Pharmacology Exam 1

Front 1

Definition of hypertension

Back 1

Any prolonged elevation in BP

Front 2

Normal BP
Stage IV hypertension

Back 2

120/80
220/120

Front 3

Stage II hypertension

Back 3

160/100

Front 4

Stage I hypertension

Back 4

140/90

Front 5

Stage III hypertension

Back 5

180/110

Front 6

Effects of hypertension

Back 6

- Generally asymptomatic until stage 4
- Increased incidence of injury or death due to stroke, MI, aneurysms, and renal failure

Front 7

T/F Hypertensive drugs can cure hypertension

Back 7

False, they just relieve the symptoms

Front 8

5-10% of cases where there is clearly a defined cause of hypertension

Back 8

Secondary HT
- i.e. renal disease, pheochromocytoma, drugs(cocaine, amphetamines, oral contraceptives)

Front 9

90-95% of cases that have no known causes

Back 9

Primary/essential HT

Front 10

Malignant hypertension

Back 10

Prolonged elevation of BP for 6+ months; will cause death.

Front 11

In the past hypertension was treated with ___.

Back 11

Sedatives

Front 12

In the CNS, NE binding to __receptors causes increased sympathetic outflow while NE bind to __receptors causes decreased sympathetic outflow

Back 12

Alpha 1 receptor; alpha 2 receptor

Front 13

Beta 1 receptors in the heart do what?

Back 13

Increase HR and CO

Front 14

Dopamine 1 receptor causes___.

Back 14

Vasodilation

Front 15

NE acting on alpha 1 receptors in blood vessels do what?

Back 15

Cause vasoconstriction

Front 16

What is renin?

Back 16

It turns angiotensinogen into angiotensin I

Front 17

What is ACE?

Back 17

It turns angiotensin I into angiotensin II. It also turns bradykinin to an inactive product.

Front 18

3 Things that angiotensin II does

Back 18

1- Causes release of aldosterone
2- Vasoconstricts
3- Causes Na+ retention

Front 19

T/F Any drug that can enter the CNS can cause behavioral effects

Back 19

True

Front 20

Alpha-methyl DOPA (Aldomet)

Back 20

Alpha 2 agonist
- Prodrug the decreases sympathetic output
- S.E.: depression, drowsiness, dry mouth, dec ejaculation

Front 21

Clonidine (Catapres)

Back 21

Alpha 2 agonist
- SE: depression, drowsiness, dry mouth, etc. Sudden withdrawal may lead to hypertensive crisis
- Used in opiate withdrawal, fibromyalgia, insomnia, Tourrettes

Front 22

What do propranolol, reserpine, and alpha-methyl tyrosine have in common?

Back 22

These are agents that have central and peripheral side effects

Front 23

This drug inhibits tyrosine hydroxyls, the rate limiting step in NE synthesis, and it treats pheochromocytoma

Back 23

Alpha-methyl tyrosine

Front 24

Mecamylamine and trimethaphan

Back 24

Drugs that block transmission at the ganglion
- Totally block nicotinic receptors
- Cause severe orthostatic hypotension

Front 25

Reserpine

Back 25

- Effects post ganglionic neuron
- Depletes catecholamines in peripheral and central neurons
- SE: depression, drowsiness, diarrhea, extrapyramidal effects (like Parkinsonianism)

Front 26

Alpha 1 Blockers
(OSIN)

Back 26

- Prevents NE from acting on alpha 1 receptors=> inhibits constriction
- SE: first dose effect, nasal congestion, inc CHF, nightmares

Front 27

Terazosin, tamulosin, alfuzosin, silodosin are all designed to do what?

Back 27

Tx urinary retention in benign prostatic hypertrophy

Front 28

A unique use for alpha 1 blockers

Back 28

Tx post traumatic stress disorder

Front 29

Beta 1 Blockers
(OLOL)

Back 29

- Prevents compensatory HR when other anti-hypertensives are used
- Lowers renin secretion=> decreases BP
- SE: depression, bradycardia w/ fatigue, impotence, B2 effects can worsen asthma
- Propranolol blocks all beta receptors while the more selective ones have less B2 effects and don't enter CNS

Front 30

Labetalol

Back 30

Blocks alpha1, B1&2 receptors. Can cause dry mouth and orthostatic hypertension.

Front 31

Carvedilol

Back 31

Combined alpha/beta blocker

Front 32

This is a VERY specific beta 1 blocker w/ vasodilator effects

Back 32

Nebivolol

Front 33

Angiotensin receptor antagonists
(ARTAN)

Back 33

- Produce vasodilation in vessels and inhibit aldosterone secretion
- SE: similar to ACE inhibitors, fetal toxicity

Front 34

There is "evidence of risk" in category ___ in FDA pregnancy category.

Back 34

Category D

Front 35

Endothelin Blockers (3 SE)
(ENTAN)

Back 35

- Used for pulmonary HT
- SE: hepatic toxicity, fetal toxicity, testicular atrophy
(bosentan, ambrisentan)

Front 36

These 4 drugs act directly on smooth muscle

Back 36

1- Minoxidil
2- Hydralazine
3- Diazoxide
4- Nitroprusside

Front 37

Minoxidil

Back 37

- Rogaine!
- Opens K+ channels on smooth m.=> vasodilation
- SE: edema and pericardial effusion

Front 38

Hydralazine
(enzyme activator)

Back 38

- Arterial vasodilator
- Inc cGMP=> relaxation, EXCEPT in coronary arteries
- SE: can cause lupus-like syndrome especially in slow acetylators, may cause heart attack due to low blood supply

Front 39

Diazoxide

Back 39

- IV, opens K+ channels
- Dec insulin secretion

Front 40

Nitroprusside

Back 40

- Drug of choice in HT emergencies
- IV, dilates ALL vessels in seconds
- SE: nausea, can cause cyanide poisoning

Front 41

Calcium Channel Blockers
(IPINE)

Back 41

- Block Ca2+ channels=> dec BP
- Nifedipine, nicardipine, amlodipine

Front 42

This agent activates dopamine 1 receptors and is used for HT emergencies

Back 42

Fenoldopam

Front 43

Angiotensin converting enzyme inhibitors AKA ACE inhibitors
(PRILS)

Back 43

- Prevents the synthesis of angiotensin II and breakdown of bradykinin
- SE: rash from the sulfur, dry cough, angioneurotic edema, altered taste, fetal toxicity

Front 44

This agent is a direct renin inhibitor

Back 44

Aliskiren

Front 45

Combined alpha/beta blockers

Back 45

Labetalol, carvedilol, nebivolol