Pharm Final - Cv1

Front 1

What are the normal and abnormal BP parameters?

Back 1

normal - 120/80
preHTN - 120-139/80-89
stage 1 - 140-159/90-99
stage 2 - >160/100

Front 2

What is primary HTN?

Back 2

no identifiable cause, chronic progressive disease

Front 3

What is secondary HTN?

Back 3

identifiable cause (treat the underlying cause and THEN treat the secondary cause)

Front 4

What are the normal treatment goals of HTN?

Back 4

maintain systolic <140 and diastolic <90

Front 5

What are the HTN treatment goals when treating diabetic and chronic kidney disease patients?

Back 5

target BP is 130/80

Front 6

How do beta blockers, verapamil, and diltiazem affect BP?

Back 6

they decrease HR and contractile force

Front 7

How do diuretics affect BP?

Back 7

decrease blood volume

Front 8

How do venodilators affect BP?

Back 8

they reduce venous return

Front 9

Describe the RAAS.

Back 9

decrease in BP induces release of renin which converts angiotensin to angiotensin I which is converted to angiotensin II by ACE resulting in the constriction of systemic and renal blood vessels; end result is an INCREASE in BP

Front 10

What is the first line antiHTN drug class?

Back 10

thiazide diuretics

Front 11

What is an important AE of thiazide diuretics?

Back 11

hypOkalemia (eat potassium rich foods to counteract)

Front 12

What drug class is chlorthalidone in?

Back 12

thiazide diuretics

Front 13

What drug class is HCTZ in?

Back 13

thiazide diuretics

Front 14

Which diuretic class causes the greatest diuresis?

Back 14

loop diuretics

Front 15

What drug class is furosemide in?

Back 15

loop diuretic

Front 16

What drug class is torsemide in?

Back 16

loop diuretic

Front 17

Which diuretic class is associated with hyperkalemia?

Back 17

potassium-sparing diuretics

Front 18

What drug class is spironolactone in?

Back 18

potassium-sparing diuretics

Front 19

Which antiHTN drug classes in particular should never be used in combination with potassium-sparing diuretics?

Back 19

ACE inhibitors, ARBs, aldosterone antagonists

Front 20

What are the classes of antiHTN medications (6)?

Back 20

diuretics, sympatholytics, direct acting vasodilators, calcium channel blockers, ACE inhibitors, ARBs

Front 21

What 2 AEs are associated with beta blockers?

Back 21

bradycardia, masking of hypOglycemia s/s

Front 22

What are the 6 subclasses of antiHTN sympatholytics?

Back 22

beta blockers, alpha blockers, beta/alpha blocker combo, centrally-acting alpha 2 agonist, adrenergic neuron blockers, sympathetic ganglia

Front 23

What is the MOA of alpha 1 blockers?

Back 23

the blockage of alpha 1 receptors on arterioles and veins prevents vasoconstriction which reduces peripheral resistance and venous return to the heart

Front 24

What is the suffix of most alpha 1 blockers?

Back 24

“-zosin”

Front 25

What is an AE of alpha 1 blockers?

Back 25

orthostatic hypoTN

Front 26

What drug class are carvedilol and labetalol in?

Back 26

alpha/beta blocker combo

Front 27

What drug class acts specifically on the CNS?

Back 27

centrally acting alpha 2 agonist

Front 28

What is the MOA of centrally acting alpha 2 agonists?

Back 28

they suppress sympathetic outflow to the heart and blood vessels; the result is vasodilation and reduced CO, HR, myocardial contractility which decreases BP

Front 29

What drug class is clonidine in?

Back 29

centrally acting alpha 2 agonist

Front 30

What is an important clonidine AE?

Back 30

rebound HTN if abruptly stopped

Front 31

What drug class is methyldopa in?

Back 31

centrally acting alpha 2 agonist

Front 32

What is the MOA of adrenergic neuron blockers?

Back 32

inhibit the release of NE or cause NE depletion resulting in the decrease of sympathetic stimulation

Front 33

What drug class is guanethidine in?

Back 33

adrenergic neuron blockers

Front 34

What drug class is quanadrel in?

Back 34

adrenergic neuron blockers

Front 35

What drug class is reserpine in?

Back 35

adrenergic neuron blockers

Front 36

What drug class is mecamylamine in?

Back 36

sympathetic ganglia blockers

Front 37

What is the MOA of sympathetic ganglia blockers?

Back 37

ganglionic blockade reduces sympathetic stimulation resulting in decreased BP

Front 38

When are sympathetic ganglia blockers used?

Back 38

only in HTN emergencies due to profound vasodilation

Front 39

Hydralazin and monoxidil are in what drug class?

Back 39

direct-acting vasodilators

Front 40

What is a significant monoxidil AE?

Back 40

fluid retention resulting in pericardial effusion

Front 41

What are the 2 calcium channel blocker groups?

