can have undesirable effects in individuals who are predisposed to angina, MI, cardiac failure.
why must you give nitroprusside as a continuous infusion
rapid onset (minutes) and rapid cessation (minutes)
use of nitroprusside might lead to an accumulation of
CN- because nitroprusside is metabolized into CN- and NO

causes decreased blood flow to the brain
which drug may result in reversible lupus like syndrome
hydralazine (direct vasodilator)
what is the mechanism of verapamil
inhibits influx of Ca through slow channesl.
dilates peripheral arterioles
negative inotropic effect
Verapamil is used to treat
it is a Ca2+ entry blocer

angina
supraventricular tachyarrhythmias

decreases afterload and Myocardial O2 consumption
what vasodilator might you use to treat a hypertensive emergency
nitropursside

acts w/in minutes but requires continious infusion. results in cyanide ion production which can causes toxicitybut you can treat this too (with sodium thiosulfate)
what non-selective adrenergic blocker might you give to someone w/ a hypertensive emergency
Labetalol

intravenous bolus or infusion. does not cause reflex tachycardia.

rapid onset (5-10 minutes) duration 30 mins

carries all the contraindications of a nonselective beta blocker
In what kind of patients wold you not use a thiazide diuretic
more side effects in geriatric pts

pregnancy

ineffective in patients with renal disease
how does verapamil affect AV conduction
is Ca channel blocker and decreases AV conduction

so used to treate angina and supraventricular tachycardia