Back 41

dihydropyridines and non-dihydropyridines

Front 42

What class and group are nifedipine and amlodipine in?

Back 42

calcium channel blockers, dihydropyridines

Front 43

What class and group are verapamil and diltiazem in?

Back 43

calcium channel blockers, non-dihydropyridines

Front 44

What suffix is often associated with ACE inhibitors?

Back 44

“-pril”

Front 45

Which 2 classes are contraindicated in pregnancy? diuretics, ACE inhibitors, ARBs, calcium channel blockers

Back 45

ACE inhibitors and ARBs

Front 46

Which class blocks the formation of angiotensin II? Which class blocks the action of angiotensin II?

Back 46

ACE inhibitors; ARBs

Front 47

Aldosterone antagonists should not be given with what other antiHTN class? Why?

Back 47

potassium-sparing diuretic due to hyperkalemia

Front 48

What agents are often used to treat stage 1 HTN?

Back 48

thiazide diuretics

Front 49

What agents are often used to treat stage 2 HTN?

Back 49

thiazide diuretics + beta blockers, ACE inhibitors, CCBs or ARBs

Front 50

What classes of antiHTNs work best to treat HTN in patients with renal disease?

Back 50

thiazide diuretics + ACE inhibitors or ARBs

Front 51

Can beta blockers be used to treat HTN in patients with diabetes?

Back 51

yes, but caution must be taken due to the potential for BBs to mask the s/s of hypOglycemia

Front 52

What is the preferred medication for HTN during pregnancy?

Back 52

methyldopa (centrally acting alpha 2 agonist)

Front 53

What is preeclampsia?

Back 53

elevated BP >140/90 and proteiniuria that develops after the 20th week of gestation; if seizures develop the condition is called eclampsia

Front 54

What is the DOC when treating eclampsia?

Back 54

magnesium sulfate

Front 55

What is the DOC for acute lowering BP?

Back 55

hydralazine (vasodilator)

Front 56

How many liters of blood does a heatlhy kidney filter per day?

Back 56

180L

Front 57

What are the 5 classes of diuretics?

Back 57

loop diuretics, thiazide diuretics, osmotic diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors

Front 58

What are 2 subclasses of potassium-sparing diuretics?

Back 58

aldosterone antagonist and non-aldosterone antagonist

Front 59

Bumetanide (Bumex), torsemide (Demandix), ethacryinc acid (Edecrin) and in what drug class?

Back 59

loop diuretics

Front 60

What is the MOA of loop diuretics?

Back 60

block reabsorption of Na⁺ and Cl- which blocks the reabsorption of H₂O

Front 61

What 2 characteristics differentiate loop and thiazide diuretics?

Back 61

the amount of diuresis; loops can be effective even if urine flow is scant

Front 62

What are 2 AEs of loop and thiazide diuretics?

Back 62

dehydration and hypOkalemia

Front 63

What category and class is spironolactone in?

Back 63

aldosterone antagonist potassium-sparing diuretic

Front 64

What category and class are triamterene (Dyerenium) and amiloride (Midamor) in?

Back 64

non-aldosterone antagonist potassium-sparing diuretics

Front 65

What is a serious AE of spironolactone and triamterene?

Back 65

hyperkalemia

Front 66

What drug class is mannitol (Osmitrol) in?

Back 66

osmostic diuretics

Front 67

What route must be utilized when administering osmotic diuretics?

Back 67

IV only (PO is not absorbed)

Front 68

What drug classes are used to treat angina?

Back 68

organic nitrates, beta blockers, CCBs, aspirin

Front 69

What are the 3 forms of angina?

Back 69

chronic stable, variant angina, unstable angina

Front 70

What triggers and causes chronic stable angina?

Back 70

physical exertion, large meals; caused by plaque buildup in the coronary arteries

Front 71

When does variant angina most likely to occur? What causes it?

Back 71

can occur at anytime; caused by coronary artery spasms

Front 72

What drugs are used to treat variant angina? What drug in particular does not treat angina?

Back 72

CCBs and organic nitrates; beta blockers

Front 73

What causes unstable angina (3)?

Back 73

severe coronary artery disease, platelet aggregation, transient coronary thrombi or emboli

Front 74

What route cascade is used to treat unstable angina?

Back 74

first SL or spray, then IV

Front 75

What is the DOC for treating angina?

Back 75

nitrates

Front 76

What characteristic allows angina to cross membranes easily?

Back 76

highly lipid soluble

Front 77

What should be considered when using the transdermal nitrate patch?

Back 77

it is VERY important that there is an 8 hour (minimum) drug-free period between patches; 12 hour break is preferred

Front 78

What 2 nitrate routes are best for quick termination of an ongoing angina attack?

Back 78

sublingual and translingual spray

Front 79

How many sublingual nitrates can be taken and over what period of time?

Back 79

3 tabs 5 min apart